A Double Burden on our Emerging Economies

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Malnutrition, in all its forms, including undernutrition (wasting, stunting, underweight), micronutrient deficiencies, overweight, obesity, and resulting diet-related noncommunicable diseases, is the leading cause of poor health globally[i]. The double burden of malnutrition is characterized by the coexistence of undernutrition along with overweight and obesity, or diet-related noncommunicable diseases within individuals, households, and populations and across the life course.

Cause for concern

The obesity epidemic has received much attention in recent decades, particularly in high-income countries, and with good reason. According to the World Health Organization, 39% of the world’s adult population is overweight, with 650 million of these adults being obese. An estimated 38.2 million children under the age of 5 were overweight or obese in 2019[ii]. Obesity brings with it a myriad of health challenges such as the increased risk for type 2 diabetes, coronary heart disease, stroke, and certain types of cancer,[iii] and increased risk of severe illness from the virus that causes COVID-19[iv]. This puts tremendous pressure on individuals and health systems.

A parallel epidemic plaguing large swaths of the globe has been undernutrition. While we have seen some positive changes with a relative reduction in undernutrition of 19% from 1991 to 2017 and the prevalence of hunger fallen from 14.8 percent in 2000 to 10.8 percent in 2018, progress remains slow. Eight hundred and twenty million people are undernourished, and 9% of the world’s population are food insecure[v].

Unfairly, these two epidemics have collided in low- and middle-income countries, giving rise to a problem known as the Double Burden of Malnutrition. These two forms of malnutrition – over and under – can coexist within countries and communities (for example, where there is a prevalence of both undernutrition and overweight in the same community), within households (when a mother may be overweight or anemic and a child or grandparent is underweight), and even within the same person over their lifetime (obesity with deficiency of one or various vitamins and minerals, or an overweight adult who was stunted during childhood). Sadly, this has become the new norm in many parts of the world that have had to continue tackling undernutrition while finding themselves increasingly challenged to fight growing rates of obesity.

These countries cannot afford to ignore the potential of unhealthy diets. A food system that is efficient in delivering healthy food to all at an affordable price, in all situations, is required. High-income countries have seen the cost and consequences of not recognizing this sooner. Current estimates suggest that malnutrition costs the global economy US$3.5 trillion a year – 11% of the world’s GDP.[vi]

Although the double burden remains a largely untapped area for integrated policy action, there are opportunities to act. It presents a unique opportunity for mutual learning and collaboration between the Global North and Global South, as every country in the world is affected by one or more forms of malnutrition.

A way forward

This sparked an idea within the Sight and Life team – The Food Systems Innovation Hub, a place poised to deliver just such a point of collaboration. Designed to accelerate technology transfer and targeted investment in emerging economies such as Nigeria, Rwanda, and Bangladesh, they will provide a mechanism for sharing techniques and knowledge to tackle this double burden. This may take the form of social marketing campaigns to generate demand for more nutritious foods or of even more ambitious measures like aggregating the output of a local crop (teff in Ethiopia, for example) to make it more affordable and nutritious by fortifying it with vitamins and minerals.

We have a long way to go to achieve the Sustainable Development Goals outlined by the UN, but I am confident that these Innovation Hubs will be a step in the right direction. Sight and Life invites you to join us in this new, bold initiative and learn how you can become involved. 

Read more on the Food Systems Innovation Hubs HERE and watch the Foods Systems Innovation Hub webinar to find out more. Learn more about the Double Burden of Malnutrition in the 2018 issue of Sight and Life Magazine.


[i] https://www.who.int/news-room/fact-sheets/detail/malnutrition (accessed 7 January 2021).
[ii]https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight#:~:text=Some%20recent%20WHO%20global%20estimates,%25%20of%20women)%20were%20overweight (accessed 7 January 2021).
[iii]https://www.ncbi.nlm.nih.gov/books/NBK44656/#:~:text=The%20prevalence%20of%20obesity%20changed,children%20during%20the%20same%20period. (accessed 7 January 2021).
[iv] https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html (accessed 7 January 2021).
[v] https://ourworldindata.org/hunger-and-undernourishment (accessed 7 January 2021).
[vi] www.nutraingredients.com/Article/2014/11/14/Malnutrition-costs-11-of-world-sGDPGlobal-Nutrition-Report (accessed 29 October 2018).