Double Burden of Malnutrition: Global Issues

This assignment delves into the complex issue of 'double burden of malnutrition', where undernutrition and overnutrition coexist within populations. Students are tasked with analyzing provided research papers to understand the phenomenon's prevalence, contributing factors (economic, social, environmental), and health consequences. The analysis should also explore potential solutions and interventions aimed at addressing this global challenge.

Running head: GLOBAL NUTRITION AND FOOD SECURITY 1
Global Nutrition and Food Security
Student’s Name
Institution

GLOBAL NUTRITION AND FOOD SECURITY 2
Introduction
The content of this paper focuses on the discussion of Dual Burden Malnutrition which is one
of the most current world phenomenons. The study starts by describing the DBM together with
its epidemiology China which is the study country choice. The consequence of dual burden
malnutrition has resulted into massive suffering and formed a foundation for other non
communicable diseases which adversely affect human beings who suffer from its effects. The
paper therefore further disuses various strategies which can be put into practice in order to
prevent severe effects of DBM.
Dual Burden Malnutrition
Double burden of Malnutrition is also known as DBM and is a disease which effects most people
in the whole world. Double Burden of Malnutrition is the coexistence of over nutrition and under
nutrition in the same populace across a life course. The term across of life means a phenomenon
that under nutrition which occurs in an early life leads to an elevated propensity for over
malnutrition during adulthood. Double burden malnutrition comes as a result of various factors
and affects various poor, medium rich and very rich countries double burden malnutrition is one
of the concerns in various countries with stunting rates (Grijalva et.al, 2012). Double burden
malnutrition results into serious impact enormous consequences, various young people have lost
their precious lives due to the effects of under nutrition in the early ages.
Undernutrition also weakens an individual’s immunity towards diseases and survivors who
became stunted during the immediate two years of life lose their ability to carry heavy loads or
do various physical work. Some of the survivors do not progress perfectly in terms of academics

GLOBAL NUTRITION AND FOOD SECURITY 3
and these effects are experienced all through the life course (Oddo et.al, 2012). The effects are
further experienced in later in the life course, malnutrition and poor diet as well as obesity forms
underlying causes for various non communicable diseases like diabetes, hypertensions, stroke,
cancer, stroke as well as ischemic heart diseases. The main cause of Double Burden of
Malnutrition is nutrition transition, epidemiological transitions as well as demographic
transitions. The term dual burden malnutrition is therefore the existence of both underweight
and overweight cause by under nutrition and over nutrition.
Determinants of Dual Burden Malnutrition
The study selects China an Asian country to identify and come up with various determinants of
dual burden malnutrition. From the evidence obtained from various studies in relation to the
determinants of dual burden malnutrition. One of the determinants of the dual burden
malnutrition is the coexistence of both under nutrition as well as over nutrition. The
simultaneous existence of both underweight and overweight among the members of the populace
acts as one of the determinant to dual burden malnutrition. Obesity as a disease is also another
determinant of the dual burden malnutrition existence (Oddo et.al, 2012). Weakness among
various individual within a given populace is another factor which acts as a determinant of the
dual burden malnutrition. The nature and the rate of stunting and overweight determine the
existence of dual burden malnutrition. This is evident in China as one of the nations in the
content which experience dual burden malnutrition.
The stunting rate which is a determinant of DBM stands at 43 percent. Another determinant of
dual burden malnutrition is the existence of overweight and obesity among young children
within a given population. The rate of dependent of stunting prevalence rate on various factors

GLOBAL NUTRITION AND FOOD SECURITY 4
such as socioeconomic, environmental factors and demographic is also used to determine the
dual burden malnutrition. The rate of obesity among young individuals in a given population
determines the dual burden malnutrition existence in a country or within the households. Apart
from the three basic factors such as overweight, underweight and obesity, dual burden
malnutrition can also be determined through various non communicable diseases affecting young
people as well as adults within a given population or region (Piernas et.al, 2015). The key
determinants of dual burden malnutrition are therefore, overweight, underweight, obesity and
non communicable diseases affecting various people in various areas of the continent.
Etiolgy and epidemiology of dual burden malnutrition
Dual burden malnutrition has been an issue affecting various nations, people, regions as well as
households over a given period of time. The greater impact of the DBM has been as a result of
economic and income growth, movement into urban areas and change in globalization.
According to the world health organization WHO, in the year 2014, almost 19 million people
who are all adults, old people as well as people of age 18 and above were determined as
overweight. On the side of people who are underweight all over the globe were over 462 million
indicating the massive dual burden malnutrition (Kimani et.al, 2013). These numbers released by
the WHO covers all continents including china which is the study country choice. 600 million
people in the world were suffering from obesity. In the same year several children were found to
be over weighing, these kids were under the age of 5years. The number of the children under the
age of five who were overweighing reached 42 million.
In china as a country, the prevalence among the children is at 9.1% of the general population. 29
percent of the children are stunted where 18.6 percent of the children were underweight as well

GLOBAL NUTRITION AND FOOD SECURITY 5
as 2.4percent of the children are overweighing. In relation to adults in china, 14 percent of
women in china are stunted, women suffering from obesity were 53.9 percent where 71.1 percent
of the general women population are have central obesity according to the current statistics. It
has been notice that several women in china suffer from central obesity (Kimani et.al, 2013).
Double burden of malnutrition and obesity according to various studies affects mostly very poor
regions in china as well as other parts of the world including Africa. It is also evident that most
of the people affected by malnutrition in china are the female where a larger percentage of
people suffering from dual burden malnutrition are females.
Summary of the food production statistics in china
China is one of the world nations which produce large turns of grains in order to sustain lives.
Ensuring food security forms the base of the economic and provides a foundation to eradicate
dual burden malnutrition. Food security also forms the foundation for economic and social
stability within the any given nation. China as a nation has ventured majorly into agricultural
production (Ramirez et.al, 2014). The nation has been in the past sixty years, China in the past
years has produced grains with an increase of fivefold to 571 million tons from 113 million tons
in the year 1949. China statistical research provides information which inspires other producers
in the world to venture more in agricultural production.
The grain production per capita in china increased with the same margin in the recent years from
209 kg to 425 kilograms. China as a nation has succeeded at the national scale to maintain a
basic self efficiency for grain production in the past decades (Bygbjerg, 2012). The country is
currently planning to generate 770million tons of food comes 2030. China over the decades have
maintained food production at a constant percentage that is 95 % contributing significantly to the

GLOBAL NUTRITION AND FOOD SECURITY 6
global food security. China has produced cereals and staple crops at 207 million tons and 225
million tons respectively in the last decade. At this rate of production Chinese cereal production
forms 22.5 percent of the world cereal product while staple food produced in China forms the 25
percent of the world staple food production.
Crop 1949 Output (tons) 1978 Output (tons) 1999 Output (tons)
1. Grain 113,180,000 304,770,000 508,390,000
2. Cotton 444,000 2,167,000 3,831,000
3. Oil-bearing crops 2,564,000 5,218,000 26,012,000
4. Sugarcane 2,642,000 21,116,000 74,700,000
5. Sugarbeet 191,000 2,702,000 8,640,000
6. Flue-cured tobacco 43,000 1,052,000 2,185,000
7. Tea 41,000 268,000 676,000
8. Fruit 1,200,000 6,570,000 62,376,000
9. Meat 2,200,000 8,563,000 59,609,000
10. Aquatic products 450,000 4,660,000 41,220,000
General summary of the national dietary patterns in china
The Chinese dietary experts developed dietary pattern based on several obesity reports made
through epidemiological studies. The pattern was created between the year 2010 and 2012 to
ensure that the dual burden malnutrition in China is minimised (Bygbjerg, 2012). The national
dietary pattern in China is composed of five dietary patterns which are well recognised various
individuals in the nation. The diet is organised in terms of age value, the age value that is greater
than 1 is required to take: a cereal, animal food and plant food’, ‘high protein food’, ‘plant
food’, ‘poultry’, and ‘beverage’. After a while with the increment or the adjustment in terms of
age and gender, the ‘cereal, animal, and plant food’ and ‘beverage’ pattern is associated with

GLOBAL NUTRITION AND FOOD SECURITY 7
obesity (OR = 2.924, 3.257; 95% CI = 1.147–7.463, 1.372–7.692) and should not be taken in
large amounts (Kolčić, 2012). I the dietary pattern in suggest that a diet composed of ‘cereal,
animal, and plant food’ and ‘beverage’ may be linked with augmented risk of obesity. ‘Cereal,
animal, and plant food’ dietary patterns may be associated with increased risk of overweight due
to the increase in the total energy intake resulting from high protein and fats within the pattern.
Another pattern which should be avoided is a diet with a lot of ‘beverage’, such kind of dietary
pattern is good but is also associated with increased risk of obesity to some extent due to the total
energy intake by increased carbohydrate intake in present within the beverages. The general diet
pattern accepted at various ages are those which are not composed or do not produce large
amount of energy when taken or consumed.
Food Groups
Dietary Pattern
Cereal, Animal, and Plant
Food
High Protein
Food
Plant
Food Poultry Beverage
Cereals 0.603 −0.005 −0.012 0.181 0.190
Tubers −0.080 0.169 0.277 −0.491 −0.222
Beans 0.195 −0.268 0.735 0.003 −0.115
Vegetables 0.663 0.140 0.210 −0.249 −0.057
Fruits −0.201 0.398 0.622 −0.163 0.170
Nut 0.125 0.132 0.389 0.265 0.104
Pork 0.739 0.111 −0.007 0.075 −0.066
Poultry −0.018 0.092 0.175 0.813 −0.131
Milk and dairy
products 0.056 0.697 −0.027 0.093 −0.156
Eggs 0.047 0.635 0.031 −0.068 0.204
Fish and shellfish 0.358 0.519 0.094 −0.012 −0.123
Beverage 0.023 −0.011 0.051 0.013 0.895
Intervention strategy to address increasing prevalence of dual burden malnutrition

GLOBAL NUTRITION AND FOOD SECURITY 8
The main contribution to the increase of Dual Burden Malnutrition is the in ability of the modern
world to employ various techniques used by our fore fathers in food preservation and security. The
modern world has resolved in the use and consumption of various western generated food staffs which
offer low nutrients into the body but instead results into over intake of energy materials into the body
(Piernas et.al, 2015). The world should go back into previous ways of food preservation as one the
strategies to cub dual burden malnutrition which affects as very large population of the world. With
implementation of traditional food staffs such as cereals, the increased prevalence of dual burden
malnutrition can be reduced to a certain level. China as one of the nations in the world practicing
traditional cereal production provides 22 % food staff consumed through traditional cereal production.
Various countries in the world should therefore embrace traditional methods of food preservation instead
of depending on westernised food staff which merely provides for the body the basic nutrients for proper
growth and development (Kolčić, 2012).
Dual burden malnutrition according to the discussion severely affects areas with low income
generation. The government of each nations should thereby settle a perfect way to equitable distribute the
national wealth in order to allow every individual to have aces to food staff. This kind of strategy is
crucial for the reduction of underweight disease among the young generation as well as the adults. As part
of strategy to prevent the continuous elevation of dual burden malnutrition, the members of the general
public should be made aware of the best dietary patterns in order to assist them not to take over nutrition
as well as under nutrition (Piernas et.al, 2015). The provision of awareness on the dietary pattern
should be accompanied by a proper channel of reporting prevalence of overweight and underweight in
relation to varied age setting or grouping. The international health organization such WHO should
provide people with proper guidelines on dual burden malnutrition indicators in order to enable
immediate course of action to be implemented in order to cover high stunting rates. The most developed
and industrialised countries should come up with an appropriate channel to mange overweight.

GLOBAL NUTRITION AND FOOD SECURITY 9
The international as well as national sectors concerned with the collection and reporting of
children and maternal overweight should provide information inform data to the international organs for
systematic inclusion of the data into the nutrition surveys. By making sure that dual burden malnutrition
data is accessible to the nutrition survey organs, a perfect dietary plan can be created thereby minimizing
over or under consumption of body building nutrients (Subramanian, Perkins & Khan, 2009). In order
to also cub the increased prevalence on dual burden malnutrition, inclusion should be advocated for WHA
to deal with childhood obesity and underweight. The epidemiological and operational data concerning
dual burden malnutrition should be integrated into the available international forums dealing with
malnutrition problems. Appropriate food storage facilities should be created in areas with large number of
individuals suffering from malnutrition. This is to provide enough meal for sustenance in such areas
where people suffer from under nutrition.
Amore systematic research should be implemented as it results into an impact in relation to the
promotion of RUTF there by leading to a rapid weight gain in areas where individuals suffer from acute
malnutrition. Research concerning malnutrition should be emphasised and a more favourable and perfect
malnutrition programmes should be created to help with sensitization and monitoring of possible
conflicting interest in both public and private sector (Subramanian, Perkins & Khan, 2009). Deeper
research which involves full mapping of dual burden malnutrition activities of the international
organizations should be initiated. These types of research should be done by various specialists w hoe are
able to explore operational evidences in order to come up with away on how to prevent the prevalence of
dual burden malnutrition.
Conclusion
Dual burden malnutrition is global phenomenon which affects almost all countries of the world
both rich and poor. Proper research should be done on how DBM can be prevented. With proper
implementation of various strategies discussed above the great world disease (DBM) can be be reduced to

GLOBAL NUTRITION AND FOOD SECURITY 10
a certain level as more research is conducted on how to come up with a remedy. DBM results into a great
impact on the life of human beings have suffer from it and sometimes leads to death and should be taken
as a key concern by the WHO.
References
Grijalva-Eternod, C. S., Wells, J. C., Cortina-Borja, M., Salse-Ubach, N., Tondeur, M. C., Dolan,
C., ... & Seal, A. J. (2012). The double burden of obesity and malnutrition in a protracted
emergency setting: a cross-sectional study of Western Sahara refugees. PLoS medicine, 9(10),
e1001320. https://www.ncbi.nlm.nih.gov/pubmed?
db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=23055833
Oddo, V. M., Rah, J. H., Semba, R. D., Sun, K., Akhter, N., Sari, M., ... & Kraemer, K. (2012).
Predictors of maternal and child double burden of malnutrition in rural Indonesia and
Bangladesh. The American journal of clinical nutrition, 95(4), 951-958.
https://www.google.com/search?client=firefox-a&rls=org.mozilla%3Aen-US
%3Aofficial&channel=fflb&q=Oddo%2C+V.+M.%2C+Rah%2C+J.+H.%2C+Semba
Kimani-Murage, E. W. (2013). Exploring the paradox: double burden of malnutrition in rural
South Africa. Global health action, 6(1), 19249.

GLOBAL NUTRITION AND FOOD SECURITY 11
https://www.google.com/search?client=firefox-a&rls=org.mozilla%3Aen-US
%3Aofficial&channel=fflb&q=Kimani-Murage%2C+E.+W.+(2013).+Exploring
Ramirez-Zea, M., Kroker-Lobos, M. F., Close-Fernandez, R., & Kanter, R. (2014). The double
burden of malnutrition in indigenous and nonindigenous Guatemalan populations. The American
journal of clinical nutrition, 100(6), 1644S-1651S.
https://www.ncbi.nlm.nih.gov/pubmed/25411307
Bygbjerg, I. C. (2012). Double burden of noncommunicable and infectious diseases in
developing countries. Science, 337(6101), 1499-1501.
https://www.ncbi.nlm.nih.gov/pubmed/2299732
Kolčić, I. (2012). Double burden of malnutrition: A silent driver of double burden of disease in
low–and middle–income countries. Journal of global health, 2(2).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529312/
Piernas, C., Wang, D., Du, S., Zhang, B., Wang, Z., Su, C., & Popkin, B. M. (2015). The double
burden of under-and overnutrition and nutrient adequacy among Chinese preschool and school-
aged children in 2009-2011. European journal of clinical nutrition, 69(12), 1323.
https://uncch.pure.elsevier.com/en/publications/the-double-burden-of-under-and-overnutrition-
and-nutrient-adequac-2
Subramanian, S. V., Perkins, J. M., & Khan, K. T. (2009). Do burdens of underweight and
overweight coexist among lower socioeconomic groups in India?. The American journal of
clinical nutrition, 90(2), 369-376.
http://ajcn.nutrition.org/content/90/2/369