The double burden of malnutrition

When you think of malnutrition, you typically picture a starving person. But overweight people can also be malnourished. This phenomenon is formally recognised as the “double burden of malnutrition”.

According to the World Health Organisation it is “characterised by the coexistence of undernutrition along with overweight, obesity or diet-related noncommunicable diseases (NCDs), within individuals, households and populations, and across the life course.”

While the prevalence of undernutrition has gradually fallen in low- and middle-income countries, these nations are now experiencing a steady rise in overweight and obesity rates from excess foods and drinks devoid of nutrition.

This is a major public health crisis. Undernutrition impacts children’s cognitive development and can lead to stunted growth and increased mortality while overnutrition contributes to increased risk of chronic diseases including diabetes and hypertension.


Not just the developing world

At an individual level this double whammy might be seen as obesity alongside deficiencies in essential nutrients or an underweight child with stunted growth who becomes an obese adult. At a household level, a parent might be overweight or anaemic while a child or grandparent is underweight.

This doesn’t just occur in developing countries – the double burden of malnutrition is alive and well right here on our doorstep in Australia, likely contributing to our growing decline in health ratings.

Older adults are particularly impacted by malnutrition, which has been hailed as a “silent epidemic” that affects up to two in three people. And while 63% of Australians are overweight or obese, paradoxically this also includes older adults.

When malnutrition leads to loss of muscle mass in the presence of increased body fat, this is referred to as “sarcopenic obesity”, which could have worse outcomes than sarcopenia without obesity.


Taking charge

Addressing this public health challenge is complex and multi-faceted. But the end solution is not rocket science: it boils down to healthy food and physical activity.

In older adults, protein from quality sources such as fish, eggs, legumes, nuts and seeds is a critical factor in reducing loss of muscle mass and strength and associated problems including falls, poor wound healing and mortality.

Physical activity – even just a daily walk in the park and incidental exercise like housecleaning and gardening – can help boost muscle mass and melt excess fat, going a long way to reducing chronic disease.

Getting rid of processed junk food in aged care and replacing it with high quality, nutrient dense food is another no-brainer for improving overall diet quality.

Quite simply, embracing wholesome, nutritious, home-cooked food in a pleasant environment can bring the joy back to eating and the zing back to good health.





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