Tackling the public health concern of the double burden of malnutrition on the global scale

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Tackling the public health concern of the double burden of malnutrition on the global scale. Ann Trop Med Public Health 2017;10:493-4


How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Tackling the public health concern of the double burden of malnutrition on the global scale. Ann Trop Med Public Health [serial online] 2017 [cited 2020 Aug 8];10:493-4. Available from: https://www.atmph.org/text.asp?2017/10/3/493/213142

Dear Editor,

It is a very well known fact that with an unhealthy start to life in terms of the nutritional state of a child, the future prospects of an individual’s health are not very bright.[1]

More often than not, these individuals are exposed to an increased potential risk of both infectious and lifestyle disorders, as any kind of malnutrition augment the risk of morbidities and even premature death.[1] The double burden of malnutrition or in other words two extremes of the nutritional status are characterized by the simultaneous presence of undernutrition and overweight/obesity, within individuals, and communities across their lifetime.[1],[2]

Amidst the globalization, urbanization, and the socioeconomic development happening across the world, the nutritional status of the population and the diet-related epidemiology has shown a significant shift.[2],[3] In-fact, in the year 2014, close to 2 billion and 460 million adults were overweight and underweight, respectively, worldwide.[1] However, among the under-five-year age-group, an estimated 40 million were overweight, whereas another 160 million and 50 million of the children were stunted and had wasting, respectively.[1] Further, it is a real cause of public health concern that even now, close to 5 million children die due to under-nutrition and its associated sequels in low-income and middle-income nations, and that in the same settings the problem of childhood obesity has shown a 30% quicker rise in contrast to the high-income nations.[1]

The double burden of malnutrition is not merely a coexistence, and has been observed at individual, household and even at the population level.[2],[3] Acknowledging the magnitude of the problem and its impact on the quality of life of affected individuals, families, community, and the health system, a range of nutrition-related global targets have been proposed to be accomplished by the year 2025 for improving the nutrition standards of vulnerable group of population.[1],[3],[4] These targets include a 30% decline in the prevalence of low-birth weight, improving the prevalence of exclusive breastfeeding for the recommended period to a minimum of 50%, minimize and sustain childhood wasting to less than 5%, a 40% decline in the proportion of stunting among children aged less than five years, no hike in prevalence of childhood overweight or adult/adolescent diabetes and obesity, and achieving a 50% decline in the prevalence of anemia among women in the reproductive age-group.[1],[4]

From the policy maker’s perspective, it is a unique platform for all the stakeholders to formulate an effective, comprehensive strategy to counter all forms of malnutrition.[1],[2],[3] In-fact, an action plan has been developed that aims to negate the predisposing risk factors for malnutrition and even promote the development of healthy dietary practices, through the deployment of coordinated and evidence-based strategies, implemented in collaboration with multiple sectors (viz. agriculture, trade, environment, etc.), to ultimately ensure that food is made available, accessible, affordable, and acceptable to all the people and thereby assist them in living a healthy and productive life.[4]

In general, the action plan proposes different steps to accomplish five objectives, namely prioritizing the issue of nutrition in the nation’s overall plan, improve and support the practices of breastfeeding and complementary feeding, strengthen legal provisions to encourage promotion of healthy diets, ameliorate the nutrition-related services across the public health sector, and deploy financing approaches to reinforce healthy dietary practices.[3],[4],[5] It lays extra emphasis on the initial thousand days life of a child and aims to deliver the services through the human rights based and participatory approach, and enables monitoring with the help of appropriate indicators.[2],[4],[6]

To conclude, it is high time to address the double burden of malnutrition, if we really aim to achieve the Sustainable Development Goals. The proposed action plan offers lays down guidelines and strategies to negate the existing problem through a combination of cost-effective approaches implemented in collaboration with concerned stakeholders in an integrated manner.


S.R.S. contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

P.S.S. contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

J.R. contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest to declare.



UNICEF-WHO-The World Bank GroupJoint child malnutrition estimates -Levels trends (2015 edition). Geneva WHO press; 2015. P.1-3.
Shrimpton R. Tackling the double burden of malnutrition across the life course: a global imperative. Cien Saude Colet 2015;20:2300-
Kimani-Murage EW, Muthuri SK, Oti SO, Mutua MK, van de Vijver S, Kyobutungi C. Evidence of a double burden of malnutrition in urban poor settings in Nairobi, Kenya. PLoS One 2015;10:e0129943.
World Health OrganizationAction plan to reduce the double burden of malnutrition in the Western Pacific Region (2015–2020). Geneva WHO press; 2015. P.1-24.
Chomtho S, Breastfeeding to prevent double burden of malnutrition. Southeast Asian J Trop Med Public Health 2014;45:132-36.
Kavle JA, Flax VL, Abdelmegeid A, Salah F, Hafez S, Ramzy M. Factors associated with early growth in Egyptian infants: implications for addressing the dual burden of malnutrition. Matern Child Nutr 2016;12:139-51.

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.213142

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