A Kenyan health worker weighs a young Kenyan boy.

Obesity has become one of the most pressing health risks of our generation. We have begun to see what has become a pandemic of obesity and its accompanying non-communicable diseases. Despite the growing obesity pandemic, world hunger and childhood malnutrition have not come close to being eliminated. While one of the Millennium Development Goals was to eradicate poverty and hunger by 2015 (an admittedly lofty goal), leaving health service workers with a compounding dilemma of solving both malnutrition and over-nutrition concurrently.

Predictions say the current generation may be the first generation of children to die younger and live sicker than their parents (Olshansky et al. 2005). Obesity is no longer just a crisis in the United States. Developing countries, especially in urban areas, have increasing obesity problems as well. “The pandemic is transmitted through the vectors of subsidized agriculture and multinational companies providing cheap, highly refined fats, oils, and carbohydrates, labour-saving mechanized devices, affordable motorized transport, and the seductions of sedentary pastimes such as television”  (Prentice, 2005).

The interesting paradox is that data has shown how malnutrition earlier in life often leads to over-nourishment (another form of malnutrition) later in life. Malnutrition is not always the result of food scarcity; it can also be caused by foods that are poor in essential nutrients. Lack of access to nutrient-rich food has in turn lead to nutritional deformities (like stunting), which increases the likelihood of obesity later in life. One study in a poor urban area of Sao Paulo, Brazil, found that “stunting was the most predominant type of malnutrition in both sexes. Obesity associated with stunting was more common than obesity without stunting, both in younger children and adolescents” (Sawaya et al. 2012).

The same study also showed that, “In 9% of families there was a coexistence of obesity in the adults and malnutrition in the children. These results demonstrate a coexistence of malnutrition and obesity in poor urban Brazilian communities.”

Cross-sectional Demographic and Health Surveys from 27 sub-Saharan countries show a rapid rise in obesity rates, one report found. Most of the obesity increases are in African cities and the study predicts that by 2030, nearly 18 per cent of all adults in sub-Saharan Africa could be obese. This is a region that also has the world’s highest rate of stunting among children (43 percent) and where the number of undernourished people of all ages was 225 million in 2008. This figure is expected to reach 325 million by 2015 (Population Reference Bureau).

The greatest challenge will be to find a way to combat malnutrition and obesity simultaneously. It is estimated that by the year 2015 noncommunicable diseases associated with overnutrition will surpass undernutrition as the leading causes of death in low-income communities (Tanumihardjo et al. 2007).

Ultimately, the root cause of both malnutrition and over-nutrition/obesity is inadequate or improper nutrients. Consumption of an appropriate portion of food rich in essential nutrients can eliminate both pandemics. However, the logistics of implementing such dietary plans worldwide isn’t feasible. There are some solutions that, if implemented on a smaller-scale, could improve conditions. Improved outreach to mothers and children about dietary needs, more nutritious school food offerings, and accessibility of low cost nutritious food in low-income urban areas could all help provide more nutrients for undernourished, and adjust the amount and type of nutrients in over-nourished adults and children.

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