More than one in three low- and middle-income countries face both extremes of malnutrition, according to a new The Lancet Series on nutrition launched on 16 December 2019.

A new approach is needed to help reduce undernutrition and obesity at the same time, as the issues become increasingly connected due to rapid changes in countries’ food systems. This is especially important in low- and middle-income countries, according to a new four-paper report published in The Lancet in December.

Undernutrition and obesity can lead to effects across generations as both maternal undernutrition and obesity are associated with poor health in offspring. However, because of the speed of change in food systems, more people are being exposed to both forms of malnutrition at different points in their lifetimes, which further increases harmful health effects.

“This report reiterates that malnutrition has many faces, and diet-related NCDs like cancers, diabetes, heart disease and obesity are now two sides of the same coin, and dysfunctional food systems are a common denominator,” said Katie Dain, CEO of the NCD Alliance and co- author of a comment piece featured in the series: A new nutrition manifesto for a new nutrition reality.

Globally, estimates suggest that almost 2.3 billion children and adults are overweight, and more than 150 million children are stunted. However, in low- and middle-income countries these emerging issues overlap in individuals, families, communities and countries. The new report explores the trends behind this intersection – known as the double burden of malnutrition – as well as the societal and food system changes that may be causing it, its biological explanation and effects, and policy measures that may help address malnutrition in all its forms.

The report identifies a set of ‘double-duty actions’ that simultaneously prevent or reduce the risk of nutritional deficiencies leading to underweight, wasting, stunting or micronutrient deficiencies, and obesity or NCDs, with the same intervention, programme, or policy.

“The globalisation of processed junk food has brought us all to this precipice, and getting off it will require swift, coordinated and creative action from a range of decision makers across society who recognise the value in ensuring healthy diets for all in all countries. The costs of ignoring NCD prevention as we tackle all forms of malnutrition will be borne by us all,” said Katie Dain.

To create the systemic changes needed to end malnutrition in all its forms, the authors call on governments, the UN, civil society, academics, the media, donors, the private sector and economic platforms to address the double burden of malnutrition and bring in new actors, such as grass-roots organisations, farmers and their unions, faith-based leaders, advocates for planetary health, innovators and investors who are financing fair and green companies, city mayors and consumer associations.

Read the full press release here.