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A new nutrition manifesto for a new nutrition reality

2019; Elsevier BV; Volume: 395; Issue: 10217 Linguagem: Inglês

10.1016/s0140-6736(19)32690-x

1474-547X

Francesco Branca, Alessandro Demaio, Emorn Udomkesmalee, Phillip Baker, Víctor M. Aguayo, Sı́món Barquera, Katie Dain, Lindsay S. Keir, Anna Lartey, Gladys Mugambi, Stineke Oenema, Ellen Piwoz, Ruth Richardson, Sudhvir Singh, Lucy Sullivan, G. Verburg, Patrizia Fracassi, Lina Mahy, Lynnette M. Neufeld,

Birth, Development, and Health

Malnutrition is a global challenge that all countries need to address. Despite some progress, the world is not on track to meet globally agreed goals and targets for nutrition. 1 UN General AssemblyImplementation of the United Nations Decade of Action on Nutrition (2016–2025). A/RES/72/306. United Nations, New York2018 Google Scholar While more than 149 million children have stunted growth, childhood overweight and obesity are increasing almost everywhere, 2 United Nations Children's FundWHOInternational Bank for Reconstruction and Development/The World BankLevels and trends in child malnutrition: key findings of the 2019 Edition of the Joint Child Malnutrition Estimates. World Health Organization, Geneva2019 Google Scholar and suboptimal diets are responsible for one in five (22%) adult deaths globally. 3 GBD 2017 Diet CollaboratorsHealth effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019; 393: 1958-1972 Summary Full Text Full Text PDF PubMed Scopus (2060) Google Scholar The Lancet's Series on the Double Burden of Malnutrition 4 Popkin BM Corvalan C Grummer-Strawn LM Dynamics of the double burden of malnutrition and the changing nutrition reality. Lancet. 2019; (published online Dec 15.)https://doi.org/10.1016/S0140-6736(19)32497-3 Summary Full Text Full Text PDF PubMed Scopus (441) Google Scholar , 5 Wells JC Sawaya AL Wibaek R et al. The double burden of malnutrition: aetiological pathways and consequences for health. Lancet. 2019; (published online Dec 15.)https://doi.org/10.1016/S0140-6736(19)32472-9 Summary Full Text Full Text PDF Scopus (253) Google Scholar , 6 Hawkes C Ruel MT Salm L Sinclair B Branca F Double-duty actions: seizing programme and policy opportunities to address malnutrition in all its forms. Lancet. 2019; (published online Dec 15)https://doi.org/10.1016/S0140-6736(19)32506-1 Summary Full Text Full Text PDF Scopus (164) Google Scholar , 7 Nugent R Levin C Hale J Hutchinson B Economic effects of the double burden of malnutrition. Lancet. 2019; (published online Dec 15)https://doi.org/10.1016/S0140-6736(19)32473-0 Summary Full Text Full Text PDF Scopus (56) Google Scholar highlights this new nutrition reality: we can no longer characterise countries as low-income and undernourished or high-income and only concerned with obesity. Dynamics of the double burden of malnutrition and the changing nutrition realityThe double burden of malnutrition (DBM), defined as the simultaneous manifestation of both undernutrition and overweight and obesity, affects most low-income and middle-income countries (LMICs). This Series paper describes the dynamics of the DBM in LMICs and how it differs by socioeconomic level. This Series paper shows that the DBM has increased in the poorest LMICs, mainly due to overweight and obesity increases. Indonesia is the largest country with a severe DBM, but many other Asian and sub-Saharan African countries also face this problem. Full-Text PDF The double burden of malnutrition: aetiological pathways and consequences for healthMalnutrition has historically been researched and addressed within two distinct silos, focusing either on undernutrition, food insecurity, and micronutrient deficiencies, or on overweight, obesity, and dietary excess. However, through rapid global nutrition transition, an increasing proportion of individuals are exposed to different forms of malnutrition during the life course and have the double burden of malnutrition (DBM) directly. Long-lasting effects of malnutrition in early life can be attributed to interconnected biological pathways, involving imbalance of the gut microbiome, inflammation, metabolic dysregulation, and impaired insulin signalling. Full-Text PDF Double-duty actions: seizing programme and policy opportunities to address malnutrition in all its formsActions to address different forms of malnutrition are typically managed by separate communities, policies, programmes, governance structures, and funding streams. By contrast, double-duty actions, which aim to simultaneously tackle both undernutrition and problems of overweight, obesity, and diet-related non-communicable diseases (DR-NCDs) have been proposed as a way to effectively address malnutrition in all its forms in a more holisitic way. This Series paper identifies ten double-duty actions that have strong potential to reduce the risk of both undernutrition, obesity, and DR-NCDs. Full-Text PDF Economic effects of the double burden of malnutritionObservations from many countries indicate that multiple forms of malnutrition might coexist in a country, a household, and an individual. In this Series, the double burden of malnutrition (DBM) encompasses undernutrition in the form of stunting, and overweight and obesity. Health effects of the DBM include those associated with both undernutrition, such as impaired childhood development and greater susceptibility to infectious diseases, and overweight, especially in terms of increased risk of added visceral fat and increased risk of non-communicable diseases. Full-Text PDF