Fighting a double whammy

This week the World Health Organization (WHO) called for a whole-of-society approach to address the double burden of malnutrition, which affects populations across Southeast Asia, particularly women and girls. 

The current nutrition profile of the Southeast Asian region is characterised by under-nutrition rates that are declining slowly alongside rapidly rising rates of overweight and obesity, often within the same communities, and even in the same households. This double burden is depriving people of reaching their potential and is fuelling rising rates of non-communicable diseases. 

In developing countries such as Sri Lanka the health system is often geared towards dealing with malnutrition but often does not have the capacity to deal with the opposite extreme. 

According to WHO, across Southeast Asia, an estimated 60 million children under the age of five are stunted, a condition characterised by reduced growth rate and development, while 8.8 million are overweight. 

Furthermore, thinness affects 24% to 47% of adolescent girls, while between 2% and 24% are overweight and the prevalence of overweight or obesity among adult women ranges between 18%-30%.

With economic prosperity in the region, millions of children have come out of poverty. But this economic gain led to a change in food habits and lifestyles, resulting in the rise of conditions like obesity. 

Economic growth has led to a greater market reach of “unhealthy products” into rural areas, as well as poor and middle-class families, able to afford the products but without making the right choices to use healthier foods instead. 

The causes of overweight and under-nutrition are intertwined. Children with stunted growth in early childhood are mostly at a greater risk of becoming overweight later in life. The tendency to be overweight goes up with increased access to junk food and drinks (those with high trans-fat or sugar content and low nutritional value), physical inactivity and sedentary lifestyles. This trend has been noticed across several countries in the region and is a major cause behind growing instances of non-communicable chronic diseases like diabetes and cardiovascular diseases.

The double burden of nutrition cannot be tackled in silos. It demands cross-sectorial and multidimensional actions from Governments and other stakeholders. Multi-sectoral approaches including Water, Sanitation and Hygiene (WASH), agriculture, education, trade and social protection are increasingly important to address the double burden of malnutrition. 

The institutionalisation of nutrition services within health systems, benefiting from healthcare reforms and the move to universal health coverage in some countries are necessary to deal with this double extreme.  

Demanding an increase in the budget to tackle malnutrition, WHO asks governments to focus on improving feeding practices for infants and young children, provide treatment for acutely malnourished children, increase agricultural varieties and hygiene practices as well as ensuring actions to educate girls. 

It demands political will and actions from all stakeholders and especially governments to strengthen nutrition policies and actions. 

Even as WHO calls for effective regulations on the marketing of junk food and sugary drinks to children, it deserves the attention of the booming food processing and beverages sector for a socially and ethically-responsible investment for the sake of the millions of children in not just the region, but in other developing countries too, including the global south.