World’s Malnutrition Paradox; Gaps in Looking Back and Looking Ahead

Objective: This paper examines paradigms in the double burden of malnutrition. It explores the speed of nutrition transition, summarizes the drifts and trends in prevalence rates between under nutrition and overnutrition. Design and Setting: Review of outcomes that focus on large scale surveys, national and global representative studies on diet, physical activity, obesogenic environment and obesity among children, adolescents and adults. Subjects: The WHO guidelines for classifying and defining overweight and obesity are used for children and adolescents and the body mass index of ≥ 25kg/m2 and 30kg/m2 are used for adult’s overweight and obesity respectively. Results: The nutrition transition shifts are examined from the 20th century to the current century in Europe. China, USA and the low and middle income countries of Africa, Asia and Middle East. Paradoxically, the two forms of malnutrition exist. Undernutrition is observed to be decreasing whereas overnutrition is increasing rampantly. The problem is cutting across all classes of people; rich or poor and the magnitude is becoming a health burden especially in developing countries. The shifts have dominated to overweight, obesity and diet related comorbidities such as cardiovascular diseases, diabetes and some cancers. Conclusive evidence on the global malnutrition situation is still elusive but available data forecasts trend in the shifts. Conclusion: This work shows that the two forms of malnutrition exists in discordance but overweight and obesity is encroaching rapidly and is a risk to diet-related NCDs, yet they can be significantly reduced.