Defining double burden of malnutrition across individual, household and population level: A narrative review.

Aims: This study aims to evaluate the existing definitions of double burden of malnutrition and to synthesise and propose operational definitions at different levels, with the goal of improving consistency in measurement and policy development.

Methods: We conducted a narrative review that used structured search and narrative synthesis to review and summarise how double burden of malnutrition has been defined at different levels. We performed a structured search across PubMed, Web of Science and Scopus, focusing on peer-reviewed articles published between January 2010 and December 2024. We screened articles for relevance to double burden of malnutrition and categorised them based on the level of the definition, such as households, individuals and populations.

Results: Of the 60 selected studies, the majority originated from Latin America (n = 19, 32%), followed by South Asia (n = 10, 17%) and Southeast Asia (n = 8, 13%). At the household level, the most common definition of double burden of malnutrition was the coexistence of an overweight/obese mother and a stunted child. Individual-level definitions commonly included the coexistence of overweight/obesity with anaemia or stunting. However, definitions at the population level varied considerably and lacked consistency across studies.

Conclusions: Our findings highlight the need for consistent operational definitions of double burden of malnutrition across different levels of analysis. Drawing on existing literature, we synthesise practical definitions at different levels to more accurately reflect the coexistence of different forms of malnutrition. Clarifying these definitions can improve the comparability of prevalence estimates across contexts and support the development of more effective, evidence-based strategies to address the growing burden of double burden of malnutrition.