Impact of Nutrition Interventions on the Double Burden of Malnutrition
Abstract
A new review has looked at the impact of nutrition interventions on the double burden of malnutrition in low- and middle-income countries.
Introduction
The double burden of malnutrition occurs when the same populations, households, or individuals suffer from both overnutrition (e.g. overweight and obesity) and undernutrition (e.g. stunted growth and deficiency in important micro-nutrients) – this represents a serious public health challenge.
Research and Findings
The research, published in The Lancet Global Health, aimed to identify programmes and policies that could reduce the burden of both undernutrition and overnutrition, as well as those that may unintentionally cause harm to some forms of malnutrition.
The study analyzed 26 papers that evaluated nutrition-based interventions, specifically focusing on those that assessed the impact on both undernutrition and overnutrition. The authors noted that many papers only addressed one aspect of malnutrition.
Out of the included studies, 20 evaluated nutrition-specific interventions that targeted immediate causes of malnutrition, such as improving access to healthy foods. The remaining six studies evaluated nutrition-sensitive interventions that addressed underlying socioeconomic factors, such as poverty.
The study identified ten interventions that had the potential to improve both overnutrition and undernutrition simultaneously. These included five school-based interventions, three behavioral interventions among mothers and children, and two conditional cash transfers.
However, the research team also found 13 interventions that effectively addressed undernutrition but unintentionally had adverse impacts on overnutrition. For example, a program in Guatemala that provided fortified food rations to pregnant mothers reduced child stunting but led to greater postpartum weight retention in a population with already high obesity rates.
Policy Implications
The study’s lead author, Nora Escher, highlighted the importance of identifying and implementing policies to address the double burden of malnutrition. She cited the example of Mexico’s national conditional cash transfer program, which significantly reduced stunting and overweight in children by linking financial aid to low-income families’ compliance with health check-ups and school attendance.
Dr. Suparna Ghosh-Jerath, co-author of the study, mentioned the need for policy adaptations to mitigate unintended harm caused by interventions that focus on a single aspect of malnutrition. She referred to India’s recent amendment of the nutritional prescription for children receiving supplementary nutrition, which now tailors nutritional standards based on individual age and nutritional status.
Conclusion
The research team emphasized the importance of future studies evaluating nutrition-based interventions to monitor their impact on both undernutrition and overnutrition. This evidence will provide a stronger case to influence nutrition policy in low- and middle-income countries, which face the public health consequences of the double burden of malnutrition.
Full Paper
Full paper is available: (2024). The effect of nutrition-specific and nutrition-sensitive interventions on the double burden of malnutrition in low-income and middle-income countries: a systematic review. The Lancet Global Health. 10.1016/S2214-109X(23)00562-4.
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(23)00562-4/fulltext
SDGs, Targets, and Indicators
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SDG 2: Zero Hunger
- Target 2.2: By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women, and older persons.
- Indicator 2.2.1: Prevalence of stunting (height for age <-2 standard deviation from the median of the World Health Organization (WHO) Child Growth Standards) among children under 5 years of age.
- Indicator 2.2.2: Prevalence of malnutrition (weight for height >+2 or <-2 standard deviation from the median of the WHO Child Growth Standards) among children under 5 years of age.
-
SDG 3: Good Health and Well-being
- Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
- Indicator 3.4.1: Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease.
- Indicator 3.4.2: Suicide mortality rate.
Table: SDGs, Targets, and Indicators
| SDGs | Targets | Indicators |
|---|---|---|
| SDG 2: Zero Hunger | Target 2.2: By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women, and older persons. |
|
| SDG 3: Good Health and Well-being | Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. |
|
Analysis
The article addresses the issue of the double burden of malnutrition, which refers to the coexistence of overnutrition (e.g. overweight and obesity) and undernutrition (e.g. stunted growth and nutrient deficiencies) within the same populations, households, or individuals. This issue is relevant to SDG 2: Zero Hunger and SDG 3: Good Health and Well-being.
Under SDG 2, Target 2.2 aims to end all forms of malnutrition, including achieving targets on stunting and wasting in children under 5 years of age. The article discusses interventions that can address both overnutrition and undernutrition simultaneously, highlighting the potential to improve the nutritional status of children. The indicators mentioned in the article, such as the prevalence of stunting and malnutrition among children under 5 years of age, can be used to measure progress towards achieving this target.
Under SDG 3, Target 3.4 focuses on reducing premature mortality from non-communicable diseases and promoting mental health and well-being. While the article does not directly discuss mortality rates or mental health, addressing the double burden of malnutrition can contribute to achieving this target by improving overall health outcomes and reducing the risk of chronic diseases associated with both overnutrition and undernutrition.
In conclusion, the article highlights the importance of addressing the double burden of malnutrition and identifies interventions that can improve both overnutrition and undernutrition. By aligning with SDG 2 and SDG 3 targets, progress can be measured using indicators related to child stunting, malnutrition prevalence, and mortality rates attributed to non-communicable diseases.
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Fuente: imperial.ac.uk
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