For many developing countries, the health problems caused by obesity now nearly equal the public health concerns brought on by undernutrition. Benjamin Caballero, MD, professor and director of the Center for Human Nutrition at the Johns Hopkins Bloomberg School of Public Health analyzes what scientists call the “nutrition transition” in an editorial in the April 14, 2005 issue of the New England Journal of Medicine. In the editorial, Dr. Caballero notes that in countries undergoing rapid socioeconomic change, the problems of overweight and underweight frequently co-exist even within the same household. This double burden of disease is more common in countries of intermediate development, including Brazil, Mexico, and China where being overweight now ranks fifth among the top ten contributors to the overall disease burden, just below undernutrition.
Caballero mentions some key factors contributing to this combination. In urban areas, an increased access to energy-dense processed foods and the adoption of sedentary lifestyles is creating an "obesogenic" environment, not dissimilar from that of developed countries. Yet at the same time, socioeconomic disparities and limited access to preventive health care result in a widening of the gap between rich and poor, affecting primarily infants and children. Caballero says that combating this double burden in developing countries will require not only interventions to reduce risk factors for obesity but also initiatives to eliminate those economic and health disparities. —Kelly Blake “A Nutrition Paradox—Underweight and Obesity in Developing Countries” was written by Benjamin Caballero. |
