Poverty, Obesity, and Malnutrition: An International Perspective Recognizing the Paradox

Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA.
Journal of the American Dietetic Association (Impact Factor: 3.92). 12/2007; 107(11):1966-72. DOI: 10.1016/j.jada.2007.08.007
Source: PubMed


In the year 2000, multiple global health agencies and stakeholders convened and established eight tenets that, if followed, would make our world a vastly better place. These tenets are called the Millennium Development Goals. Most of these goals are either directly or indirectly related to nutrition. The United Nations has led an evaluation team to monitor and assess the progress toward achieving these goals until 2015. We are midway between when the goals were set and the year 2015. The first goal is to "eradicate extreme poverty and hunger." Our greatest responsibility as nutrition professionals is to understand the ramifications of poverty, chronic hunger, and food insecurity. Food insecurity is complex, and the paradox is that not only can it lead to undernutrition and recurring hunger, but also to overnutrition, which can lead to overweight and obesity. It is estimated that by the year 2015 noncommunicable diseases associated with overnutrition will surpass undernutrition as the leading causes of death in low-income communities. Therefore, we need to take heed of the double burden of malnutrition caused by poverty, hunger, and food insecurity. Informing current practitioners, educators, and policymakers and passing this information on to future generations of nutrition students is of paramount importance.

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Available from: Martha Kaufer-Horwitz, Apr 29, 2015
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    • "In developed countries, it may be related to poverty (Tanumihardjo et al. 2007) and the built environment (Cummins et al. 2005), where fast food is affordable and outlets selling low-cost energy-dense foods are widely available. In people with ID, undernourishment, rather than over-nutrition, traditionally has been a problem (Beange et al. 1995), but it may be that people with ID are displaying the same patterns as the general population: that is, tending to being over-nourished (Tanumihardjo et al. 2007). It is should be noted that although most participants were overweight or obese, the majority (60.3%) had little choice in the food they ate, and their consumption of takeaway food was generally low. "
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    ABSTRACT: Background: The aim of this study was to describe the nutrition, food choice, physical activity and weight status in a group of adults with intellectual disability (ID) in Victoria, Australia. Method: Disability workers and adults with ID were recruited through disability services. In total, 51 disability workers (11 men, 40 women) and 68 (47 men, 21 women) adults with ID participated in the research. Disability workers provided information about the nutrition, food choice and physical activity levels of adults with ID through a questionnaire administered by a general practitioner or research nurse. The questionnaire also included The Australian Nutrition Screening Initiative checklist. Results: Body Mass Index was in the healthy range for only 37.5% of participants and in the obese range for almost half (41%). Similarly, the majority of participants had an abdominal circumference in a range that put them at increased or substantially increased risk of metabolic complications. The mean score obtained on the Australian Nutrition Screening Initiative checklist indicated a moderate risk of malnutrition (M = 4.2); however, 17.6% of participants achieved scores that put them in the high-risk category. More than half of the participants were reported to have a little choice in the type of food they ate and when they ate. Physical activity data indicated that the majority of participants (60.3%) did not meet national physical activity guidelines. Conclusions: These findings suggest that people with ID are at risk of developing diseases associated with obesity, inactivity, and poor nutrition. Strategies to encourage people with ID to engage in physical activity and healthy eating are, therefore, a matter of priority and should involve their disability workers.
    Full-text · Article · Dec 2015 · Journal of Intellectual Disability Research
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    • "Como contraparte, durante muchos años el sobrepeso y la obesidad fueron considerados privativos de los países desarrollados (Aranceta Bartrina, 2002). No obstante, en las últimas décadas se ha verificado en países en vías de desarrollo un rápido incremento de estos indicadores (Tanumihardjo et al., 2007; Popkin, 2009). De hecho, se ha informado que muchos países con ingresos bajos y medianos afrontan actualmente , morbilidad de " doble carga " : mientras continúan con los problemas de las enfermedades infecciosas y la desnutrición, experimentan un aumento brusco en sobrepeso y obesidad con el riesgo de contraer enfermedades no transmisibles . "

    Full-text · Dataset · Mar 2015
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    • "The idea that serum retinol or its active metabolites may play an important role in the genesis, or the prevention of chronic inflammatory diseases is relatively new but increasingly plausible (Chai et al., 2010). Better understanding how vitamin A or other anti-inflammatory nutrients may be involved in the relationships between hsCRP, BMI and cardiovascular risks is particularly important in the context of the dual burden of underweight and overweight as well as micronutrient insufficiencies/deficiencies found in developing and middle income countries (Doak et al., 2005; Tanumihardjo et al., 2007). "
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    ABSTRACT: Objectives Low-grade elevation of C-reactive protein (CRP) is a non-specific inflammatory marker, used as a predictor for cardiovascular disease development and chronic inflammatory risks. Research investigating dietary influences on inflammation has focused primarily on the relationship between dietary characteristics, CRP elevation and BMI in the populations at greatest risk for cardiovascular disease, namely those in the overweight and obese ranges, often in clinical settings and/or among those middle aged or older, leaving little information about normal to underweight populations of reproductive age in ecological settings. This study evaluates impacts of dietary nutrients on serum CRP levels in a population of predominantly underweight to normal weight adult women experiencing the additional nutritional demands of lactation. Methods Data from non-overweight breastfeeding Ariaal women of Kenya collected in 2006 were used (n = 194). Logistic regression models were applied using low-grade CRP elevation (hsCRP > 3 mg/L) as the outcome variable and dietary nutrients, age, BMI, and serum retinol as predictors. ResultsModels showed that energy intake (Kcal) and age were positive predictors of CRP elevation while folate intake, total vitamin A intake, and serum retinol concentration were protective against CRP elevation. Unlike previous studies among higher BMI populations, this study found no significant effect of dietary lipids/fatty acids or BMI on CRP elevation. Conclusions The effects of specific dietary nutrients on inflammatory status may vary with BMI or, in women, reproductive status. Further research should investigate the role of dietary fats, fatty acids, and antioxidant vitamins across populations with a wide range of BMI, including postpartum women. Am. J. Hum. Biol. 26:796-802, 2014. (c) 2014 Wiley Periodicals, Inc.
    Full-text · Article · Nov 2014 · American Journal of Human Biology
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