Asia’s Double Nutrition Burden

More than any other region in the world, Asia faces two quite different diet-related health problems: undernutrition and overnutrition. The socio-economic transition experienced by many countries in Asia is resulting in a shift from large proportions of the population suffering nutritional deficiency diseases, to increasing numbers experiencing diseases associated with excess consumption, most importantly overweight and obesity. The following article briefly outlines the nature of this double burden and suggests some common principles that may be of value in addressing both.

Inadequate Nutritional Consumption

A significant proportion of Asia’s population still suffers from under-consumption of specific nutrients.

Undernutrition is still a significant problem in many countries, is more common in rural areas, and is more common amongst children.

Basic hunger (protein-energy malnutrition) is the most obvious example of inadequate nutrition. However, micronutrient deficiencies (especially of iron, vitamin A, zinc, iodine and calcium) may be less easy to recognize, but are a greater cause of ill-health in Asia.

Children and women of child-bearing age are especially at risk because of increased nutritional demands during these life-cycle Reprinted by kind permission of Wilma B. Freire, PhD., Coordi-nator, Food and Nutri-tion Program, Pan American Health Organization, World Health Organization.

Excess Consumption

Conversely, excess consumption of total energy (calories), saturated fats and refined carbohydrates, coupled with reduced physical activity, increases the risk of obesity and associated diseases such as diabetes, osteoporosis, cardiovascular diseases and possibly some cancers.

The incidence of non-communicable or lifestyle diseases is rapidly increasing in many Asian countries.

Such disease patterns are often associated with increasing affluence of populations. However, it is simplistic to say increased wealth is the cause. These illnesses affect both the poorest and the richest. It is probably more helpful to look at the link between physical activity levels and the increase in non-communicable diseases. Industrial development and the migration of rural populations to urban areas is almost always associated with declining physical activity levels.

Many of those previously employed in manual labour such as agriculture are now engaged in more sedentary employment. Those regularly engaged in heavy physical labour often find it difficult to consume food to meet their daily energy needs, particularly those with low incomes and limited diets, whilst those leading more sedentary lifestyles often find it difficult to restrict their food intake to match their energy expenditure levels. Research in the industrialised countries demonstrates that energy consumption has fallen during the last 2 decades, but nevertheless, prevalence of overweight and obesity has risen inexorably during this period. The result may be a gradual increase in body weight, as excess calories consumed are converted to body fat.

Two different nutritional needs but a common communications approach?

There are any reasons for this: increasing affluence of national populations and/or individuals concerned; reduced exposure to infectious diseases and food-borne illnesses as natural immunity is developed, and the tendency for physical activity levels to decline with age. There is also strong evidence that early malnutrition before and after birth, might increase susceptibility to overweight, insulin resistance, and other chronic diet-related ill health in later life.

Refs.World Declaration on Nutrition - Plan of Action WHO (1993)