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Global Evidence on Double Burden of Malnutrition

Global Evidence on Double Burden of Malnutrition

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Double Burden of Malnutrition Global Review. World Bank Paper. By Roger Shrimpton and Claudia Rokx
Double Burden of Malnutrition Global Review. World Bank Paper. By Roger Shrimpton and Claudia Rokx

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08/20/2013

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THE DOUBLE BURDEN OF MALNUTRITION:
 
 A Review of Global Evidence
Roger Shrimpton and Claudia Rokx
November 2012
 
ii
Health, Nutrition and Population (HNP) Discussion Paper 
This series is produced by the Health, Nutrition, and Population Family (HNP) of the WorldBank 
s Human Development Network (HDN). The papers in this series aim to provide a vehiclefor publishing preliminary and unpolished results on HNP topics to encourage discussion anddebate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliatedorganizations or to members of its Board of Executive Directors or the countries they represent.Citation and the use of material presented in this series should take into account this provisionalcharacter.Enquiries about the series and submissions should be made directly to the Editor, Martin Lutalo(mlutalo@worldbank.org). Submissions undergo informal peer review by selected internalreviewers and have to be cleared by the Task Team Leader 
s Sector Manager. The sponsoringdepartment and author(s) bear full responsibility for the quality of the technical contents and presentation of material in the series.Since the material will be published as presented, authors should submit an electronic copy in the pre-defined template (available at www.worldbank.org/hnppublications on the Guide for Authors  page). Drafts that do not meet minimum presentational standards may be returned to authors for more work before being accepted.For information regarding the HNP Discussion Paper Series, please contact Martin Lutalo atmlutalo@worldbank.org or 202-522-3234 (fax).© 2012 The International Bank for Reconstruction and Development / The World Bank 1818 H Street, NW Washington, DC 20433All rights reserved.
 
iii
Health, Nutrition, and Population (HNP) Discussion Paper 
 
THE DOUBLE BURDEN OF MALNUTRITION:
 
 A Review of Global Evidence
Roger Shrimpton
a
Claudia Rokx
 b
 
a
Principal author, Consultant, Health, Nutrition, and Population Unit, East Asia Pacific HumanDevelopment Sector, The World Bank, Jakarta, Indonesia
 b
Task Team Leader, Lead Health Specialist, Eastern Europe and Central Asia, HumanDevelopment Sector, the World Bank Financing of this work was generously provided by the Millennium Challenge Corporation.
Abstract
:The Double Burden of Malnutrition (DBM) is the coexistence of both undernutrition andovernutrition in the same population across the life course.
Across the life course
refers to the phenomenon that undernutrition early in life contributes to an increased propensity for overnutrition in adulthood. The DBM affects all countries, rich and poor, and is a particular concern in countries with high stunting rates. The consequences of the DBM are enormous; earlylife undernutrition is an underlying cause associated with about a third of young child deaths.Among the survivors who become stunted during the first two years of life, their capacity to resistdisease, to carry out physical work, to study and progress in school, are all impaired across thelife course. Later in the life course, diet and nutrition, and especially obesity, are importantunderlying causes of many non-communicable diseases (NCDs), including hypertension,diabetes, cancer, stroke, and ischemic heart disease. The causes of the DBM are related to a seriesof changes occurring in the world called the
nutrition transition,
the
demographic transition,
andthe
epidemiological transition
of countries. The variables associated with the nutrition transitionand obesity epidemic can be grouped into four cross-cutting themes, which include: (i) theHealth/Biological Environment; (ii) the Economic/Food Environment; (iii) the Physical/BuiltEnvironment; and (iv)the Socio/Cultural Environment. The solutions for the DBM problems arereasonably well recognized in each of its parts: undernutrition and overnutrition. However, thesolutions have not been combined into an overarching policy and program framework, whichtogether with raising awareness about the serious future implications for the low-and middle-income countries is the aim of this paper.
Keywords
: Undernutrition, Overnutrition, Obesity, Double Burden of Malnutrition
Disclaimer 
: The findings, interpretations, and conclusions expressed in the paper are entirelythose of the authors, and do not represent the views of the World Bank, its Executive Directors, or the countries they represent.
Correspondence Details
:
Claudia Rokx, Lead Health Specialist, ECSH1, World Bank, 1818H Street N.W. Washington DC, 20433, crokx@worldbank.org 

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