Double Burden of Malnutrition

Double Burden of Malnutrition

This week’s discussion led me to reflect on how globalization has had an impact on maternal nutrition in developing countries. In my search, I came across many articles discussing the concept of Double Burden of Malnutrition (DBMN) which is defined by the World Bank as both under and overnutrition being present in the same population; often “across the life course” (Shrimpton & Rokx, 2013). A very interesting phenomena that is often attributed to the rise of globalization (Winichagoon, 2013). Many countries such as Cambodia, Democratic Republic, Bangladesh, and Vietnam, have now been having to deal with undernutrition in infancy and obesity in later years in the life course of an individual (Haddad, Cameron, & Barnett, 2014; Shafique et al., 2007; Shrimpton & Rokx, 2013).

One study in particular by Winichagoon (2013) studied DBMN with regards to maternal and child nutrition in Thailand by examining both food and nutrition data from national surveys between 1960 and 2009. They found that although progress was made in maternal and child undernutrition, many primary concerns still exist post globalization including nutrient deficiencies and anemia. The alarming result was the rise in not only obesity, but various diseases among women and children over the course of almost 50 years (Winichagoon, 2013). I admire one of the author’s recommendations that he refers to in the paper in that intervention programs with regards to maternal and child nutrition need to be based on findings studied over a longer period of time in order to communicate its importance in developing countries. It is through these measurable results that DBMN may be seen as a prevailing issue and appropriate nutrition programs can be implemented in the right outlets and at multiple life stages of those in the impacted communities.

However, how can we address this effect of globalization in a sustainable way in order to leverage its benefits such as developing infrastructure, increase healthcare access, food security, and trade yet at the same time, eliminate the DBMN risk?

A guided ‘framework’ that I found to be most appropriate in approaching DBMN that also touched on a lot of the points we have been discussing in class, was brought up by Pinstrup-Andersen & Babinard (2001). Here, the researchers discuss the importance of needing to manage the degree in which globalization is infiltrated through policy implementation, standards that are customized by region, and having the national institutions be the driver of these decisions. On this incremental basis, things such as food safety standards and food security can be looked at through a microscope when implementing factors of globalization such as trade agreements in order to minimize its impact on the nutrition status of both parties involved. Two primary questions when approaching policy reformation and standard creations should be examined:

            (1)   Whose standards will be used as a norm? Having customization food safety standards is important in order to outweigh high or low food prices that often come as a result

            (2)   Is there a trade-off between food safety and food security? In the evolution of an increase in trading amongst countries, high food safety standards in a more wealthier area may impact the food security of the smaller community farmer (Pinstrup-Andersen & Babinard, 2001).

It is through these open discussions that globalization can be optimally used for its many benefits to global public health initiatives as well becoming the driving force towards progress for the human race- a progress that is built on the foundation of health and opportunity for all. Perhaps its not the black and white argument of globalization being 'bad' or 'good', but the need to think of it as an intrinsic process as part our evolution. 

Would love to hear any comments or thoughts! 

References 

Pinstrup-Andersen, P., & Babinard, J. (2001). GLOBALIZATION AND HUMAN NUTRITION: OPPORTUNITIES AND RISKS FOR THE POOR IN DEVELOPING COUNTRIES. African Journal of Food, Agriculture, Nutrition and Development, 1(1), 9–18.

Shafique, S., Akhter, N., Stallkamp, G., Pee, S. de, Panagides, D., & Bloem, M. W. (2007). Trends of under- and overweight among rural and urban poor women indicate the double burden of malnutrition in Bangladesh. International Journal of Epidemiology, 36(2), 449–457. http://doi.org/10.1093/ije/dyl306

Shrimpton R, Rokx C. World Bank Health, Nutrition and Population (HNP) Discussion Paper. Washington, DC; 2013. The double burden of malnutrition: a review of global evidence.

Winichagoon, P. (2013). Thailand nutrition in transition: situation and challenges of maternal and child nutrition. Asia Pacific Journal of Clinical Nutrition, 22(1), 6–15.