By: Mimi Chung
Obesity, a growing problem in industrial and post-industrial countries, is in many areas intertwined with malnutrition. Though many industrial nations have seen a sharp increase in the number of people facing problems stemming from obesity, such as heart disease and diabetes, hunger and undernutrition still persist in wide swaths of the same nation. In China, 100 million citizens faced obesity in 2009, while 200 million suffered from undernutrition. Increasingly, developing countries face the double threat of the food paradox: confronting over and undernutrition at the same time.
Increasingly, developing countries face the double threat of the food paradox: confronting over- and undernutrition at the same time.
The World Food Programme estimates that some 795 million people around the globe still face severe problems with hunger and food insecurity, with a majority living in developing nations. Even as statistics for the number of undernourished people slowly decline, stunting in children suggests that much more needs to be done: for example, South Africa reports approximately 12% of their children as underweight, and 27% as still exhibiting signs of stunting.
On the other hand, global trends reveal that obesity has continued to increase, even in nations still struggling with hunger – one in three people around the world are overweight, with an increase of 4.5% in children from 2000 to 2015. Surprisingly, 62% of these overweight individuals live in developing countries, indicating the increasing prevalence of these nations having both an obesity epidemic and persistent hunger. Nutritionists have coined the phrase “nutrition transition” to define the phenomenon – as the area becomes more wealthy, those with more access to resources will naturally increase in weight much faster than those without. However, this phrase suggests that eventually, the entire country will soon face a uniform struggle with obesity. Real-life statistics paint a much more nuanced portrait of the future.
Though a stereotypical portrayal of obese people commonly connects higher weight with increased wealth and access to more food, overweight individuals can be found at both ends of the socioeconomic spectrum, often dictated by the relative wealth of their nation. For less industrialized or lower-income nations, obesity and wealth are more likely to be directly correlated. Problems stemming from being overweight concentrate on urban populations, where income tends to be much higher. This phenomenon makes the most sense logically – with more money, people can buy more food and are thus at more risk for gaining too much weight. However, those in poverty can and do face the same nutritional issues as those with a higher income. Especially prevalent in more well-off nations is the existence of a high poverty, high obesity connection. As countries become more industrialized, high calorie and low nutrition foods becomes cheaper and easier to obtain, and food deserts, or areas with few options for healthy foods like fresh fruits and vegetables, grow more prevalent in large cities.
Thus, obesity cannot be tied directly to income or the wealth of a nation. Similarly, hunger issues persist even in the wealthiest areas. Almost 15.7 million facing chronic hunger live in developed nations while the Pew Research Institute study saw over 20% of Americans struggle to afford groceries in 2012. For all nations, infrastructure and social support nets contribute greatly to the inability to effectively combat this continuing and systematic issue.
Strikingly, nutritional deficits and obesity are not mutually exclusive: numerous studies highlight the seeming contradiction of having too much to eat and yet receiving too few nutrients. Even though many overweight people are getting an overabundance of calories in their daily diet, they lack several essential micronutrients, creating yet another hunger paradox of being both overweight and undernourished. For example, Vitamin D deficiencies in obese people in America range from 80% to 90%; 17% to 79% of obese people looking to undergo surgery have a severe lack of thiamine, a nutrient that works in regulatory systems.
Therefore, obesity and malnutrition cannot be extracted from each other – many causes of obesity like fast and junk food can be implicated in the high level of malnutrition in these populations. Implications of this connection may be vast, especially in hospital settings. Because of the difficulties in sight identification of malnutrition in overweight individuals as well as a general lack of laboratory tests for malnutrition, clinicians may fail to take this issue into account when the patient is recovering from treatment. This problem is especially worrying for those undergoing surgery for weight loss, since their treatment team may miss an important factor essential for convalescence.
While obesity and hunger may once have existed as separate entities for nations to tackle individually, the continued development and socioeconomic changes within countries now requires multiple initiatives to tackle both forms of food issues. Simply addressing one is insufficient to solving the dual threat of food overabundance and underabundance.