Two Sides of the Same Coin: Strategies to Address Under- and Over-Nutrition.

Although malnutrition in the form of child wasting, stunting, and micronutrient deficiencies remain prevalent on many of the poorest and war-torn places on earth, there has been major progress in other regions and the direction of travel remains generally good. However, as countries pass through the economic transition there has been a seemingly inevitable rise in overweight and obesity with its attendant personal health costs (reduced life span due to obesity-related chronic conditions) and a rise in the societal costs of care. Strategies, by healthcare professionals and others, to combat the two sides of the malnutrition coin must be built on a solid foundational knowledge of the causes of each condition. The individual, nutritional, and environmental drivers are summarized here. It is sometimes helpful to focus on a single unifying concept as a way of rationalizing the causes and required solutions; namely the nutrient density of foods. Malnutrition is caused, inter alia, by foods lacking in sufficient energy, protein, and micronutrients. The same is true for obesity which, in large part, is driven by foods overly dense in energy but lacking other critical nutrients. Food quality therefore emerges as a key concept that healthcare professionals can adopt as they educate parents and children at the microlevel and schools, health systems, and government bodies at the macrolevel.

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