Double burden of malnutrition: a contemporary global health challenge

23 Mar 2021

The double burden of malnutrition (DBM) is recognised by the World Health Organisation (WHO) as an important contemporary global health challenge. DBM is the co-existence of underweight and overweight (obesity) at the individual, household or population level. Addressing DBM is seen to be key to achieving the Sustainable Development Goal 2.2 (SDG2)—a set of nutritional targets to be achieved by 2030, with the goal of eradicating all forms of malnutrition worldwide. 

DBM is currently of greatest concern in many low to middle-income countries. For example, while the burden of underweight is well known and targeted by policy interventions in South and Southeast Asian countries, obesity remains neglected as a public health issue. If immediate action is not taken, significant numbers of people will develop an array of serious and chronic health disorders and incur huge health care cost due to these nutritional disorders.

By undertaking the first systematic evaluation of the scientific literature on population level and household level DBM in Southeast Asia, this research aimed to:

  • understand and identify the current status of DBM in eight countries[1].
  • identify what can be done to improve DBM at a policy level.
  • assess South and Southeast Asia’s progress towards its SDG2 target in particular by estimating trends and forecasting the prevalence of underweight and overweight by 2030.

“We found a decline in the prevalence of underweight and an increase in the prevalence of overweight among women in South Asia and Southeast Asia over the study period”.

Other key findings included:

  • the prevalence of both underweight and overweight/obesity is higher in those who with lower education compared to those who had higher education.
  • being underweight was more pronounced in rural populations compared to populations living in urban centres.
  • at the household level, DBM in South and Southeast Asian countries is gradually increasing.

These findings also demonstrate that countries in South and Southeast Asia are unlikely to achieve the nutrition related SDG2 target unless urgently initiated policies to achieve these targets are implemented.

Other policy implications of these findings suggest that the promotion of education for women may aid in overcoming the DBM at the population and household levels. This research also developed subnational level prevalence maps for DBM that could be used by malnutrition programs to better target interventions.

Future research should investigate within-country driving forces behind the increasing rates of overweight and explain the inequalities in both conditions. Policy approaches should be developed to counter DBM, with integrated interventions to combat both overweight and undernutrition.

The full publication, Double burden of malnutrition among women in South and Southeast Asia: Geographical variation, health inequality and health achievement is available here.

This research was led by Tuhin Biswas under the supervision of Associate Professors Abdullah Mamun (ISSR), Associate Professor Ricardo J Soares Magalhaes (UQ) and Associate Professor Nick Townsend (University of Bath). Tuhin will continue working with ISSR in a Post-Doctoral Research Fellow position within the Social Science of Health research group.


[1] Bangladesh, Cambodia, East Timor, India, Maldives, Myanmar, Nepal and Pakistan.