Obesity: Not Just a US Problem
The effects of hunger and under-nutrition on maternal and child health in low-income and middle-income countries have been well-studied. Some regions, such as Southeastern Asia and sub-Saharan Africa, certainly still struggle with child hunger. But globalization has made the world wealthier, and wealth and weight are linked. Now obesity, generally considered a problem of affluent nations, is emerging as a leading threat to child health in the developing world. As poor countries move up the income scale and switch from traditional to Western diets, obesity rates rise.
One result of this so-called “nutrition transition” is that low- and middle-income countries often face a dual burden: the infectious diseases that accompany malnutrition, especially in childhood, as well as the increasingly debilitating chronic diseases linked to obesity and Western lifestyles. Childhood obesity, like stunting, is a form of malnutrition characterized by life-threatening micronutrient deficiency. The rising rate of obesity and Type 2 Diabetes in some of the poorest countries is alarming (1,2).
In 2010, the International Association for the Study of Obesity/The International Obesity Taskforce (IASO/IOTF -- now called World Obesity) estimated that up to 200 million school-aged children were either overweight or obese; of those, 40-50 million were classified as obese, and 43 million preschool age children (<5 years) were overweight or obese (35 million live in developing countries), a 60% increase since 1990(1,3,4).
For example, in Africa, hunger, underweight, and stunting have long been the more pressing child nutrition concerns, and even today, 20 to 25 percent of preschoolers in sub-Saharan Africa are underweight (5). Yet here, too, child obesity rates are on the rise: The percentage of preschoolers in Africa who are overweight or obese more than doubled over the past two decades, from 4 percent in 1990 to 8.5 percent in 2010 (4). Even though the aim of development agencies, including the United States Government, is to fight hunger and under-nutrition in the most vulnerable populations, we cannot afford to ignore the rising rates of obesity among children and women in many of the world poorest countries. Studies have shown that children born to obese mothers are at higher risk of developing childhood obesity and lower cognitive function (7,8). Obesity can harm nearly every system in a child’s body - heart, lungs, and kidneys as well as the hormones that control blood sugar and puberty - and can also take a heavy social and emotional toll. Youth who are overweight or obese have substantially higher odds of remaining overweight or obese into adulthood, increasing their risk of disease and disability later in life (6).
For long-term success, development efforts must address all facets of the malnutrition problem, not only under-nutrition alone. As part of an integrated approach, the food industry should be seen as a partner, not as a foe. Sound nutrition policies for development must engage all stakeholders: donor organizations, the private sector, non-government organizations, national governments, etc. Overabundance carries as many risks to long-term security and prosperity as scarcity -- we must develop policies to avoid falling into the nutrition transition trap as we help undernourished mothers and children.
- International Obesity TaskForce (www.IOTF.org)
- WHO Obesity: Preventing and Managing the Global Epidemic. Geneva: World Health Organization TRS 894, 2000.
- The new BMI Criteria for Asians by regional Office for the Western Pacific Region of WHO are Suitable for Screening of Overweight to prevent Metabolic Syndrome in Elder Japanese Workers, Annurad E. et al J Occup Health, 2003
- De Onis M et al, Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr. 2010; 92:1257-64.
- United Nations. Childinfo.org: Statistics by area / child nutrition / undernutrition / progress. 2012. Accessed March 6, 2012.
- Popkin BM et al. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012; 70:3-21.
- Tanda R et al, The Impact of Prepregnancy Obesity on Children's Cognitive Test Scores, Maternal child health J, Feb 2012
- Josefson JL et al, Excessive weight gain in women with a normal pre-pregnancy BMI is associated with increased neonatal adiposity, Pediatr Obes. 2013 Jan 3
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