The alarming sight of overweight and underweight found in the SAME household has become increasingly common especially to developing countries.
In the Philippines, according to the latest available statistics provided by the Food and Nutrition Research Institute (DOST), there was an increase in the trend of OVERWEIGHT and OBESITY from 16.6% in 1993 to 29.9% in 2013.
Three (3) in every 10 adults are OVERWEIGHT and OBESE and more female adults are overweight and obese.
On the other hand, in a separate study for children over the same year, it was noted that there was a slight reduction in underweight among the 0-10 years old.
UNDERWEIGHT prevalence of 0-5 y/o = 19.9%
UNDERWEIGHT prevalence of 5-10 y/o = 29.1%
However, despite the decline over the years, underweight issue still remains to be a medium-to-high and a public health concern.
Co-existence of underweight and overweight remains as challenge to public health authorities since the program to reduce under-nutrition can apparently be the OPPOSITE for those of obesity prevention.
Following the conventional nutrition guidelines, if we want to prevent obesity, people HAVE TO EAT LESS. On the contrary, if we want to prevent under-nutrition, we have to PROVIDE MORE FOOD.
And since both underweight and overweight are becoming widespread, moreover, they are found in the same household, it leaves us health experts with a tough question:
WHAT DO WE DO NOW?
Overnutrition & Undernutrition (The Dual Burden of Malnutrition)
These two forms of malnutrition are both associated with adverse health conditions:
Obesity/Overweight is associated with chronic diseases such as hypertension, stroke, diabetes type 2, and cancer. In particular, obesity in childhood may even lead to EARLIER ONSET of these chronic diseases.
Underweight is linked to poor infant and maternal health as well as to compromised childhood growth and development.
The emergence of this phenomenon can perhaps be attributed to the changing trend in diets and lifestyle among Filipinos.
The impact of “urbanization” and “modernization” also translates to the MODIFICATIONS of dietary habits and activity levels.
Our country is not new to this problem.
In a case study conducted by Food & Nutrition Research Institute, DOST in 2003, results showed that about 59% of the child-mother pairs were suffering from two different types of malnutrition.
From this, 31 (8.2%) child-mother pairs in the same household were experiencing underweight/overweight: the child was underweight and the mother was overweight.
The study reckons that factors such as the following impact the existence of underweight child and overweight mother:
In another article in 2012 entitled “HEALTH AT A GLANCE: ASIA/PACIFIC 2012” (source: OECD/WHO 2012), the dual burden of malnutrition was also explained well.
It says that “as countries experience economic growth and lower mortality, they undergo demographic and epidemiological transition.”
The prevalence of overweight and obesity tends to increase, accompanied by rises in non-communicable diseases such as cardiovascular disease, diabetes and cancer.
For a fact, it stated that populations of a number of countries currently undergoing health transition – such as Thailand, the Philippines, Singapore and Malaysia – exhibit sizeable rates of both underweight and overweight.
The problem in a nutshell
Malnutrition such as obesity coexists with under-nutrition because of the rising shift from local or traditional diets to foods that are increasingly heavy in SUGAR (Refined carbohydrates), BAD (Trans) FATS, and PROCESSED (High Salt) FOODS.
All of these can destroy a perfectly working metabolism.
The reason for the shift is due to the INCREASING COST of nutritious and natural foods -this forces people who cannot afford to expend more on the purchase of UNHEALTHY PROCESSED FOOD over the healthy and staple but costly food.
High quality diets that are limited in TRANS-FATS, SUGAR, and PROCESSED FOODS can benefit those at risk of either UNDER or OVER weight.
Going for the more NATURAL FOOD like vegetables and fruits improves not only weight in obese people but also reduces the risks of heart disease and diabetes.
Similarly, an increase in quality protein intake accompanied by adequate physical activity can help both under/overweight groups in improving their body composition.
Since poor households are often unable to afford healthier foods, the GOVERNMENT must play a key role in monitoring and regulating the food market.
They can HELP improve access to healthy foods so that purchasing constraints of the poor can be alleviated.
Furthermore, programs promoting nutritious foods and a healthy lifestyle to address both types of malnutrition should be emphasized.
On a side note, I suddenly remember those days when my grandmother used to ask me to pick vegetables and fruits and catch native chicken from her backyard.
We are an agricultural country, it is not yet too late to bring back some sort of self-sustenance and relying more on organic. We just need to find time and practical ways.
While it is currently true that coexistence of underweight and overweight in the same families poses challenge to public health programs, I also consider however that it poses more as a challenge to our beliefs about the REAL cause of obesity & overweight.
Only a person can eventually decide what goes in and out of his body and what choices he or she has to make to remain healthy.
At the end of the day, despite all the answers laid in front of us, the choice to be well-nourished remains personal.
Alex Saroca is the founder of Tabachoy Academy. He is a general physician by profession, an author, a blogger, and an entrepreneur. He is on a mission to educate and make Filipinos realize - especially those with overweight, high blood pressure, and type 2 diabetes - that lifestyle modification is still more powerful than any drug in preventing heart disease, treating heart disease, and improving one's physical state and longevity.