Over one in three low-middle-income countries face malnutrition.

NEW YORK -- A new approach is needed to help reduce undernutrition and obesity at the same time, as the issues become increasingly connected due to rapid changes in countries' food systems. This is especially important in low- and middle-income countries, according to a new four-paper report published in The Lancet. More than a third of such countries had overlapping forms of malnutrition (45 of 123 countries in the 1990s, and 48 of 126 countries in the 2010s), particularly in sub-Saharan Africa, south Asia, and east Asia and the Pacific.

Undernutrition and obesity can lead to effects across generations as both maternal undernutrition and obesity are associated with poor health in offspring. However, because of the speed of change in food systems, more people are being exposed to both forms of malnutrition at different points in their lifetimes, which further increases harmful health effects.

"We are facing a new nutrition reality," said lead author of the report Dr Francesco Branca, Director of the Department of Nutrition for Health and Development, World Health Organization. "We can no longer characterize countries as low-income and undernourished, or high-income and only concerned with obesity. All forms of malnutrition have a common denominator - food systems that fail to provide all people with healthy, safe, affordable, and sustainable diets. Changing this will require action across food systems - from production and processing, through trade and distribution, pricing, marketing, and labelling, to consumption and waste. All relevant policies and investments must be radically re-examined."

In a Lancet editorial accompanying the report, Dr Richard Horton, Editor-in-Chief of The Lancet, says: "Today's publication of the WHO Series on the Double Burden of Malnutrition comes after 12 months of Lancet articles exploring nutrition in all its formsa[euro]A| With these and other articles across Lancet journals throughout 2019, it has become clear that nutrition and malnutrition need to be approached from multiple perspectives, and although findings have sometimes converged, there is still work to be done to understand malnutrition's multiple manifestationsa[euro]A| With 6 years remaining in the UN Decade of Action on Nutrition (2016-2025), this Series and Comment define the...