From Undernutrition to Overweight: A Comprehensive Approach to Dual Malnutrition

Nutrition plays a crucial role in health and development. Optimum nutrition that provides an adequate intake of essential nutrients to support human life is the cornerstone of good health. The coexistence of undernutrition and overnutrition (obesity) in the same population across the life course is called the double burden of malnutrition. Undernutrition is associated with non-communicable diseases, a global health issue, with most cases arising in low-and middle-income countries (LMICs). Although many LMICs have remarkably improved their nutritional status in the past decade, undernutrition still exists, coupled with increased overweight and obesity prevalence in some countries. The co-existence of undernutrition and overnutrition, known as the “double burden of malnutrition,” is driven by dietary patterns and nutrient intake changes, described as the “nutrition transition.” The last two centuries have seen a fundamental transformation of diets in all countries. This chapter describes the relationship between nutrition and health, the “double burden of malnutrition” phenomenon, and its drivers, including nutrition transition, and explains their consequences on health and development. The chapter also explores the relevance of nutrition in physical therapy, pathogenesis, and diagnosis of malnutrition, including the sequelae of undernutrition, nutritional rehabilitation, and medical nutrition therapy in managing undernutrition. Furthermore, the chapter presents a synopsis of the clinical practice guidelines utilized in the management of both undernutrition and obesity. It delves into evidence-based strategies for the prevention and treatment of obesity, encompassing nutritional interventions, behavior modification, physical activity, pharmacotherapeutic approaches, noninvasive endoscopic procedures, and bariatric surgery. Finally, the chapter addresses the interdisciplinary approach to managing dual malnutrition, using clinical vignettes and case studies to enrich and contextualize the discussion.