Over and Under: The Role of Urbanization on the Double Burden of Nutrition in Developing Countries
Developing countries around the world are rapidly undergoing economic transition, resulting in increasing urbanization and rural-urban migration. Urbanization is linked to direct and indirect impacts on the nutritional transition towards obesogenic diets in the developed and developing world. However, in developing countries, the nutrition transition has led to a “double burden of nutrition” which is simultaneous occurrence of under- and over-nutrition within a population (Kennedy et al., 2006). Often, the prevalence of over-nutrition is outpacing reductions in the prevalence of under-nutrition (Dearth-Wesley et al., 2008), resulting in an overlap where both problems co-exist in the same household (Doak et al., 2000) or even the same individual (Pop- kin et al., 1996). The severity and consequences of under and over-nutrition have been extensively studied, showing the detrimental health effects on children and adults. The global scope of the double burden of nutrition has been widespread and identified as an emerging public health concern in numerous developing countries in Asia, Africa, the Middle East, and Latin America (Ramachandran, 2006; Pedro et al., 2006; Hassan et al., 2006; Steyn et al., 2006; Custodio et al., 2010; Motlagh et al., 2010; Raphael et al., 2005; Barquera et al., 2006). This emerging public health crisis will undoubtedly add additional strains to the economy and health care systems of developing countries.