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The Double Burden of Malnutrition in East Asia & Pacific

August 17, 2010

  • Many East Asian Countries like Indonesia and Phillipines are still dealing with double burden of malnutrition
  • One is under nutrition and underweight rates and the other one is having epidemic of obesity, diabetes or other diseases related to over nutrition.
  • Recent Workshop organized by the World Bank produced a series of Business Plans in addressing malnutrition at scale in each of the participating countries

Bali, June 9, 2010 – Having achieved remarkable levels of economic growth, the Bank’s East Asian clients are now left between a rock and a hard place on the human development front. On the one hand, many East Asian countries are still dealing with issues of under-nutrition and persistent underweight rates among women and children 0-2 years of age. On the other hand, these same countries are also heading straight into an epidemic of obesity, diabetes and other non-communicable diseases related to over-nutrition—until recently the exclusive plight of developed countries.

“Obesity in East Asia is like a train crash waiting to happen,” said Professor Boyd Swinburn of Deakin University in Melbourne, Australia, one of the keynote speakers at Scaling Up Nutrition Investments in EAP (East Asia & Pacific), a regional consultation held on June 9-11, 2010.

As part of this consultation event, the World Bank organized a workshop in Bali, Indonesia to engage the region on the double burden of malnutrition. “In 2005, we had successful consultations with African countries on reaching their Nutrition MDG Targets. We thought it would be useful for countries in EAP to share operational experiences on what works and doesn’t work, in terms of scaling up successful nutrition interventions,” said Claudia Rokx, Lead Health Specialist for East Asia and the Pacific.


In Cambodia and the Philippines too many babies begin
life already malnourished, weighing in at less than 2500
grams at time of birth

The six countries participating in the workshop all have serious undernutrition in children under five, with alarmingly high prevalence rates: 40-50% in Cambodia, Laos and Timor Leste; and well above 20% in Indonesia, the Philippines and Vietnam. In Cambodia and the Philippines too many babies begin life already malnourished, weighing in at less than 2500 grams at time of birth. Yet incredibly, lifestyle and dietary changes are likely to propel these countries into a myriad of problems related to over-nutrition in the near future. The Pacific Islands suffer some of the highest obesity rates in the world. The Philippines and Indonesia already face the double burden of both under- and over-nutrition.Country participants could all relate to the fact that the growing number of overweight and obese people in China is a by-product of changing cultural values: “Some parents [in China] take their children to Western fast food restaurants, not only to save time, but also because eating there seems to elevate social status,” explained Dr. Jiang Jingxiong from China’s National Center for Women’s Health, who served as a technical advisor at the workshop.

Addressing under- and over-nutrition at the same time would take strong political will, an emphasis on educating consumers, innovative approaches, functioning public health systems, and partnerships with the private sector. Fortunately, as Leslie Elder, World Bank Senior Nutrition Specialist in the Human Development anchor described to the group “there is a growing global momentum to make the needed investments in nutrition at scale.”

A policy brief outlining a consensus framework for action on nutrition—signed by more than 100 agencies and institutions from around the world—was launched in April at a meeting hosted by Japan, USAID, Canada, and the World Bank. The objectives of the meeting were:

  • to allow country teams to meet and review the nutrition situation in their respective countries;
  • to share current technical nutrition information and effective approaches to prevent and treat under-nutrition;
  • to share strategies to prevent or mitigate over-nutrition;
  • to exchange information and experiences in implementing nutrition programs in the region

“The interface of basic social services with strong people participation at the community level is crucial for the prevention and control of the double burden of malnutrition,” emphasized Prof. Kraisid Tontisirin, Senior Advisor for Thailand’s Institute of Nutrition.

The key outcome of the Bali consultation was a series of Business Plans to move towards investing in and addressing malnutrition at scale in each of the participating countries. One example of a promising business plan came from the conference’s host country. Having taken on board some of the evidence presented at the consultation, Indonesia committed to launching a pilot study on how to prevent obesity through school and community initiatives, an issue that to date has not gained prominence among policymakers.