Module 4: Overnutrition

By 2020, an estimated two-thirds of the global burden of disease will be caused by chronic non-communicable diseases, most of which are associated with diet.(1) However, while hunger is a tremendous global health concern that cannot be minimized, overnutrition should similarly be addressed as a top priority. The global prevalence of malnutrition and undernutrition is devastatingly high—one billion people are adversely affected by malnutrition, but another one billion people suffer from obesity.(2) Globally, the problem is not the availability of food resources, but the allocation of food.

Definition

Overnutrition is defined as the overconsumption of nutrients and food to the point at which health is adversely affected.(3) Overnutrition can develop into obesity, which increases the risk of serious health conditions, including cardiovascular disease, hypertension, cancer, and type-2 diabetes.

Until recently, overnutrition had been viewed as a problem that only affected developed nations. However, overnutrition is a growing problem worldwide. The World Health Organization (WHO) describes the current problem: “In the poorest countries, even though infectious diseases and undernutrition dominate their current disease burden, the major risk factors for chronic diseases are spreading. The prevalence of overweight and obesity is increasing in developing countries, and even in low-income groups in richer countries.”(4) Problems of overnutrition are increasing even in countries where hunger is prevalent. In 2002, the WHO reported that the levels of overweight and obese women in the Eastern Mediterranean region and North Africa exceed those in the United States, while levels of overweight and obese women in Eastern Europe and Latin America are similar to those in the United States. Furthermore, obesity is now becoming a marker of poverty in a growing number of nations, including Brazil and Mexico.(5)

Factors Contributing to Overnutrition

The United States is now engulfed in an obesogenic environment. The National Center for Health Statistics found that in 2009, 35.7% of adults in the U.S. were obese, and even more were overweight.(6) As of 2002, there were over 170,000 fast food restaurants and three million soft drink vending machines in the United States alone.(7) Furthermore, a survey found that only 38% of meals were homemade.(8) Restaurants are serving incredibly caloric meals, with some meals containing 2,000 calories. People are becoming more sedentary in both the home and office.

This obesogenic culture has spread to other nations, including many developing countries. China, for example, now has nearly 3,000 Kentucky Fried Chicken (KFC) restaurants, with one new KFC opening in mainland China almost every day.(9) McDonald’s has already opened 1,300 locations in China and has plans to open up one new restaurant every day for another two years.(10) Furthermore, a growing number of Chinese households own television sets, personal vehicles, and other technologies that reduce physical activity and facilitate weight gain.

Economic inequality in these nations is a primary cause of both overnutrition and undernutrition. Studies conducted in India show that income inequality had the same effect on the risk of being overweight as it did on the risk of being underweight; specifically, for each standard deviation increase in income inequality, the odds of being underweight increased by 19% and the odds of being obese increased by 21%.(11) While some people have the resources to purchase amounts of food beyond their daily caloric requirements, others cannot meet their recommended caloric intake. However, increasing numbers of poor people are becoming overweight in more nations, as these individuals consume affordable, yet highly caloric meals, such as fast food and processed foods.

Overnutrition Interventions

The WHO began sounding the alarm to the overnutrition epidemic in the early 1990s. Since then, the WHO has initiated public awareness campaigns targeting policy-makers, private sector partners, medical professionals, and the general population. The WHO began collaborating with universities, including the University of Sydney (Australia) and the University of Auckland (New Zealand), to understand the economic impact and factors of overweight and obesity.(12) The WHO has also formulated a Global Strategy on Diet, Physical Activity and Health, which outlines steps to combat global overnutrition. The overall goal of the Global Strategy is to “promote and protect health by guiding the development of an enabling environment for sustainable actions at individual, community, national and global levels that, when taken together, will lead to reduced disease and death rates related to unhealthy diet and physical inactivity. These actions support the United Nations Millennium Development Goals and have immense potential for public health gains worldwide.”(13) 

Footnotes

(1) Chopra M, Galbraith S, Darnton-Hill I: A global response to a global problem: the epidemic of overnutrition.  Bulletin of the World Health Organization 2002, 80:952-958.

(2)“Nutrition In Global Health.” Global Health Education Consortium, 29 June 2011. Web. 15 May 2012.

(3) Parks, Naomi. "What Is Overnutrition and Undernutrition?" Livestrong. 18 Aug. 2011. Web. 16 May 2012.

(4) World Health Organization. World Health Assembly. Global Strategy on Diet, Physical Activity and Health. 2004.

(5) Chopra M, Galbraith S, Darnton-Hill I: A global response to a global problem: the epidemic of overnutrition.  Bulletin of the World Health Organization 2002, 80:952-958.

(6) Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity in the United States, 2009–2010. NCHS data brief, no 82. Hyattsville, MD: National Center for Health Statistics. 2012.

(7) Chopra M, Galbraith S, Darnton-Hill I: A global response to a global problem: the epidemic of overnutrition.  Bulletin of the World Health Organization 2002, 80:952-958.

(8) Ibid.

(9) Rooney, Ben. "China: The New Fast Food Nation." CNNMoney. Cable News Network, 13 July 2010. Web. 16 May 2012.

(10) Polis, Carey. "McDonald's China Plans To Open A New Store Every Day In Four Years." The Huffington Post. TheHuffingtonPost.com, 29 July 2011. Web. 16 May 2012.

(11) Subramanian SV, Kawachi I, Smith GD. Income inequality and the double burden of under- and overnutrition in India. J Epidemiol Community Health 2007;61:802–9.

(12) "Controlling the Global Obesity Epidemic." WHO. Web. 16 May 2012.

(13) World Health Organization. World Health Assembly. Global Strategy on Diet, Physical Activity and Health. 2004.