CO-EXISTENCE OF OVER- AND UNDERNUTRITION RELATED DISEASES IN LOW INCOME, HIGH-BURDEN COUNTRIES: A CONTRIBUTION TOWARDS THE 17TH IUNS CONGRESS OF NUTRITION, VIENNA AUSTRIA 2001

Adequate nutrition is a basic human right, but globally it remains unmet for many pre-school children. Poverty, food insecurity and malnutrition continue to be obstacles to human rights, quality of life and dignity. The 1995 goal to eradicate poverty in the world by 2020 is not on target in developing countries; rather, poverty has been increasing. Over 800 million people suffer from malnutrition in developing countries and over 20 % of the populations are hungry. About one third of the world's population suffer from micronutrient deficiencies and hundreds of millions suffer from chronic diseases of lifestyle. Prevalence rates, particularly low birth weight, stunting and underweight, remain high particularly in Eastern Africa and South Central Asia. More than a third of all children in developing countries remain constrained in their physical growth and cognitive development. The 1990 ambitious goal of halving childhood underweight prevalence by the year 2000 has not been achieved by most countries. Global progress in fighting malnutrition is slow and crippled by rapid increase of both communicable and non-communicable diseases, the so-called “double burden of disease”. About 115 million people suffered from obesity related diseases in the year 2000. Overweight and obesity (globesity) prevalence is advancing rapidly in developing countries. Cardiovascular diseases (CVD), myocardial infarction, angina pectoris and stroke as one of the most important causes of mortality and morbidity globally, will continue to be first and second leading causes of death in the world. Most developing countries, including South Africa, currently are in the process of transition and experiencing the double burden of both communicable and non-communicable diseases in which chronic diseases of lifestyle such as CVD have emerged while the battle against infectious diseases has not been won. In the last few years the HIV/AIDS epidemic has spread extremely rapidly and is likely to double overall mortality rates, undermine child survival and halve the life expectancy over the next five years. The co-existence of over- and under-nutrition calls for urgent innovative strategies and interventions to tackle the problem. The importance of prevention as the most sensible strategy is emphasised. This overview emphasises that, in planning nutrition strategies and interventions in low income, high-burden countries such as South Africa risk factors for both over- and under-nutrition and related diseases should be targeted and addressed. Keywords: over- and under-nutrition, double burden of disease and developing countries. (Af. J. Food and Nutritional Sciences: 2001 1 (1): 34-42