Physiological aspects of the double burden of malnutrition: iron deficiency and obesity

The steady decline in the prevalence of undernutrition globally has been accompanied by a rapid increase in overweight, obesity, and associated non-communicable diseases. As a consequence, many countries are now faced with the coexistence of under- and overnutrition. This double burden of malnutrition poses critical challenges for programs and policies.

The proposed symposium will document this complex set of challenges related to the double burden of malnutrition by presenting research on the physiological and program- and policy-related aspects of this problem. The objective is to show that solutions will have to integrate a wide-set of perspectives and disciplines to be effective. The symposium will feature three presentations.

Dra. Ana Carla Cepeda López (Universidad de Monterrey, Mexico) will present her research on the physiological aspects of the double burden. Studies have reported an increased risk of iron deficiency in overweight and obese subjects Dra Cepeda's work in Mexico and Switzerland using stable isotopes shows that this is mainly the result of reduced dietary iron absorption which, in turn, is due to increased inflammation and hepcidin concentrations. Additionally, hemodilution due to higher blood volume at least partly contributes to the observed hypoferremia. Dra. Cepeda will show how inflammation and the increase in blood volume in overweight and obese compared to normal-weight individuals affects the interpretation of iron biomarkers; in addition, she will discuss how these findings complicate the development of effective interventions to improve iron status in overweight populations.

The second presentation, by Dr. Jef Leroy (International Food Policy Research, USA), will feature program evaluation research conducted in Guatemala, a country with one of the highest global rates of under-five stunting and a simultaneous rapid increase in overweight and obesity. A cluster-randomized controlled trial was conducted to evaluate the impact of a food-assisted integrated maternal and child health and nutrition program. The intervention met its objective of reducing child stunting. Dr. Leroy will present the intervention’s undesirable effect on weight gain in mothers and the challenges for future nutrition programs.

Dr. Olivier Ecker (International Food Policy Research, USA), will present his research on the policy aspects of the double burden. Social protection policies and programs can aggravate the problem of the double burden but may also provide a gateway to mitigate the negative effects associated with economic growth, depending on their design. Dr. Ecker will show how food subsidies in Egypt have contribute to the double burden. He will also discuss the potential implications of a reform of the food subsidies toward a more nutrition-sensitive social protection system and discuss how his findings apply to the Latin American context.

After each presentation, time for clarifying question will be provided. At the end of the symposium, we foresee ample time for questions and discussions with the audience.