Too few nutrients and too many calories: climate change and the double burden of malnutrition in Asia

About half of children age under five worldwide who are classified as undernourished (84 million out of 151 million) or overweight or obese (17.5 million out of 38 million) live in Asia. Tackling malnutrition in Asia is however fairly complex since the nutritional transition, a consequence of rapid economic development and globalisation, made many Asian nations undergo the simultaneous burdens of under- and over-nutrition. The dual burden of malnutrition is characterised by a concurrence of undernutrition along with overweight and obesity within the same individual, household, community, region and/or country. Providing that household food security is closely linked to malnutrition, this raises questions about the implications of climate change on the dual burden of malnutrition. That climate change affects food availability, access, utilisation and stability is evident. Accordingly, households facing food insecurity due to climatic shocks may allocate food differentially. Adult members may receive low-cost high-calorie food inducing obesity, whilst children receive nutrient-poor foods leading to undernutrition. Little is known about the climate impacts on the double burden of malnutrition and how this affects population subgroups differentially. This Editorial discusses the potential impacts of climate change on the double burden of malnutrition and concludes with the recommendation of strategies to tackle the issue.     

Sex,Socioeconomic and Regional Disparities in Age Trajectories of Childhood BMI,Underweight and Overweight in China

Using a longitudinal dataset from the China Health and Nutrition Survey (CHNS), growth-curve models were employed to examine age trajectories of body mass index (BMI) for 1694 subjects in China, who were aged 2–11 in 1993 and followed in four waves (1997, 2000, 2004 and 2006). Based on age- and sex-specific BMI cut-points recommended for international use, the prevalence rates of overweight and underweight in the transition from childhood to adulthood (age 6–18) were also predicted. Sex, family income, rural–urban residency and geographical location were found to be significantly associated with the onsets, slopes, and acceleration of age trajectories in BMI, overweight, and underweight (p < 0.01). Children who had lower prevalence of underweight in the transition from childhood to adulthood exhibited higher prevalence of overweight than their counterparts. Moreover, the age interval during which children were more vulnerable to an increase in underweight was different from that for overweight. There were substantial regional disparities in the age trajectories of childhood overweight and underweight. Whereas the analyses suggest that the dual burden of nutritional problems (the coexistence of overweight and underweight) in China, is more like two sides of a coin than two separate health issues; the critical age period for intervening in childhood overweight is different from that of childhood underweight. Geographical indicators of childhood obesity in China deserve further attention.     

Under the one child policy regime in China: did having younger sibling(s) increase the risk of overweight and underweight status?

The implications of having any younger sibling(s) on child overweight and underweight status under China’s One Child Policy Regime are complicated by multiple factors, including potential resource dilution, the stage of economic development, changing child-rearing norm, mandated birth interval and parental son preference. Using the instrumental variable method and data from China Health and Nutrition Survey 1991–2006, we find that having younger sibling(s) generally does not affect a firstborn child’s risk of being overweight or obese, neither does it increase the risk of being underweight. The findings on underweight status suggest that the favourable effect of economic growth and child rearing practice have outperformed the resource dilution effect in basic nutrition needs through the years of the study. It implies that further relaxation of the One Child Policy should not increase the nutritional risk for children.