Double burden of malnutrition: A silent driver of double burden of disease in low– and middle–income countries

Double burden of diseases in low– and middle–income countries (LMICs) is well recognised. However, proper understanding of the need for a joint intervention against both infectious diseases and non–communicable diseases (NCD) has arisen only recently [1]. In 2008, the proportion of premature deaths due to NCD in population under 60 years of age in low–income countries was 41%, in lower middle-income countries 28%, and in high–income countries only 13% [2]. The most frequent causes of death included cardiovascular diseases, diabetes, cancers and chronic lung disease, and the main underlying risk factors were increased blood pressure (responsible for 13% of deaths globally), tobacco use (9%), elevated blood glucose levels (6%), physical inactivity (6%), and overweight and obesity (5%) [3]. Excessive intake of calories is one of the main common factors behind those conditions and risk factors, along with other lifestyle choices and genetic predisposition.