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Written Paper

Micronutrient Malnutrition, Obesity, and Chronic Disease in Countries Undergoing the Nutrition Transition: Potential Links and Program/Policy Implications  [2006]

Eckhardt, Cara L.;

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Background: The nutrition transition occurring in many developing countriesmay invite the misconception that diets are moving entirely away from undernutritiontoward problems of excess. But despite the sufficiency of energy in these countries, dietquality is poor and micronutrient deficiencies often remain. In this context, micronutrientdeficiencies may actually contribute to the development and severity of diet-relatedchronic diseases.Objectives: This paper discusses the potential long-term effects of micronutrientmalnutrition in early childhood on obesity and related disease outcomes. The linksbetween early micronutrient malnutrition, stunting, and subsequent short adult stature—emerging risk factors for obesity and associated chronic diseases—are reviewed. Thispaper also explores recent literature linking micronutrient malnutrition in adults toincreased risk and severity of chronic disease. Finally, this paper discusses the programand policy implications of these relationships.Methods: Literature searches on the topics of interest were conducted in Medline.This paper is not the result of a systematic literature review, but rather discusses relevantliterature to bring attention to links between under- and over-nutrition that have not beenwidely considered.Conclusions: In children, micronutrient malnutrition is a cause of stunting andmay be accompanied by metabolic adaptations that increase the risk of later obesity andrelated disease. In adults, deficien
cies in key micronutrients may promote oxidativestress, folate deficiency may increase risk for heart disease, and zinc deficiency may beexacerbated in the presence of diabetes while also affecting glucose transport. Low fruitand vegetable consumption may additionally increase the risk of cardiovascular disease(CVD) and cancer through a variety of mechanisms. The importance of supporting programs and policies that address the spectrum of malnutrition, including micronutrientmalnutrition and emerging obesity together, is stressed.