What is Impact of Malnutrition vs Carrying Excess Weight on Health Risk?
Being overweight doesn't equate to being overnourished. Nutrition is much more complicated than energy balance. Nutrition poverty, food security and poor dietary choices can result in being overweight and undernourished. Today we ask, how much of the increased risk observed with excess weight could be the consequence of insufficient intakes of essential nutrients (vitamins and minerals)?
To begin, let’s examine the relationship among adiposity and physical activity and sleep. Physical inactivity and short sleep duration are associated with obesity. However, researchers are finding evidence that low physical activity and long periods of sedentary behavior may be a result of fatness rather than a cause.
Similarly, insufficient vitamin and mineral intake may be contributing to health risk among a segment of the overweight and obese, i.e. the malnourished. Eating a Mediterranean diet consist of olive oil, almonds, and citrus fruit is associated with longevity and low levels of obesity. Low fruit and vegetable consumption is prevalent globally. As people migrate from rural to urban settings, the prevalence of unhealthy lifestyles, obesity and non-communicable diseases increases (Riha et al., 2014). Comparing the most urban and rural villages in Uganda, urbanites had a 50% increase in overweight, a 3X increase in heavy drinking, and were 20% more likely to have low physical activity levels or a diet low in fruits and vegetables (Razak & Berkman, 2014). What is the health impact of being overweight versus being malnourished? How much of the burden of obesity could be attributable to a lack of vitamins and minerals?
The question is complex. Food intake may be underreported, especially by the overweight, and methods of preparation (frying, use of condiments/sauces) need to be considered (Bradlee et al., 2010).
More studies are needed using objective measures of status (body weight, body composition, fitness, nutrient status) among the underweight, normal weight and overweight.
Riha J, Karabarinde A, Ssenyomo G, Allender S, Asiki G, Kamali A, Young EH, Sandhu MS, Seeley J. Urbanicity and lifestyle risk factors for cardiometabolic diseases in rural Uganda: A cross-sectional study. 2014 PLoS Med doi: 10.1371/journal.pmed.1001683
Hjorth MF, Chapult J-P, Ritz C, Dalskov S-M, Andersen R, Astrup A, Tetens I, Michaelsen KF, Sjodin A. Fatness predicts decreased physical activity and increased sedentary time, but not vice versa: support from a longitudinal study in 8- to 11-year-old children. 2014 Int J Obesity doi: 10.1038/ijo.2013.229
Razak F, Berkman L. Urban development in sub-Saharan Africa: Bearer of Goods and Risks. 2014 PLoS Med doi: 10.1371/journal.pmed.1001684
Bradlee ML, Singer MR, Queresh MM, Moore LL. Food group intake and central obesity among children and adolescents in the Third National Health and Nutrition Examination Survey (NHANES III). 2010 Public Health Nutr doi: 10.1017/S1368980009991546