Double burden of malnutrition in persons with obesity

Rev Endocr Metab Disord. 2020 Sep;21(3):307-313. doi: 10.1007/s11154-020-09578-1.

Abstract

A paradoxical double challenge has emerged in the last decades with respect to nutrition and nutrition-related clinical conditions. Hunger-related undernutrition continues to represent an unacceptable burden, although its prevalence has been encouragingly reduced worldwide. On the other hand, the prevalence of overweight and obesity, defined as fat excess accumulation with negative impact on individual health, has dramatically increased due to increasingly pervasive obesogenic lifestyle changes. Undernutrition and obesity may coexist in world regions, Countries and even smaller communities and households, being referred to as double burden of malnutrition. It is however important to point out that fat accumulation and obesity may also induce additional nutritional derangements in affected individuals, both directly through metabolic and body composition changes and indirectly through acute and chronic diseases with negative impact on nutritional status. In the current narrative review, associations between fat accumulation in obesity and malnutrition features as well as their known causes will be reviewed and summarized. These include risk of loss of skeletal muscle mass and function (sarcopenia) that may allow for malnutrition diagnosis also in overweight and obese individuals, thereby introducing a new clinically relevant perspective to the obesity-related double burden of malnutrition concept.

Keywords: Malnutrition; Obesity; Sarcopenia; Sarcopenic obesity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adipose Tissue / metabolism
  • Feeding Behavior / physiology
  • Food Preferences / physiology
  • Humans
  • Life Style
  • Malnutrition / complications*
  • Malnutrition / epidemiology
  • Malnutrition / metabolism
  • Nutritional Status / physiology
  • Obesity / epidemiology
  • Obesity / etiology*
  • Obesity / metabolism
  • Sarcopenia / epidemiology
  • Sarcopenia / etiology
  • Sarcopenia / metabolism