{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T13:47:01Z","timestamp":1792504021401,"version":"4.5.0"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1368980026101840_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To discuss the growing challenge of the double burden of malnutrition (DBM), the co-existence of undernutrition and obesity, and the associated clinical and policy complexities in low- and middle-income countries (LMIC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980026101840_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This commentary synthesises evidence from recent multi-country and country-specific studies in sub-Saharan Africa and other LMIC. Many LMIC are typified by food insecurity, socio-economic inequalities and fragile health systems which drive DBM patterns, as well as informal community structures such as rotating savings groups which influence access to healthier diets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980026101840_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Evidence indicates that DBM disproportionately affects disadvantaged households and complicates obesity management. Current clinical guidelines remain obesity-centric and often overlook contexts where individuals with obesity may also experience stunting or micronutrient deficiencies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1368980026101840_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This commentary aligns with global frameworks including WHO\u2019s double-duty actions for nutrition, the UN Decade of Action on Nutrition (2016\u20132025) and the FAO-WFP food systems agenda. To achieve health equity, a coordinated approach is needed: clinical practice must improve diagnosis of co-existing undernutrition and obesity, while public policy must ensure that efforts to manage obesity are supported by food systems that provide equitable access to affordable, nutritious diets.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1368980026101840","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T07:06:52Z","timestamp":1768288012000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["The double burden of malnutrition: rethinking clinical and policy responses in the era of rising obesity in low- and middle-income countries"],"prefix":"10.1017","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2534-3731","authenticated-orcid":false,"given":"Akim Tafadzwa","family":"Lukwa","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"},{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Okova","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"S1368980026101840_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32822-8"},{"key":"S1368980026101840_ref8","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1451898"},{"key":"S1368980026101840_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31788-4"},{"key":"S1368980026101840_ref21","doi-asserted-by":"publisher","DOI":"10.3390\/su14063153"},{"key":"S1368980026101840_ref4","unstructured":"4. World Health Organisation (WHO) (2017) WHAT IS THE DOUBLE BURDEN OF MALNUTRITION? Double-Duty Actions for Nutrition Policy Brief. Geneva: World Health Organization."},{"key":"S1368980026101840_ref22","doi-asserted-by":"publisher","DOI":"10.2499\/9780896294417_05"},{"key":"S1368980026101840_ref23","doi-asserted-by":"publisher","DOI":"10.1596\/978-1-4648-1575-1"},{"key":"S1368980026101840_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13384"},{"key":"S1368980026101840_ref16","unstructured":"16. World Health Organization (WHO), UNICEF & World Bank (2023) Levels and Trends in Child Malnutrition Child Malnutrition: UNICEF\/WHO\/World Bank Group Joint Child Malnutrition Estimates: Key Findings of the 2023 Edition. Geneva: World Health Organization."},{"key":"S1368980026101840_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31647-0"},{"key":"S1368980026101840_ref9","first-page":"e48037","article-title":"The role of childhood obesity in early-onset type 2 diabetes mellitus: a scoping review","volume":"15","author":"Oranika","year":"2023","journal-title":"Cureus"},{"key":"S1368980026101840_ref20","doi-asserted-by":"publisher","DOI":"10.3389\/fsufs.2024.1301578"},{"key":"S1368980026101840_ref11","first-page":"34","article-title":"Urbanization and the nutrition transition","volume":"4","author":"Hawkes","year":"2017","journal-title":"Global Food Policy Report"},{"key":"S1368980026101840_ref19","doi-asserted-by":"publisher","DOI":"10.3390\/su14063153"},{"key":"S1368980026101840_ref2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20085489"},{"key":"S1368980026101840_ref17","unstructured":"17. World Health Organization (WHO) (2021) Second Round of the National Pulse Survey on Continuity of Essential Health Services during the COVID-19 Pandemic: January\u2013March 2021: Interim Report, 22 April 2021. Geneva: World Health Organization."},{"key":"S1368980026101840_ref12","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09295-z"},{"key":"S1368980026101840_ref13","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14482-1"},{"key":"S1368980026101840_ref18","unstructured":"18. United Nations System Standing Committee (2022) The UN Decade of Action on Nutrition 2016\u20132025. https:\/\/www.who.int\/news\/item\/26-03-2025-united-nations-decade-of-action-on-nutrition-(2016-2025)-extended-to-2030"},{"key":"S1368980026101840_ref3","unstructured":"3. World Health Organisation (WHO) (2016) Report of the Commission on Ending Childhood Obesity. Geneva: World Health Organization."},{"key":"S1368980026101840_ref14","unstructured":"14. World Health Organization (2021) The State of Food Security and Nutrition in the World 2021: Transforming Food Systems for Food Security, Improved Nutrition and Affordable Healthy Diets for All. vol. 2021. Rome: FAO."},{"key":"S1368980026101840_ref1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2011.00456.x"},{"key":"S1368980026101840_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.glt.2025.04.008"}],"container-title":["Public Health Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1368980026101840","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T07:15:03Z","timestamp":1784272503000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1368980026101840\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S1368980026101840"],"URL":"https:\/\/doi.org\/10.1017\/s1368980026101840","relation":{},"ISSN":["1368-9800","1475-2727"],"issn-type":[{"value":"1368-9800","type":"print"},{"value":"1475-2727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e22"}}