Can You Be Overweight and Malnourished?

What’s the image you get in your head when you hear the word “malnourished”? I can bet it is not of an overweight person. Can an overweight person be malnourished? Yes. In fact, obesity and malnourishment usually go hand in hand.

If you think malnutrition is a condition that only affects those who do not get enough food this is going to be an eye-opener for you. You might be eating all day and still have nutrition deficiencies.

12-year-old Rashmi lives in humble accommodation in Chennai. Her family barely manages to get two meals on a good day. Devoid of any nutritious food, she is extremely weak and lethargic.

25-year-old Krystal lives in a posh area in the US. She eats 3 main meals a day while snacking several times. Most of her meals come from upscale restaurants near her place. Far from appearing weak, she has been struggling to lose weight.

Of the two girls in the examples above, who would you say is suffering from malnutrition? Rashmi, you’d say without a doubt. However, in reality, Krystal also has malnutrition.  

Sounds shocking? Well, you’re not alone in thinking of obesity and malnutrition as opposites of each other. Until now, the world has been seeing malnutrition just as the case of getting too few calories. Eating enough – even if highly processed food – has been thought to be taking care of one’s nutritional needs. It’s a common mistake to think that consuming high calories automatically brings in all the required nutrients your body needs.

However, it is now that the experts are alarmed by the sharp rise in malnutrition among obese children and adults globally. According to the World Health Organization (WHO), every country in the world is affected by one or more forms of malnutrition. In fact, combating malnutrition is one of the greatest global health challenges today.

Consider the findings of the Global Nutrition Report 2018: a) India has the highest number of malnourished children in the world. Many of them are “stunted,” meaning they are too short for their age. 

b) While most countries are struggling with the issues of poor nutrition and food insecurity, the United States appears to be badly off track on all its nutrition targets. The world’s largest economy, it states, has alarming rates of obesity, diabetes, and anemia, and has more than a million overweight children.

Both of these facts point to the rising level of malnutrition all over the world. Overconsumption of processed and unhealthy food and not having enough to eat are, in fact, are two sides of the malnutrition coin.

What is Malnutrition?

Malnutrition is a condition resulting from getting too little or too much of certain nutrients. The WHO describes three forms of malnutrition:

• Undernutrition: The condition includes wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age);
• Micronutrient-related malnutrition: This refers to micronutrient deficiencies, which is a lack of essential vitamins and minerals or micronutrient excess.
• Overnutrition: Overconsumption leading to obesity and diet-related non-communicable diseases (such as heart disease, stroke, diabetes, and some cancers) also leads to malnutrition.

Common Causes of Malnutrition

It’s easy to understand how malnutrition occurs in those who have limited access to food. Undernourishment leads to deficiencies in important vitamins and minerals such as iron, iodine, and zinc.

But you might be wondering how overnutrition might lead to nutrient deficiencies. Blame it all on the unhealthy lifestyles and increased consumption of highly processed food that has made it possible being overweight or obese without getting enough minerals and vitamins.

Excessive use of refined food is another reason why malnutrition is on the rise even in developed countries.

Dr. Mark Hyman, a renowned American physician and New York Times best-selling author, talks extensively about this in his books and podcasts. “Foods are increasingly being stripped of their nutrients during the refining process. One of the most telling examples of this mistake is wheat. The process of refining whole wheat flour into white flour reduces the fibre by 80 percent and slashes levels of essential minerals, vitamins, and phytonutrients,” he warns.

Excessive alcohol consumption is another factor leading to malnutrition as it leads to an insufficient intake of vital proteins and micronutrients.

Effects

Obesity and undernutrition are major drivers in diet-related non-communicable diseases, including cancer. Studies have shown that undernutrition in childhood can lead to a higher risk of obesity later in life. So, both forms of malnutrition can lead to a higher chance of heart disease and type 2 diabetes.

Ways to Prevent Malnutrition

At a macro level, preventing malnutrition calls for intervention by government agencies and independent organizations. Providing supplements and vitamin pills can help countries with high undernutrition numbers.

At an individual level, a lifestyle change towards healthy food choices and physical activity can prevent malnutrition resulting from obesity.

Here are some of my suggestions for healthy lifestyle changes:

• Eat a diet that includes essential carbohydrates (all vegetables, whole wheat pasta, oats), proteins (eggs, nuts, legumes, quinoa, peanut butter), good fats (avocado, walnuts, olive oil), vitamins, and minerals.  
• Include more plant-based foods: Plant foods are the richest sources of not just vitamins and minerals but fibre as well. This includes fruits, nuts, seeds, whole grains, along with the greens.
• Increase your water intake.
• Use extra-virgin olive oil and ghee

What to Avoid:

• Minimize fast food to only eating out during special occasions
• Highly refined oils such as canola, soybean, corn oil
• Processed food: Avoid any item with more than 5 ingredients listed on its box
• Fried food: This category of food offers only empty calories that do you no good!

While there is a long road ahead in preventing malnutrition from lack of sufficient food to all, the other form is certainly avertable. All we need to win this fight is to get the most from whole foods and cut out empty calories from our diets.

Signs of Malnutrition:

• Involuntary excess weight loss or gain
• Weak muscles
• Feeling tired all the time
• Hair loss
• Depression
• Anemia
• An increase in illnesses or infections 

First published in August issue of Viva L’Amore magazine