Obesity may be Malnutrition

The Pan American Health Organisation (PAHO) reports that rates of obesity and obesity-related illnesses - such as type II diabetes, high blood pressure, heart disease, some forms of cancer and osteoporosis - are rising rapidly in Latin America, and especially among the poorest sectors of the population. In an interview with IPS, Dr. Cecilia Albala of the University of Chile’s Nutrition and Food Technology Institute said that among all of the risk factors that contribute to chronic illnesses, "obesity is the one that has increased the most in the region, and today it is the most common nutritional disorder in Latin American countries." Obesity and malnutrition are problems that have traditionally been viewed as opposite extremes, but today, obesity and undernourishment are recognised as different forms of malnutrition, she explained. Albala said that the problem lies in "inadequate prenatal, postnatal and early infant nutrition," followed by "exposure to diets high in fats and calories and low in micronutrients." PAHO has highlighted obesity as a new public health challenge in Latin America and the Caribbean, one which currently affects 53 million of the 561 million people living in the region. It also stresses that food prices contribute to the greater consumption of food products that are high in saturated fats, sugar and salt and low in nutritional value. The problem is not a lack of availability but rather a lack of access to healthy food, said Argentine anthropologist Patricia Aguirre, the author of studies entitled "Ricos flacos y gordos pobres" (Thin and Rich, Fat and Poor) and "Estrategias de consumo: Qué comen los argentinos que comen" (Consumption Strategies: What Argentines Who Can Eat Are Eating). "In free-market societies, food security does not depend on availability, but rather on buying power," Aguirre told IPS. Food products are chosen on the basis of price, and high-calorie foods are cheaper than those that are high in nutrients, she explained. As a result, the traditional view of malnourished children as nothing but "skin and bone" is being replaced by the new reality of children suffering from both obesity and malnutrition. Argentine nutritionist Sergio Britos agrees. "There is still this common belief that a ‘chubby’ child is a healthy child, and we should only be concerned about children who are underweight. But in fact, both could be malnourished, if their diets are high in carbohydrates, fats and sugar and seriously lacking in micronutrients," he told IPS. "Food consumption by the poorest of the poor is not necessarily lacking in quantity, but it is poor in quality," added Britos, a professor at the University of Buenos Aires. The latest National Nutrition Survey conducted in Argentina reflects these trends, Britos noted. While 3.8 percent of children between the ages of six months and five years included in the study were underweight, 6.6 percent were obese. In the meantime, nutritional deficiencies were widespread, with 16.6 percent of children in this age group found to be suffering from anaemia (iron deficiency), a problem that also affected 30.5 percent of pregnant women studied. In Latin America and the Caribbean as a whole, according to PAHO figures, 16 million children under the age of five and another 32 million between the ages of five and 14 are anaemic, along with five million pregnant women. Iodine and vitamin A and B12 deficiencies, also linked to chronic illnesses, are widespread in the region as well. "The obese poor hide their malnutrition with potatoes and pasta," commented Aguirre. "These are new forms of hunger. The poor do not eat what they want to eat, or what they know they should eat, but rather what they can," she stressed. And the choices available to them rarely include lean meat, dairy products, fruits and vegetables. The foods typically consumed by the poor are primarily chosen on the basis of price, Aguirre explained. Fatty meats and starchy foods like pasta are common, while fruits and vegetables are rare, because they are expensive and less filling. These are the strategies developed by poor families in order to eat, she said. Up until 30 years ago, the diets of the rich and poor were fairly similar, but since that time, a large gap has emerged in dietary habits, Aguirre noted. Today, higher-income families consume around 250 different foodstuffs, while the food purchases of the poor are limited to a mere 22 products. "The diets of the poor are diets low in calcium, iron, vitamins and minerals," she said. This imbalance is reflected in bodies that are "thicker and shorter. This is not typical acute malnutrition, but rather chronic malnutrition alongside obesity," she said. In Latin America, obesity is most prevalent among lower socioeconomic levels and is markedly associated with low incomes, said Aguirre, adding that it is especially frequent among poor women.
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