Background and Aims: In recent decades, lifestyle patterns have undergone significant transformations, particularly in low- and middle-income countries (LMICs). These changes have contributed to a dual nutritional crisis characterized by the coexistence of undernutrition and overweight/obesity, commonly referred to as the Double Burden of Malnutrition (DBM). Compounding this issue is the persistent prevalence of parasitic infections, due to poor personal hygiene and sanitation practices which further exacerbate nutritional imbalances, creating what is now recognized as the Triple Burden of Malnutrition (TBM). This review aims to explore the evolving lifestyle factors that have contributed to the emergence of the DBM and to examine its intersection with parasitic infections. The focus is particularly on South Asian low- and middle-income countries, where these overlapping burdens present a significant public health challenge. By highlighting the interconnectedness of malnutrition, obesity, and parasitic diseases, this study seeks to provide a comprehensive understanding of the current nutritional landscape in South Asian LMICs and to inform future health interventions and policies.
Methods: This study was conducted using published and unpublished secondary data that are available on websites and other printed materials. One of the main requirements is date, with 2013 being regarded as the initiative’s landmark. Another crucial factor is the availability of the entire article. For this study, only research publications published in English were taken into consideration. Zotero was used for compilation. The majority of the analysis was performed using percentages and ratios. A thorough evaluation of all the studies’ methodology, design, execution, and reporting was performed in order to spot any systematic flaws in this study.
Results: Only 45 of the 105 full-text papers that were screened met the requirements for inclusion. Of these studies, 15 satisfied the inclusion and exclusion requirements. The results show that China, with a comparatively higher income level status, has more prevalence of overweight and obesity among children (11.5%) and women (34.6%) than India (2.1% of OWOB among children and 20.6% among women). Nepal stands behind China and India with 1.2% of OWOB among children and between them with 22.2% OWOB among women. Interestingly, among the three South Asian nations, India has the highest stunting, wasting, and underweight among children (38.4%, 21%, and 35.7%, respectively) followed by Nepal (35.8%, 9.7%, and 27%) and China (8.1%, 2%, and 2.5%). This study finds no significant difference in the prevalence of intestinal parasitic infections among OWOB and underweight populations. This review finds that the DBM along with parasitic infections has resulted in a Triple Burden of Malnutrition, which is currently a major public health issue in low- and middle-income countries in South Asia.
Discussion: The various types of malnutrition were once thought of and treated as distinct public health problems, but the new understanding is that undernutrition and overnutrition are linked, and that in order for policy solutions to be successful, double-duty measures that simultaneously address multiple dimensions must be put in place. When the DBM is combined with parasite illnesses, it becomes the Triple Burden of Malnutrition, which is the primary cause of the financial burden in LMICs. China has the worst obesity problem, yet it also has more obesity-related laws and intervention programs than India and Nepal combined. All three nations, however, have failed to stop or deal with the dramatic increase in OWOB over the last 20 years. For effective implementation and results, genetic and psychological factors must also be taken into account when developing policies and programs to tackle the obesity epidemic, undernutrition, and parasite diseases.
Conclusions: The prevalence of the DBM has been rising globally, with South Asia seeing a faster rate of increase. A growing DBM is favorably correlated with national economic development. In South Asian LMICs, the DBM combined with parasite diseases has resulted in a Triple Burden of Malnutrition, a debilitating illness.
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