Double burden of malnutrition (DBM) is characterized by the simultaneous existence of undernutrition and overweight or obesity, which is common in low-income and middle-income countries (LMICs). Now, a new study by Rishi Caleyachetty and colleagues shows that DBM during adolescence is common in LMICs and the differences in prevalence across LMICs could be caused by large-scale factors, such as internal conflict in a country.

“Despite adolescence being a period of rapid growth with increased nutritional demands, the global health community has largely neglected the nutritional needs of this population,” explains Caleyachetty. Comprehensive data on the cause of DBM in adolescents living in LMICs are needed to guide global efforts in solving this problem; however, this information is lacking, which prompted the authors to quantify DBM in adolescents and uncover the large-scale factors associated with the varying burden of adolescent malnutrition.

The authors performed meta-analyses on the height and weight data of 129,276 adolescents (mean age of 14.3 years) from surveys taken from 57 LMICs. Undernutrition was defined as stunting, thinness or both, and overnutrition was characterized as overweight or obese. The analysis showed that in LMICs the prevalence of undernutrition in adolescents was 15.6% and overnutrition was 21.6%. There was a 38–59% difference in prevalence of adolescent malnutrition across the different LMICs, which could be explained by internal conflict in the country, lack of democracy, the gross domestic product of the country, food insecurity, year of the survey and urbanization.

“This deeper understanding of adolescent malnutrition in LMICs will have a pivotal role, not only for the development and nutrition community, but also for policy makers and governments,” concludes Caleyachetty.