TYRE is a small province on Lebanon’s border with Israel, a place of poor tobacco farmers and tin-roofed shacks. Only about half the population has enough to eat. Many say that, in the past six months, somebody in the household has spent a day without food or gone hungry to bed. But there is something odd about the burden of malnutrition. While in hungry households just over a quarter of children under five are too short for their age—a classic symptom of malnutrition—a third are overweight, malnourished in the opposite sense. Tyre is suffering malnutrition and obesity simultaneously.This is all part of the nutrition transition, first identified many years ago by Barry Popkin and his colleagues at UNC, Chapel Hill, and now unfolding throughout the world.
This “dual burden” is growing everywhere, but nowhere as quickly as in the Arab world. Between 15% and 25% of Arab children under five are too short for their age and between 5% and 15% are underweight. Almost half of pregnant Egyptian women are anaemic, reflecting an iron deficiency often caused by poor diets. Yet a survey in 2006 reckoned that 30% of Egyptian adults were obese. Obesity estimates for Jordan, Kuwait, Saudi Arabia and the United Arab Emirates were even higher: between 35% and 45%.
In Egypt, Peru and Mexico, about half the women with anaemia are overweight or obese. They are simultaneously over- and underfed: too many calories, not enough micronutrients.