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Double-Duty Actions: Seizing Program and Policy Opportunities to Address Malnutrition in all its Forms

Hawkes, C. ORCID: 0000-0002-5091-878X, Ruel, M., Salm, L., Sinclair, B. and Branca, F. (2019). Double-Duty Actions: Seizing Program and Policy Opportunities to Address Malnutrition in all its Forms. The Lancet, 395(10218), pp. 142-155. doi:


Actions to address different forms of malnutrition are typically managed by separate communities, policies, programmes, governance structures, and funding streams. In contrast, double duty actions, which aim to simultaneously tackle both undernutrition and problems of overweight, obesity and diet-related non-communicable diseases (DR-NCDs) have been proposed as a way to effectively address malnutrition in all its forms in a more holsitic way. This paper identifies ten double duty actions that have strong potential to reduce the risk of both undernutrition and obesity/DR-NCDs. It does so by : 1) summarizing evidence on common drivers of different forms of malnutrition; 2) documenting examples of unintended harm caused by some undernutrition-focused programmes on obesity/DR-NCDs; and 3) highlighting a few examples of first double duty actions undertaken to tackle multiple forms of malnutrition. We find that undernutrition and obesity/DR-NCDs are intrinsically linked through early life nutrition; dietary quality; food environments; and socioeconomic factors. There is some evidence that undernutrition-focused programs have raised risks of poor quality diets and obesity/DR-NCDs, especially in countries undergoing a rapid nutrition transition. The paper builds on this evidence to develop a framework to guide the design of double duty approaches and strategies, and defines the first steps needed to deliver them. With a clear package of double duty actions now identified, there is an urgent need to move forward with double duty actions to address malnutrition in all its forms.

Publication Type: Article
Additional Information: © Elsevier 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Subjects: H Social Sciences > HM Sociology
R Medicine > RA Public aspects of medicine
T Technology > TX Home economics
Departments: School of Arts & Social Sciences > Sociology > Food Policy
Date Deposited: 23 Sep 2019 07:34
Text - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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