Background

Many Asian countries have experienced rapid social economic developments in the past three decades. These developments have transformed people’s lifestyles and nutrition status. However, limited research has systematically examined these shifts or explored how these social economic developments have affected people’s nutritional status in Asia. This study investigated the nutrition transition in Asia from 2000 to 2016; identified factors associated with the shifts; and provided recommendations for interventions.

Methods

Based on considerations of gross national income per capita, population size, and geographic location, 8 countries (Japan, Saudi Arabia, China, Thailand, India, Myanmar, Nepal, Afghanistan) were selected to represent high-,upper-middle, lower-middle, and low-income countries in Asia. Related national data were obtained from various sources. Analysis was conducted separately for children under 5 years old, those aged 5-17 years, and adults >=18 years.

Results

Obesity/overweight prevalence increased while underweight rate decreased; large differences in the rates and over time changes existed among the selected countries. Lower- and upper-middle income countries experienced the highest double burden of malnutrition compared with other countries. Countries with higher economic status tended to have lower prevalence of underweight, while India (lower middle country) had the highest prevalence of underweight for children, adolescents, and adults in both 2000 (46.3%, 28.1%, 29.0%) and 2016 (35.7%, 26.9%, 23.3%). The countries with high- or middle economic status had rapidly increased obesity/overweight rate among adolescent and adults, while this trend was only found in Saudi Arabia (1.2% vs. 6.1%) and China (3.4% vs. 6.6%) from 2000 to 2016 in children under 5 years old.

Conclusions

Nutritional status is associated with country level economic status, and some countries faced double burden (coexistence of under- and over-nutrition).