Inequalities of nutrition: The Namibian paradox

Abstract

The paradoxical coexistence of obesity with undernutrition has been we!l documented worldwide. In many developing countries, 6o % of households contain both underweight and obese individuals, a situation referred to as the "dual burden household". The Namibian population is simultaneously made up of groups of overweight and obese individuals as well as a large group of underweight individuals. Based on data collected from 2003 to 2004, 28 % of Namlbians were categorized as underweight, 11 % as overweight and 7 % as obese. Among adults, aged 30-46, 29% were categorized as overweight or obese. In a middle-income country such as Namibia, food scarcity may no longer be the driving factor behind energy intake. Instead, the availability of cheap, energy dense foods may facilitate the consumption of more calories whiJe an indoor, sedentary lifestyle would further reduce the average daily energy expenditure. Specific cultural perceptions may also encourage obesity. The 'double burden' of disease that has been created threatens to overwhelm the health services in Namibia. In this paper, we document reports on nutritional inequality internationally, and in Namibia specifically, and propose a research strategy to address the burden of the coexistence of under nutrition and obesity in Namibia. The paper documents a useful starting point for understanding the determinants of inequalities in nutritional status and provides some understanding of the causes of inequalities in nutritional status as well as the factors responsible for inequalities in health and nutritional status of individuals.