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P.T. Jyothi Datta

NEW DELHI, Dec. 24

THE paradox could not be starker. About 170 million children in less economically developed countries are underweight and over three million die each year, as a result. At the same time, there are more than one billion adults worldwide who are overweight and at least 300 million are clinically obese, points out the World Health Report 2002.

The world's burden, the report points out, "is the result of under-nutrition among the poor and over-nutrition among those who are better off, wherever they live." So at one end of the risk factor scale lies poverty, where under-weight is the leading cause of disease among hundreds of millions of the world's poorest people and a major cause of death, especially among young children. On the flip side, of 300 million who are clinically obese, half a million people in North America and Western Europe die from obesity-related diseases every year.

Most of the risk factors highlighted in the report, brought out by the World Health Organisation, are linked to patterns of living and consumption - "where it can be a case of too much or too little. At the other end of the scale from poverty lies over-nutrition or more accurately, over-consumption," the report said. Overweight and obesity are important factors in the health sector as they lead to adverse metabolic changes, including increases in blood pressure, unfavourable cholesterol levels and increased resistance to insulin. "They increase the risk of coronary heart disease, stroke, diabetes and many forms of cancer," it points out.

The report also traces the evolution of the tobacco epidemic and the number of "attributable deaths" in 2000, an estimated 4.9 million, is over one million more than its was in the 1990s. Closely following under-weight as a global risk factor is unsafe sex, the main factor in the spread of HIV/AIDS, with a major impact on Africa and Asia, the report points out. Alarmingly, life expectancy in sub-Saharan Africa is estimated at 47 years, while it would have been about 62 years without AIDS. Other leading risk factors for disease that the report has zeroed-in upon, include: unsafe water, sanitation and hygiene, iron deficiency and indoor smoke from solid fuels.

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