Upper limits in developing countries: warning against too much in lands of too little.
Recent trends in dietary patterns have provided a confusing and sometimes contradictory statement about the state of nutrition throughout the world. On the one hand, undernutrition caused by caloric and micronutrient deficiencies are still prevalent in developing countries. On the other hand, obesity caused by excess caloric intake is increasing at alarming rates in most developed and some developing countries. At the center of this confusion is the desire by health ministries to provide sound nutritional advice to prevent chronic diseases. One approach is to provide upper limits for nutrients that may be harmful if consumed in large quantities. This policy may be effective and sound for those nations with a low prevalence of food insecurity, but for many countries, especially those with trouble ensuring an adequate intake of protein and micronutrient-rich foods, the use of upper limits may result in unknown and potentially harmful effects and lead to delayed improvement in overall nutritional status. To explore this idea, a recent study looking at the relationship between early undernutrition and risk for obesity in children living in the shantytowns of Sao Paulo, Brazil is reviewed. The focus of this study was to better understand how the long-term effects of undernutrition on health and later risk for chronic diseases. This study illustrates the precarious state of health in developing countries and provides the backdrop for a discussion on food security and the potential effects of establishing policies on food intake in unstable settings.