Reuniting overnutrition and undernutrition, macronutrients, and micronutrients

Miji Kim*, Anam Basharat, Ramchandani Santosh, Syed F. Mehdi, Zanali Razvi, Sun K. Yoo, Barbara Lowell, Amrat Kumar, Wunnie Brima, Ann Danoff, Rachel Dankner, Michael Bergman, Valentin A. Pavlov, Huan Yang, Jesse Roth

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


Over-nutrition and its late consequences are a dominant theme in medicine today. In addition to the health hazards brought on by over-nutrition, the medical community has recently accumulated a roster of health benefits with obesity, grouped under “obesity paradox.” Throughout the world and throughout history until the 20 th century, under-nutrition was a dominant evolutionary force. Under-nutrition brings with it a mix of benefits and detriments that are opposite to and continuous with those of over-nutrition. This continuum yields J-shaped or U-shaped curves relating body mass index to mortality. The overweight have an elevated risk of dying in middle age of degenerative diseases while the underweight are at increased risk of premature death from infectious conditions. Micronutrient deficiencies, major concerns of nutritional science in the 20 th century, are being neglected. This “hidden hunger” is now surprisingly prevalent in all weight groups, even among the overweight. Because micronutrient replacement is safe, inexpensive, and predictably effective, it is now an exceptionally attractive target for therapy across the spectrum of weight and age. Nutrition-related conditions worthy of special attention from caregivers include excess vitamin A, excess vitamin D, and deficiency of magnesium.

Original languageEnglish
Article numbere3072
JournalDiabetes/Metabolism Research and Reviews
Issue number1
StatePublished - Jan 2019


  • infectious diseases
  • micronutrients
  • obesity
  • obesity paradox
  • overnutrition
  • undernutrition


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