Southeast Asia’s double burden: Tracking nutrition, food security, and noncommunicable diseases

Background: Diet is a key determinant of health across the life course. Balanced and healthy diets reduce risks of malnutrition and noncommunicable diseases (NCDs), whereas unhealthy diets high in refined carbohydrates, fats, sugars, and salt increase risks of obesity, diabetes, cardiovascular diseases, and cancers. Southeast Asia faces a nutrition transition marked by rising consumption of processed foods, contributing to a double burden of undernutrition and NCDs. Strengthened nutrition surveillance is essential to inform policy and public health action. Methodology: A systematic search and narrative review were conducted across 10 WHO Southeast Asia Region countries. Reports and national surveys from governments, WHO, and peer-reviewed publications were examined. Data on surveillance coverage, frequency, indicators (dietary diversity, micronutrient intake, anthropometry, and biomarkers), and prevalence of NCD risk factors were synthesized. Results: NCDs account for 53%–85% of mortality across the region. Hypertension and diabetes are most prevalent in Timor-Leste and India, while overweight and obesity are highest in Nepal and Thailand. Physical inactivity is widespread in the Maldives and India, but lower in Nepal and Myanmar. Daily per capita calorie intake ranges from 1485 kcal in Thailand to 2571 kcal in Myanmar. Existing surveillance systems – such as India’s National Nutrition Monitoring Bureau and the Comprehensive National Nutrition Survey, WHO STEPS, and national health surveys – vary considerably in scope, frequency, and integration of dietary and metabolic indicators. Conclusion: Nutrition surveillance in Southeast Asia remains fragmented, limiting timely responses to the double burden of malnutrition and NCDs. Inferences: The substantial heterogeneity and fragmentation of nutrition surveillance systems across Southeast Asia highlight an urgent need for harmonized, integrated, and periodic monitoring frameworks that combine dietary, anthropometric, and metabolic indicators. Strengthening regional surveillance capacity is critical to guide evidence-based policies addressing both undernutrition and the escalating burden of NCDs.