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Socio-economic causes of undernutritionIn this chapter we explore the role of socio-economic factors in the development of under-nutrition in high-income countries, such as the UK, with particular reference to food access and nutrition inequality. For the purpose of this chapter we use the term under-nutrition to refer to the physiological effects of inadequate food supply resulting from the inability to access sufficient quantity and quality of food to meet recommended nutritional requirements; a situation otherwise termed food poverty or food insecurity (See Box 1 for definitions). In affluent societies, hunger and malnutrition coexist alongside obesity and diet-related diseases such as coronary heart disease and diabetes. Before the food system was industrialised in the mid-20th Century, people ate a basic, traditional diet of limited variety. Hunger and under nutrition was common. Today, food is both varied and widely available. Access to cheap, energy-dense and nutrient-poor food is linked with the so-called obesity epidemic and diseases of affluence. Despite this a growing number of people in societies such as the UK experience hunger or malnutrition because of limited access or availability to a nutritionally adequate diet (3, 4, and 5).