1
|
Pradhananga P, Shrestha A, Adhikari N, Shrestha N, Adhikari M, Ide N, Dhungel S, Bajracharya S, Aryal A. Double burden of malnutrition in Nepal: A trend analysis of protein-energy malnutrition and High Body Mass Index using the data from Global Burden of Disease 2010–2019. PLoS One 2022; 17:e0273485. [PMID: 36174008 PMCID: PMC9521909 DOI: 10.1371/journal.pone.0273485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 08/10/2022] [Indexed: 11/18/2022] Open
Abstract
Background
The co-existence of undernutrition and overnutrition is a global public health threat. We aim to report the burden of both nutritional deficiency (Protein-Energy Malnutrition) and overweight (high Body Mass Index) in Nepal over a decade (2010–2019) and observe the changes through trend charts.
Methods
We did a secondary data analysis using the Institute for Health Metrics and Evaluation (IHME)’s Global Burden of Disease (GBD) database to download age-standardized data on Protein Energy Malnutrition (PEM) and high Body Mass Index (BMI). We presented the trend of death, Disability Adjusted Life Years (DALYs), Years of Life Lost (YLL), and Years Lost due to Disability (YLD) of PEM and high BMI in Nepal from 2010 to 2019 and also compared data for 2019 among South Asian countries.
Results
Between 2010 and 2019, in Nepal, the Disability Adjusted Life Years (DALYs) due to PEM were declining while high BMI was in increasing trend. Sex-specific trends revealed that females had higher DALYs for PEM than males. In contrast, males had higher DALYs for high BMI than females. In 2019, Nepal had the highest death rate for PEM (5.22 per 100,000 populations) than any other South Asian country. The burden of PEM in terms of DALY was higher in under-five children (912 per 100,000 populations) and elderly above 80 years old (808.9 per 100,000 populations), while the population aged 65–69 years had the highest burden of high BMI (5893 per 100,000 populations). In the last decade, the DALYs for risk factors contributing to PEM such as child growth failure (stunting and wasting), unsafe water, sanitation and handwashing, and sub-optimal breastfeeding have declined in Nepal. On the contrary, the DALYs for risk factors contributing to high BMI, such as a diet high in sugar-sweetened beverages, a diet high in trans fatty acid, and low physical activity, have increased. This could be a possible explanation for the increasing trend of high BMI and decreasing trend of PEM.
Conclusion
Rapidly growing prevalence of high BMI and the persistent existence of undernutrition indicate the double burden of malnutrition in Nepal. Public health initiatives should be planned to address this problem.
Collapse
Affiliation(s)
- Priza Pradhananga
- Department of Public Health and Community Programs, Dhulikhel Hospital- Kathmandu University Hospital, Dhulikhel, Nepal
- * E-mail:
| | - Archana Shrestha
- Department of Public Health and Community Programs, Dhulikhel Hospital- Kathmandu University Hospital, Dhulikhel, Nepal
- Department of Chronic Disease Epidemiology, Yale School of Public, New Haven, Nepal
- Institute for Implementation Science and Health, Kathmandu, Nepal
| | - Nabin Adhikari
- Department of Public Health and Community Programs, Dhulikhel Hospital- Kathmandu University Hospital, Dhulikhel, Nepal
| | - Namuna Shrestha
- Department of Public Health and Community Programs, Dhulikhel Hospital- Kathmandu University Hospital, Dhulikhel, Nepal
| | - Mukesh Adhikari
- Institute for Implementation Science and Health, Kathmandu, Nepal
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Nicole Ide
- Resolve to Save Lives, Vital Strategies, New York, New York, United States of America
| | - Saurya Dhungel
- Department of Epidemiology, University of Washington School of Public Health, Seattle, United States of America
| | | | - Anu Aryal
- Department of Public Health and Community Programs, Dhulikhel Hospital- Kathmandu University Hospital, Dhulikhel, Nepal
- Institute for Implementation Science and Health, Kathmandu, Nepal
- Department of Health Policy and Management, University of California Los Angeles, Los Angeles, California, United States of America
| |
Collapse
|