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Sagastume D, Barrenechea-Pulache A, Ruiz-Alejos A, Polman K, Beňová L, Ramírez-Zea M, Peñalvo JL. Quantifying Overlapping Forms of Malnutrition Across Latin America: A Systematic Literature Review and Meta-Analysis of Prevalence Estimates. Adv Nutr 2024; 15:100212. [PMID: 38493876 PMCID: PMC11015105 DOI: 10.1016/j.advnut.2024.100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/07/2024] [Accepted: 03/05/2024] [Indexed: 03/19/2024] Open
Abstract
Estimating the prevalence of double burden of malnutrition (DBM) is challenging in the Latin American and Caribbean (LAC) region where various DBM typologies (e.g., obesity and stunting) are heterogeneous and estimates are scattered across literature This study aimed to assess the prevalence of DBM typologies in the LAC region. We searched PubMed, Embase, Scopus, and Web of Science to identify studies on the prevalence of DBM published between 1 January, 2000, and 23 January, 2023. Outcomes were the prevalence of the identified DBM typologies at the household, individual, or across life course levels. Random-effect meta-analyses of proportions were used to estimate pooled period prevalence for all outcomes. Heterogeneity was explored using meta-regressions. From 754 records identified, 60 (8%) studies were eligible, with a median of 4379 individuals. Studies reported data from 27 LAC countries collected between 1988 and 2017. Most studies used nationally representative surveys (68%) and scored as low risk of bias (70%). We identified 17 DBM typologies for which 360 estimates were analyzed. The prevalence of the identified DBM typologies ranged between 0% and 24%, with the DBM typology of "adult with overweight and child with anemia" having the highest prevalence (24.3%; 95% CI: 18.8%, 30.2%). The most frequently reported DBM typology was "adult with overweight and child with stunting," with a prevalence of 8.5% (95% CI: 7.7, 9.3). All prevalences carried large heterogeneity (I2>90%), modestly explained by subregions and countries. DBM across the life course could not be estimated owing to insufficient estimates. In conclusion, using available data, our study suggests that the burden of DBM in the LAC region ranges between 0% and 24%. In the most frequent DBM typologies, overweight was a common contributor. Substantial progress can be made in curbing the burden of DBM in the LAC region through strategies addressing excess weight within these population groups. This study was registered at PROSPERO as CRD42023406755.
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Affiliation(s)
- Diana Sagastume
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Global Health Institute, University of Antwerp, Wilrijk, Belgium.
| | | | | | - Katja Polman
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Department of Health Sciences, Vrije Universiteit (VU) Amsterdam, Netherlands
| | - Lenka Beňová
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Manuel Ramírez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - José L Peñalvo
- Global Health Institute, University of Antwerp, Wilrijk, Belgium; National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
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Medina-Vadora MM, Plaza-Diaz J, Llorente-Cantarero FJ, Severi C, Lecot C, Ruiz-López MD, Gil Á. A Clustering Study of Dietary Patterns and Physical Activity among Workers of the Uruguayan State Electrical Company. Nutrients 2024; 16:304. [PMID: 38276542 PMCID: PMC10820101 DOI: 10.3390/nu16020304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/08/2024] [Accepted: 01/14/2024] [Indexed: 01/27/2024] Open
Abstract
Recent studies have shown that certain nutrients, specific food groups, or general dietary patterns (DPs) can promote health and prevent noncommunicable chronic diseases (NCCDs). Both developed and developing countries experience a high prevalence of NCCDs due to poor lifestyle habits, DPs, and low physical activity levels. This study aims to examine the dietary, physical activity, sociodemographic, and lifestyle patterns of Uruguayan State Electrical Company workers (the IN-UTE study). A total of 2194 workers participated in the study, providing information about their sociodemographics, lifestyles, and dietary habits through different questionnaires. To identify DPs from 16 food groups, principal component analysis (PCA) was performed. A hierarchical cluster algorithm was used to combine food groups and sociodemographic/lifestyle variables. Four DPs were extracted from the data; the first DP was related to the intake of energy-dense foods, the second DP to the characteristics of the job, the third DP to a Mediterranean-style diet, and the fourth DP to age and body mass index. In addition, cluster analysis involving a larger number of lifestyle variables produced similar results to the PCA. Lifestyle and sociodemographic factors, including night work, working outside, and moderate and intense PA, were significantly correlated with the dietary clusters, suggesting that working conditions, socioeconomic status, and PA may play an important role in determining DPs to some extent. Accordingly, these findings should be used to design lifestyle interventions to reverse the appearance of unhealthy DPs in the UTE population.
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Affiliation(s)
- Maria Mercedes Medina-Vadora
- Department of Nutrition and Food Sciences, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain; (M.M.M.-V.); (M.D.R.-L.)
| | - Julio Plaza-Diaz
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Francisco Jesús Llorente-Cantarero
- Department of Specific Didactics, Faculty of Education, Maimónides Institute of Biomedicine Research of Córdoba (IMIBIC), University of Córdoba, 14071 Córdoba, Spain;
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Cecilia Severi
- Department of Preventive Medicine, School of Medicine, Universidad de la República Oriental del Uruguay (UdelaR), Montevideo 11800, Uruguay;
- Uruguayan Society of Collective Health (SUSAC), Montevideo 11800, Uruguay
| | - Carlos Lecot
- Department of Occupational Health, National Administration of Power Plants and Electric Transmissions (UTE), Montevideo 11800, Uruguay;
| | - María Dolores Ruiz-López
- Department of Nutrition and Food Sciences, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain; (M.M.M.-V.); (M.D.R.-L.)
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18016 Granada, Spain
- Iberoamerican Nutrition Foundation (FINUT), 18016 Armilla, Spain
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain;
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18016 Granada, Spain
- Iberoamerican Nutrition Foundation (FINUT), 18016 Armilla, Spain
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Barg G, Frndak S, Queirolo EI, Peregalli F, Kordas K. Dietary patterns and cognitive achievement among school children in socio-cultural context, a case of Montevideo, Uruguay. Eur J Nutr 2023; 62:2475-2488. [PMID: 37148356 PMCID: PMC10927011 DOI: 10.1007/s00394-023-03167-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/27/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE The benefits of a healthy diet on children´s cognition have been described in several studies. However, many previous studies have analyzed the effect on general cognitive domains (e.g. intelligence), used measures based almost exclusively on local examinations, and rarely consider social context. OBJECTIVE The objective of the present study was to examine the relationship between two diet patterns and contextualized cognitive performance measures of children aged 6-8 years from low-average income neighborhoods in Montevideo, Uruguay. METHODS 270 first-grade children with complete data participated in the study. Consumption of foods was determined via two averaged 24-h dietary recalls with the mother. Two dietary patterns were identified via principal component analysis: "processed (high calorie) foods" and "nutrient dense". Children´s cognitive performance, including general cognitive abilities, achievement in mathematics and reading, and discrepancy scores between predicted and actual achievement was assessed with the Woodcock-Muñoz Cognitive and Achievement scales. The association of dietary patterns and cognitive endpoints was analyzed in multilevel models, clustered by children´s school. Sociodemographic and biological variables were used as covariates. RESULTS The nutrient dense foods pattern, characterized by higher consumption of dark leafy and red-orange vegetables, eggs, beans & peas, potatoes, was associated with better performance in reading, with beta coefficient 3.28 (95% CI 0.02, 6.54). There was also an association between the nutrient dense foods factor and the Discrepancy in reading, 2.52 (0.17, 4.87). Processed (high calorie) foods pattern, characterized by higher consumption of breads, processed meats, fats and oils, sweetened beverages, and sweetened yogurt/dairy products; reduced intake of milk, pastries and pizza dinners was not associated with cognitive performance. CONCLUSIONS Nutrient dense food pattern was positively associated with children's reading achievement. A nutrient-rich diet may benefit written language acquisition at the beginning of schooling.
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Affiliation(s)
- Gabriel Barg
- Department of Neuroscience and Learning, Faculty of Health Sciences, Universidad Católica del Uruguay, Comandante Braga 2715, CP 11600, Montevideo, Uruguay.
| | - Seth Frndak
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Elena I Queirolo
- Department of Neuroscience and Learning, Faculty of Health Sciences, Universidad Católica del Uruguay, Comandante Braga 2715, CP 11600, Montevideo, Uruguay
| | - Fabiana Peregalli
- Department of Neuroscience and Learning, Faculty of Health Sciences, Universidad Católica del Uruguay, Comandante Braga 2715, CP 11600, Montevideo, Uruguay
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
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Pereyra-González I, Mattei J. Combined intake of sugar-sweetened beverages and sugar-containing ultra-processed foods is associated with an increase in body mass index during early childhood. Pediatr Obes 2023; 18:e13025. [PMID: 36945180 DOI: 10.1111/ijpo.13025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 02/07/2023] [Accepted: 02/20/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Sugar-containing ultra-processed (SUP) foods and beverages consumption has increased globally in recent years and contributes to the rising global trends of obesity and diet-related chronic non-communicable diseases. However, there are limited longitudinal studies of SUP foods and beverages intake and weight gain in children. OBJECTIVES To examine associations between intake of sugar-sweetened beverages (SSB) and SUP foods and changes in body mass index during early childhood. METHODS Multistage sampling was used to select a nationally representative sample of Uruguayan children living in urban areas from the 2012-2013 Continuous Household Survey. The sample for this analysis included all children aged 0-3 years 11 months with dietary data in 2013-2014 (wave 1; n = 2611) and in 2015-2016 (wave 2; n = 2383). Multilevel regression modelling tested the association between children's consumption of SSB and SUP foods and change in BMI z-score (BMIz). RESULTS In multivariable-adjusted models, intake of SSB and SUP foods (in combination but not individually) in both waves was positively associated with change in BMIz over 2 years β coefficient: 0.13 (95% confidence interval [CI]: 0.02, 0.23). BMIz decreased among non-consumers (β: -0.12, 95% CI: -0.24, -0.00, p = 0.048). Associations were significant for SUP foods but not SSB foods individually. Children consuming ≥2 SSB and SUP foods (vs. <2) at baseline had increased BMIz (p for trend = 0.02). CONCLUSION Early and current intake of SSB and SUP foods and beverages was associated with increases in BMIz in children over 2 years.
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Affiliation(s)
- Isabel Pereyra-González
- School of Nutrition, Faculty of Health Sciences of the Catholic University of Maule, Curicó, Chile
- Faculty of Health Sciences of the Catholic University of Uruguay, Montevideo, Uruguay
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Steyn NP, Nel JH. Prevalence and Determinants of the Double Burden of Malnutrition with a Focus on Concurrent Stunting and Overweight/Obesity in Children and Adolescents. Curr Nutr Rep 2022; 11:437-456. [PMID: 35715686 DOI: 10.1007/s13668-022-00417-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE OF THE REVIEW To determine the prevalence and determinants of concurrent stunting and overweight/obesity (CSO) in the same child or adolescent. RECENT FINDINGS After searching PubMed and the Web of Science, 26 articles comprised the prevalence and/or determinants of concurrent stunting and overweight/obesity. Most of the articles were published from 2018 onwards. There is great variation in the prevalence of concurrent stunting and overweight/obesity across the globe. For children under five years the prevalence of CSO is higher among children under two years compared with those 2-<5 years. The main determinants of this condition appear to be associated with gender, age, and urban versus rural ones. Income varied greatly between studies. However, a few additional variables were mentioned including having a mother with a short stature, time of weaning, having an improved toilet facility, being dewormed in the past few months, and the level of education of the mother.
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Affiliation(s)
- Nelia P Steyn
- Department of Human Biology, University of Cape Town, Anzio Road, Observatory, South Africa.
| | - Johanna H Nel
- Department of Logistics, University of Stellenbosch, Stellenbosch, South Africa
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Khaliq A, Wraith D, Nambiar S, Miller Y. A review of the prevalence, trends, and determinants of coexisting forms of malnutrition in neonates, infants, and children. BMC Public Health 2022; 22:879. [PMID: 35505427 PMCID: PMC9063291 DOI: 10.1186/s12889-022-13098-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/22/2022] [Indexed: 01/04/2023] Open
Abstract
Objective Coexisting Forms of Malnutrition (CFM) refers to the presence of more than one type of nutritional disorder in an individual. Worldwide, CFM affects more than half of all malnourished children, and compared to standalone forms of malnutrition, CFM is associated with a higher risk of illness and death. This review examined published literature for assessing the prevalence, trends, and determinants of CFM in neonates, infants, and children. Methods A review of community-based observational studies was conducted. Seven databases, (CINAHL, Cochrane Library, EMBASE, Medline, PubMed, Scopus, and Web of Science) were used in December-2021 to retrieve literature. Google, Google Scholar and TROVE were used to search for grey literature. Key stakeholders were also contacted for unpublished documents. Studies measuring the prevalence, and/or trends, and/or determinants of CFM presenting in individuals were included. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools for prevalence and longitudinal studies. Results The search retrieved 14,207 articles, of which 24 were included in this review. The prevalence of CFM varied by geographical area and specific types. In children under 5 years, the coexistence of stunting with overweight/obesity ranged from 0.8% in the United States to over 10% in Ukraine and Syria, while the prevalence of coexisting wasting with stunting ranged from 0.1% in most of the South American countries to 9.2% in Niger. A decrease in CFM prevalence was observed in all countries, except Indonesia. Studies in China and Indonesia showed a positive association between rurality of residence and coexisting stunting with overweight/obesity. Evidence for other risk and protective factors for CFM is too minimal or conflicting to be conclusive. Conclusion Evidence regarding the prevalence, determinants and trends for CFM is scarce. Apart from the coexistence of stunting with overweight/obesity, the determinants of other types of CFM are unclear. CFM in any form results in an increased risk of health adversities which can be different from comparable standalone forms, thus, there is an urgent need to explore the determinants and distribution of different types of CFM. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13098-9.
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Affiliation(s)
- Asif Khaliq
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, 4059, Australia.
| | - Darren Wraith
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, 4059, Australia
| | - Smita Nambiar
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, 4059, Australia
| | - Yvette Miller
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, 4059, Australia
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Kolkenbeck-Ruh A, Soepnel LM, Kim AW, Naidoo S, Smith W, Davies J, Ware LJ. Pulse wave velocity in South African women and children: comparison between the Mobil-O-Graph and SphygmoCor XCEL devices. J Hypertens 2022; 40:65-75. [PMID: 34285149 PMCID: PMC8654263 DOI: 10.1097/hjh.0000000000002976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Carotid-femoral pulse wave velocity (PWV) is the gold-standard noninvasive measure of arterial stiffness. Data comparing tonometry-based devices such as the SphygmoCor XCEL to simpler brachial-cuff-based estimates of PWV, such as from the Mobil-O-Graph in African populations are sparse. We therefore aimed to compare PWV measured by the Mobil-O-Graph and the SphygmoCor XCEL device in a sample of South African women and children. METHODS Women (n = 85) 29 years [interquartile range (IQR): 29-69] and their children/grandchildren (n = 27) 7 years (IQR: 4-11) were recruited for PWV measurement with Mobil-O-Graph and SphygmoCor XCEL on the same day. Wilcoxon signed-rank test, regression analysis, spearman correlation and Bland-Altman plots were used for PWV comparison between devices. RESULTS For adults, the SphygmoCor XCEL device had a significantly higher PWV (7.3 m/s, IQR: 6.4-8.5) compared with the Mobil-O-Graph (5.9 m/s, IQR: 5.0-8.1, P = 0.001) with a correlation coefficient of 0.809 (P ≤ 0.001). Bland--Altman analysis indicated an acceptable level of agreement but significant bias (mean difference PWV: 0.90 ± 1.02 m/s; limits of agreement: -1.10 to 2.90). The odds of having a PWV difference more than 1 m/s decreased with a higher age [odds ratio (OR): 0.95, 95% confidence interval (95% CI) = 0.92-0.98] and increased with greater height (OR: 1.10, 95% CI = 1.01-1.21, P = 0.03) in multivariable analysis. In children, the Bland-Altman indicated an excellent level of agreement (-0.03 ± 0.63 m/s; limits of agreement: -1.26 to 1.21), but no correlation was found (rs = 0.08, P = 0.71). CONCLUSION Particularly in younger and taller women, the Mobil-O-Graph significantly underestimated PWV compared with the SphygmoCor. Although no correlation was found between the two devices for children, further research is required due to the small sample size. Furthermore, the clinical value of both methods in young African populations requires further investigation.
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Affiliation(s)
- Andrea Kolkenbeck-Ruh
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Larske Marit Soepnel
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Andrew Wooyoung Kim
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Anthropology, Northwestern University, Evanston, Illinois
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sanushka Naidoo
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Wayne Smith
- Hypertension in Africa Research Team (HART)
- South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Justine Davies
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Lisa Jayne Ware
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
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Double burden of malnutrition and its association with infant and young child feeding practices among children under-five in Thailand. Public Health Nutr 2021; 24:3058-3065. [PMID: 33054885 PMCID: PMC9884786 DOI: 10.1017/s1368980020003304] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study examined the prevalence of stunting-overweight and socio-demographic determinants among children under-five years of age, as well as associations with infant and young child feeding (IYCF) among children aged 6-23 months. DESIGN Secondary data analysis based on the Thailand Multiple Indicator Cluster Survey 2015-2016. SETTING Cross-national study. PARTICIPANTS Nationally representative sample of children under-five years of age (n 12 313). RESULTS The prevalence of wasting, stunting, overweight and stunting-overweight was 5·3, 10·5, 10·1 and 1·6 %, respectively. In multivariate analyses, children under 6 months, children from low and middle wealth tertiles, and children living in rural areas were prone to being wasted. Male children, low wealth tertile and a non-Thai speaking household head were positively and children aged 48-59 months and a one-child household were inversely associated with stunting. Children from a low wealth tertile were less likely to be overweight, while older age, male children and children from a one-child household were more likely to be overweight. Stunting-overweight was associated with children aged 24-47 months, male children, mothers having secondary education, a one-child household, a non-Thai speaking household head and an urban area. In terms of IYCF indicators, despite no association with stunting and stunted-overweight children, current breast-feeding and inadequate meal frequency were associated with being wasting, while current breast-feeding and dietary diversity were inversely associated with being overweight. CONCLUSIONS This study revealed the double burden of malnutrition at the individual and population levels among Thai children under-five, which calls for concrete integrated interventions to tackle all forms of malnutrition.
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Guevara-Romero E, Flórez-García V, Egede LE, Yan A. Factors associated with the double burden of malnutrition at the household level: A scoping review. Crit Rev Food Sci Nutr 2021; 62:6961-6972. [PMID: 33840313 DOI: 10.1080/10408398.2021.1908954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The double burden of malnutrition (DBM) at the household level has been defined as the coexistence of underweight children and overweight mothers within the same household. The objective of the scoping review was to identify and understand factors associated with DBM. We conducted the scoping review of published, peer-reviewed journal articles in two major databases used in public health research (PubMed and Web of Science). A total of 70 articles met the eligibility criteria. The following factors were identified: mother's age, height, educational level, occupation, food intake, breastfeeding, family income, family size, and urbanization type. Overall, results were heterogeneous. Two scenarios have been identified. The first scenario is those obese women with a job, having a sufficient income, a high educational level, the ability to purchase food, and live either in rural or urban areas. The second scenario is obese women without a job, having an insufficient income, a low educational level, without the ability to purchase food, and live either in rural or urban areas. The DBM at the household level is a complex public health problem. There is a need for target-specific interventions to address child undernutrition and maternal overweight/obesity simultaneously.
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Affiliation(s)
- Edwin Guevara-Romero
- Joseph J. Zilber School of Public Health, University of Wisconsin Milwaukee, Milwaukee, Wisconsin, USA
| | - Víctor Flórez-García
- Joseph J. Zilber School of Public Health, University of Wisconsin Milwaukee, Milwaukee, Wisconsin, USA.,Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Leonard E Egede
- Center for Advancing Population Science, Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Alice Yan
- Center for Advancing Population Science, Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Nutrient density and affordability of foods in Brazil by food group and degree of processing. Public Health Nutr 2020; 24:4564-4571. [PMID: 33109278 DOI: 10.1017/s1368980020004358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Affordable nutrition refers to the relation between nutrient density of foods and their monetary cost. There are limited data on affordable nutrition in low- and middle-income countries. The present study aimed to develop a nutrient density score and nutrient affordability metrics for 377 most consumed foods in Brazil. DESIGN The foods were aggregated into seven major food groups and four NOVA food categories. Nutrient composition data were obtained from the Brazilian Institute of Geography and Statistics. Food prices were obtained from retailer websites and were converted to prices per 100 g and 418 kJ. The Nutrient Rich Food (NRF8.2) score was based on protein, fiber, vitamins A, C and E, Ca, Fe and K. Nutrients to limit were sugar and Na. Affordability was measured as kcal/R$ and nutrients/R$. RESULTS Grains, fats and sweets were more energy dense and had lower NRF8.2 scores than dairy, vegetables and fruits. Grains, fats and sweets were the lowest cost sources of energy. Vegetables and fruits, beans, nuts and seeds and eggs and dairy were the lowest cost sources of multiple nutrients. Ultra-processed foods (48 % of total) had higher energy density and lower NRF8.2 scores than did unprocessed foods. In Brazil, fruits, vegetables and dairy products offered the most nutrients per real. CONCLUSIONS Analysis of the relationship between nutrient density of foods and their cost can help identify locally available foods that are nutrient rich, affordable and culturally acceptable. Achieving high nutrient density at an affordable cost should be the goal of Brazil's food systems.
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Shimabuku RL, Delgado CA, Nakachi G, Teruya AA, Velasquez PM. Double Burden of Excess Weight and Anemia in Latin American Children up to 2019. TOHOKU J EXP MED 2020; 252:159-168. [PMID: 33041315 DOI: 10.1620/tjem.252.159] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
The double burden of malnutrition is the coexistence of two different conditions, mainly reflected as excess or deficit in weight. Anemia is a specific nutritional deficit not always included in the double burden assessment. We reviewed overweight and/or obesity (OW/OB) and anemia studies from Latin-American Children over the last ten years up to 2019. Two authors evaluated the MEDLINE, SCOPUS, and LILACS databases. A scale of ten questions was used to assess the risk of bias in prevalence studies. Fourteen studies were selected. The population studies' size ranged from 147 to 20,342 children with different socio-economic backgrounds, such as urban, peri-urban and rural settings, socio-economic status, schooling, population (ethnic minorities and indigenous), and environmental differences (sea level or high altitude). The prevalence of OW/OB ranged from 4.9% to 42%. The prevalence of anemia was from 3.4% to 67%. The double burden, including OW/OB and anemia, ranged from 0.7% to 67%. A higher prevalence of excess weight and anemia was found in rural and high altitude above sea level environments, extreme poverty, low education level, and indigenous communities. These heterogeneous data, before the 2020 (COVID-19 pandemic), reflect the vast inequities between countries and within each country. Food insecurity linked to poverty and the induced change in eating habits and lifestyles threaten optimal child nutrition in ongoing and future scenarios. The existence of OW/OB and anemia and their simultaneous coexistence in the community, home, and individual levels, indicates that interventions should be comprehensive to face the double burden of malnutrition.
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Affiliation(s)
- Roberto L Shimabuku
- Department of Pediatrics, Faculty of Medicine, Universidad Nacional Mayor de San Marcos
| | - Carlos A Delgado
- Department of Pediatrics, Faculty of Medicine, Universidad Nacional Mayor de San Marcos
- Neonatal Unit, Instituto Nacional de Salud del Niño
| | | | - Alberto A Teruya
- Department of Endocrinology, Hospital Edgardo Rebagliati Martins
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12
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Prevalence of malnutrition among children and women of reproductive age in Uruguay by socio-economic status and educational level. Public Health Nutr 2020; 23:s101-s107. [PMID: 32299530 DOI: 10.1017/s1368980020000804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To describe the magnitude and distribution of malnutrition in all forms (stunting, wasting, overweight and obesity) by level of education and socio-economic status (SES). DESIGN Representative data from three national surveys were used: the socio-economic characteristics of Uruguayan households the 2012-2013; the Survey of Child Health, Nutrition and Development and the Survey of Chronic Disease Risks. We defined overweight, obesity, wasting/underweight and stunting/short stature according to WHO criteria. We conducted a comparison between malnutrition prevalence values per SES and education level. SETTING In total, 1 183 177 households were surveyed, including 2265 children's and 752 women's households, forming a nationally representative sample in urban areas with more than 5000 habitants. PARTICIPANTS A total of 3079 children aged <4 years from the National Survey of Child Health, Nutrition and Development 2013 and 752 women aged 20-49 years from the National Survey of Chronic Disease Risks 2013 were included. RESULTS Among children aged <4 years, stunting and overweight disproportionately affected low-wealth groups, with 5·45 % of children in the lower income tertile and 3·44 % in the upper tertile presenting stunting (P < 0·05). Overweight and obesity were higher in the third tertile of income. Among the women, 54·8 % (95 % CI 48·0, 61·6) had excess weight (overweight and obesity) and significant differences were found between those with the lowest and highest levels of SES. Regarding excess weight with respect to educational level, significant differences were also found between the low and high levels and between the medium and high levels. CONCLUSIONS In Uruguay, there are slight differences in the prevalence of all forms of malnutrition according to SES and education levels in the populations considered. Excess weight in children and women poses the greatest public health nutritional challenge at all levels of SES and education. The fact that more educated mothers are more overweight differs from the findings in other countries and should be studied in more detail. Stunting in children is also important, requiring more focused interventions. Notably, excess weight is higher in more educated mothers, a fact that differs from other countries. Further analysis is important to understand this discrepancy.
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Nutrition status in adult Chilean population: economic, ethnic and sex inequalities in a post-transitional country. Public Health Nutr 2020; 23:s39-s50. [PMID: 32131930 DOI: 10.1017/s1368980019004439] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess the relationship between malnutrition, socioeconomic status (SES) and ethnicity in Chilean adult population. DESIGN Nationally representative survey (ENS) conducted in 2016-2017. Sociodemographic information, weight, height and hemoglobin (Hb) were measured (2003 ENS). Excess weight was defined as BMI ≥25 kg/m2. Undernutrition included underweight (BMI <18·5 kg/m2), short stature (height <1·49 m in women and <1·62 m in men) or anaemia (Hb <12 g/l). Education and household income level were used as indicators of SES; ethnicity was self-reported. We applied linear combinations of estimators to compare the prevalence of excess weight and undernutrition by SES and ethnicity. SETTING Chile. PARTICIPANTS In total, 5082 adults ≥20 years (64 % women) and 1739 women ≥20 years for anaemia analyses. RESULTS Overall, >75 % of women and men had excess weight. Low SES women either by income or education had higher excess weight ((82·0 (77·1, 86·1) v. 65·0 (54·8, 74·1)) by income; (85·3 (80·6, 89·0) v. 68·2 (61·6, 74·1) %) by education) and short stature (20-49 years; 31(17·9, 48·2) v. 5·2 (2·2,11·4) by education); obesity was also more frequent among indigenous women (20-49 years; 55·8 (44·4, 66·6) v. 37·2 (32·7, 42·0) %) than non-indigenous women. In men, excess weight did not significantly differ by SES or ethnicity, but short stature concentrated in low SES (20-49 years; 47·6 (24·6, 71·6) v. 4·5 (2·1, 9·5) by education) and indigenous men (21·5 (11·9, 5·5, 11·9) v. 8·2 (5·5, 11·9)) (P < 0·05 for all). CONCLUSIONS In Chile, malnutrition is disproportionately concentrated among women of low SES and indigenous origin; these inequalities should be considered when implementing prevention policies.
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Ghattas H, Acharya Y, Jamaluddine Z, Assi M, El Asmar K, Jones AD. Child-level double burden of malnutrition in the MENA and LAC regions: Prevalence and social determinants. MATERNAL AND CHILD NUTRITION 2019; 16:e12923. [PMID: 31828957 PMCID: PMC7083402 DOI: 10.1111/mcn.12923] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 11/05/2019] [Accepted: 11/15/2019] [Indexed: 12/18/2022]
Abstract
Although the prevalence of obesity has rapidly increased in the low‐ and middle‐income countries of the Middle East and North Africa (MENA) and Latin America and the Caribbean (LAC) regions, child undernutrition remains a public‐health challenge. We examined region‐specific sociodemographic determinants of this double burden of malnutrition, specifically, the co‐occurrence of child stunting and overweight, using Demographic and Health Survey and Multiple Indicator Cluster Survey data (2003–2016) from 11 countries in the MENA (n = 118,585) and 13 countries in the LAC (n = 77,824) regions. We used multiple logistic regressions to model region‐specific associations of maternal education and household wealth with child nutritional outcomes (6–59 months). The prevalence of stunting, overweight, and their co‐occurrence was 24%, 10%, and 4.3% in children in the MENA region, respectively, and 19%, 5%, and 0.5% in children in the LAC region, respectively. In both regions, higher maternal education and household wealth were significantly associated with lower odds of stunting and higher odds of overweight. As compared with the poorest wealth quintiles, decreased odds of co‐occurring stunting and overweight were observed among children from the second, third, and fourth wealth quintiles in the LAC region. In the MENA region, this association was only statistically significant for the second wealth quintile. In both regions, double burden was not statistically significantly associated with maternal education. The social patterning of co‐occurring stunting and overweight in children varied across the two regions, indicating potential differences in the underlying aetiology of the double burden across regions and stages of the nutrition transition.
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Affiliation(s)
- Hala Ghattas
- Faculty of Health SciencesAmerican University of Beirut, Beirut, Lebanon
| | - Yubraj Acharya
- Department of Health Policy and Administration, The Pennsylvania State University, Pennsylvania
| | - Zeina Jamaluddine
- Faculty of Health SciencesAmerican University of Beirut, Beirut, Lebanon
| | - Moubadda Assi
- Faculty of Health SciencesAmerican University of Beirut, Beirut, Lebanon
| | - Khalil El Asmar
- Faculty of Health SciencesAmerican University of Beirut, Beirut, Lebanon
| | - Andrew D Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
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15
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Sahargahi B, Abdollahzad H, Moludi J, Nachvak SM, Pasdar Y, Naderi MR, Rezaei M. Anthropometric Indices from Primary to High School in the West of Iran: Epidemiologic Trends. Clin Nutr Res 2018; 7:189-198. [PMID: 30079317 PMCID: PMC6073175 DOI: 10.7762/cnr.2018.7.3.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/14/2018] [Accepted: 07/16/2018] [Indexed: 11/21/2022] Open
Abstract
Examining the trend of anthropometric indices in children and adolescents in each region can be highly beneficial in providing effective strategies to improve the status of their growth. This study was conducted with the aim of determining the trend of anthropometric indices in students from primary to high school in the west of Iran. Data were collected using a demographic questionnaire and health certificates for anthropometric information of primary school students, and current anthropometric measurements with scale for high school students. Then, all of the data were analyzed in AnthroPlus and SPSS software. Of the 731 students, 350 were female and 381 were male. Mean height Z-score to age showed a significant reduction from primary to high school (from +0.0386 to −0.27416), and mean body mass index Z-score to age showed a significant increase (from −0.3916 to +0.1826). Prevalence of stunting and overweight/obesity in high school was 1.4 and 2.5 times higher than primary school, respectively, but the prevalence of wasting reduced by 2.3 fold. Girls were more affected by the increased trend of obesity and stunting compared to boys. Nutritional transition was evident in students. Healthcare policy-makers should design and implement a comprehensive health strategy to deal with this situation, especially in girls.
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Affiliation(s)
- Badrieh Sahargahi
- Administration of Food and Drug, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Hadi Abdollahzad
- Department of Nutrition, Faculty of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Jalal Moludi
- Nutrition Research Center, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz 5166614711, Iran.,Students' Research Committee, Tabriz University of Medical Sciences, Tabriz 5166614711, Iran
| | - Seyed Mostafa Nachvak
- Department of Nutrition, Faculty of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Yahya Pasdar
- Department of Nutrition, Faculty of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Mohammad Reza Naderi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Mansour Rezaei
- Health and Treatment Network of Eslamabade Gharb, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
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16
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Martinez H, Morin C, Gandy J, Carmuega E, Arredondo JL, Pimentel C, Moreno LA, Kavouras SA, Salas-Salvadó J, Guelinckx I. Fluid intake of Latin American adults: results of four 2016 Liq.In 7 national cross-sectional surveys. Eur J Nutr 2018; 57:65-75. [PMID: 29858627 PMCID: PMC6008364 DOI: 10.1007/s00394-018-1724-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/18/2018] [Indexed: 01/22/2023]
Abstract
Purpose To report total fluid intake (TFI) and the intake of different fluid types in adults (≥ 18 years old) from Mexico, Argentina, Brazil and Uruguay. To compare intakes between countries and with recommended adequate intake (AI) of water from fluids. Methods Cross-sectional data were collected using a validated liquid intake 7-day record (Liq.In7) in populations from Argentina (n = 1089), Brazil (n = 477), Mexico (n = 1677) and Uruguay (n = 554). Population characteristics, including age, gender, body mass index and socioeconomic level were recorded. Mean TFI was compared with the AI of water from fluids set by the USA Institute of Medicine. Results The lowest TFI was recorded in Mexican women (1748 mL/day) and the highest in Argentinean men (2318 mL/day). Median daily TFI was significantly different between countries; Uruguay and Argentina had higher values than Mexico and Brazil. In the former, plain water contributed to only 25% of TFI, the remainder being predominantly from hot beverages. Approximately, a third of adults did not drink enough fluid to meet the recommended AI. High SSB consumption was reported, which was significantly different between countries (p < 0.05), the highest being in Mexico (median 25–75th percentiles): 531 (300–895 mL/day. Conclusions This survey highlights the need to increase water consumption and reduce SSB intake in this region to avoid potential associated health risks. These findings may be useful information in monitoring public health policy strategies. Electronic supplementary material The online version of this article (10.1007/s00394-018-1724-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- H Martinez
- Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - C Morin
- Department of Hydration and Health, Danone Research, Route Départemental 128, 91767, Palaiseau, France
| | - J Gandy
- British Dietetic Association, Birmingham, UK.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - E Carmuega
- Center of Studies on Infant Nutrition (CESNI) Buenos Aires, Buenos Aires, Argentina
| | - J L Arredondo
- Unidad de Apoyo a la Investigación Clínica, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - C Pimentel
- Unidad de Apoyo a la Investigación Clínica, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - L A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto Investigación Sanitaria Aragón (IIS Aragón) Zaragoza, Zaragoza, Spain.,CIBERobn (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición), Institute of Health Carlos III, Madrid, Spain
| | - S A Kavouras
- Hydration Science Lab, University of Arkansas, Fayetteville, AR, USA.,Division of Endocrinology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J Salas-Salvadó
- CIBERobn (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición), Institute of Health Carlos III, Madrid, Spain.,Human Nutrition Unit, Biochemistry and Biotechnology Department, Faculty of Medicine and Health Sciences, Hospital Universitari de Sant Joan de Reus, IISPV (Institut d'Investigació Sanitària Pere Virgili), Universitat Rovira i Virgili, Reus, Spain
| | - I Guelinckx
- Department of Hydration and Health, Danone Research, Route Départemental 128, 91767, Palaiseau, France.
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Abstract
While some of our countries are still facing nutrition deficiencies (stunting/short stature and micronutrient deficiencies), overweight and obesity are increasing in an alarming way. In addition, a very limited research network and lack of funding make it extremely challenging to foster collaborative efforts to address the complex nutritional problems that Latin America is facing. Therefore, as the future leaders in nutrition, we reinforce our commitment to improve our research capacity to identify opportunities for action to end malnutrition in all its forms in our region to address health disparities and to strengthen the Latin American Society of Nutrition.
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18
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Montagnese C, Santarpia L, Iavarone F, Strangio F, Caldara AR, Silvestri E, Contaldo F, Pasanisi F. North and South American countries food-based dietary guidelines: A comparison. Nutrition 2017; 42:51-63. [PMID: 28870479 DOI: 10.1016/j.nut.2017.05.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/07/2017] [Accepted: 05/29/2017] [Indexed: 11/18/2022]
Abstract
Food-based dietary guidelines (FBDGs) are regularly updated educational documents that provide scientific information on nutritional needs and food composition to the general population. The aim of this study was to review the FBDGs of countries in the Americas and compare them based on their pictorial representation, food grouping, and associated messages on healthy eating and behavior, considering intercultural differences. FBDGs from 30 countries in the Americas were collected, representing 97% of the entire North and South American population. Of these FBDGs, 93% (28 of 30) have adopted a food guide illustration shape that conveys local traditions and classifies foods into six or seven groups. The main food groups are vegetables, fruits, cereals, starchy vegetables and fruits, legumes, milk and dairy, protein-rich foods, oils and fats, and sugar and sweeteners. Some differences include single food classifications. Despite the dietary pattern resulting from geographic conditions and cultural heritages, the main nutritional keypoints are similar among the different American FBDGs as follows: (1) Consume large amounts of fruits, vegetables, and cereals; and (2) limit intake of fat, simple sugars, and salt. Although there is general agreement on the basic nutritional messages, FBDGs remain insufficient regarding food groups and the identification of subgroup population nutritional requirements, particularly in countries where both excess and deficit malnutrition are present.
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Affiliation(s)
- Concetta Montagnese
- Clinical Nutrition and Internal Medicine, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Lidia Santarpia
- Clinical Nutrition and Internal Medicine, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy; Interuniversity Center for Obesity and Eating Disorders, Department of Clinical Nutrition and Internal Medicine, Federico II University, Naples, Italy
| | - Fabio Iavarone
- Clinical Nutrition and Internal Medicine, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Francesca Strangio
- Clinical Nutrition and Internal Medicine, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Anna Rita Caldara
- Clinical Nutrition and Internal Medicine, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Eufemia Silvestri
- Clinical Nutrition and Internal Medicine, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Franco Contaldo
- Clinical Nutrition and Internal Medicine, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy; Interuniversity Center for Obesity and Eating Disorders, Department of Clinical Nutrition and Internal Medicine, Federico II University, Naples, Italy
| | - Fabrizio Pasanisi
- Clinical Nutrition and Internal Medicine, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy; Interuniversity Center for Obesity and Eating Disorders, Department of Clinical Nutrition and Internal Medicine, Federico II University, Naples, Italy
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19
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A systematic review of the prevalence and predictors of the double burden of malnutrition within households. Br J Nutr 2017; 117:1118-1127. [PMID: 28514987 DOI: 10.1017/s0007114517000812] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Recently, increasing attention has been paid to the emergence of the double burden of malnutrition within households. We provide an overview of the literature regarding this phenomenon by reviewing previous studies of the prevalence of double-burden households and associated factors together with the research methods used. Studies were identified from the electronic databases PubMed and Web of Science, using the same search terms for both. A total of thirty-five articles met the eligibility criteria, and 367 sets of prevalence data were extracted. In all, thirty-four articles were published in 2000 or later; twenty-four used secondary data and twenty-five focused on mother-child pairs. The ages of children varied from 0 to 19 years. All the studies used BMI as a nutritional indicator for adults. For children, height-for-age was most frequently used, whereas weight-for-age, weight-for-height and BMI-for-age were also used in multiple studies. The reported national prevalence of double-burden households varied from 0·0 to 26·8 % by country and year; however, few studies were directly comparable, because of differences in the combinations of undernourished and overweight persons, age ranges, nutritional indicators and cut-off points. Whereas many focused on African countries, a few involved Asian countries. Although urban residence, income and education were frequently assessed, the role of intermediate factors in nutritional status, such as diet and physical activity, remains unclear. It is recommended that future studies use comparable indicators and cut-off points, involve Asian countries, and investigate individual diet and physical activity.
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Stunting coexisting with overweight in 2·0-4·9-year-old Indonesian children: prevalence, trends and associated risk factors from repeated cross-sectional surveys. Public Health Nutr 2016; 19:2698-707. [PMID: 27120968 PMCID: PMC5039402 DOI: 10.1017/s1368980016000926] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective The persistence of undernutrition, along with overweight and obesity, constitute the double burden of malnutrition. The present study aimed to: (i) describe the prevalence and trends of concurrent stunting and overweight in Indonesian children; (ii) identify potentially associated risk factors; and (iii) determine whether stunted children are at greater risk of overweight compared with those of healthy height. Design A secondary data analysis of children aged 2·0–4·9 years in four cross-sectional studies of the Indonesian Family Life Survey. Children’s height and BMI Z-scores were calculated based on the WHO Child Growth Standards (2006). We defined ‘concurrent stunting and overweight’ as height-for-age Z-score <−2 and BMI Z-score >+1. Multivariate generalised linear latent and mixed models were used to determine associated risk factors. Setting Thirteen out of twenty-seven provinces in Indonesia. Subjects Children (n 4101) from four waves of the Indonesian Family Life Survey (1993–2007). Results There were inconsistent trends in the prevalence of concurrent stunting and overweight from waves 1 to 4. Children were more likely to be stunted and overweight when they were in the youngest age group (2·0–2·9 years), were weaned after the age of 6 months, had short-statured mothers or lived in rural areas. Stunted children were significantly more likely to be overweight than healthy-height children (OR>1) but did not differ significantly different across each wave (OR=1·34–2·01). Conclusions Concurrent stunting and overweight occurs in Indonesian children aged 2·0–4·9 years. Current policies and programmes need to be tailored for the management of this phenomenon.
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Abstract
Many developing countries have achieved a remarkable improvement in nutrition status in the past decades. However, the prevalence of undernutrition remains a serious problem. At the same time, the prevalence of obesity is increasing substantially, and in some countries, it has approached that of developed countries. This article provides an update on this double burden of malnutrition (DBMN) in developing nations. One hundred countries (lower, middle-lower, and upper-middle income countries) were selected and analysed, and to support the analysis, a systematic review of current published studies was performed. The results show that DBMN already exists in almost all developing countries and that the DBMN ratio (i.e., overweight/underweight) has increased as income per capita has increased. DBMN may manifest within the community, household, or individual. In addition to common factors, poor nutrition in early childhood is suggested as another important driving factor behind the rising obesity rate in most developing countries. A life-course approach has been proposed to prevent undernutrition and overnutrition and should be integrated into the development of health systems to control double burden in developing countries.
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Affiliation(s)
- Asnawi Abdullah
- Department of Biostatistics and Population Health, Faculty of Public Health, University Muhammadiyah Aceh, Jln. Leung Bata, Batoh, Banda Aceh, Indonesia, 23245.
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Malvern East, Australia.
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Rivera JA, Pedraza LS, Martorell R, Gil A. Introduction to the double burden of undernutrition and excess weight in Latin America. Am J Clin Nutr 2014; 100:1613S-6S. [PMID: 25411302 DOI: 10.3945/ajcn.114.084806] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Juan A Rivera
- From the Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico (JAR and LSP); the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA (RM); and the Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain (AG)
| | - Lilia S Pedraza
- From the Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico (JAR and LSP); the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA (RM); and the Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain (AG)
| | - Reynaldo Martorell
- From the Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico (JAR and LSP); the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA (RM); and the Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain (AG)
| | - Angel Gil
- From the Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico (JAR and LSP); the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA (RM); and the Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain (AG)
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