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Hossain MI, Rahman A, Uddin MSG, Zinia FA. Double burden of malnutrition among women of reproductive age in Bangladesh: A comparative study of classical and Bayesian logistic regression approach. Food Sci Nutr 2023; 11:1785-1796. [PMID: 37051361 PMCID: PMC10084956 DOI: 10.1002/fsn3.3209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 12/04/2022] [Accepted: 12/19/2022] [Indexed: 01/08/2023] Open
Abstract
Although the prevalence of undernutrition among women of reproductive age has declined in Bangladesh, the increase in the prevalence of overnutrition remains a major challenge. To achieve Sustainable Development Goal 2.2, it is important to identify the drivers of the double burden of malnutrition on women in Bangladesh. The Bangladesh Demographic and Health Survey, 2017-2018 was used to model the relationship between the double burden of malnutrition among women and the risk factors using a logistic regression model under the classical and Bayesian frameworks and performed the comparison between the regression models based on the narrowest confidence interval. Regarding the Bayesian application, the Metropolis-Hastings algorithm with two types of prior information (historical and noninformative prior) was used to simulate parameter estimates from the posterior distributions. The Boruta algorithm was used to determine the significant predictors. Almost half of reproductive aged women experienced a form of malnutrition (12% were underweight, 26.1% were overweight, and 6.8% were obese). In terms of the narrowest interval estimate, it was found that Bayesian logistic regression with informative priors performs better than the noninformative priors and the classical logistic regression model. Women who were older, highly educated, from rich families, unemployed, and from urban residences were more likely to experience the double burden of malnutrition. This study recommended using the historical prior as the informative prior rather than the flat/noninformative prior to estimating the parameter uncertainty if historical data are available. The double burden of malnutrition among women is a major public health challenge in Bangladesh. This study was to determine the impact of effective risk factors on the double burden of malnutrition among women by applying the Bayesian framework. Using both informative and noninformative priors, "historical prior" was proposed as informative prior information. The main strength is that the proposed prior (historical prior) provided improved estimation as compared to the flat prior distribution.
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Affiliation(s)
| | - Azizur Rahman
- Department of StatisticsJahangirnagar UniversitySavar, DhakaBangladesh
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Rifat M, Wahab MA, Rahman MA, Nahiduzzaman M, Mamun AA. Nutritional value of the marine fish in Bangladesh and their potential to address malnutrition: A review. Heliyon 2023; 9:e13385. [PMID: 36873138 PMCID: PMC9975239 DOI: 10.1016/j.heliyon.2023.e13385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 01/14/2023] [Accepted: 01/29/2023] [Indexed: 02/11/2023] Open
Abstract
Marine fish are good source of essential macro- and micronutrients and major food items in coastal areas in Bangladesh. However, there is no review that details the nutritional value of marine fish in Bangladesh. Therefore, this review focuses on the nutrient composition of marine fish in Bangladesh and how the marine fish can address common nutrient deficiencies among women and children. Nutrient composition data was collected through literature searching in databases and source, including PubMed, Web of Science, Google Scholar, ScienceDirect, WorldFish, and Bangladesh-based database Banglajol. Calculation was carried out to present how one serving marine fish could potentially meet the daily requirement of protein, iron, zinc, calcium, vitamin A, and docosahexaenoic acid (DHA) for pregnant and lactating women and children aged 6-23 months. A total of 97 entries covering nutrient composition analysis of 67 individual fish species were extracted from 12 articles published between 1993 and 2020. Included articles contained analysis of proximate composition, vitamins, minerals, fatty acids, and amino acid. Twelve minerals and nine vitamins were analyzed and reported. The average energy, protein, fat, and ash content per 100 g edible raw marine fish was 343.58 kJ, 16.76 g, 4.16 g, and 2.22 g, respectively. According to available data, marine fish are good sources of protein, zinc, calcium, and DHA. Pelagic small fish, which are mainly captured by artisanal small-scale fishers, had more nutritional value than other categories of fish. Furthermore, marine small fish were found more nutritious than commonly consumed freshwater fish types in Bangladesh, including major carps, introduced carps, and tilapia. Therefore, the study concludes that marine fish have high potential to address malnutrition in Bangladesh. There was scarcity of literature regarding the nutrient composition of marine fish in Bangladesh and in South Asia as a whole, so more comprehensive quality research in this area is recommended.
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Affiliation(s)
- M.A. Rifat
- Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden
- WorldFish, Dhaka, 1212, Bangladesh
- Corresponding author. Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden.
| | | | | | | | - Abdullah-Al Mamun
- Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
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Sahiledengle B, Mwanri L, Agho KE. Association between maternal stature and household-level double burden of malnutrition: findings from a comprehensive analysis of Ethiopian Demographic and Health Survey. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:7. [PMID: 36691083 PMCID: PMC9872360 DOI: 10.1186/s41043-023-00347-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/20/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND Undernutrition among under-five children is one of the intractable public health problems in Ethiopia. More recently, Ethiopia faced a rising problem of the double burden of malnutrition-where a mother may be overweight/obese, and a child is stated as having undernutrition (i.e., stunting, wasting, or underweight) under the same roof. The burden of double burden of malnutrition (DBM) and its association with maternal height are not yet fully understood in low-income countries including Ethiopia. The current analysis sought: (a) to determine the prevalence of double burden of malnutrition (i.e., overweight/obese mother paired with her child having one form of undernutrition) and (b) to examine the associations between the double burden of malnutrition and maternal height among mother-child pairs in Ethiopia. METHODS We used population-representative cross-sectional pooled data from four rounds of the Ethiopia Demographic and Health Survey (EDHS), conducted between 2000 and 2016. In our analysis, we included children aged 0-59 months born to mothers aged 15-49 years. A total of 33,454 mother-child pairs from four waves of EDHS were included in this study. The burden of DBM was the primary outcome, while the maternal stature was the exposure of interest. Anthropometric data were collected from children and their mothers. Height-for-age (HFA), weight-for-height (WFH), and weight-for-age (WFA) z-scores < - 2 SD were calculated and classified as stunted, wasting, and underweight, respectively. The association between the double burden of malnutrition and maternal stature was examined using hierarchical multilevel modeling. RESULTS Overall, the prevalence of the double burden of malnutrition was 1.52% (95% CI 1.39-1.65). The prevalence of overweight/obese mothers and stunted children was 1.31% (95% CI 1.19-1.44), for overweight/obese mothers and wasted children, it was 0.23% (95% CI 0.18-0.28), and for overweight/obese mothers and underweight children, it was 0.58% (95% CI 0.51-0.66). Children whose mothers had tall stature (height ≥ 155.0 cm) were more likely to be in the double burden of malnutrition dyads than children whose mothers' height ranged from 145 to 155 cm (AOR: 1.37, 95% CI 1.04-1.80). Similarly, the odds of the double burden of malnutrition was 2.98 times higher for children whose mothers had short stature (height < 145.0 cm) (AOR: 2.98, 95% CI 1.52-5.86) compared to those whose mothers had tall stature. CONCLUSIONS The overall prevalence of double burden of malnutrition among mother-child pairs in Ethiopia was less than 2%. Mothers with short stature were more likely to suffer from the double burden of malnutrition. As a result, nutrition interventions targeting households' level double burden of malnutrition should focus on mothers with short stature to address the nutritional problem of mother and their children, which also has long-term and intergenerational benefits.
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Affiliation(s)
- Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia
| | - Lillian Mwanri
- grid.449625.80000 0004 4654 2104Centre for Public Health Research, Equity and Human Flourishing, Torrens University Australia, Adelaide Campus, Adelaide, SA 5000 Australia
| | - Kingsley Emwinyore Agho
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia ,grid.1029.a0000 0000 9939 5719School of Medicine, Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, NSW 2571 Australia ,grid.16463.360000 0001 0723 4123African Vision Research Institute, University of KwaZulu-Natal, Durban, 4041 South Africa
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Habtu M, Agena AG, Umugwaneza M, Mochama M, Munyanshongore C. Effect of integrated nutrition-sensitive and nutrition-specific intervention package on maternal malnutrition among pregnant women in Rwanda. MATERNAL & CHILD NUTRITION 2022; 18:e13367. [PMID: 35538044 PMCID: PMC9218321 DOI: 10.1111/mcn.13367] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/28/2022] [Accepted: 04/05/2022] [Indexed: 01/10/2023]
Abstract
Maternal undernutrition remains a major public health concern in Rwanda despite significant gains and progress. An integration of nutrition‐specific and nutrition‐sensitive interventions was implemented in five districts of Rwanda to improve maternal and child nutrition. The package included nutrition education and counselling, promotion of agricultural productivity, promotion of financial literacy/economic resilience and provision of Water, Hygiene and Sanitation services. However, there is limited evidence about the effect of such interventions in reducing maternal undernutrition. A postintervention quasi‐experimental study was conducted among pregnant women to determine the effect of the integrated intervention on their nutritional status. It was carried out in two intervention districts, namely Kicukiro and Kayonza, and two control districts, namely Gasabo and Gisagara between November 2020 and June 2021. Five hundred and fifty‐two women were recruited for the intervention arm, while 545 were recruited for the control arm. Maternal undernutrition was defined as either having low mid‐upper arm circumference (<23 cm) during delivery or low body mass index (<18.5 kg/m2) in the first trimester or both. A multivariable logistic regression model was used to assess the effect of the integrated interventions. The prevalence of maternal undernutrition was significantly lower in the intervention group compared with the control group (4.7% vs. 18.2%; p < 0.001). After controlling the potential confounders, the risk of maternal undernutrition was 77.0% lower in the intervention group than in the control group [adjusted odds ratio= 0.23; 95% confidence interval = 0.15–0.36; p < 0.001]. Further studies are therefore recommended to establish causation and inform the potential scale‐up of these interventions nationally in Rwanda. Empirical evidence on the effect of integrated nutrition‐specific and nutrition‐sensitive interventions on maternal undernutrition is limited as existing studies are mainly directed at the effectiveness of nutritional interventions on improving child nutritional status. The results indicated that the integrated nutrition‐specific and nutrition‐sensitive intervention package was significantly associated with low maternal undernutrition. This study adds more evidence to the 2008, 2013 and 2021 Lancet Series regarding the proposed effectiveness of integrated nutrition‐sensitive and nutrition‐specific interventions. Further research should focus on follow‐up randomized controlled trials and the cost‐effectiveness of these integrated nutrition‐specific and nutrition‐sensitive interventions.
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Affiliation(s)
- Michael Habtu
- College of Medicine and Health Sciences, School of Public Health, University of Rwanda, Kigali, Rwanda.,Catholic Relief Services, Kigali, Rwanda.,Department of Public Health, School of Health Sciences, University of Mount Kenya, Kigali, Rwanda
| | | | - Maryse Umugwaneza
- College of Medicine and Health Sciences, School of Public Health, University of Rwanda, Kigali, Rwanda
| | - Monica Mochama
- Department of Public Health, School of Health Sciences, University of Mount Kenya, Kigali, Rwanda
| | - Cyprien Munyanshongore
- College of Medicine and Health Sciences, School of Public Health, University of Rwanda, Kigali, Rwanda
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Saha S, Pandya A, Kandre Y, Raval D, Saxena D. Cross-Sectional Analysis of Nutritional Status, Knowledge and Uptake of Nutritional Services Among Adolescent Girls in Western India. Adolesc Health Med Ther 2021; 12:117-125. [PMID: 34934378 PMCID: PMC8684370 DOI: 10.2147/ahmt.s336071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/11/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Malnutrition status of adolescent girls remains a major public health problem in India. The present study assessed nutritional status, associated factors contributing to malnutrition and their access to health-care services in Dev Bhumi Dwarka district of Gujarat situated in western part of India. Materials and Methods The study was carried out using descriptive cross-sectional design. A total of 1252 adolescent girls from all four blocks of Dev Bhumi Dwarka district were interviewed by field investigators. The data were collected on socio-demographic characteristics, physical activities, diet, and anthropometry. The WHO classification for body mass index (BMI) was used to assess underweight, overweight, and obesity among adolescent girls. Chi-square analyses were performed to identify significant determinants of under-nutrition. Results Mean age of the study population was 13.82±2.31. Of the total, around 34% of the adolescent girls were out-of-school. The prevalence of underweight (<-2SD) was 19.6%, 8.9% were overweight, and 2.6% were obese. The mean BMI was 19.77±2.42 kg/m2, and height was 149.15 (2.23m2). In terms of knowledge, almost 79.6% were unaware of iron-deficiency anaemia, about 70% were not aware of haemoglobin test, and 44% did not know the benefit of using sanitary napkins. In addition, uptake of nutritional and health services was limited. The study found a statistically significant association of age (p = 0.00), the number of family members (p = 0.016), knowledge (p = 0.05), and use of toilet (0.041) with low-BMI. Conclusion Existing nutritional interventions need to focus on nutrition, health and hygiene education. It also reinforces a need for implementation research to understand barriers in uptake of health and nutrition services.
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Affiliation(s)
- Somen Saha
- Department of Public Health, Indian Institute of Public Health, Gandhinagar, Gujarat, India
- Correspondence: Somen Saha Department of Public Health, Indian Institute of Public Health, Opp. Air Force Headquarter, Gandhinagar-Chiloda Highway, Near Lekawada Bus Stop, Gandhinagar, Gujarat, IndiaTel +91-968-7207549 Email
| | - Apurvakumar Pandya
- Parul Institute of Public Health, Parul University, Vadodara, Gujarat, India
| | - Yogini Kandre
- Department of Public Health, Indian Institute of Public Health, Gandhinagar, Gujarat, India
| | - Devang Raval
- Department of Public Health, Indian Institute of Public Health, Gandhinagar, Gujarat, India
| | - Deepak Saxena
- Department of Public Health, Indian Institute of Public Health, Gandhinagar, Gujarat, India
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Kamruzzaman M. Is BMI associated with anemia and hemoglobin level of women and children in Bangladesh: A study with multiple statistical approaches. PLoS One 2021; 16:e0259116. [PMID: 34710186 PMCID: PMC8553127 DOI: 10.1371/journal.pone.0259116] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/12/2021] [Indexed: 01/09/2023] Open
Abstract
Background The coexistence of undernutrition and obesity is an emerging problem for developing countries like Bangladesh. Anemia is another critical public health threat, prevalent predominantly among women and children. Undernutrition is linked with a higher risk of anemia, and lower dietary iron intake might be the possible reason. However, the risk of anemia among obese/overweight individuals is controversial. The study explores the relation of BMI with anemia and blood hemoglobin level among women and children in Bangladesh. Methods Multiple statistical approaches were employed to nationally representative secondary data (BDHS 2011) on women (n = 5680) age 15–49 years and children (n = 2373) age 6–59 months to illuminate the relation between BMI and anemia. BMI was categorized according to the WHO recommended BMI category for Asian people. Descriptive statistics were used to measure mean hemoglobin level. Chi-square test, Pearson correlation, Two-way ANOVA, binary, ordinal, and restricted cubic splines (RCS) regression were used to study the association of BMI with anemia and hemoglobin level. Results Chi-square test reveals significant association, though not intense, among BMI and anemia categories of women (15–49 years) (χ2 ≥99, p<2.2e-16 and Cramér’s V = 0.0799–0.1357). From ANOVA analysis, a significant difference in blood hemoglobin level was found among women (total sample and nonpregnant) with different BMI categories (p≤0.05). Binary (Severely Underweight: OR 1.2680, 95% CI 0.755–2.161; Obese: OR 0.4038, 95% CI 0.120–1.177), Ordinal logistic regression (Severely Underweight: OR 1.337, 95% CI 0.842–2.115; Obese: OR 0.504, 95% CI 0.153–1.411) and restricted cubic spline regression (Severely Underweight: OR >1.5; Obese: OR ~0.5) reveal that the risk of anemia was higher among underweight and lower among obese/overweight women compared to normal women. Lower anemia risk among richest women indicates probable higher dietary iron intake among obese/overweight women. Conclusion In the current study, women with overweight/obesity from Bangladesh were shown to have lower likelihood of being anemic, while underweight women more likely to be anemic. However, no relation between BMI and anemia was found among children.
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Affiliation(s)
- Md Kamruzzaman
- Dept. of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh
- * E-mail: ,
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The association of sleep problem, dietary habits and physical activity with weight status of adolescents in Nepal. BMC Public Health 2021; 21:938. [PMID: 34001092 PMCID: PMC8130305 DOI: 10.1186/s12889-021-10985-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 05/05/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Overweight/obesity among adolescents is an emerging public health issue worldwide. However, the evidence on the determinants of body weight status and lifestyle behaviors among Nepalese adolescents is limited. This study aims to explore the sleep characteristics, dietary habits, and physical activity and its association with body mass index (BMI) among Nepalese adolescents. METHODS A cross-sectional study was conducted between July and November 2019 among 627 randomly selected adolescents from eight schools located in Kathmandu Metropolitan City, Nepal. A self-administrated structure questionnaire was used to collect the data. Anthropometric measurements (adolescent's BMI), sleep characteristics, dietary habits, and physical activity were assessed using validated tools. Multinomial logistic regression analyses assessed the association between covariates and BMI categories. The statistical significance was considered at p-value < 0.05 and 95% confidence intervals (CIs). RESULTS The overall prevalence of underweight and overweight/obesity among adolescents was 9.1% (95% CI: 7.1-11.6) and 23.7% (95% CI: 20.6-27.7) respectively. In multinomial logistic regression, adolescents who reported sleep problem compared to those with no such problem (Relative risk ratio (RRR) = 13.37, 95% CI: 7.14-25.05), adolescents who had obstructive sleep apnea (OSA) symptoms (RRR = 3.21, 95% CI:1.31-7.86), who consumed soft drink ≥1 time/day in past 1 months (RRR = 5.44, 95% CI: 2.93-10.10), consumed high-fat dietary ≥2 times/day (RRR = 2.17, 95% CI: 1.18-3.99), and had a habit of junk food consumptions (RRR = 5.71, 95% CI:2.55-12.82), adolescents who had 5-6 h/day sedentary behavior (RRR = 3.21, 95% CI: 1.14-9.09), adolescents from Terai/Madhesi castes (RRR = 2.81, 95% CI: 1.19-6.64) and adolescents whose father was employed (RRR = 2.04, 95% CI: 1.04-3.98) were at increased risk of being overweight/obesity. In contrast, adolescents aged 14-16 years had 71% lower (RRR = 0.29, 95% CI: 0.16-0.52), and adolescents who consumed less than five food groups had 45% lower (RRR = 0.55, 95% CI: 0.31-0.97) risk of being overweight/obesity compared to 12-14 years age groups and consumed more than five food groups respectively. CONCLUSIONS The findings of this study warrant immediate interventions to improve the lifestyle to reduce overweight/obesity among Nepalese adolescents. Creating a conducive environment, both at school and home is essential to encourage adolescents for the adoption of healthy lifestyle behaviors.
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Sajjadi SF, Mirzababaei A, Abdollahi A, Shiraseb F, Mirzaei K. The association between deficiency of nutrient intake and resting metabolic rate in overweight and obese women: a cross-sectional study. BMC Res Notes 2021; 14:179. [PMID: 33980283 PMCID: PMC8117621 DOI: 10.1186/s13104-021-05582-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 04/22/2021] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE The double burden of malnutrition is an emerging public health concern nowadays which a correlation with obesity. This study aimed to examine the relationship between resting metabolic rate (RMR) and dietary intake of zinc, vitamin C, and riboflavin in overweight and obese women. RESULTS The RMR/FFM showed a significant association with riboflavin (β = 1.59; 95% CI 1.04-23.26, P = 0.04) and zinc (β = 0.78; 95% CI 1.04-4.61, P = 0.03) in the crude model. Moreover, differences in vitamin C and RMR/FFM was marginal significant (β = 0.75; 95% CI 0.95-4.77, P = 0.06). After adjusting for confounders the riboflavin association change to marginal significance (β = 1.52; 95% CI 0.91-23.04, P = 0.06). After controlling for potential confounders, the associations change between zinc and RMR/FFM (β = 0.66; 95% CI 0.78-4.86, P = 0.15) and between RMR/FFM and vitamin C (β = 0.48; 95% CI 0.66-3.96, P = 0.28). Our study showed a significant association between dietary intake of zinc, riboflavin, and vitamin C and change in RMR/FFM in overweight and obese women.
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Affiliation(s)
- Seyedeh Forough Sajjadi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Afsoun Abdollahi
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran.
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Rahman A, Sathi NJ. Sociodemographic Risk Factors of Being Underweight Among Ever-Married Bangladeshi Women of Reproductive Age: A Multilevel Analysis. Asia Pac J Public Health 2020; 33:220-226. [PMID: 33291961 DOI: 10.1177/1010539520979924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study's primary goal is to identify a few sociodemographic risk factors associated with women's underweight status. We have applied multilevel binary logistic regression using the Bangladesh Demographic and Health Survey 2014 data, considering hierarchical effect. The model implies that age <30 years (odds ratio [OR]: 2.19; 95% CI: 1.82-2.63), no education (OR: 1.44; 95% CI: 1.28-1.61), oral contraceptive nonuser (OR: 1.26; 95% CI: 1.14-1.39), and not watching TV (OR: 1.56; 95% CI: 1.41-1.73) are significant risk factors associated with women's underweight status. Remarkably, women from rural areas and belonging to a community with poverty rates of 50% and higher are 46% and 52% more likely to be underweight, respectively. Policy makers and organizations should create a supportive environment for rural women by controlling education, media coverage, and poverty to enrich their knowledge about healthy weight to reduce community inequality and maintain a healthy life.
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Ahmed KY, Rwabilimbo AG, Abrha S, Page A, Arora A, Tadese F, Beyene TY, Seiko A, Endris AA, Agho KE, Ogbo FA. Factors associated with underweight, overweight, and obesity in reproductive age Tanzanian women. PLoS One 2020; 15:e0237720. [PMID: 32834011 PMCID: PMC7444815 DOI: 10.1371/journal.pone.0237720] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/31/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Underweight, overweight, and obesity are major public health challenges among reproductive-age women of lower- and middle-income countries (including Tanzania). In those settings, obesogenic factors (attributes that promote excessive body weight gain) are increasing in the context of an existing high burden of undernutrition. The present study investigated factors associated with underweight, overweight, and obesity among reproductive age women in Tanzania. METHODS This study used 2015-16 Tanzania Demographic and Health Survey data (n = 11735). To account for the hierarchical nature of the data (i.e., reproductive age women nested within clusters), multilevel multinomial logistic regression models were used to investigate the association between individual-level (socioeconomic, demographic and behavioural) and community-level factors with underweight, overweight, and obesity. RESULTS Reproductive age women who were informally employed (relative risk ratio [RRR] = 0.79; 95% confidence interval [CI]: 0.64, 0.96), those who were currently married (RRR = 0.59; 95% CI: 0.43, 0.82) and those who used contraceptives (RRR = 0.70; 95% CI: 0.54, 0.90) were less likely to be underweight. Reproductive age women who attained secondary or higher education (RRR = 1.48; 95% CI: 1.11, 1.96), those who resided in wealthier households (RRR = 2.31; 95% CI: 1.78, 3.03) and those who watched the television (RRR = 1.26; 95% CI: 1.06, 1.50) were more likely to be overweight. The risk of experiencing obesity was higher among reproductive age women who attained secondary or higher education (RRR = 1.79; 95% CI: 1.23, 2.61), those who were formally employed (RRR = 1.50; 95% CI: 1.14, 1.98), those who resided in wealthier households (RRR = 4.77; 95% CI: 3.03, 7.50), those who used alcohol (RRR = 1.43; 95% CI: 1.12, 1.82) and/or watched the television (RRR = 1.70; 95% CI: 1.35, 2.13). CONCLUSION Our study suggests that relevant government jurisdictions need to identify, promote, and implement evidence-based interventions that can simultaneously address underweight and overweight/obesity among reproductive age women in Tanzania.
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Affiliation(s)
- Kedir Y. Ahmed
- College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- * E-mail:
| | - Abdon G. Rwabilimbo
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- Chato District Council, Geita Region, Northwestern Tanzania
| | - Solomon Abrha
- School of Public Health, College of Medicine and Health Science, Wolayta Sodo University, Wolayta Sodo, Ethiopia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Amit Arora
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia
| | - Fentaw Tadese
- College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tigistu Yemane Beyene
- CDT Africa, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Kingsley E. Agho
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- General Practice Unit, Prescot Specialist Medical Centre Makurdi, Makurdi, Benue State, Nigeria
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Ahmed KY, Abrha S, Page A, Arora A, Shiferaw S, Tadese F, Seifu CN, Yeneabat T, Alemu E, Gebremichael DY, Seiko A, Ogbo FA. Trends and determinants of underweight and overweight/obesity among urban Ethiopian women from 2000 to 2016. BMC Public Health 2020; 20:1276. [PMID: 32838771 PMCID: PMC7447570 DOI: 10.1186/s12889-020-09345-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 08/04/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Nutritional, epidemiological and demographic transitions have been associated with the emergence of the double burden of malnutrition globally. In Ethiopia, there has been no nationally representative investigation of trends and determinants of both underweight and overweight/obesity among urban women. This study examined the trends and determinants of underweight and overweight/obesity in urban Ethiopian women from 2000 to 2016. METHODS Trends in the prevalence of underweight and overweight/obesity were investigated based on a series of the Ethiopia Demographic and Health Survey (EDHS) data for the years 2000 (n = 2559), 2005 (n = 1112), 2011 (n = 3569), and 2016 (n = 3106). Multivariable multinomial logistic regression was used to investigate the association between socioeconomic, demographic, behavioural, and community-level factors with underweight and overweight/obesity. RESULTS The prevalence of underweight in urban Ethiopian women reduced significantly from 23.2% (95% confidence interval [CI]: 20.3, 26.3%) in 2000 to 14.8% (95% CI: 13.1, 16.7%) in 2016, while overweight/obesity increased significantly from 10.9% (95% CI: 9.1, 13.0%) in 2000 to 21.4% (95% CI: 18.2, 25.1%) in 2016. Urban women from rich households and those who had never married were less likely to be underweight. Urban women who were from wealthy households and those who attained at least secondary education were more likely to be overweight/obese. Women who were informally employed and listened to the radio were less likely to be overweight/obese compared to those who were unemployed and did not listen to the radio, respectively. CONCLUSION The prevalence of overweight/obesity increased from 2000 to 2016, with a concurrent reduction in the prevalence of underweight. Interventions aiming to reduce overweight and obesity should target urban women with higher education, those who resided in wealthier households and those who watched the television.
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Affiliation(s)
- Kedir Y Ahmed
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia. .,College of Medicine and Health Sciences, Samara University, Samara-Logia, Ethiopia.
| | - Solomon Abrha
- School of Public Health, College of Medicine and Health Sciences, Wolayta Sodo University, Wolayta Sodo, Ethiopia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia
| | - Amit Arora
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia.,School of Health Sciences, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia.,Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, Sydney, NSW, Australia
| | - Solomon Shiferaw
- School of Public Health, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fentaw Tadese
- College of Medicine and Health Sciences, School of Public Health, Wollo University, Dessie, Ethiopia
| | - Canaan Negash Seifu
- School of Nursing and Midwifery, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia
| | - Tebikew Yeneabat
- Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, Australia
| | - Emana Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Abdulaziz Seiko
- CARE Ethiopia, Partner for The Resilience Project, Afar, Samara-Logia, Ethiopia
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia.,General Practice Unit, Prescot Specialist Medical Centre, Makurdi, Benue State, Nigeria
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Yeshaw Y, Kebede SA, Liyew AM, Tesema GA, Agegnehu CD, Teshale AB, Alem AZ. Determinants of overweight/obesity among reproductive age group women in Ethiopia: multilevel analysis of Ethiopian demographic and health survey. BMJ Open 2020; 10:e034963. [PMID: 32156768 PMCID: PMC7064084 DOI: 10.1136/bmjopen-2019-034963] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Overweight/obesity among women is associated with an increased risk of gestational diabetes, pre-eclampsia, postpartum haemorrhage, low birth weight, congenital malformation and neonatal deaths. Although the magnitude of overweight and obesity among the reproductive age group women is a common problem in Ethiopia, there are limited studies that determine the associated factors of overweight and obesity at the national level. Therefore, this study aimed to identify the determinant factors of overweight/obesity among reproductive age group women in Ethiopia. DESIGN Cross-sectional study design. SETTING Ethiopia. PARTICIPANTS Non-pregnant women aged 15-49 years. PRIMARY OUTCOME Overweight/obesity. METHODS The present study used the Ethiopia Demographic Health Survey (EDHS) data for 2016. A total of 10 938 non-pregnant reproductive age group women were included in the analysis. Both bivariable and multivariable multilevel logistic regression were performed to determine the determinants of overweight and obesity among women in Ethiopia. The OR with a 95% CI was estimated for potential determinants included in the final model. RESULTS Those women with secondary education (adjusted OR (AOR)=1.48, 1.01, 2.18), higher education (AOR=1.78, 1.13, 2.81), richer (AOR=1.85, 1.15, 2.98) and richest wealth index (AOR=3.23, 1.98, 5.29), urban residence (AOR=4.46, 2.89, 6.87), married (AOR=1.79, 1.21, 2.64), widowed (AOR=2.42, 1.41, 4.15), divorced (AOR=1.84, 1.13, 3.00), aged 25-34 years (AOR=2.04, 1.43, 2.89), 35-44 years (AOR=2.79, 1.99, 3.93) and 45-49 years (AOR=2.62, 1.54, 4.45) had higher odds of developing overweight and obesity. CONCLUSION Women with higher education level, high wealth status, older age, formerly married and those urban dwellers had higher odds of overweight and obesity. Therefore, regular physical activity, reducing consumption of fat/energy-dense food as well as modifying the mode of transportation is recommended.
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Affiliation(s)
- Yigizie Yeshaw
- Medical Physiology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Sewnet Adem Kebede
- Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Chilot Desta Agegnehu
- School of Nursing, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Dutta M, Selvamani Y, Singh P, Prashad L. The double burden of malnutrition among adults in India: evidence from the National Family Health Survey-4 (2015-16). Epidemiol Health 2019; 41:e2019050. [PMID: 31962037 PMCID: PMC6976728 DOI: 10.4178/epih.e2019050] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 12/18/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES India still faces the burden of undernutrition and communicable diseases, and the prevalence of overweight/obesity is steadily increasing. The discourse regarding the dual burden of underweight and overweight/obesity has not yet been widely explored in both men and women. The present study assessed the determinants of underweight and overweight/obesity in India among adult men and women aged 15-49. METHODS Population-based cross-sectional and nationally representative data from the National Family Health Survey-4 (2015-16), consisting of a sample of men and women, were analyzed. Stratified 2-stage sampling was used in the NFHS-4 study protocol. In the present study, bivariate and adjusted multinomial logistic regression analyses were performed to determine the correlates of underweight and overweight/obesity. RESULTS The results suggested a persistently high prevalence of underweight coexisting with an increased prevalence of overweight/obesity in India. The risk of underweight was highest in the central and western regions and was also relatively high among those who used either smoking or smokeless tobacco. Overweight/obesity was more prevalent in urban areas, in the southern region, and among adults aged 35-49. Furthermore, level of education and wealth index were positively associated with overweight/obesity. More educated and wealthier adults were less likely to be underweight. CONCLUSIONS In India, underweight has been prevalent, and the prevalence of overweight/obesity is increasing rapidly, particularly among men. The dual burden of underweight and overweight/obesity is alarming and needs to be considered; public health measures to address this situation must also be adopted through policy initiatives.
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Affiliation(s)
- Mili Dutta
- International Institute for Population Sciences (IIPS), Mumbai, India
| | - Y Selvamani
- Department of Development Studies, International Institute for Population Sciences (IIPS), Mumbai, India
| | - Pushpendra Singh
- Department of Humanities and Social Sciences, Indian Institute of Technology Roorkee, Roorkee, India
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Fish is the Preferred Animal-Source Food in the Rural Community of Southern Bangladesh. SUSTAINABILITY 2019. [DOI: 10.3390/su11205764] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Increased intake of animal-source foods (ASFs) is crucial to tackle multiple nutritional challenges in Bangladesh, and contribute to achieving targets under the Sustainable Development Goals (SDGs). Qualitative and quantitative data were collected to assess current ASFs intake behaviors and preferred ASFs, among three types of households, namely 1. aquaculture intervention (AI); 2. aquaculture non-intervention (ANI); and 3. non-aquaculture non-intervention (NANI) households and children aged 6–59 months, to understand whether intake of ASFs vary by the types of households. Purposive sampling was conducted to obtain a total of 100 households (AI, 50; ANI, 25; NANI, 25). Fish was the most commonly consumed (52.2–61.5%) and preferred (73.9–84.6%) ASF by the majority households, across study groups; although amount (mean ± SD) of intake (g/d/person) by NANI households was statistically significantly lower (NANI, 105.5 ± 53.3; p < 0.001), compared to other two groups (AI, 163.6 ± 64.7 and ANI, 159.6 ± 53). Fish species selection for household consumption was led by taste, health benefits, availability, and price. Pangasius was the first fish species of choice fed to children, due to having fewer small bones compared to other commonly consumed fish species. Dietary interventions to prioritize fish, in targeting increased intake of ASFs among study population, for improved food and nutrition security.
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Amugsi DA, Dimbuene ZT, Kyobutungi C. Correlates of the double burden of malnutrition among women: an analysis of cross sectional survey data from sub-Saharan Africa. BMJ Open 2019; 9:e029545. [PMID: 31272983 PMCID: PMC6615784 DOI: 10.1136/bmjopen-2019-029545] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To investigate the correlates of the double burden of malnutrition (DBM) among women in five sub-Saharan African countries. DESIGN Secondary analysis of Demographic and Health Surveys (DHS). The outcome variable was body mass index (BMI), a measure of DBM. The BMI was classified into underweight (BMI <18.50 kg/m2), normal weight (18.50-24.99 kg/m2), overweight (25.0-29.9 kg/m2) and obesity (≥30.0 kg/m2). SETTINGS Ghana, Nigeria, Kenya, Mozambique and Democratic Republic of Congo (DRC). SUBJECTS Women aged 15-49 years (n=64698). RESULTS Compared with normal weight women, number of years of formal education was associated with the likelihood of being overweight and obese in Ghana, Mozambique and Nigeria, while associated with the likelihood of being underweight in Kenya and Nigeria. Older age was associated with the likelihood of being underweight, overweight and obese in all countries. Positive associations were also observed between living in better-off households and overweight and obesity, while a negative association was observed for underweight. Breastfeeding was associated with less likelihood of underweight in DRC and Nigeria, obesity in DRC and Ghana, overweight in Kenya and overweight and obesity in Mozambique and Nigeria relative to normal weight. CONCLUSIONS Our analysis reveals that in all the countries, women who are breastfeeding are less likely to be underweight, overweight and obese. Education, age and household wealth index tend to associate with a higher likelihood of DBM among women. Interventions to address DBM should take into account the variations in the effects of these correlates.
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Affiliation(s)
- Dickson Abanimi Amugsi
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Zacharie Tsala Dimbuene
- Population Sciences and Development, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
- Social Analysis and Modeling Division, Statistics Canada, Ottawa, Canada
| | - Catherine Kyobutungi
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
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Dadi AF, Desyibelew HD. Undernutrition and its associated factors among pregnant mothers in Gondar town, Northwest Ethiopia. PLoS One 2019; 14:e0215305. [PMID: 31009475 PMCID: PMC6476509 DOI: 10.1371/journal.pone.0215305] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 03/30/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Regardless of significant gains and signs of progress in the last decades, maternal undernutrition remains a major public health concern in Ethiopia. Supporting the progress of interventions being taken in the country with evidence might be important to keep the sustainability of the government effort. We aimed at determining the extent of undernutrition and its associated factors among pregnant mothers in Gondar town, Northwest Ethiopia. METHOD A community-based cross-sectional study was conducted by including 940 selected pregnant mothers through a cluster sampling. A face-to-face interview was administered to pregnant mothers at a household level. We collected data using an Online Data collection kit (ODK) and the collected data was directly downloaded from the Google Cloud platform and finally imported to Stata 14 for further analysis. A multivariable logistic regression model was fitted to identify factors associated with undernutrition. A crude and adjusted odds ratio with their 95% confidence interval was calculated to declare the association and its significance. Model fitness was assured through the Hosmer and Lemeshow goodness of fit test and model classification accuracy. RESULT 14.4% (95%CI: 12.3-16.7) of pregnant mothers were undernourished. After adjusting for the main covariates; as the age of the pregnant mothers increases the odds of being undernourished decreases by 10% (AOR: 0.90; 95%CI: 0.87-0.95) and having a poor marital condition (AOR: 2.18; 95%CI: 1.03-4.59) increased the odds of undernutrition. The risk of undernutrition was also decreased by 43% among those pregnant mothers who consumed coffee sometimes (AOR: 0.57; 95%CI: 0.36-0.89) as compared to daily consumers. CONCLUSION A significant proportion of pregnant mother were undernourished. Integration of nutritional interventions with maternity health services would be highly important to improve the nutritional status of the mothers. It is also important to counsel pregnant mothers about a consequence of frequent coffee drinking during their pregnancy.
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Affiliation(s)
- Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hanna Demelash Desyibelew
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Ara G, Khanam M, Rahman AS, Islam Z, Farhad S, Sanin KI, Khan SS, Rahman MM, Majoor H, Ahmed T. Effectiveness of micronutrient-fortified rice consumption on anaemia and zinc status among vulnerable women in Bangladesh. PLoS One 2019; 14:e0210501. [PMID: 30629717 PMCID: PMC6328150 DOI: 10.1371/journal.pone.0210501] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 12/22/2018] [Indexed: 12/28/2022] Open
Abstract
Micronutrient deficiency is one of the biggest public health concerns in Bangladesh. As per World Health Organisation (WHO) in the 2016 report, 40% women of reproductive age suffer from anaemia. According to the National Micronutrient Survey 2011–2012, 57% women suffer from zinc deficiency. The objective of the present study was to determine the effectiveness of fortified rice (FFR in addressing anaemia and zinc deficiency among vulnerable women. Baseline and endline surveys were conducted among female Vulnerable Group Development (VDG) beneficiaries in five districts in Bangladesh before and after 12 months of FFR distribution. The intervention group received 30 kg FFR; the control group received 30 kg non-FFR for every month from January 2013 to December 2013. The sample sizes were 870 women (435/group) at baseline and 800 (400/group) at endline. Difference-in-difference (DID) was estimated to measure the effect of FFR on anaemia and serum zinc. In the baseline survey, 39% of the FFR group and 34% of the non-FFR group had anaemia. At endline, 34% of women in the FFR group were anaemic compared to 40.7% in the non-FFR group. At endline, prevalence of anaemia was reduced in the FFR group by 4.8% but increased in the non-FFR group by 6.7%. The DID estimation showed the reduction in anaemia after 12 months of FFR consumption was significant (p = 0.035). The DID in mean haemoglobin level after 12 months of FFR consumption was also statistically significant (p = 0.002). Zinc deficiency decreased by 6% in the FFR group at endline, though the DID was not significant. Most of the respondents of the FFR group reported that they received their entitled rice on a regular basis however only half of the non-FFR respondents received every month in 12 months. Anaemia was significantly associated with not consuming fortified rice, geographical region, older age and heavy menstrual bleeding (P<0.05). FFR reduced anaemia and zinc deficiency prevalence. Replacement of regular rice with FFR in the VGD programme is recommended to reduce anaemia among vulnerable groups.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Herma Majoor
- United Nations World Food Programme, IDB Bhaban, Begum Rokeya Sarani, Dhaka, Bangladesh
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Ahmad S, Shukla NK, Singh JV, Shukla R, Shukla M. Double burden of malnutrition among school-going adolescent girls in North India: A cross-sectional study. J Family Med Prim Care 2018; 7:1417-1424. [PMID: 30613535 PMCID: PMC6293888 DOI: 10.4103/jfmpc.jfmpc_185_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CONTEXT Double burden of malnutrition comprising both undernutrition and overnutrition is nowadays emerging as a major public health concern among adolescent girls in India. AIM The present study was conducted to determine the prevalence of underweight, overweight, and obesity among school-going adolescent girls along with dietary and physical activity-related factors associated with them. SETTINGS AND DESIGN The present cross-sectional survey was conducted among 2400 school-going adolescent girls (10-19 years) in Barabanki district of Uttar Pradesh. SUBJECTS AND METHODS Multistage sampling technique was used for enrolment of the study subjects. Data were collected on sociodemographic profile, physical activity, dietary intake, and anthropometry. WHO body mass index (BMI)-for-age cutoff classification of girls was used for assessment of underweight, overweight, and obesity. STATISTICAL ANALYSIS USED Statistical analysis was done with the Epi Info software. Multinomial logistic regression analysis was used to ascertain various predictors of underweight, overweight, and obesity among adolescent females (P < 0.05 was considered as significant). RESULTS The proportion of underweight, overweight, and obese students were 47.0%, 5.9%, and 2.7%, respectively. The girls in mid and late adolescent age group were significantly less susceptible for being underweight for age (odds ratio [OR] 0.28; 95% confidence interval [CI] 0.22-0.36; P = 0.00). The girls belonging to middle and upper socioeconomic strata were about 35 times more susceptible toward obesity (OR 35.12; 95% CI 13.33-92.49; P = 0.00) and 12 times more susceptible toward being overweight (OR 12.46; 95% CI 13.33-92.49; P = 0.00) as compared to those in lower income groups. The probability of overweight and obesity were about 3 times (OR 3.13; 95% CI 1.76-5.55; P = 0.00) and 10 times (OR 9.66; 95% CI 4.00-23.35; P = 0.00) higher among adolescent girls who reside in urban areas as compared to rural one. Apart from these, non-Hindu religion, nuclear type of family, parent's education profile of middle school and above, and engagement in physical activities more than 2 h a day were other factors found to be directly associated with increased chances of overweight/obesity (OR > 1; P < 0.05). CONCLUSIONS The high prevalence of the double burden of malnutrition revealed the need of the hour to modify and strengthen the existing adolescent health programs of India so as to deal with both the facets of nutrition spectrum substantially.
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Affiliation(s)
- Siraj Ahmad
- Department of Community Medicine, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
| | - Nirpal Kaur Shukla
- Department of Community Medicine, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
| | - Jai Vir Singh
- Department of Community Medicine, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
| | - Ram Shukla
- Department of Master of Business Administration, Institute of Engineering and Technology, Lucknow, Uttar Pradesh, India
| | - Mukesh Shukla
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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