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Shariff ZM, Ismail R, Mohd Shukri NH. Double Burden of Malnutrition and Its Associated Factors in Urbanized Indigenous Peoples ( Orang Asli) of Peninsular Malaysia. Ecol Food Nutr 2024; 63:519-538. [PMID: 38941571 DOI: 10.1080/03670244.2024.2373231] [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] [Indexed: 06/30/2024]
Abstract
Double burden of malnutrition (DBM) is a global public health concern. This study determined the prevalence of DBM and its associated factors among 451 indigenous households in an urbanized state of Malaysia. Mothers and children were measured for weight and height/length. Mothers were interviewed for socio-demographics and diets of mothers and children. Prevalence of DBM (overweight/obese mother and underweight/stunted child) was 28.8%. Food insecurity, maternal height (<150 cm) and energy intake (>recommendation), child's age (≥24 months) and energy intake (
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Affiliation(s)
- Zalilah Mohd Shariff
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Rozalina Ismail
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nurul Husna Mohd Shukri
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Fletcher AJ, Lozano R, McNabb WC. Analysis of global nutrient gaps and their potential to be closed through redistribution and increased supply. Front Nutr 2024; 11:1396549. [PMID: 39183987 PMCID: PMC11342806 DOI: 10.3389/fnut.2024.1396549] [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: 03/05/2024] [Accepted: 07/17/2024] [Indexed: 08/27/2024] Open
Abstract
Global food systems are crucial for sustaining life on Earth. Although estimates suggest that the current production system can provide enough food and nutrients for everyone, equitable distribution remains challenging. Understanding global nutrient distribution is vital for addressing disparities and creating effective solutions for the present and future. This study analyzes global nutrient supply changes to address inadequacies in certain populations using the existing DELTA Model®, which uses aggregates of global food production to estimate nutrient adequacy. By examining the 2020 global food commodity and nutrient distribution, we project future food production in 2050 needs to ensure global adequate nutrition. Our findings reveal that while some nutrients appear to be adequately supplied on a global scale, many countries face national insufficiencies (% supply below the population reference intake) in essential vitamins and minerals, such as vitamins A, B12, B2, potassium, and iron. Closing these gaps will require significant increases in nutrient supply. For example, despite global protein supply surpassing basic needs for the 2050 population, significant shortages persist in many countries due to distribution variations. A 1% increase in global protein supply, specifically targeting countries with insufficiencies, could address the observed 2020 gaps. However, without consumption pattern changes, a 26% increase in global protein production is required by 2050 due to population growth. In this study, a methodology was developed, applying multi-decade linear convergence to sufficiency values at the country level. This approach facilitates a more realistic assessment of future needs within global food system models, such as the DELTA Model®, transitioning from idealized production scenarios to realistic projections. In summary, our study emphasizes understanding global nutrient distribution and adjusting minimum global nutrient supply targets to tackle country-level inequality. Incorporating these insights into global food balance models can improve projections and guide policy decisions for sustainable, healthy diets worldwide.
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Affiliation(s)
- Andrew J. Fletcher
- Riddet Institute, Massey University, Palmerston North, New Zealand
- Sustainable Nutrition Initiative, Riddet Institute, Massey University, Palmerston North, New Zealand
- Fonterra Research and Development Centre, Palmerston North, New Zealand
| | - Raquel Lozano
- Riddet Institute, Massey University, Palmerston North, New Zealand
- Sustainable Nutrition Initiative, Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Warren C. McNabb
- Riddet Institute, Massey University, Palmerston North, New Zealand
- Sustainable Nutrition Initiative, Riddet Institute, Massey University, Palmerston North, New Zealand
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Damasco-Avila E, Ubico P, Blanco J, Perez M, Farncombe T, Morales G, Antillon-Klussmann F, Ladas E, Barr R. The Nutritional Burden of Cancer: Nutritional Status and Body Composition Differences Between Children with Acute Lymphoblastic Leukemia and their Siblings in Guatemala. Nutr Cancer 2024:1-7. [PMID: 39033402 DOI: 10.1080/01635581.2024.2382391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
During treatment, children with acute lymphoblastic leukemia (ALL) gain fat mass and lose skeletal muscle mass. The great majority live in low- and middle-income countries with few studies of their body composition and none addressing the hypothesis that the disease itself contributes to nutritional morbidity. At diagnosis, children with ALL were compared to their siblings on socioeconomic status (SES). Nutritional status was assessed by mid-upper arm circumference (MUAC)-for-age Z scores and body composition by dual energy x-ray absorptiometry (DXA). Median SES scores for the patients (47.5) and their siblings (47.0) were very similar (P = 0.5). MUAC Z scores for patients aged >5 years were lower than for siblings (P < 0.001). On DXA siblings had a higher mean appendicular lean mass index Z score, a surrogate of skeletal muscle mass, than patients (P = 0.019). A logistic model to estimate the odds ratio (OR) of being severely/moderately under-nourished (classified by MUAC Z score) by SES revealed that, compared with siblings (n = 49), children with ALL (n = 60) had a higher probability of being under-nourished (OR 5.25, 95% CI 1.44-25.95, P = 0.02). The results support the hypothesis that children at diagnosis of ALL in Guatemala are more nutritionally depleted than their apparently healthy siblings.
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Affiliation(s)
- Erika Damasco-Avila
- Division of Hematology/Oncology/Stem Cell Transplantation, Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - Paulina Ubico
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Jessica Blanco
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | | | - Troy Farncombe
- Department of Nuclear Medicine, McMaster University and Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada
| | - Gerson Morales
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Federico Antillon-Klussmann
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
- School of Medicine, Francisco Marroquín University, Guatemala
| | - Elena Ladas
- Division of Hematology/Oncology/Stem Cell Transplantation, Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - Ronald Barr
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Akhtar A, Masood R, Ibrahim M, Gurmani N, Abdullah M, Ali A, Kareem T. Exploring the Multifaceted Influences on Childhood Nutritional Status: A Study Conducted in South Punjab, Pakistan. Cureus 2024; 16:e64329. [PMID: 39130973 PMCID: PMC11316499 DOI: 10.7759/cureus.64329] [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] [Accepted: 07/10/2024] [Indexed: 08/13/2024] Open
Abstract
Introduction The double burden of malnutrition (DBM) in Pakistan is a rising concern affecting school-going children, marked by coexisting under- and over-nutrition within the same population. Key influences include shifts in dietary habits, socioeconomic status, and lifestyle changes due to rapid urbanization. With a focus on Multan, Pakistan, the study seeks to assess the proportion of underweight and overweight students while identifying the risk factors and sociodemographic characteristics associated with this incidence. The aim is to guide future health interventions addressing this multidimensional health challenge. Materials and methods This study, adopting a descriptive cross-sectional research design, collected data from female teenage students through interviews and anthropometric measurements. A total of 300 participants were randomly selected from a comprehensive school list representing diverse urban and rural settings. Participants' weight and height were measured to calculate their body mass index (BMI), categorizing them into underweight, normal weight, and overweight groups. The relevant risk factors were collected through an interview questionnaire. Collected data were analyzed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States), with the results stratified according to socioeconomic, dietary, and psychosocial factors and compared across different weight categories. Results The study collected data from 300 students, revealing a correlation between socioeconomic status, dietary habits, and BMI. Parental occupation significantly affected nutritional status, with children of laborers primarily falling within normal and underweight categories. Dietary habits like frequency of fast food and milk or dairy consumption showed notable associations with nutritional status. Psychosocial factors such as peer or teacher comments about weight and outdoor sports participation also influenced the students' nutritional status. However, factors like family income, video game hours, and the presence of pets at home did not show significant associations with nutritional status. Conclusions The study illustrates a multi-faceted association between socioeconomic status, dietary habits, and BMI among schoolchildren in Multan, Pakistan, emphasizing the need for comprehensive interventions.
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Affiliation(s)
- Aiman Akhtar
- National Institute of Health, Health Services Academy, Islamabad, PAK
| | - Rabiya Masood
- Community Medicine, Nishtar Medical University, Multan, PAK
| | | | - Neelab Gurmani
- Preventive Medicine, Integrated Reproductive, Maternal, Newborn and Child Health (IRMNCH) Program, Multan, PAK
| | - Muhammad Abdullah
- Surgery, Shifa College of Medicine, Shifa Tameer-E-Millat University, Islamabad, PAK
| | - Abdullah Ali
- Surgery, Shifa College of Medicine, Shifa Tameer-E-Millat University, Islamabad, PAK
| | - Talha Kareem
- General Surgery and Vascular Surgery, Indus Hospital, Indus Hospital and Health Network, Muzaffargarh, PAK
- General Surgery, Nishtar Medical University, Multan, PAK
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Pradeilles R, Irache A, Norris T, Chitekwe S, Laillou A, Baye K. Magnitude, trends and drivers of the coexistence of maternal overweight/obesity and childhood undernutrition in Ethiopia: Evidence from Demographic and Health Surveys (2005-2016). MATERNAL & CHILD NUTRITION 2024; 20 Suppl 5:e13372. [PMID: 35615766 PMCID: PMC11258774 DOI: 10.1111/mcn.13372] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 04/11/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
Ethiopia faces a rising problem of overweight and obesity alongside a high prevalence of undernutrition; a double burden of malnutrition (DBM). This study aimed to quantify the magnitude and trends of household-level DBM-defined as the coexistence of maternal overweight/obesity and child undernutrition (i.e., stunting or anaemia)-in Ethiopia between 2005, 2011 and 2016 and understand the potential drivers influencing DBM and the change in DBM over time. Data come from the Ethiopian Demographic and Health Surveys. National and regional prevalence estimates of the DBM were calculated (n = 13,107). Equiplots were produced to display inequalities in the distribution of DBM. Factors associated with DBM were explored using pooled multivariable logistic regression analyses for 2005, 2011 and 2016 (n = 9358). These were also included in a logistic regression decomposition analysis to understand their contribution to the change in DBM between 2005 and 2016 (n = 5285). The prevalence of household-level DBM at the national level was low, with a modest increase from 2.4% in 2005% to 3.5% in 2016. This masks important within-country variability, with substantially higher prevalence in Addis Ababa (22.8%). Factors positively associated with DBM were maternal age (odds ratio [OR] = 1.04 [1.02, 1.06]), urban residence (OR = 3.12 [2.24, 4.36]), wealth (OR = 1.14 [1.06, 1.24]) and the number of children <5 in the household (OR = 1.30 [1.12, 1.49]). Overall, 70.5% of the increase in DBM between 2005 and 2016 was attributed to increased wealth, urban residence and region. Double-duty actions that address multiple forms of malnutrition are urgently needed in urban settings.
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Affiliation(s)
- Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences (SSEHS)Loughborough UniversityLoughboroughUK
| | - Ana Irache
- Warwick Medical SchoolUniversity of WarwickCoventryUK
| | - Tom Norris
- Department of Targeted Intervention, Division of Surgery and Interventional ScienceUniversity College LondonLondonUK
| | | | | | - Kaleab Baye
- Center for Food Science and NutritionAddis Ababa UniversityAddis AbabaEthiopia
- Research Center for Inclusive Development in Africa (RIDA)Addis AbabaEthiopia
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Chitekwe S, Baye K, Noor R, Rudert C. Addressing malnutrition in Ethiopia: A call for a systems approach to match the scope and complexity of the problem. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 5:e13701. [PMID: 38963149 PMCID: PMC11258762 DOI: 10.1111/mcn.13701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 06/19/2024] [Accepted: 06/24/2024] [Indexed: 07/05/2024]
Affiliation(s)
| | - Kaleab Baye
- Center for Food Science and NutritionCollege of Natural and Computational Sciences, Addis Ababa UniversityAddis AbabaEthiopia
- Nutrition and Food Systems' DivisionResearch Center for Inclusive Development in Africa (RIDA)Addis AbabaEthiopia
| | | | - Christiane Rudert
- Regional Nutrition AdviserUNICEF Eastern and Southern Africa Regional Office (ESARO)NairobiKenya
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De Zanetti L, Van Der Straeten D. 'From metabolism to metabolism': holistic considerations on B-vitamin interactions, biofortification, and deficiencies. Curr Opin Biotechnol 2024; 87:103132. [PMID: 38669731 DOI: 10.1016/j.copbio.2024.103132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/26/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024]
Abstract
In the post-Green Revolution era, disparities in dietary access, rising obesity rates, demographic shifts, adoption of plant-based diets, and the impact of climate change collectively contribute to a progressive decline in dietary nutritional value, exacerbating B vitamin deficiencies across both low- and high-income countries. While the prevailing focus of biofortification has been on three micronutrients - provitamin A, iron, and zinc - utilizing conventional breeding, it is imperative to diversify biofortification strategies to combat micronutrient malnutrition. Metabolic engineering, facilitated by biotechnological tools, presents a promising avenue, contingent upon advances in fundamental knowledge, technological innovation, regulatory updates, and sustained public funding. Recognizing the intricate metabolic interplay of B vitamins in plants and humans, a comprehensive 'from metabolism to metabolism' approach is crucial for designing effective biofortification strategies that target multiple vitamins. This holistic perspective also extends beyond individual crops to encompass the entire food chain, a complex socioeconomic ecosystem that necessitates a paradigm shift, prioritizing quality over quantity.
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Affiliation(s)
- Lisa De Zanetti
- Laboratory of Functional Plant Biology, Ghent University, K.L. Ledeganckstraat 35, B-9000 Ghent, Belgium
| | - Dominique Van Der Straeten
- Laboratory of Functional Plant Biology, Ghent University, K.L. Ledeganckstraat 35, B-9000 Ghent, Belgium.
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Chen S, Shimpuku Y, Honda T, Mwakawanga DL, Mwilike B. Dietary diversity moderates household economic inequalities in the double burden of malnutrition in Tanzania. Public Health Nutr 2024; 27:e141. [PMID: 38751248 PMCID: PMC11374552 DOI: 10.1017/s136898002400106x] [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] [Indexed: 06/04/2024]
Abstract
OBJECTIVE Improved food availability and a growing economy in Tanzania may insufficiently decrease pre-existing nutritional deficiencies and simultaneously increase overweight within the same individual, household or population, causing a double burden of malnutrition (DBM). We investigated economic inequalities in DBM at the household level, expressed as a stunted child with a mother with overweight/obesity, and the moderating role of dietary diversity in these inequalities. DESIGN We used cross-sectional data from the 2015-2016 Tanzania Demographic and Health Survey. SETTING A nationally representative survey. PARTICIPANTS Totally, 2867 children (aged 6-23 months) and their mothers (aged 15-49 years). The mother-child pairs were categorised into two groups based on dietary diversity score: achieving and not achieving minimum dietary diversity. RESULTS The prevalence of DBM was 5·6 % (sd = 0·6) and significantly varied by region (ranging from 0·6 % to 12·2 %). Significant interaction was observed between dietary diversity and household wealth index (Pfor interaction < 0·001). The prevalence of DBM monotonically increased with greater household wealth among mother-child pairs who did not achieve minimum dietary diversity (Pfor trend < 0·001; however, this association was attenuated in those who achieved minimum dietary diversity (Pfor trend = 0·16), particularly for the richest households (P = 0·44). Analysing household wealth index score as a continuous variable yielded similar results (OR (95 % CI): 2·10 (1·36, 3·25) for non-achievers of minimum dietary diversity, 1·38 (0·76, 2·54) for achievers). CONCLUSIONS Greater household wealth was associated with higher odds of DBM in Tanzania; however, the negative impact of household economic status on DBM was mitigated by minimum dietary diversity.
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Affiliation(s)
- Sanmei Chen
- Global Health Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima734-8553, Japan
| | - Yoko Shimpuku
- Global Health Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima734-8553, Japan
| | - Takanori Honda
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Dorkasi L Mwakawanga
- Global Health Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima734-8553, Japan
| | - Beatrice Mwilike
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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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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Johnson W, Mansukoski L, Galvez-Sobral JA, Furlán L, Bogin B. Inequalities in adiposity trends between 1979 and 1999 in Guatemalan children. Am J Hum Biol 2024; 36:e24031. [PMID: 38148505 DOI: 10.1002/ajhb.24031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/06/2023] [Accepted: 12/09/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Guatemala suffered from civil war and high levels of inequality and childhood stunting in the second half of the 20th century, but little is known about inequalities in secular trends in adiposity. OBJECTIVES To investigate differences in childhood body mass index (BMI) and skinfold thickness trajectories from 1979 to 1999 between three groups of children: High socioeconomic position (SEP) Ladino, Low SEP Ladino, and Low SEP Indigenous Maya. METHODS The sample comprised 19 346 children aged 7-17 years with 54 638 observations. The outcomes were height, BMI, triceps skinfold thickness (TST), and subscapular skinfold thickness (SST) Z-scores according to the Centers for Disease Control and Prevention (CDC) references. Sex-specific multilevel models were used to estimate and compare mean trajectories from 1979 to 1999 between the three groups. RESULTS Mean Z-scores were always highest for High SEP Ladino children and lowest for Low SEP Maya children. Despite their very short stature, the Low SEP groups had SST trajectories that were above the 50th centile. The BMI trajectories were relatively flat and within one major centile band of the CDC median, with differences between the three groups that were small (0.2-0.3 Z-scores) and did not attenuate over time. Conversely, the TST Z-score trajectories demonstrated larger positive secular trends (e.g., from -1.25 in 1979 to -0.06 in 1999 for Low SEP Maya boys), with differences between the three groups that were large (0.5-1.2 Z-scores) and did attenuate over time (in boys). Secular trends and between-group difference in the SST Z-score trajectories were less pronounced, but again we found stronger evidence in boys that the estimated inequalities attenuated over time. CONCLUSIONS Secular trends and inequalities in skinfolds differ from those for BMI in Guatemalan children. Differences between groups in skinfolds attenuated over time, at least in boys, but whether this is good news is questionable given the very short stature yet relatively large subscapular skinfolds of the Low SEP groups.
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Affiliation(s)
- William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - J Andres Galvez-Sobral
- Centro de Investigaciones Educativas, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Luis Furlán
- Centro de Estudios en Informática Aplicada, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Barry Bogin
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- UCSD/Salk Center for Academic Research and Training in Anthropogeny (CARTA), USA
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Bofa A, Zewotir T. Key predictors of food security and nutrition in Africa: a spatio-temporal model-based study. BMC Public Health 2024; 24:885. [PMID: 38519902 PMCID: PMC11220996 DOI: 10.1186/s12889-024-18368-2] [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: 07/13/2023] [Accepted: 03/15/2024] [Indexed: 03/25/2024] Open
Abstract
There is voluminous literature on Food Security in Africa. This study explicitly considers the spatio-temporal factors in addition to the usual FAO-based metrics in modeling and understanding the dynamics of food security and nutrition across the African continent. To better understand the complex trajectory and burden of food insecurity and nutrition in Africa, it is crucial to consider space-time factors when modeling and interpreting food security. The spatio-temporal anova model was found to be superior(employing statistical criteria) to the other three models from the spatio-temporal interaction domain models. The results of the study suggest that dietary supply adequacy, food stability, and consumption status are positively associated with severe food security, while average food supply and environmental factors have negative effects on Food Security and Nutrition. The findings also indicate that severe food insecurity and malnutrition are spatially and temporally correlated across the African continent. Spatio-temporal modeling and spatial mapping are essential components of a comprehensive practice to reduce the burden of severe food insecurity. likewise, any planning and intervention to improve the average food supply and environment to promote sustainable development should be regional instead of one size fit all.
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Affiliation(s)
- Adusei Bofa
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Westville campus, Durban, South Africa.
| | - Temesgen Zewotir
- School of Mathematics, Statistics, and Computer Science, University of KwaZulu Natal, Westville campus, Oliver Tambo Building, Durban, South Africa
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Mekonnen S, Birhanu D, Menber Y, Gebreegziabher ZA, Belay MA. Double burden of malnutrition and associated factors among mother-child pairs at household level in Bahir Dar City, Northwest Ethiopia: community based cross-sectional study design. Front Nutr 2024; 11:1340382. [PMID: 38445209 PMCID: PMC10912183 DOI: 10.3389/fnut.2024.1340382] [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: 11/17/2023] [Accepted: 01/29/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction The double burden of malnutrition refers to the simultaneous presence of under nutrition and overweight, obesity, or diet-related non-communicable diseases which might occur at the population, household, and individual level. The simultaneous presence of overweight/obese mothers with undernourished children in the same household, as well as overweight children with underweight mothers, holds particular significance. This phenomenon primarily impacts low-income and middle-income countries. The prevalence of double-burden malnutrition at the household level has increased significantly in sub-Saharan African countries. However, there is limited knowledge regarding the extent and factors associated with the double burden of malnutrition among mother-child pairs in Ethiopia. Consequently, the objective of this study was to assess the prevalence and determinants of the double burden of malnutrition among mother-child pairs at the household level in Bahir Dar City, Ethiopia. Method In the year 2021, a community-based cross-sectional study design was employed among 702 mother-child pairs in Bahir Dar City from February 28 to March 23. A multistage sampling technique was used to identify study participants who were interviewed using an interviewer-administered questionnaire. The nutritional status of children was evaluated using WHO Anthro Software. To determine the strength of the association, multivariable logistic regression analysis was performed, and adjusted odds ratios with their respective 95% confidence intervals were computed. Results The prevalence of the double burden of malnutrition among mother-child pairs was 14.5% (95% CI: 12.8, 15.7%}. Participants who were in the richest wealth index were 2.72 {AOR = 2.72, 95% CI 2.01, 5.63} times more odds of double burden of malnutrition than the poorest. The odds of the double burden of malnutrition among children who had high dietary diversity decreased by 63% {AOR = 0.37, 95% CI 0.22, 0.61} than low dietary diversity. Food secure households were 1.96 {AOR = 1.96, 95% CI 1.13, 3.39} times more likely to have the double burden of malnutrition than food insecure households. The odds of the double burden of malnutrition among mothers who completed college and above decreased by 74% {AOR = 0.26 95% CI 0.121, 0.549} than those unable to read and write. Conclusions and recommendation The magnitude of the double burden of malnutrition was lower than the Ethiopian Demographic and Health Survey. Wealth index, dietary diversity, food security, and educational status were significantly associated with the double burden of malnutrition. Therefore, it is recommended to implement public health interventions that target the identified associated factors in order to reduce the burden of double malnutrition.
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Affiliation(s)
| | - Dereje Birhanu
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yonatan Menber
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Zenebe Abebe Gebreegziabher
- Department of Epidemiology and Biostatistics, School of Public Health, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Mahider Awoke Belay
- Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
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Martins RBM, Torres JL, Moreira BDS, Lima-Costa MF, Ygnatios NTM. [Sociodemographic characteristics associated with underweight and overweight in adults aged 50 years and over (ELSI-Brasil): differences between sexes]. CAD SAUDE PUBLICA 2024; 40:e00037023. [PMID: 38324866 PMCID: PMC10841375 DOI: 10.1590/0102-311xpt037023] [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: 02/26/2023] [Revised: 09/01/2023] [Accepted: 09/18/2023] [Indexed: 02/09/2024] Open
Abstract
The objective were to describe the prevalence of underweight and overweight, assessed by body mass index (BMI), stratified by sex and age group, and to analyze the sociodemographic characteristics associated with BMI in older women and men. This is a cross-sectional analysis of 8,974 participants aged ≥ 50 years from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brasil, 2015-2016). BMI was classified as underweight, eutrophy, and overweight according to the participant's age. A multinomial logistic regression model was used, considering the sociodemographic characteristics of women and men. The results showed a higher prevalence of overweight in women compared to men (64.1% vs. 57.3%). In both sexes, the prevalence of underweight was higher in the longest-lived individuals, while overweight was lower. In women, the chance of underweight was higher than the chance of eutrophy in those who were single/widowed/divorced (OR = 1.95; 95%CI: 1.42-2.66) and in those living in rural areas (OR = 1.58; 95%CI: 1.01-2.49), while the chance of being overweight was lower than the chance of being eutrophy in those living in rural areas (OR = 0.78; 95%CI: 0.62-0.97) and in all geographic macro-regions related to the South Region. For men, the chance of being overweight was lower than the chance of being eutrophy among single/widowed/divorced individuals (OR = 0.58; 95%CI: 0.48-0.69). The richest had a lower chance of being underweight (OR = 0.59; 95%CI: 0.38-0.90), as well as a higher chance of being overweight (OR = 1.52; 95%CI: 1.20-1.92). In conclusion, the sociodemographic characteristics associated with BMI differed between the sexes.
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Affiliation(s)
| | - Juliana Lustosa Torres
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Bruno de Souza Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Maria Fernanda Lima-Costa
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
| | - Nair Tavares Milhem Ygnatios
- Centro Universitário Santa Rita, Conselheiro Lafaiete, Brasil
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Mostafa I, Sthity RA, Lamiya UH, Tariqujjaman M, Mahfuz M, Hasan SMT, Ahmed T. Effect of Gut Microbiota-Directed Complementary Food Supplementation on Fecal and Plasma Biomarkers of Gut Health and Environmental Enteric Dysfunction in Slum-Dwelling Children with Moderate Acute Malnutrition. CHILDREN (BASEL, SWITZERLAND) 2024; 11:69. [PMID: 38255381 PMCID: PMC10814735 DOI: 10.3390/children11010069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/31/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024]
Abstract
Dietary supplementation with a gut microbiota-directed complementary food (MDCF-2) significantly improved weight gain and repaired gut microbiota, as reported in a recent randomized controlled trial on Bangladeshi children with moderate acute malnutrition (MAM). Environmental enteric dysfunction (EED) is a small bowel disorder, and recent evidence shows that it is linked to growth failure in children. Therefore, we intended to investigate whether supplementation with MDCF-2 has any role in modifying gut health by changing the levels of biomarkers of EED and gut inflammation in children with MAM. We randomly assigned 124 children aged 12-18 months to one of two intervention diets, either MDCF-2 or ready-to-use supplementary food (RUSF). Approximately 50 g of the diet was administered in two feeding sessions daily for 12 weeks. Stool and plasma biomarkers were assessed to evaluate intestinal health. Results showed that the average change in citrulline concentration (µmol/L) significantly increased among children who consumed MDCF-2 compared to those who consumed RUSF (mean difference-in-differences: 123.10; 95% CI: 3.60, 242.61; p = 0.044). The research findings demonstrated that MDCF-2 might have a beneficial effect on improving the gastrointestinal health of malnourished children.
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Affiliation(s)
- Ishita Mostafa
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh; (R.A.S.); (U.H.L.); (M.T.); (M.M.); (S.M.T.H.); (T.A.)
- Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| | - Rahvia Alam Sthity
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh; (R.A.S.); (U.H.L.); (M.T.); (M.M.); (S.M.T.H.); (T.A.)
| | - Umme Habiba Lamiya
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh; (R.A.S.); (U.H.L.); (M.T.); (M.M.); (S.M.T.H.); (T.A.)
| | - Md. Tariqujjaman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh; (R.A.S.); (U.H.L.); (M.T.); (M.M.); (S.M.T.H.); (T.A.)
| | - Mustafa Mahfuz
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh; (R.A.S.); (U.H.L.); (M.T.); (M.M.); (S.M.T.H.); (T.A.)
- Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| | - S. M. Tafsir Hasan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh; (R.A.S.); (U.H.L.); (M.T.); (M.M.); (S.M.T.H.); (T.A.)
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh; (R.A.S.); (U.H.L.); (M.T.); (M.M.); (S.M.T.H.); (T.A.)
- Department of Public Health Nutrition, James P Grant School of Public Health, BRAC University, Dhaka 1212, Bangladesh
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15
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Herrera DJ, Herrera ML, Amora D, Bas S, Miranda CA, Van Hal G. Mixed-method study on the association between inclusion to conditional cash transfer program and the multiple faces of malnutrition in children and adolescents aged 3 to 19 years: a school-based evidence from Caraga Region, the Philippines. BMC Pediatr 2023; 23:630. [PMID: 38093230 PMCID: PMC10717276 DOI: 10.1186/s12887-023-04438-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND This study aimed to investigate the association between inclusion to Pantawid Pamilyang Pilipino Program (4Ps), a CCT program in the Philippines, and malnutrition in children and adolescents and examine the perceptions and experiences of parents and other stakeholders on how 4Ps influenced child nutrition. METHODS A concurrent mixed-method study was conducted in the Caraga Region, Philippines. Quantitative data from 5541 children and adolescents aged 3 to 19 were analyzed using multilevel mixed-effect logistic models. To allow in-depth understanding of the programmatic components that support the findings from the quantitative study, eight focused group discussions (FGDs) were concurrently conducted, cumulating 33 participants, including 4Ps parents, school coordinators/teachers, and school nurses. A constructivist grounded theory approach was used for analysis, and joint displays were employed to integrate quantitative and qualitative results. RESULTS Quantitative findings revealed high rates of malnutrition, with significant rates of stunting (12.0%), wasting/thinness (9.4%), and overweight/obesity (16.4%) among children and adolescents. 4Ps beneficiaries had higher odds of stunting and overweight/obesity compared to non-4Ps beneficiaries (AOR = 1.43, 95%CI: 1.08-1.91; AOR = 1.21, 95%CI: 1.01-1.45, respectively). However, no significant association was observed between inclusion to 4Ps and concurrent stunting and wasting/thinness or overweight/obesity (AOR = 1.05, 95%CI: 0.72-1.55). Geographic variations were observed, with 4Ps children in Agusan del Sur having lower odds of stunting than those in Agusan del Norte (AOR = 0.41, 95%CI: 0.23-0.71). Age and gender also showed significant associations with malnutrition. The qualitative analysis provided insights into the challenges contributing to malnutrition, including child labor, sickness, long distances to school, limited access to healthy food, and larger families. Unintended consequences such as cash card mismanagement, inappropriate cash grant allocation, and falsification of school attendance were identified. However, teachers and parents demonstrated resilience by implementing adaptive approaches to enhance child nutrition. CONCLUSIONS While 4Ps beneficiaries exhibit higher odds of stunting and overweight/obesity, the program's association with malnutrition was significantly influenced by geographic variations. It is crucial for social protection programs to prioritize comprehensive support strategies that effectively counter unintended consequences and challenges faced by beneficiaries and other stakeholders and address malnutrition in children and adolescents.
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Affiliation(s)
- Deborah Jael Herrera
- Family Medicine and Population Health Department, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - Miraluna L Herrera
- Action for Greater Advancement of Knowledge (AGAK) Center, Caraga State University, Agusan del Norte, Butuan City, Philippines
| | - Donnacham Amora
- Department of Medical Technology, Agusan del Norte, Butuan Doctors College, Butuan City, Philippines
| | - Sherlyn Bas
- Action for Greater Advancement of Knowledge (AGAK) Center, Caraga State University, Agusan del Norte, Butuan City, Philippines
| | - Caryl Aya Miranda
- Action for Greater Advancement of Knowledge (AGAK) Center, Caraga State University, Agusan del Norte, Butuan City, Philippines
| | - Guido Van Hal
- Family Medicine and Population Health Department, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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16
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Martins RS, Poulikidis K, Razi SS, Latif MJ, Tafuri K, Bhora FY. From emissions to incisions and beyond: the repercussions of climate change on surgical disease in low- and-middle-income countries. BMC Surg 2023; 23:348. [PMID: 37974149 PMCID: PMC10655255 DOI: 10.1186/s12893-023-02260-8] [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: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
Climate change has far-reaching repercussions for surgical healthcare in low- and middle-income countries. Natural disasters cause injuries and infrastructural damage, while air pollution and global warming may increase surgical disease and predispose to worse outcomes. Socioeconomic ramifications further strain healthcare systems, highlighting the need for integrated climate and healthcare policies.
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Affiliation(s)
- Russell Seth Martins
- Division of Thoracic Surgery, Department of Surgery, Hackensack Meridian School of Medicine, Hackensack Meridian Health Network - Central Region, Edison, NJ, 08820, United States of America.
| | - Kostantinos Poulikidis
- Division of Thoracic Surgery, Department of Surgery, Hackensack Meridian School of Medicine, Hackensack Meridian Health Network - Central Region, Edison, NJ, 08820, United States of America
| | - Syed Shahzad Razi
- Division of Thoracic Surgery, Department of Surgery, Hackensack Meridian School of Medicine, Hackensack Meridian Health Network - Central Region, Edison, NJ, 08820, United States of America
| | - M Jawad Latif
- Division of Thoracic Surgery, Department of Surgery, Hackensack Meridian School of Medicine, Hackensack Meridian Health Network - Central Region, Edison, NJ, 08820, United States of America
| | - Kyle Tafuri
- Hackensack Meridian Health Network, Nutley, NJ, 08820, United States of America
| | - Faiz Y Bhora
- Division of Thoracic Surgery, Department of Surgery, Hackensack Meridian School of Medicine, Hackensack Meridian Health Network - Central Region, Edison, NJ, 08820, United States of America.
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17
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Singh S, Shri N, Singh A. Inequalities in the prevalence of double burden of malnutrition among mother-child dyads in India. Sci Rep 2023; 13:16923. [PMID: 37805548 PMCID: PMC10560231 DOI: 10.1038/s41598-023-43993-z] [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: 11/29/2022] [Accepted: 10/01/2023] [Indexed: 10/09/2023] Open
Abstract
In the midst of rapid urbanization and economic shifts, the global landscape witnesses a surge in overweight and obese individuals, even as child malnutrition persists as a formidable public health challenge in low- and middle-income countries (LMICs). This study seeks to unravel the prevalence of the double burden of malnutrition (DBM) within the context of India and delve into the associated disparities rooted in wealth. This study leverages data from the fifth wave of the National Family and Health Survey (NFHS-5), a nationally representative survey conducted in the year 2019-21 in India. This study focuses on mother-child dyads with children under the age of 3 years. Descriptive, bivariate and logistic regression analysis is used to decipher the intricate web of DBM's prevalence and risk factors, as underscored by socio-demographic attributes. Wagstaff decomposition analysis is applied to quantify the contribution of each inequality in the social determinants on the observed income-related inequality in the DBM. Result from bivariate and logistic regression indicated a heightened risk of DBM within households marked by C-section births, affluence, ongoing breastfeeding practices, advanced maternal age, and larger household sizes. Additionally, households harbouring women with abdominal obesity emerge as hotspots for elevated DBM risk. Notably, the interplay of abdominal obesity and geographical disparities looms large as drivers of substantial inequality in DBM prevalence, whereas other factors exert a comparably milder influence. As India grapples with the burgeoning burden of DBM, a conspicuous imbalance in its prevalence pervades, albeit inadequately addressed. This juncture warrants the formulation of dual-purpose strategies, and a slew of innovative actions to deftly navigate the complex challenges poised by the dual burden of malnutrition. Amidst these exigencies, the imperative to forge a holistic approach that encompasses both sides of the malnutrition spectrum remains a beacon guiding the quest for equitable health and nutrition outcomes.
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Affiliation(s)
- Saurabh Singh
- International Institute for Population Sciences, Mumbai, 400088, Maharashtra, India
| | - Neha Shri
- International Institute for Population Sciences, Mumbai, 400088, Maharashtra, India.
| | - Akancha Singh
- International Institute for Population Sciences, Mumbai, 400088, Maharashtra, India
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Pradeilles R, Landais E, Pareja R, Eymard‐Duvernay S, Markey O, Holdsworth M, Rousham EK, M. Creed‐Kanashiro H. Exploring the magnitude and drivers of the double burden of malnutrition at maternal and dyad levels in peri-urban Peru: A cross-sectional study of low-income mothers, infants and young children. MATERNAL & CHILD NUTRITION 2023; 19:e13549. [PMID: 37485734 PMCID: PMC10483951 DOI: 10.1111/mcn.13549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/25/2023]
Abstract
Multiple forms of malnutrition coexist in Peru, especially in peri-urban areas and poor households. We investigated the magnitude of, and the contribution of, dietary and socio-demographic factors to the double burden of malnutrition (DBM) at maternal (i.e., maternal overweight/obesity with anaemia) and dyad (i.e., maternal overweight/obesity with child anaemia) levels. A cross-sectional survey was conducted among low-income mother-child (6-23 months) dyads (n = 244) from peri-urban communities in Peru. Dietary clusters and the minimum dietary diversity score (MDD) were generated for mothers and infants, respectively. A composite indicator using the maternal dietary clusters and the MDD was created to relate to dyad level DBM. Two dietary clusters were found: (i) the 'high variety (i.e., animal-source foods, fruit and vegetables), high sugary foods/beverages' (cluster 1) and (ii) the 'high potato, low fruit and vegetables, low red meat' (cluster 2). DBM prevalence among mothers and dyads was 19.9% and 36.3%, respectively. Logistic regression analyses revealed that the only socio-demographic factor positively associated with maternal DBM was maternal age (aOR/5 years: 1.35 [1.07, 1.71]). Mothers belonging to diet cluster 1 were less likely to experience the DBM (aOR = 0.52 [0.26, 1.03]), although CIs straddled the null. Socio-demographic factors positively associated with dyad level DBM included maternal age (aOR/5 years: 1.41 [1.15, 1.73]), and having ≥ two children under 5 years (aOR = 2.44 [1.23, 4.84]). Diet was not associated with dyad-level DBM. Double-duty actions that tackle the DBM are needed given that one-third of dyads and a fifth of mothers had concurrent overweight/obesity and anaemia.
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Affiliation(s)
- Rebecca Pradeilles
- Centre for Global Health and Human Development School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri‐Food Systems)Univ Montpellier, CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro, IRDMontpellierFrance
| | - Edwige Landais
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri‐Food Systems)Univ Montpellier, CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro, IRDMontpellierFrance
| | | | - Sabrina Eymard‐Duvernay
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri‐Food Systems)Univ Montpellier, CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro, IRDMontpellierFrance
| | - Oonagh Markey
- Centre for Global Health and Human Development School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri‐Food Systems)Univ Montpellier, CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro, IRDMontpellierFrance
| | - Emily K. Rousham
- Centre for Global Health and Human Development School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
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Dwivedi LK, Puri P, Pant A, Chauhan A, Scott S, Singh S, Pedgaonker S, Nguyen PH. Concurrent Undernutrition and Overnutrition within Indian Families between 2006 and 2021. Curr Dev Nutr 2023; 7:101987. [PMID: 37720241 PMCID: PMC10502368 DOI: 10.1016/j.cdnut.2023.101987] [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: 06/01/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 09/19/2023] Open
Abstract
Background The double burden of malnutrition (DBM), characterized by concurrent undernutrition and overnutrition, is a growing global concern. Families share resources and eating behaviors and programs often target households, yet evidence of the DBM at the family level is scarce. Objectives This study examined trends and inequality in the intrahousehold DBM in India between 2006 and 2021. Methods Data were from 3 waves of India's National Family Health Survey (NFHS 2006, 2016, and 2021). We examined 3 types of household member (with children aged <5 y) combinations: mother-child (N = 328,039 across 3 waves), father-child, and parent (mother and father)-child (N = 47,139 for each pair). The DBM was defined as one or more individuals with undernutrition (either wasting or stunting in children or underweight in adults) and one or more overweight individuals within the same household. DBM was examined over time, at national and subnational levels, and by residence and wealth. Results Nearly all DBM was in the form of an overweight parent and an undernourished weight or stunted child. The prevalence of parent-child DBM increased from 15% in 2006 to 26% in 2021. Father-child pairs experienced the most rapid DBM increase, from 12% in 2006 to 22% in 2021, an 83% increase, driven by increasing overweight among men. In 2021, the DBM was highest in North-Eastern and Southern states, and among relatively rich households from urban areas. The increase in the DBM was faster in rural areas and among poor households compared with that in urban areas and rich households. Urban-rural and rich-poor inequalities in the DBM have decreased over time. Conclusions The intrahousehold DBM has increased over time, affecting 1 in 4 households in India in 2021. Family-based interventions that can simultaneously address child underweight and parent overweight are required to address India's increasing intrahousehold DBM.
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Affiliation(s)
| | - Parul Puri
- International Institute of Population Sciences, Mumbai, India
| | - Anjali Pant
- International Food Policy Research Institute, South Asia Office, New Delhi, India
| | - Alka Chauhan
- International Institute of Population Sciences, Mumbai, India
| | - Samuel Scott
- International Food Policy Research Institute, South Asia Office, New Delhi, India
| | - Shrikant Singh
- International Institute of Population Sciences, Mumbai, India
| | | | - Phuong H. Nguyen
- International Food Policy Research Institute, South Asia Office, New Delhi, India
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Konner M, Eaton SB. Hunter-gatherer diets and activity as a model for health promotion: Challenges, responses, and confirmations. Evol Anthropol 2023; 32:206-222. [PMID: 37417918 DOI: 10.1002/evan.21987] [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: 09/19/2021] [Revised: 07/27/2022] [Accepted: 04/17/2023] [Indexed: 07/08/2023]
Abstract
Beginning in 1985, we and others presented estimates of hunter-gatherer (and ultimately ancestral) diet and physical activity, hoping to provide a model for health promotion. The Hunter-Gatherer Model was designed to offset the apparent mismatch between our genes and the current Western-type lifestyle, a mismatch that arguably affects prevalence of many chronic degenerative diseases. The effort has always been controversial and subject to both scientific and popular critiques. The present article (1) addresses eight such challenges, presenting for each how the model has been modified in response, or how the criticism can be rebutted; (2) reviews new epidemiological and experimental evidence (including especially randomized controlled clinical trials); and (3) shows how official recommendations put forth by governments and health authorities have converged toward the model. Such convergence suggests that evolutionary anthropology can make significant contributions to human health.
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Affiliation(s)
- Melvin Konner
- Department of Anthropology, Program in Anthropology and Human Biology, Emory University, Atlanta, Georgia, USA
| | - S Boyd Eaton
- Department of Radiology, Emory University School of Medicine (Emeritus), Adjunct Lecturer, Department of Anthropology, Emory University, Atlanta, Georgia, USA
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21
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Seenivasan S, Talukdar D, Nagpal A. National income and macro-economic correlates of the double burden of malnutrition: an ecological study of adult populations in 188 countries over 42 years. Lancet Planet Health 2023; 7:e469-e477. [PMID: 37286244 DOI: 10.1016/s2542-5196(23)00078-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 02/24/2023] [Accepted: 03/29/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND The double burden of malnutrition (DBM) represents a growing global challenge with adverse health and economic consequences. We aimed to investigate the associative roles of national income (gross domestic product per capita [GDPPC]) and macro-environmental factors on the DBM trends among national adult populations. METHODS In this ecological study we assembled extensive historical data on GDPPC from the World Bank World Development Indicators database and population-level DBM data of adults (aged ≥18 years) from the WHO Global Health Observatory database in 188 countries over 42 years (1975-2016). In our analysis, a country was considered to have the DBM in a year when adult overweight (BMI ≥25·0 kg/m2) and underweight (BMI <18·5 kg/m2) prevalence was each 10% or more in that year. We used a Type 2 Tobit model to estimate the association of GDPPC and selected macro-environmental factors (globalisation index, adult literacy rate, female share in the labour force, share of agriculture in the national gross domestic product [GDP], prevalence of undernourishment, and percentage of principal display area mandated to be covered by health warnings on cigarette packaging) with DBM in 122 countries. FINDINGS We find a negative association between GDPPC and the likelihood of a country having the DBM. However, conditional on its presence, DBM level exhibits an inverted-U shaped association with GDPPC. We found an upward shift in DBM levels from 1975 to 2016 across countries at the same level of GDPPC. Among the macro-environmental variables, share of females in the labour force and share of agriculture in the national GDP are negatively associated with DBM presence in a country, whereas the prevalence of undernourishment in the population is positively associated. Further, globalisation index, adult literacy rate, share of females in the labour force, and health warnings on cigarette packaging are negatively associated with DBM levels in countries. INTERPRETATION DBM level in national adult populations rises with GDPPC until US$11 113 (in 2021 constant dollar terms) and then starts declining. Given their current GDPPC levels, most low-income and middle-income countries are thus unlikely to have a decline in the DBM levels in the near future, ceteris paribus. Those countries will also be expected to experience a higher DBM level at similar levels of national income than were historically experienced by the current high-income countries. Our findings point to a further intensification of the DBM challenge in the near future for the low-income and middle-income countries as they continue to have income growth. FUNDING None.
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Affiliation(s)
- Satheesh Seenivasan
- Department of Marketing, Monash Business School, Monash University, Clayton, VIC, Australia.
| | - Debabrata Talukdar
- School of Management, State University of New York at Buffalo, Buffalo, NY, USA
| | - Anish Nagpal
- Department of Management and Marketing, Faculty of Business and Economics, The University of Melbourne, Parkville, VIC, Australia
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Wongupparaj P, Wongupparaj R, Morris RG, Kumari V. Seventy years, 1000 samples, and 300,000 SPM scores: A new meta-analysis of Flynn effect patterns. INTELLIGENCE 2023. [DOI: 10.1016/j.intell.2023.101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Caleyachetty R, Kumar NS, Bekele H, Manaseki-Holland S. Socioeconomic and urban-rural inequalities in the population-level double burden of child malnutrition in the East and Southern African Region. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000397. [PMID: 37097991 PMCID: PMC10128925 DOI: 10.1371/journal.pgph.0000397] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 02/28/2023] [Indexed: 04/26/2023]
Abstract
Socioeconomic and urban-rural inequalities in the population-level double burden of child malnutrition threatens global nutrition targets 2025, especially in East and Southern Africa. We aimed to quantify these inequalities from nationally representative household surveys in the East and Southern African region. 13 Demographic and Health Surveys between 2006 and 2018 including 72,231 children under five years old were studied. Prevalence of stunting, wasting and overweight (including obesity) were disaggregated by wealth quintiles, maternal education categories and urban-rural residence for visual inspection of inequalities. The slope index of inequality (SII) and the relative index of inequality (RII) were estimated for each country. Regional estimates of child malnutrition prevalence and socioeconomic and urban-rural inequalities were generated from pooling country-specific estimates using random-effects meta-analyses. Regional stunting and wasting prevalence were higher among children living in the poorest households, with mothers with the lowest educational level and in rural areas. In contrast, regional overweight (including obesity) prevalence was higher among children living in the richest households, with mothers with the highest educational level and urban areas. This study indicates pro-poor inequalities are present in child undernutrition and pro-rich inequalities are present in child overweight including obesity. These findings re-emphasise the need for an integrated approach to tackling the population-level double burden of child malnutrition in the region. Policy makers must target specific populations that are vulnerable to child malnutrition, to avoid further widening of socioeconomic and urban-rural inequalities.
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Affiliation(s)
- Rishi Caleyachetty
- Warwick Centre for Global Health, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Niraj S. Kumar
- University College London Medical School, University College London, London, United Kingdom
| | - Hana Bekele
- World Health Organization, Inter-Country Support Team, Zimbabwe WHO Country Office, Harare, Zimbabwe
| | - Semira Manaseki-Holland
- Institute for Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Chen S, Richardson S, Kong Y, Ma N, Zhao A, Song Y, Lu C, Subramanian SV, Li Z. Association Between Parental Education and Simultaneous Malnutrition Among Parents and Children in 45 Low- and Middle-Income Countries. JAMA Netw Open 2023; 6:e2251727. [PMID: 36692884 PMCID: PMC10408270 DOI: 10.1001/jamanetworkopen.2022.51727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/26/2022] [Indexed: 01/25/2023] Open
Abstract
IMPORTANCE Parental education is known to be associated with the health status of parents and their offspring. However, the association between parental education and the simultaneous manifestation of multiple forms of malnutrition within households remains underinvestigated globally. OBJECTIVE To assess the association between parental education and the simultaneous manifestation of malnutrition of both parent and child (either overnutrition or undernutrition)-referred to as the double burden of malnutrition (DBM)-at the household level in mother-child and father-child pairs in low- and middle-income countries (LMICs). DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the US Agency for International Development Demographic and Health Surveys (January 1, 2010, to December 31, 2021) to identify mother-child pairs and father-child pairs from LMICs. The eligibility criteria were as follows: (1) children aged 0 to 59 months; (2) nonpregnant mothers at the time of the survey in the sample of mother-child pairs; and (3) valid measures of the weight, height, and hemoglobin level for the child and at least 1 of their parents. EXPOSURES Highest level of parental education obtained and number of years of education completed. MAIN OUTCOMES AND MEASURES Four sets of multivariable logistic regression models were constructed to assess the association between parental education and DBM, and analysis was performed between March 10 and May 15, 2022. RESULTS This study included 423 340 mother-child pairs from 45 LMICs and 56 720 father-child pairs from 16 LMICs. The mean (SD) age of the mother-child pairs was 28.2 (6.1) and 1.9 (1.4) years, respectively; 48.8% of the children were female. We observed that 49.0% of mother-child pairs experienced DBM. Compared with mother-child pairs with no maternal education, higher maternal education was associated with a lower risk of DBM. For example, the odds ratio (OR) for tertiary maternal education was 0.71 (95% CI, 0.67-0.74). However, the association differed by DBM subtypes: higher maternal education was associated with a lower risk of both mothers and children being undernourished but with a higher risk of almost all DBM subtypes involving overnutrition. For example, compared with mother-child pairs with no maternal education, those with secondary education were less likely to develop simultaneous maternal and child undernutrition (OR, 0.83 [95% CI, 0.80-0.86]) but were more likely to experience simultaneous maternal and child overnutrition (OR, 2.20 [95% CI, 1.61-3.00]); similar results were observed for pairs with primary and tertiary education. The results in mother-child pairs remained consistent after controlling for paternal education. Among the father-child pairs, 26.5% had DBM, with fathers with tertiary education significantly more likely to experience simultaneous paternal overnutrition and child undernutrition (OR, 1.55 [95% CI, 1.23-1.95]) compared with pairs with no paternal education; they were also less likely to have both paternal and child undernutrition (OR, 0.70 [95% CI, 0.59-0.84]). CONCLUSIONS AND RELEVANCE In this study, maternal education and paternal education were independently associated with DBM, and the associations differed by DBM subtypes. These findings suggest that the different risks of malnutrition faced by households with various levels of education should thus be considered in policy evaluation.
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Affiliation(s)
- Shaoru Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Sol Richardson
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuhao Kong
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Ning Ma
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Chunling Lu
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts
| | - S. V. Subramanian
- Harvard Center for Population and Development Studies, Cambridge, Massachusetts
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Zhihui Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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Li C, Zhang M, Tarken AY, Cao Y, Li Q, Wang H. Secular trends and sociodemographic determinants of thinness, overweight and obesity among Chinese children and adolescents aged 7-18 years from 2010 to 2018. Front Public Health 2023; 11:1128552. [PMID: 37213615 PMCID: PMC10192611 DOI: 10.3389/fpubh.2023.1128552] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/06/2023] [Indexed: 05/23/2023] Open
Abstract
Background Most studies have focused on overweight/obesity and its secular trend, with insufficient studies on the factors influencing thinness and trends recently. To examine the trends of prevalence and sociodemographic determinants of thinness, overweight, and obesity among Chinese children and adolescents aged 7 to 18 years from 2010 to 2018. Methods This study was based on cross-sectional data of 11,234 children and adolescents aged 7 to 18 years from the Chinese Family Panel Studies (CFPS) in 2010, 2014, and 2018, including anthropometric and sociodemographic characteristics variables. The nutritional status of each individual was determined according to China and WHO criteria. The demographic characteristics of different subgroups were tested by chi-square, and log-binomial regression was used to analyze the trend of prevalence and the relationship between sociodemographic characteristics and different nutritional statuses. Results After adjusting for age, from 2010 to 2018, the overall prevalence of thinness decreased, and the prevalence of overweight increased in Chinese children and adolescents. The overall prevalence of obesity declined in boys and increased in girls, but in adolescents aged 16-18 years, it increased significantly. Log-binomial regression analysis showed that among all subjects, time (years), 16-18 years were negatively associated with thinness, while 13-15 years, walking to school, large family size, and paternal age at childbirth older than 30 years old were positively associated with thinness; 10-12/13-15/16-18 years, boarding at school, medium and large family sizes, and mother's education at junior middle school/junior high school and above were negatively associated with overweight/obesity, while time (years), boys were positively associated with overweight/obesity in the multivariate model by adjusting for the statistically significant factors (all p < 0.05). Conclusion Chinese children and adolescents are facing a double burden of malnutrition. Future public health policies and interventions should prioritize high-risk groups specifically young age groups, boys, larger family sizes and so on.
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Otten HS, Seferidi P. Prevalence and socioeconomic determinants of the double burden of malnutrition in mother-child pairs in Latin America and the Caribbean. BMJ Nutr Prev Health 2022; 5:263-270. [PMID: 36619319 PMCID: PMC9813618 DOI: 10.1136/bmjnph-2022-000489] [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: 05/16/2022] [Accepted: 10/10/2022] [Indexed: 12/31/2022] Open
Abstract
Background The double burden of malnutrition (DBM), which refers to the coexistence of overnutrition and undernutrition among populations, households or individuals, is a growing problem in low/middle-income countries. The Latin America and the Caribbean (LAC) region has been particularly affected by the DBM, following a nutrition transition and a rapid increase in overweight, obesity and diet-related disease, while high levels of undernutrition persist. This study aims to describe the prevalence of four different DBM definitions in mother-child pairs across nine LAC countries and investigate the socioeconomic determinants of overweight mothers with at least one stunted child (SCOM). Methods We used cross-sectional data from the Demographic and Health Surveys for all analyses. We used descriptive statistics to obtain prevalence rates and conducted multiple logistic regression analyses to investigate the association between SCOM households and socioeconomic determinants, including wealth index, maternal education, place of residency and whether the mother was working, adjusted for a range of variables. Results Overweight/obese mothers with at least one anaemic child were the most common type of DBM, with a prevalence of 19.39%, followed by SCOM with a prevalence of 10.44%. Statistically significant socioeconomic predictors of SCOM were households with a lower wealth index, lower maternal education and living in rural areas. Conclusion This study showed that the overall prevalence of most DBM definitions examined was high, which points to the need for urgent interventions in the LAC region. The unique set of socioeconomic predictors of SCOM identified in this study calls for future double-duty policies that simultaneously target food affordability, nutrition education and access to healthy food.
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Affiliation(s)
| | - Paraskevi Seferidi
- Public Health Policy Evaluation Unit, Imperial College London School of Public Health, London, UK
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Anandh U, Meena P, Karam S, Luyckx V. Social, political and legal determinants of kidney health: Perspectives from lower- and middle-income countries with a focus on India. FRONTIERS IN NEPHROLOGY 2022; 2:1024667. [PMID: 37745281 PMCID: PMC10513032 DOI: 10.3389/fneph.2022.1024667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/21/2022] [Indexed: 09/26/2023]
Abstract
The social determinants of health (SDoH) are the non-medical factors that influence kidney health outcomes directly or indirectly in a substantial manner and include conditions in which people are born, grow, work, live, and age. Many such challenges in lower- and middle- income countries have an unfavourable impact on kidney health. These conditions potentially influence economic policies and systems, development agendas, social norms, social policies, and political systems. In addition, many political and legal factors also determine and modify the ultimate outcome in patients with kidney disease. Legal factors that ensure universal health care, promote gender and racial equality, prevent malpractices and regulate strict laws in the field of kidney transplantation are the paramount determinants for the provision of necessary kidney care. Converging lines of evidence have supported the impact of social variables such as socioeconomic resources, social inclusion, housing conditions, educational attainment, and financial status on kidney health, particularly affect vulnerable and disadvantaged groups and result in challenges in kidney care delivery. Furthermore, the climate is an important SDoH that plays a crucial role in the occurrence, prevalence, and progression of kidney diseases as highlighted by the presence of higher prevalence of chronic kidney disease in hot tropical countries. The rising incidence of water and vector-borne diseases causing acute kidney injury is another consequence of disruptive environmental and climate change which is detrimental to kidney health. Political risk factors such as conflict also have a devastating influence on kidney health. The relationship between SDoH and kidney health outcomes requires more clarity. Gaps in the current knowledge need to be identified to inform the development of appropriate interventions to address upstream socio-economic risk factors for kidney disease.
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Affiliation(s)
- Urmila Anandh
- Department of Nephrology, Amrita Hospitals, Faridabad, Delhi NCR, India
| | - Priti Meena
- Department of Nephrology, All India Institute of Medical Sciences, Bhubaneshwar, India
| | - Sabine Karam
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States
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Rana K, Chimoriya R, Haque NB, Piya MK, Chimoriya R, Ekholuenetale M, Arora A. Prevalence and Correlates of Underweight among Women of Reproductive Age in Nepal: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11737. [PMID: 36142012 PMCID: PMC9516984 DOI: 10.3390/ijerph191811737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/07/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to examine the prevalence of underweight and determine the sociodemographic and household environmental correlates of underweight among women of reproductive age in Nepal. This study also compared the time trends in the prevalence of underweight with the trends in the prevalence of overweight and obesity. This cross-sectional study was a secondary data analysis of the nationally representative population-based Nepal Demographic and Health Surveys (NDHSs). Firstly, the time trends of the prevalence of underweight (body mass index (BMI) < 18.5 kg/m2) among women aged 15-49 years were examined at five-year intervals, from the 1996, 2001, 2006, 2011, and 2016 NDHSs (n = 33,507). Secondly, the sociodemographic and household environmental correlates of underweight were examined from the latest NDHS 2016 (n = 6165). Univariable and multivariable logistic regression analyses were performed to examine the sociodemographic and household environmental correlates of underweight. From 1996 to 2016, the prevalence of underweight decreased from 25.3% (95% confidence interval (CI) 23.8%, 26.8%) to 16.9% (95%CI 16.0%, 17.8%), while the prevalence of overweight and obesity increased from 1.6% (95%CI 1.2%, 2.1%) to 15.6% (95%CI 14.7%, 16.5%) and 0.2% (95%CI 0.1%, 0.4%) to 4.1% (95%CI 3.6%, 4.6%), respectively. Sociodemographic factors, such as age, educational status, marital status, wealth index, and religion, were independently associated with the risk of underweight. Similarly, household environmental factors, such as province of residence, ecological zone, type of toilet facility, and household possessions, including television and mobile phone, were independently associated with the risk of underweight. Despite the declining trends, the prevalence of underweight among Nepalese women remains a public health challenge. Understanding the key sociodemographic and household environmental correlates of underweight may assist in streamlining the content of health promotion campaigns to address undernutrition and potentially mitigate adverse health outcomes.
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Affiliation(s)
- Kritika Rana
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
- School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
| | - Ritesh Chimoriya
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Nabila Binte Haque
- Department of Health Systems and Populations, Macquarie University, Macquarie Park, Sydney, NSW 2109, Australia
| | - Milan K. Piya
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
- Macarthur Diabetes Endocrinology and Metabolism Service, Camden and Campbelltown Hospitals, Campbelltown, NSW 2560, Australia
| | - Romila Chimoriya
- Philanthropy Nepal (Paropakari Nepal) Research Collaboration, Auburn, NSW 2144, Australia
- Department of Pediatrics, Nepal Medical College Teaching Hospital, Kathmandu 44600, Nepal
| | - Michael Ekholuenetale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan 200214, Nigeria
| | - Amit Arora
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
- School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
- Discipline of Child and Adolescent Health, The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
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Mchiza ZJR. Diet Therapy and Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8312. [PMID: 35886174 PMCID: PMC9321782 DOI: 10.3390/ijerph19148312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 02/05/2023]
Abstract
A major threat to the achievement of the Sustainable Development Goals and Universal Health Coverage continues to be malnutrition [...].
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Affiliation(s)
- Zandile June-Rose Mchiza
- Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; or ; Tel.: +27-21-938-0673
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
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Korir EC, Tuitoek PJ, Marais D. Perception of proposed preliminary food-based dietary guidelines for Lake Victoria region of Kenya: findings from a qualitative study among adult community members. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2022. [DOI: 10.1080/16070658.2022.2079259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- EC Korir
- Department of Human Nutrition, Faculty of Health Sciences, Egerton University, Njoro, Kenya
| | - PJ Tuitoek
- Murang’a University of Technology, Murang’a, Kenya
| | - D Marais
- Warwick Medical School, University of Warwick, United Kingdom
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Talukdar D, Seenivasan S. Associations between country-level macroeconomic factors and the double burden of malnutrition. THE LANCET GLOBAL HEALTH 2022; 10:e449-e450. [DOI: 10.1016/s2214-109x(22)00010-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/30/2022] Open
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Gut microbiome dysbiosis in malnutrition. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2022; 192:205-229. [DOI: 10.1016/bs.pmbts.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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