Concurrent stunting and overweight or obesity among under-five children in sub-Saharan Africa: a multilevel analysis

BACKGROUND

Globally, the co-occurrence of stunting and overweight or obesity (CSO) in the same individual is becoming an emerging layer of malnutrition and there is a paucity of information in low- and middle-income countries, particularly in sub-Saharan Africa. Hence, this study aimed to determine the pooled prevalence and determinants of concurrent stunting and overweight or obesity among under-five children in SSA.

METHODS

Secondary data analysis was conducted from a recent nationally representative Demographic and Health Survey dataset of 35 SSA countries. A total weighted sample of 210,565 under-five children was included in the study. A multivariable multilevel mixed effect model was employed to identify the determinant of the prevalence of under-5 CSO. The Intra-class Correlation Coefficient (ICC) and Likelihood Ratio (LR) test were used to assess the presence of the clustering effect. A p-value of p < 0.05 was used to declare statistical significance.

RESULT

The pooled prevalence of concurrent stunting and overweight/obesity among under-five children was 1.82% (95% CI: 1.76, 1.87) in SSA. Across the SSA regions, the highest prevalence of CSO was reported in Southern Africa (2.64%, 95% CI: 2.17, 3.17) followed by the Central Africa region (2.21%, 95% CI: 2.06, 2.37). Under five children aged 12-23 months (AOR = 0.45, 95% CI: 0.34, 0.59), 24-35 months (AOR = 0.41, 95% CI: 0.32, 0.52), 36-59 months (AOR = 055, 95% CI: 0.43, 0.70), ever had no vaccination (AOR = 1.25, 95% CI: 1.09, 1.54), under-five children born from 25 to 34 years mother (AOR = 0.75, 95% CI: 0.61, 0.91), under-five children born from overweight/obese mothers (AOR = 1.63, 95% CI: 1.14, 2.34), and under-five children living in West Africa (AOR = 0.77, 95% CI: 0.61, 0.96) were significant determinants for under-five CSO.

CONCLUSION

Concurrent stunting and overweight or obesity is becoming an emerging layer of malnutrition. Under five children born in the SSA region had almost a 2% overall risk of developing CSO. Age of the children, vaccination status, maternal age, maternal obesity, and region of SSA were significantly associated with under-five CSO. Therefore, nutrition policies and programs should base on the identified factors and promote a quality and nutritious diet to limit the risk of developing CSO in early life.

The association between deficiency of nutrient intake and resting metabolic rate in overweight and obese women: a cross-sectional study

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.