Journal
PUBLIC HEALTH NUTRITION
Volume 24, Issue 10, Pages 2944-2951Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1368980020001226
Keywords
Double burden; Malnutrition; Health inequalities; Stunting; Overweight
Funding
- Bill & Melinda Gates Foundation [OPP1135522]
- Wellcome Trust [101815/Z/13/Z]
- Bill and Melinda Gates Foundation [OPP1135522] Funding Source: Bill and Melinda Gates Foundation
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This study assessed the prevalence of double burden of malnutrition (DBM) in children under 5 years old in LMIC countries. It found that a few countries or wealth quintiles had higher-than-expected DBM rates, with most differences being small. Individual-level analyses showed that one-third of countries presented higher prevalence of DBM than would be expected.
Objective: To assess whether the observed prevalence of the double burden of malnutrition (DBM) would be higher than expected on the basis of chance, through analyses at national, wealth quintile and individual child levels. Design: We selected nationally representative surveys from low- and middle-income countries (LMIC) carried out since 2005 with anthropometric measures on children under 5 years of age. Household wealth was assessed through asset indices. The expected prevalence of DBM was estimated by multiplying the prevalence of stunting (low height/length for age) and overweight (high weight for height/length). The WHO recommended cut-offs (20% for stunting and 10% for overweight) that were used to define DBM at national level. DBM at individual level was defined as co-occurrence of stunting and overweight in the same child. Setting: Nationally representative surveys from ninety-three LMIC. Participants: A total of 825 633 children were studied. Results: DBM at national level was observed in five countries, whereas it would be expected to occur in eleven countries. Six countries did not present evidence of DBM at national level but did so in at least one wealth quintile. At individual level, thirty countries (32 center dot 3%) showed higher prevalence of DBM than would be expected, but most differences were small except for Syria, Azerbaijan, Albania and Egypt. Conclusions: The observed number of countries or socio-economic subgroups within countries with the DBM using recommended thresholds was below what would be expected by chance. However, individual-level analyses showed that one-third of countries presented higher prevalence of DBM than would be expected.
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