Maternal height and double-burden of malnutrition households in Mexico: stunted children with overweight or obese mothers

2020 ◽  
Vol 24 (1) ◽  
pp. 106-116
Author(s):  
Lucía Félix-Beltrán ◽  
James Macinko ◽  
Randall Kuhn
Keyword(s):  
Short Stature ◽  
Child Nutrition ◽  
Multinomial Logistic Regression ◽  
Nutrition Status ◽  
Inverse Association ◽  
Maternal Height ◽  
Nutrition Survey ◽  
Double Burden ◽  
Obese Mother ◽  
Nationally Representative

AbstractObjective:To assess the association between short maternal height and four types of mother–child nutritional status groupings within Mexican households.Design:We classified mother–child dyads into four groups: stunted child and a non-overweight/non-obese mother (stunting-only), non-stunted child and an overweight/obese mother (overweight-only), stunted child with an overweight/obese mother (double-burden) and households with neither child stunting nor overweight/obese mothers (neither-condition). We assessed the association between maternal height and mother–child nutrition status using multinomial logistic regression, controlling for socio-economic covariates.Setting:Nationally representative cross-section of households from the 2012 Mexican National Health and Nutrition Survey.Participants:Children <5 years of age were matched to their mothers, resulting in a sample of 4706 mother–child dyads.Results:We found that among children with stunting, 53·3% have an overweight/obese mother. Double-burden was observed in 8·1% of Mexican households. Maternal short stature increased the probability of stunting-only by 3·5% points (p.p.) and double-burden by 9·7 p.p. (P < 0·05). The inverse association was observed for overweight-only and neither-condition households, where the probability of these outcomes decreased by 7·2 and 6 p.p. in households with short-statured mothers (P < 0·05), respectively.Conclusions:Women with short stature are more likely to develop overweight and simultaneously have a stunted child than those who are not short-statured. Our findings underline the challenges faced by public health systems, which have to balance the provision of services for both an undernourished and increasingly overweight/obese population.

Prevalence and regional variations of coexistence of child stunting and maternal overweight or obesity in Myanmar

2020 ◽  
pp. 1-11
Author(s):  
Seo Ah Hong
Keyword(s):  
Multinomial Logistic Regression ◽  
Household Survey ◽  
Double Burden ◽  
Regional Variations ◽  
Children Under Five ◽  
Multinomial Logistic Regression Analysis ◽  
Under Five ◽  
Obese Mother ◽  
Maternal Overweight ◽  
National Prevalence

Abstract Objective: The current study aimed to investigate double burden of malnutrition within households at the national and subnational levels and to identify its association with sociodemographic factors in Myanmar. Design: All the variables were extracted from children’s file of the Myanmar Demographic and Health Survey 2015–2016. Children under five were identified as stunted based on a height-for-age < −2 sd below the WHO reference median. Maternal overweight/obesity was defined as a BMI ≥ 23 kg/m2. A stunted child with an overweight/obese mother (SCOM) was classified as a double-burden household. Setting: A national household survey in Myanmar. Participants: Children under five and their mothers (n 3954 pairs). Results: Mean ages of children and mothers were 29 (se 0·14) months and 30·9 (se 0·32) years, respectively. National prevalence of childhood stunting and maternal overweight/obesity was 28·0 % and 39·4 %, respectively, and the prevalence of SCOM was 9·1 %. Significant regional differences were found in SCOM, ranging from 3·6 % in Naypyitaw to 12 % in Kachin and Mon and 14·6 % in Kayah. In the multinomial logistic regression analysis, relative to neither a stunted child nor an overweight/obese mother, child’s age, maternal age, maternal experience of a teen birth, short mothers, mothers with primary education and in middle or rich wealth tertiles, and some regions (Kachin, Kayah, Shan, Sagaing, Taninthayi, Ayeyarwaddy, Mon and Yangon) were associated with greater odds of SCOM. Conclusions: The current study showed a relatively high national prevalence of SCOM and significant regional variations. Overarching policies and programmes with culturally sensitive strategies need to be formulated and implemented.

scholarly journals Nutrition status in adult Chilean population: economic, ethnic and sex inequalities in a post-transitional country

2020 ◽  
Vol 23 (S1) ◽  
pp. s39-s50 ◽  
Author(s):  
María F Mujica-Coopman ◽  
Deborah Navarro-Rosenblatt ◽  
Sandra López-Arana ◽  
Camila Corvalán
Keyword(s):  
Short Stature ◽  
Adult Population ◽  
Indigenous Women ◽  
Excess Weight ◽  
Nutrition Status ◽  
Low Ses ◽  
Or Education ◽  
Transitional Country ◽  
Nationally Representative ◽  
The Relationship

AbstractObjective:To assess the relationship between malnutrition, socioeconomic status (SES) and ethnicity in Chilean adult population.Design:Nationally representative survey (ENS) conducted in 2016–2017. Sociodemographic information, weight, height and hemoglobin (Hb) were measured (2003 ENS). Excess weight was defined as BMI ≥25 kg/m2. Undernutrition included underweight (BMI <18·5 kg/m2), short stature (height <1·49 m in women and <1·62 m in men) or anaemia (Hb <12 g/l). Education and household income level were used as indicators of SES; ethnicity was self-reported. We applied linear combinations of estimators to compare the prevalence of excess weight and undernutrition by SES and ethnicity.Setting:Chile.Participants:In total, 5082 adults ≥20 years (64 % women) and 1739 women ≥20 years for anaemia analyses.Results:Overall, >75 % of women and men had excess weight. Low SES women either by income or education had higher excess weight ((82·0 (77·1, 86·1) v. 65·0 (54·8, 74·1)) by income; (85·3 (80·6, 89·0) v. 68·2 (61·6, 74·1) %) by education) and short stature (20–49 years; 31(17·9, 48·2) v. 5·2 (2·2,11·4) by education); obesity was also more frequent among indigenous women (20–49 years; 55·8 (44·4, 66·6) v. 37·2 (32·7, 42·0) %) than non-indigenous women. In men, excess weight did not significantly differ by SES or ethnicity, but short stature concentrated in low SES (20–49 years; 47·6 (24·6, 71·6) v. 4·5 (2·1, 9·5) by education) and indigenous men (21·5 (11·9, 5·5, 11·9) v. 8·2 (5·5, 11·9)) (P < 0·05 for all).Conclusions:In Chile, malnutrition is disproportionately concentrated among women of low SES and indigenous origin; these inequalities should be considered when implementing prevention policies.

scholarly journals Trends and determinants of underweight and overweight/obesity among urban Ethiopian women from 2000 to 2016

2020 ◽  
Author(s):  
Kedir Yimam Ahmed ◽  
Solomon Abrha ◽  
Andrew Page ◽  
Amit Arora ◽  
Solomon Shiferaw ◽  
...  
Keyword(s):  
Higher Education ◽  
Multinomial Logistic Regression ◽  
Urban Women ◽  
Overweight And Obesity ◽  
Obese Women ◽  
Double Burden ◽  
Never Married ◽  
Demographic Transitions ◽  
Double Burden Of Malnutrition ◽  
Nationally Representative

Abstract Background:Nutritional, epidemiological and demographic transitions have been associated with the emergence of the double burden of malnutrition globally. In Ethiopia, there has been no nationally representative investigation of trends and determinants of both underweight and overweight/obesity among urban women. This study examined the trends and determinants of underweight and overweight/obesity in urban Ethiopian women from 2000 to 2016.Methods:Trends in the prevalence of underweight and overweight/obesity were investigated based on a series of the Ethiopia Demographic and Health Survey (EDHS) data for the years 2000 (n=2559), 2005 (n=1112), 2011 (n=3569), and 2016 (n=3106). Multivariable multinomial logistic regression was used to investigate the association between socioeconomic, demographic, behavioural, and community-level factors with underweight and overweight/obesity.Results:The prevalence of underweight in urban Ethiopian women reduced significantly from 23.2% (95% confidence interval [CI]: 20.3%, 26.3%) in 2000 to 14.8% (95% CI: 13.1%, 16.7%) in 2016, while overweight/obesity increased significantly from 10.9% (95% CI: 9.1%, 13.0%) in 2000 to 21.4% (95% CI: 18.2%, 25.1%) in 2016. Urban women from rich households and those who had never married were less likely to be underweight. Urban women who were from wealthy households and those who attained at least secondary education were more likely to be overweight/obese. Women who were informally employed and listened to the radio were less likely to be overweight/obese compared to those who were unemployed and did not listen to the radio, respectively.Conclusion:The prevalence of overweight/obesity increased from 2000 to 2016, with a concurrent reduction in the prevalence of underweight. Interventions aiming to reduce overweight and obesity should target urban women with higher education, those who resided in wealthier households and those who watched the television.

scholarly journals Association between ultraprocessed food intake and cardiovascular health in US adults: a cross-sectional analysis of the NHANES 2011–2016

2020 ◽  
Author(s):  
Zefeng Zhang ◽  
Sandra L Jackson ◽  
Euridice Martinez ◽  
Cathleen Gillespie ◽  
Quanhe Yang
Keyword(s):  
Cardiovascular Health ◽  
Multinomial Logistic Regression ◽  
Calorie Intake ◽  
Inverse Association ◽  
Cross Sectional ◽  
Hispanic Origin ◽  
Increased Risk ◽  
Total Calorie ◽  
Nationally Representative ◽  
Sectional Analysis

ABSTRACT Background Higher intake of ultraprocessed foods (UPFs) might be associated with increased risk of cardiovascular disease. Objectives Our objective was to examine the association between usual percentage of calories (%kcal) from UPFs and the American Heart Association's “Life's Simple 7” cardiovascular health (CVH) metrics in US adults. Methods We analyzed data from 11,246 adults aged ≥20 y from the NHANES 2011–2016 (a cross-sectional, nationally representative survey). UPF designation was assigned on the basis of the NOVA classification system, according to the extent and purpose of food processing. Each CVH metric was given a score of 0, 1, or 2 representing poor, intermediate, or ideal health, respectively. Scores of the 6 metrics (excluding diet) were summed, and CVH was categorized as inadequate (0–4), average (5–8), or optimum (9–12). We used the National Cancer Institute's methods to estimate the usual %kcal from UPFs, and multivariable linear and multinomial logistic regression to assess the association between UPFs and CVH, adjusted for age, sex, race and Hispanic origin, education, and poverty. Results The weighted prevalence of inadequate, average, and optimum CVH was 8.0%, 51.7%, and 40.3%, respectively. The mean usual %kcal from UPFs was 55.4%, and midpoint of quartiles of intake ranged from 40.4% (quartile 1) to 70.5% (quartile 4). Every 5% increase in calories from UPFs was associated with 0.14 points lower CVH score (P &lt; 0.001). The adjusted ORs for inadequate CVH were 1.40 (95% CI: 1.23, 1.60), 1.82 (1.45, 2.29), and 2.57 (1.79, 3.70), respectively, comparing quartiles 2, 3, and 4 with quartile 1 of UPF intake. The pattern of association was largely consistent across subgroups. Conclusions Usual %kcal from UPFs represented more than half of total calorie intake in US adults. A graded inverse association between %kcal from UPFs and CVH was observed.

scholarly journals The Coexistence of Dual Malnutrition At Household Level in India: Evidence From The Comprehensive National Nutrition Study 2016–18

2021 ◽  
Author(s):  
Akash Porwal ◽  
Sana Ashraf ◽  
Sowmya Ramesh ◽  
Nizamuddin Khan ◽  
Robert Johnston ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Multivariate Regression Analysis ◽  
Outcome Variable ◽  
Nutrition Survey ◽  
Double Burden ◽  
Household Level ◽  
Mother And Child ◽  
Proximate Determinants ◽  
Nationally Representative

Abstract Objective To examine the prevalence of DBM at national, state, regional level and its proximate determinants in households with a mother and child under 5 years of age. Methods The present study includes data on 38,060 children under 5 years of age and their biological mothers, drawn from the nationally representative Comprehensive National Nutrition Survey (CNNS) of children and adolescents aged 0–19 years in India. The outcome variable for this study was the double burden of malnutrition at the household level. A child was classified as stunted if the height was at least -2SD below the mean for their age. A mother with a body mass index (BMI) of more than or equal to 25kg/m2 (BMI ≥ 25 kg/m2) was considered as overweight. A binary variable with coexistence of both conditions was created and categorized as 1 (existence of stunted child and overweight mother), and 0 otherwise. Multivariate regression analysis was used to examine the association between DBM and covariates at maternal, child and household level. Results 3.4% of households were found to be with DBM, with higher prevalence in urban areas (6.2%) as compared to rural areas (2.5%). Inter-state and regional variations were present in the prevalence of DBM. The proportion of DBM was higher in households with mothers aged 30 years or more, mothers not working and those who had cesarean births. Prevalence of DBM was found to be higher in urban area and rich households. Conclusion This study shows the prevalence of DBM and its proximate determinants. These findings highlight the need for a comprehensive nutrition programme that targets both undernutrition and overnutrition. While formulating standalone policies for both forms of malnutrition is relatively easier, customized policies and programmes are needed to combat the conflicting situation of dietary excess and deprivation at the household level.

scholarly journals Trends and Determinants of Underweight and Overweight/Obesity among Urban Ethiopian Women from 2000 to 2016

2020 ◽  
Author(s):  
Kedir Yimam Ahmed ◽  
Solomon Abrha ◽  
Andrew Page ◽  
Amit Arora ◽  
Solomon Shiferaw ◽  
...  
Keyword(s):  
Multinomial Logistic Regression ◽  
Urban Women ◽  
Obese Women ◽  
Double Burden ◽  
Never Married ◽  
Demographic Transitions ◽  
Policy Interventions ◽  
Dietary Choices ◽  
Nationally Representative ◽  
Context Specific

Abstract Background: Nutritional, epidemiological and demographic transitions have been associated with the emergence of the double burden of malnutrition globally. In Ethiopia, there has been no nationally representative investigation of trends and determinants of both underweight and overweight/obesity among urban women. This study examined the trends and determinants of underweight and overweight/obesity in urban Ethiopian women from 2000 to 2016.Methods: Trends in the prevalence of underweight and overweight/obesity were investigated based on a series of the Ethiopia Demographic and Health Survey (EDHS) data for the years 2000 (n=2559), 2005 (n=1112), 2011 (n=3569), and 2016 (n=3106). Multivariate multinomial logistic regression was used to investigate the association between socioeconomic, demographic, behavioural, and community-level factors with underweight and overweight/obesity.Results: The prevalence of underweight in urban Ethiopian women improved significantly from 23.2% (95% confidence interval [CI]: 20.3%, 26.3%) in 2000 to 14.8% (95% CI: 13.1%, 16.7%) in 2016, while overweight/obesity increased significantly from 10.9% (95% CI: 9.1%, 13.0%) in 2000 to 21.4% (95% CI: 18.2%, 25.1%) in 2016. Urban women from rich households and those who had never married were less likely to be underweight. Urban women who were from wealthy households and those who attained at least secondary education were more likely to be overweight/obese. Women who were informally employed and listened to the radio were less likely to be overweight/obese compared to those who were unemployed and did not listen to the radio, respectively.Conclusion: The prevalence of overweight/obesity increased from 2000 to 2016, with a concurrent reduction in the prevalence of underweight. Context-specific policy interventions that target improvement in socioeconomic status, regular physical activity and healthier dietary choices for urban Ethiopian women are needed.

scholarly journals Trends and patterns of the double burden of malnutrition (DBM) in Peru: a pooled analysis of 129,159 mother–child dyads

2021 ◽  
Author(s):  
Marco Pomati ◽  
Daniel Mendoza-Quispe ◽  
Cecilia Anza-Ramirez ◽  
Akram Hernández-Vásquez ◽  
Rodrigo M. Carrillo Larco ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Absolute Number ◽  
Pooled Analysis ◽  
Relative Increase ◽  
Double Burden ◽  
Logistic Regression Models ◽  
Individual Level ◽  
Obese Mother ◽  
Nationally Representative ◽  
Nutritional Status Of Children

Abstract Background This study aims to evaluate trends of DBM in Peru over the last 20 years. Methods Using individual-level data collected in nationally representative household surveys from Peru between 1996 and 2017, we analysed trends in the prevalence and patterning of the DBM. We classified the nutritional status of children and their mothers as undernourished (either underweight, stunted or wasted for children), normal, overweight or obese. Children classified as experiencing the DBM were those undernourished and living with an overweight or obese mother. We also fitted logistic regression models to evaluate the probability of children having an overweight/obese mother across subgroups of socioeconomic status, place of residence and education. Results The overall percentage of children experiencing the DBM in 2016 was 7%, and constitutes ~203,600 children (90% of whom were stunted). Between 1996 and 2016, undernourished children have seen the largest relative increase in the risk of having an overweight mother (31% vs. 37%) or obese mother (6% vs. 17%); however, due to the substantial decrease in the absolute number of undernourished children, the DBM has not grown. Moreover, all children, irrespective of their own nutritional status, are now more likely to live with an overweight or obese mother, a consistent pattern across wealth, location and education subgroups, and all regions of Peru. Conclusions DBM prevalence in Peru has decreased, although the number of DBM cases is estimated to be above 200,000. In addition, all children are now more likely to live with overweight or obese mothers. The basic pattern has shifted from one of undernourished children whose mothers have a ‘normal’ BMI, to one where now most children have a ‘normal’ or healthy anthropometric status, but whose mothers are overweight or obese. This suggest that Peru is on the cusp of a major public health challenge requiring significant action.

scholarly journals Factors associated with double and triple burden of malnutrition among mothers and children in Nepal: evidence from 2016 Nepal demographic and health survey

2019 ◽  
Author(s):  
Dev Ram Sunuwar ◽  
Devendra Raj Singh ◽  
Pranil Man Singh Pradhan
Keyword(s):  
Short Stature ◽  
Age Groups ◽  
Multivariate Logistic Regression ◽  
Wealth Status ◽  
Double Burden ◽  
Factors Associated ◽  
Obese Mother ◽  
Underweight Child ◽  
Double Burden Of Malnutrition ◽  
Anemic Child

Abstract Background Double and triple burden of malnutrition is defined by the coexistence of overweight/obese mother and undernourished child and coexistence of overweight/obese mother and undernourished and anemic child at the same household level respectively. The aims of this study were to explore the coexistence of overweight/obesity among mothers and undernourished and anemia among children and associated factors among the mother-child pairs in the same household. Methods A total sample of 5018 mother-child pairs from the Nepal Demographic and Health Survey (NDHS) 2016 were included in the study. Anthropometric measurements, hemoglobin level of the children and their mothers were taken. The bivariate and multivariate logistic regression were performed to observe the factors associated with the double and triple burden of malnutrition. To assess the outcome, we created the categories such as the double and triple burden of malnutrition where the overweight/obese mother and undernourished (stunted or wasted or underweight) child and overweight/obese mother and undernourished (stunted or wasted or underweight) child and anemic child respectively. Results Prevalence of double burden of malnutrition (DBM) and triple burden of malnutrition (TBM) was 6.59(5.13-8.84)% and 7(5.42-8.99)% respectively at the same household. In the adjusted multivariate logistic regression, mothers with short stature (AOR=3.94, 95% CI: 1.94-8.00), from the richest wealth status (AOR=2.59, 95% CI= 1.27-5.28), age groups of 26-49 years (AOR=2.38, 95% CI: 1.18-4.77), attended at least a secondary level of education (AOR=1.93, 95% CI: 1.01-3.69) were more likely to have the double burden of malnutrition. Similarly, mothers who had short stature (AOR=4.48, 95% CI: 2.19-9.16), the richest wealth status (AOR=2.46, 95% CI= 1.19-5.08) and age groups of 26-49 years (AOR=2.27, 95% CI: 1.16-4.44) were more likely to suffer from the triple burden of malnutrition. Conclusions Our study concludes with the prevalence of double and triple burden of malnutrition existence among mothers and children in Nepal. Mothers having short stature and from the richest family are more prone to double and triple burden of malnutrition. Integration of maternal health promotion and nutrition education program would be a good strategy to prevent mother overweight/obesity and stunting among children under five years of age in Nepal.

scholarly journals Characteristics of those most vulnerable to employment changes during the COVID-19 pandemic: a nationally representative cross-sectional study in Wales

2021 ◽  
pp. jech-2020-216030
Author(s):  
Benjamin J Gray ◽  
Richard G Kyle ◽  
Jiao Song ◽  
Alisha R Davies
Keyword(s):  
Multinomial Logistic Regression ◽  
Household Survey ◽  
Well Being ◽  
Employment Outcomes ◽  
Cross Sectional Study ◽  
Public Health Response ◽  
Cross Sectional ◽  
Exact Test ◽  
Nationally Representative ◽  
The Impact

BackgroundThe public health response to the SARS-CoV-2 (COVID-19) pandemic has had a detrimental impact on employment and there are concerns the impact may be greatest among the most vulnerable. We examined the characteristics of those who experienced changes in employment status during the early months of the pandemic.MethodsData were collected from a cross-sectional, nationally representative household survey of the working age population (18–64 years) in Wales in May/June 2020 (n=1379). We looked at changes in employment and being placed on furlough since February 2020 across demographics, contract type, job skill level, health status and household factors. χ2 or Fisher’s exact test and multinomial logistic regression models examined associations between demographics, subgroups and employment outcomes.ResultsOf our respondents, 91.0% remained in the same job in May/June 2020 as they were in February 2020, 5.7% were now in a new job and 3.3% experienced unemployment. In addition, 24% of our respondents reported being placed on furlough. Non-permanent contract types, individuals who reported low mental well-being and household financial difficulties were all significant factors in experiencing unemployment. Being placed on ‘furlough’ was more likely in younger (18–29 years) and older (60–64 years) workers, those in lower skilled jobs and from households with less financial security.ConclusionA number of vulnerable population groups were observed to experience detrimental employment outcomes during the initial stage of the COVID-19 pandemic. Targeted support is needed to mitigate against both the direct impacts on employment, and indirect impacts on financial insecurity and health.

scholarly journals Transitions in hookah (Waterpipe) smoking by U.S. sexual minority adults between 2013 and 2015: the population assessment of tobacco and health study wave 1 and wave 2

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mary Rezk-Hanna ◽  
Ian W. Holloway ◽  
Joy Toyama ◽  
Umme Shefa Warda ◽  
Lorree Catherine Berteau ◽  
...  
Keyword(s):  
Multinomial Logistic Regression ◽  
Health Study ◽  
Chi Square ◽  
Population Assessment ◽  
Logistic Regression Models ◽  
Global Epidemic ◽  
Product Use ◽  
Hookah Smoking ◽  
Nationally Representative ◽  
And Gender

Abstract Background Tobacco smoking using a hookah (i.e., waterpipe) is a global epidemic. While evidence suggests that sexual minorities (SM) have higher odds of hookah use compared to heterosexuals, little is known about their hookah use patterns and transitions. We sought to examine transitions between hookah smoking and use of other tobacco and electronic (e-) products among SM adults aged 18 years of age and older versus their heterosexual counterparts. Methods We analyzed nationally representative data of ever and current hookah smokers from Wave 1 (2013–2014; ever use n = 1014 SM and n = 9462 heterosexuals; current use n = 144 SM and n = 910 heterosexuals) and Wave 2 (2014–2015; ever use n = 901 SM and n = 8049 heterosexuals; current use n = 117 SM and n = 602 heterosexuals) of the Population Assessment of Tobacco and Health Study. Comparisons between groups and gender subgroups within SM identity groups were determined with Rao-Scott chi-square tests and multivariable survey-weighted multinomial logistic regression models were estimated for transition patterns and initiation of electronic product use in Wave 2. Results Ever and current hookah smoking among SM adults (ever use Wave 1: 29% and Wave 2: 31%; current use Wave 1: 4% and Wave 2: 3%) was higher than heterosexuals (ever use Wave 1: 16% and Wave 2: 16%; current use Wave 1: 1% and Wave 2: 1%; both p < 0.0001). Among SM adults who reported hookah use at Wave 1, 46% quit hookah use at Wave 2; 39% continued hookah use and did not transition to other products while 36% of heterosexual adults quit hookah use at Wave 2 and 36% continued hookah use and did not transition to other products. Compared with heterosexuals, SM adults reported higher use of hookah plus e-products (Wave 2 usage increased by 65 and 83%, respectively). Conclusions Compared to heterosexuals, in addition to higher rates of hookah smoking, higher percentages of SM adults transitioned to hookah plus e-product use between 2013 and 2015. Results have implications for stronger efforts to increase awareness of the harmful effects of hookah as well as vaping, specifically tailored among SM communities.

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