scholarly journals Double burden of malnutrition in children aged 24-59 months by socioeconomic status in five South Asian countries: evidence from Demographic and Health Surveys

2019 ◽  
Author(s):  
Fariha Binte Hossain ◽  
Md Shajedur Rahman Shawon ◽  
Md Shehab Uddin Al-Abid ◽  
Sultan Mahmood Sami ◽  
Gourab Adhikary ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Educational Attainment ◽  
South Asian ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Socioeconomic Conditions ◽  
Asian Countries ◽  
Double Burden ◽  
Lower Odds ◽  
Double Burden Of Malnutrition

ABSTRACTBackgroundDeveloping countries are now facing double burden of undernutrition and overnutrition among children and adults. We aimed to explore the double burden of malnutrition among children aged 24-59 months by household’s socioeconomic status in South Asian context.MethodsChildren with valid information on height and weight from the latest Demographic and Health Survey from Bangladesh, India, Pakistan, Maldives, and Nepal were included in this study. Underweight and overweight were defined according to definitions of World Health Organisation and International Obesity Task Force, respectively. We used multiple logistic regressions to estimate the association of socioeconomic status with childhood underweight and overweight.ResultsSouth Asian countries had significant burden of underweight, ranging from 19% in Maldives to 38% in India. Bangladesh, India, and Nepal had prevalence of overweight between 2% and 4%, whereas Pakistan and Maldives had prevalence of 7% and 9%, respectively. Households with higher wealth index and education were consistently associated with lower odds of underweight children. When compared to poorest households, richest households had higher odds of being overweight in Bangladesh (OR 1.96, 95% CI 1.27-3.02) and India (OR 1.53, 95% CI 1.41-1.66) while lower odds of being overweight in Pakistan (OR 0.22, 95% CI 0.14-0.34). Households with higher education were more likely to have overweight children in Bangladesh and India.ConclusionsChildhood underweight is associated with lower socioeconomic conditions while there is a substantial burden of childhood overweight in higher socioeconomic groups. These disparities by socioeconomic conditions should be considered while developing national nutrition programs and strategies.KEY MESSAGESIn South Asia, there is a substantial burden of undernutrition among under-five children while a differential burden of overnutrition is also seen.Household wealth and educational attainment were inversely associated with childhood underweight.Children in households with higher levels of wealth and educational attainment were more likely to be overweight in Bangladesh and India, while evidence supporting such association was not clear for other South Asian countries.The urban-rural difference in the burden of childhood underweight and overweight can be explained by the distributions of households’ socioeconomic status.

scholarly journals Socioeconomic status and the double burden of malnutrition in Cambodia between 2000 to 2014: overweight mothers and stunted children

2021 ◽  
pp. 1-26
Author(s):  
Michelle K. Nakphong ◽  
Hiram Beltrán-Sánchez
Keyword(s):  
Socioeconomic Status ◽  
Maternal Employment ◽  
Household Survey ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Double Burden ◽  
Household Level ◽  
Child Stunting ◽  
Double Burden Of Malnutrition ◽  
The Impact

ABSTRACT Objective: The Cambodian population has experienced an increase in the proportion of stunted children who have overweight mothers during a period of rapid social and economic growth. We aimed to identify socioeconomic factors associated with this household-level double burden over time. Design: We used data from four Cambodia Demographic and Health Surveys from 2000 to 2014 to study the impact of socioeconomic status (SES) on the link between child stunting and overweight mothers in two periods 2000-2005 vs. 2010-2014. We hypothesized that SES would be a primary factor associated with this phenomenon. Participants: We included 14,988 children under age 5, among non-pregnant mothers aged 15-49 years of age and conducted analysis on a subsample of 1,572 children with overweight mothers. Setting: Nationally-representative household survey across all regions. Results: SES factors, specifically household wealth and maternal employment in service or manual occupations (in 2010-2014), are the main drivers of stunting among children of overweight mothers. Children with overweight mothers in the poorest households are more than twice as likely to be stunted than in the richest in both periods (2000-2005: aOR=2.53, 95%CI: 1.25, 5.13; 2010-2014: aOR=2.61, 95%CI: 1.43, 4.77), adjusting for other SES factors, indicating that despite decreasing income inequality, the poorest continue to bear excess risk of a double burden of malnutrition. Maternal short stature also doubled the likelihood of child stunting in both periods, which suggests intergenerational transmission of adversity and physical underdevelopment. Conclusions: Socioeconomic inequalities should be addressed to reduce disparities in the household-level double burden of malnutrition.

scholarly journals Double burden of malnutrition in children aged 24 to 59 months by socioeconomic status in five South Asian countries: evidence from demographic and health surveys

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e032866 ◽  
Author(s):  
Fariha Binte Hossain ◽  
Md Shajedur Rahman Shawon ◽  
Md Shehab Uddin Al-Abid ◽  
Sultan Mahmood ◽  
Gourab Adhikary ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
South Asian ◽  
Health Surveys ◽  
Task Force ◽  
Wealth Index ◽  
Socioeconomic Inequalities ◽  
Demographic And Health Surveys ◽  
Overweight Children ◽  
Asian Countries ◽  
Double Burden

ObjectivesWe aimed to investigate the socioeconomic inequalities in the burden of underweight and overweight among children in South Asia. We also examined other factors that were associated with these outcomes independently of household’s socioeconomic status.DesignNationally-representative surveys.SettingsDemographic and Health Surveys from Bangladesh, India, Pakistan, Maldives and Nepal, which were conducted between 2009 and 2016.ParticipantsChildren aged 24 to 59 months with valid measurement for height and weight (n=146 996).Primary exposure and outcome measuresPrimary exposures were household’s wealth index and level of education. Underweight and overweight were defined according to the WHO and International Obesity Task Force definitions, respectively.ResultsUnderweight prevalence was 37% in Bangladesh, 38% in India, 19% in Maldives, 29% in Nepal and 28% in Pakistan. Bangladesh, India and Nepal had similar overweight prevalence (between 2% and 4%) whereas Pakistan (7%) and Maldives (9%) had higher prevalence. Households with higher wealth index or education had lower odds of having underweight children. Adjusted ORs of underweight for richest versus poorest households were 0.4 (95% CI: 0.3 to 0.5), 0.5 (95% CI: 0.5 to 0.6), 0.5 (95% CI: 0.2 to 1.4), 0.5 (95% CI: 0.3 to 0.8) and 0.7 (95% CI: 0.5 to 1.1) for Bangladesh, India, Maldives, Nepal and Pakistan, respectively. Compared with poorest households, richest households were more likely to have overweight children in all countries except Pakistan, but such associations were not significant after adjustment for other factors. There were higher odds of having overweight children in households with higher education in Bangladesh (OR 2.1 (95% CI: 1.3 to 3.5)), India (OR 1.2 (95% CI: 1.2 to 1.3)) and Pakistan (OR 1.8 (95% CI: 1.1 to 2.9)) when compared with households with no education. Maternal nutritional status was consistently associated with children’s nutritional outcomes after adjustments for socioeconomic status.ConclusionsOur study provides evidence for socioeconomic inequalities for childhood underweight and overweight in South Asian countries, although the directions of associations for underweight and overweight might be different.

scholarly journals Wasting and Associated Factors among Children under 5 Years in Five South Asian Countries (2014–2018): Analysis of Demographic Health Surveys

2021 ◽  
Vol 18 (9) ◽  
pp. 4578
Author(s):  
Nidhi Wali ◽  
Kingsley E. E. Agho ◽  
Andre M. N. Renzaho
Keyword(s):  
South Asia ◽  
South Asian ◽  
Health Surveys ◽  
Associated Factors ◽  
Common Factor ◽  
Household Wealth ◽  
Health Concern ◽  
Demographic And Health Surveys ◽  
Asian Countries ◽  
Sampling Weights

Child wasting continues to be a major public health concern in South Asia, having a prevalence above the emergency threshold. This paper aimed to identify factors associated with wasting among children aged 0–23 months, 24–59 months, and 0–59 months in South Asia. A weighted sample of 564,518 children aged 0–59 months from the most recent demographic and health surveys (2014–2018) of five countries in South Asia was combined. Multiple logistic regression analyses that adjusted for clustering and sampling weights were used to examine associated factors. Wasting prevalence was higher for children aged 0–23 months (25%) as compared to 24–59 months (18%), with variations in prevalence across the South Asian countries. The most common factor associated with child wasting was maternal BMI [adjusted odds ratio (AOR) for 0–23 months = 2.02; 95% CI: (1.52, 2.68); AOR for 24–59 months = 2.54; 95% CI: (1.83, 3.54); AOR for 0–59 months = 2.18; 95% CI: (1.72, 2.77)]. Other factors included maternal height and age, household wealth index, birth interval and order, children born at home, and access to antenatal visits. Study findings suggest need for nutrition specific and sensitive interventions focused on women, as well as adolescents and children under 2 years of age.

scholarly journals Correlates of the double burden of malnutrition among women: an analysis of cross sectional survey data from sub-Saharan Africa

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029545 ◽  
Author(s):  
Dickson Abanimi Amugsi ◽  
Zacharie Tsala Dimbuene ◽  
Catherine Kyobutungi
Keyword(s):  
Household Wealth ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Sub Saharan Africa ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Double Burden ◽  
Double Burden Of Malnutrition ◽  
Sub Saharan

ObjectiveTo investigate the correlates of the double burden of malnutrition (DBM) among women in five sub-Saharan African countries.DesignSecondary analysis of Demographic and Health Surveys (DHS). The outcome variable was body mass index (BMI), a measure of DBM. The BMI was classified into underweight (BMI <18.50 kg/m2), normal weight (18.50–24.99 kg/m2), overweight (25.0–29.9 kg/m2) and obesity (≥30.0 kg/m2).SettingsGhana, Nigeria, Kenya, Mozambique and Democratic Republic of Congo (DRC).SubjectsWomen aged 15–49 years (n=64698).ResultsCompared with normal weight women, number of years of formal education was associated with the likelihood of being overweight and obese in Ghana, Mozambique and Nigeria, while associated with the likelihood of being underweight in Kenya and Nigeria. Older age was associated with the likelihood of being underweight, overweight and obese in all countries. Positive associations were also observed between living in better-off households and overweight and obesity, while a negative association was observed for underweight. Breastfeeding was associated with less likelihood of underweight in DRC and Nigeria, obesity in DRC and Ghana, overweight in Kenya and overweight and obesity in Mozambique and Nigeria relative to normal weight.ConclusionsOur analysis reveals that in all the countries, women who are breastfeeding are less likely to be underweight, overweight and obese. Education, age and household wealth index tend to associate with a higher likelihood of DBM among women. Interventions to address DBM should take into account the variations in the effects of these correlates.

Current Progress and Future Directions in the Double Burden of Malnutrition Among Women in South and Southeast Asian Countries

2018 ◽  
Author(s):  
Tuhin Biswas ◽  
Nick Townsend ◽  
R. J. Soares Magalhaes ◽  
Md. Saimul Islam ◽  
Md. Mehedi Hasan ◽  
...  
Keyword(s):  
Southeast Asian ◽  
Asian Countries ◽  
Double Burden ◽  
Future Directions ◽  
Double Burden Of Malnutrition ◽  
Southeast Asian Countries

scholarly journals Trends and determinants of undernutrition among young Kenyan children: Kenya Demographic and Health Survey; 1993, 1998, 2003 and 2008–2009

2012 ◽  
Vol 15 (9) ◽  
pp. 1715-1727 ◽  
Author(s):  
Peninah K Masibo ◽  
Donald Makoka
Keyword(s):  
Health Survey ◽  
Urban Areas ◽  
Child Nutrition ◽  
Maternal Education ◽  
Sampling Technique ◽  
Household Wealth ◽  
Demographic And Health Survey ◽  
Demographic And Health Surveys ◽  
Double Burden ◽  
Percentage Points

AbstractObjectiveTo report on the trends and determinants of undernutrition among children <5 years old in Kenya.DesignData from four nationwide Kenya Demographic and Health Surveys, conducted in 1993, 1998, 2003 and 2008–2009, were analysed. The Demographic and Health Survey utilizes a multistage stratified sampling technique.SettingNationwide covering rural and urban areas in Kenya.SubjectsThe analysis included 4757, 4433, 4892 and 4958 Kenyan children aged <5 years in 1993, 1998, 2003 and 2009–2009, respectively.ResultsThe prevalence of stunting decreased by 4·6 percentage points from 39·9 % in 1993 to 35·3 % in 2008–2009, while underweight decreased by 2·7 percentage points from 18·7 % in 1993 to 16·0 % in 2008–2009. The effects of household wealth, maternal education and current maternal nutritional status on child nutrition outcomes have changed dynamically in more recent years in Kenya. Inadequate hygiene facilities increased the likelihood of chronic undernutrition in at least three of the surveys. Small size of the child at birth, childhood diarrhoea and male gender increased the likelihood of undernutrition in at least three of the surveys. Childhood undernutrition occurred concurrently with maternal overnutrition in some households.ConclusionsThe analysis reveals a slow decline of undernutrition among young children in Kenya over the last three decades. However, stunting and underweight still remain of public health significance. There is evidence of an emerging trend of a malnutrition double burden demonstrated by stunted and underweight children whose mothers are overweight.

scholarly journals Gender inequalities in excess adiposity and anaemia combine in a large double burden of malnutrition gap detrimental to women in an urban area in North Africa

2016 ◽  
Vol 19 (8) ◽  
pp. 1428-1437 ◽  
Author(s):  
Pierre Traissac ◽  
Jalila El Ati ◽  
Agnès Gartner ◽  
Houda Ben Gharbia ◽  
Francis Delpeuch
Keyword(s):  
Gender Equity ◽  
Gender Inequality ◽  
North Africa ◽  
Gender Gap ◽  
Household Wealth ◽  
Professional Activity ◽  
Gender Inequalities ◽  
Double Burden ◽  
Excess Adiposity ◽  
Double Burden Of Malnutrition

AbstractObjectiveThe nutrition transition has exacerbated the gender gap in health in the Middle East and North Africa region as the increase in excess adiposity has been much higher among women than men. This is not exclusive of the persistence of anaemia, generally also more prevalent among women. We assessed the magnitude and sociodemographic factors associated with gender inequality vis-à-vis the double burden of excess adiposity and anaemia.DesignCross-sectional study, stratified two-stage cluster sample. BMI (=weight/height2) ≥25·0 kg/m2 defined overweight and BMI≥30·0 kg/m2 obesity. Anaemia was defined as Hb <120 g/l for women, <130 g/l for men. Gender inequalities vis-à-vis the within-subject coexistence of excess adiposity and anaemia were assessed by women v. men relative prevalence ratios (RPR). Their variation with sociodemographic characteristics used models including gender × covariate interactions.SettingGreater Tunis area in 2009–2010.SubjectsAdults aged 20–49 years (women, n 1689; men, n 930).ResultsGender inequalities in excess adiposity were high (e.g. overweight: women 64·9 % v. men 48·4 %; RPR=2·1; 95 % CI 1·6, 2·7) and much higher for anaemia (women 38·0 % v. men 7·2 %; RPR=8·2; 95 % CI 5·5, 12·4). They were striking for overweight and anaemia (women 24·1 % v. men 3·4 %; RPR=16·2; 95 % CI 10·3, 25·4). Gender inequalities in overweight adjusted for covariates increased with age but decreased with professional activity and household wealth score; gender inequality in anaemia or overweight and anaemia was more uniformly distributed.ConclusionsWomen were much more at risk than men, from both over- and undernutrition perspectives. Both the underlying gender-related and sex-linked biological determinants of this remarkable double burden of malnutrition inequality must be addressed to promote gender equity in health.

scholarly journals A systematic review of the prevalence and predictors of the double burden of malnutrition within households

2017 ◽  
Vol 117 (8) ◽  
pp. 1118-1127 ◽  
Author(s):  
Satoko Kosaka ◽  
Masahiro Umezaki
Keyword(s):  
Physical Activity ◽  
Secondary Data ◽  
Asian Countries ◽  
African Countries ◽  
Eligibility Criteria ◽  
Double Burden ◽  
Search Terms ◽  
Diet And Physical Activity ◽  
Double Burden Of Malnutrition

AbstractRecently, increasing attention has been paid to the emergence of the double burden of malnutrition within households. We provide an overview of the literature regarding this phenomenon by reviewing previous studies of the prevalence of double-burden households and associated factors together with the research methods used. Studies were identified from the electronic databases PubMed and Web of Science, using the same search terms for both. A total of thirty-five articles met the eligibility criteria, and 367 sets of prevalence data were extracted. In all, thirty-four articles were published in 2000 or later; twenty-four used secondary data and twenty-five focused on mother–child pairs. The ages of children varied from 0 to 19 years. All the studies used BMI as a nutritional indicator for adults. For children, height-for-age was most frequently used, whereas weight-for-age, weight-for-height and BMI-for-age were also used in multiple studies. The reported national prevalence of double-burden households varied from 0·0 to 26·8 % by country and year; however, few studies were directly comparable, because of differences in the combinations of undernourished and overweight persons, age ranges, nutritional indicators and cut-off points. Whereas many focused on African countries, a few involved Asian countries. Although urban residence, income and education were frequently assessed, the role of intermediate factors in nutritional status, such as diet and physical activity, remains unclear. It is recommended that future studies use comparable indicators and cut-off points, involve Asian countries, and investigate individual diet and physical activity.

scholarly journals Association of Socioeconomic Status With Ideal Cardiovascular Health in Black Men

2021 ◽  
Author(s):  
Rosevine A. Azap ◽  
Timiya S. Nolan ◽  
Darrell M. Gray ◽  
Kiwan Lawson ◽  
John Gregory ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Cardiovascular Risk ◽  
Educational Attainment ◽  
Black Men ◽  
Employment Status ◽  
Cardiovascular Health ◽  
Annual Income ◽  
Lower Odds ◽  
Ideal Cardiovascular Health ◽  
Ich Score

Background Black men are burdened by high cardiovascular risk and the highest all‐cause mortality rate in the United States. Socioeconomic status (SES) is associated with improved cardiovascular risk factors in majority populations, but there is a paucity of data in Black men. Methods and Results We examined the association of SES measures including educational attainment, annual income, employment status, and health insurance status with an ideal cardiovascular health (ICH) score, which included blood pressure, glucose, cholesterol, body mass index, physical activity, and smoking in African American Male Wellness Walks. Six metrics of ICH were categorized into a 3‐tiered ICH score 0 to 2, 3 to 4, and 5 to 6. Multinomial logistic regression modeling was performed to examine the association of SES measures with ICH scores adjusted for age. Among 1444 men, 7% attained 5 to 6 ICH metrics. Annual income <$20 000 was associated with a 56% lower odds of attaining 3 to 4 versus 0 to 2 ICH components compared with ≥$75 000 ( P =0.016). Medicare and no insurance were associated with a 39% and 35% lower odds of 3 to 4 versus 0 to 2 ICH components, respectively, compared with private insurance (all P <0.05). Education and employment status were not associated with higher attainment of ICH in Black men. Conclusions Among community‐dwelling Black men, higher attainment of measures of SES showed mixed associations with greater attainment of ICH. The lack of association of higher levels of educational attainment and employment status with ICH suggests that in order to address the long–standing health inequities that affect Black men, strategies to increase attainment of cardiovascular health may need to address additional components beyond SES.

scholarly journals Maternal internal migration and child growth and nutritional health in Peru: an analysis of the demographic and health surveys from 1991 to 2017

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Emeline Rougeaux ◽  
J. Jaime Miranda ◽  
Mary Fewtrell ◽  
Jonathan C. K. Wells
Keyword(s):  
Internal Migration ◽  
Urban Areas ◽  
Health Surveys ◽  
Child Outcomes ◽  
Child Growth ◽  
Demographic And Health Surveys ◽  
Double Burden ◽  
Nutritional Health ◽  
Double Burden Of Malnutrition ◽  
Overweight Prevalence

Abstract Background Peru has historically experienced high rural-to-urban migration. Despite large reductions in undernutrition, overweight is increasing. Elsewhere, internal migration has been associated with differences in children’s growth and nutritional health. We investigated how child growth and nutritional status in Peru varied over time and in association with maternal internal migration. Methods Using data from Demographic & Health Surveys from 1991 to 2017, we assessed trends in child growth (height-for-age [HAZ], weight-for-age [WAZ], weight-for-height [WHZ] z scores) and nutritional health (stunting, underweight, overweight) by maternal adult internal migration (urban [UNM] or rural non-migrant [RNM], or urban-urban [UUM], rural-urban [RUM], rural-rural [RRM], or urban-rural migrant [URM]). Using 2017 data, we ran regression analyses, adjusting for confounders, to investigate associations of maternal migration with child outcomes and the maternal and child double burden of malnutrition. We further stratified by timing of migration, child timing of birth and, for urban residents, type of area of residence. Results are given as adjusted predictive margins (mean z score or %) and associated regression p-values [p]. Results In 1991–2017, child growth improved, and undernutrition decreased, but large differences by maternal migration persisted. In 2017, within urban areas, being the child of a migrant woman was associated with lower WHZ (UUM = 0.6/RUM = 0.5 vs UNM = 0.7; p = 0.009 and p < 0.001 respectively) and overweight prevalence ((RUM 7% vs UNM = 11% [p = 0.002]). Results however varied both by child timing of birth (birth after migration meant greater overweight prevalence) and type of area of residence (better linear growth in children of migrants [vs non-migrants] in capital/large cities and towns but not small cities). In rural areas, compared to RNM, children of URM had higher HAZ (− 1.0 vs − 1.2; p < 0.001) and WAZ (− 0.3 vs − 0.4; p = 0.001) and lower stunting (14% vs 21%; [p < 0.001]). There were no differences by timing of birth in rural children, nor by time since migration across all children. The mother and child double burden of malnutrition was higher in rural than urban areas but no differences were found by maternal internal migration. Conclusions Migration creates a unique profile of child nutritional health that is not explained by maternal ethnic and early life factors, but which varies depending on the pathway of migration, the child timing of birth in relation to migration and, for urban dwellers, the size of the place of destination. Interventions to improve child nutritional health should take into consideration maternal health and migration history.

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