scholarly journals Using Body Composition Assessment to Evaluate the Double Burden of Malnutrition

2019 ◽  
Vol 75 (2) ◽  
pp. 103-108 ◽  
Author(s):  
Jonathan C.K. Wells
Keyword(s):  
Body Composition ◽  
Early Life ◽  
Noncommunicable Disease ◽  
Body Composition Assessment ◽  
Double Burden ◽  
Poor Growth ◽  
Middle Income ◽  
Child Undernutrition ◽  
Double Burden Of Malnutrition ◽  
The Individual

Background: Populations in low- and middle-income countries are increasingly experiencing a double burden of malnutrition (DBM), incorporating both persistent levels of child undernutrition and rising prevalence of overweight/obesity at later ages. A growing number of individuals experience both components of the DBM through the life-course, thereby accumulating high susceptibility to noncommunicable disease (NCD). Summary: Measurements of body composition may prove valuable for assessing NCD risk at the level of the individual. The capacity-load model provides a simple conceptual framework for integrating data on different components of body composition to predict NCD risk. Poor growth in early life, indexed by becoming wasted or stunted, constrains the development of lean mass components such as muscle and organ mass, each of which contribute to the metabolic capacity for homeostasis. Catch-up weight gain in early life, or the development of excess weight from childhood onwards, is associated with elevated adiposity, especially abdominal adiposity, which challenges cardio-metabolic homeostasis and elevates NCD risk. Key Messages: A variety of techniques are now available for the measurement of body composition, helping research the association of the DBM with NCD risk. Reference charts allow raw data to be converted to age- and sex-specific z-scores, aiding interpretation.

scholarly journals The prevalence and correlates of the double burden of malnutrition among women in Ghana

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244362
Author(s):  
Sandra Boatemaa Kushitor ◽  
Lily Owusu ◽  
Mawuli Kobla Kushitor
Keyword(s):  
Normal Weight ◽  
Chi Square ◽  
Double Burden ◽  
Middle Income ◽  
Individual Level ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Chi Square Test ◽  
Double Burden Of Malnutrition ◽  
The Individual

Anaemia and underweight or overweight/obesity are major public health problems driving maternal and child mortality in low- and middle-income countries. While the burden of these conditions is recognised, the evidence for the co-occurrence of these conditions is fragmented and mixed, especially at the individual level. Further, many studies have focused on families and communities. The different pathways for the occurrence of anaemia and BMI challenges indicate that an individual can potentially live with both conditions and suffer the complications. This study examined the prevalence and factors associated with the co-occurrence of anaemia and BMI challenges among a cohort of women in Ghana. Data from the 2014 Ghana Demographic and Health Survey were used. The sample size was 4 337 women aged 15–49 years who were not pregnant during the survey. Women who suffered simultaneously from underweight or overweight/obesity and anaemia were considered as having the double burden of malnutrition. The data were analysed using descriptive statistics, Chi-square test and logistic regression in STATA. One-fifth of the participants were overweight (21%), 4% were underweight and about one-tenth were obese (12%). The prevalence of anaemia was 41%. Only one in three women had normal weight and was not anaemic (34%). About 14% of the women experienced the double burden of malnutrition. Being overweight and anaemic (57%) was the most common form of this double burden. Age, marital status, parity, and wealth were t key risk factors associated with the double burden of malnutrition. The findings from this study show that women experience multiple nutritional challenges concurrently and that only a few women had healthy nutritional status. This information is particularly important and can be introduced into health education programmes to help address misconceptions about body weight and health.

scholarly journals Various forms of double burden of malnutrition problems exist in rural Kenya

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Andrea Fongar ◽  
Theda Gödecke ◽  
Matin Qaim
Keyword(s):  
Developing Countries ◽  
Rural Areas ◽  
Micronutrient Deficiency ◽  
Double Burden ◽  
Household Level ◽  
Individual Level ◽  
Child Undernutrition ◽  
Rural Kenya ◽  
Double Burden Of Malnutrition ◽  
The Individual

Abstract Background The coexistence of overweight/obesity and undernutrition is often referred to as the double burden of malnutrition (DB). DB was shown to exist in many developing countries, especially in urban areas. Much less is known about DB in rural areas of developing countries. Also, the exact definition of DB varies between studies, making comparison difficult. The objective of this study is to analyse DB problems in rural Kenya, using and comparing different DB definitions and measurement approaches. Methods Food intake and anthropometric data were collected from 874 male and female adults and 184 children (< 5 years) through a cross-section survey in rural areas of Western Kenya. DB at the individual level is defined as a person suffering simultaneously from overweight/obesity and micronutrient deficiency or stunting. DB at the household level is defined as an overweight/obese adult and an undernourished child living in the same household, using underweight, stunting, wasting, and micronutrient deficiency as indicators of child undernutrition. Results DB at the individual level is found in 19% of the adults, but only in 1% of the children. DB at the household level is relatively low (1–3%) when using wasting or underweight as indicators of child undernutrition, but much higher (13–17%) when using stunting or micronutrient deficiency as indicators. Conclusion Various forms of DB problems exist in rural Kenya at household and individual levels. Prevalence rates depend on how exactly DB is defined and measured. The rise of overweight and obesity, even in rural areas, and their coexistence with different forms of undernutrition are challenges for food and nutrition policies.

scholarly journals EXAMINING THE DOUBLE BURDEN OF MALNUTRITION FOR PRESCHOOL CHILDREN AND WOMEN OF REPRODUCTIVE AGE IN LOW- AND MIDDLE-INCOME COUNTRIES: A SCOPING REVIEW PROTOCOL

2021 ◽  
Author(s):  
Jason Mulimba Were ◽  
SAVERIO STRANGES ◽  
Ishor Sharma ◽  
Juan-Camilo Vargas-Gonzalez ◽  
M. Karen Campbell
Keyword(s):  
Preschool Children ◽  
Scoping Review ◽  
Reproductive Age ◽  
World Health ◽  
Women Of Reproductive Age ◽  
Double Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Double Burden Of Malnutrition ◽  
Low And Middle Income

Introduction: The majority of the populations in Low-and Middle-Income Countries (LMICs) are encountering the double burden of malnutrition (DBM): the coexistence of both undernutrition and overnutrition sequalae. With DBM being a new phenomenon in research, little is known about its etiology, operational definitions and risk factors influencing its manifestation. The proposed scoping review is aimed at mapping literature with regards to the DBM phenomenon among preschool children and women of reproductive age in LMICs who are among the most high-risk groups to encounter DBM. Methods: A comprehensive literature search will be conducted in the following electronic databases: MEDLINE, EMBASE, Scopus, CINAHL, LILACS and ProQuest Dissertations & Thesis Global. Additionally, searches in other government and institutional sources (World Health Organization website and university repositories) and forward and backward citation tracking of seminal articles will also be done. Two reviewers will independently conduct title and abstract screening and full text screening. Similarly, data extraction and coding will independently be done by two reviewers. Information extracted from included literature will be analysed qualitatively using thematic analysis approach and reported as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Ethics and Dissemination: Ethical approval is not required for this study because the review is based on literature from publicly available sources. The dissemination of our findings will be done through presentations in relevant conferences and publication in a peer-reviewed journal.

scholarly journals Intraindividual double burden of overweight or obesity and micronutrient deficiencies or anemia among women of reproductive age in 17 population-based surveys

2020 ◽  
Vol 112 (Supplement_1) ◽  
pp. 468S-477S ◽  
Author(s):  
Anne M Williams ◽  
Junjie Guo ◽  
O Yaw Addo ◽  
Sanober Ismaily ◽  
Sorrel M L Namaste ◽  
...  
Keyword(s):  
Population Based ◽  
Micronutrient Deficiency ◽  
High Income ◽  
Reproductive Age ◽  
Micronutrient Deficiencies ◽  
Women Of Reproductive Age ◽  
Chi Square ◽  
Double Burden ◽  
Middle Income ◽  
The Individual

ABSTRACT Background Rising prevalence of overweight/obesity (OWOB) alongside persistent micronutrient deficiencies suggests many women face concomitant OWOB and undernutrition. Objectives We aimed to 1) describe the prevalence of the double burden of malnutrition (DBM) among nonpregnant women of reproductive age, defined as intraindividual OWOB and either ≥1 micronutrient deficiency [micronutrient deficiency index (MDI) &gt; 0; DBM-MDI] or anemia (DBM-anemia); 2) test whether the components of the DBM were independent; and 3) identify factors associated with DBM-MDI and DBM-anemia. Methods With data from 17 national surveys spanning low- and middle-income countries (LMICs) and high-income countries from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia project (n = 419 to n = 9029), we tested independence of over- and undernutrition using the Rao–Scott chi-square test and examined predictors of the DBM and its components using logistic regression for each survey. Results Median DBM-MDI was 21.9% (range: 1.6%–39.2%); median DBM-anemia was 8.6% (range: 1.0%–18.6%). OWOB and micronutrient deficiencies or anemia were independent in most surveys. Where associations existed, OWOB was negatively associated with micronutrient deficiencies and anemia in LMICs. In 1 high-income country, OWOB women were more likely to experience micronutrient deficiencies and anemia. Age was consistently positively associated with OWOB and the DBM, whereas the associations with other sociodemographic characteristics varied. Higher socioeconomic status tended to be positively associated with OWOB and the DBM in LMICs, whereas in higher-income countries the association was reversed. Conclusions The independence of OWOB and micronutrient deficiencies or anemia within individuals suggests that these forms of over- and undernutrition may have unique etiologies. Decision-makers should still consider the prevalence, consequences, and etiology of the individual components of the DBM as programs move towards double-duty interventions aimed at addressing OWOB and undernutrition simultaneously.

scholarly journals The Impact of Dietary Protein in Complementary Foods on Infant Growth and Body Composition in a Population Facing the Double Burden of Malnutrition: Protocol for a Multicenter, Prospective Cohort Study (Preprint)

2020 ◽  
Author(s):  
Kulnipa Kittisakmontri ◽  
Julie Lanigan ◽  
Jonathan C K Wells ◽  
Mary Fewtrell
Keyword(s):  
Amino Acids ◽  
Growth Hormone ◽  
Body Composition ◽  
Protein Intake ◽  
Complementary Feeding ◽  
Iron Status ◽  
Plasma Amino Acids ◽  
Double Burden ◽  
Protein Sources ◽  
Double Burden Of Malnutrition

BACKGROUND Protein is an essential macronutrient with an important role during complementary feeding. Low protein intake contributes to undernutrition while high intake, especially from animal sources, may increase obesity risk. However, the influences of different protein sources (dairy, meat, and plants) on growth, and underlying mechanisms for these effects, are poorly understood. Animal-sourced foods provide both high-quality protein and iron and are recommended to improve iron status. However, it is unclear whether current dietary recommendations are adequate to support healthy growth and optimize iron status. These issues are of particular concern in countries facing the double burden of malnutrition, the coexistence of all forms of malnutrition. More evidence is needed to develop appropriate recommendations for these countries. OBJECTIVE This study will investigate associations between protein intake during complementary feeding and growth, body composition, and iron status of infants in Thailand, a country facing the double burden of malnutrition. The study will also explore how different protein sources influence growth via the growth hormone—insulin-like growth factor I (IGF-1) axis and plasma amino acids. METHODS A multicenter cohort study will be conducted in Chiang Mai, Thailand, in 150 healthy term infants aged 4-6 months with birth weight ≥2500 g. Demographic data, dietary intake, and anthropometry will be collected at 6, 9, and 12 months. Dietary intake will be assessed using 24-hour dietary recalls, 3-day food records, and food frequency questionnaires. Blood samples for iron status, growth hormone, IGF-1, insulin-like growth factor-binding protein III (IGFBP-3), and plasma amino acids and urine samples for body composition analysis using stable isotope dilution will be obtained at 12 months. RESULTS The recruitment of study participants and data collection was undertaken from June 2018 to May 2019. Data and laboratory analyses are ongoing and are expected to be completed by December 2020. A total of 150 participants were enrolled, and 146 completed the study. We hypothesized that protein intake from animal-sourced foods in recommended quantities could support normal weight and length gain and lower the risk of undernutrition associated with similar amounts of plant-based protein. However, higher protein intake, especially from milk protein, may be linked to increased body fat via plasma amino acids and the growth hormone-IGF axis. CONCLUSIONS The results of this study will provide data on current complementary feeding practices, focusing on protein and iron intake in Thai infants. This information, combined with data on associations with infant growth and iron status, will help inform complementary feeding recommendations for this population and may be found relevant to other settings experiencing the double burden of malnutrition. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/18112

scholarly journals Examining the double burden of malnutrition for preschool children and women of reproductive age in low-income and middle-income countries: a scoping review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e054673
Author(s):  
Jason Mulimba Were ◽  
Saverio Stranges ◽  
Ishor Sharma ◽  
Juan Camilo Vargas-Gonzalez ◽  
M. Karen Campbell
Keyword(s):  
Preschool Children ◽  
Scoping Review ◽  
Low Income ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Double Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Scoping Reviews ◽  
Double Burden Of Malnutrition

IntroductionThe majority of the populations in low-income and middle-income countries (LMICs) are encountering the double burden of malnutrition (DBM): the coexistence of both undernutrition and overnutrition sequalae. With DBM being a new phenomenon in research, little is known about its aetiology, operational definitions and risk factors influencing its manifestation. The proposed scoping review is aimed at mapping literature with regard to the DBM phenomenon among preschool children and women of reproductive age in LMICs who are among the most high-risk groups to encounter DBM.MethodsA comprehensive literature search will be conducted in the following electronic databases: MEDLINE, EMBASE, Scopus, CINAHL, LILACS and ProQuest Dissertations and Thesis Global. Additionally, searches in other government and institutional sources (WHO website and university repositories) and forward and backward citation tracking of seminal articles will also be done. Two reviewers will independently conduct title and abstract screening and full-text screening. Similarly, data extraction and coding will independently be done by two reviewers. Information extracted from included literature will be analysed qualitatively using thematic analysis approach and reported as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.Ethics and disseminationEthical approval is not required for this study because the review is based on literature from publicly available sources. The dissemination of our findings will be done through presentations in relevant conferences and publication in a peer-reviewed journal.

scholarly journals Double Burden of Malnutrition (DBM) and Anaemia under the Same Roof: A Bangladesh Perspective

2018 ◽  
Author(s):  
Sumaiya Mamun ◽  
Christopher Guy Nicholas Mascie-Taylor
Keyword(s):  
Drinking Water ◽  
Wealth Index ◽  
Cross Sectional Study ◽  
Demographic Health Survey ◽  
Sectional Study ◽  
Double Burden ◽  
Cross Sectional ◽  
Child Undernutrition ◽  
Double Burden Of Malnutrition ◽  
Maternal Overweight

Double burden of malnutrition (DBM) and anaemia is a growing concern in developing countries. 5,763 mother-child pairs were selected from a cross-sectional study (Bangladesh Demographic Health Survey, 2011) to examine DBM and anaemia in households. Overweight mothers had stunted (24.5%), underweight (19.8%), wasted (9.3%) and anaemic (51.7%) children. Region and drinking water were positively associated with both DBM and anaemia (p &lt; 0.001). Father&rsquo;s occupation and wealth index were positively associated with DBM (p &lt;0.001) only. More policies and awareness programmes are needed to address the coexistence of child undernutrition and maternal overweight/obesity and anaemia in the same household.

scholarly journals The Double Burden of Malnutrition: A Systematic Review of Operational Definitions (P22-006-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Jennie Davis ◽  
Brietta Oaks ◽  
Reina Engle-Stone
Keyword(s):  
Policy Development ◽  
Data Extraction ◽  
Secondary Data ◽  
Population Level ◽  
Double Burden ◽  
Funding Sources ◽  
Food And Agriculture ◽  
Micronutrient Status ◽  
Double Burden Of Malnutrition ◽  
The Individual

Abstract Objectives The double burden of malnutrition (DBM) has received increased attention in research and policy arenas, with wide variation in how DBM is defined. We aimed to systematically identify current operational definitions for DBM (e.g., the coexistence of overnutrition and undernutrition) used in research and evaluate their frequency of use and implications for nutrition surveillance and programs. Methods We conducted a structured search for peer-reviewed articles published up to July 2017, using terms describing overnutrition (e.g., overweight, obesity) and undernutrition (e.g., stunting, anemia) in PubMed and Scopus. Additional references were added through snowball searches and online searches for gray literature. We included studies that reported DBM prevalence, including those with primary or secondary data analyses (see Figure 1). Screening of abstracts and full texts for inclusion was conducted in duplicate, with discrepancies resolved by discussion and consensus. Information extracted included the level of DBM assessment (population, household, or individual), measures of overnutrition and undernutrition (BMI, waist circumference, micronutrient status, etc.), and stated definitions of DBM. Results We identified 1920 titles and abstracts for screening through the structured search, and added an additional 66 papers and reports. Of these, 500 full-texts were reviewed and 239 were eligible for data extraction. Frequently-occurring DBM definitions included the coexistence of: 1) overweight/obesity and underweight within a population (e.g., entire country or region); 2) adult overweight/obesity and child stunting within a population or household; and 3) overweight/obesity and anemia or iron deficiency within an individual. DBM was most frequently measured at the population level, followed by the individual and household levels. Conclusions The most common operational definitions of DBM relied on population-level analyses of anthropometric indicators, with many studies leveraging existing data, such as national health surveys. Further research exploring DBM definitions in relation to key health outcomes and country priorities may help select indicators that best inform public health program and policy development. Funding Sources This work was supported by the USDA National Institute of Food and Agriculture Hatch Project. Supporting Tables, Images and/or Graphs

Economic Status Moderates the Association Between Early-Life Famine Exposure and Hyperuricemia in Adulthood

2020 ◽  
Vol 105 (11) ◽  
Author(s):  
Yuying Wang ◽  
Pan Weng ◽  
Heng Wan ◽  
Wen Zhang ◽  
Chi Chen ◽  
...  
Keyword(s):  
Early Life ◽  
Metabolic Diseases ◽  
Outcome Measure ◽  
Economic Status ◽  
Regression Analyses ◽  
Obesogenic Environment ◽  
Double Burden ◽  
Study Population ◽  
Famine Exposure ◽  
Double Burden Of Malnutrition

Abstract Context The double burden of malnutrition (DBM), undernutrition in early life and an obesogenic environment later on, influences later risk of chronic disorders. The Great Famine in China from 1959 to1962 and remarkable economic development from the 1980s provided such a burden for a large number of people in their 60s. Objective We aimed to analyze the effect of economic status on the association between famine exposure in early life and hyperuricemia in adulthood. Design and Setting Participants numbering 12 666 were enrolled in China based on the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) Study from 2014 to 2016. Participants Participants with fetal or childhood famine exposure (birth year 1949-1962) formed the exposure group. Main Outcome Measure Hyperuricemia was defined as uric acid (UA) &gt; 420 μmol/L for men and &gt; 360 μmol/L for women. The association of famine with hyperuricemia was assessed via regression analyses. Results Early-life famine exposure was negatively associated with UA levels (P = .045) but was not associated with hyperuricemia (P = .226) in the whole study population. Economic status could moderate the association of famine exposure with UA and hyperuricemia (P ≤ .001). In participants with high economic status, early-life famine exposure was positively associated with UA levels (unstandardized coefficients 7.61, 95% CI 3.63-11.59, P &lt; .001), and with hyperuricemia (odds ratio 1.47, 95% CI 1.19-1.81, P &lt; .001). Conclusions Economic status could moderate the association between exposure to famine in early life and hyperuricemia in adulthood, indicating that the DBM might affect hyperuricemia in an opposite direction of the effects of undernutrition in early life alone.

scholarly journals Strengthened Data Systems to Mitigate the Double Burden of Malnutrition: The Role of Stable Isotope Technique-Derived Nutrition Indicators

2019 ◽  
Vol 75 (2) ◽  
pp. 119-122
Author(s):  
Victor O. Owino ◽  
Theodora Mouratidou
Keyword(s):  
Body Composition ◽  
Stable Isotope ◽  
Metabolic Response ◽  
Data Availability ◽  
Noncommunicable Diseases ◽  
Surveillance Systems ◽  
Data Systems ◽  
Population Surveys ◽  
Double Burden ◽  
Double Burden Of Malnutrition

Indicators reflecting the double burden of malnutrition are rarely measured in nutrition surveys and are needed to strengthen national data systems. Indicators such as body composition reflect both metabolic response to undernutrition and obesity risk and nutrition-related noncommunicable diseases. Stable isotope techniques (SITs) provide accurate data on body composition, exclusive breastfeeding and vitamin A status that are otherwise problematic with routine methods. Integration of SIT-derived nutrition indicators in data systems could improve the design and evaluation of programmes focused on obesity prevention, food fortification and infant and young child feeding practices. The Working Group at the symposium considered “how SIT-derived nutrition indicators may be integrated into surveillance systems to strengthen data availability and capacity at national and regional levels”. Practical considerations for the use of SITs include cost, sample size, rigorous training and logistics. It was concluded that SITs are best suited, at present, for use in sub-samples of population surveys and for validating tools that can be scaled-up more easily in population surveys. In the long term, SITs could be applied to larger surveys following potential innovations in more affordable, hand-held devices for analysis of stable isotope enrichment in the field and simpler specimen collection protocols.

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