Household Levels of Double Burden of Malnutrition in Low–Middle-income Countries: A Review

2021 ◽  
pp. 2277436X2110436
Author(s):  
A. Bose ◽  
N. Mondal ◽  
J. Sen
Keyword(s):  
Infant Health ◽  
Health Conditions ◽  
Double Burden ◽  
Middle Income ◽  
Household Level ◽  
Middle Income Countries ◽  
Under Nutrition ◽  
Low Middle Income Countries ◽  
Wide Range ◽  
Double Burden Of Malnutrition

Malnutrition is characterised by both over-nutrition and under-nutrition. Over-nutrition is defined as excessive intake of energy and/or macronutrients. Both over-nutrition and under-nutrition are associated with a wide range of detrimental health conditions. Under-nutrition can contribute to high mortality, morbidity and poor infant health conditions; lead to delayed physical and mental development among children; and cause poor physical productivity and reproductive outcomes among adults. Over-nutrition remains the main risk factor for non-communicable diseases such as hypertension, cardiovascular diseases, type 2 diabetes and certain types of cancers. The world has witnessed a global obesity epidemic with levels rising at alarming rates in the low-middle-income countries. The higher prevalence of obesity is often accompanied by under-nutrition, and these two health issues coexist at household levels. This is termed as ‘Double Burden of Malnutrition’. The objectives of the present article are to account for the evidences, causes and risk factors of household level of double burden of malnutrition in the low-middle-income countries.

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 EXPLORATION OF THE HEALTH IMPACT OF DOUBLE BURDEN OF MALNUTRITION AMONG BANGLADESHI WOMEN

2017 ◽  
Vol 3 (4) ◽  
pp. 138-141
Author(s):  
Mehedi Hasan ◽  
Ipsita Sutradhar
Keyword(s):  
Nutritional Status ◽  
Birth Outcome ◽  
Health Impact ◽  
Health Conditions ◽  
Double Burden ◽  
Policy Makers ◽  
Under Nutrition ◽  
Poor Birth Outcome ◽  
Double Burden Of Malnutrition ◽  
To Come

Double burden of malnutrition (DBM) is a growing concern, which refers to the coexistence of under nutrition and over nutrition within the same population. The recent increase in the prevalence of overweight and existing prevalence of underweight among Bangladeshi women clearly indicates the advent of a double burden of malnutrition in Bangladesh. Women’s nutritional status is extremely important for a nation because it affects not only their own health but also the health of their children. Both under nutrition and over nutrition have the potential to make women vulnerable to various adverse health conditions as well as adverse obstetric experience and poor birth outcome. It is a timely need for policy makers of this country to come up with specific interventions for both undernourished and overnourished women considering all these factors.

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 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 Costs, contracts and the narrative of prosperity: an economic analysis of smallholder tobacco farming livelihoods in Kenya

2018 ◽  
Vol 28 (3) ◽  
pp. 268-273 ◽  
Author(s):  
Peter Magati ◽  
Raphael Lencucha ◽  
Qing Li ◽  
Jeffrey Drope ◽  
Ronald Labonte ◽  
...  
Keyword(s):  
Smallholder Farmers ◽  
Economic Benefits ◽  
Control Measures ◽  
Middle Income ◽  
Tobacco Leaf ◽  
Household Level ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Nationally Representative ◽  
Negative Impacts

BackgroundThe tobacco industry has used the alleged negative impacts on economic livelihoods for tobacco farmers as a narrative to oppose tobacco control measures in low/middle-income countries. However, rigorous empirical evidence to support or refute this claim remains scarce. Accordingly, we assess how much money households earn from selling tobacco, and the costs they incur to produce the crop, including labour inputs. We also evaluate farmers’ decision to operate under contract directly with tobacco manufacturers and tobacco leaf-buying companies or to operate as independent farmers.MethodsA stratified random sampling method was used to implement a nationally representative household-level economic survey of 585 farmers across the three main tobacco growing regions in Kenya. The survey was augmented with focus group discussions in all three regions to refine and enrich the context of the findings.ResultsBoth contract and independent farmers experience small profit margins per acre, with contract farmers operating at a loss. Even when family labour is excluded from the calculation, income levels remain low, particularly considering the typically large households. Generally, tobacco farmers enter into contracts with tobacco companies because they have a ‘guaranteed’ buyer for their tobacco leaf and receive the necessary agricultural inputs (fertiliser, seeds, herbicides and so on) without paying cash up-front.ConclusionsTobacco farming households enter into contract with tobacco companies to realise perceived economic benefits. The narrative that tobacco farming is a lucrative economic undertaking for smallholder farmers, however, is inaccurate in the context of Kenya.

scholarly journals The double burden of malnutrition among adolescents: analysis of data from the Global School-Based Student Health and Health Behavior in School-Aged Children surveys in 57 low- and middle-income countries

2018 ◽  
Vol 108 (2) ◽  
pp. 414-424 ◽  
Author(s):  
Rishi Caleyachetty ◽  
G N Thomas ◽  
Andre P Kengne ◽  
Justin B Echouffo-Tcheugui ◽  
Samantha Schilsky ◽  
...  
Keyword(s):  
Health Behavior ◽  
Contextual Factors ◽  
Student Health ◽  
Double Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
School Aged Children ◽  
School Based ◽  
Double Burden Of Malnutrition ◽  
Overweight Or Obesity

ABSTRACT Background Adults and young children in countries experiencing the nutrition transition are known to be affected simultaneously by undernutrition and overnutrition. Adolescence is a critical period for growth and development. Yet, it is unknown to what extent this double burden of malnutrition affects adolescents in low- and middle-income countries (LMICs) and the macrolevel contextual factors associated with the double burden of malnutrition. Objective The aim was to quantify the magnitude of the double burden of malnutrition among adolescents and to examine the potential sources of heterogeneity in prevalence estimates across LMICs. Design We used individual-participant data from the Global School-Based Student Health and Health Behavior in School-Aged Children surveys conducted in 57 LMICs between 2003 and 2013, comprising 129,276 adolescents aged 12–15 y. Pooled estimates of stunting, thinness, or both; overweight or obesity; and concurrent stunting and overweight or obesity were calculated overall, by regions, and stratified by sex, with random-effects meta-analysis. Guided by UNICEF's conceptual framework for child malnutrition, we used ecological linear regression models to examine the association between macrolevel contextual factors (internal conflict, lack of democracy, gross domestic product, food insecurity, urbanization, and survey year) and stunting, thinness, and overweight and obesity prevalence, respectively. Results The prevalence of stunting was 10.2% (95% CI: 8.3%, 12.2%) and of thinness was 5.5% (95% CI: 4.3%, 6.9%). The prevalence of overweight or obesity was 21.4% (95% CI: 18.6%, 24.2%). Between 38.4% and 58.7% of the variance in adolescent malnutrition was explained by macrolevel contextual factors. The prevalence of concurrent stunting and overweight or obesity was 2.0% (95% CI: 1.7%, 2.5%). Conclusions The double burden of malnutrition among adolescents in LMICs is common. Context-sensitive implementation and scale-up of interventions and policies for the double burden of malnutrition are needed to achieve the Sustainable Development Goal to end malnutrition in all of its forms by 2030. This trial was registered at clinicaltrials.gov as NCT03346473.

scholarly journals Addressing malnutrition in low- and middle-income countries with double-duty actions

2018 ◽  
Vol 78 (3) ◽  
pp. 388-397 ◽  
Author(s):  
Rebecca Pradeilles ◽  
Kaleab Baye ◽  
Michelle Holdsworth
Keyword(s):  
Environmental Sustainability ◽  
De Novo ◽  
School Food ◽  
Double Burden ◽  
Middle Income ◽  
The Sustainable Development ◽  
Middle Income Countries ◽  
Effective Interventions ◽  
Double Burden Of Malnutrition ◽  
Low And Middle Income

Multiple forms of malnutrition co-exist (the double burden) in low- and middle-income countries, but most interventions and policies target only one form. Identifying shared drivers of the double burden of malnutrition is a first step towards establishing effective interventions that simultaneously address the double burden of malnutrition (known as double-duty actions). We identified shared drivers for the double burden of malnutrition, to assess which double-duty actions are likely to have the greatest reach in preventing all forms of malnutrition, in the context of the sustainable development goals. We reviewed existing conceptual frameworks of the drivers of undernutrition, obesity and environmental sustainability. Shared drivers affecting all forms of malnutrition and environmental sustainability were captured using a socio-ecological approach. The extent to which drivers were addressed by the five double-duty actions proposed by the WHO was assessed. Overall, eighty-three shared drivers for the double burden of malnutrition were identified. A substantial proportion (75·0%) could be addressed by the five WHO double-duty actions. ‘Regulations on marketing’ and ‘promotion of appropriate early and complementary feeding in infants’ addressed the highest proportion of shared drivers (65·1% and 53·0%, respectively). Twenty-four drivers were likely to be sensitive to environmental sustainability, with ‘regulations on marketing’ and ‘school food programmes and policies’ likely to have the greatest environmental reach. A quarter of the shared drivers remained unaddressed by the five WHO double-duty actions. Substantially more drivers could be addressed with minor modifications to the WHO double-duty actions and the addition of de novo actions.

scholarly journals Role of food aid and assistance in addressing the double burden of malnutrition in Ghana: a qualitative policy analysis

2020 ◽  
pp. bmjnph-2020-000136
Author(s):  
Niisoja M Torto ◽  
Kelly D Brownell
Keyword(s):  
Low Income ◽  
Food Systems ◽  
Overweight And Obesity ◽  
Food Aid ◽  
Double Burden ◽  
Middle Income ◽  
Roles And Responsibilities ◽  
Middle Income Countries ◽  
Double Burden Of Malnutrition

Background and aimsIn many low-income and middle-income countries, the double burden of malnutrition threatens public health and economic progress, urging a re-evaluation of the roles and responsibilities of nutrition actors, both traditional and non-traditional. This study examines the food aid and assistance activities of the United Nations World Food Programme (WFP)—one non-traditional actor in the double burden conversation—and the potential for these activities to reach beyond their traditional mandate on undernutrition to also address overweight and obesity in Ghana.MethodsInformation on WFP activities in Ghana from 2012 up through its planning into 2023 was extracted from 11 WFP planning, operations and evaluation documents. WFP activities were then judged against the WHO’s framework on the determinants of the double burden of malnutrition to determine their potential to address the double burden. Semistructured interviews were also conducted with 17 key informants in the global nutrition landscape to identify challenges that may complicate the role of WFP and other actors in addressing the double burden.ResultsThe analysis demonstrates that WFP activities in Ghana can serve as a platform on which to address the double burden, particularly by targeting the food access, food systems and socioeconomic disadvantage determinants of the double burden. Actors’ uncertainty with what role WFP should play in addressing the double burden, insufficient government attention to malnutrition and poor data on overweight and obesity were identified as potential challenges that complicate addressing the double burden.ConclusionThe findings suggest that integrating WFP as a partner in the effort to address the double burden in Ghana might help amplify progress. To better address the double burden, WFP might prioritise retrofitting existing activities rather than implementing new interventions.

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