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

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.

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The double burden of malnutrition in under-five children at national and individual levels: observed and expected prevalence in ninety-three low- and middle-income countries

Public Health Nutrition ◽

10.1017/s1368980020001226 ◽

2020 ◽

pp. 1-8

Author(s):

Beatriz Raffi Lerm ◽

Inácio Crochemore-Silva ◽

Janaína Calu Costa ◽

Cesar Gomes Victora

Keyword(s):

National Level ◽

Wealth Quintile ◽

Household Wealth ◽

Double Burden ◽

Middle Income ◽

Individual Level ◽

Middle Income Countries ◽

Double Burden Of Malnutrition ◽

Nationally Representative ◽

Low And Middle Income

Abstract Objective: To assess whether the observed prevalence of the double burden of malnutrition (DBM) would be higher than expected on the basis of chance, through analyses at national, wealth quintile and individual child levels. Design: We selected nationally representative surveys from low- and middle-income countries (LMIC) carried out since 2005 with anthropometric measures on children under 5 years of age. Household wealth was assessed through asset indices. The expected prevalence of DBM was estimated by multiplying the prevalence of stunting (low height/length for age) and overweight (high weight for height/length). The WHO recommended cut-offs (20% for stunting and 10% for overweight) that were used to define DBM at national level. DBM at individual level was defined as co-occurrence of stunting and overweight in the same child. Setting: Nationally representative surveys from ninety-three LMIC. Participants: A total of 825 633 children were studied. Results: DBM at national level was observed in five countries, whereas it would be expected to occur in eleven countries. Six countries did not present evidence of DBM at national level but did so in at least one wealth quintile. At individual level, thirty countries (32·3%) showed higher prevalence of DBM than would be expected, but most differences were small except for Syria, Azerbaijan, Albania and Egypt. Conclusions: The observed number of countries or socio-economic subgroups within countries with the DBM using recommended thresholds was below what would be expected by chance. However, individual-level analyses showed that one-third of countries presented higher prevalence of DBM than would be expected.

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

10.1101/2021.06.17.21259113 ◽

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.

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Perceived Trust and Confidence for Cryptocurrency Adoption

10.4018/978-1-7998-9035-5.ch014 ◽

2022 ◽

pp. 250-279

Author(s):

Ewilly Jie Ying Liew ◽

Wei Li Peh ◽

Zhuan Kee Leong

Keyword(s):

Large Scale ◽

Social Impact ◽

Public Perceptions ◽

Middle Income ◽

Individual Level ◽

Perceived Trust ◽

Middle Income Countries ◽

Regulatory Bodies ◽

The Individual ◽

National Databases

This chapter seeks to examine the influence of public perceptions of trust in people and confidence in institutions on cryptocurrency adoption, taking into account the individual-level demographic factors and the regional-level contextual factors. Data is obtained from three large-scale international surveys and national databases and analyzed using R software. The multivariate results demonstrate that individuals' public perceptions of trust and confidence significantly contribute to cryptocurrency adoption. Lower perceived trust in people and higher perceived confidence in civil service and international regulatory bodies increase cryptocurrency adoption, while perceived confidence in political and financial institutions discourages cryptocurrency adoption. Additionally, the univariate results find significant comparisons of gender and perceived trust differences on the predictors of cryptocurrency adoption. This chapter discusses and provides insights on the social impact and future of cryptocurrency adoption, particularly among the upper- and lower-middle-income countries.

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

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa118 ◽

2020 ◽

Vol 112 (Supplement_1) ◽

pp. 468S-477S ◽

Cited By ~ 1

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) > 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.

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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 ◽

10.1136/bmjopen-2021-054673 ◽

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.

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Perception against COVID-19 Threat Affecting the Behavior of Indonesia People Three Months after the Outbreak

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.5432 ◽

2020 ◽

Vol 8 (T1) ◽

pp. 459-464

Author(s):

Putri C. Eyanoer ◽

Farhat Farhat ◽

Elvita Rahmi Daulay ◽

Fotarisman Zaluchu

Keyword(s):

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Individual Level ◽

Chi Square Test ◽

Study Population ◽

The Difference ◽

The Government ◽

The Individual ◽

Actual Health

BACKGROUND: In Indonesia, a new behavior has been introduced in the community to prevent COVID-19 transmission following 3 months of the COVID-19 outbreak. The Ministry of Health, Republic of Indonesia, names this new concept as “the adaptation of new behavior.” However, preventive measures and health protocols encouraged by the government have not yet yielded a significant impact on reducing the COVID-19 positivity rate. This unsuccessful outcome indicates that infective circulation is still occurring caused by incompliant to the health protocol. AIM: This study aimed to measure community perceptions against COVID-19 at the individual level. METHODS: A cross-sectional study with a total of 1687 respondents was performed. Questionnaires distributed thru sharing online links which contain questions on perception of vulnerability and severity of COVID-19. Chi-square test used in analysis to determine the difference in perception with respondents’ behavior. RESULTS: A total of 81.7% of respondents who had a perception of “susceptible to contract” performed behavior suited to recommendations and 81.2% study population had a perception of “COVID-19 is severe” executed behavior suited to the recommendation. CONCLUSION: This study demonstrated the establishment of government recommendations for COVID-19 infection did not guarantee the actual health practice/behavior in the community. The existing misconception of the perspective of seriousness/severity and susceptibility would prevent the country from flattening the curve.

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Using Body Composition Assessment to Evaluate the Double Burden of Malnutrition

Annals of Nutrition and Metabolism ◽

10.1159/000503666 ◽

2019 ◽

Vol 75 (2) ◽

pp. 103-108 ◽

Cited By ~ 3

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.

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