scholarly journals Socio-Ecological Model of Correlates of Double Burden of Malnutrition in Developing Countries: A Narrative Review

2019 ◽  
Vol 16 (19) ◽  
pp. 3730 ◽  
Author(s):  
Mahmudiono ◽  
Segalita ◽  
Rosenkranz
Keyword(s):  
Maternal Education ◽  
Ecological Model ◽  
Dietary Diversity ◽  
Integrated Approach ◽  
Complex Problem ◽  
Household Food Security ◽  
Double Burden ◽  
Rural And Urban ◽  
Pubmed Database ◽  
Double Burden Of Malnutrition

(1) Background: The double burden of malnutrition (DBM) is a complex problem involving the coexistence of under- and over-nutrition within the same individual, household or population. This review aimed to discuss the correlates of the double burden of malnutrition through the socio-ecological model (SEM); (2) Methods: The PubMed database was systematically searched for peer-reviewed articles related to the double burden of malnutrition. Information on correlates of the double burden of malnutrition was extracted for analysis and discussion in alignment with the levels of the socio-ecological model.; (3) Results and Discussion: The correlates of the double burden of malnutrition identified from previous literature were: race/genetics; maternal short stature; breastfeeding status; low maternal education; family size; household food security; household dietary diversity; and rural and urban settings. In the absence of evidence linking factors in a certain level of the SEM and the double burden of malnutrition, we employed correlates of overweight status and obesity to complete this narrative. Potential intervention strategies were proposed in alignment with the targets and settings identified, based on the socio-ecological approach; (4) Conclusions: The double burden of malnutrition is a public health phenomenon associated with a variety of socio-ecological determinants. An integrated approach is needed to address the root causes of malnutrition in all its forms, and at all life stages.

scholarly journals Trends of under- and overweight among rural and urban poor women indicate the double burden of malnutrition in Bangladesh

2007 ◽  
Vol 36 (2) ◽  
pp. 449-457 ◽  
Author(s):  
Sohana Shafique ◽  
Nasima Akhter ◽  
Gudrun Stallkamp ◽  
Saskia de Pee ◽  
Dora Panagides ◽  
...  
Keyword(s):  
Urban Poor ◽  
Double Burden ◽  
Rural And Urban ◽  
Poor Women ◽  
Double Burden Of Malnutrition

scholarly journals Rural and Urban Differences in Household Food Insecurity and Diet Diversity of Preschool Children (PSC) in Occidental Mindoro

2020 ◽  
Vol 54 (5) ◽  
Author(s):  
Kim Leonard G. Dela Luna ◽  
Ernani R. Bullecer
Keyword(s):  
Food Security ◽  
Preschool Children ◽  
Rural Communities ◽  
Food Insecurity ◽  
Urban Communities ◽  
Dietary Diversity ◽  
Household Food Security ◽  
Household Food Insecurity ◽  
Household Food ◽  
Rural And Urban

Objective. Rural and urban differences affect food availability, accessibility, and sustainability; thus, it has a greatimpact on household food security and dietary diversity. The relationship between the human environment andother factors threatens different domains of food systems resulting in food security. The objective of this study isto determine significant differences between the prevalence of household food security and diet diversity betweenurban and rural communities in Occidental Mindoro. Specifically, to determine the pattern of usual food intake ofpreschool children between rural and urban communities Methods. This study utilized a comparative, cross-sectional, analytic study design in order to determine theprevalence of each variable of interest in the two study areas. Radimer-Cornell Tool was utilized to assess the foodsecurity status of the household while the FAO-Dietary Diversity Score Questionnaire was used to the diversityof diet among PSC. A total of 480 (rural: n=240; urban: n=240) preschool children were recruited to participatein this study. Ratio and proportion using the point and interval estimate were used to determine the prevalencein different areas, meanwhile, chi-square of homogeneity was used to determine significant difference in the twoareas under study. Results. Food insecurity in rural communities was found to be at 56.25% (95% CI: 49.97% to 62.53%) while theprevalence in urban communities was 45.83% (95% CI: 39.53% to 52.14%). There was a significant differencein the prevalence of household food insecurity between rural and urban communities (p=0.0224). Meanwhile,the prevalence of less dietary diversity among preschool children in rural communities was 37.08% (95%: 30.97%to 43.19%) and 26.25% (CI: 20.68% to 31.82%) for urban communities. There was a significant differencein prevalence of low dietary diversity score among preschool children between rural and urban communities(p=0.0107). Conclusion. There were significant differences in terms of household food insecurity and less diverse dietbetween two community settings. Higher prevalence in rural areas signifies that there is a need to prioritize thesevulnerable communities in terms of hunger mitigation and nutrition programs. A combination of milk-rice-meat-fishwas observed in the diet of preschool children for both communities however, higher prevalence of less dietarydiversity was detected among rural communities.

Using Trials of Improved Practices to identify practices to address the double burden of malnutrition among Rwandan children

2019 ◽  
Vol 22 (17) ◽  
pp. 3175-3186
Author(s):  
Pamela A Williams ◽  
Courtney H Schnefke ◽  
Valerie L Flax ◽  
Solange Nyirampeta ◽  
Heather Stobaugh ◽  
...  
Keyword(s):  
Dietary Diversity ◽  
Sub Saharan Africa ◽  
Overweight Child ◽  
Overweight Children ◽  
Structured Interviews ◽  
Urban District ◽  
Double Burden ◽  
Double Burden Of Malnutrition ◽  
Recommended Practices ◽  
Sub Saharan

AbstractObjective:Low- and middle-income countries (LMIC) are increasingly experiencing the double burden of malnutrition. Studies to identify ‘double-duty’ actions that address both undernutrition and overweight in sub-Saharan Africa are needed. We aimed to identify acceptable behaviours to achieve more optimal feeding and physical activity practices among both under- and overweight children in Rwanda, a sub-Saharan LMIC with one of the largest recent increases in child overweight.Design:We used the Trials of Improved Practices (TIPs) method. During three household visits over 1·5 weeks, we used structured interviews and unstructured observations to collect data on infant and young child feeding practices and caregivers’ experiences with testing recommended practices.Setting:An urban district and a rural district in Rwanda.Participants:Caregivers with an under- or overweight child from 6 to 59 months of age (n 136).Results:We identified twenty-five specific recommended practices that caregivers of both under- and overweight children agreed to try. The most frequently recommended practices were related to dietary diversity, food quantity, and hygiene and food handling. The most commonly cited reason for trying a new practice was its benefits to the child’s health and growth. Financial constraints and limited food availability were common barriers. Nearly all caregivers said they were willing to continue the practices and recommend them to others.Conclusions:These practices show potential for addressing the double burden as part of a broader intervention. Still, further research is needed to determine whether caregivers can maintain the behaviours and their direct impact on both under- and overweight.

scholarly journals Double Burden of Malnutrition: The Role of Framing in Development of Political Priority in the Context of Rising Diet-related Non-communicable Diseases in Tamil Nadu, India (P22-005-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Shilpa Constantinides ◽  
Christine Blake ◽  
Edward Frongillo ◽  
Rasmi Avula ◽  
Anne-Marie Thow
Keyword(s):  
Tamil Nadu ◽  
Dietary Diversity ◽  
Communicable Disease ◽  
State Level ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Double Burden ◽  
Key Informants ◽  
Policy Actors ◽  
Double Burden Of Malnutrition

Abstract Objectives In low- and middle-income countries, non-communicable disease (NCD) prevalence is increasing while undernutrition persists, resulting in a double-burden of malnutrition. How policy actors frame malnutrition may shape policy, programming, and investment. In India, where NCDs are rising rapidly and undernutrition persists throughout the country, much of food and health policy is decentralized, but little is known of how the double burden of malnutrition is understood at the state level. This study aimed to identify and compare frames and priorities for nutrition used by relevant policy actors to help understand the narrative emerging around policy solutions for the double burden of malnutrition. Methods Key informants in the health, nutrition, and agriculture fields were identified from policy documents and purposive and snowball sampling. In-depth, semi-structured interviews were held with 28 key informants including international policy advocates, government officials, and state-level implementers in Tamil Nadu. Interviews were audio-recorded, transcribed, and coded with Nvivo 12. Major themes were identified using elements from prior published work: actor power, internal frame, issue characteristics, evaluative dimensions of target populations, priorities emphasized, and potential effects of the frame or likely policy result. Results Different actors reported differing priorities for the double burden of malnutrition. There was almost universal concern about stunting and anemia in children and women and consensus on sanitation and dietary diversity as causes of undernutrition, but a lack of clarity regarding diet-related NCDs. Respondents were unclear about which populations to target for the double burden, compared to clear targeting of women and children to address undernutrition. They described lack of convergence or clear roles for actors addressing the double burden, unlike for undernutrition. Conclusions There is a lack of consensus on the causes, manifestation, and solutions for the double burden of malnutrition within the policy community. Creating a shared narrative is critical for cohesive and efficient programming to address the double burden of malnutrition. Funding Sources Bill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute.

scholarly journals Determinants of the Double Burden of Malnutrition at the Community Level in Bangladesh (P10-084-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Qumrun Islam ◽  
Masum Ali ◽  
Md Alam ◽  
Jillian Waid
Keyword(s):  
European Union ◽  
Logistic Regression ◽  
International Development ◽  
Dietary Diversity ◽  
Community Level ◽  
The European Union ◽  
Double Burden ◽  
Double Burden Of Malnutrition ◽  
The Uk ◽  
Household Dietary Diversity

Abstract Objectives We use a community-level analysis to better understand the determinates of the nutrition transition in Bangladesh. Methods We utilize data from the nationally representative Food Security and Nutrition Surveillance Project collected in 13 rounds (2011–2015) in 4413 communities. Definitions of women's overweight/obesity were BMI >23.0 and child undernutrition was height for age z-score <-2 standard deviations from the mean. Communities were divided into four categories: healthy (stunting <30%, overweight <30%), modern (stunting <30%, overweight ≥30%), undernourished (stunting ≥30%, overweight <30%), and double burden (stunting ≥30%, overweight ≥30%). Logistic regression analysis was used to determine which factors were associated with community adherence to each category. Results Over the period from 2011 to 2015, the proportion of women overweight increased from 30% to 40%, and the proportion of children stunted declined from 40% to 35%. There was a large reduction of the proportion of the population living in undernourished communities (47% to 24%) and a sizable increase in the proportion of the population in modern communities (17% to 36%). The proportion of the population in communities with a double burden of malnutrition increased from 24% to 30%. In multivariable logistic regression models, only wealth, household diets, and division of residence were significant determinants across community nutritional categorization. Healthy communities were characterized by fewer households in the wealthiest quintile and data collection prior to 2015. The odds of a community having a modern nutritional structure increased with the wealth of the area and increasing household dietary diversity. The odds of a community having an undernourished nutritional structure decreased with increasing wealth. A higher proportion of the population in the lowest wealth quintile and household dietary diversity was negatively associated with communities with a double burden of malnutrition. Conclusions Results indicate that the double burden of malnutrition is not associated with urban residence, pointing to a need for programs in rural as well as urban areas. In addition, the rapid increase in the population living in modern communities points to a need to increase behavior change communication around what is needed for a healthy adult diet. Funding Sources This publication has been produced with the assistance of the European Union and the UK Department for International Development. The contents of this publication are the sole responsibility of its authors and do not necessarily reflect the views of the European Union or the UK Department for International Development. Supporting Tables, Images and/or Graphs

The Double Burden of Malnutrition in East Asia and the Pacific

10.1596/26102 ◽  
2016 ◽  
Author(s):  
Roger Shrimpton ◽  
Nkosinathi Vusizihlobo Mbuya ◽  
Anne Marie Provo
Keyword(s):  
East Asia ◽  
Double Burden ◽  
The Pacific ◽  
Double Burden Of Malnutrition

Safety of medical activities as an integrated problem

2019 ◽  
Vol 2019 (6) ◽  
pp. 30-35
Author(s):  
Алан Карсанов ◽  
Alan Karsanov ◽  
Наталья Полунина ◽  
Natal'ya Polunina
Keyword(s):  
Integrated Approach ◽  
Complex Problem ◽  
Healthcare Organization ◽  
Structural Components ◽  
Medical Activity ◽  
Staff Motivation ◽  
Medical Technologies ◽  
Systemic Nature ◽  
Clinical Risks

The combined nature of the factors that threaten the patient and the complex subordination of many clinical risks are the basis of the authors' perception of the safety of medical activity (SMA) as a complex problem, the solution of which should be sought in improving managerial measures of a systemic nature. As structural components of an integrated approach to providing SMA, measures should be implemented aimed at increasing staff motivation, at increasing the level of medical communications, at introducing modern diagnostic and medical technologies, at improving the control and administrative component based on the industrial model of healthcare organization.

scholarly journals Smoking status and second-hand smoke biomarkers in COPD, asthma and healthy controls

2020 ◽  
Vol 6 (2) ◽  
pp. 00192-2019 ◽  
Author(s):  
Matteo Bradicich ◽  
Macé M. Schuurmans
Keyword(s):  
Sensitivity And Specificity ◽  
Smoking Status ◽  
Final Analysis ◽  
Integrated Approach ◽  
Second Hand Smoke ◽  
Healthy Controls ◽  
Tobacco Exposure ◽  
Urinary Cotinine ◽  
Pubmed Database ◽  
Shs Exposure

IntroductionTobacco smoke worsens COPD and asthma. For healthy individuals, quantifying active and second-hand smoke (SHS) exposure clarifies the epidemiology of tobacco consumption and the efficacy of nonsmoking measures. Identifying tobacco exposure biomarkers and cut-offs might allow the creation of sensitive and specific tests.AimWe describe the state-of-the-art serum, urinary cotinine and exhaled carbon monoxide (CO) cut-offs for assessing smoking status and SHS exposure in adult patients with COPD or asthma, and healthy controls.MethodologyAfter a keyword research in the PubMed database, we included papers reporting on the cut-offs of the investigated biomarkers in one of the populations of interest. Papers published before 2000, not in English, or reporting only data on nonadult subjects or on pregnant women were excluded from the analysis. 14 papers were included in the final analysis. We summarised diagnostic cut-offs for smoking status or SHS exposure in COPD, asthmatic and healthy control cohorts, reporting sensitivity and specificity when available.ConclusionSerum and urinary cotinine and exhaled CO are easy-to-standardise, affordable and objective tests for assessing smoking status and SHS exposure. Evidence on cut-offs with good sensitivity and specificity values is available mainly for healthy controls. For COPD and asthmatic patients, most of the currently available evidence focuses on exhaled CO, while studies on the use of cotinine with definite sensitivity and specificity values are still missing. Solid evidence on SHS exposure is available only for healthy controls. An integrated approach with a combination of these markers still needs evaluation.

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