Recently, 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.
The results to this study demonstrate that daily PA was high among female subjects living in a NE with land use mix-diversity, and who had an awareness of places to walk to and the accessibility to facilities for daily necessities in their neighborhood. For male subjects, daily PA was high among those who perceived the aesthetics of and accessibility to facilities for pleasure in their neighborhood. Further research is needed to determine the association between PA and NE on the basis of sex differences.
Papua New Guinea (PNG) is a culturally, environmentally and ethnically diverse country of 7.3 million people experiencing rapid economic development and social change. Such development is typically associated with an increase in non-communicable disease (NCD) risk factors.AimTo establish the prevalence of NCD risk factors in three different regions across PNG in order to guide appropriate prevention and control measures.MethodsA cross-sectional survey was undertaken with randomly selected adults (15–65 years), stratified by age and sex recruited from the general population of integrated Health and Demographic Surveillance Sites in West Hiri (periurban), Asaro (rural highland) and Karkar Island (rural island), PNG. A modified WHO STEPS risk factor survey was administered along with anthropometric and biochemical measures on study participants.ResultsThe prevalence of NCD risk factors was markedly different across the three sites. For example, the prevalences of current alcohol consumption at 43% (95% CI 35 to 52), stress at 46% (95% CI 40 to 52), obesity at 22% (95% CI 18 to 28), hypertension at 22% (95% CI 17 to 28), elevated levels of cholesterol at 24% (95% CI 19 to 29) and haemoglobin A1c at 34% (95% CI 29 to 41) were highest in West Hiri relative to the rural areas. However, central obesity at 90% (95% CI 86 to 93) and prehypertension at 55% (95% CI 42 to 62) were most common in Asaro whereas prevalences of smoking, physical inactivity and low high-density lipoprotein-cholesterol levels at 52% (95% CI 45 to 59), 34% (95% CI 26 to 42) and 62% (95% CI 56 to 68), respectively, were highest in Karkar Island.ConclusionAdult residents in the three different communities are at high risk of developing NCDs, especially the West Hiri periurban population. There is an urgent need for appropriate multisectoral preventive interventions and improved health services. Improved monitoring and control of NCD risk factors is also needed in all regions across PNG.
The influence of urbanisation on physical activity and dietary changes was examined in a Papua New Guinea Highland population. Adult male and female subjects (n 56) were selected, including twenty-seven rural villagers and twenty-nine urban migrants. BMR was calculated from values measured in similar samples of Huli-speaking population, according to gender and body weight. Total daily energy expenditure (TEE) was assessed by 24 h heart rate (HR) monitoring (flex-HR method) and physical activity level (PAL) calculation was based on BMR. Energy, protein and fat intakes were measured by weighing food on a single day. Urban subjects were heavier and taller than their rural counterparts; significant differences were found in stature in men P , 0´05 and body weight in women P , 0´05X Urban subjects had longer sedentary periods HR # flex-HR) and shorter active periods HR . flex-HR) than rural subjects. Consequently, the former had lower TEE and PAL than the latter; significant differences were found in women (TEE, P , 0´05Y PAL, P , 0´01 but not in men. Total daily energy intake and TEE were well balanced (,7 %) in all groups, whereas protein and fat intakes were considerably higher in urban subjects than rural subjects. Reduced PAL and increased fat intake by urban dwellers may increase the risks of obesity and chronic degenerative diseases.
On 11th March 2011 a magnitude nine earthquake struck the Tohoku region of Japan. The earthquake resulted in a large tsunami and an accident at the Fukushima Nuclear Power Plant. Previous studies have suggested that demographic indices relating to reproduction and marriage change after such massive disasters (e.g. large earthquakes). The present study investigated whether the number of births, number of marriages and the secondary sex ratio (SSR) changed after the East Japan Earthquake. The monthly number of births (males and females, separately) and marriages in each prefecture in Japan from January 1997 to June 2012 were obtained from the Demographic Survey of Japan. An analysis was performed for three different geographic boundary units: the disaster-stricken area, the non-disaster-stricken area and the whole of Japan. In each unit, the numbers of births and marriages in a given month during the post-disaster period were predicted based on a regression equation estimated by the numbers of births and marriages in that month during the pre-disaster period. The numbers of observed monthly births and marriages during the post-disaster period were compared with the predicted figures. Differences between the observed and predicted numbers were determined by referring to the 95% confidence limits for the predicted mean number. The observed probability of a male birth in a given month during the post-disaster period was compared with a 95% confidence interval of a binominal distribution. In all three boundary units, the number of births was significantly lower than the predicted number by about 3-8% from nine months after the disaster, while the number of marriages in October 2011 was significantly lower than the predicted number by about 25-28%. In October 2011, the SSR in the whole of Japan had decreased from 104.8 (the predicted SSR) to 102.9. The number of births and marriages and the SSR decreased in Japan after the East Japan Earthquake irrespective of locality.
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