Temporal trends in the nutritional status of women and children under five years of age in sub-Saharan African countries: ecological study

Abstract

INTRODUCTION Obesity, a complex condition that affects all ages and socioeconomic groups, has become one of the world's most challenging public health problems. Because it has been raising the prevalence of noncommunicable diseases in low and middle-income countries that are still burdened with infections and nutritional deficiencies, it has helped to create a "double burden" of disease that threatens to overwhelm healthcare services. 1-3 Its prevalence is increasing rapidly worldwide, and this trend is believed to be related to dietary excess, physical inactivity 4 and increasing urbanization. 5 Childhood overweight has also been increasing at an alarming rate. This is defined in accordance with the World Health Organization child growth standards as a weight-for-height z-score ≥ 2 standard deviations above the median of the reference population. 6 Its worldwide prevalence increased from 4.2% (95% confidence interval, CI, 3.2%-5.2%) in 1990 to 7.8% (95% CI, 6.4%-9.1%) in 2015. This trend is expected to reach 9.1% (95% CI, 7.3%-10.9%) in 2020. 7 Currently, at least 41 million children under five years of age are obese or overweight, and the greatest rise is being seen in low and middle-income countries. 7 In Africa, the number of overweight children rose from 5 million in 1990 to 10 million in 2014. 8 While tackling obesity is a current public health priority in most of the world, in sub-Saharan Africa the issue has received less attention, especially within the context of maternal and child health. In this region, the main nutritional concern continues to be undernutrition, particularly among children. Most data available on the nutritional situation in sub-Saharan African countries are derived from standardized national surveys. However, to our knowledge, no studies focusing on sub-Saharan

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

“…Globally in 2017, an estimated 38.3 million (5.6%) children under 5 were overweight and 50.5 million (7.5%) were wasted 15 (48%) of overweight children lived in LMICs, with Africa and Asia accounting for the largest shares of the global burden (25% and 46% of overweight and 27% and 69% of wasted children, respectively) 16 . Direct comparisons of population-level trends of childhood overweight and wasting generally provide regional-or country-level estimates 5,[16][17][18][19][20] , potentially masking important subnational differences. Previously, we mapped 2000-2017 prevalence and trends in wasting, stunting and underweight among children under 5 across LMICs 21 using Bayesian model-based geostatistical techniques 22 .…”

Trends and inequalities in the nutritional status of adolescent girls and adult women in sub-Saharan Africa since 2000: a cross-sectional series study

“…5 Similarly, another study estimated a six PP rise in obesity among women aged 15-49 years in SSA, using survey data from 1993 to 2014. 27 Associations between socioeconomic status and obesity among women have been previously reported, suggesting that obesity is more prevalent among the richer households in SSA, although the results by education levels remain inconsistent. 15 Rapid rises in overweight and obesity have been observed in LMIC in response to changes in food systems, lifestyles, physical activity urbanisation, migration and countries' economic development, 8 28 29 leading to an increased consumption of energy dense foods and reduced physical activity.…”

“… 5 Similarly, another study estimated a six PP rise in obesity among women aged 15–49 years in SSA, using survey data from 1993 to 2014. 27 Associations between socioeconomic status and obesity among women have been previously reported, suggesting that obesity is more prevalent among the richer households in SSA, although the results by education levels remain inconsistent. 1 5 …”

Transitions to adulthood and the changing body mass index of adolescent girls in Zambia

“…Understanding how transitions to adulthood are related to young women's nutritional status is highly relevant in this region as the burdens of under‐ and overnutrition are increasingly coexisting, and obesity is a health concern particularly affecting women . Evidence from our paper identified characteristics among AGYW that would be useful for targeted nutritional interventions and social behavior change programming, including girls leaving school (at risk for being overweight/obese), recently married, and young women undergoing a marital separation (higher risk of undernutrition), and young mothers and their children (at higher risk of undernutrition).…”