A systematic review of the prevalence and predictors of the double burden of malnutrition within households

Abstract

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.

Child‐level double burden of malnutrition in the MENA and LAC regions: Prevalence and social determinants

“…Much of the literature has described the household-level double burden of maternal overweight and childhood stunting (El Kishawi, Soo, Abed, & Muda, 2016;Garrett & Ruel, 2003;Kosaka & Umezaki, 2017). Factors associated with this double-burden include (a) urbanicity, with higher odds of double-burden in urban and peri-urban areas as compared with rural areas (Jones et al, 2016); (b) economic status (income and wealth), with some positive associations found between higher income and double burden although some studies show no association (Bassett, Romaguera, Giménez, Lobo, & Samman, 2014;Kosaka & Umezaki, 2017;Saibul et al, 2009); and (c) maternal or head of household education, where the associations are mixed (Kosaka & Umezaki, 2017). the coexistence of stunting and overweight in individual children (Bates, Gjonca, & Leone, 2017;Fernald & Neufeld, 2007;Mamabolo, Alberts, Steyn, Delemarre-van de Waal, & Levitt, 2005; Barry M Popkin, Richards, & Montiero, 1996;Said-Mohamed, Bernard, Ndzana, & Pasquet, 2012;Varela-Silva et al, 2012;Wang et al, 2009).…”

“…Household wealth and maternal education are well-documented key determinants of childhood nutritional status: both stunting and overweight (Black et al, 2013;Hong & Mishra, 2006;Keino, Plasqui, Ettyang, & van den Borne, 2014;Vollmer et al, 2014). Lower wealth and maternal education are both associated with higher prevalence of stunting, whereas the associations of these factors with childhood overweight are not consistent (Keino et al, 2014;Kosaka & Umezaki, 2017;Tzioumis, Kay, Bentley, & Adair, 2016). Differentials exist by level of economic development and stage of the nutrition transition; in low-income countries, most studies point to positive associations between household wealth and maternal education and childhood overweight, whereas in high-income countries, overweight appears to be more common in low socioeconomic and education groups, with mixed results in middle-income countries that have faced rapid changes in food environments and parallel increases in the prevalence of overweight (Martorell, Khan, Hughes, & Grummer-Strawn, 2000;Subramanian, Perkins, Ozaltin, & Davey Smith, 2011).…”

Water, food, and the dual burden of disease in Galápagos, Ecuador

“…Rapid economic development in low‐ and middle‐income countries (LMIC) has contributed to increasing rates of obesity and cardiometabolic disease in children and adults, as individuals are exposed to new high‐fat, energy‐dense diets, more sedentary lifestyles and differing disease exposures (Monteiro, Conde, & Popkin, ; Popkin, ; Popkin, Adair, & Ng, ). At the same time, decreases in undernutrition, assessed through the prevalence of stunting and/or micronutrient deficiencies, have not kept pace, particularly among poorer or more rural individuals (Kosaka & Umezaki, ). This co‐occurrence of overnutrition and cardiometabolic disease and undernutrition and infectious disease, termed the “dual burden,” has come to characterize LMIC settings (Perez‐Escamilla et al, ).…”

Nutritional status of Tajik children and women: Transition towards a double burden of malnutrition

“…As a consequence, noncommunicable diseases like cardiovascular diseases, diabetes, musculoskeletal disorder, and some cancers are increasing (Collins et al, ; Igel, Saunders, & Fins, ; Steele et al, ). This fast increase in overweight and obesity along with a slow decrease or stagnancy in undernutrition (wasting, stunting, and micronutrient deficiencies) experienced in many low‐ and middle‐income countries (Freire, Silva‐Jaramillo, Ramirez‐Luzuriaga, Belmont, & Waters, ; Haddad, Cameron, & Barnett, ; WHO, ) leads to the so‐called double burden of malnutrition (Kosaka & Umezaki, ). It can exist at various levels: At individual level, for example, as overweight along with nutritional deficiencies; at household level, with underweight or stunted children and overweight adults; or at population level, with the coexistence of undernutrition and overweight.…”

“…As a consequence, noncommunicable diseases like cardiovascular diseases, diabetes, musculoskeletal disorder, and some cancers are increasing (Collins et al, 2018;Igel, Saunders, & Fins, 2018;Steele et al, 2017). This fast increase in overweight and obesity along with a slow decrease or stagnancy in undernutrition (wasting, stunting, and micronutrient deficiencies) experienced in many low-and middle-income countries (Freire, Silva-Jaramillo, Ramirez-Luzuriaga, Belmont, & Waters, 2014;Haddad, Cameron, & Barnett, 2015;WHO, 2018a) leads to the socalled double burden of malnutrition (Kosaka & Umezaki, 2017) and United Nations Children's Fund [UNICEF], 2010;UNICEF, 2003). In 2009, an association between overweight/obesity and anaemia in children under 5 years was investigated, but no association could be confirmed, and with this, no intraindividual double burden of malnutrition (Crivelli et al, 2018) Tajikistan et al, 2013;2018).…”