The Double Burden of Malnutrition at the Individual Level Among Adults: A Nationwide Survey in the Philippines

Abstract

Introduction: Double burden of malnutrition (DBM) is a fast-evolving public health challenge. The rising prevalence of obesity and diet-related non-communicable diseases alongside persistent nutritional deficiencies are compelling problems in many developing countries. However, there is limited evidence on the coexistence of these conditions in the same individual among community-dwelling adults. This cross-sectional study describes the various forms of DBM and examines the determinants of DBM at the individual level among adults in the Philippines.Materials and Methods: A nationwide dataset from the 2013 Philippine National Nutrition Survey was used. The final study sample consisted of 17,157 adults (8,596 men and 8,561 non-pregnant and non-lactating women). This study focused on three DBM types within adults: (#1) Underweight and at least one cardiometabolic risk factor (Uw + ≥1 CMRF), (#2) Anemia and at least one cardiometabolic risk factor (An + ≥1 CMRF), (#3) Vitamin A deficiency or iodine insufficiency and at least one cardiometabolic risk factor (Other MND + ≥1 CMRF). The total double burden of malnutrition was also evaluated as the sum of the aforementioned three types. Logistic regression models were used to assess associations between socio-demographic and lifestyle factors and DBM.Results: The prevalence of the three types of DBM were: type #1, 8.1%; type #2, 5.6%; type #3, 20.6%, and the total DBM prevalence was 29.4%. Sex, age, educational attainment, employment status, wealth quintile, and alcohol drinking were the risk factors for DBM. In contrast, marital status, smoking, and physical activity were associated with the different DBM types.Conclusion: The study findings contribute to the current state of knowledge on the broad spectrum of individual-level DBM. Understanding the disparities of this phenomenon could guide integrated actions directed to the concomitance of malnutrition in various forms and cardiometabolic disease risks.

Exploring the double burden of malnutrition at the household level in the Philippines: Analysis of National Nutrition Survey data

“…Studies of the DBM most frequently report on the coexistence of undernutrition and overnutrition at the population level [ 8 ]. DBM research in the Philippines is similarly population-level focused, with some recent work assessing individual-level DBM [ 9 , 10 ]. However, household-level manifestations of the DBM have not been widely studied in the Philippines.…”

Sexual dimorphism in selenium deficiency is associated with metabolic syndrome and prevalence of heart disease

“…Compared to females, males associated with an increased BMI and proportion of diabetes with higher selenium levels encountered in people with overweight, which in turn may lead to chronic inflammation, impaired immune reponses, and higher risk of (cardiovascular) comorbidity [36,37]. Sex differences in the incidence and presentation of the double burden of malnutrition have been increasingly described, affecting females in particular [10,[38][39][40]. In line with this, the current study showed robust interactions between females and lower selenium levels with increased BMI in two separate populations.…”

UsingFIGONutrition Checklist counselling in pregnancy: A review to support healthcare professionals

“…In many countries, there is a double or triple burden of malnutrition, characterized by concurrent high rates of overnutrition, undernutrition, and micronutrient deficiencies in the population, along with associated cardiometabolic or other health complications 6,7 . This burden is seen at an individual level where people with obesity or overweight may also have nutritional deficiencies such as iron and iodine 8 . This challenge is also prevalent in maternal nutrition.…”

“…6,7 This burden is seen at an individual level where people with obesity or overweight may also have nutritional deficiencies such as iron and iodine. 8 This challenge is also prevalent in maternal nutrition.…”

“… 6 , 7 This burden is seen at an individual level where people with obesity or overweight may also have nutritional deficiencies such as iron and iodine. 8 This challenge is also prevalent in maternal nutrition. Most women do not consume diets in line with the national dietary guidelines before or during pregnancy, and there are high rates of low or late nutritional supplement use.…”