The Co-Occurrence of Overweight and Micronutrient Deficiencies or Anemia among Women of Reproductive Age in Malawi

被引:16
作者
Rhodes, Elizabeth C. [1 ]
Suchdev, Parminder S. [1 ,2 ,3 ,4 ]
Narayan, K. M. Venkat [1 ,2 ]
Cunningham, Solveig [1 ,2 ]
Weber, Mary Beth [1 ,2 ]
Tripp, Katie [3 ]
Mapango, Carine [5 ]
Ramakrishnan, Usha [1 ,2 ]
Hennink, Monique [2 ]
Williams, Anne M. [1 ,3 ]
机构
[1] Emory Univ, Laney Grad Sch, Nutr & Hlth Sci Program, Atlanta, GA 30322 USA
[2] Emory Univ, Rollins Sch Publ Hlth, Hubert Dept Global Hlth, Atlanta, GA 30322 USA
[3] CDC, Div Nutr Phys Act & Obes, Atlanta, GA 30333 USA
[4] Emory Univ, Dept Pediat, Atlanta, GA 30322 USA
[5] CDC, Div Lab Sci, Atlanta, GA 30333 USA
关键词
double burden; malnutrition; overweight; obesity; anemia; micronutrient deficiency; women; Africa; Malawi; BIOMARKERS REFLECTING INFLAMMATION; MIDDLE-INCOME COUNTRIES; EXCESS BODY-WEIGHT; DOUBLE BURDEN; NUTRITIONAL DETERMINANTS; UNDERNUTRITION; MALNUTRITION; PREVALENCE; URBANICITY; TRANSITION;
D O I
10.1093/jn/nxaa076
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: In low-resource settings, urbanization may contribute to the individual-level double burden of malnutrition (DBM), whereby under- and overnutrition co-occur within the same individuals. Objective: We described DBM prevalence among Malawian women by urban-rural residence, examined whether urban residence was associated with DBM, and assessed whether DBM prevalence was greater than the prevalence expected by chance given population levels of under- and overnutrition, which would suggest DBM is a distinct phenomenon associated with specific factors. Methods: We analyzed nationally representative data of 723 nonpregnant women aged 15-49 y from the 2015-2016 Malawi Micronutrient Survey. DBM was defined as co-occurring overweight or obesity (OWOB) and >= 1 micronutrient deficiency or anemia. We used Poisson regression models to examine the association between urban residence and DBM and its components. The Rao-Scott modified chi-square test compared the observed and expected DBM prevalence. Results: Nationally, 10.8% (95% CI: 70, 14.5) of women had co-occurring OWOB and any micronutrient deficiency and 3.4% (95% CI: 1.3, 5.5) had co-occurring OWOB and anemia. The prevalence of co-occurring OWOB and any micronutrient deficiency was 2 times higher among urban women than rural women [urban 32.6 (24.1, 41.2) compared with rural 8.6 (5.2, 11.9), adjusted prevalence ratio: 2.0 (1.1, 3.5)]. Co-occurring OWOB and anemia prevalence did not significantly differ by residence [urban 6.9 (0.6, 13.2) compared with rural 3.0 (0.8, 5.3)]. There were no statistically significant differences in observed and expected prevalence estimates of DBM. Conclusions: This analysis shows that co-occurring OWOB and any micronutrient deficiency was higher among women in urban Malawi compared with rural areas. However, our finding that co-occurring OWOB and any micronutrient deficiency or anemia may be due to chance suggests that there may not be common causes driving DBM in Malawian women. Thus, there may not be a need to design and target interventions specifically for women with DBM.
引用
收藏
页码:1554 / 1565
页数:12
相关论文
共 62 条
[1]   Chronic diseases 1 - The burden and costs of chronic diseases in low-income and middle-income countries [J].
Abegunde, Dele O. ;
Mathers, Colin D. ;
Adam, Taghreed ;
Ortegon, Monica ;
Strong, Kathleen .
LANCET, 2007, 370 (9603) :1929-1938
[2]   Diet and mortality rates in Sub-Saharan Africa: Stages in the nutrition transition [J].
Abrahams, Zulfa ;
Mchiza, Zandile ;
Steyn, Nelia P. .
BMC PUBLIC HEALTH, 2011, 11
[3]   Prevalence and time trends in overweight and obesity among urban women: an analysis of demographic and health surveys data from 24 African countries, 1991-2014 [J].
Amugsi, Dickson Abanimi ;
Dimbuene, Zacharie T. ;
Mberu, Blessing ;
Muthuri, Stella ;
Ezeh, Alex C. .
BMJ OPEN, 2017, 7 (10)
[4]  
[Anonymous], 2015, Serum and red blood cell folate concentrations for assessing folate status in populations. Vitamin and Mineral Nutrition Information System
[5]  
[Anonymous], 2011, Vitamin and Mineral Nutrition Information System
[6]  
[Anonymous], 2011, Serum retinol concentrations for determining the prevalence of vitamin A deficiency in populations
[7]  
[Anonymous], 2017, Policy Brief, V21, P402, DOI [10.1111/j.17456584.1983.tb00740.x, DOI 10.1111/J.17456584.1983.TB00740.X]
[8]   Diabetes in sub-Saharan Africa: from clinical care to health policy [J].
Atun, Rifat ;
Davies, Justine I. ;
Gale, Edwin A. M. ;
Barnighausen, Till ;
Beran, David ;
Kengne, Andre Pascal ;
Levitt, Naomi S. ;
Mangugu, Florence W. ;
Nyirenda, Moffat J. ;
Ogle, Graham D. ;
Ramaiya, Kaushik ;
Sewankambo, Nelson K. ;
Sobngwi, Eugene ;
Tesfaye, Solomon ;
Yudkin, John S. ;
Basu, Sanjay ;
Bommer, Christian ;
Heesemann, Esther ;
Manne-Goehler, Jennifer ;
Postolovska, Iryna ;
Sagalova, Vera ;
Vollmer, Sebastian ;
Abbas, Zulfiqarali G. ;
Ammon, Benjamin ;
Angamo, Mulugeta Terekegn ;
Annamreddi, Akhila ;
Awasthi, Ananya ;
Besancon, Stephane ;
Bhadriraju, Sudhamayi ;
Binagwaho, Agnes ;
Burgess, Philip I. ;
Burton, Matthew J. ;
Chai, Jeanne ;
Chilunga, Felix P. ;
Chipendo, Portia ;
Conn, Anna ;
Joel, Dipesalema R. ;
Eagan, Arielle W. ;
Gishoma, Crispin ;
Ho, Julius ;
Jong, Simcha ;
Kakarmath, Sujay S. ;
Khan, Yasmin ;
Kharel, Ramu ;
Kyle, Michael A. ;
Lee, Seitetz C. ;
Lichtman, Amos ;
Malm, Carl P. ;
Mbaye, Maimouna N. ;
Muhimpundu, Marie A. .
LANCET DIABETES & ENDOCRINOLOGY, 2017, 5 (08) :622-667
[9]   Micronutrient Adequacy of Women's Diet in Urban Burkina Faso Is Low [J].
Becquey, Elodie ;
Martin-Prevel, Yves .
JOURNAL OF NUTRITION, 2010, 140 (11) :2079S-2085S
[10]  
Black RE, 2008, LANCET, V371, P243, DOI [10.1016/S0140-6736(07)61690-0, 10.1016/S0140-6736(13)60937-X]