Double burden of malnutrition among women of reproductive age in 55 low- and middle-income countries: progress achieved and opportunities for meeting the global target

Hasan, Md. Mehedi; Ahmed, Saifuddin; Magalhães, Ricardo J. Soares; Fatima, Yaqoot; Biswas, Tuhin; Mamun, Abdullah

doi:10.1038/s41430-021-00945-y

Cited by 19 publications

(19 citation statements)

References 40 publications

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“…Prevalence of malnutrition among women in India follows trends similar to other low- to middle-income countries (LMIC) where the prevalence of underweight has declined considerably among women over the span of 10 years [ 56 , 57 ], Though the burden of acute undernutrition is concentrated among the women belonging to poor households. But a positive change is that the inequality between the rich and poor quintile has reduced with respect to acute undernutrition between 2005 and 06 and 2015–16.…”

Section: Discussionmentioning

confidence: 88%

Wealth related inequality in women and children malnutrition in the state of Chhattisgarh and Tamil Nadu

2022

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Background Child and maternal malnutrition are the most serious health risks in India, accounting for 15% of the country’s total disease burden. Malnutrition in children can manifest as ‘stunting’ (low height in relation to age) or ‘wasting’ (low weight in relation to height) or both and underweight or obesity among women. Other nutritional indicators show that India lags behind, with high levels of anaemia in women of reproductive age. The study aims to analyse the wealth related inequalities in the nutrition status among women and children of different wealth quintiles in a high focus state (Chhattisgarh; CG) and a non-high focus state (Tamil Nadu; TN) in India. Methods We used National Family Health Survey-3rd (2005–06) & 4th (2015–16) to study the trends and differentials of inequalities in the nutrition status. We have used two summary indices. - absolute inequalities using the slope index of inequality (SII), and relative inequalities using the concentration index (CIX). Results There is reduction in wealth related inequality in nutrition status of women and children from all wealth quintiles between 2005–06 and 2015–16. However the reduction in inequality in some cases such as that of severe stunting among children was accompanied by increase among children from better off households The values of SII and CIX imply that malnutrition except obesity is still concentrated among the poor. The prevalence of anaemia (mild, moderate and severe) has reduced among women and children in the past decade. The converging pattern observed with respect to prevalence of mild and moderate anaemia is not only due to reduction in prevalence of anaemia among women from poor households but an increase in prevalence in rich households. Conclusion Malnutrition remains a major challenge in India, despite encouraging progress in maternal and nutrition outcomes over the last decade. Our study findings indicate the importance of looking at the change in inequalities of nutrition status of women and children of different wealth quintiles sub nationally. Given the country’s rapidly changing malnutrition profile, with progress across several indicators of under nutrition but rapidly rising rates of overweight/obesity, particularly among adults, appropriate strategies needs to be devised to tackle the double burden of malnutrition.

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Section: Discussionmentioning

confidence: 88%

Wealth related inequality in women and children malnutrition in the state of Chhattisgarh and Tamil Nadu

2022

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“…Among women aged 18–44 years, the prevalence of overweight and obesity in 2019 reached 60%, of which 30% were overweight and 30% were obese [ 61 ]. Compared to earlier national surveys, the rates of overweight and obesity showed a fluctuating trend [ 36 , 39 , 40 , 61 ], with rates predicted to reach 75% in 2030 [ 66 ].…”

Section: Resultsmentioning

confidence: 96%

Review of the Nutrition Situation in Jordan: Trends and Way Forward

et al. 2021

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Jordan is witnessing an escalating pace of nutrition transition, which may be associated with an increased burden of malnutrition and related non-communicable diseases. This review analyzes the nutrition situation in Jordan by exploring specific nutrition indicators, namely infant and young child feeding, low birthweight, micronutrient deficiencies, anthropometric indicators, and food consumption patterns. Results showed that although most children were ever breastfed and early initiation of breastfeeding had a two-fold increasing trend, rates of exclusive breastfeeding below 6 months of age and continued breastfeeding until two years of age were low. Complementary feeding indicators, particularly minimum diet diversity and minimum acceptable diet standards, were suboptimal. An overall low burden of stunting, wasting, and underweight among children under 5 years and remarkable progress in optimizing iodine status among school-aged children were reported. Conversely, the burden of low birthweight and overweight/obesity exacerbated, coexisting with anemia, vitamin A deficiency, and vitamin D deficiency. Overall, fruit and vegetable consumption were inadequate. The consumption of soft drinks and salt on the other hand was higher than recommended. This review acknowledges the double burden of malnutrition in Jordan and recommends the prioritization and evaluation of interventions towards improving the population’s nutritional status and achieving nutrition targets.

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“…[20]. A study assessing the predicted burden of over-and underweight among WRA in several low-and middle-income countries, including India, highlighted that burden of DFM is becoming more and more prominent due to the rapid increase of overweight, especially in WRA belonging to the poorest wealth quintiles [21].…”

Section: Discussionmentioning

confidence: 99%

Nutritional Status and Intra-household Food Distribution Among Reproductive-Age-Group Women in a Slum Area of Hooghly District, West Bengal: A Mixed-Methods Approach

Chattopadhyay¹,

Paul²,

Bandyopadhyay³

et al. 2022

Cureus

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IntroductionMalnutrition among women of reproductive age (WRA), especially those living in slum areas, is one of the most concerning nutritional issues because of the extreme nutritional stress they face in the form of inequitable intra-household food distribution (IHFD). This study aimed to assess the nutritional status (NS) and its association with IHFD among reproductive-age-group women along with exploring the perspectives of the stakeholders regarding inequitable food distribution. Materials and methodsThe quantitative part of the convergent parallel mixed-methods design study was conducted among 150 WRA, selected by cluster random sampling from 15 slum areas of Hooghly District, between December 2020 and May 2021. Data were collected using a predesigned pretested schedule with anthropometric measurements. IHFD was quantified by the relative dietary energy adequacy ratio (RDEAR). Ordinal logistic regression was performed to obtain adjusted-proportional odds ratios (aPOR) for higher categories of NS (underweight: reference category). Stratified subgroup analysis was done to assess the influencers of IHFD. For the qualitative part, in-depth interviews were conducted with eight purposively selected in-laws of study participants, and the data were interpreted by thematic analysis. ResultsThe mean age of the study participants was 28.6±6.3 years. The proportion of malnutrition and inequitable IHFD (RDEAR<1) among them was 50% and 46%, respectively. Higher categories of NS were found to be significantly associated with an increase in RDEAR (aPOR=22.6, 95% CI: 2.75-185.45, p-value=0.004). Among underweight and normal NS women, those who were earning members and directly involved in food preparation/production had a greater allocation of food within their households. Physiological intolerance, incapacity of earning, and traditional customs were the most recurring themes transcribed as the barriers to equitable food distribution. ConclusionA high magnitude of malnutrition and its association with inequitable IHFD among WRA warrant policylevel support to increase women's employment opportunities and address gender-based inequities through comprehensive information education communication (IEC) techniques as well.

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Double burden of malnutrition among women of reproductive age in 55 low- and middle-income countries: progress achieved and opportunities for meeting the global target

Cited by 19 publications

References 40 publications

Wealth related inequality in women and children malnutrition in the state of Chhattisgarh and Tamil Nadu

Wealth related inequality in women and children malnutrition in the state of Chhattisgarh and Tamil Nadu

Review of the Nutrition Situation in Jordan: Trends and Way Forward

Nutritional Status and Intra-household Food Distribution Among Reproductive-Age-Group Women in a Slum Area of Hooghly District, West Bengal: A Mixed-Methods Approach

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