Double burden of maternal and child malnutrition and socioeconomic status in urban Sri Lanka

Abstract

Child malnutrition and maternal obesity are serious public health issues in Sri Lanka. This study explores the associations between socioeconomic status and the double burden of malnutrition among school-aged children and within their household. A total of 543 primary school children aged 5–10 years (204 boys and 339 girls) in Gampaha District, Sri Lanka, were included in the analysis. The nutritional statuses of thinness, normal, overweight, and obesity for children and mothers were defined according to WHO growth references and body mass index. Maternal education, household equivalent income, and maternal employment were used as socioeconomic status indicators. The proportion of child thinness and overweight was 19.3% and 13.4%, respectively, and that of maternal overweight (body mass index ≥ 25 kg/m2) was 36.5%. A positive correlation was found between maternal body mass index and the child’s body mass index for age z-score in older boys and younger girls. A multivariate stepwise logistic regression analysis showed that lower education of mothers posed a higher association with child thinness (adjusted odds ratio = 2.33, 95% confidence interval: 1.08–5.00). Mothers with overweight and obesity were less likely to have a child with thinness (adjusted odds ratio = 0.30, 95% confidence interval: 0.16–0.58). Maternal employment status and household equivalent income were not significantly, but marginally, associated with child overweight and obesity. Socioeconomic inequality combined with maternal nutritional status affected child malnutrition. These findings suggest that the underlying circumstances within households should be considered to improve child malnutrition.

Nutritional status of school children living in Northern part of Sri Lanka

“…A study done in the Colombo district shows a prevalence of obesity in boys was 4.3% and 3.1% in girls while our study indicated 8.7% in boys and 4.1% in girls [6]. The difference even years apart may be explained by the economic status of the populations.…”

“…Our study done in a single district in the North shows stunting in 10.9% of boys and 11.8% of girls. A similar study done in Colombo district showed stunting in 5.1% of boys and 5.2% of girls [6]. Low prevalence of stunting in two districts may be in uenced by the demography where both these districts are urban, and the economic status and educational level of the population is higher.…”

“…This pandemic is penetrating the poorest nations in the world mainly among the urban middle-aged adults and younger age groups [3]. Childhood obesity is also increasing in Sri Lanka with 14-15% prevalence of overweight and obesity among 8-12year-old school children within the Colombo Municipal area and the world bank report in 2016 estimates that 2% of the under ve-year-old children to be affected [5,6].…”

Use of Mid-Upper Arm Circumference (MUAC) to Predict Malnutrition among Sri Lankan Schoolchildren

“…Students were selected from the index number of the attendance register using a random number table. Details of the sampling procedure have been described elsewhere [2]. In our analysis, we included 538 of 555 students who participated in the study, after excluding 17 students: 9 students whose age was not within the 5-10 years age group, and 8 students who had outlying or missing data for the main variables.…”

“…Child malnutrition is a serious public health concern worldwide [1]. In urban Sri Lanka, approximately one in three primary-school children suffer the double burden of malnutrition (thinness or overweight/obesity), defined by the World Health Organization (WHO) Child Growth Standards as body mass index (BMI)-for-age z-score (BAZ) that is <−2 standard deviation (SD) and >1 SD, respectively [2]. Stunting (low height-for-age) is also recognized as a critical indicator of chronic undernutrition in assessing child growth and development, and the proportion of stunting among children aged 5-6 years old is estimated at 8.7% in Sri Lanka [3].…”