Intra‐household double burden of overweight/obesity and anaemia: Evidence from 49 low‐and middle‐income countries

Abstract

Globally, overweight/obesity is rising rapidly while anaemia persists. Nevertheless, evidence on their coexistence at the household level remains limited. Using data from the Demographic and Health Surveys, we quantified the magnitude, distribution and inequalities (i.e., estimates by wealth, education level and residence) in the intrahousehold double burden (DBM) of overweight/obesity and anaemia among mothers and their children under-5 living in 49 low-and middle-income countries (LMICs). The pooled prevalence of total intrahousehold DBM was 17.2% (95% confidence interval [CI]: 15.6, 18.8); 16.2% (95% CI: 14.6, 17.9) for mothers with overweight/obesity and children with anaemia; and 2.8% (95% CI: 2.5, 3.1) for mothers with anaemia and children with overweight/obesity. South Africa had the highest prevalence of total DBM at the household level, affecting almost one in three households. Households with mothers with overweight/obesity and children with anaemia followed an inverse social gradient, with higher estimates found in the richest quintile, highest maternal education level and in urban areas; although with some variation across regions. The opposite was observed for mothers with anaemia and children with overweight/obesity. The largest inequality gaps were found for mothers with overweight/obesity and children with anaemia in Togo by household wealth (29.3% points; p < 0.001), in Ghana by maternal education level (28.0% points; p = 0.001) and in Niger by area of residence (25.2% points; p < 0.001). Although double-duty actions might help accelerate action towards reducing malnutrition in all its forms, a comprehensive assessment of the causes of anaemia is first warranted to design effective country-specific programmes.

Spatial distribution and associated factors of co-occurrence of overweight/obesity and Anemia among women in the reproductive age in sub-Saharan Africa: A multilevel analysis, DHS 2016–2021

“…This study indicated that reproductive women with a primary level of education were negatively associated with co-occurrence of OWOB and anemia compared to women with no education. Even though, there are some literatures [ 17 , 53 ], stated that women who attain a higher level of education were more likely to develop co-occurrence of overweight/obesity and anemia, our finding revealed that the odds of co-occurrence of OWOB and anemia among women with a primary level of education was lower by 14% than non-educated. This might be because reproductive women who are educated are expected to get more information from different sources about appropriate dietary intake and health care services regarding the co-occurrence of overweight/obesity and anemia [ 54 ].…”

Exploring the magnitude and drivers of the double burden of malnutrition at maternal and dyad levels in peri‐urban Peru: A cross‐sectional study of low‐income mothers, infants and young children

“…). It was also higher than estimates for the Americas region (21.6%) and for 49 LMICs combined (16.2%)(Irache et al, 2022b). The average prevalence of dyad level Demographic and Health Survey (DHS) reported that between 2009 and 2016, household level DBM (defined as a child with undernutrition [stunting, underweight or wasting] and a mother with overweight/ obesity) decreased from 10.7% to 7.2%(Mendoza-Quispe et al, 2021).…”

“…(b) Distribution (%) of the coexistence of anaemia in the child (<2 years) and overweight (including obesity) in the mother. A, anaemia; OW, overweight (including obesity).level DBM (maternal overweight, including obesity, and child anaemia) was high (36.3%), when compared with estimates of household level DBM (defined as a mother with overweight/obesity and at least one of her children <5 years with anaemia or a mother with anaemia and at least one of her children with overweight/obesity or both combinations) for Peru (19.4%)(Irache et al, 2022b…”

Double burden of malnutrition and associated factors among women of reproductive age in sub-Saharan Africa: a multilevel multinomial logistic regression analysis

“…Moreover, some of these studies do not employ appropriate statistical method (ie, multilevel multinomial analysis) that accounts for hierarchical nature of data and polytomous nature of the nutritional status to identify determinants for each type of malnutrition 29–31. And other studies only focused either on overnutrition33 34 49–51 or undernutrition30 and did not assess the effect of some community-level factors (community-level poverty and community-level illiteracy) 29–31. Therefore, by taking into account the aforementioned methodological limitations, this study aimed to estimate the pooled burden and individual and community-level determinants of underweight, overweight and obesity among reproductive-age women in 33 sub-Saharan African countries.…”