Prevalence and regional variations of coexistence of child stunting and maternal overweight or obesity in Myanmar

Hong, Seo Ah

doi:10.1017/s136898002000186x

Cited by 13 publications

(23 citation statements)

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“…Low prevalence of child wasting (21%) compared to underweight and stunting might be the cause behind less occurrence of OBM/WC pairs [23]. The results are in accordance with other studies that reported DBM in Asia [48,49,53,54]. In the literature, it is well established that co-occurrence of under-and overnutrition is associated with nutrition transition [8].…”

Section: Plos Onesupporting

confidence: 87%

“…Among LMICs countries, the prevalence of DBM was 24.3% in Bangladesh [48], (16.3%) in Indonesia [53], (9.1%) in Myanmar [54], (8%) in China [55], (6.60%) in Nepal [49], and 3 (.9%) in Pakistan [47]. However, there are some methodological differences in conceptualising the MCDBM, but one thing is common that all these studies have taken mother-child pairs as…”

Section: Discussionmentioning

confidence: 99%

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Does maternal overnutrition carry child undernutrition in India?

Kumar

Mohanty

2022

PLoS ONE

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Background and objectives Studies in low-and middle-income countries where nutrition transition is underway provides mixed evidence of double burden of maternal overnutrition and child undernutrition among mother-child pairs. Shifting dietary pattern and rapid increase in overweight/obesity among adults with persistent child undernutrition indicate that India is experiencing nutrition transition and double burden of malnutrition. Hence, the study explores the presence of and the factors associated with mother-child dyads of over- and undernutrition in India. Methods and materials The study uses National Family Health Survey 2015–16 data. The analytic sample consists of 28,817 weighted mother-child pairs where an overweight/obese mother is paired with an undernourished child. The nutritional status of children is defined according to WHO 2006 child growth standards as underweight (i.e., low weight-for-age), stunting (i.e., low height-for-age) and wasting (i.e., low weight-for-height). Maternal overweight/obesity (i.e., BMI ≥ 25 kg/m2) is defined using adult BMI criterion. Descriptive, bivariate, and adjusted multivariable logistic regression analysis are conducted. Results Of the overweight/obese mothers, 21.3%, 26.5%, and 14% have underweight, stunted, and wasted children respectively. In adjusted models, maternal short stature (aOR: 2.94, 95% CI: 2.30–3.75), age of child (aOR: 3.29, 95% CI: 2.76–3.92), and poorest wealth status (aOR: 2.01, 95% CI: 1.59–2.54) are significant predictors of overweight/obese mothers and stunted child pairs. Similarly, poor wealth status (aOR: 1.68, 95% CI:1.32–2.14), maternal stature (aOR: 2.70, 95% CI: 2.08–3.52), and child aged 2–5 years (aOR: 1.77, 95% CI:1.51–2.08) are also significantly associated with higher occurrence of overweight/obese mother and-underweight child pairs. Conclusion Findings of the study are consistent with the phase of nutrition transition and double burden of malnutrition. The paper concludes with suggestions to improve the socioeconomic condition, more strategic nutrition specific investments and policy interventions to eliminate all forms of malnutrition for achieving SDGs.

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Section: Plos Onesupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Does maternal overnutrition carry child undernutrition in India?

Kumar

Mohanty

2022

PLoS ONE

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“…In our study, we followed previous practice and classified DBM into the following 4 subtypes: (1) coexistence of maternal (paternal) overnutrition and child undernutrition, (2) coexistence of maternal (paternal) undernutrition and child overnutrition, (3) coexistence of maternal (paternal) overnutrition and child overnutrition, and (4) coexistence of maternal (paternal) undernutrition and child undernutrition. 3,7,20 We constructed dichotomous variables for DBM and all DBM subtypes, with 1 indicating the households confronting adverse health outcomes and 0 indicating otherwise. For children, overnutrition referred to a weight-for-age z score of more than 2 SDs; undernutrition referred to 1 or more of the following conditions: underweight (weight-for-age z score of <−2 SD), wasting (weightfor-height z score of <−2 SD), stunting (height-for-age z score of <−2 SD), or anemia (hemoglobin count <11 g/dL).…”

Section: Outcome Measuresmentioning

confidence: 99%

“…In terms of studies on DBM, maternal education has often been included as a covariate, but the findings have been inconsistent. Some studies reported that higher maternal education was associated with a higher risk of DBM . A study in Myanmar found that households with mothers with primary education had 62% higher odds of experiencing DBM than those with no maternal education .…”

Section: Introductionmentioning

confidence: 99%

Association Between Parental Education and Simultaneous Malnutrition Among Parents and Children in 45 Low- and Middle-Income Countries

et al. 2023

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ImportanceParental education is known to be associated with the health status of parents and their offspring. However, the association between parental education and the simultaneous manifestation of multiple forms of malnutrition within households remains underinvestigated globally.ObjectiveTo assess the association between parental education and the simultaneous manifestation of malnutrition of both parent and child (either overnutrition or undernutrition)—referred to as the double burden of malnutrition (DBM)—at the household level in mother-child and father-child pairs in low- and middle-income countries (LMICs).Design, Setting, and ParticipantsThis cross-sectional study used data from the US Agency for International Development Demographic and Health Surveys (January 1, 2010, to December 31, 2021) to identify mother-child pairs and father-child pairs from LMICs. The eligibility criteria were as follows: (1) children aged 0 to 59 months; (2) nonpregnant mothers at the time of the survey in the sample of mother-child pairs; and (3) valid measures of the weight, height, and hemoglobin level for the child and at least 1 of their parents.ExposuresHighest level of parental education obtained and number of years of education completed.Main Outcomes and MeasuresFour sets of multivariable logistic regression models were constructed to assess the association between parental education and DBM, and analysis was performed between March 10 and May 15, 2022.ResultsThis study included 423 340 mother-child pairs from 45 LMICs and 56 720 father-child pairs from 16 LMICs. The mean (SD) age of the mother-child pairs was 28.2 (6.1) and 1.9 (1.4) years, respectively; 48.8% of the children were female. We observed that 49.0% of mother-child pairs experienced DBM. Compared with mother-child pairs with no maternal education, higher maternal education was associated with a lower risk of DBM. For example, the odds ratio (OR) for tertiary maternal education was 0.71 (95% CI, 0.67-0.74). However, the association differed by DBM subtypes: higher maternal education was associated with a lower risk of both mothers and children being undernourished but with a higher risk of almost all DBM subtypes involving overnutrition. For example, compared with mother-child pairs with no maternal education, those with secondary education were less likely to develop simultaneous maternal and child undernutrition (OR, 0.83 [95% CI, 0.80-0.86]) but were more likely to experience simultaneous maternal and child overnutrition (OR, 2.20 [95% CI, 1.61-3.00]); similar results were observed for pairs with primary and tertiary education. The results in mother-child pairs remained consistent after controlling for paternal education. Among the father-child pairs, 26.5% had DBM, with fathers with tertiary education significantly more likely to experience simultaneous paternal overnutrition and child undernutrition (OR, 1.55 [95% CI, 1.23-1.95]) compared with pairs with no paternal education; they were also less likely to have both paternal and child undernutrition (OR, 0.70 [95% CI, 0.59-0.84]).Conclusions and RelevanceIn this study, maternal education and paternal education were independently associated with DBM, and the associations differed by DBM subtypes. These findings suggest that the different risks of malnutrition faced by households with various levels of education should thus be considered in policy evaluation.

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“…Our primary outcome was DBM, defined at child level as the coexistence of an undernourished child and an overweight/obese mother [24][25][26][27]. Data on the DBM were also decomposed into the two components of this definition, child undernutrition and maternal overweight/obesity, to highlight the different combinations and permutations of maternal and child nutritional status.…”

Section: Outcome Variablementioning

confidence: 99%

Trends and patterns of the double burden of malnutrition (DBM) in Peru: a pooled analysis of 129,159 mother–child dyads

et al. 2021

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Background This study aims to evaluate trends of DBM in Peru over the last 20 years. Methods Using individual-level data collected in nationally representative household surveys from Peru between 1996 and 2017, we analysed trends in the prevalence and patterning of the DBM. We classified the nutritional status of children and their mothers as undernourished (either underweight, stunted or wasted for children), normal, overweight or obese. Children classified as experiencing the DBM were those undernourished and living with an overweight or obese mother. We also fitted logistic regression models to evaluate the probability of children having an overweight/obese mother across subgroups of socioeconomic status, place of residence and education. Results The overall percentage of children experiencing the DBM in 2016 was 7%, and constitutes ~203,600 children (90% of whom were stunted). Between 1996 and 2016, undernourished children have seen the largest relative increase in the risk of having an overweight mother (31% vs. 37%) or obese mother (6% vs. 17%); however, due to the substantial decrease in the absolute number of undernourished children, the DBM has not grown. Moreover, all children, irrespective of their own nutritional status, are now more likely to live with an overweight or obese mother, a consistent pattern across wealth, location and education subgroups, and all regions of Peru. Conclusions DBM prevalence in Peru has decreased, although the number of DBM cases is estimated to be above 200,000. In addition, all children are now more likely to live with overweight or obese mothers. The basic pattern has shifted from one of undernourished children whose mothers have a ‘normal’ BMI, to one where now most children have a ‘normal’ or healthy anthropometric status, but whose mothers are overweight or obese. This suggest that Peru is on the cusp of a major public health challenge requiring significant action.

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Prevalence and regional variations of coexistence of child stunting and maternal overweight or obesity in Myanmar

Cited by 13 publications

References 36 publications

Does maternal overnutrition carry child undernutrition in India?

Does maternal overnutrition carry child undernutrition in India?

Association Between Parental Education and Simultaneous Malnutrition Among Parents and Children in 45 Low- and Middle-Income Countries

Trends and patterns of the double burden of malnutrition (DBM) in Peru: a pooled analysis of 129,159 mother–child dyads

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