Intraindividual double burden of overweight and micronutrient deficiencies or anemia among preschool children. (4th August 2020)

• Record Type: Journal Article
• Authors: Engle-Stone, Reina; Guo, Junjie; Ismaily, Sanober; Addo, O Yaw; Ahmed, Tahmeed; Oaks, Brietta; Suchdev, Parminder S; Flores-Ayala, Rafael; Williams, Anne M
• Is Part Of: American journal of clinical nutrition. Volume 112(2020)Supplement 1
• Page Start: 478S
• Page End: 487S
• Publication Date: 2020-08-04
• Subjects: double burden of malnutrition -- preschool children -- anemia -- overweight/obesity -- micronutrients; Diet therapy -- Periodicals; Nutrition -- Periodicals; Dietetics -- Periodicals; 613.205
• DOI: 10.1093/ajcn/nqaa101
• Languages: English
• ISSNs: 0002-9165

Abstract

ABSTRACT: Background: Child overweight prevalence is increasing globally, but micronutrient deficiencies persist. Objectives: We aimed to 1 ) describe the prevalence and distribution of intraindividual double burden of malnutrition (DBM), defined as coexistence of overweight or obesity (OWOB) and either micronutrient deficiencies or anemia, among preschool children; 2 ) assess the independence of DBM components, e.g., whether the prevalence of DBM is greater than what would be expected by chance; and 3 ) identify predictors of intraindividual DBM, to guide intervention targeting. Methods: We analyzed data from 24 population-based surveys from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia project (separately by survey; n = 226 to n = 7166). We defined intraindividual DBM as coexisting OWOB and ≥1 micronutrient deficiency [e.g., Micronutrient Deficiency Index (MDI) > 0; DBM-MDI] or anemia (DBM-Anemia). We assessed independence of DBM components with the Rao–Scott chi-square test and examined predictors of DBM and its components with logistic regression. Results: DBM prevalence ranged from 0% to 9.7% (median: 2.5%, DBM-MDI; 1.4%, DBM-Anemia), reflecting a lower prevalence of OWOB (range: 0%–19.5%) than of micronutrient deficiencies and anemia, which exceeded 20% in most surveys. OWOB was generally not significantly associated with micronutrient deficiencies or anemia. In more than half of surveys, children 6–23 mo of age, compared with ≥24 mo, had greater adjusted odds of DBM-Anemia, anemia, and micronutrient deficiencies. Child sex and household socioeconomic status, urban location, and caregiver education did not consistently predict DBM or its components. Conclusions: Intraindividual DBM among preschool children was low but might increase as child OWOB increases. The analysis does not support the hypothesis that DBM components cluster within individuals, suggesting that population-level DBM may be addressed by programs to reduce DBM components without targeting individuals with DBM.