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


Autoři: Chisa Shinsugi aff001;  Deepa Gunasekara aff003;  N. K. Gunawardena aff004;  Wasanthi Subasinghe aff003;  Miki Miyoshi aff005;  Satoshi Kaneko aff006;  Hidemi Takimoto aff001
Působiště autorů: National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan aff001;  Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan aff002;  Department of Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka aff003;  Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka aff004;  Department of Nutrition, Aomori University of Health and Welfare, Aomori, Japan aff005;  Department of Eco-epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan aff006
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224222

Souhrn

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.

Klíčová slova:

Body mass index – Employment – Childhood obesity – Children – Malnutrition – Mothers – Nutrition – Schools


Zdroje

1. Galgamuwa LS, Iddawela D, Dharmaratne SD, Galgamuwa GLS. Nutritional status and correlated socio-economic factors among preschool and school children in plantation communities, Sri Lanka. BMC public health. 2017;17(1):377. doi: 10.1186/s12889-017-4311-y 28464868

2. Naotunna NPGCR, Dayarathna M, Maheshi H, Amarasinghe GS, Kithmini VS, Rathnayaka M, et al. Nutritional status among primary school children in rural Sri Lanka; a public health challenge for a country with high child health standards. BMC public health. 2017;17(1):57. doi: 10.1186/s12889-016-4001-1 28068960

3. Galloway R. Global Nutrition Outcomes at Ages 5 to 19. In: Bundy DAP, Silva N, Horton S, Jamison DT, Patton GC, editors. Child and Adolescent Health and Development 3rd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017.

4. Ministry of Health, Nutrition and Indigenous Medicine. Annual Health Bulletin 2015. 2017. Available from: http://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/AHB/2017/AHB%202015.pdf.

5. Ministry of Health, Nutrition and Indigenous Medicine. Sri Lanka Demographic and Health Survey 2016. 2017. Available from: http://www.statistics.gov.lk/social/SLDHS%202016%20Report%20Final%20Full%2010%20Oct%202017.pdf.

6. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet (London, England). 2013;382(9890):427–51.

7. Tzioumis E, Adair LS. Childhood dual burden of under- and overnutrition in low- and middle-income countries: a critical review. Food and nutrition bulletin. 2014;35(2):230–43. doi: 10.1177/156482651403500210 25076771

8. Fernald LC, Neufeld LM. Overweight with concurrent stunting in very young children from rural Mexico: prevalence and associated factors. Eur J Clin Nutr. 2007;61(5):623–32. doi: 10.1038/sj.ejcn.1602558 17136036

9. Ruel MT, Alderman H. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet (London, England). 2013;382(9891):536–51.

10. Shinsugi C, Matsumura M, Karama M, Tanaka J, Changoma M, Kaneko S. Factors associated with stunting among children according to the level of food insecurity in the household: a cross-sectional study in a rural community of Southeastern Kenya. BMC public health. 2015;15:441. doi: 10.1186/s12889-015-1802-6 25924925

11. Hawkins SS, Cole TJ, Law C, Group. TMCSCH. Maternal employment and early childhood overweight: findings from the UK Millennium Cohort Study. International journal of obesity. 2008;32(1):30–8. doi: 10.1038/sj.ijo.0803682 17637703

12. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization. 2007;85(9):660–7. doi: 10.2471/BLT.07.043497 18026621

13. Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. International journal of pediatric obesity: IJPO: an official journal of the International Association for the Study of Obesity. 2006;1(1):11–25.

14. Juliusson PB, Roelants M, Markestad T, Bjerknes R. Parental perception of overweight and underweight in children and adolescents. Acta paediatrica (Oslo, Norway: 1992). 2011;100(2):260–5.

15. Rolland-Cachera MF, Deheeger M, Maillot M, Bellisle F. Early adiposity rebound: causes and consequences for obesity in children and adults. International Journal Of Obesity. 2006;30:S11. doi: 10.1038/sj.ijo.0803514 17133230

16. Rathnayake KM, Roopasingam T, Wickramasighe VP. Nutritional and behavioral determinants of adolescent obesity: a case–control study in Sri Lanka. BMC public health. 2014;14:1291. doi: 10.1186/1471-2458-14-1291 25519979

17. Franks PW, Ravussin E, Hanson RL, Harper IT, Allison DB, Knowler WC, et al. Habitual physical activity in children: the role of genes and the environment. Am J Clin Nutr. 2005;82(4):901–8. doi: 10.1093/ajcn/82.4.901 16210723

18. Oddo VM, Rah JH, Semba RD, Sun K, Akhter N, Sari M, et al. Predictors of maternal and child double burden of malnutrition in rural Indonesia and Bangladesh. Am J Clin Nutr. 2012;95(4):951–8. doi: 10.3945/ajcn.111.026070 22357721

19. Sharma A, Sharma K, Mathur KP. Growth pattern and prevalence of obesity in affluent schoolchildren of Delhi. Public health nutrition. 2007;10(5):485–91. doi: 10.1017/S1368980007223894 17411469


Článek vyšel v časopise

PLOS One


2019 Číslo 10