Child‐level dual burden of malnutrition in the MENA and LAC regions: prevalence and predictors

Abstract

Whilst the prevalence of obesity has rapidly increased in the Middle East and North Africa (MENA) and Latin America and the Caribbean (LAC) regions, child undernutrition remains a public health challenge. We examined region‐specific sociodemographic determinants of the co‐occurrence of within‐child stunting and overweight using the most recent Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) data (2004‐2013) from 8 countries in the MENA (n=103,879) and 8 countries in the LAC (n=49,918) regions. We used multiple logistic regression to model country‐ and region‐specific associations of sex, maternal education, household wealth, and area of residence with stunting, overweight and the co‐occurrence of within‐child stunting and overweight in children aged 6‐59 months. The prevalence of stunting, overweight, and their co‐occurrence within children in the MENA and LAC regions respectively, were 21% and 17%; 12% and 6.9%; and 6.1% and 1.3%. In both regions, higher maternal education and household wealth were associated with lower odds of stunting and higher odds of overweight. Post‐secondary education among mothers (OR (95% CI): 0.62 (0.43, 0.90)) and greater household wealth (0.52 (0.30, 0.90)) were associated with a lower odds of concurrent child stunting and overweight in the LAC region but not the MENA region. Stunted‐overweight children were more likely to be boys in both regions. There was no association between rural/urban residence and any nutritional outcomes in either region. Child stunting and overweight coexist throughout the MENA and LAC regions, and cross urban/rural and sociodemographic divides.