Abstract
BackgroundDouble-burden of malnutrition (DBM) is an emerging public health concern among the Orang Asli (indigenous peoples) of Peninsular Malaysia. This study aimed to identify the presence of DBM at the community and household levels in Orang Asli population and its associated demographic and socio-economic factors.MethodsThis cross-sectional study was conducted in 11 Orang Asli villages surrounding the Krau Wildlife Reserve, Peninsular of Malaysia from October 2011 to January 2012. Of 438 households, a total of 981 adults and 304 children who met the study criteria agreed to participate. About 160 households were further selected with pairs of children aged 3–59 months and non-pregnant mothers aged 15–55 years. Demographic and socio-economic data were obtained using interviewer-administered questionnaire while weight and height were measured using standard procedures. Double-burden of malnutrition was defined as overweight/obese mother-underweight child (OWOBM/UWC), overweight/obese mother-stunted child (OWOBM/STC) or overweight/obese mother-underweight or/and stunted child (OWOBM/UWSTC). Binary logistic regression identified the demographic and socio-economic factors associated with double-burden households.ResultsAbout 26 % of overweight and obese adults coexisting with high proportions of underweight (49 %) and stunted (64 %) children in these Orang Asli villages. There was a higher prevalence of households with OWOBM/UWSTC (20 %) and OWOBM/STC (19.4 %) than households with OWOBM/UWC (12.5 %). Boys (P < 0.05), older age mothers (P < 0.05), mothers with higher education (P < 0.05) and households with income per capita less than USD 29.01 (RM 97.00) (P < 0.01) were associated with higher odds of OWOBM/STC. Jah Hut (P < 0.05) and higher number of children (P < 0.05) were significantly associated with lower odds of OWOBM/UWC.ConclusionsThe occurrence of double-burden of malnutrition in Orang Asli population deserves attention. Poverty reduction, access to quality diet and improved health and nutrition literacy are among strategies that could address the coexistence of DBM in this population.
Highlights
Double-burden of malnutrition (DBM) is an emerging public health concern among the Orang Asli of Peninsular Malaysia
Demographic and socio-economic characteristics A total of 981 adults (86.7 % Jah Hut, 7.0 % Temuan and 6.2 % Che Wong) from 485 Orang Asli households participated in this study (Table 2)
More than 70 % of households had per capita monthly income below the poverty line for Peninsular Malaysia of United States Dollar (USD) 58.02 (RM 194) [35]
Summary
Double-burden of malnutrition (DBM) is an emerging public health concern among the Orang Asli (indigenous peoples) of Peninsular Malaysia. In many low- and middle-income countries, the persistence of undernutrition in children is accompanied by increasing overweight and obesity in older children, adolescents and adults This phenomenon, known as “double-burden of malnutrition” (DBM), is emerging within countries, communities and even households [1,2,3,4,5]. National surveys from six low- to middleincome countries showed that 3.7–15.5 % of households were with underweight and overweight members [1], while national surveys from 42 developing countries in Africa, Asia and Latin America reported that there were 0.9–16.0 % of households with a stunted child and an overweight or obese mother [2] This DBM phenomenon is an emergent public health problem that could lead to impaired child growth and cognitive development which in turn will dramatically increase the risk of obesity and non-communicable. Factors such as household size, number of children, maternal (age, marital status, education and employment status) and child factors (age and sex) were associated with risk of DBM households [3, 9, 11,12,13]
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