Global trends in the childhood dual burden of malnutrition (621.2)

Abstract

The childhood dual burden of under‐ and overnutrition is a growing public health concern.We used nationally representative, cross‐sectional, repeated Demographic and Health Surveys of children 0‐5y from 30 countries, 1990‐2011 (n=749,830). We estimated annualized rates of change (ARC) in stunting (height‐for‐age <‐2SD) and overweight (weight‐for‐height >2SD) based on WHO Child Growth Standards, accounting for survey design.Comparing trends before and after 2000, stunting decreased in almost half the countries in both intervals, with larger rates of decline before 2000 (mean ACR = ‐0.71 vs. ‐0.54%/yr). Stunting trends switched direction in 2000 for 8 countries; for 5 countries, ARC decreased before 2000 then increased after (mean ARC = ‐0.93 vs. 0.79%/yr), and for 3 countries, ARC increased then decreased (mean ARC = 0.83 vs. ‐0.98%/yr).Two countries had no appreciable change in overweight ARC, while 4 countries increased overweight in both intervals, with larger rates of increase after 2000 than before (mean ARC = 0.40 vs. 0.24%/yr). Eight switched trend direction; for 4 countries, ARC decreased before 2000 then increased after (mean ARC = ‐0.20 vs. 0.29%/yr), and for 4 countries, ARC increased then decreased (mean ARC = 0.43 vs. ‐0.25%/yr). Countries with greater decreases in stunting ARC tended to have greater increases in overweight ARC.Overall, stunting has decreased and overweight has increased but trends vary, requiring deeper exploration.Grant Funding Source: Supported by an educational grant from Wyeth Nutrition