The Double Burden of Malnutrition and Associated Factors among South Asian Adolescents: Findings from the Global School-Based Student Health Survey.

Sara Estecha Querol,Laura Kudrna,Paramijit Gill,Romaina Iqbal,Lena Al-Khudairy

doi:10.3390/nu13082867

Abstract

The health and nutrition of the global adolescent population have been under-researched, in spite of its significant size (1.2 billion). This study investigates the prevalence and associated factors of malnutrition (stunting, thinness and overweight) among adolescents living in South Asia. The sample analysed was 24,053 South Asian schooled adolescents aged 12–15 years that participated in the cross-sectional Global School-Based Student Health Survey (GSHS) between 2009 and 2016. The prevalence of stunting, thinness and overweight was calculated using the World Health Organization (WHO) Child Growth Reference 2007. Associations between the three forms of malnutrition and their possible associated factors were assessed with binary logistic regression analysis using bootstrapping as a resampling method. The overall prevalence of stunting in South Asia was 13%, thinness was 10.8% and overweight was 10.8%. In the logistic regression model of the overall pooled sample, the factors associated with adolescent malnutrition were: age, hygiene behaviours, social support, sedentary behaviour, and tobacco use. A substantial proportion of stunting, thinness and overweight was found among school-going South Asian adolescents, indicating that the double burden of malnutrition is present in this population. Future research should seek to further understand the relationship between all forms of malnutrition and its associated factors in the adolescent population.

Highlights

The growing challenge of populations experiencing multiple forms of malnutrition has drawn special attention from the global health community in the last three decades [1]
This study aims to address these gaps in knowledge by examining country and regional prevalence of the burden of stunting, thinness and overweight among South Asian adolescents aged 12–15 years
Parental supervision was positively associated with underweight and parental bonding increased the odds for overweight or obesity among schooled adolescents in AESAN countries [76]. This is the first study that investigates the relationship between the double burden and peer influence in the South Asian context, these findings suggest that the double burden of malnutrition may be reduced with social support

Summary

Introduction

The growing challenge of populations experiencing multiple forms of malnutrition has drawn special attention from the global health community in the last three decades [1] This concept, called the double burden of malnutrition, refers to the coexistence of overnutrition (overweight and obesity) and undernutrition (micronutrient deficiencies, underweight, and childhood stunting and wasting) at country, household, and individual levels [2]. This health issue is especially prevalent and persistent in low and middle-income countries (LMIC) [3]. The double burden of malnutrition introduces considerable global health challenges that need to be urgently addressed [4]

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