Triple Burden Research Articles

Malnutrition: A Longstanding Challenge in India

Abstract: According to the World Health Organization, “malnutrition is the “deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients”. Indian population has the highest rate of adolescent malnutrition. Deficiency, Illness, Small level of education, and a range of other factors contribute to India's malnutrition crisis. Undernutrition, micronutrient deficiency conditions, and overnutrition are all forms of malnutrition. A malnourished always lags in every aspect of life which will eventually affect the productivity of the country. In the 2023 Global Hunger Index, India is positioned at 111th among 125 countries, reflecting a serious level of hunger with a score of 28.7. India is grappling with a substantial population affected by anemia, malnutrition, and obesity. Other than this Indian population is also affected by several other micronutrient deficiencies. The present article provides an overview of the triple burden of malnutrition in India by applying the literature review method and the data were collected from online sources such as government survey reports, articles, and publications related to nutrition, healthcare status, healthcare indicators, nutritional indicators, and healthcare survey reports, etc. A brief introduction of the strategies followed by the Government as well as global health organisations to combat the issue is also discussed.

A Policy Proposal to Strengthen the Income Redistribution Function of the National Pension Scheme in South Korea: An Analysis of South Korea’s 5th National Pension Comprehensive Plan (Draft)

In this study, we elucidate the income redistribution effects of the proposal to incorporate the Bend Points mechanism of the U.S. OASDI into the Korean National Pension Scheme (BP-KNPS Proposal) through a micro-simulation analysis using individual data from the Korean Labor and Income Panel Study (KLIPS). In addition to examining the effects of introducing the BP-KNPS Proposal into the current National Pension Scheme (NPS), we also consider the impact of this scheme being combined with the 5th National Pension Comprehensive Plan (Draft), announced by Korea’s Ministry of Health and Welfare on 30 October 2023. When the BP-KNPS Proposal is introduced into the current NPS, the Mean Log Deviation (MLD) of the net transfer amount (lifetime pension benefits minus lifetime pension contributions) for regular employees decreases from 0.2022863 to 0.1929960. Similarly, the MLD for self-employed and irregular workers decreases from 0.2046127 to 0.1721433, indicating a reduction in income inequality. Furthermore, when the BP-KNPS Proposal is combined with the 5th National Pension Comprehensive Plan (Draft), the effects are mixed. The proposals to increase the pension contribution rate and adjust the rate increase speed via generation lead to a reduction in income inequality compared to the current NPS when combined with the BP-KNPS Proposal. However, the proposals to raise the pensionable age result in increased income inequality, similar to the outcomes under the current system. This finding suggests that the triple burden identified by literature review—the reduction in benefits due to disparities in contribution periods and life expectancy, and the raised pensionable age—has a greater impact on low-income participants than the inequality-reducing effects of the BP-KNPS Proposal.

Childhood trauma, substance use and depressive symptoms in people with HIV during COVID-19

Background: Adverse childhood experiences (ACEs), substance use, depressive symptoms, and HIV outcomes in people living with HIV (PLWHIV) have not been comprehensively investigated within a single study.Aim: The aim of this study was to investigate the prevalence and association of ACEs, substance use, depressive symptoms and human immunodeficiency virus (HIV) outcomes in PLWHIV accessing HIV care during the coronavirus disease 2019 (COVID-19) pandemic.Setting: District hospital HIV clinic in South Africa.Methods: A total of 196 PLWHIV completed a socio-demographic and clinical questionnaire; an adapted World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test; WHO ACEs International Questionnaire, and Patient Health Questionnaire.Results: The most common ACEs were having one or no parent, parental separation or divorce (n = 131, 66.8%), exposure to collective (n = 57, 29.1%) and community violence (n = 55, 28.1%), with 40.3% (n = 79) experiencing ≥ 3 ACEs. The most commonly used substances were alcohol (n = 34, 17.3%), tobacco (n = 33, 16.8%), and cannabis (n =13, 6.6%). The prevalence of depressive symptoms was 19.4% (n = 38). Linear regression analyses indicated greater alcohol (adj β = 2.84, p 0.01), tobacco (adj β = 3.64, p 0.01) and cannabis use risk scores (adj β = 2.39, p 0.01) were associated with ≥ 3 ACEs. Logistic regression indicated depressive risk (adjusted odds ratio [OR] = 9.39, 95% confidence interval [CI] 4.78–23.51) was associated with ≥ 3 ACEs.Conclusion: A high prevalence of ACEs, substance use and depressive symptoms exists among PLWHIV, along with an association between cumulative ACEs and both substance use and depressive symptoms.Contribution: Enhanced screening and management services are recommended to address this triple burden in PLWHIV.

Effects of the Local Environment and Nutritional Status on the Incidence of Acute Respiratory Infections Among Children Under 5 Years Old in Indonesia.

This study aimed to map the incidence of acute respiratory infections (ARIs) among under-5 children in Indonesia, address the triple burden of malnutrition, and analyze the impact of malnutrition on ARIs, taking into account the environmental and wealth disparities in Indonesia. This study utilized an ecological design, analyzing aggregate data from the Indonesia Nutrition Survey, 2022. It encompassed 33 provinces and 486 districts/cities, involving a total of 334 878 children under 5 years of age. Partial least squares structural equation modeling was employed to investigate the relationships among wealth, environment, malnutrition (stunting, wasting, and underweight), and ARIs. The proportion of ARI cases in Indonesia was generally concentrated in central Sumatra, the western and eastern parts of Java, and eastern Papua. In contrast, the northern part of Sumatra, central Kalimantan, central Sulawesi, and central Papua had a higher proportion of malnutrition cases compared to other regions. Negative associations were found between malnutrition and ARIs (path coefficient =-0.072; p<0.01) and between wealth and environment (path coefficient =-0.633; p<0.001), malnutrition (path coefficient=-0.399; p<0.001), and ARIs (path coefficient=-0.918; p<0.001). An increasing wealth index is expected to contribute to reducing ARIs, malnutrition and environmental burdens in the future. This study emphasizes the necessity for focused strategies that address both immediate health challenges and the underlying socioeconomic determinants to improve child health outcomes in the Indonesian context.

Triple burden of hepatitis B, hepatitis Delta viruses, and Plasmodium falciparum to pregnant women

ObjectivesChronic hepatitis B virus (HBV) infection remains a major health problem worldwide. This infection is more severe when combined with hepatitis Delta virus (HDV). Moreover, Plasmodium falciparum (Pf) malaria infection during pregnancy can have severe consequences for the mother and the newborn. Importantly, the manifestation of these three infections has never been described to date. MethodsThus, we conducted a prospective study, between May 27, 2022, and April 15, 2023, and we investigated these three infections in 260 pregnant women aged 24 to 46 years, in Gabon and evaluated the impact on newborns. The sera were used to screen hepatitis B surface antigen (HBsAg) and Pf by determining HBsAg® ALERE rapid diagnostic test and malaria rapid diagnostic test kits. The positive sample was confirmed using MINI VIDAS® for HBV and Lambaréné method for “Pf”. The real-time-polymerase chain reaction assay was used to amplify HBV DNA and HDV RNA on Roche instrument. ResultsOur results showed that the prevalences of HBV and (Pf) infection were 4.23% (n = 11) and 34.62% (n = 90), respectively. Moreover, we found that 3.46 % (n = 9) of pregnant women infected with HBV were coinfected with HDV. The prevalence of triple infection was 1.15% (n = 3). In addition, the leukocytes and lymphocytes absolute count were significantly lower for the triple-infected pregnant women. ConclusionsWe describe for the first time the triple coinfection by HBV, HDV, and Pf, which could induce a great inflammatory reaction and high liver disorder in newborns.

Prevalence and socio-demographic factors associated with double and triple burden of malnutrition among mother-child pairs in India: Findings from a nationally representative survey (NFHS-5)

IntroductionImproper consumption of food leads to various forms of malnutrition such as undernutrition, overnutrition and micronutrient deficiency. The coexistence of various malnutrition forms in the same household is a public health concern in developing countries. Very little research has been done on exploring the burden and risk factors associated with double (DBM) and triple burden of malnutrition (TBM). MethodsSecondary analysis was done using data from India's National Family Health Survey-5 (NFHS-5), 2019-21. Mothers and under-five children were paired at the household level as a unit of analysis. DBM and TBM were interpreted from children's height-for-age, weight-for-height, weight-for-age and anaemia status and mothers' body-mass-index. Stratification and clustering in the sample design were accounted for during the analysis in STATA v14.2. DBM and TBM were summarized as weighted proportions with 95 % confidence interval (CI) and the risk factors associated were reported as adjusted odds ratio (aOR) with 95%CI using mixed effects logistic regression. ResultsWe included 167,380 mother-child pairs for analysis. In India, the prevalence of DBM was 7.7 % (95 % CI: 7.5–7.9 %) and TBM was 5.1 % (5.0–5.3 %) at the household level among mother-child dyads. Mothers' age, age at first birth, educational levels, current breastfeeding habits, mode of delivery, child's age, gender, twin birth, birth weight, geographical region, residence, caste and religion, and wealth index were associated with both DBM and TBM. ConclusionBoth DBM and TBM are public health concerns in India. Thus, scaling-up of health intervention, effective implementation of nutritional programmes and life-course approach are needed to control malnutrition.

Trends of high fat, salt and sugar food consumption and its impact on nutritional status of school children

Background: India is currently in a phase of nutrition transition. Increased consumption of food high in fat, sugar and salt (HFSS) is contributing significantly to prevalence of triple burden of malnutrition among children. Methods: In this study, the nutritional status and frequency of HFSS food consumption were assessed in 360 school children (boys n=171, girls n=189) aged between 6-16 years using standard tools and techniques. Results: From the results, it was evident that the frequency of consumption of HFSS food among children of both the age group 6-10 years and 11-16 years was significantly high (p≤0.05). Children aged between 6-10 years were more prone to under nutrition (38%) and they were consuming more snacks such as chips, biscuits, packaged fruit juices high in sodium, saturated fat and sugar. On the other hand, adolescents aged between 11-16 years show a higher prevalence of both under nutrition and overweight (10%), potentially linked to their consumption of bakery products, street foods, sugary drinks and carbonated beverages. Conclusions: The nutrition transition shift is towards consumption of refined, ultra processed, high sodium and fat foods. The age-based trend is a nutritional challenge among children and adolescents. The findings of this study emphasized the urgent need for early screening of nutrient deficiencies, comprehensive interventions to address the triple burden of malnutrition among school children. Efforts should focus on promoting healthy dietary behaviours, enhancing nutritional literacy among children, parents and care givers, improving access to nutritious foods, and regulating the marketing and availability of HFSS foods.

Perspectives of mothers and primary caregivers on undernutrition in children under 5 years in the Northwest region of Cameroon: a community based cross-sectional study

Background: Cameroon is one of the sub-Saharan African countries where undernutrition is a significant public health concern, with a national prevalence of 29% among children under five. The Northwest Region of Cameroon in particular, faces a triple burden of undernutrition, with high rates of stunting (32%), wasting (6.5%) and underweight (17.2%). Caregivers play a critical role in the management of undernutrition. This study analyzed their knowledge, attitudes and predictors of knowledge levels on undernutrition. Methods: A community-based cross-sectional study was carried out among 1279 mothers and primary caregivers of under five children from six health districts. Data on their knowledge and attitudes towards undernutrition was collected using a pre-tested questionnaire. Binary logistic regression analysis was used to identify predictors of nutrition knowledge levels. Results: Overall, 78.5% of the caregivers had ‘good knowledge’ on undernutrition and 21.7% had ‘poor knowledge’. Correct knowledge was highest on the causes of undernutrition and incorrect knowledge was highest on prevention of undernutrition in children especially as 32.9% didn’t know that exclusive breastfeeding could prevent undernutrition in children below six months. Regarding attitude, 52.2% had a ‘positive attitude’ and 47.7% had a ‘less positive or negative attitude’. The main predictors of knowledge levels among primary caregivers were sex of carer (p=0.001), household size (p=0.001), religion (p=0.010), residence status (p<0.001), occupation (p<0.001), and degree of urbanization (p=0.002). Conclusions: Caregivers in Northwest Cameroon showed good undernutrition knowledge (78.5%), but lacked knowledge on prevention, especially breastfeeding benefits. Sociodemographic factors influenced knowledge. This could inform interventions to improve practices.

Policy analysis of the triple burden of malnutrition in children below 5 years of age in Oman

Policy analysis of the triple burden of malnutrition in children below 5 years of age in Oman

Prevalence and Correlates of Double and Triple Burden of Malnutrition Among Children and Adolescents in India: The Comprehensive National Nutrition Survey

BackgroundLimited information on the co-prevalence of undernutrition, micronutrient deficiencies, overnutrition, and abnormal levels of noncommunicable disease biomarkers at the same time in children and adolescents in India hinders efforts to comprehensively address their health. ObjectivesThis study aimed to examine the prevalence and correlates of double burden of malnutrition (DBM) and triple burden of malnutrition (TBM) among children and adolescents (5–19 y) to inform policies and programs. MethodsA total of 17,599 children (5–9 y) and 16,184 adolescents (10–19 y) with available biomarker data from the Comprehensive National Nutrition Survey were included. Malnutrition was defined based on either undernutrition based on anthropometry, overnutrition/abnormal metabolic markers, and anemia/micronutrient deficiency. DBM was defined as the coexistence of any 2 forms of malnutrition. DBM+ was defined as the coexistence of undernutrition and/or micronutrient deficiency along with overnutrition. TBM was defined as having the coexistence of all 3 forms of malnutrition. The prevalence of DBM, DBM+, and TBM was estimated accounting for probabilistic selection. We used mixed-effect binomial regression to determine correlates of DBM/TBM in children and adolescents separately. ResultsThe prevalence of DBM, DBM+, and TBM was 50.8%, 37.2%, and 14.4%, respectively, in children and 53.4%, 36.1%, and 12.7%, respectively, in adolescents. The prevalence of DBM+ was significantly higher in girls compared to in boys in the 5–9 y age group. In children, being in a disadvantaged caste group, having a lower wealth index, having inadequate diet diversity, having no maternal schooling, and having a recent history of acute illness were associated with DBM. In adolescents, being in a disadvantaged caste group, maternal occupation, and lower paternal age were correlated with DBM. A similar set of variables was associated with TBM in both age groups. ConclusionsThe prevalence of DBM and TBM is substantial in children and adolescents in India and varies across states. Socioeconomic factors and acute illness were the main correlates for DBM and TBM.

An accounting perspective on the IFRS sustainability reporting standards for greenhouse gas emissions: implications for the Asia Pacific

ABSTRACT From an accounting perspective, we critically review the IFRS sustainability standards regarding its acceptability. The sustainability standards have serious implementation issues due to (1) their lack of financial reporting framework; (2) high compliance cost issues, particularly for entities in developing countries; (3) forward-looking disclosure requirements; (4) triple cost burden for the measurement, attestation and increased audit involvement for GHG emissions; (5) the possibility of compromised audit quality; and (6) issues with financed emissions. IFRS does not have accounting standards for recognizing, measuring and presenting climate-related financial statement items. As a result, diverse methods for climate-related accounting are practiced. IFRS must set GHG-related accounting standards to culminate the goal of integrating sustainability reporting into the financial reporting framework. In the Appendix, we developed two illustrative examples as temporary guidance to help the regulated entities recognize GHG-related financial statement items until IFRS releases the standards.

Triple Burden: The Incorrigible Threat of Tuberculosis, HIV, and COVID-19.

<p>The Coronavirus-19 (COVID-19) hasn't seen the dawn since its emergence, however waxing and waning has resulted in the emergence of deadly variants. The effects of pandemic have not been limited to its virulence, but have rather conferred multiple collateral effects, especially in developing countries; thereby, designating it as a SYNDEMIC. The same culminated in neglect of non-COVID-19 conditions like tuberculosis (TB) and human immunodeficiency virus-acquired immunodeficiency syndrome (HIV/AIDS). Besides being the prognostic factor for severe COVID-19, these infections in hidden pockets served as reservoir for emergence of the deadly Omicron. Another significant impact of this juxtaposition was on the delivery of healthcare services for TB and HIV. <p> The unanticipated COVID-19 pandemic turned the path of ongoing progress of elimination programs. Direct consequences of the COVID-19 pandemic were pronounced on diagnosis, treatment, and services for patients with TB and HIV. Essential TB services were reallocated to the COVID-19 rapid response task force. However, despite escalating the tribulations, this triple burden has simultaneously taught lessons to escalate the progress of halted programs. The pandemic has catalyzed an unusual level of collaboration among scientists, which can be exploited for TB and HIV. Fast-track diagnostics, digitalization, contact tracing, and vaccine development have enabled world to envision the same for TB/HIV.</p>.

Triple burden of malnutrition among Vietnamese 0·5-11-year-old children in 2020-2021: results of SEANUTS II Vietnam.

SEANUTS II Vietnam aims to obtain an in-depth understanding of the nutritional status and nutrient intake of children between 0.5-11.9 years old. Cross-sectional survey. A multistage cluster systematic random sampling method was implemented in different regions in Vietnam: North Mountainous, Central Highlands, Red River Delta, North Central and Coastal Area, Southeast and Mekong River Delta. 4001 children between 6 months and 11.9 years of age. Prevalence of stunting and underweight was higher in rural than in urban children, whereas overweight and obese rates were higher in urban areas. 12.0% of the children had anemia and especially children 0.5-1-year-old were affected (38.6%). Low serum retinol was found in 6.2% of children ≥ 4 years old. Prevalence of vitamin D insufficiency was 31.1% while 60.8% had low serum zinc. For nutrient intake, overall, 80.1% of the children did not meet the estimated energy requirements. For calcium intake, ∼60% of the younger children did not meet the RNI while it was 92.6% in children >7 years old. For vitamin D intake, 95.0% of the children did not meet RNI. SEANUTS II Vietnam indicated that overnutrition was more prevalent than undernutrition in urban areas, while undernutrition was found more in rural areas. The high prevalence of low serum zinc, vitamin D insufficiency and the inadequate intakes of calcium and vitamin D are of concern. Nutrition strategies for Vietnamese children should consider three sides of malnutrition and focus on approaches for the prevention malnutrition.

Assessment of malnutrition using Z-scores and Composite Index of Anthropometric Failure among street children in Delhi

BackgroundStreet children are poverty-stricken and have insufficient money to meet their daily nutritional requirements. They do not have a proper place to sleep and defecate. They sleep at traffic signals, in religious places, and on footpaths. This exposes them to pollution, dirt, and other pathogens. ObjectivesThis study aimed to measure the nutritional status of street children in Delhi using Z-scores and Composite Index of Anthropometric Failure (CIAF). MethodsAnthropometric measurements are direct methods of measuring the nutritional status of humans. Anthropometric indicators such as underweight (weight-for-age), stunting (height-for-age) and BMI/wasting (weight-for-height) are used to measure the nutritional status of street children. Z-scores and CIAF are calculated for street children based on the WHO 2009 reference. ResultsAccording to Z-scores, stunting (56%) is the most common anthropometric failure among street children followed by underweight (31%) and wasting (19%). According to the CIAF, 63% of street children are malnourished, where stunting (37%) is the highest single burden of anthropometric failure, followed by wasting (3%) and underweight (1%); children suffering from the double burden of anthropometric failure are 9%, and children suffering from the triple burden of anthropometric failure (i.e., wasting, stunting, and underweight) are 13%. ConclusionA high incidence of stunting points to poor quality of food and suggests prolonged nutrition deficiency among street children. The Z-score or conventional measures of anthropometry underestimate the total burden of malnutrition among street children, while CIAF provides an estimation of children with single-burden, double-burden, and triple-burden malnutrition or total burden of malnutrition.

HUBUNGAN POLA ASUH DAN PEMBERIAN ASI EKSKLUSIF DENGAN STATUS GIZI BAYI DI KLINIK SARGIATI Amd.Keb TAHUN 2023

The focus on improving public nutrition in Indonesia remains centered on addressing the nutritional status of Indonesian children. According to the 2014 Global Nutrition Report (GNR), Indonesia is one of 17 out of 117 countries facing the triple burden of stunting, wasting, and overweight among infants or toddlers within the first days of life. Despite efforts, exclusive breastfeeding rates in Indonesia have not met the targeted 80%. In 2016, exclusive breastfeeding rates for infants aged 0-5 months were at 54.0%, while only 29.5% were exclusively breastfed up to 6 months. Although South Sumatra province has surpassed the national average with a rate of 60.4%, it still falls short of the desired 80%. Researchers focused on the Sargiati Amd clinic, particularly exploring the correlation between parenting styles, exclusive breastfeeding, and infant nutritional status. Among the 19 respondents, the majority exhibited a certain parenting style. Among them, 11 individuals had good nutritional status (36.7%), while 8 had poor nutritional status (36.7%). Only a minority (6.7%) had poor nutritional status. Surprisingly, among those with good parenting habits, the majority had poor nutritional status (23.3%), while the minority had good nutritional status (13.3%). Statistical analysis using a chi-square test with a significance level of 0.05 yielded a p-value of 0.256 (P &gt; 0.05), indicating acceptance of the null hypothesis (Ho) and rejection of the alternative hypothesis (Ha). Thus, no significant relationship was found between parenting style and nutritional status. However, there was a significant relationship between parents' eating habits and healthy habits with nutritional status (p = 0.014; p = 0.006).

Thirty-year trends of triple burden of disease in the adult population of Pakistan.

The triple burden of disease, i.e. communicable diseases, non-communicable diseases and injuries, has significantly affected the healthcare system of Pakistan during the last three decades. Therefore, this study aims to determine and analyse the 30-year disease burden trends through prevalence, death rates and percentages. The data for the last three decades, i.e. 1990 to 2019, was extracted from the Global Burden of Disease for Pakistan. Percentage change in prevalence and deaths over 30years was calculated. Poisson regression analysis was performed to evaluate the triple disease burden trends and the incidence rate ratio. A relative decrease of 23.4% was noted in the prevalence rate of communicable diseases except for human immunodeficiency virus and dengue fever. A relative increase of 1.4% was noted in the prevalence rate of non-communicable diseases. A relative increase of 56.1% was recorded in the prevalence rate of injuries. The prevalence rate ratios of communicable diseases significantly decreased to 0.9796 [95% CI: 0.9887-0.9905], but the prevalence rate of injury increased to 1.0094 [95% CI: 1.0073-1.01145], respectively. Pakistan must take the next steps and develop strategies to decrease this burden and mortality rates in the population to create better outcomes and therefore help the healthcare system overall.

Intake of energy and macronutrients in the diets of 11–13-year-old schoolchildren living in Delhi India

National surveys in India, through measures of anthropometry and biomarkers, have identified a triple burden of malnutrition (undernutrition, micronutrient deficiencies and overnutrition) in adolescents(1). However, there is a dearth of high-quality data on individual dietary behaviour of this population(2) and the importance of sub-national dietary surveys in filling this gap has been identified(3). The objective of this study was to assess the intake of energy (E) and macronutrients and the contribution of macronutrients to E in a random sample of 11–13-year-old schoolchildren in Delhi, India. Method: The study was approved by The University of Adelaide Human Research Ethics Committee and the Independent Ethics Committee of the Centre for Chronic Disease Control, New Delhi. The target sample size of 360 was based on a ± 5% margin of error in estimated sugars intakes. Using the list of private schools in Delhi (n = 1374), a statistician external to the research team generated a random sample of 150 schools stratified by districts (n = 11). Using this list, schools were invited to participate, and recruitment continued until 10 schools consented. Teachers shared study information with parents; interested parents filled in the online consent form. Assent was obtained from schoolchildren. Participants recorded all food and drink consumed over three consecutive days, including one weekend day, in a food diary. Information recorded was entered into an online dietary assessment tool, Intake24 Southeast Asia version, during an interview with each participant. The Intake24 database of over 2400 food photographs of more than 100 foods was used to ascertain portion size. The Intake24 database converts food and drink reported into the intake of nutrients through integrated food compositional tables. Of 514 pupils providing consent, 393 participants (76.4%) (169 girls, 224 boys) completed the study. The median daily E intake was 10.8 (IQR 9.0 −12.5) MJ for girls, and 12.3 (IQR 10.3- 15.2) MJ for boys. For the 97 girls and 144 boys providing body weight data, Physical Activity Level ratios were 2.0 and 2.1 respectively. The median daily intakes for girls were: protein 64.6 (IQR 54.8-79.3) g; carbohydrate 336.5 (IQR 285.3- 393.6) g; and saturated fat 45.6 (IQR 34.8-58.3) g. The respective values in boys were: protein 74.4 (IQR 61.4; 89.4) g; carbohydrate 379.6 (IQR 317.8; 461.8) g; and saturated fat 54.6 (IQR 41.9-69.5) g. There were no significant between-gender differences in percent E from protein (10.2 (IQR 9.2; 11.4)), or carbohydrate (52.4 (IQR 48.7; 56.7)). Girls obtained less E from saturated fat (16.1 (IQR 11.0-18.2) compared with boys 16.3 (IQR 14.2 - 19.1) (P&lt;0.05). In conclusion, in this sample of adolescents from private schools in Delhi, E intake was above FAO recommended levels and median total fat intake exceeded the recommended threshold of 35%(4).

Machine learning models for prediction of double and triple burdens of non-communicable diseases in Bangladesh.

Increasing prevalence of non-communicable diseases (NCDs) has become the leading cause of death and disability in Bangladesh. Therefore, this study aimed to measure the prevalence of and risk factors for double and triple burden of NCDs (DBNCDs and TBNCDs), considering diabetes, hypertension, and overweight and obesity as well as establish a machine learning approach for predicting DBNCDs and TBNCDs. A total of 12,151 respondents from the 2017 to 2018 Bangladesh Demographic and Health Survey were included in this analysis, where 10%, 27.4%, and 24.3% of respondents had diabetes, hypertension, and overweight and obesity, respectively. Chi-square test and multilevel logistic regression (LR) analysis were applied to select factors associated with DBNCDs and TBNCDs. Furthermore, six classifiers including decision tree (DT), LR, naïve Bayes (NB), k-nearest neighbour (KNN), random forest (RF), and extreme gradient boosting (XGBoost) with three cross-validation protocols (K2, K5, and K10) were adopted to predict the status of DBNCDs and TBNCDs. The classification accuracy (ACC) and area under the curve (AUC) were computed for each protocol and repeated 10 times to make them more robust, and then the average ACC and AUC were computed. The prevalence of DBNCDs and TBNCDs was 14.3% and 2.3%, respectively. The findings of this study revealed that DBNCDs and TBNCDs were significantly influenced by age, sex, marital status, wealth index, education and geographic region. Compared to other classifiers, the RF-based classifier provides the highest ACC and AUC for both DBNCDs (ACC = 81.06% and AUC = 0.93) and TBNCDs (ACC = 88.61% and AUC = 0.97) for the K10 protocol. A combination of considered two-step factor selections and RF-based classifier can better predict the burden of NCDs. The findings of this study suggested that decision-makers might adopt suitable decisions to control and prevent the burden of NCDs using RF classifiers.

Co-existence of maternal overweight/obesity, child undernutrition, and anaemia among mother-child pairs in Ethiopia.

Ethiopia is currently known to be the most food-insecure country in sub-Saharan Africa, where childhood undernutrition remains endemic. While attention is increasingly being paid to childhood undernutrition in Ethiopia, a current surge of "triple burden of malnutrition" (TBM) has received less attention. The purpose of this study was to determine the prevalence of TBM and identify the associated factors in Ethiopia. Data were from the Ethiopian Demographic and Health Surveys (2005-2016) and a total of 20,994 mother-child pairs were examined in this study. The TBM was our primary outcome variable, which encompasses three types of nutritional problems-when a mother may be overweight/obese, while her child is stunted, wasted, or underweight plus has anaemia under the same roof. A multilevel logistic regression explored the individual- and community-level factors associated with TBM. Our study indicated that children under-five years of age were anaemic, stunted, wasted, and underweight [49.3% (95% CI: 48.7-49.9), 43.1% (95% CI: 42.4-43.7), 10.3% (95% CI: 9.9-10.7), and 27.6% (95% CI: 27.0-28.1)] respectively. The overall prevalence of TBM was 2.6% (95% CI: 2.39-2.83). Multilevel analyses revealed that TBM was more likely to occur among children aged 12-23 months (AOR: 2.54, 95% CI: 1.68-3.83), 24-35 months (AOR: 1.54, 95% CI: 1.03-2.29), children perceived by their mothers to be smaller than normal at birth (AOR: 1.94, 95% CI: 1.48-2.56), who experienced fever in the past 2 weeks (AOR: 1.58, 95% CI: 1.24-2.01), and lived in urban settings (AOR: 1.79, 95% CI: 1.13-2.86). Lower odds of TBM were reported among female children (AOR: 0.59, 95% CI: 0.47-0.72), and those who lived in rich households (AOR: 0.69: 95% CI: 0.49-0.98). TBM was found to be present in almost three percent of households in Ethiopia. Addressing the TBM through double-duty actions will be of critical importance in achieving malnutrition in all its forms in Ethiopia.

PELATIHAN PEMBUATAN TEH HERBAL UNTUK MENINGKATKAN KUALITAS KESEHATAN MASYARAKAT DI DESA CIBIRU WETAN

&lt;p&gt;&lt;em&gt;The current condition of Indonesia can be said to be facing a triple burden&lt;/em&gt;&lt;em&gt;.&lt;/em&gt; &lt;em&gt;Based on research results from the Central Statistics Agency, the percentage of the population, especially the population of West Java, who had health complaints during the last month in 2022 showed an increase compared to the previous year (2021), this is of course related to the quality of public health. The problem currently faced by partners is the lack of information and education regarding the processing of nutritious plants. So far, the crops obtained have been used in simple ways, eaten directly as fresh vegetables or processed as food.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;This time the community service program was carried out in Cibiru Wetan Village, Cileunyi District, Bandung Regency. Activities include providing education regarding efficacious herbal plants and tutorials on making herbal tea as an effort to improve the quality of health.&lt;/em&gt;&lt;/p&gt;&lt;em&gt;From the results of implementing this community service activity, the residents of Cibiru Wetan Village, Cileunyi District, Bandung Regency have understood the ingredients that can be used in an effort to improve the quality of health and one way of processing them&lt;/em&gt;