The double burden of malnutrition in under-5 year old children in arab countries : an analysis of prevalence and predictors -

Abstract

Globalization and increased urbanization catalyzed a series of socioeconomic changes in low- and middle-income countries that have resulted in a nutrition transition characterized by the westernization of diets paralleled with a decrease in physical activity. In a context still facing the burden of infectious diseases and chronic nutrient deficiencies, this has led to a coexistence of both extremities of malnutrition within populations, commonly referred to as the double burden of malnutrition (DBM). Although paradoxical in nature, this double burden is thought to be rooted in the same social determinants. This study uses a pooled representative sample from the Middle East and North Africa (MENA) region for children between the ages of 6 to 59 months to estimate the prevalence of the individual single burdens “stunted child” and “overweight child”, as well as the double burden “stunted -overweight child” among children less than 5 years of age. Furthermore, this study assesses the association of these outcomes with wealth, maternal education, urbanization and gender. The results indicate that the highest proportions of child stunting (32.8percent) were found in Sudan while the highest proportions of child overweight (19.6percent) and child double burdens (11.8percent) were found in Egypt. Males were at a greater risk of both child stunting and overweight. The urban-rural dichotomy did not significantly dissociate the burdens across most countries. Stunting was clustered within low socio-economic status whereas overweight was clustered in high socio-economic status, indicating that the nutrition transition was still at a relatively early stage in the region. The pooled analyses masked large heterogeneities across countries, particularly in the determinants of the double burden of malnutrition. This study acknowledges that the pattern of associations between determinants and outcomes still reflect those common in LMICs at the early stages of the nutrition transition. Furthermore, it appears that