Background: The nutrition and epidemiologic transition is
characterised by changes in diet and activity patterns, leading to the
development of a double burden of malnutrition. At the household level
this often manifests as an overweight mother and underweight child.
However, child and adolescent overweight and obesity also appear to be
on the rise in transitional countries, although it is not well studied.
Parent and child overweight are associated, and overweight children have
a greater risk of becoming overweight adults. Understanding why these
two extremes of child malnutrition occur in households with an
overweight mother is necessary for policy and programmes to target both
<i>Methods: </i> This study examined Young Lives data on 256 adolescents
with overweight (BMI>23kg/m<sup>2</sup>) or obese mothers
(BMI>27kg/m<sup>2</sup>) from India. Child weight status was
determined using BMI-for-age z-scores based on the 2007 WHO reference
median. The aim was to identify independent predictors of child over-
and underweight in two categories of dual burden households: 61(23.8%)
underweight child/overweight mother (U/O) households, 21(8.2%)
overweight child/overweight mother (O/O) households. The reference
category was 174(68.0%) normal weight child/overweight mother (N/O)
households. Bivariate analysis was used to examine associations between
child, parent and household-level indicators and household nutrition
status. Polychotomous logistic regression techniques were employed to
identify independent predictors of U/O and O/O households compared to
the reference N/O households.
<i>Results: </i>After controlling for nutritional and sociodemographic
variables, several indicators emerged as being significant. Households
were less likely to be U/O compared to N/O if: the child was female
<i>Conclusion: </i> Both U/O and O/O double burden households are
present in this sample. Longitudinal data suggests under- and overweight
among children in this cohort are both increasing. Indicators for either
type of household imply that social and physiological factors may be
involved, but more research is required to better define these pathways.
In the meantime, nutrition intervention programmes must recognise the
existence of both extremes of malnutrition at population and household
level, and incorporate this into their targeting strategies in order to
manage the dual burden of malnutrition effectively.
VanderKloet, M. Dual Burden of Malnutrition in Andhra Pradesh, India: Identification of Independent Predictors for Underweight and Overweight in Adolescents with Overweight Mothers. (2008) 30 pp. [Paper submitted in part fulfilment of the requirements for the degree of MSc in Public Health Nutrition, London School of Hygiene and Tropical Medicine]
Dual Burden of Malnutrition in Andhra Pradesh, India: Identification of Independent Predictors for Underweight and Overweight in Adolescents with Overweight Mothers [MSc Thesis]