Stunting coexisting with overweight in 2·0–4·9-year-old Indonesian children: prevalence, trends and associated risk factors from repeated cross-sectional surveys

Public Health Nutrition - Tập 19 Số 15 - Trang 2698-2707 - 2016
Cut Novianti Rachmi1, Kingsley Agho2, Mu Li3, Louise A. Baur1,3
1Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead (University of Sydney Clinical School), Locked Bag 4001, Westmead, NSW 2145, Australia
2School of Science and Health, University of Western Sydney, Penrith, NSW, Australia
3Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia

Tóm tắt

AbstractObjective

The persistence of undernutrition, along with overweight and obesity, constitute the double burden of malnutrition. The present study aimed to: (i) describe the prevalence and trends of concurrent stunting and overweight in Indonesian children; (ii) identify potentially associated risk factors; and (iii) determine whether stunted children are at greater risk of overweight compared with those of healthy height.

Design

A secondary data analysis of children aged 2·0–4·9 years in four cross-sectional studies of the Indonesian Family Life Survey. Children’s height and BMI Z-scores were calculated based on the WHO Child Growth Standards (2006). We defined ‘concurrent stunting and overweight’ as height-for-age Z-score <−2 and BMI Z-score >+1. Multivariate generalised linear latent and mixed models were used to determine associated risk factors.

Setting

Thirteen out of twenty-seven provinces in Indonesia.

Subjects

Children (n 4101) from four waves of the Indonesian Family Life Survey (1993–2007).

Results

There were inconsistent trends in the prevalence of concurrent stunting and overweight from waves 1 to 4. Children were more likely to be stunted and overweight when they were in the youngest age group (2·0–2·9 years), were weaned after the age of 6 months, had short-statured mothers or lived in rural areas. Stunted children were significantly more likely to be overweight than healthy-height children (OR>1) but did not differ significantly different across each wave (OR=1·34–2·01).

Conclusions

Concurrent stunting and overweight occurs in Indonesian children aged 2·0–4·9 years. Current policies and programmes need to be tailored for the management of this phenomenon.

Từ khóa


Tài liệu tham khảo

10.1038/sj.ijo.0802824

10.1079/PHN2005786

Shrimpton, 2013, The Double Burden of Malnutrition in Indonesia

10.3945/ajcn.114.083808

10.1177/156482650402500405

2007

Frankenberg, 1995, The 1993 Indonesian Family Life Survey: Overview and Field Report

10.1017/S1368980010002971

10.3109/09540261.2012.688195

2014

10.3945/ajcn.114.083857

Popkin, 1996, Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition, J Nutr, 126, 3009, 10.1093/jn/126.12.3009

10.1596/27417

10.1542/peds.2014-3111

Serrato, 1995, The Indonesian Family Life Survey: Overview and Descriptive Analysis of the Population, Health, and Education Data

Pan H & Cole TJ (2010) LMSGROWTH, a Microsoft Excel add-in to access growth references based on the LMS method (Version 2.68). http://www.healthforallchildren.com/shop-base/shop/software/lmsgrowth/ (accessed April 2014).

10.3945/ajcn.111.026070

World Health Organization (2006) The WHO Child Growth Standards. http://www.who.int/childgrowth/standards/en/ (accessed May 2014).

10.1016/S0140-6736(02)08837-2

10.3945/ajcn.114.083766

10.1038/ejcn.2015.106

2006

Vorster, 2013, An introduction to the revised food-based dietary guidelines for South Africa, S Afr J Clin Nutr, 26, S5

10.1016/j.earlhumdev.2012.04.002

10.1046/j.1467-789x.2001.00036.x

2014

10.3945/jn.114.193664

10.1016/S0140-6736(12)61728-0

10.1542/peds.2009-1519

Filmer, 2001, Estimating wealth effects without expenditure data – or tears: an application to educational enrollments in states of India, Demography, 38, 115

Rabe-Hesketh, 2012, Multilevel and Longitudinal Modelling Using Stata

10.1177/156482651403500203

10.1093/ije/26.2.349

10.3945/ajcn.114.083832

10.1017/S0007114513002079

Doak, 2000, Overweight and underweight coexist within households in Brazil, China and Russia, J Nutr, 130, 2965, 10.1093/jn/130.12.2965

10.1016/S0140-6736(13)60937-X

10.1210/er.2010-0028

10.3945/ajcn.2010.29786

10.1177/15648265130342S103

2014, Global Nutrition Report 2014: Actions and Accountability to Accelerate the World’s Progress on Nutrition

10.1371/journal.pone.0154756

2003, Diet, Nutrition and the Prevention of Chronic Diseases. Report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series

Rand Corporation (2014) The Indonesian Family Life Survey (IFLS). http://www.rand.org/labor/FLS/IFLS.html (accessed May 2014).

Simondon, 2001, Breast-feeding is associated with improved growth in length, but not weight, in rural Senegalese toddlers, Am J Clin Nutr, 73, 959, 10.1093/ajcn/73.5.959

World Health Organization (2014) Global Nutrition Targets 2025: Childhood Overweight Policy Brief. http://www.who.int/nutrition/globaltargets_overweight_policybrief.pdf (accessed November 2014).

10.1111/mcn.12075

Fernald, 2007, Overweight with concurrent stunting in very young children from rural Mexico: prevalence and associated factors, Eur J Clin Nutr, 61, 623, 10.1038/sj.ejcn.1602558

Iriart, 2013, Obesity and malnutrition among Hispanic children in the United States: double burden on health inequities, Rev Panam Salud Publica, 34, 235

10.1093/heapol/czu110