Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, United States.
Econ Hum Biol. 2012 Jul;10(3):232-41. doi: 10.1016/j.ehb.2011.08.002. Epub 2011 Aug 16.
The double burden of malnutrition, defined here as households with a stunted child and an overweight mother (SCOM), is a growing problem in Guatemala. We explored the magnitude of SCOM and the identification of socio-economic factors associated with this malnutrition duality. From the 2000 Living Standards Measurement Study from Guatemala, we obtained a sample of 2492 households with pairs of children 6-60 months and their mothers (18-49 years) and estimated the prevalence of SCOM. Economic characteristics of this sample were assessed with the Concentration Index (CI). Results revealed higher prevalence of child stunting, but a lower prevalence of maternal overweight among the poor compared to the rich households. Economic inequality in child stunting was greater than economic inequality in maternal overweight (CI=-0.22 vs. +0.14). SCOM pairs were more prevalent among the poor and middle SES groups as compared to the rich households. A multivariate logistic regression model showed that SCOM was more likely to occur in households from the middle consumption quintile than in those from the first quintile (odds ratio=1.7). The findings reported here add new insights into the complex phenomenon observed in households with both extremes of the malnutrition continuum, and support the need for the identification of economic, social and biological interventions aimed at, on the one hand, the prevention of this duality of the malnutrition in those households where it is still non-existent, and on the other hand, to deter or correct the economic, social and biological environments where those mother-child dyads are already affected by such phenomena.
营养不良的双重负担，在这里定义为有发育迟缓儿童和超重母亲的家庭（SCOM），是危地马拉日益严重的问题。我们探讨了 SCOM 的严重程度，以及与这种营养不良双重性相关的社会经济因素的识别。我们从危地马拉的 2000 年生活水平衡量研究中获得了一个有 2492 对 6-60 个月大的儿童及其母亲（18-49 岁）的样本，并估计了 SCOM 的患病率。该样本的经济特征采用集中指数（CI）进行评估。结果显示，与富裕家庭相比，贫困家庭的儿童发育迟缓患病率较高，但母亲超重的患病率较低。儿童发育迟缓的经济不平等程度大于母亲超重的经济不平等程度（CI=-0.22 对+0.14）。与富裕家庭相比，SCOM 对在贫困和中等 SES 群体中更为普遍。多变量逻辑回归模型显示，与来自第一消费五分位数的家庭相比，SCOM 更可能发生在来自中等消费五分位数的家庭中（比值比=1.7）。这里报告的发现为那些处于营养不良连续体两个极端的家庭中观察到的复杂现象提供了新的见解，并支持需要确定经济、社会和生物干预措施，一方面，防止那些尚未存在这种营养不良双重性的家庭出现这种情况，另一方面，遏制或纠正那些母婴对子已经受到这种现象影响的经济、社会和生物环境。
