Humbwavali João Baptista, Giugliani Camila, Silva Inácio Crochemore Mohnsam da, Duncan Bruce Bartholow
MSc. Nurse and Associate Professor, Instituto Superior de Ciências da Saúde, Universidade Agostinho Neto (ISCS/UAN), Luanda, Angola.
MD, PhD. Physician and Associate Professor, Postgraduate Program on Epidemiology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre (RS), Brazil.
Sao Paulo Med J. 2018 Sep-Oct;136(5):454-463. doi: 10.1590/1516-3180.2017.0267261117.
While the global prevalence of obesity is rapidly increasing, this pandemic has received less attention in sub-Saharan Africa, particularly in the light of the persistent undernutrition that exists in the context of maternal and child health. We aimed to describe obesity trends among women of childbearing age over recent decades, along with trends in over and undernutrition among children under five years of age, in sub-Saharan African countries.
Ecological study with temporal trend analysis in 13 sub-Saharan African countries.
This was a description of temporal trends in nutritional status: adult obesity, childhood overweight, low height-for-age (stunting), low weight-for-height (wasting), low weight-for-age (underweight) and low birth weight. Publicly available data from repeated cross-sectional national surveys (demographic and health surveys and multiple-indicator cluster surveys) were used. We chose 13 sub-Saharan African countries from which at least four surveys conducted since 1993 were available. We investigated women aged 15-49 years and children under five years of age.
In multilevel linear models, the prevalence of obesity increased by an estimated 6 percentage points over 20 years among women of childbearing age, while the prevalence of overweight among children under 5 years old was stable. A major decrease in stunting and, to a lesser extent, wasting accompanied these findings.
The upward trend in obesity among women of childbearing age in the context of highly prevalent childhood undernutrition suggests that the focus of maternal and child health in sub-Saharan Africa needs to be expanded to consider not only nutritional deficiencies but also nutritional excess.
尽管全球肥胖患病率正在迅速上升，但在撒哈拉以南非洲地区，这一流行病受到的关注较少，尤其是考虑到在母婴健康背景下持续存在的营养不良状况。我们旨在描述近几十年来撒哈拉以南非洲国家育龄妇女的肥胖趋势，以及五岁以下儿童超重和营养不良的趋势。
对13个撒哈拉以南非洲国家进行时间趋势分析的生态研究。
这是对营养状况时间趋势的描述：成人肥胖、儿童超重、年龄别身高低（发育迟缓）、身高别体重低（消瘦）、年龄别体重低（体重不足）和低出生体重。使用了来自重复横断面全国调查（人口与健康调查和多指标类集调查）的公开数据。我们选择了13个撒哈拉以南非洲国家，自1993年以来至少有四项调查数据可用。我们调查了15至49岁的女性和五岁以下的儿童。
在多水平线性模型中，育龄妇女的肥胖患病率在20年内估计增加了6个百分点，而五岁以下儿童的超重患病率保持稳定。与此同时，发育迟缓率大幅下降，消瘦率也有所下降。
在儿童营养不良普遍存在的情况下，育龄妇女肥胖呈上升趋势，这表明撒哈拉以南非洲地区的母婴健康重点需要扩大，不仅要考虑营养缺乏，还要考虑营养过剩。
