CeMIS, University of Göttingen, Göttingen, Germany,
CeMIS, University of Göttingen, Göttingen, Germany.
World Rev Nutr Diet. 2020;121:138-148. doi: 10.1159/000507521. Epub 2020 Oct 6.
The double burden of malnutrition (DBM), i.e., coexistence of under- and overnutrition, is an emerging issue in most of the low- and middle-income countries of the world. Using field survey data conducted in and around the city of Bangalore, India in 2018, we examine the patterns of DBM among women, young children (0-6 years), older children (7-18 years), and intrahousehold DBM between mothers and children. A unique aspect of the survey is that it is conducted in an area undergoing rapid urbanization, which is one of the factors responsible for DBM and can inform on the future of DBM in India. Compared to undernutrition, the prevalence of overnutrition is much higher in our study area. We find that, like other developing countries, the socioeconomic distance in prevalence of under- and overnutrition among women has decreased over time. Additionally, overnutrition among women is no longer an urban phenomenon. Similar trends were observed for older children. For younger children, on the other hand, the socioeconomic and locational differences persist, suggesting that this age group is not witnessing nutrition transition yet. The intrahousehold burden of DBM has also increased over time and the risk increases with maternal education. Although under- and overnutrition are opposite in nature, both have several common drivers, suggesting that an integrated approach might work better in tackling DBM. Several existing programs in India, such as ICDS, PDS, and the school meal program, provide excellent infrastructure to roll out policies and interventions, especially diet-based programs, aimed at both under- and overnutrition.
营养不良的双重负担(DBM),即营养不足和营养过剩的同时存在,是世界上大多数低收入和中等收入国家面临的一个新问题。我们利用 2018 年在印度班加罗尔市及其周边地区进行的实地调查数据,研究了妇女、幼儿(0-6 岁)、大龄儿童(7-18 岁)以及母子之间家庭内 DBM 的模式。该调查的一个独特方面是,它是在一个快速城市化的地区进行的,这是导致 DBM 的因素之一,可以为印度未来的 DBM 提供信息。与营养不足相比,营养过剩在我们的研究地区更为普遍。我们发现,与其他发展中国家一样,在妇女中,营养不足和营养过剩的社会经济距离随着时间的推移而缩小。此外,妇女营养过剩不再是城市现象。大龄儿童也出现了类似的趋势。另一方面,对于幼儿来说,社会经济和地理位置的差异仍然存在,这表明这一年龄组尚未经历营养转型。家庭内 DBM 的负担也随着时间的推移而增加,并且随着母亲教育程度的提高,风险也会增加。尽管营养不足和营养过剩在性质上是相反的,但它们有几个共同的驱动因素,这表明综合方法可能更适合解决 DBM 问题。印度现有的几项计划,如 ICDS、PDS 和学校供餐计划,为实施政策和干预措施,特别是针对营养不足和营养过剩的饮食计划提供了良好的基础设施。