Lee Hocheol, Kim Ji Eon, Amarilla Adriana, Kang Yanghee, Boram Boram, Nam Eun Woo
Yonsei Global Health Center, Yonsei University, Wonju.
Pan American Health Organization (PAHO), Asuncion.
J Public Health Res. 2021 Jul 31;10(4):2196. doi: 10.4081/jphr.2021.2196.
The World Health Organization (WHO) defines the double burden of malnutrition as the new face of malnutrition. This is a serious problem in Latin American countries, especially Paraguay, which has a high obesity rate. This study aimed to gather data to inform a national strategy for confronting the double-burden challenge in Paraguay by 1) identifying whether the body mass index (BMI) of study subjects differed significantly according to social determinants, and 2) assessing the factors affecting BMI and the extent of their impact according to BMI quantile levels.
Data were collected using a questionnaire adapted from the WHO World Health Survey. We collected 2,200 responses from September 16 to October 7, 2018. After excluding the questionnaires with missing data, we analyzed 1,994 respondents aged 17 years and older living in Limpio, Paraguay. The analyses included t-test and chi-squared test to identify significant differences and 10th quantile regression to assess associations.
Analyses showed significant differences in participants' BMI levels based on age and diagnoses of diabetes or hypertension. In quantile regression analyses, age was significantly associated with BMI quantiles at all but one level. Educational attainment was significantly associated with the 10%-40% and 60%-70% quantiles of BMI.
Age, education level, diabetes, and hypertension were significant predictors of obesity. Obesity programs that focus on people aged more than 60 years are required. In addition, targeted nutritional education may be a useful intervention.
世界卫生组织（WHO）将营养不良的双重负担定义为营养不良的新面貌。这在拉丁美洲国家是一个严重问题，尤其是在肥胖率很高的巴拉圭。本研究旨在收集数据，以制定一项应对巴拉圭双重负担挑战的国家战略，具体方法如下：1）根据社会决定因素确定研究对象的体重指数（BMI）是否存在显著差异；2）根据BMI分位数水平评估影响BMI的因素及其影响程度。
使用改编自WHO世界卫生调查的问卷收集数据。我们在2018年9月16日至10月7日期间收集了2200份回复。在排除有缺失数据的问卷后，我们分析了1994名年龄在17岁及以上、居住在巴拉圭林皮奥的受访者。分析包括用于确定显著差异的t检验和卡方检验，以及用于评估关联的第10分位数回归。
分析显示，参与者的BMI水平在年龄以及糖尿病或高血压诊断方面存在显著差异。在分位数回归分析中，除一个水平外，年龄与所有BMI分位数均显著相关。受教育程度与BMI的10%-40%和60%-70%分位数显著相关。
年龄、教育水平、糖尿病和高血压是肥胖的重要预测因素。需要针对60岁以上人群开展肥胖项目。此外，有针对性的营养教育可能是一种有效的干预措施。
