Lowe Callum, Kelly Mattthew, Sarma Haribondhu, Richardson Alice, Kurscheid Johanna M, Laksono Budi, Amaral Salvador, Stewart Donald, Gray Darren J
Department of Global Health, Research School of Population Health, Australian National University, Acton 2601, Australia.
Health Systems Support Unit, Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel 4051, Switzerland.
Lancet Reg Health West Pac. 2021 Jul 15;14:100205. doi: 10.1016/j.lanwpc.2021.100205. eCollection 2021 Sep.
Indonesia is undergoing a nutrition transition (NT) comprised of rising rates of overweight/obesity and consumption of high fat food/snacks but is still struck by undernutrition, causing a double burden of malnutrition. Little research pertains to the double burden of malnutrition and its associations with diet in rural Indonesia using primary village level data.
We conducted a 24-hour food recall and food frequency questionnaire and assessed anthropometric status of rural villagers from four villages in Central Java, Indonesia. Exploratory principal component analysis was used to identify dietary patterns and multi-level modeling was performed to identify variables associated with dietary pattern indicative of the NT.
1,521 participants were included in analysis. Double burden of malnutrition was prevalent whereby 32.3% of children were stunted, 68.8% of women 35-49 years-old were overweight, and 39% of homes were classified as double burden. The NT was evident in a dietary pattern associated with soft drink, snacks, and animal products. There was small but significant correlation between undernutrition and stunting status among children (r = -0.139, p < 0.01). The NT was associated with young age (B = 1.696, 95% CI = 1.508-1.885) but not with overweight (B = -0.099, 95% CI = -0.184--0.013).
Our findings suggest that whilst the typical pattern of the double burden of malnutrition (stunted child/overweight adult) exists in rural Central Java, dietary patterns indicative of the NT are predominant among children, not adults. Overweight among adults may not be necessarily due to a diet indicative of the NT, and nutrition interventions in rural Central Java should focus on educating parents of young children about the health-risks of a diet associated with a NT.
Funding was obtained from the UBS-Optimus Foundation and the National Health and Medical Research Council.
印度尼西亚正在经历营养转型（NT），其特征是超重/肥胖率上升以及高脂肪食品/零食的消费量增加，但仍受到营养不良的困扰，从而导致了营养不良的双重负担。很少有研究利用村庄一级的原始数据来探讨印度尼西亚农村地区营养不良的双重负担及其与饮食的关联。
我们开展了一项24小时食物回顾和食物频率问卷调查，并评估了印度尼西亚中爪哇四个村庄农村村民的人体测量状况。采用探索性主成分分析来确定饮食模式，并进行多层次建模以确定与表明营养转型的饮食模式相关的变量。
1521名参与者纳入分析。营养不良的双重负担普遍存在，32.3%的儿童发育迟缓，68.8%的35至49岁女性超重，39%的家庭被归类为双重负担家庭。营养转型在与软饮料、零食和动物产品相关的饮食模式中很明显。儿童的营养不良与发育迟缓状况之间存在微小但显著的相关性（r = -0.139，p < 0.01）。营养转型与年轻年龄相关（B = 1.696，95%置信区间 = 1.508 - 1.885），但与超重无关（B = -0.099，95%置信区间 = -0.184 - -0.013）。
我们的研究结果表明，虽然中爪哇农村地区存在营养不良双重负担的典型模式（发育迟缓儿童/超重成人），但表明营养转型的饮食模式在儿童中占主导地位，而非成年人。成年人超重不一定是由于表明营养转型的饮食所致，中爪哇农村地区的营养干预应侧重于教育幼儿家长有关与营养转型相关饮食的健康风险。
资金来自瑞银 - 优擎基金会和澳大利亚国家健康与医学研究委员会。
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