Khan Durray Shahwar A, Das Jai K, Zareen Shagufta, Lassi Zohra S, Salman Afsah, Raashid Muhammad, Dero Aftab A, Khanzada Aijaz, Bhutta Zulfiqar A
Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan.
Front Nutr. 2022 Feb 2;8:739447. doi: 10.3389/fnut.2021.739447. eCollection 2021.
The prevalence of double burden of malnutrition (DBM) is high in low- and middle-income countries (LMICs). Data on malnutrition trends is present for children <5 years of age, however the data for school-going children and adolescents aged 5-15 years is scarce.
This systematic review presents the pooled prevalence of nutritional status and dietary intake among school-going children and adolescents (5-15 years of age) in an LMIC of Pakistan and the perspective for broader global nutrition in this age group.
An electronic search of databases was run on Pubmed and Medline (via Ovid) along with gray literature and archives of local scientific journals till 2nd January 2021. Studies meeting the eligibility criteria were included and relevant data were extracted, and a pooled proportional analysis was performed.
A total of 51 studies including 62,148 children of 5-15 years met the inclusion criteria, of which 30 studies reported on anthropometric indices alone, eight on dietary intake patterns while 13 reported both. All of the included studies had a cross-sectional study design. There were 20 studies from the province of Punjab, 15 from Sindh, eight from Khyber Pakhtoonkhwa, two from Balochistan, and three from multiple cities across Pakistan. The pooled proportional analysis showed that the proportion of underweight children and adolescents was 25.1% (95% CI 17.3-33.7%); stunting 23% (95% CI 11.8-36.7%); wasting 24% (95% CI 15.2-34%); thinness 12.5% (95% CI 9.4-16.1%); overweight 11.4% (95% CI 7.2-16.3%); and obesity 6.9% (95% CI 3-12%). A relatively high intake of carbohydrates, soft drinks, and sweets/chocolates; and a low intake of protein-rich foods, fruits, and vegetables, compared to the recommended daily allowance (RDA), was reported.
The limited data suggests the presence of DBM amongst children aged 5-15 years and also identified that dietary intake patterns are not meeting the recommended allowance. This review highlights the gaps and the need for larger, well-designed studies for this age group with the representation of different contexts and the need for similar studies in various LMICs, so that appropriate actions be deliberated and appropriate programs should be designed focusing on this vital population.
营养不良双重负担（DBM）在低收入和中等收入国家（LMICs）中普遍存在。关于5岁以下儿童营养不良趋势的数据已有，但5至15岁学龄儿童和青少年的数据却很稀少。
本系统评价呈现了巴基斯坦一个低收入和中等收入国家中学龄儿童和青少年（5至15岁）的营养状况和饮食摄入量的汇总患病率，以及该年龄组更广泛的全球营养前景。
截至2021年1月2日，在PubMed和Medline（通过Ovid）以及灰色文献和当地科学期刊档案中对数据库进行了电子检索。纳入符合资格标准的研究，提取相关数据，并进行汇总比例分析。
共有51项研究纳入了62148名5至15岁的儿童，其中30项研究仅报告了人体测量指标，8项报告了饮食摄入模式，13项同时报告了两者。所有纳入研究均采用横断面研究设计。有20项研究来自旁遮普省，15项来自信德省，8项来自开伯尔-普赫图赫瓦省，2项来自俾路支省，3项来自巴基斯坦多个城市。汇总比例分析表明，体重不足的儿童和青少年比例为25.1%（95%CI 17.3-33.7%）；发育迟缓23%（95%CI 11.8-36.7%）；消瘦24%（95%CI 15.2-34%）；消瘦12.5%（95%CI 9.4-16.1%）；超重11.4%（95%CI 7.2-16.3%）；肥胖6.9%（95%CI 3-12%）。与推荐每日摄入量（RDA）相比，报告的碳水化合物、软饮料和糖果/巧克力摄入量相对较高；而富含蛋白质的食物、水果和蔬菜摄入量较低。
有限的数据表明5至15岁儿童中存在营养不良双重负担，并且还发现饮食摄入模式未达到推荐摄入量。本综述强调了差距以及对该年龄组进行更大规模、设计良好的研究的必要性，这些研究应涵盖不同背景，并且低收入和中等收入国家也需要进行类似研究，以便审议适当行动并设计针对这一重要人群的适当方案。
