Evidence of a Double Burden of Malnutrition in Urban Poor Settings in Nairobi, Kenya.
Evidence of a Double Burden of Malnutrition in Urban Poor Settings in Nairobi, Kenya.
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DOI：
10.1371/journal.pone.0129943
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Kyobutungi C
中科院分区：
文献类型：
--
作者：
Kimani-Murage EW;Muthuri SK;Oti SO;Mutua MK;van de Vijver S;Kyobutungi C
许多低收入和中等收入国家正在经历与快速社会和经济转型相关的营养转型。我们探讨了在肯尼亚内罗毕的城市贫困环境中，社区和家庭层面营养过剩和营养不足的共存。2010年收集了2006年至2010年间出生的一组五岁以下儿童的数据。对儿童及其母亲进行人体测量。此外，通过2008年至2009年在同一环境中进行的单独横断面研究，从18岁及以上成年人的分层随机样本中收集了饮食摄入量、体力活动和人体测量数据。在儿童中测定发育迟缓、体重不足、消瘦和超重/肥胖的比例，而在成人中测定体重不足和超重/肥胖的比例。在纳入分析的3335名儿童中，共有6750次就诊，46%（51%男孩，40%女孩）发育迟缓，11%（13%男孩，9%女孩）体重不足，2.5%（3%男孩，2%女孩）消瘦，而9%的男孩和女孩分别超重/肥胖。在他们的母亲中，7.5%体重过轻，32%超重/肥胖。超重和肥胖母亲中有很大比例（分别为43%和37%）的孩子发育迟缓.在纳入分析的5190名成年人中，9%（6%女性，11%男性）体重不足，22%（35%女性，13%男性）超重/肥胖。调查结果证实，在这种情况下存在营养不良的双重负担，其特点是营养不良的发生率很高，特别是在生命早期发育迟缓，成年后超重/肥胖的发生率很高，特别是在妇女中。在城市人口迅速增加的背景下，特别是在城市贫困环境中，这需要采取紧急行动。鉴于城市贫困环境中普遍情况的复杂性，多部门行动可能最有效。需要进一步研究，以了解这种共存的途径，并测试针对具体情况的干预措施的可行性和有效性，以遏制相关的健康风险。
Many low- and middle-income countries are undergoing a nutrition transition associated with rapid social and economic transitions. We explore the coexistence of over and under- nutrition at the neighborhood and household level, in an urban poor setting in Nairobi, Kenya. Data were collected in 2010 on a cohort of children aged under five years born between 2006 and 2010. Anthropometric measurements of the children and their mothers were taken. Additionally, dietary intake, physical activity, and anthropometric measurements were collected from a stratified random sample of adults aged 18 years and older through a separate cross-sectional study conducted between 2008 and 2009 in the same setting. Proportions of stunting, underweight, wasting and overweight/obesity were dettermined in children, while proportions of underweight and overweight/obesity were determined in adults. Of the 3335 children included in the analyses with a total of 6750 visits, 46% (51% boys, 40% girls) were stunted, 11% (13% boys, 9% girls) were underweight, 2.5% (3% boys, 2% girls) were wasted, while 9% of boys and girls were overweight/obese respectively. Among their mothers, 7.5% were underweight while 32% were overweight/obese. A large proportion (43% and 37%%) of overweight and obese mothers respectively had stunted children. Among the 5190 adults included in the analyses, 9% (6% female, 11% male) were underweight, and 22% (35% female, 13% male) were overweight/obese. The findings confirm an existing double burden of malnutrition in this setting, characterized by a high prevalence of undernutrition particularly stunting early in life, with high levels of overweight/obesity in adulthood, particularly among women. In the context of a rapid increase in urban population, particularly in urban poor settings, this calls for urgent action. Multisectoral action may work best given the complex nature of prevailing circumstances in urban poor settings. Further research is needed to understand the pathways to this coexistence, and to test feasibility and effectiveness of context-specific interventions to curb associated health risks.
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