The double burden of malnutrition in indigenous and nonindigenous Guatemalan populations
The double burden of malnutrition in indigenous and nonindigenous Guatemalan populations
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DOI：
10.3945/ajcn.114.083857
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发表时间：
2014-12-01
影响因子：
7.1
通讯作者：
Kanter, Rebecca
中科院分区：
文献类型：
--
作者：
Ramirez-Zea, Manuel;Kroker-Lobos, Maria F.;Kanter, Rebecca
背景资料：随着发展中国家肥胖患病率的增加，营养不良的双重负担（DBM）已成为一个公共卫生问题，特别是在危地马拉等土著社区高度集中的国家，发育迟缓的患病率仍然很高。目的：目的是描述和分析DBM随时间的患病率（1998-2008年）在危地马拉土著和非土著人口中的作用。我们使用了1998年至2008年期间在危地马拉进行的3次全国妇幼健康调查，其中包括0-60个月儿童和育龄妇女（15- 18岁）的人体测量数据。49 y）。我们评估了1998年至2008年间儿童发育迟缓以及儿童和成年女性超重和肥胖的患病率。2008年，我们评估了家庭中DBM的患病率（发育不良的孩子和超重的母亲）和个人（发育迟缓/身材矮小和超重或贫血和超重在同一个人）的水平，并比较预期和观察到的患病率，以测试是否DBM条件的共存对应于预期值。1998年至2008年期间，土著和非土著人口的儿童发育迟缓患病率均有所下降，而土著人口中妇女超重和肥胖的增长速度快于非土著人口（0.91%对0.38%/年; P趋势< 0.01）。2008年，与非土著人口相比，土著人口中发育迟缓儿童的患病率高出28.8个百分点，超重妇女的患病率低出4.6个百分点（分别为63.7%对34.9%和46.7%对51.3%）。DBM在家庭和个人层面是较高的土著人口和较高的地理区域，其中大部分人口是土著人，在那里也有一个更大的患病率发育迟缓和DBM在个人层面上，无论是在妇女和children.Conclusions：在危地马拉，DBM是更普遍的土著比非土著人口在家庭和个人层面。为了提高有效性，目前的国家政策和方案战略应考虑DBM，并侧重于土著人口。
Background: As the prevalence of obesity increases in developing countries, the double burden of malnutrition (DBM) has become a public health problem, particularly in countries such as Guatemala with a high concentration of indigenous communities where the prevalence of stunting remains high.Objective: The aim was to describe and analyze the prevalence of DBM over time (1998-2008) in indigenous and nonindigenous Guatemalan populations.Design: We used 3 National Maternal and Child Health Surveys conducted in Guatemala between 1998 and 2008 that include anthropometric data from children aged 0-60 mo and women of reproductive age (15-49 y). We assessed the prevalence of childhood stunting and both child and adult female overweight and obesity between 1998 and 2008. For the year 2008, we assessed the prevalence of DBM at the household (a stunted child and an overweight mother) and individual (stunting/short stature and overweight or anemia and overweight in the same individual) levels and compared the expected and observed prevalence rates to test if the coexistence of the DBM conditions corresponded to expected values.Results: Between 1998 and 2008, the prevalence of childhood stunting decreased in both indigenous and nonindigenous populations, whereas overweight and obesity in women increased faster in indigenous populations than in nonindigenous populations (0.91% compared with 0.38%/y; P-trend < 0.01). In 2008, the prevalence of stunted children was 28.8 percentage points higher and of overweight women 4.6 percentage points lower in indigenous compared with nonindigenous populations (63.7% compared with 34.9% and 46.7% compared with 51.3%, respectively). DBM at the household and individual levels was higher in indigenous populations and was higher in geographic areas in which most of the population was indigenous, where there was also a greater prevalence of stunting and DBM at the individual level, both in women and children.Conclusions: In Guatemala, DBM is more prevalent in indigenous than in nonindigenous populations at the household and individual levels. To enhance effectiveness, current strategies of national policies and programs should consider DBM and focus on indigenous populations.