The Double Burden of Obesity and Malnutrition in a Protracted Emergency Setting: A Cross-Sectional Study of Western Sahara Refugees
The Double Burden of Obesity and Malnutrition in a Protracted Emergency Setting: A Cross-Sectional Study of Western Sahara Refugees
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DOI：
10.1371/journal.pmed.1001320
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发表时间：
2012-10-01
期刊：
影响因子：
15.8
通讯作者：
Seal, Andrew J.
中科院分区：
文献类型：
--
作者：
Grijalva-Eternod, Carlos S.;Wells, Jonathan C. K.;Seal, Andrew J.
背景：众所周知，经历流行病学转变的弱势群体家庭同时受到营养不良和肥胖的影响。然而，尚不清楚这种双重负担对依赖粮食援助的难民人口有何影响。我们评估了生活在长期紧急状态下的西撒哈拉难民营养不良的双重负担。方法和结果：我们于 2010 年 10 月至 11 月在阿尔及利亚的四个西撒哈拉难民营实施了分层营养调查。我们对 2,005 个家庭进行了抽样调查，收集了 1,608 名儿童（6-59 个月）和 1,781 名女性（15-49 岁）的人体测量数据（体重、身高和腰围）。我们估计了全球儿童急性营养不良（GAM）、发育迟缓、体重不足和超重的患病率；以及女性发育迟缓、体重不足、超重和中心性肥胖。为了评估家庭内营养不良的负担，首先根据每种营养不良的存在情况对家庭进行分类。然后，如果家庭成员的营养不良、超重或两者兼而有之，则将其分类为营养不良、超重或受到双重负担的影响。儿童GAM患病率为9.1%，其中29.1%发育迟缓，18.6%体重不足，2.4%超重；女性中，14.8%发育迟缓，53.7%超重或肥胖，71.4%患有中心性肥胖。女性中心性肥胖（47.2%）和超重（38.8%）影响的家庭比例高于儿童GAM（7.0%）、发育迟缓（19.5%）或体重不足（13.3%）的家庭比例。总体而言，超重家庭（31.5%）最为常见，其次是营养不良家庭（25.8%），然后是双重负担家庭（24.7%）。结论：西撒哈拉难民家庭中肥胖和营养不良的双重负担非常普遍。结果强调，需要更多地关注这一人群的非传染性疾病，并在肥胖预防和管理与解决营养不良问题的干预措施之间取得平衡。
Background: Households from vulnerable groups experiencing epidemiological transitions are known to be affected concomitantly by under-nutrition and obesity. Yet, it is unknown to what extent this double burden affects refugee populations dependent on food assistance. We assessed the double burden of malnutrition among Western Sahara refugees living in a protracted emergency.Methods and Findings: We implemented a stratified nutrition survey in October-November 2010 in the four Western Sahara refugee camps in Algeria. We sampled 2,005 households, collecting anthropometric measurements (weight, height, and waist circumference) in 1,608 children (6-59 mo) and 1,781 women (15-49 y). We estimated the prevalence of global acute malnutrition (GAM), stunting, underweight, and overweight in children; and stunting, underweight, overweight, and central obesity in women. To assess the burden of malnutrition within households, households were first classified according to the presence of each type of malnutrition. Households were then classified as undernourished, overweight, or affected by the double burden if they presented members with under-nutrition, overweight, or both, respectively. The prevalence of GAM in children was 9.1%, 29.1% were stunted, 18.6% were underweight, and 2.4% were overweight; among the women, 14.8% were stunted, 53.7% were overweight or obese, and 71.4% had central obesity. Central obesity (47.2%) and overweight (38.8%) in women affected a higher proportion of households than did GAM (7.0%), stunting (19.5%), or underweight (13.3%) in children. Overall, households classified as overweight (31.5%) were most common, followed by undernourished (25.8%), and then double burden-affected (24.7%).Conclusions: The double burden of obesity and under-nutrition is highly prevalent in households among Western Sahara refugees. The results highlight the need to focus more attention on non-communicable diseases in this population and balance obesity prevention and management with interventions to tackle under-nutrition.