Exploring the magnitude and drivers of the double burden of malnutrition at maternal and dyad levels in peri-urban Peru: A cross-sectional study of low-income mothers, infants and young children.
Exploring the magnitude and drivers of the double burden of malnutrition at maternal and dyad levels in peri-urban Peru: A cross-sectional study of low-income mothers, infants and young children.
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DOI：
10.1111/mcn.13549
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发表时间：
2023-10
影响因子：
3.4
通讯作者：
M. Creed-Kanashiro, Hilary
中科院分区：
文献类型：
--
作者：
Pradeilles, Rebecca;Landais, Edwige;Pareja, Rossina;Eymard-Duvernay, Sabrina;Markey, Oonagh;Holdsworth, Michelle;Rousham, Emily K.;M. Creed-Kanashiro, Hilary
关键词：
在秘鲁，多种形式的营养不良并存，尤其是在城市贫民区和贫困家庭。我们调查了饮食和社会人口因素对孕产妇营养不良双重负担（DBM）的影响程度和贡献（即，母体超重/肥胖伴贫血）和二联体（即，母亲超重/肥胖伴儿童贫血）水平。在来自秘鲁郊区社区的低收入母子（6-23个月）二人组（n = 244）中进行了一项横断面调查。分别为母亲和婴儿生成饮食聚类和最小饮食多样性评分（MDD）。一个复合指标，使用孕产妇饮食集群和MDD创建与二元水平DBM。发现了两个饮食集群：（i）“高品种"（即，动物源性食物、水果和蔬菜）、高糖食物/饮料“（第1类）和（ii）”高土豆、低水果和蔬菜、低红肉“（第2类）。母亲和二对儿DBM患病率分别为19.9%和36.3%。Logistic回归分析显示，与孕产妇DBM呈正相关的唯一社会人口统计学因素是孕产妇年龄（aOR/5岁：1.35 [1.07，1.71]）。属于饮食组群1的母亲不太可能经历DBM（aOR = 0.52 [0.26，1.03]），尽管CI跨越零。与二分体水平DBM呈正相关的社会人口统计学因素包括母亲年龄（aOR/5岁：1.41 [1.15，1.73]）和有≥ 2个5岁以下子女（aOR = 2.44 [1.23，4.84]）。饮食与二分体水平DBM无关。鉴于三分之一的夫妇和五分之一的母亲同时患有超重/肥胖和贫血，需要采取双重责任行动来解决DBM问题。使用人体测量数据和贫血的生物标志物（血红蛋白），我们发现在秘鲁的低收入城市社区中，孕产妇和二孩水平的营养不良双重负担（DBM）患病率相对较高。在母体或二分体水平上，DBM没有社会经济模式。这表明应采用全人群方法。确定了两个母体饮食集群;一个集群被认为更有营养，尽管饮食中存在高糖项目（即，“高品种[包括动物源食品，水果和蔬菜]，高糖食品和饮料”）和一个营养较少（即，“高土豆，低水果和蔬菜，低红肉”）。DBM是不太可能在母亲属于更有营养的集群。在这种情况下，应该采取双重责任行动，优先考虑所有人的最佳饮食质量，以解决DBM问题。我们调查了饮食和社会人口因素对孕产妇营养不良双重负担（DBM）的影响程度和贡献（即，母体超重/肥胖伴贫血）和二联体（即，在秘鲁的城市社区中，低收入的母亲-子女二人组的母亲体重过重/肥胖伴儿童贫血的比例。我们发现在母体和二分体水平上DBM的患病率相对较高（分别为19.9%和36.3%）。DBM中没有社会经济模式。尽管饮食和DBM之间的联系证据不足，但我们的研究结果表明，与“高土豆，低水果和蔬菜，低红肉”集群相比，“高品种，高糖食品和饮料”集群的超重/肥胖和贫血的并发症不太可能发生。鉴于我们的样本中超重/肥胖和微量营养素营养不良并发症的患病率相对较高，双重责任行动应优先考虑所有人的最佳饮食质量。
Multiple forms of malnutrition coexist in Peru, especially in peri‐urban areas and poor households. We investigated the magnitude of, and the contribution of, dietary and socio‐demographic factors to the double burden of malnutrition (DBM) at maternal (i.e., maternal overweight/obesity with anaemia) and dyad (i.e., maternal overweight/obesity with child anaemia) levels. A cross‐sectional survey was conducted among low‐income mother–child (6–23 months) dyads (n = 244) from peri‐urban communities in Peru. Dietary clusters and the minimum dietary diversity score (MDD) were generated for mothers and infants, respectively. A composite indicator using the maternal dietary clusters and the MDD was created to relate to dyad level DBM. Two dietary clusters were found: (i) the ‘high variety (i.e., animal‐source foods, fruit and vegetables), high sugary foods/beverages’ (cluster 1) and (ii) the ‘high potato, low fruit and vegetables, low red meat’ (cluster 2). DBM prevalence among mothers and dyads was 19.9% and 36.3%, respectively. Logistic regression analyses revealed that the only socio‐demographic factor positively associated with maternal DBM was maternal age (aOR/5 years: 1.35 [1.07, 1.71]). Mothers belonging to diet cluster 1 were less likely to experience the DBM (aOR = 0.52 [0.26, 1.03]), although CIs straddled the null. Socio‐demographic factors positively associated with dyad level DBM included maternal age (aOR/5 years: 1.41 [1.15, 1.73]), and having ≥ two children under 5 years (aOR = 2.44 [1.23, 4.84]). Diet was not associated with dyad‐level DBM. Double‐duty actions that tackle the DBM are needed given that one‐third of dyads and a fifth of mothers had concurrent overweight/obesity and anaemia. Using anthropometric data and a biomarker of anaemia (haemoglobin), we found a relatively high prevalence of the double burden of malnutrition (DBM) at maternal and dyad levels in low‐income peri‐urban communities of Peru. There was no socioeconomic patterning in the DBM at maternal or dyad level. This indicates that a whole‐population approach should be adopted. Two maternal dietary clusters were identified; one cluster was considered more nutritious despite the presence of high sugary items in the diet (i.e., the ‘high variety [including animal‐source food, fruit and vegetables], high sugary foods and beverages’) and one less nutritious (i.e., the ‘high potato, low fruit and vegetables, low red meat’). The DBM was less likely in mothers belonging to the more nutritious cluster. Double‐duty actions that prioritise optimum diet quality for all should be implemented to tackle the DBM in this context. We investigated the magnitude of, and the contribution of, dietary and socio‐demographic factors to the double burden of malnutrition (DBM) at maternal (i.e., maternal overweight/obesity with anaemia) and dyad (i.e., maternal overweight/obesity with child anaemia) levels among low‐income mother–child dyads from peri‐urban communities in Peru. We found a relatively high prevalence of the DBM at maternal and dyad levels (19.9% and 36.3%, respectively). There was no socioeconomic patterning in the DBM. Despite weak evidence linking diet and DBM, our results suggest that the concurrence of overweight/obesity and anaemia was less likely in those who belonged to the ‘high variety, high sugary foods and beverages’ cluster compared with the ‘high potato, low fruit and vegetables, low red meat’ cluster. Given the relatively high prevalence of concurrent overweight/obesity and micronutrient malnutrition in our sample, double‐duty actions should prioritise optimum diet quality for all.
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