Childhood dual burden of under- and overnutrition in low- and middle-income countries: a critical review.

Childhood dual burden of under- and overnutrition in low- and middle-income countries: a critical review.
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DOI:
10.1177/156482651403500210
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发表时间:
2014-06
影响因子:
1.9
通讯作者:
Adair LS
Adair LS
中科院分区:
农林科学3区
文献类型:
--
作者:
Tzioumis E;Adair LS

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在低收入和中等收入国家,儿童营养疾病的分布正从以营养不足为主转变为营养不足和营养过剩的双重负担。这一新颖而复杂的问题向政府和卫生组织提出了挑战,要求他们解决营养不良谱系的两端。这种双重负担可能在社区、家庭或个人中表现出来,但这些不同的层面尚未得到集体解决。批判性地回顾关于双重负担的患病率、趋势和预测因素的文献,重点是出生至18岁的儿童。我们回顾了1990年1月1日以来发表的英文文献,使用PubMed检索词:营养转变、双重负担、双重负担、营养状况、肥胖、超重、体重不足、发育迟缓、身体成分和微量营养素缺乏。根据双重负担水平(社区、家庭、个人)对调查结果进行分类和描述。全球趋势表明,营养不足疾病在减少,而营养过剩却在增加。在社区层面,经济状况可能影响双重负担的程度,肥胖对已经营养不良的穷人的影响越来越大。在一个家庭中,成员之间营养状况不良的共同决定因素可能导致几代人的营养状况不同。在个体内,由于共同的潜在决定因素或生理联系,肥胖可能与发育迟缓或贫血同时发生。营养不良的双重负担对低收入和中等收入国家的儿童健康构成威胁。我们必须继续致力于减少营养不良,同时防止营养过剩,通过综合儿童健康计划,包括预防感染、饮食质量和体育活动。
In low- and middle income countries, the distribution of childhood nutritional diseases is shifting from a predominance of undernutrition to a dual burden of under- and overnutrition. This novel and complex problem challenges governments and health organizations to tackle opposite ends of the malnutrition spectrum. The dual burden may manifest within a community, household, or individual, but these different levels have not been addressed collectively. To critically review literature on the prevalence, trends, and predictors of the dual burden, with a focus on children from birth to 18 years. We reviewed literature since January 1, 1990, published in English, using the PubMed search terms: nutrition transition, double burden, dual burden, nutrition status, obesity, overweight, underweight, stunting, body composition, and micronutrient deficiencies. Findings were classified and described according to dual burden level (community, household, individual). Global trends indicate decreases in diseases of undernutrition, while overnutrition is increasing. On the community level, economic status may influence the dual burden’s extent, with obesity increasingly affecting the already undernourished poor. In a household, shared determinants of poor nutritional status among members can result in disparate nutritional status across generations. Within an individual, obesity may co-occur with stunting or anemia, due to shared underlying determinants or physiologic links. The dual burden of malnutrition poses a threat to children’s health in low- and middle-income countries. We must remain committed to reducing undernutrition while simultaneously preventing overnutrition, through integrated child health programs that incorporate prevention of infection, diet quality, and physical activity.
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