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The double burden of 'malnutrition': Under-Nutrition & Obesity

Intraindividual double burden of malnutrition among women (15–49 years) in India, Myanmar, and Nepal: evidence from the recent Demographic and Health Surveys

European Journal of Clinical Nutrition volume 77, pages 603–610 (2023)Cite this article

Subjects

Abstract

Background

There is a concurrent increase in anaemia and overweight/obesity among women in the South and South East Asia regions. Despite these, studies on the co-existence of anaemia and overweight/obesity in these countries are abysmally limited. This secondary analysis sought to estimate the burden of the intraindividual double burden of malnutrition (IDBM), i.e., co-existence of anaemia and overweight/obesity among women of reproductive age (15–49 years) in India, Myanmar, and Nepal, and explore the impact of socio-demographic and economic factors on this health outcome.

Methods

A secondary analysis of the Demographic and Health Surveys (DHS) of India (2019–2021), Myanmar (2015–2016), and Nepal (2016) was conducted. A descriptive analysis of the health outcomes and the risk factors was done with frequencies and percentages. The association between selected socio-demographic (women’s age, education status, number of children and place of residence) and economic (occupation status, and wealth quintile) variables with IDBM was found with binary logistic regression analysis.

Results

Around one in ten women of reproductive age group in India and Myanmar had IDBM. In Nepal, it occurs in one in nearly 15 women. Maternal age, education, household wealth, number of children, place of residence, and occupation were found to be significant predictors of IDBM.

Conclusion

There is a high prevalence of IDBM in South Asian women and it varies substantially across different socio-demographic and economic predictors. Sufficient evidence from prospective studies is needed to establish causal association and also to implement need-based prevention and curative strategies.

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Fig. 1: Distribution of anaemia, overweight/obesity and IDBM.
Fig. 2: Distribution of anaemia prevalence amongst women of reproductive age in the countries understudy.
Fig. 3: Distribution of overweight/obesity prevalence amongst women of reproductive age in the countries understudy.
Fig. 4: Distribution of IDBM prevalence amongst women of reproductive age in the countries understudy.
Fig. 5: IDBM across wealth quintiles.

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Data availability

The Demographic and Health Survey datasets were available in the public domain (https://dhsprogram.com/data/available-datasets.cfm).

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Acknowledgements

We acknowledge the Demographic Health Surveys for providing us with the data upon which the findings of this study were based.

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Authors and Affiliations

  1. Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, India

    Rajeev Jayalakshmi & Christian Sewor

  2. Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana

    Christian Sewor

  3. Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India

    Srinivasan Kannan

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Contributions

RJ conceptualised the study, applied for the datasets, analysed the datasets, and wrote the manuscript with CS. SK critically reviewed the manuscript draft. All authors have reviewed and accepted the final manuscript draft.

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Correspondence to Rajeev Jayalakshmi.

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Jayalakshmi, R., Sewor, C. & Kannan, S. Intraindividual double burden of malnutrition among women (15–49 years) in India, Myanmar, and Nepal: evidence from the recent Demographic and Health Surveys. Eur J Clin Nutr 77, 603–610 (2023). https://doi.org/10.1038/s41430-023-01269-9

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