Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

Abstract

Articles https://doi.org/10.1038/s41591-020-0807-6*A list of authors and their affiliations appears online. ✉e-mail: sihay@uw.edu The profound impacts of childhood malnutrition, including both undernutrition and overweight, affect the economic, social and medical well-being of individuals, families, com- munities and nations 1,2 . Undernutrition has been the most common form of malnutrition in LMICs 3 , but as populations experience economic growth, urbanization and demographic change, over- weight is an emerging problem, leading to a double burden of mal- nutrition (DBM). DBM may be manifested at the individual level as stunting in childhood followed by overweight in adulthood4 . At the household level, research has focused on maternal and child indicators of malnutrition, whereas at the population level, preva- lence of both undernutrition with overweight has been reported5 . In children, DBM can be defined using different combinations of the various indicators of undernutrition (wasting and/or stunting) and overweight, obesity and diet-related noncommunicable dis- eases (NCDs) 6 . While the most studied type of double burden is that of stunting and obesity, it is mostly applicable at the individual level among overweight adults who were previously stunted from chronic undernutrition during childhood. Wasting is associated with high rate of child mortality, whereas stunting has significant negative impact across the life course and is highly predictive of economic outcomes7 . Public health nutrition programs designed to address undernutrition may exacerbate overweight8 , thus a compre- hensive understanding of DBM at the population level is crucial for the design of effective interventions