Abstract
Background
Double Burden of Malnutrition (DBM)—the coexistence of undernutrition along with overnutrition—is a significant public health issue in the Asia-Pacific region. The scope of the DBM in this region is largely unknown. This review aims to determine the prevalence of under- and overnutrition as major DBM components and to investigate whether there has been a shift from under- to overnutrition in the Asia-Pacific region.
Methods
Online databases including PubMed and Web of Science were searched for original studies on DBM prevalence in the Asia-Pacific region; particularly, those published from January 2008 to December 2018 were screened for eligibility. We collected data on indicators of under- and overnutrition on the population level and adapted the ratio of prevalence of overweight/obesity versus prevalence of underweight as the main outcome indicator. Pooled prevalence estimates of DBM and the ratio of overnutrition versus undernutrition were generated using R (3.4.0).
Results
In total, 33 studies were included in this review. Pooled analysis demonstrated that DBM was generally presented among countries/areas in the Asia-Pacific region except in high-income countries (HICs). Overall, the prevalence of undernutrition was 8.8% (95% CI 7.3–10.6%) while overnutrition among the same population reached 23.0% (95% CI 20.3–26.0%). Countries in the Oceania region or HICs reported low level of undernutrition (less than 3%). All subgroup analysis (geolocation, income level, sex, age) reported pooled prevalence of overweight/obesity as more than 18%. Overall, the whole region and all subgroups were more likely to experience a higher prevalence of overnutrition than undernutrition, except that low- and lower-middle-income countries (L-MICs) had similar prevalence for over- and undernutrition.
Conclusion
DBM in the Asia-Pacific region is alarmingly high and is titled toward overnutrition. As a result, future interventions/policy targeting to maintain a healthy weight for the population should not just focus on prevention and treatment toward one direction.
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Data availability statement: All codes and data for meta-analysis models and forest plots were uploaded online on GitHub opensource (https://github.com/sabrinaboasui/DoubleBurdenMalnutritionSR).
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Peng, W., Mu, Y., Hu, Y. et al. Double Burden of Malnutrition in the Asia-Pacific Region—A Systematic Review and Meta-analysis. J Epidemiol Glob Health 10, 16–27 (2020). https://doi.org/10.2991/jegh.k.191117.002
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DOI: https://doi.org/10.2991/jegh.k.191117.002