Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2017 May 22;17(1):483.
doi: 10.1186/s12889-017-4377-6.

Dual burden of malnutrition in US Affiliated Pacific jurisdictions in the Children's Healthy Living Program

Rachel Novotny  1 , Fenfang Li  2 , Rachael Leon Guerrero  3 , Patricia Coleman  4   5 , Aifili J Tufa  2 , Andrea Bersamin  6 , Jonathan Deenik  2 , Lynne R Wilkens  7
Affiliations
Comparative Study

Dual burden of malnutrition in US Affiliated Pacific jurisdictions in the Children's Healthy Living Program

Rachel Novotny et al. BMC Public Health. .

Abstract

Background: Few data are available on dual burden of under and over nutrition of children in the Pacific region. The objective was to examine prevalence of stunting at birth and current stunting and their relationship to obesity in US Affiliated Pacific (USAP) jurisdictions.

Methods: Cross sectional survey with cluster sampling by community. 5558, 2-8 years olds were measured in 51 communities in 11 USAP jurisdictions. The main outcome measures were stunting at birth, current stunting and obesity by body mass index. Prevalences of stunting at birth, current stunting and obesity were determined, adjusting for age distribution and community clustering. Differences by among age, sex, race and jurisdiction income levels were evaluated by chi-square analysis. Relationships of stunting at birth and current stunting with obesity were examined using a hierarchical model accounting for the study design.

Results: Prevalences were stunting at birth 6.8% (Standard Error, SE = 0.9%), current stunting 1.4% (SE = 0.2%) and obesity 14.03.8% (SE = 0.9%). Obesity was highest in upper middle income jurisdictions (UMIJ) at 17.5%. Stunting at birth differed by race (p = 0.0001) with highest prevalence among Native Hawaiian/Pacific Islanders (10.7%). Prevalence of stunting at birth was different by jurisdiction income level with 27.5% in lower middle income jurisdictions (LMIJ), and 22.2% in UMIJ, and 5.5% in higher than high income jurisdictions (HIJ) at 5.5% (p < 0.0001). Prevalence of current stunting was higher in LMIJ than HIJ (p = 0.001), although children with current stunting were less likely to have been stunted at birth. The association between stunting at birth and current stunting was negative (OR = 0.19, 95% CI: 0.05-0.69).

Conclusions: Currently stunted children were marginally less likely to be obese than not stunted children in the USAP, where the prevalence of current stunting is low. Stunting (at birth and current) was highest in LMIJ, while UMIJ jurisdictions had the highest dual burden of malnutrition (that is the highest combination of both stunting at birth and obesity).

Trial registration: National Institutes for Health clinical trial # NCT01881373 (clinicaltrials.gov).

Keywords: Country; Income; Obesity; Pacific; Race; Stunting.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Prevalence of Obesity and Stunting, Overall and by Sex and Age. *Differences in prevalence by demographic group, p < 0.05 Chi-square; Error bars refer to 95% Confidence Interval of the prevalence estimate
Fig. 2
Fig. 2
Prevalence of Obesity and Stunting by Race. *Differences in prevalence among race groups, compared to Asian, p < 0.05 Chi-square; Error bars refer to 95% Confidence Interval of the prevalence estimate
Fig. 3
Fig. 3
Prevalence of Stunting and Obesity by Jurisdiction Income Level. *Differences among jurisdiction income levels, p < 0.05, Chi-square; Error bars refer to 95% Confidence Interval of the prevalence estimate
See this image and copyright information in PMC

References

    1. Prendergast AJ, Humphrey JH. The stunting syndrome in developing countries. Paediatr Int Child Health. 2014;34:250–265. doi: 10.1179/2046905514Y.0000000158. - DOI - PMC - PubMed
    1. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382:427–451. doi: 10.1016/S0140-6736(13)60937-X. - DOI - PubMed
    1. Danaei G, Andrews KG, Sudfeld CR, Fink G, McCoy DC, Peet E, et al. Risk Factors for Childhood Stunting in 137 Developing Countries: A Comparative Risk Assessment Analysis at Global, Regional, and Country Levels. PLoS Med. 2016;13(11) doi: 10.1371/journal.pmed.1002164. - DOI - PMC - PubMed
    1. Sawaya AL, Grillo LP, Verreschi I, da Silva AC, Roberts SB. Mild stunting is associated with higher susceptibility to the effects of high fat diets: studies in a shantytown population in Sao Paulo, Brazil. J Nutr. 1998;128(2 Suppl):415S–420S. - PubMed
    1. Barker D, Osmond C. Fetal, infant, and childhood growth are predictors of coronary heart disease, diabetes, and hypertension in adult men and women. Env Health Perspective. 2000;108(3):545–553. - PMC - PubMed

Associated data