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Meta-Analysis
. 2020 Mar;10(1):16-27.
doi: 10.2991/jegh.k.191117.002.

Double Burden of Malnutrition in the Asia-Pacific Region-A Systematic Review and Meta-analysis

Wen Peng  1 , Yuhan Mu  1 , Yang Hu  1 , Bin Li  1 , Jayanthi Raman  2 , Zhixian Sui  3   4
Affiliations
Meta-Analysis

Double Burden of Malnutrition in the Asia-Pacific Region-A Systematic Review and Meta-analysis

Wen Peng et al. J Epidemiol Glob Health. 2020 Mar.

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.

Keywords: Asia-Pacific; Double burden; malnutrition; overnutrition; undernutrition.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of literature search of studies on double burden of malnutrition in Asia-Pacific region.
Figure 2
Figure 2
Double burden of undernutrition and overweight/obesity in different countries, separated by age (<5 years old, 5–18 years old, and 18+ years old, by columns) and sex (female indicated as round marker, male indicated as triangle marker, top row). Both: combined reports of both male and female. Only the newest reports of the country were displayed. NC: New Caledonia, NZ: New Zealand.
Figure 3
Figure 3
Overall undernutrition prevalence from pooled analysis. NC: New Caledonia; Events: Underweight (N); Time: Total (N); Dense dash line: Incidence rate from random model; Loose dash line: Incidence rate from fixed model.
Figure 4
Figure 4
Overall overweight/obesity prevalence from pooled analysis. NC: New Caledonia; Events: Underweight (N); Time: Total (N); Dense dash line: Incidence rate from random model; Loose dash line: Incidence rate from fixed model.
See this image and copyright information in PMC

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