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. 2020 Dec 14;86(1):153.
doi: 10.5334/aogh.3093.

Population and Individual-Level Double Burden of Malnutrition Among Adolescents in Two Emerging Cities in Northern and Southern Nigeria: A Comparative Cross-Sectional Study

Oghenebrume Wariri  1   2   3 , Kingsley Irelosen Akhimienho  4 , Jacob Albin Korem Alhassan  2   5 , Iliya Jalo  6   7 , Iso Precious Oloyede  4 , Eno Etim Nyong  4 , Fidelia Bode-Thomas  8
Affiliations

Population and Individual-Level Double Burden of Malnutrition Among Adolescents in Two Emerging Cities in Northern and Southern Nigeria: A Comparative Cross-Sectional Study

Oghenebrume Wariri et al. Ann Glob Health. .

Abstract

Background: Over the past three decades, double burden of malnutrition (DBM), a situation where high levels of undernutrition (stunting, thinness, or micronutrient deficiency) coexist with overnutrition (overweight and obesity), continues to rise in sub-Saharan Africa. Compared to other countries in the region, the evidence on DBM is limited in Nigeria.

Objective: This paper aimed to determine the comparative prevalence of population-level and individual-level DBM among adolescents in two emerging cities in northern and southern Nigeria.

Methods: This was a comparative cross-sectional study among apparently healthy secondary school adolescents aged 10-18 years in Gombe (northern Nigeria) and Uyo (southern Nigeria) between January 2015 and June 2017. A multistage random sampling technique was implemented to recruit adolescents from 24 secondary schools in both cities. Measures of general obesity (body mass index) and stature (height-for-age) were classified and Z-scores generated using the WHO AnthroPlus software, which is based on the WHO 2006 growth reference. Population-level DBM was defined as the occurrence of thinness and overweight/obesity within the population. Individual-level DBM was defined as the proportion of individuals who were concurrently stunted and had truncal obesity or stunted and were overweight/obese.

Findings: Overall, at the population-level in both settings, 6.8% of adolescents had thinness, while 12.4% were overweight/obese signifying a high burden of population-level DBM. Comparatively, the population-level DBM was higher in Gombe compared to Uyo (thinness: 11.98% vs 5.3% and overweight/obesity: 16.08% vs 11.27% in Gombe vs Uyo respectively). Overall, at the individual level, 6.42% of stunted adolescents had coexisting truncal obesity, while 8.02% were stunted and had coexisting general overweight/obesity. Like the trend with population-level DBM, individual-level DBM was higher in Gombe (northern Nigeria) compared to Uyo (southern Nigeria).

Conclusion: High levels of population-level and individual-level DBM exist in Gombe and Uyo. However, the level of DBM (under- and over-nutrition) is higher in Gombe located in northern Nigeria compared to Uyo in southern Nigeria.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Prevalence rate of population-level thinness, overweight/obesity, stunting, and truncal obesity among adolescents in Gombe, Uyo and the overall study population. Note: Thinness = BAZ < –2SD, overweight/obesity = BAZ > 1SD, stunting = HAZ < –2SD, and truncal obesity = WHtR ≥ 0.5. BAZ (BMI-for-age Z-scores), HAZ (Height-for-age Z-scores) and WHtR (Weight-to-Height-Ratio).
Figure 2
Figure 2
The prevalence rate of population-level malnutrition (truncal obesity, overweight/obesity, thinness and stunting) by socioeconomic status among adolescents in Gombe, Uyo and the overall study population. Note: Within-group prevalence rates are computed (i.e. the prevalence of over- or undernutrition within each socioeconomic class). Thinness = BAZ < –2SD, overweight/obesity = BAZ > 1SD, stunting = HAZ < –2SD, and truncal obesity = WHtR ≥ 0.5.
Figure 3
Figure 3
The prevalence rate of individual-level double burden malnutrition among adolescents in Gombe, Uyo and the overall study population. Note: This graph shows the proportion of adolescents who were either concurrently stunted (HAZ < –2SD) and overweight/obese (BAZ > 1SD) or Stunted (HAZ < –2SD) and had truncal obesity (WHtR ≥ 0.5).
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References

    1. World Health Organization. The state of food security and nutrition in the world In: Building Climate Resilience for Food Security and Nutrition [Internet]. Rome: FAO; 2018. https://www.wfp.org/publications/2018-state-food-security-and-nutrition-.... Accessed May 26, 2020.
    1. UNICEF/WHO/World Bank. Levels and trends in child malnutrition: key findings of the 2018 Edition of the Joint Child Malnutrition Estimates Geneva: World Health Organization; 2018.
    1. World Health Organization. Report of the Commission on Ending Childhood Obesity. Geneva: WHO; 2016.
    1. Gebremedhin S. Prevalence and differentials of overweight and obesity in preschool children in Sub-Saharan Africa. BMJ Open [Internet]. December 1, 2015; 5(12): e009005 http://bmjopen.bmj.com/ Accessed October 30, 2020. DOI: 10.1136/bmjopen-2015-009005 - DOI - PMC - PubMed
    1. Hossain FB, Shawon MSR, Al-Abid MSU, Mahmood S, Adhikary G, Bulbul MMI. Double burden of malnutrition in children aged 24 to 59 months by socioeconomic status in five South Asian countries: Evidence from demographic and health surveys. BMJ Open [Internet]. 2020; 10(3): 32866 http://bmjopen.bmj.com/ Accessed October 31, 2020. DOI: 10.1136/bmjopen-2019-032866 - DOI - PMC - PubMed