{"title":"Dietary diversity moderates household economic inequalities in the double burden of malnutrition in Tanzania.","authors":"Sanmei Chen, Yoko Shimpuku, Takanori Honda, Dorkasi L Mwakawanga, Beatrice Mwilike","doi":"10.1017/S136898002400106X","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Improved food availability and a growing economy in Tanzania may insufficiently decrease pre-existing nutritional deficiencies and simultaneously increase overweight within the same individual, household or population, causing a double burden of malnutrition (DBM). We investigated economic inequalities in DBM at the household level, expressed as a stunted child with a mother with overweight/obesity, and the moderating role of dietary diversity in these inequalities.</p><p><strong>Design: </strong>We used cross-sectional data from the 2015-2016 Tanzania Demographic and Health Survey.</p><p><strong>Setting: </strong>A nationally representative survey.</p><p><strong>Participants: </strong>Totally, 2867 children (aged 6-23 months) and their mothers (aged 15-49 years). The mother-child pairs were categorised into two groups based on dietary diversity score: achieving and not achieving minimum dietary diversity.</p><p><strong>Results: </strong>The prevalence of DBM was 5·6 % (sd = 0·6) and significantly varied by region (ranging from 0·6 % to 12·2 %). Significant interaction was observed between dietary diversity and household wealth index (<i>P</i><sub>for interaction</sub> < 0·001). The prevalence of DBM monotonically increased with greater household wealth among mother-child pairs who did not achieve minimum dietary diversity (<i>P</i><sub>for trend</sub> < 0·001; however, this association was attenuated in those who achieved minimum dietary diversity (<i>P</i><sub>for trend</sub> = 0·16), particularly for the richest households (<i>P</i> = 0·44). Analysing household wealth index score as a continuous variable yielded similar results (OR (95 % CI): 2·10 (1·36, 3·25) for non-achievers of minimum dietary diversity, 1·38 (0·76, 2·54) for achievers).</p><p><strong>Conclusions: </strong>Greater household wealth was associated with higher odds of DBM in Tanzania; however, the negative impact of household economic status on DBM was mitigated by minimum dietary diversity.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374552/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/S136898002400106X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Improved food availability and a growing economy in Tanzania may insufficiently decrease pre-existing nutritional deficiencies and simultaneously increase overweight within the same individual, household or population, causing a double burden of malnutrition (DBM). We investigated economic inequalities in DBM at the household level, expressed as a stunted child with a mother with overweight/obesity, and the moderating role of dietary diversity in these inequalities.
Design: We used cross-sectional data from the 2015-2016 Tanzania Demographic and Health Survey.
Setting: A nationally representative survey.
Participants: Totally, 2867 children (aged 6-23 months) and their mothers (aged 15-49 years). The mother-child pairs were categorised into two groups based on dietary diversity score: achieving and not achieving minimum dietary diversity.
Results: The prevalence of DBM was 5·6 % (sd = 0·6) and significantly varied by region (ranging from 0·6 % to 12·2 %). Significant interaction was observed between dietary diversity and household wealth index (Pfor interaction < 0·001). The prevalence of DBM monotonically increased with greater household wealth among mother-child pairs who did not achieve minimum dietary diversity (Pfor trend < 0·001; however, this association was attenuated in those who achieved minimum dietary diversity (Pfor trend = 0·16), particularly for the richest households (P = 0·44). Analysing household wealth index score as a continuous variable yielded similar results (OR (95 % CI): 2·10 (1·36, 3·25) for non-achievers of minimum dietary diversity, 1·38 (0·76, 2·54) for achievers).
Conclusions: Greater household wealth was associated with higher odds of DBM in Tanzania; however, the negative impact of household economic status on DBM was mitigated by minimum dietary diversity.
期刊介绍:
Public Health Nutrition provides an international peer-reviewed forum for the publication and dissemination of research and scholarship aimed at understanding the causes of, and approaches and solutions to nutrition-related public health achievements, situations and problems around the world. The journal publishes original and commissioned articles, commentaries and discussion papers for debate. The journal is of interest to epidemiologists and health promotion specialists interested in the role of nutrition in disease prevention; academics and those involved in fieldwork and the application of research to identify practical solutions to important public health problems.