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Obes Rev. 2018 Jan;19(1):49-61. doi: 10.1111/obr.12605. Epub 2017 Sep 22.

Double burden of diseases worldwide: coexistence of undernutrition and overnutrition-related non-communicable chronic diseases.

Min J1, Zhao Y2,3, Slivka L4, Wang Y1,2,3,5.

Author information

1
Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN, USA.
2
Global Health Institute, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
3
School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
4
School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA.
5
Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN, USA.

Abstract

OBJECTIVE:

This systematic examination and meta-analysis examined the scope and variation of the worldwide double burden of diseases and identified related socio-demographic factors.

DESIGN:

We searched PubMed for studies published in English from January 1, 2000, through September 28, 2016, that reported on double disease burden. Twenty-nine studies from 18 high-income, middle-income and low-income countries met inclusion criteria and provided 71 obesity-undernutrition ratios, which were included in meta-regression analysis.

RESULTS:

All high-income countries had a much higher prevalence of obesity than undernutrition (i.e. all the obesity/undernutrition ratios >1); 55% of the ratios in lower middle-income and low-income countries were <1, but only 28% in upper middle-income countries. Meta-analysis showed a pooled obesity-undernutrition ratio of 4.3 (95% CI = 3.1-5.5), which varied by country income level, subjects' age and over time. The average ratio was higher in high-income rather than that in lower middle-income and low-income countries (β [SE] = 10.8 [2.6]), in adults versus children (7.1 [2.2]) and in data collected since 2000 versus before 2000 (5.2 [1.5]; all P values < 0.05).

CONCLUSIONS:

There are considerable differences in the obesity versus undernutrition ratios and in their prevalence by country income level, age groups and over time, which may be a consequence of the cumulative exposure to an obesogenic environment.

KEYWORDS:

Double burden; obesity; undernutrition; worldwide

PMID:
28940822
PMCID:
PMC5962023
DOI:
10.1111/obr.12605
[Indexed for MEDLINE]
Free PMC Article

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