Double burden of malnutrition rife among Pakistani youngsters – systematic review
The paper titled “Nutritional Status and Dietary Intake of School-Age Children and Early Adolescents: Systematic Review in a Developing Country and Lessons for the Global Perspective” was published in the journal Frontiers in Nutrition.
“Populations in which there is co-existence of under- and over-nutrition are facing the double burden of malnutrition (DBM).
“DBM is more prevalent in low- and middle-income countries (LMIC), with a higher prevalence in poorer LMICs. It is especially prevalent in sub-Saharan Africa, South-East Asia, and the Pacific,” said the researchers.
Since Pakistan is considered an LMIC, it raises similar concerns about DBM prevalence in similar LMICs.
Therefore, the researchers conducted a systematic review using the databases PubMed and Medline and archives of various scientific journals between 2002 and 2 January 2021.
The team analysed 51 cross-sectional studies that recruited 62,148 children aged five to 15 years old in Pakistan.
The indices measured were underweight, stunting, wasting, thinness, overweight, obesity, macro- and micronutrient deficiencies, and food and nutrient intake. The data was also supported with more information on their gender, socio-economic status, education, family income and lifestyles.
Findings
The pooled analysis showed that underweight children and adolescents comprised 25.1% of the subjects; stunting, 23%; wasting, 24%; thinness, 12.5%; overweight, 11.4%; and obesity, 6.9%.
Being underweight was prevalent among females, children from government schools, low socio-economic status (SES) and disaster-stricken areas.
Another factor was stunting, which was also higher among females, government school students, low SES and those who lived in rural areas.
For dietary intake, the data from the paper produced by Aziz S. et al. (2014), for instance, reported that school children across Pakistan had an overall increased daily intake of carbohydrates of about 60% to 75%.
In contrast, the recommended daily allowance (RDA) was about 45% to 65%. Consumption of fruits and vegetables was also sub-optimal, coupled with an increased intake of soft drinks, sweets and chocolates.
The protein RDA for the children was around 10% to 30%, but they were found to consume even lesser, according to Aziz S et al. (2010). However, Sultana et al. (2017) showed an opposite result on protein intake, with children from Punjab consuming the highest protein intake compared to others.
Significance
Overall, the evidence gathered suggests the presence of DBM among school-going children and youths.
Consuming healthy, balanced meals will also support the agrarian economy and encourage the utilisation of local products to boost immunity and reduce the chances of chronic diseases occurring and, by association, a reduced burden on healthcare.
Besides Pakistan, similar trends were reported in countries within the lower quartile of GDP per capita purchasing power parity due to changes in dietary patterns, physical activity and tendency to live sedentary lifestyles.
In future, large-scale population-representative studies are required, with standardised tools for anthropometry and dietary assessment.
Similar reviews in various LMICs must be conducted for epidemiologists to assess the availability of data in the age group, identify malnutrition trends and formulate interventions to tackle the issue better.
“The progress in reducing the burden of malnutrition worldwide has been slow. It is advised to collect population-specific data to better understand the nutrition dynamics across the world and allow the nutritional needs of communities to be addressed adequately,” said the researchers.
This systematic review was funded by the SCANS consortium, including the Trust for Vaccines & Immunizations (Pakistan) and the Aga Khan University, Karachi, Pakistan, and the Mother & Child Care & Research Inc.
Source: Frontiers in Nutrition
DOI: 10.3389/fnut.2021.739447
“Nutritional Status and Dietary Intake of School-Age Children and Early Adolescents: Systematic Review in a Developing Country and Lessons for the Global Perspective”
Authors: Durray Shahwar A. Khan et al
