Double Burden of Malnutrition in Urban Poor Settings in Nairobi, Kenya
METHODS: The study uses two data sets collected in in two Nairobi slums: (i) data from a longitudinal study, collected on 4300 children born between 2006 and 2010 on their growth; and (ii) data from a cross-sectional study, collected among 5190 adults 18+ years between 2008 and 2010 on behavioral and physiological risk factors for cardio-metabolic diseases. Anthropometric measurements for both children and adults, and waist circumference for adults were taken using standard procedures. Further, data on dietary intake and physical activity were taken amongst adults.
RESULTS: The study indicates high levels of stunting among children under five years (43%) and moderate underweight (16%), simultaneous with high levels of overweight (17%: 25% in females and 12% in males) and obesity (5%: 11% in females and 1% in males) among adults aged 18+ years. Notable levels of physical inactivity and poor dietary practices were also observed: 15% of adults did not engage in any form of physical activity while over half (54%) of adults had insufficient intake of fruits and vegetables; and 37% had high salt intake.
CONCLUSIONS: The study indicates that in urban poor settings in low income countries, early stunting and adult obesity may co-exist in the same socio-geographic population. This double burden of malnutrition is likely due to the changes in nutrition and diet and physical activity patterns related to the nutritional transition sweeping LMICs. This combination of early stunting and adult obesity may be an explosive combination given that obesity and adult short stature are both risk factors for the metabolic syndrome and Type 2 diabetes. Of great worry is that poor countries have to use their limited resources to address the double burden of malnutrition.