Double burden of malnutrition (DBMN), the coexistence of under- and overnutrition in the same population, is an emerging public health concern in developing countries, including Thailand. This paper aims to review the ma- ternal and child nutrition situation and trends as the country moved from a low-income to a middle-income coun- try, using data from large scale national surveys. Protein-energy malnutrition and micronutrient deficiencies pre- dominantly affected mothers and children prior to the 1980s. The situation greatly improved during the 1980s- 1990s, with the implementation of multi-sectoral policies and programs focusing on poverty alleviation and pri- mary health care. Economic development, improved access to health services and effective community-based nu- trition programs contributed to these positive trends. However, the prevalence of low birth weight remained at 8- 10%, while stunting and underweight declined to about 10% by the 1990s, with small change thereafter. The prevalence of anemia among pregnant women and children decreased by half and vitamin A deficiency is no longer a public health problem. Iodine deficiency, especially during pregnancy is still a major concern. As the country progressed in terms of economic and social development, overnutrition among women and children af- fected all socio-economic levels. Changes in lifestyles, food access and eating patterns are observed both in urban and rural areas. Although efforts have been made to address these challenges, harmonized policy and strategic programs that address DBMN in the complex social and economic environment are urgently needed. Early life undernutrition should be considered along with measures to address obesity and chronic diseases in children.
Objective: A population-based survey was conducted to analyze the association of under-weight, blood pressure, glucose and lipid metabolism with cognitive impairment in people, 60 years and over, living in 2 towns of Shanghai. Methods: Face-to-face interviews were carried out to collect relevant information with questionnaires. Anthropo- metric indices of height, weight, waist circumference (WC) and hip circumference were measured. Multivariable logistic regression analyses were performed to evaluate the association of weight status with cognitive impairment. Results: Cognitive impairment were diagnosed in 198 (7.0%) of the 2 809 participants. Compared to the normal BMI category, the under-weight category was significantly associated with the risk of cognitive impairment (OR= 2.47, 95%CI: 1.46-5.23). Subjects with a high WC were 1.5 times (OR= 1.42, 95%CI: 1.10-2.67) more likely and subjects with a high WHR were 1.7 times (OR= 1.68, 95%CI: 1.05-2.84) more likely to be associated with cogni- tive impairment than the subjects in the reference group. This study demonstrates a significant interaction between hypertension, lipid disorder and WC or WHR on the risk of cognitive impairment in a rural population in Shanghai. Conclusions: Central obesity was significantly associated with the risk of cognitive impairment. A low BMI may be a risk factor for cognitive impairment. A significant interaction between hypertension, lipid disorder and WC or WHR on the risk of cognitive impairment in Shanghai rural population was found.
This study was carried out to investigate the nutritional status and feeding practices of young children in the worst-affected areas of China two years after the Wenchuan Earthquake. The sample consisted of 1,254 children 6-23 months of age living in four selected counties from the disaster-affected provinces of Sichuan, Shaanxi and Gansu. Length-for-age, weight-for-age, weight-for-length, and hemoglobin concentration were used to evaluate nutritional status. Interviews with selected children’s caretakers collected basic demographic information, chil- dren’s medical history, and child feeding practices. Stunting, underweight, and wasting prevalence rates in chil- dren 6-23 months of age were 10.8%, 4.9% and 2.8% respectively, and anemia prevalence was 52.2%. Only 12.3% of children had initiated breastfeeding within the first hour after birth. Overall, 90.9% of children had ever been breastfed, and 87% children 6-8 months of age had received solid, semi-solid or soft foods the day before the interview. The diets of 45% of children 6-23 months of age met the definition of minimum dietary diversity, and the diets of 39% of breastfed and 7.6% non- breastfed children 6-23 months of age met the criteria for mini- mum meal frequency. The results highlight that a substantial proportion of young children in the earthquake af- fected disaster areas continue to have various forms of malnutrition, with an especially high prevalence of anemia, and that most feeding practices are suboptimal. Further efforts should be made to enhance the nutritional status of these children. As part of this intervention, it may be necessary to improve child feeding practices.