Global Burden of Double Malnutrition Has Anyone Seen It 英文参考文献.docVIP

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Global Burden of Double Malnutrition Has Anyone Seen It 英文参考文献.doc

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Global Burden of Double Malnutrition Has Anyone Seen It 英文参考文献

GlobalBurdenofDoubleMalnutrition:HasAnyoneSeen It? DanielJ.Corsi1,JocelynE.Finlay2,S.V.Subramanian3* 1PopulationHealthResearchInstitute,McMasterUniversityandHamiltonHealthSciences,Hamilton,Canada,2DepartmentofGlobalHealthandPopulation,Harvard SchoolofPublicHealth,Boston,Massachusetts,UnitedStatesofAmerica,3DepartmentofSociety,HumanDevelopmentandHealth,HarvardSchoolofPublicHealth, Boston,Massachusetts,UnitedStatesofAmerica Abstract Background:Low-tomiddle-incomecountries(LMICs)arebelievedtobecharacterizedbythecoexistenceofunderweight andoverweight. It has also beenposited that suchcoexistence is appearingamong thelow socioeconomic status (SES) groups. Methods:Weconductedacross-sectionalanalysisofnationallyrepresentativesamplesof451321womenaged20–49years drawnfrom57DemographicandHealthSurveysconductedbetween1994and2008.BodyMassIndex(BMIinkg/m2 ),was usedtodefineunderweightandoverweightfollowingconventionalcut-points.Covariatesincludedage,householdwealth, education, and residence. We estimated multinomial multilevel models to assess the extent to which underweight (BMI,18.5kg/m2)andoverweight(BMI$25.0kg/m2)correlateatthecountry-level,andattheneighborhood-levelwithin eachcountry. Results: In age-adjusted models, there was a strong negative correlation between likelihood of being underweight and overweightatcountry-(r=20.79,p,0.001),andattheneighborhood-levelwithincountries(r=20.51,P,0.001).Negative correlationsrangingfrom20.11to20.90wereobservedin46ofthe57countriesattheneighborhood-leveland29/57 werestatisticallysignificant(p#0.05).SimilarnegativecorrelationswereobservedinanalysesrestrictedtolowSESgroups. Finally,thenegativecorrelationsacrosscountries,andwithin-countries,appearedtobestableovertimeinasub-setof36 countries. Conclusion:Theexplicitlynegativecorrelationsbetweenprevalenceofunderweightandoverweightatthecountry-level andatneighborhood-levelsuggestthatthehypothesizedcoexistenceofunderweightandoverweighthasnotyetoccurred inasubstantialmannerinamajorityofLMICs.