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Nutrients 2015, 7(10), 8376-8391;

Double Burden of Malnutrition in Rural West Java: Household-Level Analysis for Father-Child and Mother-Child Pairs and the Association with Dietary Intake

Graduate Program in Sustainability Science-Global Leadership Initiative (GPSS-GLI), Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa City 277-8563, Japan
Research Institute for Humanity and Nature, 457-4 Motoyama, Kamigamo, Kita-ku, Kyoto 603-8047, Japan
Institute of Ecology, Research Institute, Padjadjaran University, Jl. Sekeloa Selatan I, Bandung 40132, Indonesia
Faculty of Medicine, Airlangga University, Jl. Mayjen. Prof. Dr. Moestopo 47, Surabaya 60132, Indonesia
RSET, Institute of Science and Engineering, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan
Department of Human Ecology, School of International Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
Author to whom correspondence should be addressed.
Received: 22 June 2015 / Revised: 28 August 2015 / Accepted: 23 September 2015 / Published: 2 October 2015
(This article belongs to the Special Issue Dietary Pattern and Health)
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Indonesia is facing household-level double burden malnutrition. This study aimed at examining (1) household-level double burden for the mother-child and father-child pairs; (2) risk of adiposity of double burden households; and (3) associated dietary factors. Subjects were 5th and 6th grade elementary school children (n = 242), their mothers (n = 242), and their fathers (n = 225) in five communities (1 = urban, 4 = rural) in the Bandung District. Questionnaires on socioeconomic factors, blood hemoglobin measurements, and anthropometric measurements were administered. For adults, body fat percentage (BF%) was estimated by bioelectrical impedance (BF%-BI) and by converting skinfold thickness (ST) data using Durnin and Womersley’s (1974) formula (BF%-ST). Food frequency questionnaires were also completed. Double burden was defined as coexistence of maternal or paternal overweight (Body mass index (BMI) ≥ 23) and child stunting (height-for-age z-score <−2) within households. Maternal-child double burden occurred in 30.6% of total households, whereas paternal-child double burden was only in 8.4%. Mothers from double burden households showed high adiposity; 87.3% with BF%-BI and 66.2% with BF%-ST had BF% >35%, and 60.6% had waists >80 cm. The major dietary patterns identified were “Modern” and “High-animal products”. After controlling for confounding factors, children in the highest quartile of the “High-animal products” dietary pattern had a lower risk of maternal-child double burden (Adjusted OR: 0.46, 95% CI: 0.21–1.04) than those in the lowest quartile. Given that the “High-animal products” dietary pattern was associated with the decreased risk of maternal-child double burden through a strong negative correlation with child stunting, improving child stunting through adequate intake of animal products is critical to solve the problem of maternal-child double burden in Indonesia. View Full-Text
Keywords: double burden; malnutrition; adiposity; food frequency questionnaire; Indonesia double burden; malnutrition; adiposity; food frequency questionnaire; Indonesia

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Sekiyama, M.; Jiang, H.W.; Gunawan, B.; Dewanti, L.; Honda, R.; Shimizu-Furusawa, H.; Abdoellah, O.S.; Watanabe, C. Double Burden of Malnutrition in Rural West Java: Household-Level Analysis for Father-Child and Mother-Child Pairs and the Association with Dietary Intake. Nutrients 2015, 7, 8376-8391.

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