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

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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
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Research Institute for Humanity and Nature, 457-4 Motoyama, Kamigamo, Kita-ku, Kyoto 603-8047, Japan
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Institute of Ecology, Research Institute, Padjadjaran University, Jl. Sekeloa Selatan I, Bandung 40132, Indonesia
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Faculty of Medicine, Airlangga University, Jl. Mayjen. Prof. Dr. Moestopo 47, Surabaya 60132, Indonesia
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RSET, Institute of Science and Engineering, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan
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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.
Nutrients 2015, 7(10), 8376-8391; https://doi.org/10.3390/nu7105399
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)
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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