Quantifying the Coexistence of Multiple Forms of Malnutrition: A Systematic Literature Review and Meta-Analysis of Prevalence Estimates across Latin America

Background: Estimating the prevalence of the double burden of malnutrition (DBM) remains challenging in Latin America and the Caribbean (LAC), where DBM typologies are heterogeneous and estimates are scattered across the literature. We aimed to comprehensively appraise the evidence and estimate the...

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Main Authors: Diana Sagastume, Antonio Barrenechea-Pulache, Manuel Ramírez-Zea, Lenka Beňová, José L. Peñalvo
Format: Article
Language:English
Published: MDPI AG 2023-11-01
Series:Proceedings
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Online Access:https://www.mdpi.com/2504-3900/91/1/88
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author Diana Sagastume
Antonio Barrenechea-Pulache
Manuel Ramírez-Zea
Lenka Beňová
José L. Peñalvo
author_facet Diana Sagastume
Antonio Barrenechea-Pulache
Manuel Ramírez-Zea
Lenka Beňová
José L. Peñalvo
author_sort Diana Sagastume
collection DOAJ
description Background: Estimating the prevalence of the double burden of malnutrition (DBM) remains challenging in Latin America and the Caribbean (LAC), where DBM typologies are heterogeneous and estimates are scattered across the literature. We aimed to comprehensively appraise the evidence and estimate the prevalence of any typology of DBM in LAC. Methods: A systematic search was conducted on PubMed, Embase, Scopus and Web of Science to identify studies on the prevalence of DBM published in English, Spanish, French or Portuguese between 1 January 2000 and 23 January 2023. The primary outcome was any typology of DBM derived from combining levels (individual, household, across the life course) and identified DBM typologies. The data extraction and methodological quality assessment were conducted in duplicate. Random effect meta-analyses of proportions were used to estimate the pooled prevalence, stabilized using the Freeman–Tukey transformation. Heterogeneity was assessed using Cochran’s Q and I2-statistics. PROSPERO-CRD42023406755. Results: In total, 754 records were identified, of which 60 (8%) studies were eligible, with a median 4379 individuals, including 314 DBM estimates. Most studies were nationally representative surveys (68%), had a low risk of bias (70%) and came from South America (53%). In total, 40% of DBM estimates corresponded to the individual level, where the most frequent typologies were ‘overweight + stunting’ among <18 years, and ‘overweight + anemia’ among >18 years. The household level represented 59% of estimates, where ‘adults with overweight + child with stunting’ was the most frequent typology. The pooled prevalence of any typology of DBM was 4% (95% prediction interval: 4–5%). For the individual level, the most contributing typology for <18 year was ‘overweight + anemia’, 3% (2–5%), and for >18 year, ‘overweight + short stature’, 22% (14–30%). The typology of ‘adults with overweight + child with stunting, 9% (8–9%), contributed the most at the household level. The pooled prevalence estimates carried large heterogeneity (I2 > 90%). The preliminary source of heterogeneity was the setting, as Mesoamerica and South America had 5% prevalence of DBM and the Caribbean had 2%. The DBM across individuals’ life course could not be estimated due to the scarcity of estimates. Conclusion: The prevalence of multiple forms of malnutrition in LAC varies between 2 and 5%. Adult with overweight are the most common contributor to DBM across levels and typologies. Substantial progress can be made in curbing the burden of DBM in LAC through strategies addressing overweight within the general population.
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spelling doaj-art-d0a37f6dca8a40f28ceaa8c331d3a37d2025-08-20T01:48:49ZengMDPI AGProceedings2504-39002023-11-019118810.3390/proceedings2023091088Quantifying the Coexistence of Multiple Forms of Malnutrition: A Systematic Literature Review and Meta-Analysis of Prevalence Estimates across Latin AmericaDiana Sagastume0Antonio Barrenechea-Pulache1Manuel Ramírez-Zea2Lenka Beňová3José L. Peñalvo4Institute of Tropical Medicine Antwerp, 2000 Antwerp, BelgiumInstitute of Tropical Medicine Antwerp, 2000 Antwerp, BelgiumInstitute of Nutrition of Central America and Panama, Guatemala City 1188, GuatemalaInstitute of Tropical Medicine Antwerp, 2000 Antwerp, BelgiumGlobal Health Institute, University of Antwerp, 2610 Wilrijk, BelgiumBackground: Estimating the prevalence of the double burden of malnutrition (DBM) remains challenging in Latin America and the Caribbean (LAC), where DBM typologies are heterogeneous and estimates are scattered across the literature. We aimed to comprehensively appraise the evidence and estimate the prevalence of any typology of DBM in LAC. Methods: A systematic search was conducted on PubMed, Embase, Scopus and Web of Science to identify studies on the prevalence of DBM published in English, Spanish, French or Portuguese between 1 January 2000 and 23 January 2023. The primary outcome was any typology of DBM derived from combining levels (individual, household, across the life course) and identified DBM typologies. The data extraction and methodological quality assessment were conducted in duplicate. Random effect meta-analyses of proportions were used to estimate the pooled prevalence, stabilized using the Freeman–Tukey transformation. Heterogeneity was assessed using Cochran’s Q and I2-statistics. PROSPERO-CRD42023406755. Results: In total, 754 records were identified, of which 60 (8%) studies were eligible, with a median 4379 individuals, including 314 DBM estimates. Most studies were nationally representative surveys (68%), had a low risk of bias (70%) and came from South America (53%). In total, 40% of DBM estimates corresponded to the individual level, where the most frequent typologies were ‘overweight + stunting’ among <18 years, and ‘overweight + anemia’ among >18 years. The household level represented 59% of estimates, where ‘adults with overweight + child with stunting’ was the most frequent typology. The pooled prevalence of any typology of DBM was 4% (95% prediction interval: 4–5%). For the individual level, the most contributing typology for <18 year was ‘overweight + anemia’, 3% (2–5%), and for >18 year, ‘overweight + short stature’, 22% (14–30%). The typology of ‘adults with overweight + child with stunting, 9% (8–9%), contributed the most at the household level. The pooled prevalence estimates carried large heterogeneity (I2 > 90%). The preliminary source of heterogeneity was the setting, as Mesoamerica and South America had 5% prevalence of DBM and the Caribbean had 2%. The DBM across individuals’ life course could not be estimated due to the scarcity of estimates. Conclusion: The prevalence of multiple forms of malnutrition in LAC varies between 2 and 5%. Adult with overweight are the most common contributor to DBM across levels and typologies. Substantial progress can be made in curbing the burden of DBM in LAC through strategies addressing overweight within the general population.https://www.mdpi.com/2504-3900/91/1/88double burden of malnutritionLatin Americameta-analysis
spellingShingle Diana Sagastume
Antonio Barrenechea-Pulache
Manuel Ramírez-Zea
Lenka Beňová
José L. Peñalvo
Quantifying the Coexistence of Multiple Forms of Malnutrition: A Systematic Literature Review and Meta-Analysis of Prevalence Estimates across Latin America
Proceedings
double burden of malnutrition
Latin America
meta-analysis
title Quantifying the Coexistence of Multiple Forms of Malnutrition: A Systematic Literature Review and Meta-Analysis of Prevalence Estimates across Latin America
title_full Quantifying the Coexistence of Multiple Forms of Malnutrition: A Systematic Literature Review and Meta-Analysis of Prevalence Estimates across Latin America
title_fullStr Quantifying the Coexistence of Multiple Forms of Malnutrition: A Systematic Literature Review and Meta-Analysis of Prevalence Estimates across Latin America
title_full_unstemmed Quantifying the Coexistence of Multiple Forms of Malnutrition: A Systematic Literature Review and Meta-Analysis of Prevalence Estimates across Latin America
title_short Quantifying the Coexistence of Multiple Forms of Malnutrition: A Systematic Literature Review and Meta-Analysis of Prevalence Estimates across Latin America
title_sort quantifying the coexistence of multiple forms of malnutrition a systematic literature review and meta analysis of prevalence estimates across latin america
topic double burden of malnutrition
Latin America
meta-analysis
url https://www.mdpi.com/2504-3900/91/1/88
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