Concordance of weight status between mothers and children: A secondary analysis of the Pakistan Demographic and Health Survey VII (original) (raw)
Related papers
Family-based factors associated with overweight and obesity among Pakistani primary school children
2011
Background: Childhood obesity epidemic is now penetrating the developing countries including Pakistan, especially in the affluent urban population. There is no data on association of family-based factors with overweight and obesity among school-aged children in Pakistan. The study aimed to explore the family-based factors associated with overweight and obesity among Pakistani primary school children. Methods: A population-based cross-sectional study was conducted with a representative multistage cluster sample of 1860 children aged five to twelve years in Lahore, Pakistan. Overweight (> +1SD BMI-forage z-score) and obesity (> +2SD BMI-forage z-score) were defined using the World Health Organization reference 2007. Chi-square test was used as the test of trend. Linear regression was used to examine the predictive power of independent variables in relation to BMI. Logistic regression was used to quantify the independent predictors of overweight and adjusted odds ratios (aOR) with 95% confidence intervals (CI) were obtained. All regression analyses were controlled for age and gender and statistical significance was considered at P < 0.05. Results: Significant family-based correlates of overweight and obesity included higher parental education (P < 0.001), both parents working (P = 0.002), fewer siblings (P < 0.001), fewer persons in child's living room (P < 0.001) and residence in high-income neighborhoods (P < 0.001). Smoking in living place was not associated with overweight and obesity. Higher parental education (P < 0.001) and living in high-income neighborhoods (P < 0.001) showed a significant independent positive association with BMI while greater number of siblings (P = 0.001) and persons in child's living room (P = 0.022) showed a significant independent inverse association. College-level or higher parental education as compared to high school-level or lower parental education (aOR 2.54, 95% CI 1.76-3.67), living in high-income neighborhoods as compared to low-income neighborhoods (aOR 2.13, 95% CI 1.31-3.46) and three or less siblings as compared to more than three siblings (aOR 1.75, 95% CI 1.26-2.42) were significant independent predictors of overweight. Conclusion: Family-based factors were significantly associated with overweight and obesity among school-aged children in Pakistan. Higher parental education, living in high-income neighborhoods and fewer siblings were independent predictors of overweight. These findings support the need to design evidence-based child health policy and implement targeted interventions, considering the impact of family-based factors and involving communities.
Prevalence and Determinants of Nutritional Status Among Women and Children in Pakistan
Research Square (Research Square), 2021
Background: Nutrition has been a low-priority area in Pakistan, with low visibility from the political leadership. Despite various efforts, Pakistan has been reported to have one of the highest prevalence of child and women malnutrition compared to other developing counties. Therefore, this study intends to examine the prevalence and determinants of nutritional status of women and children in Pakistan. Methods: The present study uses the Demographic Health Survey (DHS) data from Pakistan 2012-13 (PDHS-3). The nutritional status of women was examined through Body-Mass Index (Underweight, normal, overweight, & obese), and that of children was examined through stunting (severe and moderate), wasting (severe, moderate, overweight), and underweight (severe, moderate, overweight). Descriptive statistics and bivariate analysis have been used along with multinomial logistic regression. Results: A higher proportion of children in rural areas were severely stunted (19.57% vs. 12.49%), severe wasted (2.36% vs. 2.23%), and severe underweight (9.37% vs. 6%) than their urban counterparts. A higher proportion of rural women (9.5% vs. 5.45%) were underweight than urban women, whereas a higher proportion of urban women were obese (24.32% vs. 19.01%) than rural women. The odds of severe stunting (OR= 0.24; C.I.=0.15-0.37), severe underweight (OR= 0.11; C.I.=0.05-0.22) were lower among children from the richest wealth quintile than their poorest counterparts. The Relative Risk Ratio (RRR) of being overweight (RRR= 3.7; C.I.=2.47-5.54) and Obese (RRR= 4.35; C.I.=2.67-7.07) than normal BMI were higher among women from richest wealth quintile than women belonged to poorest wealth quintile. Conclusion: This study has highlighted determinants associated with maternal and child nutritional status, whereby child's nutritional status was measured by stunting, wasting, and underweight, and the mother's nutritional status was measured by BMI. The main risk factors for child's poor nutritional status include low household wealth, urban residence, and mother's educational status. Similarly, the main risk factors for women's poor nutritional status include increasing the women's age, educational status, rural residence, and household wealth. Emphasis should be placed on educating mothers as it would improve their nutritional status and improve their child's nutritional status simultaneously. Background Child undernutrition is a signi cant public health concern for children under the age of ve years in underdeveloped nations including Pakistan. Malnutrition is produced by numerous interconnected causes and has both short and long long-term negative health consequences [1], [2]. According to the 2011 National Nutrition Survey of Pakistan, 31% of children under the age of ve are underweight, whereas a recent research in Pakistan found that the current incidence of underweight children in the nation is 29% [1], [3]. Pakistan is identi ed among those of the seven country that accounted about one-third of population undernourished as Bangladesh, China, Congo, Ethiopia, India, and Indonesia [4]. Undernutrition causes illness and mortality in children, as well as poor physical and cognitive development, poor academic achievement, and a diminished ability to work later in life, resulting in a loss of production and earnings [5]-[7]. As a result, due to its long-term and negative repercussions, undernutrition is one of the most urgent issues of our day [8]. A number of studies reported that inadequate nutrition is the major risk factor for the child malnutrition [9]-[11]. Studies have found that there are multiple factors associated with child undernutrition such as low birth-weight, mother's education, mother's body mass index (BMI), sex of the child, birth order, poor exclusive breast feeding, poor sanitation practices, poverty, dietary diversity, and social inequalities [9], [10], [12]-[16]. Some studies have shown that an individual and community level factors are responsible for the childhood undernutrition [12], [13]. Cumming and Cairncross (2016) concluded that the importance of water, sanitation and hygiene have been recognized as the major risk factors for the health of infant and young children, where the process of stunting is highly concentrated [17]. A study in Uganda stated that children belonging to lower socioeconomic strata are more likely to be undernourished, because of higher vulnerability of food insecurity [18]. One of the most important factor responsible for the child undernutrition is the maternal nutritional status [19]. Undernourished women are more likely to bear underweight children, and undernutrition can have an intergenerational effect [20]. A number of studies have documented that there is a signi cant relationship between mother's poor nutritional status and various pregnancy outcomes such as low birth weight, susceptibility to infections, and growth-challenged and developmentally delayed children [21]. There are several factors that affects the mother's nutrition such as high fertility, poor diet, low socioeconomic status, cultural factors, fertility
BMC Public Health, 2011
Background: Childhood obesity is becoming an equally challenging, yet under-recognized, problem in developing countries including Pakistan. Children and adolescents are worst affected with an estimated 10% of the world's school-going children being overweight and one quarter of these being obese. The study aimed to assess prevalence and socioeconomic correlates of overweight and obesity, and trend in prevalence statistics, among Pakistani primary school children. Methods: A population-based cross-sectional study was conducted with a representative multistage cluster sample of 1860 children aged 5-12 years in Lahore, Pakistan. Overweight (> + 1SD) and obesity (> + 2SD) were defined using the World Health Organization child growth reference 2007. Chi-square test was used as the test of trend. Linear regression was used to examine the predictive power of independent variables in relation to BMI. Logistic regression was used to quantify the independent predictors for overweight and adjusted odds ratios (aOR) with 95% confidence intervals (CI) were obtained. All regression analyses were controlled for age and gender and statistical significance was considered at P < 0.05. Results: Seventeen percent (95% CI 15.4-18.8) children were overweight and 7.5% (95% CI 6.5-8.7) were obese. Higher prevalence of obesity was observed among boys than girls (P = 0.028), however, there was no gender disparity in overweight prevalence. Prevalence of overweight showed a significantly increasing trend with grade (P < 0.001). Children living in the urban area with high socioeconomic status (SES) were significantly at risk for being overweight and obese (both P < 0.001) as compared to children living in the urban area with lower SES and rural children. Being in higher grade (aOR 2.39, 95% CI 1.17-4.90) and living in the urban area with higher SES (aOR 18.10, 95% CI 10.24-32.00) independently predicted the risk of being overweight. Conclusion: Alarmingly rapid rise in overweight and obesity among Pakistani primary school children was observed, especially among the affluent urban population. The findings support the urgent need for National preventive strategy for childhood obesity and targeted interventions tailored to local circumstances with meaningful involvement of communities.
BMC Public Health, 2019
Background: Childhood malnutrition is a critical public health concern in Pakistan. We aimed to explore factors associated with malnutrition in Pakistani children (< 5 years of age) using the Pakistan Demographic and Health Survey (PDHS) 2012-2013. Methods: Sample of 3071 Pakistani children aged 0-59 months from the PDHS 2012-2013, with complete anthropometric measurements were included in the study. Nutritional status was evaluated using anthropometric indices; height-forage , weight-for-height and weight-forage , as proxy measures of three forms of under-five malnutrition including stunting, wasting and underweight respectively. Uni-and multivariate binary logistic regressions were used to examine the association between selected maternal-socio-demographic and child level variables (such as child sex, age, size at birth, antenatal clinic visits, recent diarrheal incidence and breastfeeding status) and three proxy measures of child nutritional status. Results: About 44.4% of under-five children were stunted, 29.4% were underweight and 10.7% were wasted. Children whose mothers lived in rural areas (aOR = 0.67, 95%CI 0.48-0.92), were aged ≥18 years at marriage (aOR = 0.76, 95%CI 0.59-0.99) and had visited antenatal clinic more than 3 times during pregnancy (aOR = 0.61, 95%CI 0.38-0.98) were less likely to be stunted. Mother's low educational level (aOR = 2.55, 95%CI 1.26-5.17), short stature (aOR = 2.31, 95%CI 1.34-3.98), child's small size at birth (aOR = 1.67, 95%CI 1.14-2.45) and mother's BMI were significantly associated with child's underweight status. Children whose mothers had no education were more likely to be wasted (aOR = 3.61, 95%CI 1.33-9.82). Conclusion: The study suggests that most of the analysed factors that accounted for malnutrition in Pakistani children (such as mother's age at marriage, educational level and mothers' nutritional status) are preventable. Therefore, to reduce the burden of malnutrition interventions that can address these factors are required such as community based education and targeted nutritional interventions.
Journal of Population Therapeutics and Clinical Pharmacology, 2024
Background: Underweight, overweight and obesity are one of the biggest issues of the 21st century. Small and medium income countries are particularly affected by these risks. Therefore, it is surprising that the last study on the situation in Pakistan was conducted 10 years ago. An update on the BMI of Pakistani students and possible reasons is therefore highly needed. Methods: A cross-sectional study was conducted to investigate the prevalence of body mass index (BMI) among 4,201 Pakistani students. The results were analyzed using chi-square tests and logistic regression analysis to explore the association between BMI and various demographic and familylevel factors, elucidating weight status. Results: One in five children in the study exhibited underweight (23%), while overweight and obesity were diagnosed in 5.5% and 5.6% of Pakistani schoolchildren, respectively. Significant associations were found between weight status and socio-demographic characteristics such as gender, school type, age, and family-level factors including the number of siblings and parents' job nature. However, neither educational status nor parental income showed significant effects on the risks of underweight, overweight, or obesity. Conclusions: The prevalence of underweight, overweight, and obesity in Pakistan surpasses that of many other countries, with only 65% of children achieving a normal BMI status. Particularly concerning is the worsening situation regarding underweight. However, these findings provide valuable insights for establishing targeted intervention programs aimed at improving nutrition and increasing physical activity, especially among vulnerable student groups.
Journal of Nutrition and Metabolism
Child malnutrition persists in low-resource countries such as Pakistan, indicating an urgent need for interventions and policies aimed to address this critical population health issue. The World Health Organization Global Target 2025 includes the reduction of malnourishment in the form of stunting, wasting, and low weight. This study aims to examine the prevalence of factors associated with three measures of child malnutrition, i.e., stunting, wasting, and low weight in Pakistan. This study uses a secondary data analysis design based on data from Pakistan Demographic and Health Survey (2017-18) that used a two-stage cluster sampling approach. National level data covering urban and rural areas were used for this study consisting of 4,226 children less than 5 years of age. Univariate and multivariable analyses using logistic regression models were conducted. Over 23% of the children were underweight, 8.0% suffered wasting, and 37.7% were stunted. Children with small size at birth (<...
European Journal of Clinical Nutrition, 2001
Objective: To study the socio-economic differences in height and body mass index (BMI) in urban areas of Karachi. Design: A comparative study was undertaken to compare the heights and BMIs of adults and children belonging to three distinctively different income groups living in urban areas of Karachi. Setting: Data was collected from families living in small, medium and large houses located in the authorised urban residential areas of Karachi. Subjects: A total of 600 families, 200 from each income group, were included in the study. Anthropometric measurements of 1296 females and 1197 males of different ages were taken. Methods: All the housewives were interviewed to collect socio-demographic information. Height and weight of all the available family members were measured. In order to determine the socio-economic difference in height status, the mean height in cm of adults was compared. For children (2 ± 17 y) means of height-for-age Z-scores determined on the basis of NCHS reference values were compared. For studying the weight status the BMI of all the respondents was calculated and they were grouped into categories of under-, normal or overweight according to the NCHS recommended cut-off points. For adult men and women BMI values`18.5 kgam 2 indicated underweight and b 25 kgam 2 indicated overweight. Among children, those having BMI values below the 5th percentile of the NHANES III reference values were categorised as underweight and those above the 95th percentile were termed overweight. Results: Height status improved with income level among adults and children of both sexes. Among males the difference in weight status was signi®cant only among 2 to 18-y-olds (P`0.05 in each case). The rate of overweight among 2 to 18-y-old males was signi®cantly higher (P 0.004) at the middle-income level (15%) as compared to low or high income. The rate of underweight was signi®cantly higher (P 0.025) at the low-income level among 2 to 18-y-old males (31%, 21% and 22% at low-, middle-and high-income levels, respectively). Among females, rates of underweight were not signi®cantly different at any age. Rates of overweight increased signi®cantly (P 0.048) with income level among 41 to 60-y-old women (38%, 53% and 60% at low-, middleand high-income levels, respectively). Conclusion: Chronic undernutrition as indicated by de®cit in height decreased with increasing income level. Socio-economic differences in weight status were not uniform among various age ± sex groups. The in¯uence of increasing af¯uence is likely to be seen both in the form of increased obesity among older females and underweight among children. Differing patterns of association between income and weight status among male and female children need to studied further with more accurate birth records, so as to further clarify the situation. In terms of prevention of nutrition-related disorders both problems of under-and over-nutrition need to be addressed. Sponsorship: Financial support for this project was provided by ISFE, Switzerland.
Nutrition Journal, 2018
Background: Food insecurity has been associated with dietary intake and weight status in UK adults and children although results have been mixed and ethnicity has not been explored. We aimed to compare prevalence and trajectories of weight and dietary intakes among food secure and insecure White British and Pakistani-origin families. Methods: At 12 months postpartum, mothers in the Born in Bradford cohort completed a questionnaire on food security status and a food frequency questionnaire (FFQ) assessing their child's intake in the previous month; at 18 months postpartum, mothers completed a short-form FFQ assessing dietary intake in the previous 12 months. Weights and heights of mothers and infants were assessed at 12-, 24-, and 36-months postpartum, with an additional measurement of children taken at 4-5 years. Associations between food security status and dietary intakes were assessed using Wilcoxon-Mann-Whitney for continuous variables and χ 2 or Fisher's exact tests for categorical variables. Quantile and logistic regression were used to determine dietary intakes adjusting for mother's age. Linear mixed effects models were used to assess longitudinal changes in body mass index (BMI) in mothers and BMI z-scores in children. Results: At 12 months postpartum, White British mothers reported more food insecurity than Pakistani-origin mothers (11% vs 7%; p < 0.01) and more food insecure mothers were overweight. Between 12 and 36 months postpartum, BMI increased more among food insecure Pakistani-origin mothers (β = 0.77 units, [95% Confidence Interval [CI]: 0.40, 1.10]) than food secure (β = 0.44 units, 95% CI: 0.33, 0.55). This was also found in Pakistani-origin children (BMI z-score: food insecure β = 0.40 units, 95% CI: 0.22, 0.59; food secure β = 0.25 units, 95% CI: 0.20, 0. 29). No significant increases in BMI were observed for food secure or insecure White British mothers while BMI zscore increased by 0.17 (95% CI: 0.13, 0.21) for food secure White British children. Food insecure mothers and children had dietary intakes of poorer quality, with fewer vegetables and higher consumption of sugar-sweetened drinks. Conclusions: Food security status is associated with body weight and dietary intakes differentially by ethnicity. These are important considerations for developing targeted interventions.
The Lancet. Global health, 2015
Pakistan has one of the highest levels of child and maternal undernutrition worldwide, but little information about geographical and socioeconomic inequalities is available. We aimed to analyse anthropometric indicators for childhood and maternal nutrition at a district level in Pakistan and assess the association of nutritional status with food security and maternal and household socioeconomic factors. We used data from the 2011 Pakistan National Nutrition Survey, which included anthropometric measurements for 33 638 children younger than 5 years and 24 826 women of childbearing age. We estimated the prevalences of stunting, wasting, and underweight among children and of underweight, overweight, and obesity in women for all 143 districts of Pakistan using a Bayesian spatial technique. We used a mixed-effect linear model to analyse the association of nutritional status with individual and household sociodemographic factors and food security. Stunting prevalence in Pakistan's dis...
BMC Public Health
Background Underweight prevalence continues to be major public health challenge worldwide, particularly in developing countries like Pakistan. This study is focused on socio-economic and demographic aspects of underweight prevalence among children under-five in Punjab. Methods In this study, several socioeconomic and demographic factors are considered using MICS-4 data-set. Only those variables which are usually described in the nutritional studies of children were picked. Covariates include: the age of children, sex of the children, age of mother, total number of children born to women, family wealth index quintile, source of drinking water, type of sanitation, place of residence, parents’ education and occupation. All Categorical variables are effect coded. The child’s age and the mother’s age are assumed to be nonlinear, geographical region is spatial effect, while other variables are parametric in nature. Since, the response is binary, covariate comprises linear terms, nonlinear...