Abstract:
Many low- and middle-income countries are undergoing a nutrition transition associated
with rapid social and economic transitions. We explore the coexistence of over and undernutrition
at the neighborhood and household level, in an urban poor setting in Nairobi,
Kenya.
Methods
Data were collected in 2010 on a cohort of children aged under five years born between
2006 and 2010. Anthropometric measurements of the children and their mothers were
taken. Additionally, dietary intake, physical activity, and anthropometric measurements
were collected from a stratified random sample of adults aged 18 years and older through a
separate cross-sectional study conducted between 2008 and 2009 in the same setting. Proportions
of stunting, underweight, wasting and overweight/obesity were dettermined in children,
while proportions of underweight and overweight/obesity were determined in adults.
Results
Of the 3335 children included in the analyses with a total of 6750 visits, 46% (51% boys,
40% girls) were stunted, 11% (13% boys, 9% girls) were underweight, 2.5% (3% boys, 2%
girls) were wasted, while 9% of boys and girls were overweight/obese respectively. Among
their mothers, 7.5% were underweight while 32% were overweight/obese. A large proportion
(43% and 37%%) of overweight and obese mothers respectively had stunted children.
Among the 5190 adults included in the analyses, 9% (6% female, 11% male) were underweight,
and 22% (35% female, 13% male) were overweight/obese.
Conclusion
The findings confirm an existing double burden of malnutrition in this setting, characterized
by a high prevalence of undernutrition particularly stunting early in life, with high levels of
overweight/obesity in adulthood, particularly among women. In the context of a rapid
increase in urban population, particularly in urban poor settings, this calls for urgent action.
Multisectoral action may work best given the complex nature of prevailing circumstances in
urban poor settings. Further research is needed to understand the pathways to this coexistence,
and to test feasibility and effectiveness of context-specific interventions to curb associated
health risks.
