Double Burden of Excess Weight and Anemia in Latin American Children up to 2019

Invited Review for the 100^th Anniversary of the TJEM

Double Burden of Excess Weight and Anemia in Latin American Children up to 2019

ROBERTO L. SHIMABUKU,¹ CARLOS A. DELGADO,^1,2 GRACIELA NAKACHI,³ ALBERTO A. TERUYA⁴ and PABLO M. VELASQUEZ⁵

¹Department of Pediatrics, Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú
²Neonatal Unit, Instituto Nacional de Salud del Niño, Lima, Perú
³Sociedad Peruana de Pediatría, Lima, Perú
⁴Department of Endocrinology, Hospital Edgardo Rebagliati Martins, Lima, Perú
⁵Department of Neonatology, Instituto Nacional Materno Perinatal, Lima, Perú

The double burden of malnutrition is the coexistence of two different conditions, mainly reflected as excess or deficit in weight. Anemia is a specific nutritional deficit not always included in the double burden assessment. We reviewed overweight and/or obesity (OW/OB) and anemia studies from Latin-American Children over the last ten years up to 2019. Two authors evaluated the MEDLINE, SCOPUS, and LILACS databases. A scale of ten questions was used to assess the risk of bias in prevalence studies. Fourteen studies were selected. The population studies' size ranged from 147 to 20,342 children with different socio-economic backgrounds, such as urban, peri-urban and rural settings, socio-economic status, schooling, population (ethnic minorities and indigenous), and environmental differences (sea level or high altitude). The prevalence of OW/OB ranged from 4.9% to 42%. The prevalence of anemia was from 3.4% to 67%. The double burden, including OW/OB and anemia, ranged from 0.7% to 67%. A higher prevalence of excess weight and anemia was found in rural and high altitude above sea level environments, extreme poverty, low education level, and indigenous communities. These heterogeneous data, before the 2020 (COVID-19 pandemic), reflect the vast inequities between countries and within each country. Food insecurity linked to poverty and the induced change in eating habits and lifestyles threaten optimal child nutrition in ongoing and future scenarios. The existence of OW/OB and anemia and their simultaneous coexistence in the community, home, and individual levels, indicates that interventions should be comprehensive to face the double burden of malnutrition.

Keywords —— anemia; child; double burden; Latin America; obesity

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Tohoku J. Exp. Med., 2020 , 252, 159-168.

Correspondence: Roberto Shimabuku, M.D., Ph.D., Department of Pediatrics, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Av.Grau 700, Lima 1, Perú.

e-mail: rshimabukua@unmsm.edu.pe

Correspondence: Carlos A. Delgado, M.D., Ph.D., Department of Pediatrics, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Av.Grau 700, Lima 1, Perú.

e-mail: cdelgadob1@unmsm.edu.pe

*These authors should be considered as first authors.