Double burden: Poor diet links obese mothers and stunted children

Obesity and malnutrition are often thought of as problems at opposite ends of the nutrition spectrum, but new research has linked diet quality with obesity in mothers and stunted children.

The study, published in the Maternal and Child Health Journal, investigated data from mothers and children in Egypt – findingthat 6.7% of Egyptian mothers were obese and had stunted children.

In these 'double-burden' households with obese mothers and stunted children, malnutrition is unlikely to be down to scarcity of food, said the team – led by Dr Amina Aitsi-Selmi from University College London (UCL).

"Malnutrition is not only a question of not having enough food, it is also about not having good enough food," said Aitsi-Selmi. "A household diet rich in energy-dense, sugary food and poor in fruit and vegetables is unlikely to provide all the nutrients that children need to grow.”

“I would consider a child fed on nothing but sugary snacks malnourished, even if they are not under-nourished.”

The research found that children who were fed chocolate, biscuits or sweets were 51% more likely to belong to a 'double-burden' household, whereas children who were fed fruit and vegetables were 24% less likely to be in this category.

"Whether there is a biological link between obese mothers and their stunted children from birth is not known, and our study does not address this question," said Aitsi-Selmi.

"We did find that poor quality nutrition is associated with both maternal obesity and child stunting, suggesting that it may be a common factor for both conditions.”

Study details

While obesity is traditionally seen as a problem for rich countries and child stunting a problem for poor countries, the sudden availability of cheap, high energy-density foods in middle-income countries such as Egypt has led to high obesity rates.

The UCL team used data including weight and height from 25,065 mothers and their children from the Egyptian Demographic and Health Surveys in 1992, 1995, 2005 and 2008.

The study found that maternal obesity in Egypt rose from 22% in 1992/95 to 32.3% in 2005/08.

Meanwhile stunting levels among children declined from 22.4% to 14.7% over the same period, however, the number of obese mothers with stunted children increased from 4.1% to 5.6%.

“In Egypt, there is a government subsidy on oil, sugar and bread but not fruit or vegetables, favouring high calories and low micronutrients,” said Aitsi-Selmi.

“Improving the diversity and nutrient contents of the whole household diet could help to address both maternal obesity and child stunting, whereas treating them as separate problems may make things worse.”

Source: Maternal and Child Health Journal

Published online, open access, doi: 10.1007/s10995-014-1634-5

“Households with a Stunted Child and Obese Mother: Trends and Child Feeding Practices in a Middle-Income Country, 1992–2008”

Authors: Amina Aitsi-Selmi