TABLE 3.
Prevalence estimates of concomitant overweight/obesity and micronutrient deficiencies or anemia among preschool children by survey: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia project1
| Anemia | MDI > 0 | Iron | Vitamin A | Zinc | Folate | Vitamin D | Vitamin B-12 | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Geographic grouping | Country, survey year | Obs. | Exp. | Obs. | Exp. | Obs. | Exp. | Obs. | Exp. | Obs. | Exp. | Obs. | Exp. | Obs. | Exp. | Obs. | Exp. |
| Southeast Asia | Bangladesh, 2010 | 1.2 | 1.4 | 0.5 | 0.4 | 0.4 | 0.3 | 0.1 | 0.1 | — | — | — | — | — | — | — | — |
| Bangladesh, 2012 | 1.0 | 1.1 | 1.0 | 1.6 | 0.7 | 0.4 | 0.0 | 0.3 | 1.1 | 0.6 | — | — | — | — | — | — | |
| Cambodia, 2014 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | |
| Laos, 2006 | 0.0 | 0.3 | 0.0 | 0.2 | 0.0 | 0.2 | — | — | — | — | — | — | — | — | — | — | |
| Mongolia, 2006 | 1.3 | 0.0 | 9.7 | 9.9 | 4.0 | 4.7 | 2.6 | 3.0 | 8.0 | 8.4 | 1.4 | 1.7 | 6.5 | 7.0 | — | — | |
| PNG, 2005 | 1.5 | 2.3 | 0.4 | 0.6 | — | — | 0.4 | 0.6 | — | — | — | — | — | — | — | — | |
| Philippines, 2011 | 0.6 | 0.8 | 0.8 | 0.7 | 0.8 | 0.7 | 0.0 | 0.0 | — | — | — | — | — | — | — | — | |
| Vietnam, 2010 | 0.0 | 0.3 | 2.4 | 2.8 | 1.1 | 0.7 | 0.0 | 0.2 | 1.4 | 2.1 | 0.0 | 0.1 | 0.3 | 0.8 | — | — | |
| Africa | Cote d'Ivoire, 2007 | 3.7 | 3.8 | 2.6 | 2.2 | 2.3 | 2.1 | 0.2 | 0.2 | — | — | — | — | — | — | — | — |
| Cameroon, 2009 | 1.7 | 1.8 | 2.8 | 2.7 | 0.8 | 1.2 | 0.6 | 0.3 | 1.9 | 2.0 | 0.7 | 0.3 | — | — | 1.0 | 0.6 | |
| Kenya, 2007 | 3.5 | 3.1 | 3.9* | 3.5 | 3.8* | 3.4 | 0.2 | 0.3 | — | — | — | — | — | — | — | — | |
| Kenya, 2010 | 3.3 | 3.2 | 2.5 | 2.5 | 2.5 | 2.4 | 0.0 | 0.4 | — | — | — | — | — | — | — | — | |
| Liberia, 2011 | 1.2 | 1.3 | 1.1 | 1.2 | 1.1 | 1.2 | 0.0 | 0.1 | — | — | — | — | — | — | — | — | |
| Malawi, 2016 | 2.6* | 1.4 | 3.3 | 3.0 | 1.9* | 1.0 | 0.5 | 0.4 | 2.3 | 2.8 | — | — | — | — | — | — | |
| Americas | Colombia, 2010 | 0.6 | 0.5 | 2.7 | 2.3 | 0.8 | 0.5 | 0.5 | 0.6 | 2.0 | 1.7 | — | — | — | — | — | — |
| Ecuador, 2012 | 1.2* | 1.8 | 2.7 | 2.9 | 1.0 | 0.9 | 1.2 | 1.1 | 1.3 | 1.9 | 0.0 | 0.1 | — | — | — | — | |
| Mexico, 2006 | 1.0 | 1.5 | 4.2* | 3.4 | 3.4 | 2.6 | — | — | 3.0 | 2.0 | 0.6 | 0.4 | — | — | 0.0 | 0.2 | |
| Mexico, 2012 | 1.5 | 1.5 | 2.3 | 2.1 | 1.8 | 1.5 | 0.6 | 0.6 | — | — | 0.2 | 0.0 | — | — | 0.0 | 0.0 | |
| Nicaragua, 2005 | 1.2 | 1.3 | 1.5 | 1.4 | 3.0 | 2.3 | 0.1 | 0.0 | — | — | — | — | — | — | — | — | |
| USA, 2006 | 0.1 | 0.2 | 2.2* | 1.4 | 2.2* | 1.2 | — | — | — | — | 0.2 | 0.2 | 0.1 | 0.1 | 0.0 | 0.0 | |
| Europe/Eastern Mediterranean | Afghanistan, 2013 | 1.9 | 2.9 | 6.1 | 5.4 | 2.3 | 1.7 | 3.2 | 2.8 | 1.6 | 1.7 | — | — | 4.3 | 3.1 | — | — |
| Azerbaijan, 2013 | 3.5 | 4.0 | 4.8 | 4.6 | 2.6 | 3.1 | 0.8 | 0.9 | 2.2* | 1.2 | — | — | — | — | — | — | |
| Georgia, 2009 | 5.0 | 4.5 | 0.1 | 0.0 | 0.1 | 0.0 | — | — | — | — | — | — | — | — | — | — | |
| Pakistan, 2011 | 2.8 | 2.8 | 4.0 | 4.0 | 2.4 | 2.3 | 2.7* | 2.3 | 2.2 | 2.2 | — | — | 0.9 | 0.8 | — | — | |
Values are percentages. Surveys in descending order of OWOB prevalence within geographic groups. Asterisks indicate significant differences between Obs. and Exp. prevalence estimates calculated using the Rao–Scott modified chi-square test for independence of OWOB and each condition, except for Cambodia 2014, Laos 2006, and Mongolia 2006. Mongolia 2006 did not use a complex survey design, so the chi-square test was used. P values could not be computed for Laos 2006 because the observed DBM frequency was 0. No results are shown for Cambodia because the prevalence of OWOB was 0. Exp. prevalence of DBM was calculated by multiplying the prevalence of OWOB (BMI-for-age z score > 2 SD) by the prevalence of each undernutrition component of the DBM (anemia, MDI > 0, or individual micronutrient deficiencies). Iron deficiency was defined as inflammation-adjusted ferritin < 12 µg/L. Vitamin A deficiency was defined as inflammation-adjusted retinol-binding protein or retinol < 0.7 μmol/L. Zinc deficiency was defined as plasma or serum zinc < 650 µg/L for nonfasting children in the morning or <570 µg/L for nonfasting children in the afternoon/evening. Zinc concentrations were adjusted for inflammation in Afghanistan, Azerbaijan, Cambodia, Cameroon, and Ecuador. Vitamin D deficiency was defined as 25-hydroxyvitamin D < 30 nmol/L. Folate deficiency was defined as RBC folate < 226.5 nmol/L (if measured using the microbiologic assay) or serum folate < 6.8 nmol/L. Vitamin B-12 deficiency was defined as serum or plasma B-12 < 150 pmol/L. MDI was defined as the number of micronutrient biomarkers with values below the threshold used to define deficiency. DBM, double burden of malnutrition; Exp., expected; MDI, Micronutrient Deficiency Index; Obs., observed; OWOB, overweight or obesity.