The double burden of malnutrition in Association of South East Asian Nations (ASEAN) countries: a comprehensive review of the literature.

BACKGROUND AND OBJECTIVES

The double burden of malnutrition (DBM) - a combination of undernutrition and overnutrition - is a problem faced by many countries. This study aimed to comprehensively review the DBM in ASEAN (Association of South East Asian Nations) countries, including levels (population [including country, city, or any community], household, or individual), types (the type of undernutrition and overweight), and prevalence.

METHODS AND STUDY DESIGN

Data were sourced from four electronic databases, Medline via OvidSP, Scopus, Global Health via OvidSP and Web of Science, from January 1990 until May 2017. We only included studies that reported prevalence of DBM, were published in English language peer-reviewed journals and were available in full text. Studies were formally assessed against a published critical appraisal tool to produce a robust narrative review.

RESULTS

We included 48 studies in the review from eight countries. No study was found from Singapore or Brunei Darussalam. Most studies were from Indonesia and there was only one study from Lao PDR. There were a range of criteria for anthropometry used in these studies, hence comparison is impossible. DBM happened at community, household, and individual levels, with different types of undernutrition (stunting/ underweight/wasting/thinness) in combination with overweight/obesity. At the household level, DBM ranged from 5.0% in Vietnam to 30.6% in Indonesia.

CONCLUSIONS

ASEAN countries may need to strengthen surveillance using WHO standards to improve the comparability of data, further develop strategies to address under- or overweight issues and investigate potential "double-duty actions" as suggested by the World Health Organization.