Dynamics of the double burden of malnutrition in Guatemala a secondary data analysis of the demographic and health surveys from 1998-2015

Objective:
We estimated the prevalence and time trends of the double burden of malnutrition (DBM) in Guatemala and explored its occurrence based on socio-demographic factors. Study design: This was a secondary data analysis using information from four Demographic and Health Surveys covering the period 1998e2015. Methods: The unit of analysis was the household within which information was gathered from women 18e49 years and their children, 6e59 months. The main outcome was the prevalence of any DBM in the household (co-existence of undernutrition and overnutrition in a woman, her children or both). We estimated the prevalence of any DBM by survey and analysed time trends. Stepwise logistic regression was used to explore the occurrence of DBM and socio-demographic factors. Results: We analysed 39,749 households across all surveys. The prevalence of any DBM was 25.3% (95% CI: 22.1e28.7) in 1998e99, 23.8% (22.0e25.8) in 2002, 25.9% (24.3e27.5) in 2008e09 and 24.2% (22.9 e25.5) in 2014e15, with no significant change over time (P ¼ 0.782). Characteristics associated with lower odds of any DBM were rural residence, female-headed household, wealth and women's secondary education. Higher odds were seen for households with electricity, women >25y, indigenous and with >2 children. Conclusion: Our findings revealed that a quarter of Guatemala's households suffer from DBM, which has remained unchanged for 17 years. Interventions should prioritise urban areas, households of lower socioeconomic status and those less educated. To increase awareness of policymakers of this pressing public health concern, further research on DBM could be strengthened by prospective study designs, integrating all household members and expanding the types of malnutrition. ©2024 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).