The dual burden of malnutrition in Colombia

Background: Almost all nutrition policies in Colombia currently focus on either undernutrition or obesity, with the predominant emphasis on undernutrition. It is crucial to assess the prevalence of the dual burden of malnutrition in Colombia to better target programs and policies. Objective: The aim was to estimate the national prevalence of the dual burden of malnutrition in Colombia at the individual and household levels in children aged <5 y, school-age children, adolescents, and adults. Design: This was a cross-sectional analysis from the 2010 Colombian Demographic and Health Survey and the National Nutritional Survey that included 17,696 children aged <5 y, 25,508 school-aged children, 28,328 adolescents, 89,164 adults, and 10,487 households with mothers and children aged <5 y. The dual burden of malnutrition was defined as the coexistence of overweight and stunting or anemia in the same person or household. Results: In Colombia, low to high prevalences of overweight and obesity (3.4-51.2%) coexist with moderate to high prevalences of anemia (8.1-27.5%) and stunting (13.2%). The observed prevalence of the dual burden was lower than expected. Approximately 5% of households had at least one stunted child aged <5 y and an overweight mother compared with an expected prevalence of 6.9% (P < 0.001). Among school-aged children, 0.1% were classified as stunted and obese and 1.4% were both anemic and overweight compared with expected prevalences of 0.5% (P < 0.001) and 1.5% (P = 0.037), respectively. Among 13-to 49-y-old women, 3.4% had anemia and were overweight compared with an expected prevalence of 3.5% (P = 0.038). Conclusions: National estimates of the dual burden of malnutrition in Colombia are lower than expected. Despite the independence of the occurrence of these conditions, the fact that the dual burden coexists at the national, household, and intraindividual levels suggests that public policies should address both conditions through multiple strategies. It is imperative to evaluate the current nutrition policies to inform malnutrition prevention efforts in Colombia and to share lessons with other countries at a similar stage of nutritional transition.