Double burden of malnutrition in urbanized settled Tibetan communities on the Tibetan plateau

摘要

Background and Objectives: A previous pilot study revealed stunted children and obese adults in urbanized settled Tibetan communities. A survey with a representative population in selected communities was conducted to test the preliminary findings. Methods and Study Design: A cross-sectional study on the nutritional status involving 504 children (244 boys and 260 girls, 5-16 y) and 927 adults (422 men and 505 women, 18-90 y) was conducted in communities, with anthropometric parameters measured. The z-scores for height-for-age (HAZ) and BMI-for-age (BAZ) in children were calculated according to WHO 2007 reference. Results: The children showed a double burden of both under- and over-nutrition. The prevalence of under-nutrition in children was high - stunting (HAZ 2). The mean value of HAZ (0.45 +/- 1.41) was lower than, whereas that of BAZ (0.05 +/- 1.76) was comparable to, the WHO reference. No significant differences were found in under- or over-nutrition between genders. Specifically, 8.9% of children demonstrated both short stature (HAZ 1). By contrast, community adults showed almost a one-way direction tilted towards over-nutrition - overweight 61.4% (BMI >24 kg/m(2)), obesity 30.1% (BMI >28 kg/m(2)), and central obesity 62.0% (waist circumference, men >85 cm, women >80 cm). Women were marginally more likely to be obese than men (p=0.061). Conclusions: The co-existence of under- and over-nutrition in the community may have reflected the suboptimal early life nutrition and the obesogenic environment afterwards. Potential determinants need to be explored for future interventions.