title: Evidence of a Double Burden of Malnutrition in Urban Poor Settings in Nairobi, Kenya.
abstract: BACKGROUND
  Many low- and middle-income countries are undergoing a nutrition transition associated with rapid social and economic transitions. We explore the coexistence of over and under- nutrition at the neighborhood and household level, in an urban poor setting in Nairobi, Kenya.
  
  
  METHODS
  Data were collected in 2010 on a cohort of children aged under five years born between 2006 and 2010. Anthropometric measurements of the children and their mothers were taken. Additionally, dietary intake, physical activity, and anthropometric measurements were collected from a stratified random sample of adults aged 18 years and older through a separate cross-sectional study conducted between 2008 and 2009 in the same setting. Proportions of stunting, underweight, wasting and overweight/obesity were dettermined in children, while proportions of underweight and overweight/obesity were determined in adults.
  
  
  RESULTS
  Of the 3335 children included in the analyses with a total of 6750 visits, 46% (51% boys, 40% girls) were stunted, 11% (13% boys, 9% girls) were underweight, 2.5% (3% boys, 2% girls) were wasted, while 9% of boys and girls were overweight/obese respectively. Among their mothers, 7.5% were underweight while 32% were overweight/obese. A large proportion (43% and 37%%) of overweight and obese mothers respectively had stunted children. Among the 5190 adults included in the analyses, 9% (6% female, 11% male) were underweight, and 22% (35% female, 13% male) were overweight/obese.
  
  
  CONCLUSIONS
  The findings confirm an existing double burden of malnutrition in this setting, characterized by a high prevalence of undernutrition particularly stunting early in life, with high levels of overweight/obesity in adulthood, particularly among women. In the context of a rapid increase in urban population, particularly in urban poor settings, this calls for urgent action. Multisectoral action may work best given the complex nature of prevailing circumstances in urban poor settings. Further research is needed to understand the pathways to this coexistence, and to test feasibility and effectiveness of context-specific interventions to curb associated health risks.
authors.affiliation: African Population and Health Research Center, Nairobi, Kenya.
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Kimani-Murage
authors.affiliation: African Population and Health Research Center, Nairobi, Kenya.
authors.forename: Stella K
authors.initials: SK
authors.lastname: Muthuri
authors.affiliation: African Population and Health Research Center, Nairobi, Kenya; Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands.
authors.forename: Samuel O
authors.initials: SO
authors.lastname: Oti
authors.affiliation: African Population and Health Research Center, Nairobi, Kenya.
authors.forename: Martin K
authors.initials: MK
authors.lastname: Mutua
authors.affiliation: African Population and Health Research Center, Nairobi, Kenya; Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands.
authors.forename: Steven
authors.initials: S
authors.lastname: van de Vijver
authors.affiliation: African Population and Health Research Center, Nairobi, Kenya.
authors.forename: Catherine
authors.initials: C
authors.lastname: Kyobutungi
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007630:Kenya / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology*; D009752:Nutritional Status / Q000502:physiology; D009765:Obesity / Q000453:epidemiology*; D011203:Poverty; D011204:Poverty Areas; D012307:Risk Factors; D012959:Socioeconomic Factors; D013851:Thinness / Q000453:epidemiology*; D014505:Urban Population; D055815:Young Adult