摘要：Background: The World Health Organization (WHO) defines the double burden of malnutrition as the new face of malnutrition. This is a serious problem in Latin American countries, especially Paraguay, which has a high obesity rate. This study aimed to gather data to inform a national strategy for confronting the doubleburden challenge in Paraguay by i) identifying whether the body mass index (BMI) of study subjects differed significantly according to social determinants, and ii) assessing the factors affecting BMI and the extent of their impact according to BMI quantile levels.
Design and methods: Data were collected using a questionnaire adapted from the WHO World Health Survey. We collected 2,200 responses from September 16 to October 7, 2018. After excluding the questionnaires with missing data, we analyzed 1,994 respondents aged 18 years and older living in Limpio, Paraguay. The analyses included t-test and chi-squared test to identify significant differences and 10th quantile regression to assess associations.
Results: Analyses showed significant differences in participants’ BMI levels based on age and diagnoses of diabetes or hypertension. In quantile regression analyses, age was significantly associated with BMI quantiles at all but one level. Educational attainment was significantly associated with the 10-40% and 60-70% quantiles of BMI.
Conclusions: Age, education level, diabetes, and hypertension were significant predictors of obesity. Obesity programs that focus on people aged more than 60 years are required. In addition, targeted nutritional education may be a useful intervention.
Significance for public health
The World Health Organization defines the "Double burden of obesity and undernutrition" as the new face of malnutrition, where obesity and undernutrition coexist. The double burden of malnutrition is a serious problem in Latin American countries, including Paraguay, which has a high obesity rate. The double burden issue in lower-middle-income countries requires evaluation, with findings that can form the basis for national policy to face this public health challenge.
关键词：Obesity; overweight; health behavior; public health; nutrition
