Understanding the impact of maternal body composition on child nutritional status within a household sociobehavioral context in a peri-urban ni-Vanuatu community.

摘要

Prevalence of obesity is rapidly increasing in developing nations as part of the health transition, a model which describes the increase in rates of non-communicable chronic diseases in developing countries, while prevalence of undernutrition and infectious disease do not necessarily decline. The global increase in obesity prevalence is generally considered to result from increased availability of high calorie, low quality foods, coupled with decreased physical activity. Additional explanatory factors, such as the intergenerational transmission of obesity status, have been less-well explored, although maternal obesity has been demonstrated to be an important risk factor for the development of childhood obesity in developed nations. Understanding the connection between maternal-child obesity in developing nations has important public health implications for medical and economic systems which may be ill-equipped to manage increasing chronic disease rates. In this study, the impact of maternal obesity on child nutritional status was evaluated within a household sociobehavioral context in the village of Erakor, a peri-urban community on the island of Efate in the Republic of Vanuatu. Vanuatu is a South Pacific Island nation undergoing health transition resulting from rapid modernization and accompanying changes in behavior and lifestyle. In 2013, 373 individuals residing in 64 households in Erakor underwent anthropometric measurements, and participated in an extensive behavioral, demographic, and household survey. Analysis of body composition and obesity status demonstrated that prevalence of obesity is high among adults in Erakor (14.5-73.5%, depending on the measure used), and particularly among women. Rates of undernutrition and overweight/obesity were low among children. Factors associated with body composition and obesity among adults included household ownership of appliances/technological goods, and individual sociobehavioral factors including gender, age, years of education, and participation in sports activities. Factors associated with child nutritional status included household ownership of appliances/technological goods, access to piped city water, maternal occupational status, and maternal body composition. Understanding the connection between maternal obesity and child nutritional status has important public health implications, as child nutritional status is predictive of health into adulthood. Children of obese mothers may be at increased risk for developing obesity later in their lives, and thus represent an important target for the development of public health measures for the prevention of obesity in the community of Erakor.