Factors Associated with Dual Form of Malnutrition in School Children in Nakhon Pathom and Bangkok
Uruwan Yamborisut MSc*, Vongsvat Kosulwat PhD**, Uraiporn Chittchang DSc**, Wanpen Wimonpeerapattana MSc***, Umaporn Suthutvoravut MD****
Affiliation : * Division of Human Nutrition, Institute of Nutrition, Mahidol University, Nakhon Pathom ** Division of Community Nutrition, Institute of Nutrition, Mahidol University, Nakhon Pathom *** Division of Biostatistics and Computer Service, Institute of Nutrition, Mahidol University, Nakhon Pathom ****Department of Pediatrics, Ramathibodi Hospital, Faculty of Medicine, Mahidol University
Objective : The present study examined the influence of family characteristics and maternal feeding practices
on eating behaviors, food consumption and nutritional status of children living in 6 districts of Nakhon
Pathom province and 3 surrounding districts of Bangkok.
Materials and Methods : One hundred and ninety nine families were enrolled in the present study. Four specific
mother-child pair groups were purposively selected: 62 obese child/overweight mother pairs, 49 obese child/
normal weight mother pairs, 37 wasted child/overweight mother pairs, and 51 normal weight child/normal
weight mother pairs. Anthropometric measurements were performed on all subjects. Biological data, socio-
economic status, maternal feeding practices, as well as eating and lifestyle behaviors of the children were
obtained from mothers and children using structured questionnaires and interviews.
Result: Most mothers from all groups, 40.8%-62.2%, had a primary education, were non-manual workers,
with families containing 4-6 persons per household, and a family income of < 20,000 baht per month. Multi-
variate logistic regression analysis showed that maternal overweight prior to pregnancy (OR11.85, 95%CI
2.16-64.99) child’s high birth weight (OR 4.53, 95%CI 1.09-18.73) as well as maternal control over the
consumption of high caloric food (OR13.07, 95%CI 4.08-41.86) and large amounts of food consumed by the
children (OR12.58, 95%CI 4.30-36.80) were significant factors associated with childhood obesity. Compared
to normal weight children, a higher proportion of obese children were not breast-fed and a higher proportion
of normal weight mothers controlled the consumption of high caloric food in their obese children. Overweight
mothers with wasted children also controlled their children’s food intake. Higher proportion of wasted children
had a higher snack consumption frequency but lower energy food intake than the normal weight children.
Conclusion : Understanding the underlying causes of dual form of malnutrition in the households would have
implication for policy makers to address and implement a nutrition action plan. It is suggested that a malnu-
trition, (under and over-nutrition) prevention program must involve strategies within families that focus on
providing nutrition education and the powerful guidance to help parents foster appropriate patterns of food
choice and eating in their children. Promotion of increased physical activity in children is also essential.
These strategies are aimed to promote the optimal child’s weight and health.
Keywords : Dual form malnutrition, Obesity, Wasting children, Feeding practices
