Gender and adult undernutrition in developing countries.

BACKGROUND: Information on the prevalence of undernutrition in adults in developing countries is mainly restricted to data on women. Literature reporting on the occurrence of female deprivation in developing countries, in particular in South Asia, suggests that differences between undernutrition prevalence in adult men and adult women might occur, but systematic information on the subject is lacking. AIM: The study compares undernutrition prevalence rates, based on prevalence of low body mass index (BMI < 18.5), in adult men and adult women in developing countries. Regional comparison is made between the main developing regions: Sub-Saharan Africa, South/Southeast Asia and Latin America. SUBJECTS AND METHODS: The study uses data as reported in 75 samples from 31 countries(divided over the three developing regions), in which anthropometric information has been collected in adult men and women within one and the same community. RESULTS: Results indicate that, in general, prevalence rates of undernutrition are rather similar in adult men and women. However, there are regional differences. In communities in Sub-Saharan Africa, prevalence of low BMI is, on average, a few percent higher in men than in women; in South/Southeast Asia the reverse is the case. In some communities differences in undernutrition prevalence between men and women are exceptionally large. CONCLUSIONS: It can be concluded that, in general, information on undernutrition prevalence in women can be considered a proxy for undernutrition prevalence in all adults, men and women together. However, the finding that in South/Southeast Asia women's nutritional status relative to men's nutritional status compares unfavourably with results from other developing regions, in particular Sub-Saharan Africa, provides some support for the concept of female deprivation in South/Southeast Asia. Where large differences between prevalence of low BMI in men and women occur, gender-specific policies aimed at reducing under-nutrition should be considered.

Food-consumption patterns in central West Africa, 1961 to 2000, and challenges to combating malnutrition.

We discuss food-consumption patterns in Central West Africa from 1961 to 2000 and some implications for combating malnutrition. The availability of food in the region improved in the 1960s, declined sharply in the 1970s and the early 1980s, and has shown a modest positive trend since the mid-1980s. Notwithstanding obvious progress over the past decades and in the region as a whole, food availability today remains below the required levels for large parts of the population and appears unstable over time, particularly in the Sahelian zone. On average, diets in this zone contain fewer than 2,200 kcal, compared with almost 2,500 kcal in the coastal zone. Conversely, protein deficiency is more common in the coastal zone, where a typical diet contains only 45 g of protein, compared with 60 g in the Sahelian zone. Furthermore, consumption is showing a dietary shift toward cereals, while yield growth lags far behind population growth. The associated import dependency and pressure on land seem to gain significance regardless of the region's agro-ecological capacity to increase and to substitute cereal imports for locally produced food. Moreover, food consumption appears responsive to income changes (calorie-income elasticity ranges from 0.25 to 0.62), while, in turn, it has a significant impact on nutritional outcomes (stunting-calorie elasticity of -1.42). We conclude that combating malnutrition requires first broad-spectrum income growth, and next specific policies that promote the yield and the contribution to diets of nutritious food produced within the region.

Body mass index as indicator of standard of living in developing countries.

OBJECTIVE: To assess the suitability of the body mass index (BMI) as an indicator of standard of living in developing countries. DESIGN, SETTING AND SUBJECTS: The analysis is based on data collected in the first two rounds of the Ghana Living Standards Survey, held in 1987/88 (GLSS-I) and 1988/89 (GLSS-II). The dataset provides information on a wide range of socio-economic variables, at the individual, the household and the community level, including the height and weight data of approximately 9000 adults in the 20-65 y age bracket. METHOD: Bivariate analysis was used to assess, at the individual level and at the level of population groups, the relationships between adult Body Mass Index and selected household characteristics such as income and expenditure, years of schooling of head of household, access to services, quality of housing, and nutritional status of children. Through multiple regression, indicative estimates have been derived of the effects of these variables on adult BMI. For comparison, the same relationships were investigated for weight and height. RESULTS AND CONCLUSION: At the individual level, BMI shows a significantly positive relation with the various socio-economic indicators of living standard, though the correlation coefficients indicate a poor fit. However, at the level of population groups, The relationship between BMI and other characteristics of socio-economic development is strong with a correlation coefficient of 0.86 between mean BMI and mean per capita expenditures of 12 population groups in Ghana, presumed to be at different levels of standard of living. The relationships between weight and the various socioeconomic characteristics were comparable to those for BMI, while height was poorly correlated with the selected household variables. Result suggest that in low-income countries, information on adult BMI (mean and distribution) can be used for assessing differences in standards of living between population groups or for monitoring changes over time.