Identifying the determinants of coexisting over and undernutrition in Cebu, Philippines Public Deposited

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  • March 21, 2019
Creator
  • Jennings, Anna R.
    • Affiliation: Gillings School of Global Public Health, Department of Nutrition
Abstract
  • Obesity has quickly become a worldwide epidemic. Unlike in developed countries, in developing countries obesity is rapidly on the rise while chronic undernutrition remains a pervasive problem. This situation is only further complicated by the finding that over and undernutrition overlap so that in many cases both forms of malnutrition co-occur in the same communities and even households. However, developing countries do not have the healthcare infrastructure, nor do a majority of individuals have the financial means to counteract the negative impact of chronic undernutrition or obesity and its associated chronic diseases. Several studies have identified that there is a divergence of weight status between adults and offspring in countries experiencing rapid modernization but no studies that we know of have explored possible differential weight-related behavior patterns that might explain this difference. This research investigates key factors characterizing discrepant weight mother-offspring pairs in the rapidly transitioning society of Cebu, Philippines. In addition, this research identifies key determinants of diet and physical activity patterns of Filipino mothers and offspring in respond to modernization, including an evaluation of possible generational differences. We used data from multiples years of the Cebu Longitudinal Health and Nutrition Survey. Detailed individual, household, and community-level environmental, socioeconomic, and demographic information was collected at each survey year, which allowed for an exploration of the association between multiple dimensions of modernization and multiple dimensions of physical activity and diet. Specifically, in this research we identified the urbanicity and socioeconomic (SES) environment where discrepant overweight mother/underweight offspring pairs were most commonly found and explored participation in weight-related behaviors by offspring that might contribute to this dual-burden phenomenon. Second, we explored the impact of urbanicity and SES on the dietary patterns in energy adequacy, percent calories from fat and carbohydrates of mothers compared to offspring over time. Finally, we explored the association of urbanicity and SES with occupational, chores and leisure physical activity of mothers and offspring at multiple times points. This research addresses an important gap in understanding generational differences in weight-related behavior responses to modernization; knowledge necessary to develop effective age and weight-status specific interventions in transitional societies.
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  • In Copyright
Advisor
  • Adair, Linda
Degree granting institution
  • University of North Carolina at Chapel Hill
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  • Open access
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