{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T01:31:04Z","timestamp":1785634264300,"version":"3.56.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":33,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/X020851\/1"],"award-info":[{"award-number":["MR\/X020851\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Examining trajectories of undernutrition and overnutrition separately limits understanding of the double burden of malnutrition. We investigated transitions between normal, stunting, overweight and concurrent stunting and overweight (CSO) and associations with sociodemographic factors in children and adolescents.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used data from the Young Lives cohort in India, Peru and Vietnam, which follow children 1\u201315 (N\u2009=\u20095413) and 8\u201322\u2009years (N\u2009=\u20092225) over five rounds between 2002 and 2016. We estimated transitions between nutritional states using a Markov chain model and estimated sociodemographic associations employing a logit parametrization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Transitions into stunting peaked in ages 1\u20135\u2009years (India: 22.9%, Peru: 17.6%, Vietnam: 14.8%), while stunting reversal was highest during adolescence across all countries. Transitions into overweight peaked in ages 19\u201322, while overweight reversal increased in ages 1\u20135 and 12\u201315\u2009years. Transitions away from stunting to overweight were rare; more commonly, stunted individuals developed overweight while remaining stunted, leading to a CSO state. In Peru, 20.2% of 19-year-olds who were stunted reached CSO by age 22, with 4% shifting from stunted to overweight. Reversion to a normal state is least likely for those in a CSO state. Household wealth gradually reduced the likelihood of transitioning into stunting [odds ratios (ORs) for wealthiest quartile in Peru: 0.29, 95% confidence interval (CI) 0.20\u20130.41; India: 0.43, 95% CI 0.32\u20130.57; Vietnam: 0.36, 95% CI 0.26\u20130.50), with stunting reversal only being more likely in the two wealthiest quartiles across all countries (ORs for wealthiest quartile in Peru: 2.39, 95% CI 1.57\u20133.65; India: 1.28, 95% CI 1.05\u20131.54; Vietnam: 1.89, 95% CI 1.23\u20132.91). In Vietnam, only the richest quartile was at higher risk of transitioning into overweight (OR 1.87, 95% CI 1.28\u20132.72), while in Peru and India, the risk gradually rose across all wealth quartiles (ORs for wealthiest quartile in Peru: 2.84, 95% CI 2.14\u20133.77; India: 2.99, 95% CI 1.61\u20135.54).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Childhood and adolescence represent critical periods for prevention and reversal of stunting and overweight, thereby averting the development of CSO later in life. Context-specific interventions are crucial for preventing disparate transitions towards the double burden of malnutrition across socioeconomic groups.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyae151","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T10:58:43Z","timestamp":1731668323000},"source":"Crossref","is-referenced-by-count":6,"title":["Longitudinal transitions of the double burden of overweight and stunting from childhood to early adulthood in India, Peru, and Vietnam"],"prefix":"10.1093","volume":"53","author":[{"given":"Nora A","family":"Escher","sequence":"first","affiliation":[{"name":"Public Health Policy Evaluation Unit, School of Public Health, Imperial College London , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo M","family":"Carrillo-Larco","sequence":"additional","affiliation":[{"name":"Hubert Department of Global Health, Rollins School of Public Health, Emory University , Atlanta, GA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennie C","family":"Parnham","sequence":"additional","affiliation":[{"name":"Public Health Policy Evaluation Unit, School of Public Health, Imperial College London , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Curi-Quinto","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Nutricional , Lima, Peru"},{"name":"Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas , Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suparna","family":"Ghosh-Jerath","sequence":"additional","affiliation":[{"name":"Department of Nutrition, The George Institute for Global Health ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Millett","sequence":"additional","affiliation":[{"name":"Public Health Policy Evaluation Unit, School of Public Health, Imperial College London , London,","place":["UK"]},{"name":"NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center (CHRC), NOVA University Lisbon , Lisbon,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paraskevi","family":"Seferidi","sequence":"additional","affiliation":[{"name":"Public Health Policy Evaluation Unit, School of Public Health, Imperial College London , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,14]]},"reference":[{"key":"2024111510582721200_dyae151-B1","author":"United Nations","year":"2015"},{"key":"2024111510582721200_dyae151-B2","author":"World Health Organization","year":"2021"},{"key":"2024111510582721200_dyae151-B3","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1016\/S0140-6736(19)30041-8","article-title":"Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"393","author":"GBD 2017 Diet Collaborator","year":"2019","journal-title":"Lancet"},{"key":"2024111510582721200_dyae151-B4","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S0140-6736(19)32497-3","article-title":"Dynamics of the double burden of malnutrition and the changing nutrition reality","volume":"395","author":"Popkin","year":"2020","journal-title":"Lancet"},{"key":"2024111510582721200_dyae151-B5","volume-title":"The Double Burden of Malnutrition","author":"World Health Organization","year":"2017"},{"key":"2024111510582721200_dyae151-B6","volume-title":"Global Nutrition Report: Shining a Light to Spur Action on Nutrition","author":"Initiatives","year":"2018"},{"key":"2024111510582721200_dyae151-B7","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1301\/nr.2003.may.168-175","article-title":"The link between childhood undernutrition and risk of chronic diseases in adulthood: a case study of Brazil","volume":"61","author":"Sawaya","year":"2003","journal-title":"Nutr Rev"},{"key":"2024111510582721200_dyae151-B8","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(19)32472-9","article-title":"The double burden of malnutrition: aetiological pathways and consequences for health","volume":"395","author":"Wells","year":"2020","journal-title":"Lancet"},{"key":"2024111510582721200_dyae151-B9","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1093\/ajcn\/72.3.702","article-title":"Why are nutritionally stunted children at increased risk of obesity? 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