{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:43:25Z","timestamp":1791906205648,"version":"4.3.4"},"reference-count":31,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The double burden of malnutrition (DBM) affects many low- and middle-income countries. However, few studies have examined DBM at the individual level, or undernutrition and overnutrition co-occurring within the same person. This study aims to investigate the prevalence and determinants of DBM among adults in the Philippines. Data from the 2013 National Nutrition Survey were used. The sample size in the analysis was 17,010 adults aged \u226520 years old, after excluding pregnant and lactating women. DBM was defined as the co-occurrence of overweight\/obesity and anemia (definition #1), overweight\/obesity and anemia or vitamin A deficiency (definition #2), and overweight\/obesity and anemia or vitamin A deficiency or iodine insufficiency (definition #3). Anthropometric measurements and biochemical markers were used for DBM assessment. Data were analyzed using descriptive statistics, the chi-square test, and logistic regression by R software. Results showed that definition #3 is the predominant type of DBM (7.0%) in the general population, whereas the prevalence of DBM has increased to 23.7% in overweight\/obese persons. Sex, age, educational attainment, marital status, household size, wealth quintile, and smoking status were the determinants of DBM. This study revealed that Filipino adults experience malnutrition critically and must be addressed through food and nutrition interventions.<\/jats:p>","DOI":"10.3390\/nu13072339","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T10:42:17Z","timestamp":1625740937000},"page":"2339","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Prevalence and Determinants of the Co-Occurrence of Overweight or Obesity and Micronutrient Deficiencies among Adults in the Philippines: Results from a National Representative Survey"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5381-986X","authenticated-orcid":false,"given":"Aileen R.","family":"de Juras","sequence":"first","affiliation":[{"name":"Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City 701, Taiwan"},{"name":"Institute of Human Nutrition and Food, College of Human Ecology, University of the Philippines Los Ba\u00f1os, Laguna 4031, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan-Chen","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City 701, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2437-5918","authenticated-orcid":false,"given":"Susan C.","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City 701, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"ref_1","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":"ref_2","unstructured":"World Health Organization (2017). The Double Burden of Malnutrition Policy Brief, WHO."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/S0140-6736(19)32473-0","article-title":"Economic effects of the double burden of malnutrition","volume":"395","author":"Nugent","year":"2020","journal-title":"Lancet"},{"key":"ref_4","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":"ref_5","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1093\/jn\/nxaa076","article-title":"The co-occurrence of overweight and micronutrient deficiencies or anemia among women of reproductive age in Malawi","volume":"150","author":"Rhodes","year":"2020","journal-title":"J. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Fongar, A., Godecke, T., and Qaim, M. (2019). Various forms of double burden of malnutrition problems exist in rural Kenya. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-7882-y"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Huang, Q., Wang, L., Jiang, H., Wang, H., Zhang, B., Zhang, J., Jia, X., and Wang, Z. (2020). Intra-individual double burden of malnutrition among adults in China: Evidence from the China Health and Nutrition Survey 2015. Nutrients, 12.","DOI":"10.3390\/nu12092811"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Little, M., Humphries, S., Dodd, W., Patel, K., and Dewey, C. (2020). Sociodemographic patterning of the individual-level double burden of malnutrition in a rural population in South India: A cross-sectional study. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-08679-5"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1017\/S1368980016000689","article-title":"Gender inequalities in excess adiposity and anaemia combine in a large double burden of malnutrition gap detrimental to women in an urban area in North Africa","volume":"19","author":"Traissac","year":"2016","journal-title":"Public Health Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Yu, E.A., Finkelstein, J.L., Brannon, P.M., Bonam, W., Russell, D.G., Glesby, M.J., and Mehta, S. (2020). Nutritional assessment among adult patients with suspected or confirmed active tuberculosis disease in rural India. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0233306"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e50","DOI":"10.1017\/jns.2014.11","article-title":"Dietary patterns and physical inactivity, two contributing factors to the double burden of malnutrition among adults in Burkina Faso, West Africa","volume":"3","author":"Zeba","year":"2014","journal-title":"J. Nutr. Sci."},{"key":"ref_12","unstructured":"Department of Science and Technology-Food, and Nutrition Research Institute (2020, September 03). eNutrition, Facts and Figure 2013 National Nutrition Survey, Available online: https:\/\/www.fnri.dost.gov.ph\/index.php\/19-nutrition-statistic\/175-national-nutrition-survey#facts-and-figures."},{"key":"ref_13","unstructured":"Barcenas, M.L. (2004, January 4\u20135). The development of the 2003 Master Sample (MS) for Philippine Household Surveys. Proceedings of the 9th National Nutrition on Statistics, Manila, Philippines."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1093\/ije\/dyaa045","article-title":"Data Resource Profile: The Philippine National Nutrition Survey (NNS)","volume":"49","author":"Patalen","year":"2020","journal-title":"Int. J. Epidemiol."},{"key":"ref_15","unstructured":"World Health Organization (2005). WHO STEPS Surveillance Manual: The WHO STEPwise Approach to Chronic Disease Risk Factor Surveillance, WHO."},{"key":"ref_16","unstructured":"World Health Organization (2019). Global Status Report on Alcohol and Health 2018, WHO."},{"key":"ref_17","unstructured":"World Health Organization (2000). WHO Technical Report Series on Obesity: Preventing and Managing the Global Epidemic, WHO."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"International Committee for Standardization in Haematology (1978). International Committee for Standardization in Haematology: Protocol for type testing equipment and apparatus used for haematological analysis. J. Clin. Pathol., 31, 275\u2013279.","DOI":"10.1136\/jcp.31.3.275"},{"key":"ref_19","unstructured":"World Health Organization, United Nations Children\u2019s Fund, and United Nations University (2001). Iron Deficiency Anaemia: Assessment, Prevention and Control, a Guide for Programme Managers, WHO."},{"key":"ref_20","unstructured":"Furr, H.C., Tanmihardjo, S.A., and Olson, J.A. (1992). Training Manual for Assessing Vitamin A Status by Use of the Modified Relative Dose Response and Relative Dose Response Assays, United States Agency for International Development."},{"key":"ref_21","unstructured":"Sommer, A. (1995). Vitamin A Deficiency and Its Consequences: A Field Guide to Detection and Control, World Health Organization. [3rd ed.]."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Dunn, J.T., Crutchfield, H.E., Gutekunst, R., and Dunn, A.D. (1993). Methods for Measuring Iodine in Urine, International Council for Control of Iodine Deficiency Disorders (ICCIDD).","DOI":"10.1089\/thy.1993.3.119"},{"key":"ref_23","unstructured":"World Health Organization (2001). Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination: A Guide for Programme Managers, WHO."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e12886","DOI":"10.1111\/mcn.12886","article-title":"Nutritional status of Tajik children and women: Transition towards a double burden of malnutrition","volume":"16","author":"Zandberg","year":"2020","journal-title":"Matern. Child Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1017\/S0029665114001669","article-title":"An overview of the nutrition transition in West Africa: Implications for non-communicable diseases","volume":"74","author":"Bosu","year":"2015","journal-title":"Proc. Nutr. Soc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1017\/S1368980012004569","article-title":"Food consumption patterns and nutrition transition in South-East Asia","volume":"16","author":"Lipoeto","year":"2013","journal-title":"Public Health Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jcgg.2015.05.003","article-title":"Changes during aging and their association with malnutrition","volume":"6","author":"Amarya","year":"2015","journal-title":"J. Clin. Gerontol. Geriatr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s12937-019-0481-z","article-title":"Food sources, energy and nutrient intakes of adults: 2013 Philippines National Nutrition Survey","volume":"18","author":"Sun","year":"2019","journal-title":"Nutr. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1177\/0192513X13508404","article-title":"Body weight, marital status, and changes in marital status","volume":"37","author":"Teachman","year":"2016","journal-title":"J. Fam. Issues"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.pmedr.2016.07.003","article-title":"Smoking status and abdominal obesity among normal and overweight\/obese adults: Population-based FINRISK study","volume":"4","author":"Tuovinen","year":"2016","journal-title":"Prev. Med. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"468S","DOI":"10.1093\/ajcn\/nqaa118","article-title":"Intraindividual double burden of overweight or obesity and micronutrient deficiencies or anemia among women of reproductive age in 17 population-based surveys","volume":"112","author":"Williams","year":"2020","journal-title":"Am. J. Clin. 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