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We aim to evaluate weight status in mother-child household pairs and patterns specific to over-nutrition households and double burden households.We used nationally representative data from the most recent Demographic and Health Survey (2001-2014) in the Middle EastNorth African (MENA) Region (n = 45,104) to examine weight status of mother-child dyads. Under-nutrition households were defined as mothers with underweight and children with wasting; over-nutrition households as mothers with overweight/obesity and children with overweight; and double burden households as mothers with underweight and children with overweight or mothers with overweight/obesity mother and children with wasting. Survey-adjusted multinomial logistic regression were used to quantify predictors of weight patterns.Across the MENA region, 8.6% of households were experiencing double burden malnutrition, 11% were experiencing over-nutrition and 0.2% were experiencing under-nutrition. Wealthier households with older mothers, higher birth-order children, more educated parents and private water access were more likely to be over-nutrition or double burden households. Compared to over-nutrition households, double burden households were poorer and more likely to have a child with low birthweight.Over-nutrition is the most common unhealthy weight pattern, followed by double-burden; socioeconomic status and birth weight are consistent predictors of unhealthy mother-child pairs.

Purpose While high levels of obesity prevalence and incidence have been well documented, there is less research on obesity dynamics over time. In this article, we sought to understand the body mass index (BMI) trajectories in and out of obesity from adolescence to adulthood. Methods We used the National Longitudinal Study of Adolescent to Adult Health to explore American obesity dynamics from mean ages 15–28 years. We analyzed six BMI trajectories from 1994 to 2008 and examined their contextual sociodemographic correlates using ordinal logistic regression models. Results More than 50% of adolescents with normal BMI moved to overweight/obesity by adulthood; only 8% of overweight and 2% of obese adolescents achieved normal BMI in adulthood. While some sociodemographic characteristics such as sex, race/ethnicity, place of residence, and parents’ education were associated with being in certain BMI trajectories among adolescents with normal BMI, they were not so associated among adolescents starting at obesity. Conclusions Transitioning to higher BMI categories was common, whereas the opposite direction was rare. Pathways to obesity prevention might be easier to identify than those to reversal, as contextual factors had more explanatory power for youths with normal BMI than for those with obese BMI.

Purpose Given the high levels of obesity among U.S. children, we examine whether obesity in childhood is a passing phenomenon or remains entrenched into adolescence. Methods Data are from the prospective nationally representative Early Childhood Longitudinal Study, Kindergarten Class of 1998–1999 (analytic sample = 6600). Anthropometrics were measured six times during 1998–2007. Overweight and obesity were defined using CDC cut-points. Entrenched obesity was defined as obesity between ages 5–9 coupled with persistent obesity at ages 11 and 14. Results Almost 30% of children experienced obesity at some point between ages 5.6 and 14.1 years; 63% of children who ever had obesity between ages 5.6 and 9.1 and 72% of those who had obesity at kindergarten entry experienced entrenched obesity. Children with severe obesity in kindergarten or who had obesity at more than 1 year during early elementary were very likely to experience obesity through age 14, regardless of their sex, race, or socioeconomic backgrounds. Conclusions Prevention should focus on early childhood, as obesity at school entry is not often a passing phenomenon. Even one timepoint of obesity measured during the early elementary school years may be an indicator of risk for long-term obesity.

Purpose Health and administrative systems are facing spatial clustering in chronic diseases such as diabetes. This study explores how geographic distribution of diabetes in the United States is associated with socioeconomic and built environment characteristics and health-relevant policies. Methods We compiled nationally representative county-level data from multiple data sources. We standardized characteristics to a mean = 0 and a SD = 1 and modeled county-level age-adjusted diagnosed diabetes incidence in 2013 using 2-level hierarchical linear regression. Results Incidence of age-standardized diagnosed diabetes in 2013 varied across U.S. counties (n = 3109), ranging from 310 to 2190 new cases/100,000, with an average of 856.4/100,000. Socioeconomic and health-related characteristics explained ∼42% of the variation in diabetes incidence across counties. After accounting for other characteristics, counties with higher unemployment, higher poverty, and longer commutes had higher incidence rates than counties with lower levels. Counties with more exercise opportunities, access to healthy food, and primary care physicians had fewer diabetes cases. Conclusions Features of the socioeconomic and built environment were associated with diabetes incidence; identifying the salient modifiable features of counties can inform targeted policies to reduce diabetes incidence.

Purpose Urbanization may promote the rise of dual burdens of underweight and overweight in low- and middle-income countries. We assessed underweight and overweight by urban residence across the lifespan in India. Methods Using nationally representative, directly measured height and weight data (2004–2006; n = 236,039), we estimated and compared the prevalence of underweight and overweight (including obesity) at ages 0 to 54 years by urban and rural residence; absolute burdens of underweight, overweight, and combined unhealthy weight were estimated using 2011 Census data. Results Thirty-eight percent of the urban population and 36% of the rural population of India experienced unhealthy weight, amounting to 378 million underweight or overweight individuals. In urban areas, the unhealthy weight burden was largely underweight in childhood and overweight in adulthood. In rural areas, the unhealthy weight burden was largely underweight at all ages. Urban residents compared with rural residents were more likely to be overweight and less likely to be underweight at nearly all ages. Conclusions Combined unhealthy weight was comparable in urban and rural India. Although underweight continues to be the predominant nutritional problem, there is early evidence of an epidemiologic crossover from underweight to overweight. As India experiences urbanization and population aging, low overweight and obesity may be short lived.