Double burden of malnutrition in women of reproductive age in Morocco: A household-based survey

Summary: Introduction: The double burden of malnutrition (DBM) is a major challenge for developing countries. In Morocco, overall understanding of this phenomenon remains limited. National data indicate that women of reproductive age (WRA) are particularly affected: 61.3 % are overweight/obese, 34.4 % are anemic, 30.3 % suffer from iron deficiency (ID) and 49.7 % iron deficiency anemia (IDA). Objective: The current study was conducted to determine the prevalence of DBM in Morocco, defined as coexistence of iron deficiency and overweight/obesity among women of reproductive age. Methods: We conducted a nationally representative cross-sectional survey with a total of 2090 WRA focusing on both iron status and overweight/obesity. Data collection included blood sampling, socio-economic and anthropometric parameters. Biological analyses measured hemoglobin, ferritin and C-reactive protein (CRP). Results: The results obtained revealed that 60.2 % of WRA were overweight/obese, with 30.7% having ID, 34.5% having anaemia and 50.0% having IDA. Overweight/obesity was associated with anemia in 19.4% of 2086 WRA (p < 0.05), 30.7% classified as mild, 23.7% as moderate and 2.0% as severe (p > 0.05). In addition, 17% of participants were diagnosed with iron deficiency, whereas iron deficiency anaemia was detected in 29.9% of participants. (With ID in 17.0% of 1987 WRA) (p < 0.05) and with IDA in 29.9% of 1983 WRA (p < 0.05). on the other hand, 32.3% of the 1254 overweight/obese WRA had anaemia, which was classified as mild in 54.5%, moderate in 42.0%, and severe in 3.5%. Iron deficiency was detected in 28.4% of 1189 WRA and iron deficiency anaemia in 54.3% of 1185 (p > 0.05). Conclusion: DBM among WRA highlights emerging reality of interconnected and simultaneous coexistence of undernutrition and overnutrition at individual level. This phenomenon, observed on a global scale and affecting millions of individuals, has significant implications for households and population.