The underweight/overweight household: an exploration of household sociodemographic and dietary factors in China

OBJECTIVE: The goal of this paper is to explore the hypothesis that the nutrition transition is related to households having an underweight and an overweight member simultaneously (under/over households and under/over pairs). DESIGN: The 1993 China Health and Nutrition Survey (CHNS) was used to test the association between being an under/over household and household characteristics related to the nutrition transition. Sociodemographic and diet patterns were tested for the main age combinations of the under/over pairs. SETTING: In China, 8.1% of all households were found to have underweight and overweight members within the same household. SUBJECTS: Results are from the 1993 China Health and Nutrition Survey and are based on a sample of 13814 persons from 3340 households. RESULTS: The under/over household was more urban, had a higher income and was more likely to have assets such as a television, a motor vehicle and a washing machine, even after controlling for sociodemographic confounders. The under/over household had a diet that was higher in fat and protein compared with the underweight and normal weight households. There were no significant differences between the under/over and overweight households, with many of the associations near unity. Comparisons of the under/over subgroups by age of the under/over pairs showed some differences by income and occupation, but not for diet. CONCLUSIONS: It is imperative, as more individuals become exposed to the diet and lifestyle patterns of the nutrition transition, to find effective public health programmes that can simultaneously promote a healthy lifestyle, improve diet quality and address both undernutrition and chronic disease.