Risk factors modifying the double burden of malnutrition of young children in Thailand

Thailand is now faced with a double burden of malnutrition. Using nationally representative data from the 2015-2016 Multiple Indicator Cluster Survey, we utilized multinomial logistic regression models to examine factors associated with stunting only, wasting only, overweight only, concurrent stunting and overweight, and concurrent stunting and wasting among children 0-59 months of age (n = 11,068). The prevalences of <5 stunting only (height-for-age Z score < -2 SD) and wasting only (WHZ < -2 SD) were 8.5% and 4.7%, respectively. The prevalence of <5 overweight only (WHZ > +2 SD) was 7.8%. Children 12-23 months (risk ratio [RR], 95% confidence interval [CI]: 1.47 [1.18, 1.83]; p < .01) and 24-35 months (RR, 95% CI: 1.56 [1.26, 1.94]; p < .001) were at increased risk for stunting only, compared with children 48-59 months. The strongest risk factor for stunting only was low birth weight (RR, 95% CI: 3.42 [2.86, 4.10]; p < .001). Children 0-5 months were at highest risk for wasting only, compared with children 48-59 months (RR, 95% CI: 2.91 [2.16, 3.92]; p < .001). Children 48-59 months and male children were more likely to be overweight only. Higher household wealth and smaller household size were also significant predictors of overweight only. A small proportion of children were concurrently stunted and overweight (1.3%) and concurrently stunted and wasted (0.6%). A multipronged approach focused on adequate prenatal care, improving breastfeeding and complementary feeding practices, and mitigating the growing burden of overweight is needed to address the double burden of malnutrition in Thailand.