Quantifying overlapping forms of malnutrition across Latin America: A Systematic Literature Review and Meta-Analysis of Prevalence Estimates

Background Estimating the prevalence of double burden of malnutrition (DBM) is challenging in the Latin American and Caribbean region (LAC) where various DBM typologies (e.g., obesity and stunting) are heterogeneous and estimates are scattered across literature. Objective We aimed to assess the prevalence of DBM typologies in LAC. Methods We searched PubMed, Embase, Scopus, and Web of Science to identify studies on the prevalence of DBM published between 1/1/2000-23/1/2023. Outcomes were the prevalence of the identified DBM typologies at the household, individual, or across life course levels. Random effect meta-analyses of proportions were used to estimate pooled period prevalence for all outcomes. Heterogeneity was explored using meta-regressions. PROSPERO-CRD42023406755. Results From 754 records identified, 60 (8%) studies were eligible, with a median of 4 379 individuals. Studies reported data from 27 LAC countries collected between 1988 and 2017. Most studies used nationally representative surveys (68%) and scored as low risk of bias (70%). We identified 17 DBM typologies for which 360 estimates were analyzed. The prevalence of the identified DBM typologies ranged between 0%-24%, with the DBM typology of ‘adult with overweight and child with anemia’ having the highest prevalence (24.3% [95%CI 18.8-30.2]). The most frequently reported DBM typology was ‘adult with overweight and child with stunting’, with a prevalence of 8.5% [7.7-9.3]. All prevalences carried large heterogeneity (I2>90%), modestly explained by sub-regions and countries. DBM across the life course could not be estimated due to insufficient estimates. Conclusion Using available data, our study suggests that the burden of DBM in LAC ranges between 0 and 24%. In the most frequent DBM typologies, overweight was a common contributor. Substantial progress can be made in curbing the burden of DBM in LAC through strategies addressing excess weight within these population groups.