Exploring the magnitude and drivers of the double burden of malnutrition at maternal and dyad levels in peri‐urban Peru: A cross‐sectional study of low‐income mothers, infants and young children

Multiple forms of malnutrition coexist in Peru, especially in peri‐urban areas and poor households. We investigated the magnitude of, and the contribution of, dietary and socio‐demographic factors to the double burden of malnutrition (DBM) at maternal (i.e., maternal overweight/obesity with anaemia) and dyad (i.e., maternal overweight/obesity with child anaemia) levels. A cross‐sectional survey was conducted among low‐income mother–child (6–23 months) dyads (n = 244) from peri‐urban communities in Peru. Dietary clusters and the minimum dietary diversity score (MDD) were generated for mothers and infants, respectively. A composite indicator using the maternal dietary clusters and the MDD was created to relate to dyad level DBM. Two dietary clusters were found: (i) the ‘high variety (i.e., animal‐source foods, fruit and vegetables), high sugary foods/beverages’ (cluster 1) and (ii) the ‘high potato, low fruit and vegetables, low red meat’ (cluster 2). DBM prevalence among mothers and dyads was 19.9% and 36.3%, respectively. Logistic regression analyses revealed that the only socio‐demographic factor positively associated with maternal DBM was maternal age (aOR/5 years: 1.35 [1.07, 1.71]). Mothers belonging to diet cluster 1 were less likely to experience the DBM (aOR = 0.52 [0.26, 1.03]), although CIs straddled the null. Socio‐demographic factors positively associated with dyad level DBM included maternal age (aOR/5 years: 1.41 [1.15, 1.73]), and having ≥ two children under 5 years (aOR = 2.44 [1.23, 4.84]). Diet was not associated with dyad‐level DBM. Double‐duty actions that tackle the DBM are needed given that one‐third of dyads and a fifth of mothers had concurrent overweight/obesity and anaemia.