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Association of Body Mass Index with Physical Fitness among Small-holder Famers in Malawi and Kenya

Johanna L. Piotrowski1, M. Gracia Glas1,5, Lydiah Maruti Waswa2, Paul Falakeza Fatch3, Gabriella Chiutsi Phiri3, Thomas Hilger4, Sahrah Fischer4, Elizabeth Kamau2, Michael B. Krawinkel5, Ernst-August Nuppenau6, Irmgard Jordan1

1Justus-Liebig University Giessen, Center for International Development and Environmental Research, Germany
2Egerton University, Dept. of Human Nutrition, Kenya
3Lilongwe University of Agriculture and Natural Resources, Extension Department, Malawi
4University of Hohenheim, Inst. of Agric. Sci. in the Tropics (Hans-Ruthenberg-Institute), Germany
5Justus-Liebig University Giessen, Institute of Nutritional Sciences, Germany
6Justus-Liebig University Giessen, Inst. of Agric. Policy and Market Res., Germany


The double burden of malnutrition which is characterised by the co-existence of various forms of under- and overnutrition is a common health problem predominantly affecting households in low- and middle- income countries. The study objective was to investigate whether double burden of malnutrition affects the field work capacity of affected households.
Cross-sectional surveys were conducted in 2017 in Kenya and Malawi targeting households with children below six years of age (n=432 and n=355, respectively). Anthropometric measurements were assessed to determine nutritional status of the mother-child pairs. Hand-grip-strengths (HGS) for the mother was measured and used as a proxy indicator for physical fitness. Anthropometric data was used to identify households with double-burden of malnutrition. Mean HGS of the mothers was determined and comparisons made between mothers living in households with (DB-group) and without double-burden (comparison-group) of malnutrition. The comparison group were differentiated in households with only one and without any form of malnutrition.
The body-mass-index (BMI) and HGS of the women in Malawi were significantly correlated (p < 0.05). There were significant differences between women’s HGS of case-households with women’s HGS living in a household with an overweight/obese family member. In Kenya, a significant but weak non-linear correlation (p < 0.05) was identified between women’s HGS and BMI. HGS was lower among underweight and obese women compared to normal weight, but no differences were found between DB and non-double burden households.
The results of the countries vary in form and significance. However, programmes are needed in both countries addressing double-burden of malnutrition also in rural areas although a link between HGS and double burden was not proven. However, underweight and overweight women showed lower physical capacity. Thus, there is a link between the HGS and BMI that may impact on food production systems due to lower physical fitness of the farming women herself.
This study was conducted within the HealthyLAND project which was funded by BMEL/ptble.

Keywords: BMI, children, double burden of malnutrition, handgrip strength, Kenya, Malawi, smallholder farmers, women

Contact Address: Johanna L. Piotrowski, Justus-Liebig University Giessen, Center for International Development and Environmental Research, Senckenbergstr. 3, 35390 Giessen, Germany, e-mail: johanna.l.piotrowski@nu.uni-giessen.de

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