Objective: Low neighbourhood socioeconomic status (NSES) has been linked to a higher risk of overweight/obesity, irrespective of the individual’s own socioeconomic status. No meta-analysis study has been done on the association. Thus, this study was done to synthesise the existing evidence on the association of NSES with overweight, obesity and body mass index (BMI).Design: Systematic review and meta-analysis.Data sources: PubMed, Embase, Scopus, Cochrane Library, Web of Sciences and Google Scholar databases were searched for articles published until 25 September 2019.Eligibility criteria: Epidemiological studies, both longitudinal and cross-sectional ones, which examined the link of NSES to overweight, obesity or BMI, were included.Data extraction and synthesis: Data extraction was done by two reviewers, working independently. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale for the observational studies. The summary estimates of the relationships of NSES with overweight, obesity and BMI statuses were calculated with random-effects meta-analysis models. Heterogeneity was assessed by Cochran’s Q and I²statistics. Subgroup analyses were done by age categories, continents, study designs and NSES measures. Publication bias was assessed by visual inspection of funnel plots and Egger’s regression test.Result: A total of 21 observational studies, covering 1 244 438 individuals, were included in this meta-analysis. Low NSES, compared with high NSES, was found to be associated with a 31% higher odds of overweight (pooled OR 1.31, 95% CI 1.16 to 1.47, p<0.001), a 45% higher odds of obesity (pooled OR 1.45, 95% CI 1.21 to 1.74, p<0.001) and a 1.09 kg/m²increase in mean BMI (pooled beta=1.09, 95% CI 0.67 to 1.50, p<0.001).Conclusion: NSES disparity might be contributing to the burden of overweight/obesity. Further studies are warranted, including whether addressing NSES disparity could reduce the risk of overweight/obesity.PROSPERO registration number: CRD42017063889

The existing evidence is limited and contradicting on the co-occurrence of anemia and stunting (CAS) at individual level, despite a great overlap in their risk factors. We aimed to determine the prevalence of CAS, and the dietary and non-dietary factors associated with it, among infants and young children in Ethiopia. We used a nationally representative sample of 2902 children aged 6–23 months from the Ethiopian demographic and health survey, conducted in 2016. The study was cross-sectional in design. Samples were selected by two-stage clustering sampling method. CAS prevalence was estimated by various sociodemographic factors. To identify the dietary and non-dietary factors associated with CAS, we conducted hierarchical logistic regression analyses. The overall prevalence of CAS was 23.9%. The dietary factors found significantly linked to lower odds of CAS were use of vitamin A supplement [adjusted odds ratio (AOR) = 1.19, 95%CI = 1.06–1.33, P = 0.003], consumption of vitamin A rich fruit and vegetables (AOR = 1.15, 95%CI = 1.04–1.27, P = 0.006), meat (AOR = 1.55, 95%CI = 1.17–2.05, P = 0.002), legumes (AOR = 1.38, 95%CI = 1.05–1.81, P = 0.021), and meal frequency > 3 (AOR = 1.22, 95%CI = 1.04–1.37, P = 0.020). The non-dietary household and child factors found significantly linked to higher odds of CAS were rural residence (AOR = 1.29, 95%CI = 1.18–1.41, P < 0.001), low household wealth (AOR = 1.91, 95%CI = 1.53–2.39, P < 0.001), low caregivers’ education level (AOR = 2.14, 95%CI = 1.33–3.44, P < 0.001), male sex (AOR = 1.25, 95%CI = 1.04–1.50, P = 0.015), age 12–23 months (AOR = 1.65, 95%CI = 1.57–1.73, P < 0.001), history of infection (AOR = 1.14, 95%CI = 1.00–1.30, P = 0.048), and small birth size (AOR = 1.99, 95%CI = 1.58–2.51, P < 0.001). Among infants and young children in Ethiopia, there was a concerning high level of CAS, which was associated with various dietary and non-dietary factors. Enhanced public health/nutrition interventions, with due emphasis on the multifactorial nature of CAS, might stand an important consideration to reduce the burden of CAS in Ethiopia and beyond.

There are pervasive pregnancy-related food taboos and myths (PRFT) in Ethiopia. The evidence, however, is limited on whether PRFT contributes to the burden of maternal anemia. Thus, this study was aimed to determine the magnitude of PRFT, the reasons for adherence to PRFT, and the association of adherence to PRFT with anemia, among pregnant Ethiopian women. The study was case-control in design and recruited a sample of 592 pregnant women attending antenatal care in four health facilities in Addis Ababa, Ethiopia. Participants were classified into anemic cases (n = 187) and non-anemic controls (n = 405) based on their hemoglobin level. PRFT was assessed by the participants’ subjective reporting of avoidance of certain food items during the current pregnancy due to taboo reasons. The specific types of food items avoided and the underlying reasons for the avoidance were also assessed. The relation of PRFT with anemia was evaluated by multiple logistic regression analysis, controlling for covariate factors. Almost a fifth of the study participants (18.2%) avoided one or more food items due to PRFT. Adherence to PRFT was 26.2 and 14.6% among the anemic and the non-anemic individuals, respectively. The food items most avoided due to adherence to PRFT were green chili pepper, organ meat, and dark green leafy vegetables like spinach, lettuce, kale, and broccoli. The underlying reasons for the adherence to PRFT were largely traditionally held beliefs and misconceptions. After controlling for covariates, PRFT was significantly and independently associated with a higher odds of anemia [adjusted odds ratio (AOR) = 2.12, 95% confidence interval (CI) = 1.32–3.42, P = 0.002]. PRFT might be contributing to the burden of maternal anemia in Ethiopia. It is time for public health authorities in Ethiopia to recognize PRFT as a public health risk, strengthen maternal nutrition counseling, and create public awareness of the consequences of PRFT. ClinicalTrials.gov (NCT03251664), 16 August 2017.

Ethiopia bears a high stunting burden. However, there is a paucity of evidence on the socioeconomic inequalities of stunting in Ethiopia. Thus, this study was aimed to determine the degree of socioeconomic inequality in stunting and decompose it to the social determinants of stunting. We used a nationally representative sample of 8855 children, aged below 5 years, from the Ethiopian demographic and health survey, conducted in 2016. Subjects were recruited following a two-stage cluster sampling. The socioeconomic status was measured by the household wealth index, categorized into quantiles. The inequality in stunting between the poorest and the richest socioeconomic groups was decomposed into its contributing social factors following the Blinder–Oaxaca decomposition approach. The overall prevalence of stunting was 38%, with a significant pro-poor socioeconomic inequality. The prevalence of stunting among the poorest and the richest socioeconomic categories was 45.1% and 26.9%, respectively. Caregivers education status was the main contributor, accounting alone for 33% of the socioeconomic inequality in stunting, followed by region of residence (11%) and birth size (6%). Equity sensitive interventions, which prioritize the vulnerable groups might help to narrow the socioeconomic inequality as well as fasten the progress towards the goal of stunting reduction.