TY - JOUR T1 - Double or Triple Burden of Malnutrition in Turkish Adolescents: Single Center Experience TT - Türk Ergenlerde Malnütrisyonun Çoklu Yükü: Tek Merkez Deneyimi AU - Koyuncu, Hilal AU - Oflu, Ayşe Tolunay AU - Ata, Aysun AU - Soyugüzel, Aysun AU - Önen, Nur AU - Güngör, Ayşe AU - Bükülmez, Ayşegül AU - Kundak, Ahmet Afşin PY - 2025 DA - September Y2 - 2025 DO - 10.20515/otd.1703728 JF - Osmangazi Tıp Dergisi PB - Eskişehir Osmangazi Üniversitesi WT - DergiPark SN - 1305-4953 SP - 886 EP - 892 VL - 47 IS - 6 LA - en AB - Malnutrition continues to be a health problem, especially in children. The aim of this study was to investigate the prevalence of the double or triple burden of malnutrition in adolescents, both at the adolescent population and at the intra-individual. This retrospective study was conducted on adolescents admitted for any reason at a tertiary hospital between June 2022 and June 2023. Of the total 1126 cases, 67.3% were normal weight, 16.6% were underweight, %4.1 were stunting, 6.5% were overweight, and 9.6% were obese. It was determined that the obesity rate was significantly higher in late adolescence compared to early adolescence (p = 0.037). At least one micronutrient deficiency was detected in 42.1% of all cases, 34.2% of underweight cases, and 38.1% of obese cases. Any malnutrition was detected in 56.7% of the cases, DBM in 6.3% and TBM in 0.3%. The frequency of DBM and micronutrient deficiency was observed to be high in the adolescents in this study. The increased frequency of obesity and deficiency of vitamin D and vitamin B12 together with age showed that health problems due to the DBM will be reflected in adulthood. The planning of preventative health policies for societal health can be recommended KW - Adolescents 1 KW - Vitamin B12 Deficiency 2 KW - Vitamin D 3 KW - Obesity 4 N2 - Malnütrisyon, özellikle çocuklarda bir sağlık sorunu olmaya devam etmektedir. Bu çalışmanın amacı, ergenlerde hem ergen popülasyonunda hem de birey içinde ikili veya üçlü malnütrisyon yükünün yaygınlığını araştırmaktır. Bu retrospektif çalışma, Haziran 2022 ile Haziran 2023 arasında üçüncü basamak bir hastaneye herhangi bir nedenle yatırılan ergenler üzerinde yürütülmüştür. Toplam 1126 vakanın %67,3'ü normal kilolu, %16,6'sı düşük kilolu, %4,1'i bodur, %6,5'i fazla kilolu ve %9,6'sı obezdi. Obezite oranının geç ergenlikte erken ergenliğe göre anlamlı derecede daha yüksek olduğu belirlenmiştir (p = 0,037). Tüm vakaların %42,1'inde, düşük kilolu vakaların %34,2'sinde ve obez vakaların %38,1'inde en az bir mikronutrient eksikliği tespit edildi. Vakaların %56,7'sinde herhangi bir yetersiz beslenme, %6,3'ünde DBM ve %0,3'ünde TBM tespit edildi. Bu çalışmada ergenlerde DBM ve mikronutrient eksikliğinin sıklığının yüksek olduğu gözlendi. Obezite ve D vitamini ve B12 vitamini eksikliğinin yaşla birlikte artan sıklığı, DBM'ye bağlı sağlık sorunlarının yetişkinliğe yansıyacağını gösterdi. Toplum sağlığı için koruyucu sağlık politikalarının planlanması önerilebilir CR - 1. Organization WH. The double burden of malnutrition: policy brief. World Health Organization; 2016. CR - 2. Bose A, Mondal N, Sen J. A shift from double-burden to triple-burden of malnutrition: A review. Man in India. 2022;102(1-2):155-72. CR - 3. Wells JC, Sawaya AL, Wibaek R, Mwangome M, Poullas MS, Yajnik CS, et al. The double burden of malnutrition: aetiological pathways and consequences for health. The Lancet. 2020;395(10217):75-88. CR - 4. Norris SA, Frongillo EA, Black MM, Dong Y, Fall C, Lampl M, et al. Nutrition in adolescent growth and development. The lancet. 2022;399(10320):172-84. CR - 5. Prentice AM. The triple burden of malnutrition in the era of globalization. Intersections of Nutrition: Retracing Yesterday, Redefining Tomorrow. 2023;97:51-61. CR - 6. Organization WH. Methodology for monitoring progress towards the global nutrition targets for 2025: technical report. World Health Organization; 2017. CR - 7. Health TLCA. The hidden crisis of adolescent nutrition. 2022. p. 1. CR - 8. Wrottesley SV, Mates E, Brennan E, Bijalwan V, Menezes R, Ray S, et al. Nutritional status of school-age children and adolescents in low-and middle-income countries across seven global regions: a synthesis of scoping reviews. Public health nutrition. 2023;26(1):63-95. CR - 9. Heslin AM, McNulty B. Adolescent nutrition and health: characteristics, risk factors and opportunities of an overlooked life stage. Proceedings of the Nutrition Society. 2023;82(2):142-56. CR - 10. Caleyachetty R, Thomas G, Kengne AP, Echouffo-Tcheugui JB, Schilsky S, Khodabocus J, et al. The double burden of malnutrition among adolescents: analysis of data from the Global School-Based Student Health and Health Behavior in School-Aged Children surveys in 57 low-and middle-income countries. The American journal of clinical nutrition. 2018;108(2):414-24. CR - 11. Onis Md, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World health Organization. 2007;85(9):660-7. CR - 12. Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global consensus recommendations on prevention and management of nutritional rickets. The Journal of Clinical Endocrinology & Metabolism. 2016;101(2):394-415. CR - 13. Green R, Allen LH, Bjørke-Monsen A-L, Brito A, Guéant J-L, Miller JW, et al. Vitamin B12 deficiency. Nature reviews Disease primers. 2017;3(1):1-20. CR - 14. Organization WH. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. World Health Organization; 2011. CR - 15. Organization WH. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. World Health Organization; 2011. CR - 16. Ji N, Kumar A, Joe W, Kuriyan R, Sethi V, Finkelstein JL, et al. Prevalence and Correlates of Double and Triple Burden of Malnutrition Among Children and Adolescents in India: The Comprehensive National Nutrition Survey. The Journal of Nutrition. 2024;154(10):2932-47. CR - 17. Adeomi A, Fatusi A, Klipstein-Grobusch K. Double burden of malnutrition among school-aged children and adolescents: evidence from a community-based cross-sectional survey in two Nigerian States. AAS open research. 2021;4. CR - 18. Mercan Y, Kafadar GC, Arikan SH, Pancar N. An investigation of anthropometric measurements of early adolescents and determination of BMI-for-age-based neck circumference and BMI-for-age-based mid-upper-arm circumference cut-off points. Clinical Nutrition ESPEN. 2022;48:414-20. CR - 19. Hu X, Jiang H, Wang H, Zhang B, Zhang J, Jia X, et al. Intraindividual double burden of malnutrition in Chinese children and adolescents aged 6–17 Years: evidence from the China health and nutrition survey 2015. Nutrients. 2021;13(9):3097. CR - 20. Micha R, Mannar V, Afshin A, Allemandi L, Baker P, Battersby J, et al. 2020 Global Nutrition Report. Development Initiatives Bristol, UK; 2020. CR - 21. Kurumu Tİ. İstatistiklerle Çocuk 2024 [Available from: https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Cocuk-2023-53679. CR - 22. Söbü E, Köle MT. Evaluation of the Frequency of Malnutrition in Children and Adolescents Referred to Pediatric Endocrinology Outpatient Clinic for Short Stature. Acta Medica Nicomedia. 2023;6(1):77-81. CR - 23. Lister NB, Baur LA, Felix JF, Hill AJ, Marcus C, Reinehr T, et al. Child and adolescent obesity. Nature Reviews Disease Primers. 2023;9(1):24. CR - 24. Mannar V, Micha R, Allemandi L, Afshin A, Baker P, Battersby J, et al. 2020 global nutrition report: action on equity to end malnutrition. 89023; 2020. Report No.: 1916445276. CR - 25. Abarca-Gómez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128· 9 million children, adolescents, and adults. The lancet. 2017;390(10113):2627-42. CR - 26. Yavuz CM. Prevalence and trends of overweight and obesity among children and adolescents in Turkey: meta-analysis. IJHHS. 2023;7(01):20-30. CR - 27. Karakaş NM. The prevalence of low serum levels of Vitamin D, Vitamin B12, folate and ferritin in adolescents: Single center experience. Science Progress. 2021;104(2):00368504211007667. CR - 28. Çolak A, Akşit MZ, Şimşek N, Bilgi P, Anil M. Iron, folate and vitamin B12 status of children and adolescents: single center study in the Aegean region. 2019. CR - 29. Tan PY, Chan CL, Som SV, Dye L, Moore JB, Caton S, et al. Prevalence and key determinants of the triple burden of childhood malnutrition in Southeast Asian countries: a systematic review and meta-analysis within an adapted socio-ecological framework. Critical Reviews in Food Science and Nutrition. 2024:1-15. UR - https://doi.org/10.20515/otd.1703728 L1 - https://dergipark.org.tr/tr/download/article-file/4890070 ER -