Abstract
BACKGROUND: Rapid urbanisation in low- and middle-income countries (LMICs) has intensified the double burden of malnutrition, where undernutrition and overnutrition coexist in the same populationAim: This study aimed to examine the point prevalence rate and risk factors of the double burden of malnutrition among adults in urban Zimbabwe. SETTING: The study was conducted in Zimbabwe's two metropolitan provinces (Harare and Bulawayo). METHODS: A cross-sectional study of 348 urban adults explored associations between dietary intake, socio-demographics and anthropometrics using means, frequencies, and logistic regression. RESULTS: Obesity prevalence was 23.6%, and underweight prevalence was 8.6%. Men had higher odds of being underweight than women (Adjusted Odds Ratio 2.30, 95% CI 1.20-4.41), while high household income increased the odds of obesity (Adjusted Odds Ratio 2.90, 95% CI 1.47-5.60). A fruit and vegetable-rich diet reduced the odds of obesity by 47% (Adjusted Odds Ratio 0.53, 95% CI 0.26-0.89), whereas a diet dominated by staples and sugary foods increased the risk of obesity. CONCLUSION: Obesity and underweight were common among urban adults in Zimbabwe, where both undernutrition and overnutrition pose significant health risks. Public health interventions in LMICs should broaden their focus to address adult malnutrition and its contribution to diet-related non-communicable diseases (NCDs).Contribution: The double burden of malnutrition underscores an urgent need for comprehensive public health strategies in LMICs. Efforts should move beyond childhood undernutrition to address the entire spectrum of malnutrition. Tackling these challenges holistically will be key to mitigating undernutrition, curbing rising obesity rates, and, in turn, reversing the tide of diet-related NCDs.