{
  "abstract": "Background The double burden of malnutrition (DBM), characterised by coexisting undernutrition and overnutrition, remains a public health concern among adolescents especially in low- and middle-income countries. Adolescents in Nepal are nutritionally vulnerable, yet evidence on the coexistence of stunting and overweight/obesity is limited. This study assessed the prevalence and associated factors of DBM among school-going adolescents in urban Kathmandu Valley, Nepal. Methods A school-based cross-sectional study was conducted to assess factors associated with the double burden of malnutrition among adolescents in Kathmandu Valley, Nepal. A multi-stage cluster random sampling technique, using the Probability Proportional to Size method, was employed to ensure the selection of the desired number of participants. Students from grades 8 to 10 were randomly selected for face-to-face interviews and anthropometric measurements (height and weight were collected to calculate Body Mass Index (BMI)-for-age Z-scores (BAZ)), using tools adapted to the local context. Bivariate and multivariable models examined the associations between the dependent and independent variables. Results This study revealed that 15.3% of the students were stunted, 5.5% were underweight, 16.9% were overweight/obese, and 3% of students with the coexistence of DBM. In the fully adjusted model, the odds of stunting were significantly higher among adolescents aged 15-19 years (aOR = 2.03, 95% CI: 1.35-3.06), salty-snack consumers (aOR = 1.53, 95% CI: 1.00-2.36), those with low nutritional knowledge (aOR = 3.17, 95% CI: 2.17-4.66), and low diet quality (aOR = 7.27, 95% CI: 4.96-10.65). Conversely, fatty-food consumption was associated with lower odds of stunting (aOR = 0.65, 95% CI: 0.42-1.00). For overweight/obesity, older adolescents had significantly lower odds (aOR = 0.49, 95% CI: 0.35-0.67). Regarding the double burden of malnutrition (DBM), low nutritional knowledge (aOR = 2.16, 95% CI: 0.99-4.71) and low diet quality (aOR = 5.27, 95% CI: 2.42-11.48) were significantly associated with higher odds. Conclusion The double burden of malnutrition exists among adolescents in urban Kathmandu Valley, highlighting a critical public health challenge. Socio-demographic, dietary, and behavioral factors significantly influence its prevalence. Comprehensive school- and community-based interventions are crucial for addressing this dual nutritional burden.",
  "abstract_shown": true,
  "affiliations": [
    "Public Health Promotion and Development Organization"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "name": "D. R. Sunuwar"
    },
    {
      "name": "A. Shrestha"
    },
    {
      "name": "A. Kiwanayo"
    },
    {
      "name": "S. Karki"
    },
    {
      "name": "M. Shrestha"
    },
    {
      "name": "S. Sunuwar"
    },
    {
      "name": "D. R. Singh"
    },
    {
      "name": "K. Karki"
    },
    {
      "name": "N. K. Chaudhary"
    },
    {
      "affs": [
        0
      ],
      "name": "D. K.C."
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/03fs32fytt066.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.11.02.26367141",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367141v1.full",
  "id": "03fs32fytt066",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367141v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "nutrition"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367141v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-02",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/03fs32fytt066.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T00:20:38Z",
      "native_id": "10.64898/2026.11.02.26367141",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.11.02.26367141v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:nutrition",
      "subfield": "nutrition"
    }
  ],
  "title": "Prevalence and Determinants of the Double Burden of Malnutrition among Adolescents: A Cross-Sectional Study in Urban Schools of Nepal",
  "title_text": "Prevalence and Determinants of the Double Burden of Malnutrition among Adolescents: A Cross-Sectional Study in Urban Schools of Nepal",
  "type": "preprint",
  "updated_at": "2026-11-06T00:20:52Z",
  "url": "https://research.draconitic.com/paper/03fs32fytt066",
  "venue": "medRxiv",
  "versions": []
}