Factors associated with nutritional outcomes in the mother–child dyad: a population-based cross-sectional study

Abstract

Objective: To estimate factors associated with double burden of nutritional outcomes in the mother-child dyad at the household level (child stunting and/or maternal overweight). Design: Cross-sectional study using the Brazilian Demographic and Health Survey. Nutritional outcomes were: mother with normal weight and child with normal height; overweight mother and child with normal height; mother with normal weight and short-stature child; and overweight mother and child with short stature (double burden). The child was classified as short when height-for-age Z-score was <−2 and the mother as overweight when BMI was ≥ 25·00 kg/m 2 . Socio-economic status, environment, social vulnerability, maternal characteristics and the child's food intake were the exposure factors. The hierarchical approach for multinomial logistic regression modelling was used to assess the associations. Setting: National Demographic and Health Survey of Children and Women conducted in Brazil, 2006Brazil, -2007. Subjects: Mother-child dyads (n 3676). Results: After adjustments, lower maternal educational level (OR = 3·53; 95 % CI 1·33, 9·33) and inadequate household (non-masonry house; OR = 2·54; 95 % CI 1·39, 4·66) were associated with the double burden of malnutrition. Mother's short stature (OR = 3·41; 95 % CI 1·76, 6·61), child's vegetable intake on less than or equal to 4 d/week (OR = 2·21; 95 % CI 1·03, 4·75) and inadequate household (non-masonry house; OR = 2·29; 95 % CI 1·36, 3·87) were associated with child's short stature. The lack of breast-feeding (OR = 2·00; 95 % CI 1·07, 3·72) was associated with maternal overweight. Conclusions: The present findings contribute to establishing strategies promoting health and healthy diets, by considering the growth deficit and overweight/obesity concomitantly. Keywords Nutritional assessment Overweight Epidemiology Child growth WomenDeveloping countries have experienced increasing rates of overweight (1,2) . In Brazil, increasing prevalence rates of overweight have been observed in the population at all life stages. Overweight was observed in 7·3 % of children under 5 years old (3) and in 33·5 % of children aged 5-9 years (4) . Among women, over the course of a 35-year period, overweight increased from 28·7 % in 1974 to 48 % in 2008. In addition, the obesity rate among women increased more than twofold during the same period, from 8 % to 16·9 % (4) . Genetic (5) , psychosocial (6) and metabolic (7) factors may be associated with obesity. However, the factors that best explain the growing number of overweight people involve changes in lifestyle (8) , the high prevalence of physical inactivity and the increased consumption of processed foods with high energy density, particularly those rich in saturated fat and simple carbohydrates (9) .Unlike overweight, the prevalence of child undernutrition has declined globally over the past decades. However, this reduction in undernutrition is occurring unevenly; in fact, the problem has increased in some countries (10) . It is estimated that 186 milli...

Maternal Body Mass Index Is Strongly Associated with ChildrenZ-Scores for Height and BMI

“…Recent studies have shown that maternal nutritional status was related to several adverse outcomes in the offspring that also included nutritional outcomes among the latter [17][18][19][20][21]. Studies have shown maternal BMI to be closely associated with child nutritional status [22,23]. Maternal underweight was another significant factor involved [24].…”

Maternal educational level and socioeconomic status as related to the nutritional status of preschool children attending day-care centers

“…Se destaca que las madres de los niños/as con exceso de peso tienen mayor puntuación, lo cual se traduce en un peor estrato socioeconómico. Estos resultados constatan la presencia de lo que hoy se conoce como la doble carga de la malnutrición, que pone de manifiesto la presencia tanto de malnutrición por exceso como por déficit en situación de pobreza, es decir, en clases media baja y obrera que corresponden al peor estrato socioeconómico, y que no solo es un problema de países desarrollados sino (16)(17)(18) también de países en vía de desarrollo .…”

Endowments or Returns to Endowments or Both? Deciphering Disparities in Childhood Stunting in Bihar, India

“…Majority of the studies carried out in India and other developing countries have demonstrated that an array of household, individual, and contextual factors have signi cant bearing on childhood undernutrition [6][7][8][9][10][11][12][13][14][15][16][17]. Higher consumption expenditure in household lowers the risk of child malnutrition [6][7], while economic gradients contribute in maintaining vicious cycle of poverty and malnutrition [8][9][10].…”

“…Lack of household sanitation [11][12], low body-mass index (BMI) among mothers [13][14][15], less parental education [16]; lack of bargaining power of women within households [17] signi cantly and negatively affect child's anthropometric outcomes in low-and middle-income countries.…”