Understanding the double burden of malnutrition in food insecure households in Brazil

Abstract

Household food insecurity (HFI) has been associated with both obesity among mothers and undernutrition among children. However, this association has not been well investigated in mother/child pairs living in the same household. The objective of this study was to examine the relationship of coexistence of maternal overweight and child stunting with HFI in Brazil. We conducted secondary data analyses of the 2006 Brazilian National Demographic and Health Survey. We analyzed the nutritional status of 4299 pairs of 15-49-year-olds mothers and their children under 5 years of age. The double burden of malnutrition (DBM) was defined as the presence of an overweight mother and a stunted child in the same household. HFI was measured with the Brazilian HFI Measurement Scale. The association between DBM and HFI was examined with hierarchical multivariable logistic regression analyses. Severe HFI was associated with DBM after adjusting for macroeconomic and household level socio-economic and demographic variables (Adjusted OR: 2.65 - CI: 1.17-8.53). Findings suggest that policies and programmes targeting HFI are needed to prevent the coexistence of child chronic undernutrition and maternal overweight/obesity in the same household. These investments are likely to be highly cost-effective as stunting has been identified as one of the major risk factors for poor child development and adult overweight/obesity and a strong risk factor for the development of costly chronic diseases including type 2 diabetes and cardiovascular disease.

Child‐level double burden of malnutrition in the MENA and LAC regions: Prevalence and social determinants

“…Whereas household‐level double burden, has been defined as the coexistence of undernutrition in children and overweight in adults within the same household (Black et al, ; Gubert, Spaniol, Segall‐Corrêa, & Pérez‐Escamilla, ; Jones, Acharya, & Galway, ; Wojcicki, ). Both population‐level and household level double burdens have been relatively well documented in the LAC region, with findings highlighting that stunting, anaemia and overweight are prevalent in women and children in these countries (Atalah, Amigo, & Bustos, ; Conde & Monteiro, ; Freire, Silva‐Jaramillo, Ramírez‐Luzuriaga, Belmont, & Waters, ; Gubert et al, ; Kroker‐Lobos, Pedroza‐Tobías, Pedraza, & Rivera, ; Ramirez‐Zea, Kroker‐Lobos, Close‐Fernandez, & Kanter, ; Rivera et al, ; Sarmiento et al, ; Severi & Moratorio, ). The rapid increases in overweight and obesity in the LAC region have been paralleled by similar surges in the MENA region (Abarca‐Gómez et al, ; Ng et al, ).…”

Nutrition disparities and the global burden of malnutrition

“…For example, household food insecurity, a condition related to poverty that limits access to a nutritious and safe diet, has been consistently associated with both undernutrition in children and overweight in women. 3 4 5 The first 1000 days of life offer a window of opportunity to prevent both stunting and obesity, and are a worthwhile focus for strategies to tackle nutrition disparities.…”

Instrumentos de avaliação da qualidade de dietas: desenvolvimento, adaptação e validação no Brasil

“…O fenômeno da dupla carga da má nutrição é caracterizado pela ocorrência simultânea de carências nutricionais e excesso de peso corporal, no mesmo indivíduo, domicílio, comunidade, região e/ou país (SHRIMPTON;ROKX, 2012). Em diversos países, membros adultos de uma comunidade podem obter alimentos de baixo custo e alto teor calórico que induzem à obesidade, enquanto as crianças recebem alimentos pobres em nutrientes, levando à desnutrição (GUBERT et al, 2017). Tais alimentos, de baixo custo, alto teor calórico e baixo teor de nutrientes benéficos, podem ser encontrados no grupo de ultraprocessados, como será discutido mais adiante.…”