Fatores associados a desfechos nutricionais em mães e crianças brasileiras

Abstract

Introduction: Excess weight and malnutrition constitute important global nutritional problems in developing countries, which can even coexist among members of the same family. Objective: To estimate factors associated with nutritional outcomes (stunting and overweight) in Brazilian children under five years of age and double disease burden in the mother and child (short stature in children and maternal overweight). Methods: This is a cross-sectional epidemiological study, developed based on the use of data from the National Survey of Demography and Health of Children and Women (PNDS/). Exposure factors were: socioeconomic, environmental, social vulnerability, maternal characteristics and the child's food intake. Considered nutritional outcomes: short stature, overweight and double burden disease (short stature in children and overweight in mothers). To assess maternal socioeconomic factors and nutritional outcomes in children (short stature and overweight) was used the regression method of generalized estimating equations (GEE), considering the sample weights of the PNDS; logistic multinomial hierarchical regression analysis was done to evaluate the associations between factors associated with the double burden of morbidity and structural equation modeling (SEM) to study the associations of the factors related to increased BMI of children. Results: Children whose mothers had low education (OR= 3.97, 95%CI: 1.23 - 12.80) had higher chances of short stature; children whose mothers work outside the home (OR=1.57; 95%CI: 1.02 - 2.42) have a higher chance of being overweight; low maternal education (OR=3.53, 95%CI: 1.33 - 9.33) and households (non-masonry) (OR = 2.54, 95%CI: 1.39 - 4.66) were associated with the double burden of morbidity; socioeconomic conditions influenced directly on the children's BMI (=0.102; p=0.02) as well as indirectly; regarding chidrens consumption of obesogens (=0.018; p=0.04). Socioeconomic conditions were also associated with childrens consumption of obesogens ( =0.155; p=0.02). A negative association between socioeconomic conditions and food security was observed ( = -0.544; p<0.001) and direct association between maternal BMI and BMI of children ( = 0.169; p<0.001). Furthermore, the relationship between consumption of obesogenic foods and BMI of the children ( = -0.114, p <0.001). Conclusion: Based on the data found in this study, the recognition of the complexity of the interrelations between variables involved in determining the weight gain and short stature in children is confirmed. In addition, knowledge of the possible determinants of the mother-child health will contribute to the development of strategies for promoting health and healthy eating, considering two current scenarios (growth deficit and overweight / obesity).