Abstract
Objective: To describe the inequalities in the double burden of malnutrition (DBM) in the adult population. Methods: Study carried out with data from the VIGITEL study, conducted in 2019 in all Brazilian capitals. Underweight and excess weight were evaluated on the basis of years of schooling and age. Multi-level analysis was performed including Human Development Index of each capital and individual-level variables. The inequality slope index was used to assess the magnitude of the inequalities found. All analyses considered the svy command owing to the complexity of the sampling process. Results: 47.119 individuals were studied. Men with no education had 6 percentage points more underweight compared to those with higher education. Higher prevalence of excess weight was found among men with higher education and women with no education. In women, the difference was 18 percentage points between extreme categories. Elderly people with no education had 10 percentage points more excess weight than those with higher education. Conclusions: The findings suggest the need for intersectoral actions that can cope with the social inequalities and help confronting with the DBM in Brazil.
Highlights
Nutritional status can indicate associations between health conditions and social and economic context of population groups, as well as predict adverse outcomes throughout life [1, 2]
Nutritional status has been mostly identified through the Body Mass Index (BMI), because this measure is easy and fast to apply, and it allows classifying individuals into underweight, normal weight, overweight and obesity [1]
The present study aimed to describe the coexistence of underweight and excess weight in the Brazilian adult population according to age and years of schooling, as well as the socioeconomic and demographic inequalities associated with these nutritional disorders
Summary
Nutritional status can indicate associations between health conditions and social and economic context of population groups, as well as predict adverse outcomes throughout life [1, 2]. In the last few years, the expression “double burden of malnutrition (DBM)” has been highlighted in scientific publications for addressing an existing situation linked to the fast and intense process of epidemiological, nutritional and demographic transitions, especially in low-income and middleincome countries: the coexistence of malnutrition and excess weight [3]. Nutritional status has been mostly identified through the Body Mass Index (BMI), because this measure is easy and fast to apply, and it allows classifying individuals into underweight, normal weight, overweight and obesity [1]. In Brazil, in the last 13 years, there was an increase of 12.4% in the prevalence of excess weight in the adult population [10, 11]
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