Abstract
BackgroundLevels of child undernutrition have declined in many middle-income countries, whereas overweight and obesity have increased. We describe time trends in nutritional indicators at age 1 year in the 1982, 1993, 2004 and 2015 Pelotas (Brazil) Birth Cohorts.MethodsEach study included all children born in the urban area of the city, with over 4 200 births in each cohort. Children were measured at approximately 12 months of age. Anthropometric indicators were calculated according to World Health Organization Growth Standards. Stunting and wasting were defined as <-2 Z scores for length for age and weight for length, and overweight as >2 Z scores for weight for length. Prevalence was stratified by sex, maternal skin colour and family income.ResultsThe prevalence of stunting declined by 53% (from 8.3% to 3.9%) from 1982 to 2015. Wasting prevalence remained stable at low levels (1.8% in 1982 and 1.7% in 2015), whereas overweight increased by 88% (6.5% to 12.2%). Undernutrition was more common among boys, those born to mothers with brown or black skin colour and in the poorest quintile of families. Socioeconomic inequalities in undernutrition decreased markedly over time. Overweight was markedly more common among the rich in 1982, but fast increase among the poor eliminated socioeconomic differences by 2015, when all groups showed similar prevalence.ConclusionsOur results confirm the rapid nutrition transition in Brazil, with marked reduction in levels and inequalities in undernutrition in parallel with a rapid increase in overweight, which became the main nutritional problem for children.
Highlights
Child malnutrition may result from either undernutrition, overweight or micronutrient deficiencies.[1]
We report on time trends in the prevalence of stunting, wasting and overweight at the age of 1 year, in four population-based birth cohort studies carried out in the city of Pelotas in Southern Brazil between 1982 and 2015, with special attention to inequalities according to socioeconomic status, maternal skin colour and sex of the child
There was no evidence of a change in prevalence according to maternal skin colour across the four cohorts (P 1⁄4 0.67), with infants born to Black or Brown mothers presenting 1.3 times higher risk than those born to White mothers
Summary
Child malnutrition may result from either undernutrition, overweight or micronutrient deficiencies.[1]. About 24% of the world’s children under the age of 5 years are stunted, 7.5% are wasted and 6.1% overweight.[9]. The highest prevalences of stunting and wasting are observed in low- and middle-income countries (LMICs). Stunting prevalence is declining in many countries, where overweight is increasing.[9]. Levels of child undernutrition have declined in many middle-income countries, whereas overweight and obesity have increased. We describe time trends in nutritional indicators at age 1 year in the 1982, 1993, 2004 and 2015 Pelotas (Brazil) Birth Cohorts. Wasting prevalence remained stable at low levels (1.8% in 1982 and 1.7% in 2015), whereas overweight increased by 88% (6.5% to 12.2%). Conclusions: Our results confirm the rapid nutrition transition in Brazil, with marked reduction in levels and inequalities in undernutrition in parallel with a rapid increase in overweight, which became the main nutritional problem for children
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