Low Maternal Schooling Research Articles

Socioeconomic inequalities in access to online learning and its association with early childhood development during the COVID-19 pandemic in Yunnan Province, China

While online learning was widely adopted by schools during the COVID-19 pandemic globally, little is known about its effects on preschool children’s development in China. Using a unique dataset collected in Yunnan Province, China in 2020, with a sample of 11,990 children aged 3–5 years from 285 kindergartens, we provide the first comprehensive assessment of socioeconomic inequalities in access to online learning and its association with early childhood development (ECD). The study demonstrates significant inequalities in access to online learning. Particularly, preschoolers with rural household residential registration (Hukou), lower maternal schooling, and lower family income are less likely to have access to online learning than their counterparts. Regression results based on the Generalized Linear Model (GLM) and the Instrumental Variable (IV) method show that access to online learning is positively associated with a child’s ECD score. The empirical evidence of the unequal access to online learning and its possible consequence in ECD during the pandemic has policy implications that the ever-widening developmental gap for those lacking access to online learning needs to be addressed accordingly when the pandemic is over.

Assessing the Inequality of Early Child Development in China - A Population-Based Study.

BackgroundAs a country with the second largest child population in the world, China has little population-level evidence on who has been left behind in early childhood development (ECD). Knowledge of inequalities in ECD will inform the Chinese government in policies on promoting ECD and guide global-level monitoring on ECD progress.MethodsUsing data from the first wave of ECD surveys conducted in China at the least-developed region, most-developed region, and a megacity (Shanghai) in 2017 and 2018, we measured population-level ECD with early Human Capability Index for a total of 63,559 children aged 36-59 months old. A child was classified as developmentally on track if his/her overall development score was above the 20th percentile of the pooled populations. We measured inequalities in ECD with the absolute inequality in five domains: gender/sex, family income, maternal schooling, residential Hukou, and migrant- or left-behind status. Besides observed inequalities, we used a multilevel logistic regression model to generate adjusted inequalities.FindingsChildren developmentally on track ranges from 71% (95% CI 70 to 72%) in the least-developed region, 82% (95% CI 81 to 83%) in the most-developed region, and 86% (95% CI 85 to 87%) in Shanghai. Significant unadjusted inequalities in ECD were observed in all five dimensions. After controlling for other socioeconomic factors, significant differences remained in three dimensions: those living in the poorest families, or with lower maternal schooling, or boys were less likely to be developmentally on track than their counterparts (lower by 10[95% CI 8 to 11]-15[95% CI 13 to 17], 7[95% CI 5 to 10]-10[95% CI 7 to 12], and 5[95% CI 4 to 6]-6[95% CI 5 to 8] percentage points respectively).InterpretationEfforts of reducing ECD inequalities in China shall focus primarily on reducing poverty and improving maternal education.FundingNational Natural Science Foundation of China (81773443), Shanghai Committee of Science and Technology (2018SHZDZX05), Shanghai Municipal Health Commission (GWV-10.1-XK07; GDEK201708), Shanghai Education Committee, Chinese Social Science Foundation (BFA140046), Macao Tong Chai Charity Association, Beijing Sany Charitable Foundation, China Medical Board (#20-388), UNICEF, Faculty Grant of Brigham & Women's Hospital, Economic and Social Research Council [grant reference number ES/T003936/1’] as a UKRI Collective Fund Award “UKRI GCRF Harnessing the Power of Global Data to Support Young Children's Learning and Development Collaborative."

Longitudinal evaluation of determinants of the clinical consequences of untreated dental caries in early childhood.

This study aimed to evaluate whether the trajectory of family income, parental education and clinical variables are associated with the clinical consequences of untreated dental caries among children. A prospective cohort study was conducted with 439 children between one and three years of age, evaluated at baseline and re-evaluated after three years. Sociodemographic and economic variables, untreated dental caries and biofilm were investigated both at baseline and at the 3-year follow-up. The pufa index (pulpal involvement, ulceration, fistula and abscess) was used to diagnose the clinical consequences of untreated dental caries. The prevalence of pufa ≥1 was 18.2% in the follow-up. The following variables were associated with a higher risk of clinical consequences of untreated dental caries: mother's low schooling level at baseline and follow-up (RR=1.51; 95% CI: 1.04-2.18), incidence or baseline presence of biofilm (RR=4.66; 95% CI: 2.02-10.74), cavitated dental caries at baseline (RR=3.57; 95% CI:1.86 to 6.83) and incidence of cavitated dental caries (RR=2.04; 95% CI: 1.24-3.35). Low maternal schooling level, biofilm, cavitated dental caries at baseline, and incidence of dental caries were the factors determining the consequences of untreated dental caries.

Problems of feeding, sleeping and excessive crying in infancy: a general population study

ObjectiveTo study regulatory problems (RPs) of feeding, sleeping and excessive crying in infancy, and explore the influence of maternal mental health problems and parent–child relationship problems.Design and settingData were collected...

Developmental enamel defects are associated with early childhood caries: Case-control study.

Knowledge on the association between developmental enamel defects (DED) and early childhood caries (ECC) has importance for the drafting of prevention measures and oral healthcare planning. To compare the frequency of ECC in children with and without DED and verify their association with sociodemographic factors. This case-control study was carried out with Brazilian children aged one to five years. The case group made up of 98 children with ECC and the control group was made up of 98 children without ECC. DED were classified in diffuse opacity, demarcated opacity and enamel hypoplasia (Developmental Defects of Enamel Index). Sociodemographic data were collected by a questionnaire answered by parents. Statistical analysis used McNemar's test and logistic regression analyses. In the bivariate analysis, ECC was more frequent among children from families with poorer socioeconomic conditions (lower monthly household income [P≤.001] and lower maternal schooling [P=.001]) and among those with DED (P≤.001). The final logistical model showed that children with DED (OR: 1.94) and a monthly household income less than two Brazilian minimum salaries (OR: 2.24) were more likely to have ECC. The occurrence of DED and lower household income were pre-disposing factors for the occurrence of ECC.

Prevalence and determinants of the use of pacifiers and feedingbottle: a study in Southwest Bahia

Abstract Objectives: to assess the use of pacifier and feedingbottle and their determinants in children from a municipality of Southwest Bahia. Methods: a cross-sectional study was performed with 354 children younger than 12 months old. The event was categorized in: exclusive use of pacifier, exclusive use of feeding bottle,use of pacifier and feeding bottle, and not use any of them. Multinomial analysis with logistic regression was applied, and those who did not use any artificial nipples were thereference variable. Results: it was observed that 11.9% of the children exclusively used pacifiers, 21.2% only use bottles and 32.8% used both of them. The following factors were associated with the exclusive use of pacifiers: low maternal schooling level (eight or less years of education), lack of previous experience with breastfeeding, difficulty in postpartum breastfeeding, and lack of incentive to breastfeeding in puericulture. The exclusive use of feeding bottle was associated with unmarried mothers, aged 35 years old or older, and with less years of education (eight or less years). Women who worked outside home and had difficulty in breastfeeding had greater chance of giving both artificial nipples to the children. Conclusions: the findingspresent different featuresrelated to the exclusive or combined use of pacifiers and feeding bottles, being important to direct health professionals conducts towards mothers’ orientation.

Consumption of ultraprocessed foods, nutritional status, and dyslipidemia in schoolchildren: a cohort study.

This study evaluates the relation between consumption of ultraprocessed foods, nutritional status, and dyslipidemia in schoolchildren from Recife/PE, Brazil. This is a cohort study conducted in 2008-2009 and 2012-2013, with 238 students recruited from the public school system of the city of Recife, Northeast Brazil. Demographic data, stage of sexual maturation, socioeconomic, lifestyle, anthropometric, and lipid profiles were collected. There was a high prevalence of overweight, abdominal obesity, and dyslipidemia in both the time periods. The number of teenagers sufficiently active was higher in 2012-2013. There was a positive correlation between the consumption of ultraprocessed foods and age in 2008-2009. In 2008-2009, high consumption of ultraprocessed foods occurred in the majority of adolescents with normal total serum cholesterol values. In 2012-2013, low maternal schooling proved to be an important factor for a lower consumption of ultraprocessed foods. The consumption of ultraprocessed foods showed no direct relationship with overweight, abdominal obesity, and dyslipidemia in adolescents.

Nutritional profile of newborns with microcephaly and factors associated with worse outcomes

OBJECTIVE:To describe the nutritional profile of newborns with microcephaly and factors associated with worse outcomes during the first 14 days of life.METHODS:This investigation is a longitudinal, descriptive study carried out in 21 full-term neonates exposed vertically to the Zika virus and hospitalized in a neonatal intensive care unit from February to September 2016. Patients receiving parenteral nutrition were excluded. Data analysis was performed using a generalized estimating equation model and Student’s t-test to evaluate the association between worsening weight-for-age z-scores and independent clinical, sociodemographic and nutritional variables during hospitalization, with p<0.05 indicating significance.RESULTS:During hospitalization, there was a decrease in the mean values of the weight-for-age z-scores. The factors associated with worse nutritional outcomes were symptomatic exposure to the Zika virus, low maternal schooling, absence of maternal income and consumption of infant formula (p<0.05). Calcification and severe microcephaly were also associated with poor nutritional outcomes. Energy and macronutrient consumption remained below the recommendations and had an upward trend during hospitalization.CONCLUSION:The presence of cerebral calcification, the severity of microcephaly and symptomatic maternal exposure to Zika virus affected the nutritional status of newborns. In terms of nutritional factors, human milk intake had a positive impact, reducing weight loss in the first days of life. Other known factors, such as income and maternal schooling, were still associated with a poor nutritional status.

Initial difficulties with breastfeeding technique and the impact on duration of exclusive breastfeeding

Abstract Objectives: the present study aimed to evaluate the influence of initial difficulties in breastfeeding on duration of exclusive breastfeeding. Methods: a prospective study with follow up of nursing mothers and their babies in the first six months of age. The studied population was randomly selected among the Brazilian public health system (SUS, Portuguese acronym) users in three hospitals. The breastfeeding observation protocol was used to collect initial data, which also included socio-demographic, prenatal assistance, delivery care, the postpartum period and the newborn variables. After hospital discharge, data were collected by phone. The multiple regression model was used for statistical analysis. Results: 175 mother-baby binomials were followed. Problems with breasts during the postpartum hospital stay (p= 0.030; OR=2.38; CI95%=1.02-5.48), maternal work outside home (p=0.027; OR=2.12; CI95%=1.03-4.31) and low maternal schooling level (p=0.017; OR=2.13; CI95%=1.10-4.06) were shown to be associated with the early interruption of exclusive breastfeeding before the child has completed 6 months of age. A family income lower than one minimum wage was a protective factor (p=0.048; OR=0.42; CI95%=0.17-0.97). Conclusions: socioeconomic aspects and difficulties in breastfeeding associated with problems with the puerperal breasts stood out as factors which restrict the duration of exclusive breastfeeding.

Interaction between mother’s age and schooling at birth on under-five mortality

IntroductionPregnancy at age extremes and low maternal schooling are associated with under-five mortality. However, we found no study in the literature that evaluated the interaction between mother’s age and schooling on under-five mortality measured in both multiplicative and additive scales.&#x0D; Objectives and ApproachTo analyze the interaction between mother’s age and schooling on under-five mortality in a birth cohort in Rio de Janeiro City (Brazil) (N=153,527 live births). We carried out a non-concurrent cohort study using probabilistic record linkage of birth and death records for Rio de Janeiro (Brazil). The association between under-five mortality according to mother’s age (15-19, 20-34 and 35 years or more) and schooling (less than 4 years; 4 to 11 years and 12 or more years of schooling) were estimated using generalized linear models with binomial distribution and Neperian logarithm function. The interaction was evaluated in both scales.&#x0D; ResultsThe under-five mortality rate was 14.0 per thousand live births. Higher rates were observed among women with less than 4 years’ schooling and in age extremes. When compared with women aged 20 to 34 years and with more than 12 years’ schooling, these women had the following risk ratios: 15 to 19 years – RR = 3.66 (95% CI 2.39; 5.62); 35 years or more – RR = 2.74 (95% CI 1.83; 4.11). We did not observe statistically significant interactions in the additive and multiplicative scales.&#x0D; Conclusion/ImplicationsAlthough we did not observe an interaction between mother’s age and schooling, under-five mortality was more frequent among women with less the four years’ schooling, especially at the age extremes, suggests these are more vulnerable groups that demand greater attention in care.

Health inequalities in vaccination: A challenge for measles elimination (the case of outbreak in Ecuador, 2011–2012)

Introduction/background Low immunization coverage in specific population groups, together with high viral infectivity, has aggravated the measles outbreaks happening in the past decade. Ecuador, a country in northwestern South America, introduced routine measles vaccination more than three decades ago. As a result, the last cases of autochthonous measles happened in that country around 1996. However, a new measles outbreak occurred in 2011–12. This study aimed to quantify socioeconomic inequalities associated with measles immunization coverage at the population level. Methods An ecological study was performed using two datasets: the results of a measles immunization survey performed in Ecuador in 2011 and socioeconomic data from the 2010 census, aggregated by canton. The survey included 3,140,799 people aged 6 months to 14 years living in 220 cantons of Ecuador, in whom at least one dose of measles-containing vaccine received was inquired. Variables included were: previous measles immunization, Unsatisfied basic needs (UBNI) of urban cantons, percentage of the 15–17 year-old population in the canton attending school, percentage of the population self-identifying as indigenous or African-Ecuadorian in the canton, and employment rate. Multiple spatial regression was performed to identify socioeconomic inequalities associated with measles immunization coverage. Spatial autocorrelation was detected and conditional autoregressive analysis was performed for adjustment of variables. Principal components analysis was used to create a socioeconomic score. The slope index and relative index of inequality were calculated. Results Measles immunization coverage ranged from 54.1% to 98.5% in the cantons of Ecuador. Measles immunization coverage was inversely associated with unsatisfied basic needs (P = 0.0007) in urban areas and proportion of indigenous and African-Ecuadorian residents in the canton (P = 0.015), and directly associated with unemployment rate in the canton (P = 0.037). The distribution of immunization coverage across the cantons was heterogeneous, indicating spatial dependence. In cantons in the lower socioeconomic stratum, the rate of non-immunization was 71% higher than in cantons in the upper stratum, with a prevalence ratio of 1.71 (95% CI: 1.69–1.72), and an absolute difference of 6.44 percentage points. The slope index of inequality revealed a difference of 10.6 percentage points in immunization coverage between the canton estimated by linear regression as the one with the best socioeconomic level as compared to the canton with the worst socioeconomic level. In turn, the relative index of inequality showed that immunization coverage was 1.12 times higher in the canton estimated to have the best socioeconomic level compared to the canton with the worst socioeconomic level. Discussion We observed a spatial distribution pattern for immunization coverage and socioeconomic indicators that suggest socially and economically vulnerable populations are also more susceptible to epidemic outbreaks. In cantons with lower immunization coverage, a higher proportion of UBN, lower employment rate, and higher proportion of indigenous and African-Ecuadorian residents were detected. Neighboring cantons were equally vulnerable to measles. Previous studies have shown an association between low immunization coverage and poverty indicators, lower maternal schooling, higher proportion of racial or ethnic minorities, and limited access to health services. The results of the present study must be interpreted with care. It is not possible to make inferences at the individual-level. However, these results seem consistent with those of studies having individuals as the unit of analysis. Conclusions The spatial dependence between measles vaccination coverage and health inequalities suggests clusters of vulnerable populations for outbreaks. Health social inequalities must be considered to achieve and maintain measles elimination.

Food and nutrition insecurity indicators associated with iron deficiency anemia in Brazilian children: a systematic review.

This study aimed to review food and nutrition insecurity indicators associated with iron deficiency anemia in Brazilian children below 5 years. We searched in electronic databases (SciELO, Lilacs, and Medline) and selected studies by titles, abstracts and full-text reading. Of the 1,023 studies analyzed, 11 fit the inclusion criteria. The results of the studies evidenced that iron deficiency anemia in Brazilian children was associated with sociodemographic and health indicators (male, age below 24 months, children of adolescent mothers, respiratory infections, diarrhea, low maternal schooling, parents' working conditions, nursery time, lack of basic sanitation, maternal anemia, lack of ferrous sulfate use by the mother and/or child and late onset of prenatal care), nutritional indicators (low birth weight, diet characteristics, such as the habit of milk consumption close to meals, low exclusive and full breastfeeding time) and economic indicators (low per capita income). The food and nutrition insecurity analyzed in this study from the perspective of different indicators is associated with iron deficiency anemia in children under 5 years in Brazil.

Qualidade de vida e percepção estética da cárie dentária

Objetive: To relate the aesthetic perception and the oral health-related quality of life in the presence of dental caries in schoolchildren. Methods: Cross-sectional study carried out in Araraquara, Sao Paulo, Brazil, from October 2014 to March 2015, with 260 schoolchildren aged 8 to 10 years, divided into clinical groups according to the presence of dental caries. The Child Perceptions Questionnaire and the Child Questionnaire About Teeth Appearance were applied and a clinical evaluation of permanent and deciduous dentition was conducted for detection of decayed, missing or filled teeth. Data was analyzed using the chi-square test and Mann-Whitney’s test, p ≤ 0.05. Results: Of the 260 students, 130 (50%) had caries disease, with the highest frequency (62.0%) in 8-year-olds. Socioeconomic variables, such as lower family income and lower maternal schooling, were associated with the dental caries group (p<0.05 and p<0.01, respectively). In the dental caries group, the domains oral symptoms (4.9 vs 6.6), emotional well-being (3.0 vs 4.7) and social well-being (2.2 vs 3.5) were higher than in the caries-free group. Regarding the aesthetic perception, the psychological domain (0.94 vs 1.27) and the overall perception of oral health (2.26 vs 2.93) were higher in the group with dental caries. In the linear regression, there was a significant contribution of the number of permanent decayed teeth and the dmft (decayed, missing and filled deciduous teeth) index to the worst perception of quality of life. Conclusion: Dental caries negatively affects aesthetic perception and quality of life in 8- to 10-year-old children.

Introduction of inappropriate complementary feeding in the first year of life and associated factors in children with low socioeconomic status.

The study aimed to identify factors associated with the introduction of inappropriate complementary feeding in the first year of life in children living in municipalities (counties) with low socioeconomic statusl. This was a cross-sectional multicenter study in 1,567 children 12 to 59 months of age in 48 municipalities participating in the Brazil Without Poverty plan in the South of Brazil. A structured questionnaire was applied to the children's parents to obtain socio-demographic information and the age at which inappropriate complementary foods were introduced for the first time in complementary feeding. Prevalence of introduction of sugar before four months of age was 35.5% (n = 497; 95%CI: 33.1-38.0). The prevalence rates for the introduction of cookies/crackers, creamy yogurt, and jelly before six months of age were 20.4% (n = 287; 95%CI: 18.3-22.3), 24.8% (n = 349; 95%CI: 22.4-27.1), and 13.8% (n = 192; 95%CI: 12.0-15.7), respectively. Associations were identified between low maternal schooling (PR = 1.25; 95%CI: 1.03-1.51) and low monthly family income (PR = 1.22; CI95%: 1.01-1.48) and the introduction of inappropriate complementary feeding. The study identified the introduction of inappropriate complementary feeding in the first year of life among children in municipalities with high socioeconomic vulnerability in the South of Brazil, associated with low maternal schooling and low monthly family income.

Prevalence and Risk Factors for Microcephaly at Birth in Brazil in 2010.

To estimate the baseline prevalence and risk factors for microcephaly at birth before the Zika virus epidemic in 2 Brazilian cities. We used population-based data from the Brazilian Ribeirão Preto (RP) and São Luís (SL) birth cohort studies of 2010 that included hospital deliveries by resident mothers. The final sample was 7376 live births in RP and 4220 in SL. Gestational age was based on the date of the mother's last normal menstrual period or obstetric ultrasonography, if available. Microcephaly at birth was classified according to the criteria of the International Fetal and Newborn Growth Consortium for the 21st Century and the Brazilian Ministry of Health. Risk factors for microcephaly, proportionate and disproportionate microcephaly, and severe microcephaly were estimated in a hierarchized logistic regression model. According to the International Fetal and Newborn Growth Consortium for the 21st Century definition, the prevalence of microcephaly (>2 SDs below the mean for gestational age and sex) was higher in SL (3.5%) than in RP (2.5%). The prevalence of severe microcephaly (>3 SDs below the mean) was higher in SL (0.7%) than in RP (0.5%). Low maternal schooling, living in consensual union or without a companion, maternal smoking during pregnancy, primiparity, vaginal delivery, and intrauterine growth restriction were consistently associated with microcephaly. The number of cases of microcephaly is grossly underestimated, with an underreporting rate of ∼90%. The prevalence of severe microcephaly was much higher than expected in both cities. Our findings suggest that microcephaly was endemic in both municipalities before the circulation of the Zika virus.

Barreras de acceso y calidad en el control prenatal

Introducción. El control prenatal (CPN) es una estrategia de costo eficaz en la prevención de mortalidad y morbilidad materna y perinatal. Aunque Colombia tiene una inscripción de gestantes al CPN del 94%, este logro no afecta el descenso de la mortalidad materno perinatal.Objetivo. Describir las barreras de acceso al CPN y la calidad de atención a gestantes en Meta.Materiales y métodos. Se diseñó un estudio observacional descriptivo de corte transversal y se realizó una encuesta que abordó aspectos como percepción de calidad de atención, barreras de acceso e integridad de la atención.Resultados. Se trabajó con 306 gestantes, cuya edad promedio fue de 24 años. El 66% tuvo una o dos gestaciones, el 15% ha tenido aborto y el 25% cesárea. El 74.17% tuvo cuatro o más controles. Existieron factores de riesgo asociados a menos de cuatro controles, percepción de la calidad del control con Odds ratio (OR, por su sigla en inglés) 22.7, inicio del CPN en segundo trimestre con OR 5.64, nivel de ingreso bajo con OR 5.12 y baja escolaridad de la madre con OR 3.62.Conclusión. Es necesario mejorar la calidad e integridad del CPN por los prestadores de salud como estrategia complementaria para asegurar su efecto en la reducción de la morbimortalidad materno y perinatal.

Are school and home environmental characteristics associated with oral health-related quality of life in Brazilian adolescents and young adults?

The aim of this study was to test the association of contextual school and home environmental characteristics and individual factors with oral health-related quality of life (OHRQoL) in a representative sample of Brazilian adolescents and young adults. Individual-level data from 3854 fifteen- to nineteen-year-olds who participated in the Brazilian Oral Health Survey were pooled with contextual city-level data. The dependent variable was the frequency of impacts of oral disorders on daily performances (OIDP extent), as a measure of OHRQoL. Contextual school and home environmental characteristics were categorized into three equal groups according to tertiles of the contextual variable's scores (low, moderate and high). Individual demographic, socioeconomic and oral clinical measures were the covariates. The association between contextual and individual characteristics and OIDP extent was estimated using multilevel Poisson regression models. The mean of OIDP extent was 0.9 (standard error 0.1). Adolescents and young adults living in the cities with high levels of lack of security at school (RR 1.33; 95% CI=1.02-1.74), moderate levels of bullying at school (RR 1.56; 95% CI=1.20-2.03) and moderate levels of low maternal schooling (RR 1.43; 95% CI=1.06-1.92) had a higher mean OIDP extent. Male sex, higher age, skin colour, poor individual socioeconomic status and worse oral clinical measures were also associated with higher mean of OIDP extent. Poor school and home environmental characteristics were independently associated with poor OHRQoL in individuals aged between 15 and 19years. Our findings suggest the place where they study and the maternal level of education are meaningful aspects for their oral health.

Consommation des produits lactés chez l’enfant et l’adolescent marocain de 2 à 16 ans: une étude monocentrique

IntroductionEvaluer la consommation quotidienne des produits laitiers dans une population d’enfants marocains et déterminer les facteurs associés pouvant influencer cette consommation.MéthodesEtude prospective du 1er octobre 2013 au 31 avril 2014. Les enfants âgés entre 2 et 16 ans ont été inclus. Le recrutement a eu lieu dans la ville de Fès. Le recueil des données s’est fait à l’aide d’un questionnaire fréquentiel. Les parents et les enfants inclus ont été interrogés sur la consommation des produits laitiers et les facteurs socio-démographiques avec une évaluation anthropométrique des enfants. L’association des variables à la consommation des produits laitiers a été analysée en analyse univariée et multivariée par un modèle de régression logistique.RésultatsL’enquête alimentaire avait intéressé 286 enfants dont 151 filles (52,8 %) et 131 garçons (45,8%). Les enfants âgés de 2 à 3 ans représentaient 26,4 %, ceux âgés de 4 à 7 ans 28,9 %, ceux âgés de 7 à 9 ans 18,3 % et les adolescents âgés de 10 à 16 ans 26,4 %. Les enfants consommaient en moyenne 2.5±1 produits laitiers par jour. Les enfants consommaient au moins 3 produits laitiers par jour dans 57,8% chez les enfants âgés de 2 à 3 ans, 53,6% chez les enfants âgés de 4 à 6 ans, 40% chez les enfants âgés de 7 à 9 ans et 41.2% chez les enfants âgés de 10 à 16 ans. Les facteurs associés à la consommation de trois produits laitiers minimum par jour en analyse univariée étaient le niveau d’instruction maternel analphabète p < 0.001 OR = 0.1 et primaire p = 0.002 OR = 0.1, le niveau socioéconomique familial moyen p < 0.001 OR = 3, l’âge p= 0.01 OR = 0.9 et l’indice de masse corporelle normal p = 0.01 OR = 2.5 et > 90° percentiles p < 0.001 OR = 6. Il existe un lien positif entre l’indice de masse corporelle > 90° percentiles p = 0.01 OR = 3.9 est et la quantité consommée des produits laitiers et négatif avec le faible niveau de scolarité maternel analphabète p = 0.008 OR = 0.1 et primaire p = 0.009 OR = 0.1.ConclusionLa consommation du lait et des autres produits laitiers était inappropriée en particulier chez l’enfant âgé de 7 à 9 ans et l’adolescent de 10 à 16 ans. Le faible niveau d’éducation maternel et un indice de masse corporelle supérieur au 90° percentiles était des facteurs indépendamment associés à la consommation de moins de 3 produits laitiers par jour. La sensibilisation des parents et des enfants sur l’intérêt du lait et de ses dérivés dans l’alimentation de l’enfant est indispensable.

Factors associated with the consumption of school meals by Brazilian adolescents: results of the PeNSE survey 2012

The aim was to study the association between socio-demographic and routine dietary variables and consumption of school meals by adolescents enrolled in public schools in Brazil. The study used data used from the National School Health Survey (PeNSE) 2012. To assess differences between schoolchildren based on whether or not they ate school meals, the study used Pearson's chi-square test, and associations were analyzed with univariate and multivariate Poisson regression models. Of the 86,660 students included in the study, 22.8% eat school meals. Higher consumption of school meals is associated with male gender, brown skin color, residence outside state capitals, working, and low maternal schooling, for those that ate breakfast and lunch with their parents. The findings are relevant for planning strategies to encourage consumption of school meals.

Lifetime socioeconomic status and health-related risk behaviors: the ELSA-Brazil study

Our objective was to investigate the association between lifetime socioeconomic status and intra-generational social mobility and low consumption of fruits and vegetables, leisure-time physical inactivity, and smoking among 13,216 men and women participating in the baseline of the ELSA-Brazil study (2008-2010). Socioeconomic status in childhood, adolescence, and adulthood was measured by maternal schooling, socio-occupational class of the first occupation, and socio-occupational class of the current occupation, respectively. Social disadvantages in adulthood were consistently associated with higher prevalence of the three behaviors analyzed in men and women. However, socioeconomic status in youth and childhood was less consistently associated with the behaviors. For example, while low maternal schooling reduced the odds of past smoking (women) and current smoking (men and women), it was associated with higher odds of leisure-time physical inactivity in women. Meanwhile, low socioeconomic status in youth increased the odds of past smoking (men and women) and current smoking (women). Analysis of social trajectories lent additional support to the relevance of disadvantages in adulthood for risk behaviors, since only individuals that rose to the high socio-occupational class did not show higher odds of these behaviors when compared to participants that had always belonged to the high socio-occupational class. Our findings indicate that socioeconomic disadvantages in adulthood appear to be more relevant for risk behaviors than disadvantages in childhood and adolescence.