title: Nutritional status of children under 5 years of age in the Brazilian Western Amazon before and after the Interoceanic highway paving: a population-based study.
abstract: BACKGROUND
  The aim of this study was to analyse the prevalence of undernutrition, overweight and associated factors, before and after the implementation of the Interoceanic Highway.
  
  
  METHODS
  A population-based cross-sectional study on children under 5 years of age was conducted in the municipality of Assis Brasil, AC, Brazil, in 2003 and 2010. Prevalence of undernutrition was observed by using height-for-age Z-scores (HAZ) and adopting a cut-off point equal to or lower than a -2 Z-score. Overweight prevalence was defined by a cut-off point equal to or greater than a +2 Z-score of the WHZ index. Z-scores were calculated relative to WHO 2006 reference data. Semi-structured questionnaires were applied to the children's guardians, investigating family socio-economic and demographic characteristics, morbidities, access to services and child care. Associated factors were identified by hierarchical multiple logistic regression analysis.
  
  
  RESULTS
  The prevalence of low HAZ (undernutrition) was 7.0% in 2003 and 12.2% in 2010. The prevalence of high WHZ (overweight) was 1.0% and 6.6% for 2003 and 2010, respectively. It was not possible to adjust the multiple model for the year 2003. The factors associated with low HAZ in 2010 were: wealth index, the situation of living with biological parents, maternal height and presence of open sewage, whereas the factors associated with a high WHZ in the same year were: child's age, mother's time of residence in the location, mother's body mass index.
  
  
  CONCLUSIONS
  Overweight increase within this undernutrition scenario reveals that the process of nutritional transition began in this Amazonian city only in the last decade, and therefore, it is delayed when compared to overweight in other parts of Brazil. Such nutritional transition in Assis Brasil may have been facilitated by the construction of the Interoceanic Highway.
authors.forename: Alanderson A
authors.initials: AA
authors.lastname: Ramalho
authors.forename: Saulo A S
authors.initials: SA
authors.lastname: Mantovani
authors.forename: Breno M
authors.initials: BM
authors.lastname: Delfino
authors.forename: Thasciany M
authors.initials: TM
authors.lastname: Pereira
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Martins
authors.forename: Humberto
authors.initials: H
authors.lastname: Oliart-Guzmán
authors.forename: Athos M
authors.initials: AM
authors.lastname: Brãna
authors.forename: Fernando L C C
authors.initials: FL
authors.lastname: Branco
authors.forename: Rhanderson G
authors.initials: RG
authors.lastname: Campos
authors.forename: Andréia S
authors.initials: AS
authors.lastname: Guimarães
authors.forename: Thiago S
authors.initials: TS
authors.lastname: Araújo
authors.forename: Cristieli S M
authors.initials: CS
authors.lastname: Oliveira
authors.forename: Cláudia T
authors.initials: CT
authors.lastname: Codeço
authors.forename: Pascoal T
authors.initials: PT
authors.lastname: Muniz
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre, Campus Universitário, BR 364, Km 04, Bairro Distrito Industrial, Rio Branco, AC, Brazil. msnunes1@yahoo.com.br.
authors.forename: Mônica
authors.initials: M
authors.lastname: da Silva-Nunes
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004779:Environment Design / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D009752:Nutritional Status; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors