title: Understanding the double burden of malnutrition in food insecure households in Brazil.
abstract: Household food insecurity (HFI) has been associated with both obesity among mothers and undernutrition among children. However, this association has not been well investigated in mother/child pairs living in the same household. The objective of this study was to examine the relationship of coexistence of maternal overweight and child stunting with HFI in Brazil. We conducted secondary data analyses of the 2006 Brazilian National Demographic and Health Survey. We analyzed the nutritional status of 4299 pairs of 15-49-year-olds mothers and their children under 5 years of age. The double burden of malnutrition (DBM) was defined as the presence of an overweight mother and a stunted child in the same household. HFI was measured with the Brazilian HFI Measurement Scale. The association between DBM and HFI was examined with hierarchical multivariable logistic regression analyses. Severe HFI was associated with DBM after adjusting for macroeconomic and household level socio-economic and demographic variables (Adjusted OR: 2.65 - CI: 1.17-8.53). Findings suggest that policies and programmes targeting HFI are needed to prevent the coexistence of child chronic undernutrition and maternal overweight/obesity in the same household. These investments are likely to be highly cost-effective as stunting has been identified as one of the major risk factors for poor child development and adult overweight/obesity and a strong risk factor for the development of costly chronic diseases including type 2 diabetes and cardiovascular disease.
authors: Department of Nutrition, University of Brasilia, Brasília, Brazil.|Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA.
authors: Muriel Bauermann
authors: MB
authors: Gubert
authors: Department of Nutrition, University of Brasilia, Brasília, Brazil.
authors: Ana Maria
authors: AM
authors: Spaniol
authors: Department of Collective Health, University of Campinas, Campinas, Brazil.
authors: Ana Maria
authors: AM
authors: Segall-Corrêa
authors: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA.
authors: Rafael
authors: R
authors: Pérez-Escamilla
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D005523:Food Supply; D006130:Growth Disorders / Q000453:epidemiology; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013851:Thinness / Q000453:epidemiology; D055815:Young Adult
keywords: demographic health survey; dual-burden; food insecurity; malnutrition; overweight; stunting