Factors associated with stunting and overweight in Amazonian children: a population-based, cross-sectional study

Objective To examine the prevalence of stunting and overweight in children and identify demographic, socio-economic and maternal characteristics, as well as biochemical indicators, associated with these outcomes. Design A population-based, cross-sectional study was performed. Data from structured questionnaires, anthropometric measurements, and blood and stool samples were used in Poisson regression models to estimate prevalence ratios (PR) according to a hierarchical conceptual framework. Setting Acrelandia, western Brazilian Amazon. Subjects Children (n 1139) aged <10 years. Results Prevalence of stunting was 71 % (95 % CI 51, 96 %) and 37 % (95 % CI 24, 57 %) among children aged <5 years and 5 years, respectively; overweight was detected in 206 % (95 % CI 174, 242 %) and 94 % (95 % CI 72, 121 %) of children aged <5 years and 5 years, respectively. Among children <5 years of age, stunting was positively associated with the lowest maternal height tertile (PR = 309, 95 % CI 126, 763), low birth weight (PR = 270, 95 % CI 141, 519), diarrhoea for 3d (PR = 221, 95 % CI 103, 477) and geohelminth infections (PR = 253, 95 % CI 102, 613). Overweight in children <5 years of age was positively associated with caesarean delivery (PR = 145, 95 % CI 102, 206), birth weight 3500 g (PR = 182, 95 % CI 130, 255) and Fe deficiency (PR = 164, 95 % CI 107, 253). Among children aged 5 years, land or livestock ownership (PR = 185, 95 % CI 107, 322), maternal overweight (PR = 206, 95 % CI 123, 347), high C-reactive protein concentration (PR = 243, 95 % CI 126, 470), vitamin A deficiency (PR = 197, 95 % CI 113, 341) and high serum TAG concentration (PR = 216, 95 % CI 127, 368) were associated with overweight. Conclusions Overweight was more prevalent than stunting, being associated with higher household wealth, maternal overweight, caesarean delivery, high birth weight, micronutrient deficiencies and high TAG concentration. Improvements in maternal and child health care with sustainable access to healthy food are necessary to reduce short- and long-term health complications related to overweight in this population.