Overweight with concurrent stunting in very young children from rural Mexico: prevalence and associated factors

Objective: To document the prevalence of overweight or obesity concurrent with stunting in rural low-income Mexican children and to identify demographic and socio-economic characteristics that could help identify families at risk of having an overweight/obese and stunted young child in this population. Design: Cross-sectional analysis of the nutritional status of very young children, using primary data from a rural community-based survey conducted in 2003. Overweight, obesity and stunting were documented along with several maternal, household and community characteristics. Setting: Impoverished areas of rural Mexico. Subjects: Pre-school children (n = 7555), aged 24 - 72 months. Results: The combined prevalence of overweight and obesity was equal to or greater than 20% in all children, as was the prevalence of stunting. The prevalence of concurrent overweight or obesity and stunting was approximately 5% in nonindigenous children, and over 10% in indigenous children 24 - 60 months. A multinomial logistic analysis revealed that the factors associated with coexisting stunting and overweight/obesity were lower socio-economic status (SES), lower maternal age, education, intelligence (vocabulary) and perceived social status, shorter maternal height, and larger household size. Among only stunted children, the risk of also being overweight or obese was associated with younger maternal age (relative risk ratios (RRR): 0.98, P = 0.05), lower maternal perceived social status (RRR: 0.95, P < 0.01) and maternal obesity (RRR: 2.93, P < 0.0001) or overweight (RRR: 1.50, P = 0.002). Conclusions: These analyses highlight that concurrent overweight or obesity and stunting is an important public health issue in low-income areas of rural Mexico beginning in early childhood. Even within this impoverished population, children living in households with low relative SES are the most vulnerable.