Oliveira Assis Ana Marlúcia, Barreto Maurício Lima, Magalhães de Oliveira Lucivalda Pereira, de Oliveira Valterlinda Alves, da Silva Prado Matildes, da Silva Gomes Gecynalda Soares, Conceição Pinheiro Sandra Maria, Dos Santos Nedja Silva, Ribeiro da Silva Rita de Cássia, Ramos Sampaio Lilian, Pacheco Santos Leonor Maria
Escola de Nutrição, Universidade Federal da Bahia, Rua Araújo Pinho 32, Canela 40110-150, Salvador, Bahia, Brasil.
Public Health Nutr. 2008 Apr;11(4):387-94. doi: 10.1017/S1368980007000390. Epub 2007 Jul 6.
To investigate the determinants of mild-to-moderate malnutrition in preschoolers.
Cross-sectional study conducted in October and November 1996, with a representative sample of 1740 children less than 5 years old from the city of Salvador, situated in the Brazilian Northeastern region. Socio-economic and dietary data were collected through a structured questionnaire. Anthropometric measures were performed in duplicate and data analysis was based upon the hierarchical model approach. Logistic regression analysis was used to estimate the prevalence ratio and to identify the determinants of mild-to-moderate deficits in weight-for-age and height-for-age Z-scores.
Family monthly income under US$67.00 per capita and family headed by a woman were the main basic determinants of mild-to-moderate weight-for-age and height-for-age deficits in the studied children. Household agglomeration, an underlying determinant, was associated with weight-for-age and height-for-age deficits. Among the immediate determinants, age above 6 months and dietary caloric availability in the lowest tertile (<930 kcal day-1) were also associated with weight-for-age deficits. In addition to these, hospitalisation in the 12 months preceding the interview was shown to be a predictor of mild-to-moderate weight-for-age and height-for-age deficits.
Adverse social and economic factors interact with family environmental factors to define food consumption and morbidity patterns that culminate in a high prevalence of mild-to-moderate malnutrition. The strengthening and restructuring of nutrition and healthcare actions, the definition of public policies that improve family income, and the adequate insertion of women in the labour market are possible strategies to reduce mild-to-moderate malnutrition and to sustain the decline already observed in severe malnutrition.
调查学龄前儿童轻度至中度营养不良的决定因素。
1996年10月和11月进行的横断面研究，对来自巴西东北部地区萨尔瓦多市的1740名5岁以下儿童进行了代表性抽样。通过结构化问卷收集社会经济和饮食数据。人体测量指标进行了两次测量，数据分析基于分层模型方法。采用逻辑回归分析来估计患病率，并确定年龄别体重和年龄别身高Z评分轻度至中度不足的决定因素。
家庭人均月收入低于67.00美元以及由女性当家的家庭是研究儿童年龄别体重和年龄别身高轻度至中度不足的主要基本决定因素。家庭聚居这一潜在决定因素与年龄别体重和年龄别身高不足有关。在直接决定因素中，6个月以上的年龄以及饮食热量供应处于最低三分位数（<930千卡/天）也与年龄别体重不足有关。除此之外，访谈前12个月内的住院情况被证明是年龄别体重和年龄别身高轻度至中度不足的一个预测因素。
不利的社会和经济因素与家庭环境因素相互作用，决定了食物消费和发病模式，最终导致轻度至中度营养不良的高患病率。加强和调整营养与医疗保健行动、制定提高家庭收入的公共政策以及让妇女充分融入劳动力市场是减少轻度至中度营养不良并维持已观察到的重度营养不良下降趋势的可能策略。
