Intergenerational burden of malnutrition in the Western Brazilian Amazon: trajectories until preschool age and alternative measurement approaches

Abstract

The double burden of malnutrition (DBM) is the coexistence of parameters related to undernutrition and overnutrition as observed at the population level; at the family level, in an intergenerational perspective in the mother-child pair; or at the individual level, mainly in low- and middle-income regions. The DBM during childhood may be connected to health problems in adulthood, but prospective analyzes considering empirically derived combinations of anthropometric and biochemical indicators of malnutrition are currently lacking in the literature. This project aims to investigate the intergenerational burden and individual trajectories of malnutrition in the period between the first two years and preschool age, in Cruzeiro do Sul, Acre. From July 2015 to June 2016, all admissions for delivery at the Juruá Women and Children's Hospital were screened. Participants were followed up at 1, 2, and 5-6 years of age, with data collection on sociodemographic, health history and lifestyle characteristics, anthropometric measurements, and biochemical analysis of anemia, iron deficiency, and vitamins A and D status. Anthropometric measurements of mothers and children will be categorized according to body mass index and standards of linear growth and weight gain for age. Latent class analysis will be conducted to identify similar patterns of intergenerational burden of malnutrition up to two years of age, according to anthropometric and biochemical variables. Determinants of each pattern of malnutrition will be explored. The impact of the patterns of intergerational burden of malnutrition on growth trajectories and cardiometabolic risk of children at 5-6 years of age will be investigated. We expected that findings from this project will support health strategies and interventions to tackle different forms of malnutrition during childhood.