Causas do declínio da desnutrição infantil no Brasil, 1996-2007

Abstract

OBJECTIVE:To describe the evolution of prevalence of under-nutrition among Brazilian underfi ves between 1996 and 2007, and to identify major factors responsible for this evolution. METHODS:Data analyzed are from two Demographic Health Surveys carried out in Brazil in 1996 and 2006/7 based on probabilistic samples of roughly 4 thousand children under fi ve years of age. Identifi cation of factors responsible for temporal variation in prevalence of under-nutrition (height-for-age below -2 Z-scores; WHO 2006 standard) took into account changes in the distribution of four potential determinants of nutritional status. Statistical modeling of the independent association between these determinants and risk of under-nutrition, and calculation of "partial attributable fractions" were used to determine the relative importance of each factor in the evolution of infant under-nutrition. RESULTS:Prevalence of under-nutrition fell by approximately 50%, from 13.5% (95%CI: 12.1%; 14.8%) in 1996 to 6.8% (5.4%; 8.3%) in 2006/7. Twothirds of this reduction could be attributed to favorable evolution in the four factors studied: 25.7% to increased maternal schooling; 21.7% to increased purchasing power of families; 11.6% to expansion of healthcare; and 4.3%to improvements in sanitation. CONCLUSIONS:The 6.3% annual rate of decline in the proportion of children with height-for-age defi cits indicates that, in another ten years, child malnutrition in Brazil may no longer be a public health issue. Achieving this will depend on the maintenance of economic and social policies that have favored an increase in purchasing power among the poor, and on public investments aimed at completing the universalization of access to essential services such as education, health, and sanitation among the Brazilian population.

Estado nutricional de menores de 5 anos de idade no Brasil: evidências da polarização epidemiológica nutricional

“…The effect of socioeconomic status on infant growth has been observed in different contexts in the Brazilian population and is already significantly represented in the literature, which confirms this relationship 11,[27][28][29][30] . Family income has a frequent significant inverse association with nutritional deficit situations.…”

“…Family income has a frequent significant inverse association with nutritional deficit situations. Using data from the National Demographic and Health Survey (Pesquisa Nacional de Demografia e Saúde -PNDS) from 1996 and 2006, Monteiro et al 28 identified improvements in household purchasing power as a determinant responsible for 21.7% of the total decline in the prevalence of malnutrition in children under 5 years of age observed in Brazil between 1996 and 2006.…”

Aleitamento materno por trinta ou mais dias é fator de proteção contra sobrepeso em pré-escolares da região semiárida de Alagoas

“…Finally, stunting correction. 2 In Brazil, stunting prevalence in children, even if reduced from 13.5%, in 1996, to 6.8% in 2006, 3 keeps representing a problem for public health. On the other hand, obesity prevalence has acquired epidemic proportions, having already exceeded the steeple occupied by malnutrition.…”

Avaliação do estado nutricional de crianças menores de 10 anos no município de Ferros, Minas Gerais

“…Se observó que el 20,7% de los niños presentaba alguna alteración nutricional (10,1% riesgo nutricional, 3,8% desnutrición y 6,7% sobrepeso). Fueron investigados factores de riesgo para el desarrollo de la desnutrición: bajo peso al nacer, RP = 3,57, IC 95% (1,96-6,52); baja estatura, RP = 19,36, IC 95% (11,53-32,52); ausencia de amamantamiento, RP = 2,39, IC 95% (1,16). Es destacable la prevalencia del sobrepeso respecto de la desnutrición.…”