Factors associated with nutritional outcomes in the mother-child dyad: a population-based cross-sectional study.

OBJECTIVE
To estimate factors associated with double burden of nutritional outcomes in the mother-child dyad at the household level (child stunting and/or maternal overweight).

DESIGN
Cross-sectional study using the Brazilian Demographic and Health Survey. Nutritional outcomes were: mother with normal weight and child with normal height; overweight mother and child with normal height; mother with normal weight and short-stature child; and overweight mother and child with short stature (double burden). The child was classified as short when height-for-age Z-score was <-2 and the mother as overweight when BMI was ≥25·00 kg/m2. Socio-economic status, environment, social vulnerability, maternal characteristics and the child's food intake were the exposure factors. The hierarchical approach for multinomial logistic regression modelling was used to assess the associations.

SETTING
National Demographic and Health Survey of Children and Women conducted in Brazil, 2006-2007.

SUBJECTS
Mother-child dyads (n 3676).

RESULTS
After adjustments, lower maternal educational level (OR=3·53; 95 % CI 1·33, 9·33) and inadequate household (non-masonry house; OR=2·54; 95 % CI 1·39, 4·66) were associated with the double burden of malnutrition. Mother's short stature (OR=3·41; 95 % CI 1·76, 6·61), child's vegetable intake on less than or equal to 4 d/week (OR=2·21; 95 % CI 1·03, 4·75) and inadequate household (non-masonry house; OR=2·29; 95 % CI 1·36, 3·87) were associated with child's short stature. The lack of breast-feeding (OR=2·00; 95 % CI 1·07, 3·72) was associated with maternal overweight.

CONCLUSIONS
The present findings contribute to establishing strategies promoting health and healthy diets, by considering the growth deficit and overweight/obesity concomitantly.