Prevalence of the Double Burden of Malnutrition among Adolescents: Associations with Lifestyle Behaviors and Clusters of Social Determinants.

Autor:	Viana RS; Postgraduate Program in Public Health, Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.; YCARE Research Group (Youth/Child Cardiovascular Risk Environmental Research Group), Faculdade de Medicina, University of São Paulo, São Paulo 01246-903, Brazil., Nascimento-Ferreira MV; YCARE Research Group (Youth/Child Cardiovascular Risk Environmental Research Group), Faculdade de Medicina, University of São Paulo, São Paulo 01246-903, Brazil.; Research Group on Health, Physical Activity and Behavior (HEALTHY-BRA), Federal University of Tocantins, Miracema do Tocantins 77650-000, Brazil., Schaan BD; Faculty of Medicine, Postgraduate Program in Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil.; Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil.; Faculty of Medicine, Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035003, Brazil., Bloch KV; Institute of Studies in Public Health, Federal University of Rio de Janeiro, Rio de Janeiro 21941-592, Brazil., de Carvalho KMB; Postgraduate Program in Human Nutrition, University of Brasília, Brasília 70910-900, Brazil., Cureau FV; Faculty of Medicine, Postgraduate Program in Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil., De Moraes ACF; The University of Texas Health Science Center at Houston, School of Public Health in Austin, Department of Epidemiology, Michael & Susan Dell Center for Healthy Living, Texas Physical Activity Research Collaborative (Texas PARC) 1836 San Jacinto Blvd., Ste. 510, Austin, TX 78701, USA.
Jazyk:	angličtina
Zdroj:	Children (Basel, Switzerland) [Children (Basel)] 2024 May 22; Vol. 11 (6). Date of Electronic Publication: 2024 May 22.
DOI:	10.3390/children11060620
Abstrakt:	The double burden of malnutrition (DBM) is a condition in which malnutrition coexists with overweight, reflecting a new layer of malnutrition. Our objectives were to assess prevalence; test associations between DBM and 24-hour movement behaviors; and investigate whether DBM is associated with clusters of social determinants. Methods: This multicenter cross-sectional study included 1152 adolescents (12 to 17 years old) from four Brazilian cities. Body mass index (BMI, kg/m 2 ) was used to estimate overweight, and the adopted cutoff points took into account the curves established for age and sex: Z-score > 1 and ≤2 (overweight) and Z-score > 2 (obesity). The serum concentration of 25-hydroxyvitamin D [25(OH)D] was stratified into three levels: vitamin D deficiency ≤ 20 ng/mL; vitamin D insufficiency = 21-29 ng/mL; optimal vitamin D ≥ 30 ng/mL. We used multilevel Poisson regression models to estimate prevalence ratios (PRs) and their respective 95% confidence intervals (95%CI) and to analyze the association between DBM and covariates. A significance level of p < 0.05 was considered. Cluster analyses were performed by applying a combination of hierarchical and non-hierarchical methods. Results: A population prevalence of DBM of 7.3% (95% CI: 5.9-8.9) was revealed. A percentage of 19.2% (95% CI: 17.0-21.6) of adolescents were overweight, and 8.3% (95% CI: 6.8-10.1) were obese. A total of 41.5% (95% CI: 38.7-44.4) had vitamin D deficiency, and 25.8% (95% CI: 23.4-28.4) had vitamin D insufficiency. However, 24-hour movement behaviors were not associated with DBM. Adolescents living in the southern region of the country, from public schools whose mothers have higher education, have a 1.94 [PR = 2.94 (95% CI: 1.20-7.23)] times greater chance of developing DBM. These results highlight the importance of specific factors to improve the nutritional health of adolescents, considering the specific social determinants identified in this study. Competing Interests: The authors declare no conflicts of interest.
Databáze:	MEDLINE
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