Prevalence of malnutrition among children and women of reproductive age in Uruguay by socio-economic status and educational level.

OBJECTIVE

To describe the magnitude and distribution of malnutrition in all forms (stunting, wasting, overweight and obesity) by level of education and socio-economic status (SES).

DESIGN

Representative data from three national surveys were used: the socio-economic characteristics of Uruguayan households the 2012-2013; the Survey of Child Health, Nutrition and Development and the Survey of Chronic Disease Risks. We defined overweight, obesity, wasting/underweight and stunting/short stature according to WHO criteria. We conducted a comparison between malnutrition prevalence values per SES and education level.

SETTING

In total, 1 183 177 households were surveyed, including 2265 children's and 752 women's households, forming a nationally representative sample in urban areas with more than 5000 habitants.

PARTICIPANTS

A total of 3079 children aged <4 years from the National Survey of Child Health, Nutrition and Development 2013 and 752 women aged 20-49 years from the National Survey of Chronic Disease Risks 2013 were included.

RESULTS

Among children aged <4 years, stunting and overweight disproportionately affected low-wealth groups, with 5·45 % of children in the lower income tertile and 3·44 % in the upper tertile presenting stunting (P < 0·05). Overweight and obesity were higher in the third tertile of income. Among the women, 54·8 % (95 % CI 48·0, 61·6) had excess weight (overweight and obesity) and significant differences were found between those with the lowest and highest levels of SES. Regarding excess weight with respect to educational level, significant differences were also found between the low and high levels and between the medium and high levels.

CONCLUSIONS

In Uruguay, there are slight differences in the prevalence of all forms of malnutrition according to SES and education levels in the populations considered. Excess weight in children and women poses the greatest public health nutritional challenge at all levels of SES and education. The fact that more educated mothers are more overweight differs from the findings in other countries and should be studied in more detail. Stunting in children is also important, requiring more focused interventions. Notably, excess weight is higher in more educated mothers, a fact that differs from other countries. Further analysis is important to understand this discrepancy.