Nutritional Stunting Across Socioeconomic Contexts: Uncovering the Nuances of the Nutrition Transition in Barra do Corda, State of Maranhão

Abstract

Introduction: Nutritional transition reflects shifts in population dietary patterns, typically marked by reduced protein-energy malnutrition alongside rising overweight and obesity. Objective: This study aimed to assess the nutritional status of children in Barra do Corda, Maranhão, Brazil. Methods: A cross-sectional study included 509 children from various income strata. Anthropometric indicators—stunting, underweight, wasting, overweight, and obesity—were measured. Associations with maternal education, school type, and participation in income transfer programs were analyzed. Results: Overall, 12% of children were stunted, 4.1% underweight, 1.8% wasted, 14.1% overweight, and 4.9% obese. Among stunted children, some also showed overweight or obesity, reflecting the double burden of malnutrition. Stunting was more prevalent among children of mothers with lower education (17.1% vs. 9.6%; PR=1.95; 95% CI=1.22–3.12; p=0.007) and tended to be lower among private school attendees. Overweight and obesity were significantly higher in children of more educated mothers and lower among Bolsa Família beneficiaries (12.8% vs. 21.8%; PR=0.58; 95% CI=0.28–0.96; p=0.050). Mean height-for-age, weight-for-age, and BMI-for-age z-scores were lower among children in income transfer programs and those with mothers of low schooling. Conclusion: In Barra do Corda, the nutritional transition coexists with persistent food insecurity among the poorest families, demonstrating socioeconomic disparities in child nutrition and emphasizing the need for targeted public health strategies.