Triple burden of malnutrition in children and mothers from Ceará, brazil: a cross sectional study

This cross-sectional study evaluated the prevalence and associated factors of the triple burden of malnutrition (TBM)-defined as the coexistence of child undernutrition (low growth indices), anemia in children, and maternal overweight/obesity-in 3,200 mother-child pairs in Ceará, Brazil, in 2023. Standardized anthropometric measurements and hemoglobin levels were obtained. The prevalence of TBM was 3.9% (95% CI: 3.2-4.6), with 14.6% (95% CI: 13.3-16.0) of children presenting any form of undernutrition, 36.6% (95% CI: 34.5-38.8) with anemia, and 65.5% (95% CI: 63.7-67.2) of mothers with overweight/obesity. Multivariable analyses demonstrated that age was a significant predictor: children under 6 months had an odds ratio (OR) of 3.8 (95% CI: 1.8-8.3, p = 0.001) and those aged 6 to 11 months had an OR of 5.1 (95% CI: 2.6-10.1, p < 0.001) compared to children aged 24 to 71 months. The lack of cow's milk consumption was associated with a 2.1-fold increased risk (adjusted OR = 2.1; 95% CI: 1.1-3.8, p = 0.017), while non-use of anti-helminthics raised the risk by 2.4 times (adjusted OR = 2.4; 95% CI: 1.5-3.7, p < 0.001). Environmental factors also played a key role: households with more than three children (adjusted OR = 2.2; 95% CI: 1.4-3.6, p = 0.002) and the absence of daycare attendance (adjusted OR = 3.2; 95% CI: 1.8-5.7, p < 0.001) were significantly associated with TBM. Maternal factors such as possessing a pregnancy card (adjusted OR = 3.2; 95% CI: 1.5-6.7, p = 0.002) and smoking (adjusted OR = 2.1; 95% CI: 1.1-4.0, p = 0.024) also increased the risk of TBM. These findings underscore the need for early nutritional interventions and integrated public policies addressing dietary habits, healthcare access, and living conditions in vulnerable populations.