Factors Associated with Growth and Weight Status in Indigenous Children Under 5 Years of Age in Northeastern Brazil

Abstract Objective Indigenous children in Brazil experience persistent health and nutritional inequities, yet remain underrepresented in epidemiological research. This study investigated factors associated with the nutritional status of Indigenous children under 5 years in Northeastern Brazil. Methods A cross-sectional household survey collected demographic, socioeconomic, maternal, perinatal, and anthropometric data of 329 children across 13 Indigenous communities in Alagoas, Brazil. Height-for-age (HAZ) and body mass index-for-age (BAZ) z-scores were calculated using the World Health Organization growth standards. Multiple linear regression models were used to estimate coefficients (β) and confidence intervals (95%CI) of factors associated with HAZ and BAZ. Results Among 329 Indigenous children (52% boys, mean age [standard deviation, SD]: 2.4 [1.4] years), the mean HAZ was − 0.38 (SD: 1.09) and BAZ was 0.50 (SD: 1.10). Overall, 6.1% of children were stunted (HAZ <-2) and 9.5% were overweight (BAZ > + 2). HAZ was negatively associated with moderate or severe food insecurity (β: −0.37; 95%CI: −0.71, −0.03). Children living in masonry households (β: 0.71; 95%CI: 0.10, 1.32) and whose mothers were taller (β: 0.54; 95%CI: 0.24, 0.85) had higher HAZ. Regarding weight status, maternal underweight (β: −1.02; 95%CI: −2.00, −0.03) and cesarean section (β: 0.38; 95%CI: 0.14, 0.63) were significantly associated with BAZ. Conclusions for Practice Monitoring the nutritional status of Indigenous children is important in the first years of life. Strengthening traditional practices within Indigenous territories is essential for improved nutritional outcomes.