Prevalence, temporal trend and associated factors with excess body weight in mothers of children under five years

NAKANO, Ricardo Paulino; CAMINHA, Tainá Cardoso da Silva; CARVALHO, Renata Elyonara de Sousa; XAVIER JÚNIOR, Antônio Fernando Silva; ASSUNÇÃO, Monica Lopes de; FERREIRA, Haroldo da Silva

doi:10.1590/1678-98652018000200003

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ORIGINAL ARTICLES • Rev Nutr 31 (2) • Mar-Apr 2018 • https://doi.org/10.1590/1678-98652018000200003 copy

Prevalence, temporal trend and associated factors with excess body weight in mothers of children under five years

Prevalência, tendência temporal e fatores associados ao excesso de peso em mães de crianças menores de cinco anos

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

This study aims to evaluate the prevalence, temporal trends and associated factors with excess weight in mothers of children under five years of age.

Methods

This is a time-series study using data from two household surveys conducted in 2005 and 2015. A total of 1,436 mothers were evaluated in 2005, and 690 were evaluated in 2015. The dependent variables were excess body weight (Body Mass Index [BMI] ≥25.0kg/m²), high percentage of Body Fat (%BF ≥33%) and abdominal obesity (waist circumference >80cm). The independent variables were the socioeconomic and demographic factors. The changes that occurred between the two surveys were expressed in percentages, and the measure of association was the Prevalence Ratio, calculated by Poisson regression, in both the crude and multivariate analyses.

Results

There were increases of 33.2%, 59.2% and 31.0%, respectively, for the prevalence of excess weight (PR=1.33, 95% Confidence Interval [CI]:1.21-1.46), abdominal obesity (PR=1.59, 95% CI:1.43-1.77) and high %BF (PR=1.31, 95% CI:1.07-1.60). The factors independently associated with excess weight and abdominal obesity were the highest age group (>30 years), menarche ≤12 years and higher parity (>2 children). The same was observed for high %BF, except for the loss of significance in the adjusted analysis for the variable menarche ≤12 years.

Conclusion

The prevalence of high body adiposity is a problem of relevant importance in the studied population and has presented an upward trend in the last 10 years. Women over 30 years and with more than two children should be given priority in prevention and control.

Keywords
Health surveys; Mothers; Nutritional transition; Obesity; Overweight

Variables	2005		2015
Variables	n	Median (P25; P75)	n	Median (P25; P75)	p
Age (years)	1,311	26.0 (22.0; 31.0)	661	28.0 (24.0; 33.0)	<0.001^* * Significant difference according to the Mann-Whitney test.
Weight (kg)	1,158	58.4 (51.5; 67.1)	653	64.3 (56.2; 74.0)	<0.001^* * Significant difference according to the Mann-Whitney test.
Height (cm)	1,153	155.5 (152.2;159.6)	653	158.0 (153.6; 161.5)	<0.001^* * Significant difference according to the Mann-Whitney test.
Body Mass Index (kg/m²)	1,150	24.1 (21.3; 27.4)	653	25.9 (22.7; 29.5)	<0.001^* * Significant difference according to the Mann-Whitney test.
Waist circumference (cm)	1,156	76.0 (70.0; 83.3)	651	81.0 (74.0; 89.6)	<0.001^* * Significant difference according to the Mann-Whitney test.
Body fat percentage^a a Estimated by bioelectrical impedance analysis.	499	27.0 (21.8; 32.4)	629	29.3 (23.9; 34.3)	<0.001^* * Significant difference according to the Mann-Whitney test.

Variables		2005 (n=1,436)	2015 (n=690)	p	Variation % [P2-P1/P1].100	PR (95% CI)
Variables		%	%	p	Variation % [P2-P1/P1].100	PR (95% CI)
Household location
	Urban	71.9	71.1	<0.697^* * Significant difference according to the chi-square test.	-1.1	0.99 (0.93-1.05)
	Rural	28.1	28.9		2.8	1.02 (0.89-1.19)
Per capital income (minimum wages)^a a Minimum wage values at the times of the studies: R$300,00 in 2005; R$724,00 in 2015; PR: Prevalence ratio; P1: Prevalence observed in the 2005 survey; P2: Prevalence observed in the 2015 survey.
	>1/2	16.4	24.2	<0.001^* * Significant difference according to the chi-square test.	47.6	1.48 (1.23-1.78)
	≤1/2	83.6	75.8		-9.3	0.91 (0.86-0.95)
Consumer goods (TV, automobile, washing machine and refrigerator)
	>2	13.8	35.9	<0.001^* * Significant difference according to the chi-square test.	160.1	2.60 (2.20-3.07)
	≤2	86.2	64.1		-25.6	0.74 (0.70-0.79)
Number of people in the household
	≤4	44.0	69.8	<0.001^* * Significant difference according to the chi-square test.	58.6	1.57 (1.47-1.71)
	>4	56.0	30.2		-46.1	0.54 (0.48-0.61)
Education level (years)
	≤8	75.8	53.0	<0.001^* * Significant difference according to the chi-square test.	-30.1	0.70 (0.65-0.76)
	>8	24.2	47.0		94.2	1.94 (1.71-2.20)
Member of the Family Grant Program
	Yes	19.3	61.0	<0.001^* * Significant difference according to the chi-square test.	216.1	3.16 (2.80-3.57)
	No	80.7	39.0		-51.7	0.48 (0.44-053)
BMI (kg/m²)
	≥25	42.8	57.0	<0.001^* * Significant difference according to the chi-square test.	33.2	1.33 (1.21-1.46)
	<25	57.2	43.0		-24.8	0.75 (0.68-0.83)
Waist circumference (cm)
	>80	33.6	53.5	<0.001^* * Significant difference according to the chi-square test.	59.2	1.59 (1.43-1.77)
	≤80	66.4	46.5		-30.0	0.70 (0.64-0.77)
Body fat percentage (%)
	≥33	22.9	30.0	<0.007^* * Significant difference according to the chi-square test.	31.0	1.31 (1.07-1.60)
	<33	77.1	70.0		-9.2	0.91 (0.85-0.97)
Age at menarche (years)
	<12	18.1	20.9	<0.155^* * Significant difference according to the chi-square test.	15.5	1.15 (0.95-1.40)
	≥12	81.9	79.1		-3.4	0.97 (0.92-1.01)
Number of children
	>2	31.1	37.1	<0.011^* * Significant difference according to the chi-square test.	19.3	1.19 (1.04-1.37)
	≤2	68.9	62.9		-8.7	0.91 (0.85-0.98)

Variables		Excess weight (%)		Variation %^a a [P2-P1/P1].100, where P1 is the prevalence in 2005 and P2 is the prevalence in 2015;	p^b b Chi-square test; (2005 vs. 2015)	PR (95% CI) (2005 vs. 2015)	PR (95% CI)^* * Prevalence ratio of excess weight according to the categories of the respective variables observed in the 2015 survey; 2015	Adjusted PR (95% CI)^ Adjustment performed for all independent variables that, in 2015, were associated with BMI ≥25kg/m2. After excluding the non-significant variables (backward elimination), only those with p<0.05 remained in the model.
Variables		2005	2015		p^b b Chi-square test; (2005 vs. 2015)	PR (95% CI) (2005 vs. 2015)
Household condition
	Urbana	44.5	56.2	26.3	<0.001	1.26 (1.13-1.41)	0.96 (0.83-1.11)	-
	Rural	38.9	58.6	50.6	<0.001	1.51(1.26-1.81)	1	-
Per capital income (minimum wages)^c c Minimum wage values at the time of the studies: R$300,00 in 2005; R$724,00 in 2015;
	>1/2	46.6	50.0	7.3	<0.547	1.07 (0.85-1.35)	0.83 (0.70-1.00)	-
	≤1/2	42.4	59.9	41.3	<0.001	1.41 (1.27-1.57)	1	-
Consumer goods^d d TV, automobile, washing machine and refrigerator;
	>2	51.7	57.7	11.6	<0.252	1.12 (0.92-1.35)	1.02 (0.88-1.17)	-
	≤2	41.5	56.8	36.9	<0.001	1.37 (1.22-1.53)	1	-
People in the household
	≤4	42.1	52.3	24.2	<0.001	1.24 (1.09-1.42)	0.78 (0.68-0.89)	-
	>4	43.7	67.2	54.8	<0.001	1.59 (1.36-1.77)	1	-
Education level^e e Years studied;
	≤8	42.7	59.8	40.0	<0.001	1.40 (1.25-1.57)	1.11 (0.97-1.26)	-
	>8	41.7	54.1	29.7	<0.003	1.30 (1.09-1.55)	1	-
Member of the PBF^f f PBF: Programa Bolsa Família (Family Grant Program);
	Yes	45.6	57.8	26.8	<0.003	1.27 (1.08-1.50)	1.04 (0.91-1.20)	-
	No	42.1	55.5	31.8	<0.001	1.32 (1.15-1.51)	1	-
Age
	>30	53.4	65.7	23.0	<0.004	1.23 (1.07-1.41)	1.26 (1.11-1.43)	1.24 (1.11-1.38)
	≤30	38.7	52.1	34.6	<0.001	1.35 (1.19-1.53)	1	1
Age at menarche^g g Age, in years, at menarche.
	<12	49.2	69.2	40.7	<0.001	1.40 (1.17-1.69)	1.29 (1.12-1.48)	1.26 (1.12-1.41)
	≥12	41.5	53.7	29.4	<0.001	1.29 (1.16-1.45)	1	1
Number of children
	>2	50.5	64.9	28.5	<0.001	1.28 (1.11-1.49)	1.24 (1.09-1.42)	1.20 (1.07-1.33)
	≤2	37.7	52.3	38.7	<0.001	1.39 (1.21-1.59)	1	1

Variables		Abdominal obesity (%)		Variation %^a a [P2-P1/P1].100, where P1 is the prevalence in 2005 and P2 is the prevalence in 2015;	p^b b Chi-square test; (2005 vs. 2015)	PR (95% CI) (2005 vs. 2015)	PR (95% CI)^* * Prevalence ratio of excess weight according to the categories of the respective variables observed in the 2015 survey; 2015	Adjusted PR (95% CI)^ Adjustment performed for all independent variables that, in 2015, were associated with WC >80 cm. After excluding the non-significant variables (backward elimination), only those with p<0.05 remained in the model.
Variables		2005	2015		p^b b Chi-square test; (2005 vs. 2015)	PR (95% CI) (2005 vs. 2015)
Household condition
	Urbana	35.6	51.5	44.7	<0.001	1.45 (1.27-1.65)	0.89 (0.76-1.03)	-
	Rural	29.2	58.1	99.0	<0.001	1.99 (1.62-2.44)	1	-
Per capital income (minimum wages)^c c Minimum wage values at the time of the studies: R$300,00 in 2005; R$724,00 in 2015;
	>1/2	40.7	43.3	6.4	0.643	1.06 (0.82-1.38)	0.76 (0.62-0.92)	-
	≤1/2	32.1	57.4	78.8	<0.001	1.78 (1.58-2.02)	1	-
Consumer goods^d d TV, automobile, washing machine and refrigerator;
	>2	39.0	52.1	33.6	0.013	1.34 (1.05-1.69)	0.96 (0.83-1.12)	-
	≤2	32.8	54.2	65.2	<0.001	1.65 (1.46-1.87)	1	-
People in the household
	≤4	31.9	49.0	53.6	<0.001	1.54 (1.31-1.80)	0.77 (0.67-0.89)	-
	>4	34.9	63.2	81.1	<0.001	1.81 (1.56-2.10)	1	-
Education level^e e Years studied;
	≤8	32.6	58.2	78.5	<0.001	1.80 (1.58-2.06)	1.20 (1.04-1.39)	-
	>8	36.4	48.4	33.0	0.004	1.33 (1.09-1.62)	1	-
Member of the PBF^f f PBF: Programa Bolsa Família (Family Grant Program);
	Yes	34.2	54.4	59.1	<0.001	1.59 (1.30-1.94)	1.05 (0.90-1.22)	-
	No	33.4	51.9	55.4	<0.001	1.55 (1.33-1.81)	1	-
	Age
	>30	46.8	63.5	35.7	<0.001	1.36 (1.17-1.58)	1.33 (1.15-1.53)	1.41 (1.24-1.59)
	≤30	28.3	47.9	69.3	<0.001	1.69 (1.46-1.96)	1	1
Age at menarche^e g Age, in years, at menarche.
	<12	38.6	62.3	61.4	<0.001	1.61 (1.29-2.02)	1.22 (1.04-1.44)	1.24 (1.09-1.42)
	≥12	32.1	50.9	58.6	<0.001	1.58 (1.39-1.80)	1	1
Number of children
	>2	42.1	61.5	46.1	0.001	1.46 (1.23-1.73)	1.27 (1.10-1.46)	1.22 (1.08-1.38)
	≤2	28.3	48.5	71.4	<0.001	1.71 (1.46-2.01)	1	1

Variables		High body fat (%)		Variation %^a a [P2-P1/P1].100, where P1 is the prevalence in 2005 and P2 is the prevalence in 2015;	p^b b Chi-square test; (2005 vs. 2015)	PR (95% CI) (2005 vs. 2015)	PR (95% CI)^* * Prevalence ratio of excess weight according to the categories of the respective variables observed in the 2015 survey; 2015	Adjusted PR (95% CI)^ Adjustment performed for all independent variables that, in 2015, were associated with %BF ≥33%. After excluding the non-significant variables (backward elimination), only those with p<0.05 remained in the model.
Variables		2005	2015		p^b b Chi-square test; (2005 vs. 2015)	PR (95% CI) (2005 vs. 2015)
Household location
	Urban	24.2	30.3	25.2	0.047	1.25 (1.00-1.57)	1.03 (0.78-1.34)	-
	Rural	21.5	29.6	37.7	0.157	1.37 (0.87-2.16)	1	-
Per capital income (minimum wages)^c c Minimum wage values at the time of the studies: R$300,00 in 2005; R$724,00 in 2015;
	>1/2	30.0	22.8	-24.0	0.232	0.76 (0.48-1.19)	0.71 (0.51-0.98)	-
	≤1/2	21.9	32.2	47.0	0.001	1.47 (1.17-1.85)	1	-
Consumer goods^d d TV, automobile, washing machine and refrigerator;
	>2	26.9	31.6	17.5	0.461	1.18 (0.76-1.82)	1.08 (0.85-1.38)	-
	≤2	22.3	29.2	30.9	0.023	1.31 (1.04-1.66)	1	-
People in the household
	≤4	22.5	27.4	21.8	0.168	1.21 (0.92-1.60)	0.76 (0.60-0.97)	-
	>4	23.3	36.1	54.9	0.003	1.55 (1.16-2.07)	1	-
Education level
	≤8	22.7	32.6	43.6	0.004	1.44 (1.12-1.84)	1.20 (0.94-1.53)	-
	>8	25.4	27.1	6.7	0.714	1.07 (0.75-1.52)	1	-
Member of the PBF^f f PBF: Programa Bolsa Família (Family Grant Program);
	Yes	27.4	31.2	13.9	0.443	1.14 (0.81-1.59)	1.11 (0.86-1.42)	-
	No	21.6	28.1	30.1	0.061	1.31 (0.99-1.73)	1	-
Age
	>30	40.9	45.7	11.7	0.380	1.12 (0.87-1.44)	2.12 (1.68-2.68)	2.12 (1.71-2.63)
	≤30	16.4	21.6	31.7	0.070	1.31 (0.98-1.76)	1	1
Age at menarche^g g Age, in years, at the menarche.
	<12	18.4	36.3	97.3	0.005	1.97 (1.20-3.26)	1.31 (1.00-1.72)	-
	≥12	24.1	27.7	14.9	0.236	1.15 (0.91-1.45)	1	-
Number of children
	>2	29.1	40.7	39.9	0.044	1.40 (0.99-1.96)	1.72 (1.36-2.18)	1.35 (1.10-1.67)
	≤2	17.6	23.7	34.7	0.055	1.34 (0.99-1.83)	1	1

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