Fatores determinantes do estado nutricional infantil nos primeiros anos de vida: um estudo transversal de base comunitária

Abstract

Early childhood is a critical period for growth and development, during which diet and the family environment play a central role in shaping eating habits and determining nutritional status. Socioeconomic factors, caregiving practices, maternal behaviors, and household characteristics directly influence child health, making it essential to understand the determinants associated with child nutritional status to support health promotion actions in Primary Health Care. This study aimed to analyze the association between household, maternal, and childrelated determinants and child nutritional status. This cross-sectional study is part of the project “Child Health Handbook: implications for Food and Nutrition Security in Early Childhood” and was conducted with mother–child pairs living in Lavras, Minas Gerais, Brazil. Data were collected in health units and households using a semi-structured questionnaire containing socioeconomic, anthropometric, health, and dietary intake information. Child nutritional status was assessed using height-for-age (H/A) and body mass index-for-age (BMI/A), calculated with WHO Anthro software and classified according to Z-score cutoffs. Maternal nutritional status was assessed using body mass index (BMI), classified by the presence of excess weight. Dietary intake was evaluated using the Food Consumption Markers of the Brazilian Food and Nutrition Surveillance System. Statistical analyses included descriptive statistics, chi-square or Fisher’s exact tests, odds ratios with 95% confidence intervals, and multiple binary logistic regression for variables with p ≤ 0.20, retaining those with p ≤ 0.05 in the final model; decision tree analysis was also applied. A total of 287 mother–child pairs were evaluated, with a prevalence of inadequate height of 8.4% and child overweight of 23%. Factors associated with nutritional outcomes included child age, maternal age, maternal smoking, daycare attendance, and routine medical consultations. Biological, socioeconomic, behavioral, and healthcare-related factors significantly influenced child nutritional status, highlighting the need for intersectoral actions and health promotion strategies that strengthen the family environment and access to healthy eating practices.