Secondary malnutrition and overweight in a pediatric referral hospital: associated factors

J Pediatr Gastroenterol Nutr. 2009 Feb;48(2):226-32. doi: 10.1097/MPG.0b013e31818de182.

Abstract

Objectives: To establish the prevalence and identify the clinical and sociodemographic factors associated with malnutrition and overweight in a pediatric referral hospital.

Patients and methods: We studied a cross-sectional, random sample from a pediatric hospital. Malnutrition was defined as acute when the z score of weight/height was less than -2.0 and as chronic if in addition the height/age z score was less than -2.0. Overweight risk was defined as a body mass index percentile between 85 and 94, and overweight as a body mass index percentile of 95 or higher.

Results: The study included 641 patients, with mean age 7.1 +/- 4.9 years (56% male). The overall prevalence of acute malnutrition was 8% and chronic malnutrition 17.0%. Overweight risk was present in 15.4% and overweight in 12.2%. Acute malnutrition was predicted by conditions on admission (hospitalization: odds ratio [OR] 2.3, confidence interval [CI] 1.3-4.3; nonsurgical subspecialty: OR 2.1, CI 1.0-4.3) and number of siblings (1 child, single mother: OR 2.6, CI 1.3-5.0). Chronic malnutrition was predicted by age (infants vs preschoolers: OR 2.0, CI 1.1-3.6; infants vs school children: OR 3.1, CI 1.8-5.5) and illness duration (>30 days: OR 2, CI 1.1-3.7). Overweight risk was associated with age (>36 months: OR 2.0, CI 1.6-3.4) and the father's educational level (college and university: OR 2.3, CI 1.3-4.3). Overweight was predicted by sex (boys: OR 2.0, CI 1.0-3.6) and age (>36 months: OR 1.7, CI 1.0-2.8).

Conclusions: Overweight was as prevalent as malnutrition. Malnutrition was associated with clinical condition, age, family size, and illness duration, whereas overweight was related to age, sex, and father's education. Overweight appears as a novel finding in the nutritional profile of pediatric referral hospitals in Mexico.

MeSH terms

  • Acute Disease / epidemiology
  • Adolescent
  • Age Factors
  • Body Mass Index*
  • Child
  • Child Nutrition Disorders / epidemiology*
  • Child, Preschool
  • Chronic Disease / epidemiology
  • Cross-Sectional Studies
  • Educational Status
  • Family Characteristics*
  • Female
  • Humans
  • Infant
  • Male
  • Mexico / epidemiology
  • Overweight / epidemiology*
  • Prevalence
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Time Factors