Infant malnutrition and obesity in three population-based birth cohort studies in Southern Brazil: trends and differences

The aim of this study was to compare the evolution of nutritional deficits and overweight in one-year-old children from three birth cohorts started in 1982, 1993 and 2004 in Pelotas, Southern Brazil. Samples from the 1982 and 1993 cohorts and all children from 2004 were weighed and measured, and their mothers interviewed. Anthropometric deficits and overweight were assessed using both NCHS and WHO growth standards. A comparison of the existence of nutritional deficits showed that, after a decline between 1982 and 1993, its prevalence stabilized between 1993 and 2004. Across the whole period, a decrease in all deficits was observed. Obesity, on the other hand, increased. A deficit in the ratio of body length to age was found to be strongly associated with family income. The group with income below one minimum wage was the only to present a significant reduction of stunting during the study period. The most significant improvements in the reduction of nutritional deficits occurred in the first half of the study period, while social differentials remained. Fighting malnutrition is still necessary among the 40% of the population considered poor, and must be accompanied by efforts to combat overweight which is being observed in all social strata.     

Undernutrition in early life and body composition of adolescent males from a birth cohort study

The evidence for an association between poor nutrition in early life and subsequent obesity is inconclusive. In the present study, we investigated the associations between stunting, wasting and underweight at 2 and 4 years of age, and body composition in adolescence in male subjects studied since birth. The 1982 Pelotas Birth Cohort Study included all children born in maternity hospitals and living in the urban area of the city of Pelotas, Southern Brazil. All males born in 1982 were legally required to enlist in the army between January and April 2000. We were thus able to track 2250 subjects in 2000 (78.9% of the original cohort). Anthropometric measurements were collected in 1984 and 1986, and body composition was assessed in 2000. In the present analysis, we used as predictors the nutritional indices height-for-age, weight-for-height and weight-for-age presented in six categories. Outcomes included fat, lean and body mass indices and fat:lean mass ratio, derived from anthropometric and bioimpedance measurements. ANOVA and linear regression were used in the analyses to adjust for confounding. All predictors were positively associated with fat and body mass indices. Height-for-age Z score at age 2 or 4 years was not associated with lean mass index, but all other predictors were associated. Fat:lean mass ratio was associated only with weight-for-height Z score. Our results suggest that undernutrition is not a risk factor for overweight and obesity in our population and may partially protect against fatness in adolescence.     

Infant malnutrition and obesity in two population-based birth cohort studies in southern Brazil: trends and differences

Prevalence of anthropometric deficits and of obesity were studied in two population-based birth cohort studies in the city of Pelotas in Southern Brazil, in 1982 and 1993. All hospital delivered babies in each one-year period were identified, and samples of approximately 20% were visited at home at around 12 months of age, totalling 1,449 children submitted to anthropometric examination in 1982 and 1,359 in 1993. Losses and refusals accounted for 20% of the children in 1982 and 7% in 1993. In this 11-year period, prevalence of weight/age deficits (below -2 standard deviations of the NCHS reference) fell from 5.4% to 3.8%, while that of weight/height dropped from 1.3% to 0.8%. Height/age deficits increased slightly, from 5.3% to 6.1%, while the proportion of obese children increased from 4.0% to 6.7%. The increase in weight at 12 months was due to a more rapid weight gain in the first year, since birthweights remained unchanged. About 10% of the children from the lowest income group had weight/age or height/age deficits, compared to 3% or less of those with a high family income. On the other hand, obesity showed a direct association with income, except for the wealthiest group, where the prevalence dropped, possibly due to concern among these families about the consequences of infant obesity.     

The epidemiological transition in maternal and child health in a Brazilian city, 1982-93: a comparison of two population-based cohorts

Two studies carried out in 1982 and 1993 in the city of Pelotas, Southern Brazil, provide a unique opportunity for assessing the impact on maternal and child health of the economic and health care changes, which took place in Brazil in this period. The cohorts of mothers and infants of 1982 and 1993 were studied from the time of delivery. In both years, all mothers identified in the city's maternity hospitals answered a standardised questionnaire and their infants were examined. Over 99% of all children born in the city in each of the 2 years were included in the cohorts. Deaths occurring among these children were monitored prospectively, as well as all hospital admissions in the 1993 cohort. In the 1982 study, attempts were made to locate a 25% sample of the children at the mean age of 12 months using the addresses collected at the hospital (82% of the children were located), and all of the cohort children at the mean age of 20 months and 42 months, through a city census (87% were located in both follow-ups). In the 1993 study, 20% of all children plus all low birthweight infants were sought at 12 months of age, using the addresses collected at the hospital, and 95% were successfully traced. There was a 12% fall in the number of births occurring in 1993 (5,304 births), in comparison with 1982 (6,011 births), in spite of the increase in the population of reproductive age in the city during the decade. There was a marked difference in maternal height and weight at the beginning of pregnancy, with women giving birth in 1993 being, on average, 3.4 cm taller and 2.5 kg heavier than those who gave birth in 1982. The proportion of preterm babies (<37 weeks), measured by the date of last menstrual period, increased from 5.6% in 1982 to 7.5% in 1993. The median duration of breast feeding increased from 3.1 months in 1982 to 4.0 months in 1993. At 12 months of age, the prevalence of deficit of weight for age decreased from 5.4% in 1982 to 3.7% in 1993. The prevalence of deficit of height for age, however, increased from 5.3% to 6.1%. The perinatal mortality rate dropped 31%, from 32.2 per 1,000 births in 1982 to 22.1 deaths per 1,000 births in 1993. There was also a marked reduction in the infant mortality rate, from 36.4 per 1,000 livebirths in 1982 to 21.1 per 1,000 livebirths in 1993. The findings of the study indicate that there were improvements in the decade for most of the indicators evaluated, with the exception of birthweight and gestational age. It appears that improvements in perinatal and infant mortality rates are largely due to improvements in the health care sector.     

Developmental status at age 12 months according to birth weight and family income: a comparison of two Brazilian birth cohorts

Two cohorts of children born in the city of Pelotas, Southern Brazil, in 1993 and 2004, were compared in terms of neuro-psychomotor development at the age of 12 months. Children were evaluated using the Denver II screening test. Analyses were performed using the Poisson regression technique. The prevalence of suspected developmental delay fell from 37.1% in 1993 to 21.4% in 2004 and was inversely proportional to family income and birth weight. Among children born weighing under 2,000 g, there was a fourfold reduction in the prevalence of developmental delay between 1993 and 2004. With regard to family income, the poorest group showed the greatest reduction between the two cohorts--a 30% reduction in risk. Our results confirm the influence of income and birth weight on child development. The decrease in the prevalence of developmental delay in the last decade reflects, among other factors, improvements in neonatal care, increased coverage of developmental monitoring in the first year of life, and longer breastfeeding duration. Despite this reduction, the prevalence of developmental delay is still high, reinforcing the need for early diagnosis and intervention.     

Risk factors for overweight in children from Southern Brazil

Risk factors for overweight were investigated in a cross-sectional survey of children aged 12-59 months in the Southern Brazilian city of Porto Alegre (n = 2,660). Odds ratios (OR) for overweight, defined by weight/height > 2 z-scores of the NCHS standards, were estimated for socioeconomic and demographic conditions, social environment, and childhood health events. Prevalence of overweight was 6.5%. In the multivariate model, the odds of overweight were positively associated with maternal education (schooling > 12 years, OR = 2.36; 95%CI: 1.21-4.60; 9-11 years, OR = 2.07; 95%CI: 1.16-3.70) and family income per capita > 2 times the minimum wage (OR = 1.86; 95%CI: 1.13-3.08) and negatively associated with maternal work (OR = 0.72; 95%CI: 0.52-0.99). Odds were higher for children born large-for-gestational-age (OR = 2.29; 95%CI: 1.36-3.85) and lower for children born small (OR = 0.57; 95%CI: 0.33-0.99), as compared to those born with adequate birth weight for gestational age. Paternal schooling, parental occupation, and maternal age at the child's birth were associated with overweight in the unadjusted model only. Programs are needed to prevent overweight during childhood, with special attention to families and children at increased risk.     

Increase during the last 20 years of body mass of children 0 to 4 years of age born to Maghrebian immigrants

OBJECTIVE: The objective of this paper is to show the increase, in 20 years, of the prevalence of obesity of the children from Maghrebian origin, living in Parisian area, and their importance compared to non-immigrated children of the same age (birth to 4 years), according to the national French references. METHODS: The Body Mass Index (Weight/Height 2) was calculated at 0, 1, 2, 3, 4 years among 517 children born in the seventies (period A) and among 196 children born in the nineties (period B) in a longitudinal study. Obesity was defined in comparison with the 97th percentile of the French references; the children having BMI equal or superior to the 97th percentile of the French references were regarded as obese. RESULTS: The ratio of obese children was higher in the sample from Maghrebian origin compared to the French references, in period A and in period B. But the obese children were also more numerous among children born after 1990, compared to their frequency in the seventies. The prevalence of the obesity has increased from 8% to 13%, in 20 years, among the children aged from birth to 4 years. We can observe that the mean age of the adiposity rebound has decreased: 45.5% of the Maghrebian children born in the seventies had an adiposity rebound at 48 months or earlier, and 66% among Maghrebian children born in the nineties. CONCLUSION: The quantity and the kind of food provided to young children, from the age of the diversified feeding, involved in decreasing energy expenditure, can be responsible for overweight. This study shows that it is important to be vigilant with overweight children with precocious adiposity rebound, in order to avoid a durable obesity at adulthood and its consequences on health.     

Maternal-child health in Pelotas, Rio Grande do Sul State, Brazil: major conclusions from comparisons of the 1982, 1993, and 2004 birth cohorts

Important changes were observed in maternal characteristics, health care indicators, and child health during the 22 years covered by the three population-based birth cohort studies conducted in the city of Pelotas, Southern Brazil. Maternal education levels improved, cigarette smoking during pregnancy was reduced, and birth intervals became longer. Also, there were more single mothers, and maternal obesity increased. Coverage of antenatal and delivery care by professionals improved, but inductions and caesarean sections increased markedly, the latter accounting for 45% of deliveries in 2004. With regard to child health, the reductions in neonatal and infant mortality rates were modest, and the significant increase in preterm births--14.7% of all births in 2004--appears to have colluded with this stagnation. Other infant health indicators, such as immunization coverage and breastfeeding duration, showed improvements over the period. Regarding infant nutrition, malnourishment at age 12 months decreased, but the prevalence of overweight was higher in 2004. The existence of three population-based birth cohorts using comparable methodology allowed for the study of important secular trends in maternal and child health.     

Nutritional status and risk factors of overweight and obesity for children aged 9-15 years in Chengdu, Southwest China

ABSTRACT: BACKGROUND: Obesity is widespread in the world including developing countries. However malnutrition in poor areas is still a serious problem. Few investigations, especially in a large sample, have been performed in Western area of China. This study aimed to evaluate the nutritional status of school children aged 9-15 years in large Southwest city of China, and identify the differential impact of aberrant birth categories and family history of obesity related disease on childhood overweight and obesity development. METHODS: A multistage random cluster sampling was performed to evaluate the prevalence of thinness, overweight and obesity, which were defined by the new age-, sex-, specific BMI reference developed by World Health Organization (WHO) (2007). And then a frequency matched case-control study was performed to identify the risk factors of overweight and obesity. RESULTS: 7,194 children (3,494 boys, 3,700 girls) were recruited, and 1,282 (17.8%) had excess bodyweight (14.5% overweight, 3.3% obesity). The combined prevalence gradually decreased with age, and were more prevalent among boys than girls (P <0.05). Meanwhile 6.3% were found thinness and there were little differences in genders (P >0.05). Preterm large for gestational age (OR=2.746), maternal history of obesity related disease (OR=1.713), paternal history of obesity related disease (OR=1.583), preterm appropriate for gestational age (OR=1.564), full term small for gestational age (OR=1.454) and full term large for gestational age (OR=1.418) were recognized as significant risk factors in the multivariate regression analysis (P <0.05). CONCLUSIONS: While overweight and obesity was dramatically spreading, malnutrition still remained a serious problem. This unmatched nutritional status should be emphasized in backward cities of China. Children born of both preterm and LGA, whose parents particularly mothers had a history of obesity related disease, should be emphatically intervened as early as possible.     

Nutritional status of first to fourth-grade students of urban schools in Pelotas, Rio Grande do Sul State, Brazil

This cross-sectional study included 20,084 students from urban schools (first to fourth-grade) in Pelotas, Rio Grande do Sul State, Brazil. Weight and height were measured, and nutritional status was classified according to the World Health Organization (height deficit) and International Obesity Task Force (overweight and obesity) criteria. The study also recorded the variables age, gender, type of school, and schooling (grade-for-age adequacy). Prevalence of height-for-age deficit was 3.5% (3.9% in boys and 3.1% in girls). Prevalence rates for overweight and obesity were 29.8% and 9.1%, respectively. Overweight and obesity were more frequent in private schools, while height-for-age deficit was more frequent in municipal or State schools. For both boys and girls, age was positively associated with underweight and inversely related to overweight and obesity. Inadequate schooling was associated with increased risk of height deficit and decreased risk of overweight and obesity. In conclusion, primary students' nutritional status depends not only on demographic and socioeconomic factors, but also on type of school.     

Trends in socioeconomic inequalities in anthropometric status in a population undergoing the nutritional transition: data from 1982, 1993 and 2004 Pelotas Birth Cohort studies

ABSTRACT: BACKGROUND: Socioeconomic inequalities in child nutrition may change rapidly over time, particularly in populations undergoing the nutrition transition. Yet, the few available studies are repeated cross-sectional surveys. By studying three prospective birth cohorts in the same city over a period of more than two decades, we describe secular trends in overweight and stunting at different ages, according to socioeconomic position. METHODS: Population-based birth cohort studies were launched in the city of Pelotas (Brazil) in 1982, 1993 and 2004, with follow-up visits at twelve, 24 and 48 months. Children were weighed and measured at every visit. Z-scores of length/height-for-age and body mass index-for-age were calculated using the WHO Child Growth Standards. The slope and relative indices of inequality, based on family income quintiles, were estimated for each follow-up visit. RESULTS: Between the 1982 and 2004 cohorts, stunting among four-year-olds declined (from 10.9% to 3.6%), while overweight increased (from 7.6% to 12.3%). In every visit, stunting prevalence was inversely related to income. Both absolute and relative inequalities declined over time; among four-year-olds stunting dropped from 26.0% in the 1982 cohort to 6.7% in the 2004 cohort in the poorest group, while in the richest group stunting prevalence dropped from 2.7% in 1982 to 1.1% in the 2004 cohort study. The secular trend towards increased overweight was evident for four-year-olds, in almost all socioeconomic groups, but not among one and two-year-olds. Among four-year old children, overweight prevalence increased in all income quintiles, by 130% in the middle-income group, 64% in the poorest and 41% in the richest group. CONCLUSIONS: The decline in stunting is remarkable, but the increase in overweight among four-year olds - particularly among the poorest and the middle-income groups- requires concerted efforts to prevent the long term consequences of child overweight.     

闵行区0~2岁儿童贫血与营养状况分析

【目的】 了解闵行区0~2岁儿童贫血与营养状况。【方法】 整群抽取闵行区儿童保健系统中2008年出生,目前已满2周岁的儿童的体检资料进行回顾分析,共72 194人次。【结果】 闵行区0~2岁儿童贫血平均检出率为1.81%,以6月龄儿童的贫血率最高。0~2岁儿童各营养状况中贫血的检出率依次为肥胖＞超重＞营养不良＞正常,超重和肥胖较营养正常儿童患贫血的风险分别高3.14倍和3.27倍。超重检出率为10.23%,肥胖的检出率为0.84%。肥胖与超重比值平均为12.17。【结论】 闵行区贫血的发生已处于一个较低的水平,但超重、肥胖人群是贫血潜在风险人群,进一步预防控制肥胖和超重的发生将是闵行区贫血防治工作的重点内容之一。     

Facteurs associés à l’âge d’initiation de la diversification alimentaire chez des enfants âgés de 6 à 60 mois dans l’est algérien : corrélation à l’état nutritionnel

IntroductionThe practice of food diversification is linked to several factors. In Algeria, we have no study dealing with this problem. Our aim is to identify the factors associated with the age of initiation of food diversification and to establish possible correlations of this period with the nutritional status of children.MethodThis study involved 578 mother-child couples. A questionnaire allowed us to collect information on children and their parents. The data collected included socio-demographic characteristics, information on the age of diversification, the foods introduced and anthropometric parameters.ResultsDiversification before the age of 4 months was found in 13.76% of children, 67.47% had started diversification between 4 and 6 months and 18.86% were diversified at the age of 6 months. The type of breastfeeding, the birth order and the birth weight of children are factors statistically linked to the age of initiation of diversification. The prevalence of stunting is significantly higher in diverse children before 4 months and the prevalence of overweight including obesity is significantly higher in diverse children before 6 months. Diversification before the age of 6 months seems to be associated with malnutrition. In this study, 8.66% of the children were overweight and 9.17% were stunted.ConclusionFood diversification in Algeria is associated with several factors. Our results revealed that early food diversification (before 6 months) is associated to malnutrition.     

Breast feeding, pacifier use and infant development at 12 months of age: a birth cohort study in Brazil

Many studies suggest that breast feeding confers developmental and intellectual advantages on children. In a recent study, however, no association was found between breast feeding and intelligence in adult life after adjustment for other variables, and the use of pacifier in infancy was the most important predictor of intelligence. We analysed the associations between breast-feeding duration, pacifier use and suspected developmental delay at 12 months of age in a birth cohort in Pelotas, southern Brazil. All 5304 hospital births occurring during 1993 were studied and a sample was followed up at 1, 3, 6 and 12 months of age. Breast-feeding practices and use of pacifiers were assessed at each visit, as well as suspected developmental delay, measured by the Denver II test. The prevalence of developmental delay was analysed, through logistic regression, according to breast-feeding status and pacifier use, accounting for the possible confounding effect of other variables. The prevalence of suspected developmental delay at 12 months was 34.1%, being slightly higher among children who used pacifiers at 6 months than among non-users (35.3% and 28.7% respectively). There was a marked negative association between breast-feeding duration and developmental delay, with children breast fed for 9 months or more presenting significantly less suspected developmental delay (25.5%) than those breast fed for less than 1 month (42.4%). The effects of multiple variables were tested, and only high parity, smoking during pregnancy, birthweight, gestational age, pacifier use and breast-feeding duration remained significantly associated with suspected developmental delay. The effect of pacifier use, however, disappeared after adjusting for breast-feeding duration, suggesting that breast feeding, and not pacifiers, affects child development.     

Subclinical vitamin A deficiency in Israeli-Bedouin toddlers

OBJECTIVE: This study was designed to estimate the prevalence of and evaluate risk factors for subclinical vitamin A deficiency in Arab-Bedouin children at age 18 months, followed from birth. DESIGN: Community-based, prospective, cohort study conducted in Rahat, a large Arab-Bedouin township, located near the city of Beer Sheva in the Negev region of southern Israel. SUBJECTS: Healthy Bedouin infants (n=117) from the township, born at Soroka University Medical Center (SUMC) in Beer Sheva, were randomly recruited at birth. Enrollment was restricted to well infants born weighing >2500 g at birth. RESULTS: More than 15% of the children had serum retinol concentrations below 0.7 micromol/l. Male sex (odds ratio (OR) 4.17 [1.14-15.32], P=0.031), stunting at age 12 months (OR 10.09 [2.00-50.97], P=0.05) and warm season at age 18 months (OR 6.20 [1.36-28.28], P=0.018) were associated with vitamin A deficiency. Maternal education decreased the risk of vitamin A deficiency (OR 0.81 [0.68-0.95], P=0.011). CONCLUSIONS: Study results indicate a significant vitamin A deficiency problem among Bedouin children. Deficiency may be prevented by increasing dietary intake of vitamin A, especially during the warm season. Other interventions include preventing and controlling diarrheal diseases in order to avert nutritional stunting, and providing nutritional education to women of childbearing age. SPONSORSHIP: This study received financial support from the National Institute of Allergy and Infectious Diseases (AI-26497), the US-Israel Bi-national Science Foundation (BSF 90-00257), and the National Academy of Sciences/Institute of Medicine (AID/ANE 0158-G-SS-9035-00).     

Developmental status at 12 months of age in a cohort of children in southern Brazil: differences according birthweight and family income

This study evaluated all children born in 1993 in hospitals from Pelotas, Rio Grande do Sul, Brazil. Besides a perinatal study, a sample of 20% (1400 children) was followed through home visits during the first year. During these visits the nutritional status was assessed and a screening test for development (Denver II Test) was performed. Thirty-four per cent of the children assessed at 12 months failed this screening. Failure was associated with socioeconomic status, with low-income children presenting twice the risk of those from more affluent families (p<0,001). Failure in the screening test was also associated with birthweight, and children weighing less than 2,500 g showed three times the risk of those with a birthweight equal to or greater than 2,500 g (p<0,001). In addition, children weighing less than 2000 g at birth were at three times the risk of failing the test as compared to those weighing between 2000g and 2499g. Results suggest that birthweight and family income are strongly related to the potential risk of developmental delays at the age of 12 months. It also points to the need for systematic developmental screening and early intervention programs in children at risk.     

长沙市13～18岁青少年超重和肥胖流行现状

目的 了解长沙市12~18岁青少年的超重和肥胖的流行现状,认识青少年肥胖问题的严峻性,为制定控制肥胖的干预措施提供参考依据。方法 2009年9-12月期间采用整群抽样的方法随机抽取长沙市12所中学和12所高中,共纳入13～18岁中学生16 843名,并按照WHO的要求测量体重和身高。结果 本次研究的中学生共16 843名,超重人数1 703名,超重率为10.11%,肥胖人数838,肥胖率为4.98%,其中男女生超重率分别为952/8 149(11.68%)和751/8 694(8.64%),男女生肥胖率分别为578/8 149(7.09%)和260/8 694(2.99%)。不同性别儿童超重率和肥胖率差异均有统计学意义(χ²=42.89,149.73,P均<0.001)。随着年龄增长男生超重率呈现先增加后下降的趋势,肥胖率一直呈现增加的趋势。女生超重率随着年龄增长呈现增加趋势,肥胖率呈现先增加后降低的趋势。结论 长沙市13～18岁儿童青少年超重和肥胖率高,存在性别差异,应该动员家庭、幼儿园/学校、社区在内的所有相关群体采取综合干预措施,减少肥胖发生。     

1975-2005年昆明地区0~6岁儿童身体发育指数纵向研究

【目的】 对涵盖30年的昆明地区0~6岁儿童生长发育调查数据,从中研究分析他们生长的长期趋势,为建立昆明地区0~6岁儿童身体发育指数的指标体系奠定基础。 【方法】 对昆明地区参与卫生部领导下的全国九市自1975年起每隔10年一次至2005年共计四个调查年段,“0~6岁儿童体格发育调查研究”昆明地区调查数据(体重、身高、胸围的均值),进行儿童身体发育指数(维尔维克指数,身高胸围指数)的研究。 【结果】 维尔维克指数:均值没有随年龄的增长而加大,出生后由低向高至3月龄达高峰,以后随年龄的增长而均值在下降,0~6岁的转折点主要在生后3个月。学龄前一直处在出生后的下降阶段。昆明此指数约10~12月龄与出生时相同。身高胸围指数:出生后至1月龄升至高点,以后随年龄的增长而在减小,至学龄前无升高趋势。胸廓发育农村总体好于城区,只有一个年段,1995年是城区好于农村。30年的均值最高在1975年调查年段农男组,其值以后一直未被超越。但是2005年自3岁组,城市男女童该指数均值已表现出明显超越农村同龄儿童的趋势。 【结论】 30年来昆明地区0~6岁儿童的生长发育呈现波浪状生长的趋势。     

Breastfeeding and feeding patterns in three birth cohorts in Southern Brazil: trends and differentials

Breastfeeding is fundamental for child health. Changes in the duration of breastfeeding are compared for three population-based cohorts of children born in 1982, 1993 and 2004 in the city of Pelotas, Southern Brazil. Samples of the 1982 and 1993 children and all of the children from the 2004 cohort study were sought at home when they were aged around 12 months. Both the duration of breastfeeding and the stage at which different kind of foods were regularly introduced were investigated. The median duration of breastfeeding increased from 3.1 to 6.8 months in this period. Exclusive breastfeeding at three months was practically non-existent in 1982 and had reached one third of infants by 2004. The increase was faster after 1993, suggesting an important impact made by promotion activities. Up to about 6-9 months, breastfeeding was more prevalent in high-income families, but after this age it became more common among the poor. Low birth weight babies were breastfeed for shorter durations. The duration of breastfeeding is still far short of international recommendations, justifying further campaigns. Special attention should be given to low birth weight babies and those from low-income families.     

Socioeconomic and demographic indicators and nutritional status of children in a rural land settlement in Rio de Janeiro]

This study evaluated socioeconomic indicators and nutritional status in 201 children and adolescents in a rural land settlement in S?o José da Boa Morte, Rio de Janeiro. Nutritional deficit was defined as a value below -2 z score for the reference median from the National Center for Health Statistics (NCHS) for weight-for-age (W/A) and stature-for-age (S/A) for children under five years of age and weight-for-stature (W/S) and S/A for children from 5.0 to 9.9 years. For adolescents, the study used cut-off points at the 5th percentile (thin) and 85th percentile (overweight) from the distribution of body mass index (BMI) in the Brazilian population. According to the study, 53.8% of the households had 4 to 6 members, 34.5% had rudimentary cesspools, 31.2% had no running water, 11.0% had no bathroom, 58.2% burned or buried their garbage, and 13.6% of the mothers were illiterate. No case of nutritional deficit was found in the 0-4.9 year age bracket, and in the 5-9.9 year bracket there were one underweight and three overweight children. The authors concluded that the low prevalence of nutritional deficits in the study group, despite the exposure to risk factors, may be related to the presence of protective factors like access to health services, and that there was an important rate of overweight among adolescents (13.3%).