Nutritional extremes among school children in a rural Brazilian municipality.

INTRODUCTION Latin America is undergoing rapid demographic and nutritional transitions with the accompanying tendency to overweight as is common in countries emerging from poverty. In Brazil, changes due to the nutritional transition have affected the whole population, both urban and rural. Overweight in a large number of Brazilian children is one of the greatest public policy challenges. The objective of this 2009-2010 study was to estimate the prevalence of nutritional extremes among children from 7 to 10 years of age in a rural municipality on the state of Espírito Santo, Brazil. METHODS The sample consisted of 901 school children. Socio-demographic (sex, school location, age and skin color) and anthropometric (weight and height) data were collected, as well as information on eating habits (breakfast, number of meals and presence of a companion during meals). The nutritional status was classified according to BMI per age with the cut-off points: BMI for age < 3rd percentile = underweight and BMI per age > 97th percentile = obesity. RESULTS A prevalence of 3.4% underweight and 5% obesity was observed, the latter higher in urban areas (p<0.05). Living in an urban area and the habit of eating four or fewer meals/day were associated with obesity among children. Among urban located children 7.5% obesity was found, approximately twice that of rural children. CONCLUSION Underweight has been regressing, possibly due to improvements in access to health and better living conditions, even in rural areas. However obesity was associated with this in the urban location of the area studied. Children who studied and lived in rural areas showed a lower prevalence of obesity, possibly due to lower socioeconomic conditions and more intense physical activity in their daily activities. The habit of eating four or fewer meals was associated with obesity. This could be explained by the alteration it causes to biological mechanisms. The promotion of physical activity is proposed, mainly in urban areas, and nutritional education aimed at improve eating habits in both urban and rural areas.