Racial and regional inequality in the temporal trend of stunting and excess weight in Brazilian children under five years of age

Objective: To analyze the occurrence of racial and regional inequality in the temporal trend of the prevalence of stunting and overweight in Brazilian children under five years of age over the years 2008–2018. Methods: An ecological time-series study with data from the Food and Nutrition Surveillance System on the prevalence of stunting and overweight in children under five years old according to race/skin color, region, and year. To assess differences between median prevalence per year of outcomes, the Kruskal-Wallis test was performed. Linear regression analyses were proposed to assess trends in the prevalence of outcomes over the years. Results: In Brazil, black children tended to be overweight (β=4.611; p=0.042). Among black children, there was an increase over the years in stunting in the Southeast (β=3.960; p=0.014) and a decrease in the South (β=-4.654; p=0.022). In Brazil and in most regions, the median prevalence of stunting was higher in black children than in white ones (12.86 vs. 11.54%, p<0.001). In the Southeast and South, black children also had the highest prevalence of overweight (15.48 and 15.99%, respectively). Conclusion: Children from less developed regions of Brazil and of black skin color/race were more vulnerable to a double burden of malnutrition.