Análise dos determinantes do estado nutricional, medido pelo índice de massa corporal, em mulheres de 15 à 49 anos em Moçambique

Abstract

The growing prevalence of nutritional imbalances, encompassing both underweight and overweight, is a major global public health concern. In the past 30 years, the coexistence of undernutri- tion (food deficiency) and overnutrition (overweight and obesity) has been observed across populations and even within the same families. This study analyzed the determinants of nu- tritional status, measured by the Body Mass Index (BMI), among Mozambican women aged 15–49, using nationally representative data from the 2022–23 Demographic and Health Survey (DHS). A multinomial logistic regression model with a multilevel structure was applied, incor- porating random effects at the community level to capture contextual variations in the risk of underweight, overweight, and obesity. The hypotheses tested the role of (i) socioeconomic and demographic, (ii) age and reproductive, and (iii) behavioral and lifestyle factors in explaining women’s nutritional status. The results confirmed a strong socioeconomic and age gradient: underweight was more prevalent among poor and rural women, while overweight and obesity were concentrated among older, married, multiparous women and those belonging to higher wealth quintiles. Breastfeeding showed a protective effect against obesity, whereas the use of modern contraceptives and frequent television exposure increased the risk of overweight and obesity. Regional disparities were also evident, with higher obesity observed in Inhambane and Maputo City and higher underweight prevalence in Sofala. These findings highlight the dou- ble burden of malnutrition in Mozambique and reinforce the need for integrated, multisectoral public policies to address both persistent undernutrition and the growing obesity epidemic.