This cross-sectional study evaluated the prevalence and associated factors of the triple burden of malnutrition (TBM)-defined as the coexistence of child undernutrition (low growth indices), anemia in children, and maternal overweight/obesity-in 3,200 mother-child pairs in Ceará, Brazil, in 2023. Standardized anthropometric measurements and hemoglobin levels were obtained. The prevalence of TBM was 3.9% (95% CI: 3.2-4.6), with 14.6% (95% CI: 13.3-16.0) of children presenting any form of undernutrition, 36.6% (95% CI: 34.5-38.8) with anemia, and 65.5% (95% CI: 63.7-67.2) of mothers with overweight/obesity. Multivariable analyses demonstrated that age was a significant predictor: children under 6 months had an odds ratio (OR) of 3.8 (95% CI: 1.8-8.3, p = 0.001) and those aged 6 to 11 months had an OR of 5.1 (95% CI: 2.6-10.1, p < 0.001) compared to children aged 24 to 71 months. The lack of cow's milk consumption was associated with a 2.1-fold increased risk (adjusted OR = 2.1; 95% CI: 1.1-3.8, p = 0.017), while non-use of anti-helminthics raised the risk by 2.4 times (adjusted OR = 2.4; 95% CI: 1.5-3.7, p < 0.001). Environmental factors also played a key role: households with more than three children (adjusted OR = 2.2; 95% CI: 1.4-3.6, p = 0.002) and the absence of daycare attendance (adjusted OR = 3.2; 95% CI: 1.8-5.7, p < 0.001) were significantly associated with TBM. Maternal factors such as possessing a pregnancy card (adjusted OR = 3.2; 95% CI: 1.5-6.7, p = 0.002) and smoking (adjusted OR = 2.1; 95% CI: 1.1-4.0, p = 0.024) also increased the risk of TBM. These findings underscore the need for early nutritional interventions and integrated public policies addressing dietary habits, healthcare access, and living conditions in vulnerable populations.
Keywords: Child nutrition; Epidemiology.; Malnutrition; Maternal and child health; Triple burden of malnutrition.
© 2025. The Author(s).