Patterns and trends in underweight prevalence were very similar to those observed for stunting, with a reduction in overall levels and in inequalities related with skin colour and income (Table 4). The summary indices showed important reductions in inequality (Table 2). Overweight prevalence increased by 88% between 1982 and 2015, with a particularly fast upsurge after 2004 (Table 5). There was no statistical evidence of interactions between cohort year and either sex (P = 0.17) or skin colour (P = 0.10). In the pooled analyses, overweight was 1.2 (95% CI 1.1; 1.4) times more common among boys than girls, and the prevalence ratio for brown and black maternal skin colour relative to white was 0.9 (95% CI 0.8; 1.0) (Supplementary Table 1, available as Supplementary data at IJE online). Overweight was more prevalent among children from wealthy than from poor families in 1982 (prevalences of 9.5 in the richest quintile and 4.6 in the poorest quintile, Table 5), but the income gradient disappeared thereafter; there was no evidence of an interaction with cohort year (P = 0.43) (Supplementary Table 1, available as Supplementary data at IJE online). Over time, prevalence among the poorest showed a 2.7-fold increase, compared with a 1.3-fold increase in the richest quintile. The slope and concentration indices showed marked declines over time, confirming the reduction of inequalities (Table 2).
Prevalence of underweight (Z score <2 SD for weight-for-age) at age 12 months according sex, maternal skin colour and family income in the 1982, 1993, 2004 and 2015 cohorts
. | 1982 . | 1993 . | 2004 . | 2015 . | . | ||||
---|---|---|---|---|---|---|---|---|---|
. | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | Pa . |
Sex | P = 0.700b | P = 0.070b | P = 0.200b | P = 0.360b | |||||
Males | 4.1 | 2.7; 5.8 | 2.6 | 1.7; 4.0 | 2.5 | 1.9; 3.3 | 1.7 | 1.2; 2.4 | <0.001 |
Females | 3.6 | 2.4; 5.3 | 1.4 | 0.9; 2.4 | 1.9 | 1.3; 2.6 | 1.3 | 0.9; 2.0 | <0.001 |
Maternal skin colour | P <0.001b | P = 0.014b | P = 0.918b | ||||||
White | 2.9 | 2.0; 3.9 | 1.5 | 0.9; 2.3 | 1.8 | 1.4; 2.4 | 1.6 | 1.2; 2.1 | 0.001 |
Brown | 8.6c | 5.4; 12.7 | 2.0 | 0.7; 5.5 | 1.9 | 0.6; 4.3 | 1.6 | 0.7; 3.0 | <0.001 |
Black | 4.5 | 2.6; 7.8 | 3.8 | 2.5; 5.4 | 1.3 | 0.6; 2.6 | |||
Family income (quintiles)b | P <0.001b | P <0.001b | P <0.001b | P = 0.058b | |||||
Q1 (poorest) | 10.5 | 6.7; 15.3 | 5.3 | 3.2; 8.6 | 4.5 | 3.2; 6.2 | 2.7 | 1.7; 4.2 | <0.001 |
Q2 | 5.3 | 3.0; 8.4 | 1.8 | 0.8; 4.0 | 2.9 | 1.8; 4.3 | 1.3 | 0.6; 2.4 | <0.001 |
Q3 | 3.8 | 2.0; 6.5 | 1.3 | 0.7; 2.5 | 1.7 | 0.9; 2.9 | 1.2 | 0.5; 2.3 | 0.001 |
Q4 | 1.3 | 0.4; 3.0 | 1.0 | 0.4; 1.9 | 0.9 | 0.3; 1.8 | 1.2 | 0.6; 2.2 | 0.440 |
Q5 (richest) | 0.3 | 0.0; 1.8 | 0.0 | 0.0; 0.9 | 1.2 | 0.5; 2.2 | 1.2 | 0.5; 2.4 | 0.102 |
All children | 3.9 | 2.9; 5.0 | 2.1 | 1.5; 2.8 | 2.2 | 1.8; 2.7 | 1.5 | 3.3; 4.6 | <0.001 |
. | 1982 . | 1993 . | 2004 . | 2015 . | . | ||||
---|---|---|---|---|---|---|---|---|---|
. | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | Pa . |
Sex | P = 0.700b | P = 0.070b | P = 0.200b | P = 0.360b | |||||
Males | 4.1 | 2.7; 5.8 | 2.6 | 1.7; 4.0 | 2.5 | 1.9; 3.3 | 1.7 | 1.2; 2.4 | <0.001 |
Females | 3.6 | 2.4; 5.3 | 1.4 | 0.9; 2.4 | 1.9 | 1.3; 2.6 | 1.3 | 0.9; 2.0 | <0.001 |
Maternal skin colour | P <0.001b | P = 0.014b | P = 0.918b | ||||||
White | 2.9 | 2.0; 3.9 | 1.5 | 0.9; 2.3 | 1.8 | 1.4; 2.4 | 1.6 | 1.2; 2.1 | 0.001 |
Brown | 8.6c | 5.4; 12.7 | 2.0 | 0.7; 5.5 | 1.9 | 0.6; 4.3 | 1.6 | 0.7; 3.0 | <0.001 |
Black | 4.5 | 2.6; 7.8 | 3.8 | 2.5; 5.4 | 1.3 | 0.6; 2.6 | |||
Family income (quintiles)b | P <0.001b | P <0.001b | P <0.001b | P = 0.058b | |||||
Q1 (poorest) | 10.5 | 6.7; 15.3 | 5.3 | 3.2; 8.6 | 4.5 | 3.2; 6.2 | 2.7 | 1.7; 4.2 | <0.001 |
Q2 | 5.3 | 3.0; 8.4 | 1.8 | 0.8; 4.0 | 2.9 | 1.8; 4.3 | 1.3 | 0.6; 2.4 | <0.001 |
Q3 | 3.8 | 2.0; 6.5 | 1.3 | 0.7; 2.5 | 1.7 | 0.9; 2.9 | 1.2 | 0.5; 2.3 | 0.001 |
Q4 | 1.3 | 0.4; 3.0 | 1.0 | 0.4; 1.9 | 0.9 | 0.3; 1.8 | 1.2 | 0.6; 2.2 | 0.440 |
Q5 (richest) | 0.3 | 0.0; 1.8 | 0.0 | 0.0; 0.9 | 1.2 | 0.5; 2.2 | 1.2 | 0.5; 2.4 | 0.102 |
All children | 3.9 | 2.9; 5.0 | 2.1 | 1.5; 2.8 | 2.2 | 1.8; 2.7 | 1.5 | 3.3; 4.6 | <0.001 |
Prevalence of underweight (Z score <2 SD for weight-for-age) at age 12 months according sex, maternal skin colour and family income in the 1982, 1993, 2004 and 2015 cohorts
. | 1982 . | 1993 . | 2004 . | 2015 . | . | ||||
---|---|---|---|---|---|---|---|---|---|
. | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | Pa . |
Sex | P = 0.700b | P = 0.070b | P = 0.200b | P = 0.360b | |||||
Males | 4.1 | 2.7; 5.8 | 2.6 | 1.7; 4.0 | 2.5 | 1.9; 3.3 | 1.7 | 1.2; 2.4 | <0.001 |
Females | 3.6 | 2.4; 5.3 | 1.4 | 0.9; 2.4 | 1.9 | 1.3; 2.6 | 1.3 | 0.9; 2.0 | <0.001 |
Maternal skin colour | P <0.001b | P = 0.014b | P = 0.918b | ||||||
White | 2.9 | 2.0; 3.9 | 1.5 | 0.9; 2.3 | 1.8 | 1.4; 2.4 | 1.6 | 1.2; 2.1 | 0.001 |
Brown | 8.6c | 5.4; 12.7 | 2.0 | 0.7; 5.5 | 1.9 | 0.6; 4.3 | 1.6 | 0.7; 3.0 | <0.001 |
Black | 4.5 | 2.6; 7.8 | 3.8 | 2.5; 5.4 | 1.3 | 0.6; 2.6 | |||
Family income (quintiles)b | P <0.001b | P <0.001b | P <0.001b | P = 0.058b | |||||
Q1 (poorest) | 10.5 | 6.7; 15.3 | 5.3 | 3.2; 8.6 | 4.5 | 3.2; 6.2 | 2.7 | 1.7; 4.2 | <0.001 |
Q2 | 5.3 | 3.0; 8.4 | 1.8 | 0.8; 4.0 | 2.9 | 1.8; 4.3 | 1.3 | 0.6; 2.4 | <0.001 |
Q3 | 3.8 | 2.0; 6.5 | 1.3 | 0.7; 2.5 | 1.7 | 0.9; 2.9 | 1.2 | 0.5; 2.3 | 0.001 |
Q4 | 1.3 | 0.4; 3.0 | 1.0 | 0.4; 1.9 | 0.9 | 0.3; 1.8 | 1.2 | 0.6; 2.2 | 0.440 |
Q5 (richest) | 0.3 | 0.0; 1.8 | 0.0 | 0.0; 0.9 | 1.2 | 0.5; 2.2 | 1.2 | 0.5; 2.4 | 0.102 |
All children | 3.9 | 2.9; 5.0 | 2.1 | 1.5; 2.8 | 2.2 | 1.8; 2.7 | 1.5 | 3.3; 4.6 | <0.001 |
. | 1982 . | 1993 . | 2004 . | 2015 . | . | ||||
---|---|---|---|---|---|---|---|---|---|
. | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | Pa . |
Sex | P = 0.700b | P = 0.070b | P = 0.200b | P = 0.360b | |||||
Males | 4.1 | 2.7; 5.8 | 2.6 | 1.7; 4.0 | 2.5 | 1.9; 3.3 | 1.7 | 1.2; 2.4 | <0.001 |
Females | 3.6 | 2.4; 5.3 | 1.4 | 0.9; 2.4 | 1.9 | 1.3; 2.6 | 1.3 | 0.9; 2.0 | <0.001 |
Maternal skin colour | P <0.001b | P = 0.014b | P = 0.918b | ||||||
White | 2.9 | 2.0; 3.9 | 1.5 | 0.9; 2.3 | 1.8 | 1.4; 2.4 | 1.6 | 1.2; 2.1 | 0.001 |
Brown | 8.6c | 5.4; 12.7 | 2.0 | 0.7; 5.5 | 1.9 | 0.6; 4.3 | 1.6 | 0.7; 3.0 | <0.001 |
Black | 4.5 | 2.6; 7.8 | 3.8 | 2.5; 5.4 | 1.3 | 0.6; 2.6 | |||
Family income (quintiles)b | P <0.001b | P <0.001b | P <0.001b | P = 0.058b | |||||
Q1 (poorest) | 10.5 | 6.7; 15.3 | 5.3 | 3.2; 8.6 | 4.5 | 3.2; 6.2 | 2.7 | 1.7; 4.2 | <0.001 |
Q2 | 5.3 | 3.0; 8.4 | 1.8 | 0.8; 4.0 | 2.9 | 1.8; 4.3 | 1.3 | 0.6; 2.4 | <0.001 |
Q3 | 3.8 | 2.0; 6.5 | 1.3 | 0.7; 2.5 | 1.7 | 0.9; 2.9 | 1.2 | 0.5; 2.3 | 0.001 |
Q4 | 1.3 | 0.4; 3.0 | 1.0 | 0.4; 1.9 | 0.9 | 0.3; 1.8 | 1.2 | 0.6; 2.2 | 0.440 |
Q5 (richest) | 0.3 | 0.0; 1.8 | 0.0 | 0.0; 0.9 | 1.2 | 0.5; 2.2 | 1.2 | 0.5; 2.4 | 0.102 |
All children | 3.9 | 2.9; 5.0 | 2.1 | 1.5; 2.8 | 2.2 | 1.8; 2.7 | 1.5 | 3.3; 4.6 | <0.001 |
Prevalence of overweight (>2 Z scores of weight-for-length) at age 12 months according sex, maternal skin colour and family income in the 1982, 1993, 2004 and 2015 cohorts
. | 1982 . | 1993 . | 2004 . | 2015 . | . | ||||
---|---|---|---|---|---|---|---|---|---|
. | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | Pa . |
Sex | P = 0.005b | P = 0.100b | P = 0.400b | P = 0.016b | |||||
Males | 8.3 | 6.4; 10.6 | 10.7 | 8.5; 13.7 | 8.6 | 7.4; 12.0 | 13.5 | 12.0; 15.0 | <0.001 |
Females | 4.7 | 3.3; 6.5 | 8.1 | 6.0; 10.6 | 7.8 | 6.7; 9.1 | 10.9 | 9.5; 12.3 | <0.001 |
Maternal skin colour | P = 0.865b | P = 0.144b | P = 0.099b | P = 0.742b | |||||
White | 6.6 | 5.2; 8.1 | 10.0 | 8.2; 12.2 | 8.8 | 7.8; 9.9 | 12.0 | 10.8; 13.3 | <0.001 |
Brown | 6.3c | 3.6; 10.0 | 1.9 | 2.6; 13.1 | 5.9 | 3.4; 9.4 | 11.9 | 9.2; 15.0 | <0.001 |
Black | 8.7 | 5.4; 13.9 | 7.0 | 5.3; 9.1 | 13.1 | 10.5; 16.1 | |||
Family income (quintiles)b | P = 0.021b | P = 0.804b | P = 0.446b | P = 0.353b | |||||
Q1 (poorest) | 4.6 | 2.2; 8.2 | 9.2 | 5.9; 14.0 | 8.4 | 6.5; 10.6 | 12.4 | 10.1; 15.0 | <0.001 |
Q2 | 6.6 | 4.1; 10.0 | 8.0 | 5.3; 12.1 | 7.5 | 5.8; 9.6 | 10.8 | 8.7; 13.3 | 0.027 |
Q3 | 3.5 | 1.8; 6.1 | 8.9 | 5.6; 13.8 | 7.4 | 5.6; 9.5 | 13.9 | 11.5; 16.6 | <0.001 |
Q4 | 7.8 | 5.1; 11.4 | 11.6 | 7.8; 16.8 | 9.7 | 7.8; 12.0 | 12.5 | 10.3; 14.9 | 0.018 |
Q5 (richest) | 9.5 | 6.5; 13.4 | 9.4 | 6.1; 14.3 | 8.1 | 6.2; 10.3 | 12.2 | 9.8; 15.0 | 0.148 |
All children | 6.5 | 5.3; 7.9 | 9.4 | 7.8; 11.3 | 8.2 | 7.4; 9.2 | 12.2 | 11.2; 13.2 | <0.001 |
. | 1982 . | 1993 . | 2004 . | 2015 . | . | ||||
---|---|---|---|---|---|---|---|---|---|
. | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | Pa . |
Sex | P = 0.005b | P = 0.100b | P = 0.400b | P = 0.016b | |||||
Males | 8.3 | 6.4; 10.6 | 10.7 | 8.5; 13.7 | 8.6 | 7.4; 12.0 | 13.5 | 12.0; 15.0 | <0.001 |
Females | 4.7 | 3.3; 6.5 | 8.1 | 6.0; 10.6 | 7.8 | 6.7; 9.1 | 10.9 | 9.5; 12.3 | <0.001 |
Maternal skin colour | P = 0.865b | P = 0.144b | P = 0.099b | P = 0.742b | |||||
White | 6.6 | 5.2; 8.1 | 10.0 | 8.2; 12.2 | 8.8 | 7.8; 9.9 | 12.0 | 10.8; 13.3 | <0.001 |
Brown | 6.3c | 3.6; 10.0 | 1.9 | 2.6; 13.1 | 5.9 | 3.4; 9.4 | 11.9 | 9.2; 15.0 | <0.001 |
Black | 8.7 | 5.4; 13.9 | 7.0 | 5.3; 9.1 | 13.1 | 10.5; 16.1 | |||
Family income (quintiles)b | P = 0.021b | P = 0.804b | P = 0.446b | P = 0.353b | |||||
Q1 (poorest) | 4.6 | 2.2; 8.2 | 9.2 | 5.9; 14.0 | 8.4 | 6.5; 10.6 | 12.4 | 10.1; 15.0 | <0.001 |
Q2 | 6.6 | 4.1; 10.0 | 8.0 | 5.3; 12.1 | 7.5 | 5.8; 9.6 | 10.8 | 8.7; 13.3 | 0.027 |
Q3 | 3.5 | 1.8; 6.1 | 8.9 | 5.6; 13.8 | 7.4 | 5.6; 9.5 | 13.9 | 11.5; 16.6 | <0.001 |
Q4 | 7.8 | 5.1; 11.4 | 11.6 | 7.8; 16.8 | 9.7 | 7.8; 12.0 | 12.5 | 10.3; 14.9 | 0.018 |
Q5 (richest) | 9.5 | 6.5; 13.4 | 9.4 | 6.1; 14.3 | 8.1 | 6.2; 10.3 | 12.2 | 9.8; 15.0 | 0.148 |
All children | 6.5 | 5.3; 7.9 | 9.4 | 7.8; 11.3 | 8.2 | 7.4; 9.2 | 12.2 | 11.2; 13.2 | <0.001 |
Prevalence of overweight (>2 Z scores of weight-for-length) at age 12 months according sex, maternal skin colour and family income in the 1982, 1993, 2004 and 2015 cohorts
. | 1982 . | 1993 . | 2004 . | 2015 . | . | ||||
---|---|---|---|---|---|---|---|---|---|
. | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | Pa . |
Sex | P = 0.005b | P = 0.100b | P = 0.400b | P = 0.016b | |||||
Males | 8.3 | 6.4; 10.6 | 10.7 | 8.5; 13.7 | 8.6 | 7.4; 12.0 | 13.5 | 12.0; 15.0 | <0.001 |
Females | 4.7 | 3.3; 6.5 | 8.1 | 6.0; 10.6 | 7.8 | 6.7; 9.1 | 10.9 | 9.5; 12.3 | <0.001 |
Maternal skin colour | P = 0.865b | P = 0.144b | P = 0.099b | P = 0.742b | |||||
White | 6.6 | 5.2; 8.1 | 10.0 | 8.2; 12.2 | 8.8 | 7.8; 9.9 | 12.0 | 10.8; 13.3 | <0.001 |
Brown | 6.3c | 3.6; 10.0 | 1.9 | 2.6; 13.1 | 5.9 | 3.4; 9.4 | 11.9 | 9.2; 15.0 | <0.001 |
Black | 8.7 | 5.4; 13.9 | 7.0 | 5.3; 9.1 | 13.1 | 10.5; 16.1 | |||
Family income (quintiles)b | P = 0.021b | P = 0.804b | P = 0.446b | P = 0.353b | |||||
Q1 (poorest) | 4.6 | 2.2; 8.2 | 9.2 | 5.9; 14.0 | 8.4 | 6.5; 10.6 | 12.4 | 10.1; 15.0 | <0.001 |
Q2 | 6.6 | 4.1; 10.0 | 8.0 | 5.3; 12.1 | 7.5 | 5.8; 9.6 | 10.8 | 8.7; 13.3 | 0.027 |
Q3 | 3.5 | 1.8; 6.1 | 8.9 | 5.6; 13.8 | 7.4 | 5.6; 9.5 | 13.9 | 11.5; 16.6 | <0.001 |
Q4 | 7.8 | 5.1; 11.4 | 11.6 | 7.8; 16.8 | 9.7 | 7.8; 12.0 | 12.5 | 10.3; 14.9 | 0.018 |
Q5 (richest) | 9.5 | 6.5; 13.4 | 9.4 | 6.1; 14.3 | 8.1 | 6.2; 10.3 | 12.2 | 9.8; 15.0 | 0.148 |
All children | 6.5 | 5.3; 7.9 | 9.4 | 7.8; 11.3 | 8.2 | 7.4; 9.2 | 12.2 | 11.2; 13.2 | <0.001 |
. | 1982 . | 1993 . | 2004 . | 2015 . | . | ||||
---|---|---|---|---|---|---|---|---|---|
. | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | % . | 95% CI . | Pa . |
Sex | P = 0.005b | P = 0.100b | P = 0.400b | P = 0.016b | |||||
Males | 8.3 | 6.4; 10.6 | 10.7 | 8.5; 13.7 | 8.6 | 7.4; 12.0 | 13.5 | 12.0; 15.0 | <0.001 |
Females | 4.7 | 3.3; 6.5 | 8.1 | 6.0; 10.6 | 7.8 | 6.7; 9.1 | 10.9 | 9.5; 12.3 | <0.001 |
Maternal skin colour | P = 0.865b | P = 0.144b | P = 0.099b | P = 0.742b | |||||
White | 6.6 | 5.2; 8.1 | 10.0 | 8.2; 12.2 | 8.8 | 7.8; 9.9 | 12.0 | 10.8; 13.3 | <0.001 |
Brown | 6.3c | 3.6; 10.0 | 1.9 | 2.6; 13.1 | 5.9 | 3.4; 9.4 | 11.9 | 9.2; 15.0 | <0.001 |
Black | 8.7 | 5.4; 13.9 | 7.0 | 5.3; 9.1 | 13.1 | 10.5; 16.1 | |||
Family income (quintiles)b | P = 0.021b | P = 0.804b | P = 0.446b | P = 0.353b | |||||
Q1 (poorest) | 4.6 | 2.2; 8.2 | 9.2 | 5.9; 14.0 | 8.4 | 6.5; 10.6 | 12.4 | 10.1; 15.0 | <0.001 |
Q2 | 6.6 | 4.1; 10.0 | 8.0 | 5.3; 12.1 | 7.5 | 5.8; 9.6 | 10.8 | 8.7; 13.3 | 0.027 |
Q3 | 3.5 | 1.8; 6.1 | 8.9 | 5.6; 13.8 | 7.4 | 5.6; 9.5 | 13.9 | 11.5; 16.6 | <0.001 |
Q4 | 7.8 | 5.1; 11.4 | 11.6 | 7.8; 16.8 | 9.7 | 7.8; 12.0 | 12.5 | 10.3; 14.9 | 0.018 |
Q5 (richest) | 9.5 | 6.5; 13.4 | 9.4 | 6.1; 14.3 | 8.1 | 6.2; 10.3 | 12.2 | 9.8; 15.0 | 0.148 |
All children | 6.5 | 5.3; 7.9 | 9.4 | 7.8; 11.3 | 8.2 | 7.4; 9.2 | 12.2 | 11.2; 13.2 | <0.001 |
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