Socioeconomic Patterning of Stunting and Overweight Among Iranian Children Aged 2-5 Years: A National Cross-Sectional Analysis

Abstract

Background/Objectives: Evidence indicates a high prevalence of stunting and overweight among Iranian children. This study explores their socioeconomic patterning and the mediating role of nutrition adequacy. Methods: The data were derived from the most recent 2017 Demography and Health Survey and the Multiple Indicator Cluster Survey, which were conducted in Iran. Children aged between 2 and 5 years were selected for the study through a two-stage random sampling process (n = 11,147). The probability of stunting and overweight was modeled using logistic regression. Parental education, occupation, and living conditions (areas, rooms, and assets of the household) were explanatory variables, with the diet diversity score (DDS) as a mediator. Analyses were adjusted for age and sex. Results: Children had over 1.7 times higher odds of stunting with a primary-educated father [95% CI: 1.13-2.62] and twice the odds with an illiterate mother [95% CI: 1.30-3.30]. The risk of stunting was almost 1.5 higher in children living in smaller houses [95% CI: 1.12-2.04]. Finally, a significant association was observed between low asset ownership and stunting [OR = 2.01; 95% CI: 1.23-3.27]. The results showed no significant relationship between socioeconomic factors and children's overweight, indicating that overweight was less socially patterned. Higher DDS was associated with lower stunting and higher overweight prevalence but did not mediate the effects of socioeconomic status. Conclusions: Stunting disproportionately affects children from households with a lower socioeconomic background in Iran. Parental education, area, and assets were key factors, highlighting the need for targeted nutrition education programs.