The Prevalence and Correlates of Vitamin D Deficiency and Overweight/Obesity of School-Age Children in Colombia–Findings on the Double Burden of Malnutrition from Nationally-Representative Data

The double burden of malnutrition (DBM)—the coexistence of overweight/obesity and micronutrient deficiency—is an emerging public health concern among school-aged children. Using data from 6063 participants in Colombia’s 2015 National Survey of Nutritional Status (ENSIN), this study estimated DBM prevalence and identified factors associated with its occurrence among children aged 5–12 years. DBM was defined as concurrent overweight/obesity (BMI-for-age z-score > 1) and vitamin D deficiency, applying thresholds of <30, <37.5, and <50 nmol/L. The prevalence of DBM ranged from 0.7% to 6.9%. Firth’s penalized logistic regression models were conducted separately for (1) overweight/obese combined, (2) overweight-only, and (3) obesity-only groups. For DBM1, insufficient physical activity was linked to higher odds across all three models. For DBM2, smaller household size and higher maternal education were associated with greater odds in the combined model. Living in large urban areas was related to lower odds compared with major metropolitan areas, a pattern also observed in the overweight-only model. For DBM3, children from the second wealth quartile (Q2) showed higher odds than those from the poorest (Q1), with a similar pattern in the overweight-only analysis. Stricter DBM definitions tended to capture behavioral and household characteristics, whereas broader thresholds reflected structural and contextual conditions. Despite its relatively low prevalence, DBM remains a relevant public health issue among Colombian schoolchildren.