1
|
Tilahun WM, Simegn MB, Geremew H, Gebreegziabher ZA, Abay LY, Tesfie TK. Spatial variation of zero fruits/vegetables consumption and associated factors among children aged 6-23 months in Ethiopia: geographical weighted regression analysis. Front Nutr 2024; 11:1374845. [PMID: 38818130 PMCID: PMC11137304 DOI: 10.3389/fnut.2024.1374845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/03/2024] [Indexed: 06/01/2024] Open
Abstract
Background After 6 months, nutrient-dense, varied diets containing fruits and vegetables are crucial to supplement breastfeeding. Like many other low-income countries, Ethiopia has very low FV consumption. Zero vegetable or fruit (ZVF) consumption has been shown to significantly raise the risk of non-communicable diseases and has been ranked among the top 10 risk factors for mortality. And it is associated with poor health, an increased risk of obesity, and a higher risk of non-communicable diseases. Thus, this study's goal was to investigate the spatial distribution of ZVF consumption and its spatial determinants among children aged 6-23 months in Ethiopia. Methods A cross-sectional study design was employed. A total of 1,489 weighted samples were included from kids' datasets from the 2019 Ethiopian mini-demographic and health survey. STATA version 16, ArcGIS version 10.8, Kuldorff's SaTScan version 9.6, and MGWR version 2.0 software were used for analysis. Spatial regression analyses (geographical weighted regression and ordinary least squares analysis) were conducted. Models were compared using AICc and adjusted R2. A p-value of less than 0.05 was used to declare statistically significant spatial predictors, and the corresponding local coefficients were mapped. Results The spatial distribution of ZVF consumption among children aged 6-23 months was non-random in Ethiopia. Spatial scan analysis revealed a total of 120 significant clusters. Maternal education, wealth status, age of the child, place of delivery, number of under-five children in the house, and current pregnancy status were significant predictors of the spatial variation of ZVF consumption. Conclusion Significant geographic variation in ZVF consumption was found in this study throughout Ethiopia's regions. Significant predictors of the spatial variation in ZVF consumption were maternal education, wealth status, child age, place of delivery, number of under-five children in the home, and status as a pregnant woman at the time of birth. Therefore, in order to improve children's adequate consumption of fruit and vegetables, area-based interventions that can consider these significant factors into account are needed.
Collapse
Affiliation(s)
- Werkneh Melkie Tilahun
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mulat Belay Simegn
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Habtamu Geremew
- College of Health Science, Oda Bultum University, Chiro, Ethiopia
| | - Zenebe Abebe Gebreegziabher
- Department of Epidemiology and Biostatistics, School of Public Health, Debre Birhan University, Debre Birhan, Ethiopia
| | - Lamrot Yohannes Abay
- Department of Environmental and Occupational Health and Safety, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Tigabu Kidie Tesfie
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
2
|
Kamudoni P, Kiige L, Ortenzi F, Beal T, Nordhagen S, Kirogo V, Arimi C, Zvandaziva C, Garg A, Codjia P, Rudert C. Identifying and understanding barriers to optimal complementary feeding in Kenya. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 3:e13617. [PMID: 38180165 PMCID: PMC10782142 DOI: 10.1111/mcn.13617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 01/06/2024]
Abstract
Optimal complementary feeding between the ages of 6 and 23 months provides children with the required range of nutritious and safe foods while continuing to be breastfed to meet their needs for essential nutrients and develop their full physical and cognitive potential. The rates of exclusive breastfeeding in the first 6 months of life have increased from 32% in 2008 to 60% in 2022 in Kenya. However, the proportion of children between 6 and 23 months receiving a minimum acceptable diet remains low and has declined from 39% in 2008 to 31% in 2023. The Kenyan Ministry of Health, GAIN and UNICEF collaborated to understand the drivers of complementary feeding practices, particularly proximal determinants, which can be directly addressed and acted upon. A secondary analysis of household surveys and food composition data was conducted to outline children's dietary patterns within the different regions of Kenya and the extent to which the affordability of animal-source foods could be improved. Ethnographic data were analyzed to identify socio-cultural barriers to optimal complementary feeding. Furthermore, we outlined the critical steps for developing user-friendly and low-cost complementary feeding recipes. The results of all the analyses are presented in five of the six papers of this Special Issue with this additional paper introducing the Kenyan context and some of the critical findings. The Special Issue has highlighted multidimensional barriers surrounding the use and availability of animal-source foods. Furthermore, it emphasizes the need for a multi-sectoral approach in enacting policies and programmes that address these barriers.
Collapse
Affiliation(s)
| | | | | | - Ty Beal
- Global Alliance for Improved Nutrition (GAIN)WashingtonDCUSA
| | | | | | | | | | | | | | | |
Collapse
|
3
|
Gontijo de Castro T, Lovell A, Santos LP, Jones B, Wall C. Maternal determinants of dietary patterns in infancy and early childhood in the Growing up in New Zealand cohort. Sci Rep 2023; 13:22754. [PMID: 38123672 PMCID: PMC10733397 DOI: 10.1038/s41598-023-49986-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Given the importance of diet in early life, assessing children's diet is crucial to guide interventions. Using data from a nationally generalizable New Zealand (NZ) birth cohort we examined children's dietary patterns at 9- (n = 6259), 24- (n = 6292), and 54-months (n = 6131), and their association with maternal sociodemographic and health behaviours. At each time-point, children's dietary patterns were identified using principal components analysis. We then used multivariate linear regression to examine associations between each pattern and maternal variables. At 9-, 24- and 54-months, two dietary patterns were identified, explaining 36.4%, 35.3% and 33.6% of children's intake variability, respectively. Refined high in sugar, salt and fat dietary pattern, at all time-points, was characterized by high positive loadings in white/refined breads and cereals, and items with high sugar, sodium, and fat content. At 24-months, Refined high in sugar, salt and fat also included a high positive loading with protein food groups. Fruit and vegetables dietary pattern, at all time-points, had high positive loadings for fruits and vegetables (with type varying across time-points). Fruit and vegetables also included high loading in whole grain options of breads and cereals at 24-months and the protein food group was part of this dietary pattern at 9- and 54-months. Children's scores on the Refined high in sugar, salt and fat pattern had strong associations with maternal smoking habits, education level, ethnicity, and maternal scores in the "Junk" and "Traditional/White bread" dietary patterns (constructed from an antenatal interview). Children's scores on the Fruit and vegetables pattern had strong associations with the maternal scores in the dietary pattern "Health Conscious". Interventions to improve diet in early life in NZ need to be responsive to ethnicity and suitable for people of all education levels. Interventions that improve maternal health behaviours may also improve children's diet.
Collapse
Affiliation(s)
- Teresa Gontijo de Castro
- Department of Nutrition and Dietetics, Faculty of Health and Medical Sciences, University of Auckland, Grafton Road - Bldg 219, Level B, Room B01, Auckland, 1010, New Zealand.
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand.
| | - Amy Lovell
- Department of Nutrition and Dietetics, Faculty of Health and Medical Sciences, University of Auckland, Grafton Road - Bldg 219, Level B, Room B01, Auckland, 1010, New Zealand
| | | | - Beatrix Jones
- Department of Statistics, Faculty of Sciences, University of Auckland, Auckland, New Zealand
| | - Clare Wall
- Department of Nutrition and Dietetics, Faculty of Health and Medical Sciences, University of Auckland, Grafton Road - Bldg 219, Level B, Room B01, Auckland, 1010, New Zealand
| |
Collapse
|
4
|
N Naumova E. Forecasting Seasonal Acute Malnutrition: Setting the Framework. Food Nutr Bull 2023; 44:S83-S93. [PMID: 37850923 DOI: 10.1177/03795721231202238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
BACKGROUND Malnutrition is an umbrella term that refers to an impairment in nutrition indicative of subsequently compromised human well-being. The term covers the full spectrum of nutritional impairments from a small yet detectable departure from a "norm" to a terminal stage when severe malnutrition could result in death. This broad spectrum of nutritional departures from "the optimum" dictates the need for an ensemble of metrics to capture the complexity of involved mechanisms, risk factors, precipitating events, short-term, and long-term consequences. Ideally, these metrics should be universally applicable to vulnerable populations, settings, ages, and times when people are most susceptible to malnutrition. We should be able to characterize and intervene to minimize the risk of malnutrition, especially child acute malnutrition that could be assessed by anthropometric measurements. OBJECTIVES The main challenge in reaching such an ambitious goal is the complexity of measuring, characterizing, explaining, predicting, and preventing malnutrition at any dimension: temporal or spatial and at any scale: a person or a group. The expansive body of literature has been accumulated on many temporal aspects of malnutrition and seasonal changes in nutritional (anthropometric) status. The research community is now shifting their attention to predictive modeling of child malnutrition and its importance for clinical and public health interventions. This communication aims to provide an overview of challenges for understanding child malnutrition from a perspective of predictive modeling focusing on well-documented seasonal variations in nutritional outcomes and exploring "the systems approach" to tackle underlining conceptual and practical complexities to forecast seasonal malnutrition in an accurate and timely manner. This generalized approach to forecasting seasonal malnutrition is then applied specifically to child acute malnutrition.
Collapse
Affiliation(s)
- Elena N Naumova
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| |
Collapse
|
5
|
Wicaksono WA, Cernava T, Wassermann B, Abdelfattah A, Soto-Giron MJ, Toledo GV, Virtanen SM, Knip M, Hyöty H, Berg G. The edible plant microbiome: evidence for the occurrence of fruit and vegetable bacteria in the human gut. Gut Microbes 2023; 15:2258565. [PMID: 37741805 PMCID: PMC10519362 DOI: 10.1080/19490976.2023.2258565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/08/2023] [Indexed: 09/25/2023] Open
Abstract
Diversity of the gut microbiota is crucial for human health. However, whether fruit and vegetable associated bacteria contribute to overall gut bacterial diversity is still unknown. We reconstructed metagenome-assembled genomes from 156 fruit and vegetable metagenomes to investigate the prevalence of associated bacteria in 2,426 publicly available gut metagenomes. The microbiomes of fresh fruits and vegetables and the human gut are represented by members in common such as Enterobacterales, Burkholderiales, and Lactobacillales. Exposure to bacteria via fruit and vegetable consumption potentially has a beneficial impact on the functional diversity of gut microbiota particularly due to the presence of putative health-promoting genes for the production of vitamin and short-chain fatty acids. In the human gut, they were consistently present, although at a low abundance, approx. 2.2%. Host age, vegetable consumption frequency, and the diversity of plants consumed were drivers favoring a higher proportion. Overall, these results provide one of the primary links between the human microbiome and the environmental microbiome. This study revealed evidence that fruit and vegetable-derived microbes could be found in the human gut and contribute to gut microbiome diversity.
Collapse
Affiliation(s)
- Wisnu Adi Wicaksono
- Institute of Environmental Biotechnology, Graz University of Technology, Graz, Austria
| | - Tomislav Cernava
- Institute of Environmental Biotechnology, Graz University of Technology, Graz, Austria
- School of Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Birgit Wassermann
- Institute of Environmental Biotechnology, Graz University of Technology, Graz, Austria
| | - Ahmed Abdelfattah
- Institute of Environmental Biotechnology, Graz University of Technology, Graz, Austria
- Leibniz Institute for Agricultural Engineering and Bioeconomy (ATB), Potsdam, Germany
| | | | | | - Suvi M. Virtanen
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Center for Child Health Research, Tampere University and Tampere University Hospital, Tampere, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Mikael Knip
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Pediatric Research Center, Children’s Hospital, University of Helsinki, Helsinki, Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, and Fimlab Laboratories, Tampere, Finland
| | - Gabriele Berg
- Institute of Environmental Biotechnology, Graz University of Technology, Graz, Austria
- Leibniz Institute for Agricultural Engineering and Bioeconomy (ATB), Potsdam, Germany
- Institute for Biochemistry and Biology, University of Potsdam, Potsdam, Germany
| |
Collapse
|
6
|
Duong C, Patel S, Nguyen-Viet H, Chea R, Dang S, Tum S, Ramakrishnan U, Young MF. Access to food markets, household wealth and child nutrition in rural Cambodia: Findings from nationally representative data. PLoS One 2023; 18:e0292618. [PMID: 37851642 PMCID: PMC10584123 DOI: 10.1371/journal.pone.0292618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023] Open
Abstract
Access to informal fresh food markets plays a vital role in household food security and dietary quality in transitioning rural economies. However, it is not well understood if market access also improves child nutrition and if the improvement applies to all socioeconomic groups. In this secondary research study, we combined a national listing of food markets (n = 503) with a national household survey to examine the associations of market access with diet and height across wealth groups in children aged 6 to 23 months in rural Cambodia. All children under two years of age with dietary data (n = 1537) or anthropometry data (n = 989) were selected from the household survey. Food markets were geocoded using Google Maps or villages' geographical coordinates publicly available in the Open Development Mekong data platform. Regression calibration was then used to estimate household distance to the nearest market. Descriptive results indicated a highly uneven distribution of food markets with median household distance to the nearest markets ranging between 4 km (IQR: 3-8 km) in the lowland areas and 9 km (IQR: 4-17 km) in the highland areas. Results from the multivariate linear regressions showed that distance to the nearest market was modestly associated with child dietary diversity score (β: -0.17; 95% CI: -0.29, -0.05) but it was not related to child height-for-age z-score, and that household wealth did not modify the associations between distance to markets and child dietary diversity score. These findings suggest that improving access to food markets alone might not lead to meaningful improvement in child diet. Detailed surveys on household food acquisition are needed to clarify the role of food markets relative to other food sources such as subsistence fisheries, subsistence gardening and mobile food traders.
Collapse
Affiliation(s)
- Cam Duong
- Doctoral Program in Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, Georgia, United States of America
| | - Shivani Patel
- Hubert Department of Global Health, Emory University, Atlanta, Georgia, United States of America
| | - Hung Nguyen-Viet
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya
| | - Rortana Chea
- National Animal Health and Production Research Institute, General Directorate of Animal Health and Production, Phnom Penh, Cambodia
| | - Sinh Dang
- Animal and Human Health Program, International Livestock Research Institute, Hanoi, Vietnam
| | - Sothyra Tum
- National Animal Health and Production Research Institute, General Directorate of Animal Health and Production, Phnom Penh, Cambodia
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Emory University, Atlanta, Georgia, United States of America
| | - Melissa F. Young
- Hubert Department of Global Health, Emory University, Atlanta, Georgia, United States of America
| |
Collapse
|
7
|
Kang Y, Heidkamp RA, Mako-Mushaninga K, Garg A, Matji JN, Nyawo M, Craig HC, Thorne-Lyman AL. Factors associated with diet diversity among infants and young children in the Eastern and Southern Africa region. MATERNAL & CHILD NUTRITION 2023:e13487. [PMID: 36924028 DOI: 10.1111/mcn.13487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 03/18/2023]
Abstract
This study explores common factors associated with not meeting minimum dietary diversity (MDD) among 27,072 children aged 6-23 months in Eastern and Southern Africa using data from nine Demographic and Health Surveys from 2013 to 2016. MDD was defined as consumption of more than or equals to five of eight food groups including breast milk in the past 24 h. Equity gaps were calculated as the difference in MDD prevalence between the top and bottom wealth quintiles. Logistic regression was conducted to identify common factors for not meeting MDD at the household, maternal and child levels across two or more countries to inform regional policies to improve children's diets. Kenya had the highest MDD wealth equity gap (40.4 pts), and South Africa had the smallest (14.4 pts). Equity gaps for flesh foods or eggs (up to 39.8 pp) were larger than for grain or legumes (up to 20 pp). Common risk factors for not reaching MDD included younger child age (6-11 months) (n = 9 countries), no formal maternal occupation (n = 6), not receiving vitamin-A supplementation (n = 3), younger maternal age (n = 3), lower maternal education (n = 3), no media (n = 3) or newspaper (n = 3) exposure, lower household wealth quintile (n = 3), use of nonefficient cooking fuel (n = 2), longer time to get to the water source (n = 2), not listening to the radio (n = 2) and higher birth order (n = 2). Priorities for improving MDD in the region include introducing diverse foods at a young age from 6 months with early nutrition counselling, promoting higher maternal education, increasing food purchasing power and ensuring the support of younger mothers.
Collapse
Affiliation(s)
- Yunhee Kang
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rebecca A Heidkamp
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Aashima Garg
- UNICEF Program Division, New York City, New York, USA
| | - Joan N Matji
- UNICEF Eastern and Southern Africa Regional Office, Nairobi, Kenya
| | - Mara Nyawo
- UNICEF Eastern and Southern Africa Regional Office, Nairobi, Kenya
| | - Hope C Craig
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Andrew L Thorne-Lyman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
8
|
Waseem M, Li X, Jamil I, Islam AHMS, Abbas Q, Raza MH, Eliw M. Do crop diversity and livestock production improve smallholder intra-household dietary diversity, nutrition and sustainable food production? Empirical evidence from Pakistan. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2023. [DOI: 10.3389/fsufs.2023.1143774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Crop diversification and livestock production is an important strategy to enhance nutrition, sustainable food production, and improve food security, especially at the smallholder household level. However, existing evidences are mixed and there are limited information about the relationship among agriculture crops, household income diversification (HID), and household dietary diversity (HDD) among smallholder farmers in developing country setting like Pakistan. Therefore, this study aims to understand the role of crop diversification (CD) on HDD, nutrition, and sustainable agriculture and food production in the context of smallholder households in Punjab, Pakistan. The study employed ordered probit regression and cross-sectional data from 450 households collected using 24-h recall method. Regression results indicate that crop diversity and intra-household dietary diversity are positively associated across adults, adolescents, and children in all the study districts. Moreover, annual income, key crops grown by the household and family education are also the significant drivers of dietary diversity. Greater travel distance between markets was the most crucial factor in all regions which significantly affect dietary diversity. The overall research findings indicated that crop diversification and livestock production in the selected areas is significantly contributing to improve nutrition and sustainable food production. Therefore this study recommends for promoting crop diversification and livestock production for sustainable agricultural development and improving nutrition in the context of developing countries like Pakistan.
Collapse
|
9
|
Headey DD, Ecker O, Comstock AR, Ruel MT. Poverty, price and preference barriers to improving diets in sub-Saharan Africa. GLOBAL FOOD SECURITY 2023; 36:100664. [PMID: 36937376 PMCID: PMC10015269 DOI: 10.1016/j.gfs.2022.100664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
Suboptimal diets are the most important preventable risk factor for the global burden of non-communicable diseases. The EAT-Lancet reference diet was therefore developed as a benchmark for gauging divergence from healthy eating standards. However, no previous research has comprehensively explored how and why this divergence exists in poorer countries undergoing nutrition transitions. This study therefore analyzes dietary patterns and drivers of the demand for nutritious foods using nationally representative household surveys from Ethiopia, Kenya, Tanzania, and Uganda. We show how barriers to dietary convergence stem from combinations of poverty, high relative food prices and weak preferences for some specific healthy foods. The article concludes by discussing interventions for strengthening consumer demand for healthy diets in Africa.
Collapse
|
10
|
Ricardo LIC, Gatica-Domínguez G, Neves PAR, Vaz JDS, Barros AJD, Wehrmeister FC. Sociodemographic inequalities in vegetables, fruits, and animal source foods consumption in children aged 6-23 months from 91 LMIC. Front Nutr 2023; 10:1046686. [PMID: 36866060 PMCID: PMC9972219 DOI: 10.3389/fnut.2023.1046686] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/24/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction No multi-country analysis described patterns and inequalities for the brand-new feeding indicators proposed by WHO/UNICEF: zero consumption of vegetables and fruits (ZVF) and consumption of eggs and/or flesh (EFF). Our aim was to describe patterns in the prevalence and social inequalities of ZVF and EFF among children aged 6-23 months in low-and middle-income countries. Methods Data from nationally representative surveys (2010-2019) in 91 low-and middle-income countries were used to investigate within-country disparities in ZVF and EFF by place of residence, wealth quintiles, child sex and child age. The slope index of inequality was used to assess socioeconomic inequalities. Analyses were also pooled by World Bank income groups. Results The prevalence of ZVF was 44.8% and it was lowest in children from upper-middle income countries, from urban areas, and those 18-23 months. The slope index of inequality showed that socioeconomic inequalities in the prevalence of ZVF were higher among poor children in comparison to richest children (mean SII = -15.3; 95%CI: -18.5; -12.1). Overall, 42.1% of children consumed egg and/or flesh foods. Being a favorable indicator, findings for EFF were generally in the opposite direction than for ZVF. The prevalence was highest in children from upper-middle income countries, from urban areas, and those 18-23 months of age. The slope index of inequality showed pro-rich patterns in most countries (mean SII = 15.4; 95%CI: 12.2; 18.6). Discussion Our findings demonstrate that inequalities exist in terms of household wealth, place of residence, and age of the child in the prevalence of the new complementary feeding indicators. Moreover, children from low-and lower-middle countries had the lowest consumption of fruits, vegetables, eggs, and flesh foods. Such findings provide new insights towards effective approaches to tackle the malnutrition burden through optimal feeding practices.
Collapse
Affiliation(s)
- Luiza I. C. Ricardo
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | | - Paulo A. R. Neves
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | | - Aluisio J. D. Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | | |
Collapse
|
11
|
Bhati D, Tripathy A, Mishra PS, Srivastava S. Contribution of socio-economic and demographic factors to the trend of adequate dietary diversity intake among children (6-23 months): evidence from a cross-sectional survey in India. BMC Nutr 2022; 8:153. [PMID: 36575545 PMCID: PMC9793661 DOI: 10.1186/s40795-022-00655-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The present study aims to estimate the factors contributing to the change adequate diversified dietary intake (ADDI) from 2005-06 to 2015-16 among children aged 6-23 months in India. METHODS A cross-sectional study was conducted using a large representative survey data. Data from the National Family Health Survey 2005-06 and 2015-16 was used. The effective sample size for the present study was 14,422 and 74,132 children aged 6-23 months in 2005-06 and 2015-16, respectively. The outcome variable was minimum adequate dietary diversity intake. Binary logistic regression was used to evaluate the factors associated with ADDI. Additionally, the Fairlie method of decomposition was used, which allows quantifying the total contribution of factors explaining the decadal change in the probability of ADDI among children aged 6-23 months in India. RESULTS There was a significant increase in ADDI from 2005-06 to 2015-16 (6.2%; p < 0.001). Additionally, compared to the 2005-06 years, children were more likely to have ADDI [AOR; 1.29, CI: 1.22-1.35] in 2015-16. Mother's education explained nearly one-fourth of the ADDI change among children. Further, the regional level contribution of 62.3% showed that the gap was widening across regions between the year 2005-06 and 2015-16 in ADDI among children. The child's age explained 5.2% with a positive sign that means it widened the gaps. Whereas the household wealth quintile negatively contributed and explained by -5.2%, that means between the years the gaps has reduced in ADDI among children aged 6-23 months. CONCLUSION Our findings indicate that increasing awareness of the use of mass media and improving the education levels of mothers would be beneficial for adequate dietary diversity intake among children aged 6-23 months. Investments should support interventions to improve overall infant and young children feeding practices in India.
Collapse
Affiliation(s)
| | - Abhipsa Tripathy
- grid.412779.e0000 0001 2334 6133PG Department of Statistics, Utkal University, Vani Vihar, Odisha Bhubaneswar, 751004 India
| | - Prem Shankar Mishra
- grid.464840.a0000 0004 0500 9573Population Research Centre, Institute for Social and Economic Change, Bengaluru, 560072 Karnataka India
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600 Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, 400088 Maharashtra India
| |
Collapse
|
12
|
Robinson JPW, Mills DJ, Asiedu GA, Byrd K, Mancha Cisneros MDM, Cohen PJ, Fiorella KJ, Graham NAJ, MacNeil MA, Maire E, Mbaru EK, Nico G, Omukoto JO, Simmance F, Hicks CC. Small pelagic fish supply abundant and affordable micronutrients to low- and middle-income countries. NATURE FOOD 2022; 3:1075-1084. [PMID: 37118295 DOI: 10.1038/s43016-022-00643-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/20/2022] [Indexed: 04/30/2023]
Abstract
Wild-caught fish provide an irreplaceable source of essential nutrients in food-insecure places. Fishers catch thousands of species, yet the diversity of aquatic foods is often categorized homogeneously as 'fish', obscuring an understanding of which species supply affordable, nutritious and abundant food. Here, we use catch, economic and nutrient data on 2,348 species to identify the most affordable and nutritious fish in 39 low- and middle-income countries. We find that a 100 g portion of fish cost between 10 and 30% of the cheapest daily diet, with small pelagic fish (herring, sardine, anchovy) being the cheapest nutritious fish in 72% of countries. In sub-Saharan Africa, where nutrient deficiencies are rising, <20% of small pelagic catch would meet recommended dietary fish intakes for all children (6 months to 4 years old) living near to water bodies. Nutrition-sensitive policies that ensure local supplies and promote consumption of wild-caught fish could help address nutrient deficiencies in vulnerable populations.
Collapse
Affiliation(s)
| | - David J Mills
- WorldFish, Jalan Batu Maung, Batu Maung, Bayan Lepas, Malaysia
- Centre for Sustainable Tropical Fisheries and Aquaculture, James Cook University, Townsville, Australia
| | | | - Kendra Byrd
- WorldFish, Jalan Batu Maung, Batu Maung, Bayan Lepas, Malaysia
- Natural Resources Institute, University of Greenwich, Chatham, UK
| | - Maria Del Mar Mancha Cisneros
- Nicholas School of the Environment, Duke University, Durham, NC, USA
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Philippa J Cohen
- WorldFish, Jalan Batu Maung, Batu Maung, Bayan Lepas, Malaysia
- College of Science and Engineering, James Cook University, Townsville, Queensland, Australia
| | - Kathryn J Fiorella
- Department of Public & Ecosystem Health, Cornell University, Ithaca, NY, USA
| | | | - M Aaron MacNeil
- Ocean Frontier Institute, Department of Biology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Eva Maire
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - Emmanuel K Mbaru
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
- Kenya Marine and Fisheries Research Institute, Mombasa, Kenya
| | - Gianluigi Nico
- Fisheries and Aquaculture Department, Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Johnstone O Omukoto
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
- Kenya Marine and Fisheries Research Institute, Mombasa, Kenya
| | - Fiona Simmance
- WorldFish, Jalan Batu Maung, Batu Maung, Bayan Lepas, Malaysia
| | | |
Collapse
|
13
|
Dietary diversity and its determinants among children aged 6-23 months in Ethiopia: evidence from the 2016 Demographic and Health Survey. J Nutr Sci 2022; 11:e88. [PMID: 36304826 PMCID: PMC9554528 DOI: 10.1017/jns.2022.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 11/19/2022] Open
Abstract
Dietary diversity in children may be influenced not only by individual circumstances but also by the features of the community in which they live. Our study aimed to assess community and individual-level determinants of minimum dietary diversity among children aged 6-23 months in Ethiopia. We included 2960 children aged 6-23 months from the recent Ethiopia Demographic and Health Survey. A minimum dietary diversity was defined as the consumption of at least five food groups out of the eight reference food groups within 24 h by children aged 6-23 months. Multilevel logistic regression was used to investigate the drivers of minimum dietary diversity in Ethiopian children aged 6-23 months. About 12⋅5 % of children met the bare minimum of dietary diversification. Age of the child (9-11 months AOR, 3⋅3 (95 % CI 1⋅8, 5⋅6), 12-17 months AOR, 4⋅0 (95 % CI 2⋅4, 6⋅7), 18-23 months AOR, 3⋅5 (95 % CI 2⋅0, 5⋅8)), caregiver listening radio at least once a week AOR, 1⋅6 (95 % CI 1⋅1, 2⋅4) and wealth quantiles (Second AOR, 1⋅8 (95 % CI 1⋅1, 3⋅1), Fourth AOR, 2⋅9 (95 % CI 1⋅6, 5⋅2) and Highest AOR, 2⋅2 (95 % CI 1⋅1, 4⋅2)) were individual characteristics associated with dietary diversity. Place of residence was the only community-level characteristic associated with children's dietary diversity (Rural AOR, 0⋅4 (95 % CI 0⋅2, 0⋅6)). The minimum dietary diversity among Ethiopian children is suboptimal. Nutrition programmes aimed at enhancing dietary diversity should be strengthened in this population, particularly for those from poor families and residing in rural areas.
Collapse
|
14
|
Thiede BC, Randell H, Gray C. The Childhood Origins of Climate-Induced Mobility and Immobility. POPULATION AND DEVELOPMENT REVIEW 2022; 48:767-793. [PMID: 36505509 PMCID: PMC9733713 DOI: 10.1111/padr.12482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The literature on climate exposures and human migration has focused largely on assessing short-term responses to temperature and precipitation shocks. In this paper, we suggest that this common coping strategies model can be extended to account for mechanisms that link environmental conditions to migration behavior over longer periods of time. We argue that early-life climate exposures may affect the likelihood of migration from childhood through early adulthood by influencing parental migration, community migration networks, human capital development, and decisions about household resource allocation, all of which are correlates of geographic mobility. After developing this conceptual framework, we evaluate the corresponding hypotheses using a big data approach, analyzing 20 million individual georeferenced records from 81 censuses implemented across 31 countries in tropical Africa, Latin America, and Southeast Asia. For each world region, we estimate regression models that predict lifetime migration (a change in residence between birth and ages 30-39) as a function of temperature and precipitation anomalies in early life, defined as the year prior to birth through age four. Results suggest that early-life climate is systematically associated with changes in the probability of lifetime migration in most regions of the tropics, with the largest effects observed in sub-Saharan Africa. In East and Southern Africa, the effects of temperature shocks vary by sex and educational attainment and in a manner that suggests women and those of lower socioeconomic status are most vulnerable. Finally, we compare our main results with models using alternative measures of climate exposures. This comparison suggests climate exposures during the prenatal period and first few years of life are particularly (but not exclusively) salient for lifetime migration, which is most consistent with the hypothesized human capital mechanism.
Collapse
Affiliation(s)
- Brian C Thiede
- The Pennsylvania State University, University Park, PA 16802
| | - Heather Randell
- The Pennsylvania State University, University Park, PA 16802
| | - Clark Gray
- The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| |
Collapse
|
15
|
Khandelwal S, Kondal D, Chakravarti AR, Dutta S, Banerjee B, Chaudhry M, Patil K, Swamy MK, Ramakrishnan U, Prabhakaran D, Tandon N, Stein AD. Infant Young Child Feeding Practices in an Indian Maternal-Child Birth Cohort in Belagavi, Karnataka. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095088. [PMID: 35564483 PMCID: PMC9104747 DOI: 10.3390/ijerph19095088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023]
Abstract
Poor infant young child feeding (IYCF) practices result in malnutrition, poor psychosocial development, poor school performance and less productivity in later life, thereby perpetuating a vicious cycle. The current study aims to characterize the IYCF practices during the first year of life in a maternal–child birth cohort (DHANI) in Belagavi, Karnataka, India. We collected data from the dyad at birth, 6 and 12 months postpartum. We examined dietary diversity among these infants at 12 months using WHO criteria. A total of 902 live births were recorded, and 878 mother–child pairs completed the 12-month follow up. The overall prevalence of early (within 1 h of delivery) initiation of breastfeeding (EIBF) was 77.9%, and that of exclusive breastfeeding (EBF) at 6 months was 52.4%. At 12 months, most (90%) infants were breastfed, while 39% also received formula. The large majority (94.4%) of infants met minimum meal frequency (MMF), but only 55% of infants were receiving a minimum acceptable diet (MAD). The mean dietary diversity (DD) score was 4.7 ± 1.1. Only 21.9% of infants consumed egg and/or flesh food. A large proportion (33.8%) of infants received no vegetables and/or fruits till 12 months of age. Consumption of sweet beverage was 4.8%, but consumption of ultra-processed foods high in trans-fats, sugars and salt was high (85.8%). High-quality, sustainable and scalable interventions to enhance knowledge and support positive behaviour change for adopting and implementing better IYCF practices may be urgently needed in low- and middle-income group settings to improve diet diversity and overall nutritional intake amongst young children.
Collapse
Affiliation(s)
- Shweta Khandelwal
- Public Health Foundation of India, Delhi NCR 122002, India; (D.K.); (M.C.); (D.P.)
- Centre for Chronic Disease Control, New Delhi 110016, India
- Correspondence:
| | - Dimple Kondal
- Public Health Foundation of India, Delhi NCR 122002, India; (D.K.); (M.C.); (D.P.)
- Centre for Chronic Disease Control, New Delhi 110016, India
| | - Anindita Ray Chakravarti
- Department of Food & Nutrition, Maharani Kasiswari College, University of Calcutta, Kolkata 700073, India;
| | - Soumam Dutta
- Department of Home Science, University of Calcutta, Kolkata 700027, India; (S.D.); (B.B.)
| | - Bipsa Banerjee
- Department of Home Science, University of Calcutta, Kolkata 700027, India; (S.D.); (B.B.)
| | - Monica Chaudhry
- Public Health Foundation of India, Delhi NCR 122002, India; (D.K.); (M.C.); (D.P.)
| | - Kamal Patil
- KAHER’s JN Medical College, Belagavi 590010, India; (K.P.); (M.K.S.)
| | | | - Usha Ramakrishnan
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (U.R.); (A.D.S.)
| | - Dorairaj Prabhakaran
- Public Health Foundation of India, Delhi NCR 122002, India; (D.K.); (M.C.); (D.P.)
- Centre for Chronic Disease Control, New Delhi 110016, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi 110029, India;
| | - Aryeh D. Stein
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (U.R.); (A.D.S.)
| |
Collapse
|
16
|
Hanley-Cook GT, Daly AJ, Remans R, Jones AD, Murray KA, Huybrechts I, De Baets B, Lachat C. Food biodiversity: Quantifying the unquantifiable in human diets. Crit Rev Food Sci Nutr 2022; 63:7837-7851. [PMID: 35297716 DOI: 10.1080/10408398.2022.2051163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Dietary diversity is an established public health principle, and its measurement is essential for studies of diet quality and food security. However, conventional between food group scores fail to capture the nutritional variability and ecosystem services delivered by dietary richness and dissimilarity within food groups, or the relative distribution (i.e., evenness or moderation) of e.g., species or varieties across whole diets. Summarizing food biodiversity in an all-encompassing index is problematic. Therefore, various diversity indices have been proposed in ecology, yet these require methodological adaption for integration in dietary assessments. In this narrative review, we summarize the key conceptual issues underlying the measurement of food biodiversity at an edible species level, assess the ecological diversity indices previously applied to food consumption and food supply data, discuss their relative suitability, and potential amendments for use in (quantitative) dietary intake studies. Ecological diversity indices are often used without justification through the lens of nutrition. To illustrate: (i) dietary species richness fails to account for the distribution of foods across the diet or their functional traits; (ii) evenness indices, such as the Gini-Simpson index, require widely accepted relative abundance units (e.g., kcal, g, cups) and evidence-based moderation weighting factors; and (iii) functional dissimilarity indices are constructed based on an arbitrary selection of distance measures, cutoff criteria, and number of phylogenetic, nutritional, and morphological traits. Disregard for these limitations can lead to counterintuitive results and ambiguous or incorrect conclusions about the food biodiversity within diets or food systems. To ensure comparability and robustness of future research, we advocate food biodiversity indices that: (i) satisfy key axioms; (ii) can be extended to account for disparity between edible species; and (iii) are used in combination, rather than in isolation.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2051163 .
Collapse
Affiliation(s)
- Giles T Hanley-Cook
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Aisling J Daly
- Department of Data Analysis and Mathematical Modelling, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Roseline Remans
- The Alliance of Bioversity International and International Centre for Tropical Agriculture, Geneva, Switzerland
| | - Andrew D Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Kris A Murray
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
- School of Hygiene & Tropical Medicine, MRC Unit The Gambia at London, Banjul, The Gambia
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Bernard De Baets
- Department of Data Analysis and Mathematical Modelling, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| |
Collapse
|
17
|
Perceived neighbourhood food access is associated with consumption of animal-flesh food, fruits and vegetables among mothers and young children in peri-urban Cambodia. Public Health Nutr 2022; 25:717-728. [PMID: 34593072 PMCID: PMC9991642 DOI: 10.1017/s1368980021004122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine whether mothers' perceived neighbourhood food access is associated with their own and their young children's consumption of animal-flesh food, fruits and vegetables in peri-urban areas of Cambodia. DESIGN A cross-sectional survey measured food consumption frequency and perceived neighbourhood food access, the latter including six dimensions of food availability, affordability, convenience, quality, safety and desirability. Multivariate logistic regression was used to assess the association between perceived food access and food consumption. SETTING Peri-urban districts of Phnom Penh and Siem Reap, Cambodia. PARTICIPANTS 198 mothers of children between 6 and 24 months old. RESULTS Over 25 % of the mothers and 40 % of the children had low consumption (< once a day) of either animal-flesh food or fruits and vegetables. Compared with perceived high food access, perceived low food access was associated with an adjusted 5·6-fold and 4·3-fold greater odds of low animal-flesh food consumption among mothers (95 % CI 2·54, 12·46) and children (95 % CI 2·20, 8·60), respectively. Similarly, relative to perceived high food access, perceived low food access was associated with 7·6-times and 5·1-times higher adjusted odds of low fruits and vegetables consumption among mothers (95 % CI 3·22, 18·02) and children (95 % CI 2·69, 9·83), respectively. CONCLUSIONS Mothers' perceived neighbourhood food access was an important predictor of their own and their young children's nutrient-rich food consumption in peri-urban Cambodia. Future work is needed to confirm our findings in other urban settings and examine the role of neighbourhood food environment in the consumption of both nutrient-rich and nutrient-poor food.
Collapse
|
18
|
Maulu S, Nawanzi K, Abdel-Tawwab M, Khalil HS. Fish Nutritional Value as an Approach to Children's Nutrition. Front Nutr 2021; 8:780844. [PMID: 34977125 PMCID: PMC8715098 DOI: 10.3389/fnut.2021.780844] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/19/2021] [Indexed: 12/14/2022] Open
Abstract
Fish is a relatively cheap and accessible source of animal protein for human consumption even in rural communities. It is critical for global food and nutrition security, and its consumption continues to increase. As a highly nutritious food, fish consumption is highly recommended for children and expectant mothers for normal growth and development. The present paper explores the nutritional value of fish as approach to nutrition in children and its benefits. The findings reveal that fish is a valuable source of essential amino acids (EAA) and polyunsaturated fatty acids (PUFAs) that play important physiological functions for maintenance and development of fetuses, neonates, and infant brains. Therefore, it could be a valuable tool in the fight against food insecurity and malnutrition. However, fish and fish products are also highly susceptible to contamination by various organic and inorganic compounds that threaten public health. Particularly, heavy metals and biogenic amines (BAs) have shown adverse effects when contaminated fish is consumed, and the effects in children have been worse. Hence, while fish consumption is highly recommended for children's nutrition, the safety and quality of the product should always be checked to safeguard public health.
Collapse
Affiliation(s)
- Sahya Maulu
- Centre for Innovative Approach Zambia (CIAZ), Lusaka, Zambia
| | - Kundananji Nawanzi
- Department of Agriculture and Aquatic Sciences, Kapasa Makasa University, Chinsali, Zambia
| | - Mohsen Abdel-Tawwab
- Department of Fish Biology and Ecology, Central Laboratory for Aquaculture Research, Agriculture Research Center, Abbassa, Sharqia, Egypt
| | - Hala Saber Khalil
- Aquaculture and Fisheries Group, Wageningen Institute of Animal Sciences, Wageningen University and Research, Wageningen, Netherlands
- WorldFish, Africa Aquaculture Research and Training Center, Abbassa, Egypt
- Aquaculture Division, National Institute of Oceanography and Fisheries (NIOF), Cairo, Egypt
| |
Collapse
|
19
|
Cliffer IR, Masters WA, Perumal N, Naumova EN, Zeba AN, Garanet F, Rogers BL. Monthly measurement of child lengths between 6 and 27 months of age in Burkina Faso reveals both chronic and episodic growth faltering. Am J Clin Nutr 2021; 115:94-104. [PMID: 34637506 PMCID: PMC8755055 DOI: 10.1093/ajcn/nqab309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/08/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Linear growth faltering is determined primarily by attained heights in infancy, but available data consist mainly of cross-sectional heights at each age. OBJECTIVES This study used longitudinal data to test whether faltering occurs episodically in a few months of very low growth, which could potentially be prevented by timely intervention, or is a chronic condition with slower growth in every month of infancy and early childhood. METHODS Using anthropometric data collected monthly between August 2014 and December 2016, we investigated individual growth curves of 5039 children ages 6-27 mo in Burkina Faso (108,580 observations). We evaluated growth-curve smoothness by level of attained length at ∼27 mo by analyzing variation in changes in monthly growth rates and using 2-stage regressions: 1) regressing each child's length on their age and extracting R2 to represent curve smoothness, initial length, and average velocity by age; and 2) regressing extracted parameters on individual-level attained length. RESULTS Short children started smaller and remained on their initial trajectories, continuously growing slower than taller children. Growth between 9 and 11 mo was the most influential on attained length; for each 1-cm/mo increase in growth velocity during this period, attained length increased by 6.71 cm (95% CI: 6.59, 6.83 cm). Furthermore, a 0.01 increase in R2 from individual regression of length on age was associated with a 3.10-cm higher attained length (95% CI: 2.80, 3.41 cm), and having 2 consecutive months of slow growth (<15th centile relative to the sample) was associated with 1.7-cm lower attained length (95% CI: -1.80, -1.59 cm), with larger effects in younger children, suggesting that smoother growth patterns were also associated with higher attained length. CONCLUSIONS Children who experience extreme growth faltering are likely less resilient to systematic growth-limiting conditions as well as episodic insults to their growth.This trial was registered at clinicaltrials.gov as NCT02071563.
Collapse
Affiliation(s)
| | - William A Masters
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Nandita Perumal
- Global Health and Population Department, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Elena N Naumova
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Augustin N Zeba
- Department of Nutrition, Health Sciences Research Institute, National Center for Scientific and Technological Research (Institut de Recherche en Sciences de la Santé, Centre National de la Recherche Scientifique et Technologique), Ouagadougou, Burkina Faso
| | - Franck Garanet
- Department of Nutrition, Health Sciences Research Institute, National Center for Scientific and Technological Research (Institut de Recherche en Sciences de la Santé, Centre National de la Recherche Scientifique et Technologique), Ouagadougou, Burkina Faso
| | - Beatrice L Rogers
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| |
Collapse
|
20
|
Billah SM, Ferdous TE, Kelly P, Raynes-Greenow C, Siddique AB, Choudhury N, Ahmed T, Gillespie S, Hoddinott J, Menon P, Dibley MJ, Arifeen SE. Effect of nutrition counselling with a digital job aid on child dietary diversity: Analysis of secondary outcomes from a cluster randomised controlled trial in rural Bangladesh. MATERNAL AND CHILD NUTRITION 2021; 18:e13267. [PMID: 34467669 PMCID: PMC8710107 DOI: 10.1111/mcn.13267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/25/2021] [Accepted: 08/04/2021] [Indexed: 12/03/2022]
Abstract
Adequate dietary diversity among infants is often suboptimal in developing countries. We assessed the impact of nutrition counselling using a digital job aid on dietary diversity of children aged 6–23 months using data from a cluster randomised controlled trial in Bangladesh. The trial had five arms, each with 25 clusters. The four intervention arms provided counselling using a digital job aid and different prenatal and post‐natal combinations of lipid‐based supplements and the comparison arm with usual practice. We enrolled 1500 pregnant women and followed them until the children reached their second birthday. We developed a tablet‐based system for intervention delivery, data collection and project supervision. We combined the four intervention arms (n = 855), in which community health workers (CHWs) provided age‐appropriate complementary feeding counselling, to compare against the comparison arm (n = 403). We calculated the outcome indicators from the children's 24‐h dietary recalls. Overall, the intervention increased the mean dietary diversity score by 0.09 (95% confidence interval [CI]: 0.2–0.16) and odds of minimum dietary diversity by 18% (95% CI: 0.99–1.40). However, there was a significant interaction on the effect of the intervention on dietary diversity by age. The mean dietary diversity score was 0.24 (95% CI: 0.11–0.37) higher in the intervention than in the comparison arm at 9 months and 0.14 (95% CI: 0.01–27) at 12 months of age. The intervention effect was non‐significant at an older age. Overall, consumption of flesh food was 1.32 times higher in the intervention arm (odds ratio [OR] 1.32, 95% CI: 1.11–1.57) in 6–23 months of age. The intervention significantly improved child dietary diversity score in households with mild and moderate food insecurity by 0.27 (95% CI: 0.06–0.49) and 0.16 (0.05–27), respectively, but not with food‐secure and severely food‐insecure households. Although the study did not evaluate the impact of digital job aid alone, the findings indicate the utility of nutrition counselling by CHWs using a digital job aid to improve child feeding practices in broader programmes.
Collapse
Affiliation(s)
- Sk Masum Billah
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tarana E Ferdous
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Patrick Kelly
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Camille Raynes-Greenow
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Abu Bakkar Siddique
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Nuzhat Choudhury
- Nutrition and Clinical Science Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Science Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Stuart Gillespie
- Poverty, Health, And Nutrition (PHND), International Food Policy Research Institute (IFPRI), Washington, District of Columbia, USA
| | - John Hoddinott
- Poverty, Health, And Nutrition (PHND), International Food Policy Research Institute (IFPRI), Washington, District of Columbia, USA.,Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Purnima Menon
- Poverty, Health, And Nutrition (PHND), International Food Policy Research Institute (IFPRI), Washington, District of Columbia, USA
| | - Michael John Dibley
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| |
Collapse
|
21
|
Parikh P, Semba R, Manary M, Swaminathan S, Udomkesmalee E, Bos R, Poh BK, Rojroongwasinkul N, Geurts J, Sekartini R, Nga TT. Animal source foods, rich in essential amino acids, are important for linear growth and development of young children in low- and middle-income countries. MATERNAL AND CHILD NUTRITION 2021; 18:e13264. [PMID: 34467645 PMCID: PMC8710096 DOI: 10.1111/mcn.13264] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/02/2021] [Accepted: 08/02/2021] [Indexed: 11/28/2022]
Abstract
Growth faltering under 5 years of age is unacceptably high worldwide, and even more children, while not stunted, fail to reach their growth potential. The time between conception and 2 years of age is critical for development. The period from 6 to 23 months, when complementary foods are introduced, coincides with a time when growth faltering and delayed neurocognitive developments are most common. Fortunately, this is also the period when diet exercises its greatest influence. Growing up in an adverse environment, with a deficient diet, as typically seen in low‐ and middle‐income countries (LMICs), hampers growth and development of children and prevents them from realising their full developmental and economic future potential. Sufficient nutrient availability and utilisation are paramount to a child's growth and development trajectory, especially in the period after breastfeeding. This review highlights the importance of essential amino acids (EAAs) in early life for linear growth and, likely, neurocognitive development. The paper further discusses signalling through mammalian target of rapamycin complex 1 (mTORC1) as one of the main amino acid (AA)‐sensing hubs and the master regulator of both growth and neurocognitive development. Children in LMICs, despite consuming sufficient total protein, do not meet their EAA requirements due to poor diet diversity and low‐quality dietary protein. AA deficiencies in early life can cause reductions in linear growth and cognition. Ensuring AA adequacy in diets, particularly through inclusion of nutrient‐dense animal source foods from 6 to 23 months, is strongly encouraged in LMICs in order to compensate for less than optimal growth during complementary feeding.
Collapse
Affiliation(s)
| | - Richard Semba
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mark Manary
- Department of Paediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sumathi Swaminathan
- St John's Research Institute, St John's National Academy of Health Sciences, Bangalore, Karnataka, India
| | | | - Rolf Bos
- FrieslandCampina, Amersfoort, The Netherlands
| | - Bee Koon Poh
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Jan Geurts
- FrieslandCampina, Amersfoort, The Netherlands
| | - Rini Sekartini
- Faculty of Medicine, Department of Pediatrics, University of Indonesia and Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Tran Thuy Nga
- Department of Occupational and School Nutrition, National Institute of Nutrition (NIN), Hanoi, Vietnam
| |
Collapse
|
22
|
Kostecka M, Jackowska I, Kostecka J. A Comparison of the Effects of Young-Child Formulas and Cow's Milk on Nutrient Intakes in Polish Children Aged 13-24 Months. Nutrients 2021; 13:nu13082511. [PMID: 34444672 PMCID: PMC8398400 DOI: 10.3390/nu13082511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/12/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022] Open
Abstract
Adequately balanced daily food rations that provide the body with sufficient amounts of energy and nutrients, including minerals, are particularly important in early childhood when rapid physical, intellectual and motor development takes place. Cow’s milk (CM) and young-child formulas (YCFs) are introduced to a child’s diet past the first year of age. The main aim of the present study was to perform a qualitative and a quantitative analysis of daily food rations of young children based on the recommendations of the daily food ration model. An attempt was also made to determine whether the type of consumed milk (YCF or CM) adequately meets young children’s energy demands and contributes to the incorporation of different food groups into a balanced and healthy diet for children aged 13–24 months. A total of 714 parents between October 2019 and March 2020 filled out a food frequency questionnaire. In the second stage of the study, the parents participated in a dietary recall and were asked to keep diaries of all meals and foods consumed by children over a period of three days. The mean daily intake of CM/YCF and fermented milks was determined at 360 mL ± 128 mL, and it accounted for 55.4% of the guideline values. Flavored dairy products were consumed more frequently than fermented milks without added sugar or flavoring (94 ± 17 g vs. 56 ± 26 g, p < 0.05). Diets incorporating CM were significantly more abundant in protein than YCF diets (29.3 g vs. 21.9 g; p < 0.01). Liquid intake was somewhat higher in children fed YCFs (1280.8 mL vs. 1120.1; p < 0.05), mainly due to the higher consumption of fruit juice, nectars and sweetened hot beverages (246 ± 35 mL in the YCF group vs. 201 ± 56 mL in the CM group; p < 0.05). Children fed YCF consumed significantly larger amounts of sweetened beverages such as tea sweetened with sugar or honey, sweetened hot chocolate or instant teas (OR = 2.54; Cl: 1.32–3.26; p < 0.001), than children receiving CM. This group was also characterized by higher consumption of sweetened dairy products, mainly cream cheese desserts, fruit yogurt and yogurt with cereal (OR = 1.87; Cl: 1.36–2.54; p < 0.01), as well as a lower daily intake of plain fermented milks (OR = 0.56; Cl: 0.21–0.79; p < 0.001). The daily food intake and the quality of the diets administered to children aged 13–24 months were evaluated and compared with the model food ration. It was found that milk type influenced children’s eating habits and preference for sweet-tasting foods. The study also demonstrated that Polish parents and caregivers only have limited knowledge of nutritional guidelines for toddlers.
Collapse
Affiliation(s)
- Malgorzata Kostecka
- Faculty of Food Science and Biotechnology, University of Life Sciences in Lublin, Akademicka 15, 20-950 Lublin, Poland;
- Correspondence: ; Tel.: +48-814-456-846
| | - Izabella Jackowska
- Faculty of Food Science and Biotechnology, University of Life Sciences in Lublin, Akademicka 15, 20-950 Lublin, Poland;
| | - Julianna Kostecka
- Faculty of Medicine, Medical University of Lublin, Chodźki 19, 20-093 Lublin, Poland;
| |
Collapse
|
23
|
de Bruyn J, Wesana J, Bunting SW, Thilsted SH, Cohen PJ. Fish Acquisition and Consumption in the African Great Lakes Region through a Food Environment Lens: A Scoping Review. Nutrients 2021; 13:2408. [PMID: 34371918 PMCID: PMC8308864 DOI: 10.3390/nu13072408] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/04/2021] [Accepted: 07/08/2021] [Indexed: 12/15/2022] Open
Abstract
Effective actions for the fishery and aquaculture sectors to contribute toward improving nutrition rely on an understanding of the factors influencing fish intake, particularly amongst vulnerable populations. This scoping review synthesises evidence from 33 studies in the African Great Lakes Region to examine the influence of food environments on fish acquisition and consumption. We identified only two studies that explicitly applied a food environment framework and none that linked policy conditions with the contribution of fish to diets. Economic access to fish was represented in the largest number of included studies (21 studies), followed by preferences, acceptability and desirability of fish (17 studies) and availability and physical access (14 studies). Positive perceptions of taste and low cost, relative to other animal-source foods, were drivers of fish purchases in many settings; however, limited physical and economic access were frequently identified as preventing optimal intake. In lakeside communities, fish were increasingly directed toward external markets which reduced the availability and affordability of fish for local households. Few studies considered intra-household variations in fish access according to age, gender or physiological status, which represents an important knowledge gap. There is also scope for future research on seasonal influences on fish access and the design and rigorous evaluation of programmes and policies that address one or more constraints of availability, cost, convenience and preferences.
Collapse
Affiliation(s)
- Julia de Bruyn
- Natural Resources Institute, University of Greenwich, Chatham Maritime, Kent ME44TB, UK; (J.W.); (S.W.B.)
- Melbourne Sustainable Society Institute, University of Melbourne, Parkville, VIC 3010, Australia
| | - Joshua Wesana
- Natural Resources Institute, University of Greenwich, Chatham Maritime, Kent ME44TB, UK; (J.W.); (S.W.B.)
| | - Stuart W. Bunting
- Natural Resources Institute, University of Greenwich, Chatham Maritime, Kent ME44TB, UK; (J.W.); (S.W.B.)
| | - Shakuntala H. Thilsted
- WorldFish, Jalan Batu Maung, Batu Maung, Bayan Lepas 11960, Penang, Malaysia; (S.H.T.); (P.J.C.)
| | - Philippa J. Cohen
- WorldFish, Jalan Batu Maung, Batu Maung, Bayan Lepas 11960, Penang, Malaysia; (S.H.T.); (P.J.C.)
| |
Collapse
|
24
|
Ceballos F, Hernandez MA, Paz C. Short-term impacts of COVID-19 on food security and nutrition in rural Guatemala: Phone-based farm household survey evidence. AGRICULTURAL ECONOMICS (AMSTERDAM, NETHERLANDS) 2021; 52:477-494. [PMID: 34149131 PMCID: PMC8206951 DOI: 10.1111/agec.12629] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/12/2020] [Accepted: 11/20/2020] [Indexed: 05/28/2023]
Abstract
This article examines the short-term effects of the COVID-19 lockdown on food security and nutrition in rural Guatemala. We rely on a comprehensive panel dataset of 1,824 small agricultural households collected over two survey rounds, on November-December 2019 and May-June 2020. We place special emphasis on changes in agricultural and nonagricultural income sources, including remittances, and changes in dietary diversity, including consumption of animal source foods (ASF) and fruits and vegetables (F&V). We find that COVID-19 affected the incomes, food security, and dietary patterns of households, with a decrease in ASF diversity and an increase in F&V diversity, and an overall net decrease in dietary diversity across all food groups. Dietary diversity among women in reproductive age, however, remained unchanged, and increased among children under 2 years old. Interestingly, households with relatively higher incomes appear to have reduced their dietary diversity to a larger extent than lower income ones, as well as households located in communities with more severe access restrictions. The focus of the study in a region with a high prevalence of poverty and chronic malnutrition provides an important perspective into the consequences of the lockdown in complex rural contexts with vulnerable populations and contributes to inform eventual recovery measures.
Collapse
Affiliation(s)
- Francisco Ceballos
- Markets, Trade and Institutions DivisionInternational Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
| | - Manuel A. Hernandez
- Markets, Trade and Institutions DivisionInternational Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
| | - Cynthia Paz
- Markets, Trade and Institutions DivisionInternational Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
| |
Collapse
|
25
|
Inland fisheries critical for the diet quality of young children in sub-Saharan Africa. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2021. [DOI: 10.1016/j.gfs.2020.100483] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
26
|
Bonis‐Profumo G, Stacey N, Brimblecombe J. Maternal diets matter for children's dietary quality: Seasonal dietary diversity and animal-source foods consumption in rural Timor-Leste. MATERNAL & CHILD NUTRITION 2021; 17:e13071. [PMID: 32761775 PMCID: PMC7729527 DOI: 10.1111/mcn.13071] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/09/2020] [Accepted: 07/16/2020] [Indexed: 12/24/2022]
Abstract
Improving the dietary quality of women and children is essential to reduce all forms of malnutrition. In this study, we assessed seasonal child and maternal dietary diversity and consumption of animal-source foods (ASF), using 1,236 observations from combined data collected among 167 mother-child dyads in rural Timor-Leste. We used generalized linear and logistic mixed-effects models to examine the dietary differentials of mothers and children in two agricultural livelihood zones and across the seasons, as well as to identify household and agroecological characteristics associated with children's dietary quality in relation to their mothers'. We found dietary quality to be marginally better in coastal than in mid-altitude zones. However, women's diets were strikingly poor, and their intake of ASF was lower than among children. Mothers exhibited preferential allocation patterns of specific ASF, dairy products and eggs, to children. The intake of ASF was predicted by seasonality. Flesh foods and red meat were much more likely to be consumed during the dry season, when cultural ceremonies are often performed. We found a positive and strongly significant association between children's dietary indicators-dietary diversity score, minimum dietary diversity and ASF consumption, and those of their mothers'. Maternal dietary quality and educational attainment, more so than agroecological characteristics, were explanatory factors of children's diet. Our study highlights that addressing the dietary quality of children in Timor-Leste would benefit from improving women's diets through better access to nutritious foods and to secondary education.
Collapse
Affiliation(s)
- Gianna Bonis‐Profumo
- Research Institute for the Environment and LivelihoodsCharles Darwin UniversityEllengowan DriveDarwinNorthern Territory0909Australia
| | - Natasha Stacey
- Research Institute for the Environment and LivelihoodsCharles Darwin UniversityEllengowan DriveDarwinNorthern Territory0909Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health SciencesMonash University264 Ferntree Gully RoadNotting HillVictoria3168Australia
| |
Collapse
|
27
|
Conceptual framework of food systems for children and adolescents. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2020. [DOI: 10.1016/j.gfs.2020.100436] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
28
|
The diets of children: Overview of available data for children and adolescents. GLOBAL FOOD SECURITY 2020. [DOI: 10.1016/j.gfs.2020.100442] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|