Evaluation of anthropometric indices and their relationship with maternal nutritional literacy and selected socio-economic and demographic variables among children under 5 years old

Disparities in Pediatric Growth Evaluation, Diagnosis, and Treatment

Gender, racial, and socioeconomic disparities exist in the evaluation of childhood growth, namely the overevaluation/treatment of White males and under evaluation/treatment of females and children from minoritized groups. To improve disparities in growth, a comprehensive approach is crucial to improve access to health care, increase provider education and awareness, and address biases and structural racism.

Association between individual, household, and area-level socioeconomic status indicators with anthropometric indexes

Objectives

Overweight and obesity are major determinants that contribute to the occurrence of non-communicable diseases. We aim to examine the association between anthropometric indexes and socioeconomic status.

Study design

This study was a population-based cross-sectional study conducted on 9846 adults aged 35 to 70 years who participated in the Hoveyzeh Cohort Study from May 2016 to August 2018 in southwestern Iran.

Methods

We assessed the relationship between three levels of socioeconomic indicators with eight anthropometric indexes. Multiple logistic regression was used to adjust the potential confounders.

Results

The mean ± sd age of 9846 participants was 48.80 ± 9.20, and 5820 (59.1 %) were female Among the socioeconomic indicators, after control for potential confounders, the wealth index and, in the second place, the townsend deprivation index had the strongest relationships with anthropometric indexes. In contrast, the relationships between education and anthropometric indexes were mostly weak and without certain trends. Among the anthropometric indexes, waist circumference, abdominal volume index, and waist to height ratio had a statistically significant association with socioeconomic indicators. The weakest associations were found for the waist to hip ratio index.

Conclusion

This study showed significant associations between socioeconomic and anthropometric indicators. The role of economic factors is more decisive than social factors.

Investigating the correlations between nutrition literacy of mothers and offspring physical growth and development, dietary diversity and quality, and vitamin levels

OBJECTIVE

To investigate the relationship between nutrition literacy (NL) of mothers and physical growth and development, dietary diversity and quality, and vitamin levels of their children aged 24-59 months.

METHODS

A cross-sectional survey-based study was conducted at well-child outpatient clinic. Eighty-eight mother-child pairs included. Mother's Evaluation Instrument of Nutrition Literacy for Adults (EINLA) scores and child anthropometric z-scores, age when reaching six gross motor milestones, dietary diversity and the Mediterranean Diet Quality Index scores, and serum vitamin A, B1, B2, B12, C, D, and E levels were measured. Two independent groups comparison statistics and Spearman rank correlations were performed.

RESULTS

Thirty-four mothers (38.6%) had borderline and 54 mothers (61.4%) had adequate NL level. The percentages of wasted and acutely malnourished children were higher in the borderline NL group (17.6% vs. 1.9%, p=0.005 and 14.7% vs. 1.9%, p=0.030, respectively). There was no significant correlation between maternal EINLA score and child motor skill acquisition, dietary diversity, or serum vitamin status (p>0.05). There was a correlation between maternal EINLA score and child dietary quality score (r=0.218, p=0.041).

CONCLUSION

Increasing NL of mothers may be a step toward improving the dietary quality of children and reducing the burden of child undernutrition.

Analysis of Determinants of Stunting and Identifications of Stunting Risk Profiles Among Under 2-Year-Old Children in Ethiopia. A Latent Class Analysis

Background

Childhood stunting has a long-term impact on cognitive development and overall well-being. Understanding varying stunting profiles is crucial for targeted interventions and effective policy-making. Therefore, our study aimed to identify the determinants and stunting risk profiles among 2-year-old children in Ethiopia.

Methods and materials

A cross-sectional study was conducted on 395 mother-child pairs attending selected public health centers for growth monitoring and promotion under 5 outpatient departments and immunization services. The data were collected by face-to-face interviews, with the anthropometric data collected using the procedure stipulated by the World Health Organization. The data were entered using Epi Data version 4.6 and exported to STATA 16 and Jamovi version 2.3.28 for analysis. Bayesian logistic regression analysis was conducted to identify potential factors of stunting. Likewise, lifecycle assessment analysis (LCA) was used to examine the heterogeneity of the magnitude of stunting.

Results

The overall prevalence of stunting in children under 24 months was 47.34% (95% confidence interval (CI): 42.44-52.29%). The LCA identified 3 distinct risk profiles. The first profile is Class 1, which is labeled as low-risk, comprised 23.8% of the children, and had the lowest prevalence of stunting (23.4%). This group characterized as having a lower risk to stunting. The second profile is Class 2, which is identified as high-risk, comprised 47.1%, and had a high prevalence of stunting (66.7%), indicating a higher susceptibility to stunting compared to Class 1. The third profile is Class 3, which is categorized as mixed-risk and had a moderate stunting prevalence of 35.7%, indicating a complex interplay of factors contributing to stunting.

Conclusion

Our study identified 3 distinct risk profiles for stunting in young children. A substantial amount (almost half) is in the high-risk category, where stunting is far more common. The identification of stunting profiles necessitates considering heterogeneity in risk factors in interventions. Healthcare practitioners should screen, provide nutrition counseling, and promote breastfeeding. Policymakers should strengthen social safety nets and support primary education.

The relationship between parental health literacy levels and anthropometric measurements of children in Turkey

OBJECTIVE

The aim of this study was to identify the relationship between parental health literacy levels and anthropometric measurements of children in Turkey.

METHODS

The research was of cross-sectional/correlational design and carried out with 378 consenting parents registered at a Family Health Center. A Sociodemographic Data Form and the Health Literacy Scale for Turkey-32 was used to collect the study data. Data collection was completed at face-to-face interviews held in the consultation department of the family health center. The data were analyzed with the chi-square test and Ordinal Logistic Regression Analysis.

RESULTS

It was determined that parental health literacy levels were associated with level of education, income status and the state of the parents' employment (p < .05). A relationship was also found between adequate levels of parental health literacy and the health status, weight and height standard deviation scores by age of the parents' children (p < .05).

CONCLUSION

This study found that adequate levels of parental health literacy were significantly lower than the European average. The study found that adequate parental health literacy had a positive effect on children's anthropometric measurements. Health institutions and health professionals should plan training programs to improve the health literacy of parents when they apply to health institutions.

Mother's Nutrition Literacy and Offspring Anemia: A Comparison Study in a Single Center

OBJECTIVE

It is known that mother's knowledge about nutrition is associated with the prevalence of anemia in their children. The aim of this study was to evaluate the frequency of iron deficiency without anemia (ID), iron deficiency anemia (IDA), and anemia in children according to the level of mother's nutrition literacy (NL).

MATERIALS AND METHODS

A cross-sectional study was conducted in a well-child outpatient clinic. The study included healthy children aged between 24 and 59 months and their mothers. Scores of the mothers on the Nutrition Literacy Assessment Tool for Adults and children's anthropometric z-scores, dietary diversity and Mediterranean Diet Quality Index scores, and children's hemoglobin and ferritin levels were collected. Two-group comparison analysis was performed.

RESULTS

Ninety mother-child pairs were included. While 36 mothers (40%) had borderline and 54 (60%) mothers had adequate NL, 15 children (16.7%) had ID, 5 (5.6%) children had IDA, and a total of 18 children (20%) had nutritional anemia. The percentage of wasted children was higher in the group with borderline NL (13.9% vs. 1.9%, P = .036). The percentage of children with ID, IDA, or other nutritional anemia was not different between the borderline and adequate NL groups (30.6% vs. 40.7%, P = .326).

CONCLUSION

The frequency of ID, IDA, or other nutritional anemia in children does not differ significantly between mothers with borderline and adequate NL. Increasing NL of mothers could be a step toward reducing the burden of child undernutrition.

Dietary Behavior and Its Association with Nutrition Literacy and Dietary Attitude Among Breast Cancer Patients Treated with Chemotherapy: A Multicenter Survey of Hospitals in China

Background

Chemotherapy often negatively impacts the nutritional status of breast cancer patients, and healthy dietary behaviors are important for patient wellbeing. With the guidance of the "Knowledge, Attitude and Practice model" (KAP model), the objective of this survey was to determine the frequency with which patients engage in healthy dietary behaviors and to explore the association between healthy dietary behaviors and nutrition literacy and dietary attitudes.

Methods

This study included a total of 284 breast cancer patients undergoing chemotherapy from three hospitals spanning three cities in China. Face-to-face interviews were conducted to collect demographic and clinical characteristics as well as the Dietary Nutritional Knowledge, Attitude and Practice Questionnaire (DNKAPQ) and the Nutrition Literacy Measurement Scale for Chinese Adult (NLMS-CA).

Results

Participants exhibited medium to high scores for nutrition literacy, dietary attitude and dietary behavior. Nutrition literacy (r = 0.505, p < 0.001) and dietary attitude (r= 0.326, p < 0.001) scores were both positively correlated with the total dietary behavior score. The total nutrition literacy score was positively correlated with the total dietary behavior score (r = 0.286, p < 0.001). In the univariate analysis, age, body mass index, living environment, education level, monthly family income, work status, menopausal status, number of comorbidities, relapse and endocrine therapy were significantly associated with dietary behavior (p < 0.05). In the multiple linear regression analysis, patients' dietary behavior was significantly associated with nutrition literacy (β = 0.449, p < 0.001) and dietary attitude (β = 0.198, p < 0.001). These two factors accounted for 28.6% of the variation in the patients' dietary behavior scores.

Conclusion

There is an important need for targeted dietary and nutritional interventions designed and implemented by health professionals to improve dietary behaviors. Intervention design and content should take the patients' nutrition literacy and dietary attitudes into consideration. In particular, women who are older, overweight, unemployed, and postmenopausal and live in rural areas, exhibit fewer comorbidities, have a lower family income and education level, have not relapsed and are currently receiving endocrine therapy are in urgent need of diet-specific intervention.