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Long JM, Gatica‐Domínguez G, Westcott JE, Taren D, Tejeda G, Diba TS, Mastiholi SC, Khan US, Garcés A, Figueroa L, Lokangaka A, Goudar SS, Aziz Ali S, Hambidge KM, Krebs NF. Infant and young child feeding indicators are positively associated with length and family care indicators in the children of the Women First trial participants. MATERNAL & CHILD NUTRITION 2024; 20:e13572. [PMID: 37817452 PMCID: PMC10750017 DOI: 10.1111/mcn.13572] [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: 05/15/2023] [Revised: 08/24/2023] [Accepted: 09/13/2023] [Indexed: 10/12/2023]
Abstract
This research describes the proportion of children in four low- and middle-income countries with adequate dietary practices at 6, 12, 18 and 24 months of age and how these practices changed over time using the World Health Organisation and UNICEF's infant young child feeding (IYCF) indicators. The associations between the IYCF indicators and anthropometric z-scores from 6 to 24 months, and between the IYCF indicators and the family care indicators (FCIs) at 24 months are described. This was a longitudinal study of offspring from participants in the Women First Preconception Maternal Nutrition Trial conducted in Sud-Ubangi, Democratic Republic of Congo; Chimaltenango, Guatemala; Belagavi, North Karnataka, India; and Thatta, Sindh Province, Pakistan. The frequency of the minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum adequate diet (MAD) increased between 6 and 24 months, but even at 24 months MAD remained below 50% at all sites. MDD (β = 0.12; 95% CI = 0.04-0.22) and MMF (β = 0.10; 95% CI = 0.03-0.17) were positively associated with length-for-age z-score at 24 months. All IYCF indicators were positively associated with mean total FCI score: MDD (proportion ratio [PR] = 1.04; 95% CI = 1.02-1.07), MMF (PR = 1.02; 95% CI = 1.01-1.04), MAD (PR = 1.05; 95% CI = 1.02-1.08). Although there are multiple barriers to young children having an adequate diet, our results support a positive association between familial interactions and improved IYCF feeding practices.
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Affiliation(s)
- Julie M. Long
- Department of Pediatrics, Section of NutritionUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Giovanna Gatica‐Domínguez
- Maternal and Infant Health CenterInstituto de Nutrición de Centro América y PanamáGuatemala CityGuatemala
| | - Jamie E. Westcott
- Department of Pediatrics, Section of NutritionUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Douglas Taren
- Department of Pediatrics, Section of NutritionUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Gabriela Tejeda
- Maternal and Infant Health CenterInstituto de Nutrición de Centro América y PanamáGuatemala CityGuatemala
| | - Tshilenge S. Diba
- Kinshasa School of Public Health, Democratic Republic of CongoKinshasaDemocratic Republic of the Congo
| | - Shivanand C. Mastiholi
- Women's and Children's Health Research UnitKLE Academy of Higher Education and Research's Jawaharlal Nehru Medical CollegeBelagaviIndia
| | - Umber S. Khan
- Department of Community Health SciencesAga Khan UniversityKarachiPakistan
| | - Ana Garcés
- Maternal and Infant Health CenterInstituto de Nutrición de Centro América y PanamáGuatemala CityGuatemala
| | - Lester Figueroa
- Maternal and Infant Health CenterInstituto de Nutrición de Centro América y PanamáGuatemala CityGuatemala
| | - Adrien Lokangaka
- Kinshasa School of Public Health, Democratic Republic of CongoKinshasaDemocratic Republic of the Congo
| | - Shivaprasad S. Goudar
- Women's and Children's Health Research UnitKLE Academy of Higher Education and Research's Jawaharlal Nehru Medical CollegeBelagaviIndia
| | - Sumera Aziz Ali
- Department of Community Health SciencesAga Khan UniversityKarachiPakistan
| | - K. Michael Hambidge
- Department of Pediatrics, Section of NutritionUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Nancy F. Krebs
- Department of Pediatrics, Section of NutritionUniversity of Colorado School of MedicineAuroraColoradoUSA
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de Souza GR, Ribeiro-Silva RDC, Felisbino-Mendes MS, Silva NDJ, de Andrade RDCS, Pedroso J, Spaniol AM, Bortolini GA, Nilson EAF, da Silva SA, Lourenço BH, Rocha ADS, Falcão IR, Ichihara MYT, Farias DR, Barreto ML. Time trends and social inequalities in infant and young child feeding practices: national estimates from Brazil's Food and Nutrition Surveillance System, 2008-2019. Public Health Nutr 2023; 26:1731-1742. [PMID: 37231823 PMCID: PMC10478053 DOI: 10.1017/s1368980023001039] [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: 08/10/2022] [Revised: 04/26/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To describe the time trends and socio-economic inequalities in infant and young child feeding practices in accordance with the Brazilian deprivation index (BDI). DESIGN This time-series study analysed the prevalence of multiple breast-feeding and complementary feeding indicators based on data from the Brazilian Food and Nutrition Surveillance System, 2008-2019. Prais-Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. SETTING Primary health care services, Brazil. PARTICIPANTS Totally, 911 735 Brazilian children under 2 years old. RESULTS Breast-feeding and complementary feeding practices differed between the extreme BDI quintiles. Overall, the results were more favourable in the municipalities with less deprivation (Q1). Improvements in some complementary feeding indicators were observed over time and evidenced such disparities: minimum dietary diversity (Q1: Δ 47·8-52·2 %, APC + 1·44, P = 0·006), minimum acceptable diet (Q1: Δ 34·5-40·5 %, APC + 5·17, P = 0·004) and consumption of meat and/or eggs (Q1: Δ 59·7-80·3 %, APC + 6·26, P < 0·001; and Q5: Δ 65·7-70·7 %, APC + 2·20, P = 0·041). Stable trends in exclusive breast-feeding and decreasing trends in the consumption of sweetened drinks and ultra-processed foods were also observed regardless the level of the deprivation. CONCLUSIONS Improvements in some complementary food indicators were observed over time. However, the improvements were not equally distributed among the BDI quintiles, with children from the municipalities with less deprivation benefiting the most.
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Affiliation(s)
- Giesy Ribeiro de Souza
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Mariana Santos Felisbino-Mendes
- School of Nursing, Department of Mother-Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Natanael de Jesus Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Barcelona Institute for Global Health, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | | | - Jéssica Pedroso
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Ana Maria Spaniol
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Gisele Ane Bortolini
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | - Eduardo Augusto Fernandes Nilson
- Food, Nutrition and Culture Program (PALIN), Brasília Regional Management, Oswaldo Cruz Foundation, Federal District, Brasília, Brazil
| | - Sara Araújo da Silva
- General Coordination of Food and Nutrition, Ministry of Health, Federal District, Brasília, Brazil
| | | | - Aline dos Santos Rocha
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Ila Rocha Falcão
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
| | - Maria Yury Travassos Ichihara
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maurício Lima Barreto
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia41745-715, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
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Allen CK, Assaf S, Namaste S, Benedict RK. Estimates and trends of zero vegetable or fruit consumption among children aged 6-23 months in 64 countries. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001662. [PMID: 37368873 DOI: 10.1371/journal.pgph.0001662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
Children require a diverse diet, that includes vegetables and fruits, to support growth and development and prevent non-communicable diseases. The WHO-UNICEF established a new infant and young child feeding (IYCF) indicator: zero vegetable or fruit (ZVF) consumption among children aged 6-23 months. We estimated the prevalence, trends, and factors associated with ZVF consumption using nationally representative, cross-sectional data on child health and nutrition in low-and-middle-income countries. We examined 125 Demographic and Health Surveys in 64 countries conducted between 2006-2020 with data on whether a child ate vegetables or fruits the previous day. Prevalence of ZVF consumption was calculated by country, region, and globally. Country trends were estimated and tested for statistical significance (p<0.05). Logistic regression analysis was used to examine the relationship between ZVF and child, mother, household, and survey cluster characteristics by world region and globally. Using a pooled estimate of the most recent survey available in each country, we estimate the global prevalence of ZVF consumption as 45.7%, with the highest prevalence in West and Central Africa (56.1%) and the lowest in Latin America and the Caribbean (34.5%). Recent trends in ZVF consumption varied by country (16 decreasing, eight increasing, 14 no change). Country trends in ZVF consumption represented diverse patterns of food consumption over time and may be affected by the timing of surveys. Children from wealthier households and children of mothers who are employed, more educated, and have access to media were less likely to consume ZVF. We find the prevalence of children aged 6-23 months who do not consume any vegetables or fruits is high and is associated with wealth and characteristics of the mother. Areas for future research include generating evidence from low-and-middle-income countries on effective interventions and translating strategies from other contexts to improve vegetable and fruit consumption among young children.
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Affiliation(s)
- Courtney K Allen
- Sociology Department, University of Washington, Seattle, Washington, United States of America
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Shireen Assaf
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Sorrel Namaste
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Rukundo K Benedict
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
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