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Kishino M, Hida A, Ishikawa-Takata K, Tada Y, Kariuki L, Maundu P, Matsuda H, Irie K, Morimoto Y. Relationship of dietary intake between children aged 12-59 months and their mothers in rural Kenya: a cross-sectional study in two seasons. J Hum Nutr Diet 2024; 37:491-502. [PMID: 38130112 DOI: 10.1111/jhn.13271] [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: 09/14/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The aim of the study was to investigate the quantitative association between the dietary intakes of children and their caregivers. METHOD In this cross-sectional study, a non-consecutive 2-day 24-h dietary recall was conducted in two seasons. Participants comprised 142 pairs of 12-59-month-old children and their female caregivers from rural areas of Kenya. Energy and micronutrient adequacy, food group intakes and food allocation were assessed. Differences and correlations between caregiver and child diets were examined, and multiple regression analysis was used to investigate the relationship between the children's and caregivers' dietary intakes. RESULTS The child's diet was significantly lower in energy and higher in micronutrient adequacy than was the caregiver's diet (p < 0.001). Specifically, the child's diet contained more fruits, dairy products, sugar and confectionaries per 4184 kj. Children were allocated relatively more dishes containing nutrient-rich foods than staple foods. The correlation coefficients between the dietary intake of caregivers and children were stronger among 24-59-month-old children. After controlling with covariates, caregiver energy intake was significantly associated with child energy intake (standardised beta [β] = 0.512, p < 0.001), and caregiver micronutrient adequacy was associated with child micronutrient adequacy (β = 0.679 and β = 0.262 after energy adjustment, p < 0.001). CONCLUSIONS The dietary intakes of caregivers and children were closely related. The children had a more nutrient-rich diet compared to that of their caregivers. Differences in food group intakes and food allocation may contribute to the higher nutrient adequacy of children. There is a need to improve the diet of caregivers, which would contribute to improving the diet of children.
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Affiliation(s)
- Madoka Kishino
- Department of Food and Nutritional Science, Graduate School of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Azumi Hida
- Department of Nutritional Science, Faculty of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan
| | - Kazuko Ishikawa-Takata
- Department of Nutritional Science, Faculty of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan
| | - Yuki Tada
- Department of Nutritional Science, Faculty of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan
| | - Lucy Kariuki
- Food Environment and Consumer Behavior Program, Alliance of Bioversity International and International Center for Tropical Agriculture - CIAT, Nairobi, Kenya
| | - Patrick Maundu
- Food Environment and Consumer Behavior Program, Alliance of Bioversity International and International Center for Tropical Agriculture - CIAT, Nairobi, Kenya
- Kenya Resource Center for Indigenous Knowledge, National Museum of Kenya, Nairobi, Kenya
| | - Hirotaka Matsuda
- Department of Agricultural Innovation for Sustainable Society, Faculty of Agriculture, Tokyo University of Agriculture, Kanagawa, Atsugi, Japan
| | - Kenji Irie
- Department of International Agricultural Development, Faculty of International Agriculture and Food Studies, Tokyo University of Agriculture, Tokyo, Japan
| | - Yasuyuki Morimoto
- Food Environment and Consumer Behavior Program, Alliance of Bioversity International and International Center for Tropical Agriculture - CIAT, Nairobi, Kenya
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Abdelmenan S, Berhane HY, Turner C, Worku A, Selling K, Ekström EC, Berhane Y. Perception of affordable diet is associated with pre-school children's diet diversity in Addis Ababa, Ethiopia: the EAT Addis survey. BMC Nutr 2024; 10:47. [PMID: 38449007 PMCID: PMC10916157 DOI: 10.1186/s40795-024-00859-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/22/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Despite improvements in food access and nutrition security over the last few decades, malnutrition remains a major public health problem. One of the significant contributors to these problems is affordability of nutritious food. This study aimed to examine the association between perceived food affordability and pre-school children's diet diversity in Addis Ababa, Ethiopia. METHODS Cross-sectional data from 2017 to 18 were used for the analysis. A 24-hour dietary recall assessment was done to assess children's dietary diversity (DD). We used a modified operational definition of affordability indicator called perceived affordability of dietary diversity (afford-DD) to evaluate the impact of the food environment in terms of affordability at the household level. A sample (n 4,898) of children aged 6-59 months representative of households in Addis Ababa was randomly selected using a multistage sampling procedure including all districts in the city. Mixed-effects linear regression models were used to assess the association between children's DD and afford-DD. RESULTS The survey revealed that the mean (standard deviation [SD]) of children's DD was 3.9 [± 1.4] while the mean [SD] of afford-DD was 4.6 [± 2.1]. Overall, 59.8% of children met the minimum dietary diversity (≥ 4 food groups). White roots and tubers were the most commonly consumed food groups regardless of their affordability. Considerable variations were observed between households that reported the food item affordable and not affordable in consumption of Vitamin A rich vegetables and fruits, meat and fish, egg, and dairy. The children's DD was positively associated with afford-DD after adjusting for maternal education, household wealth status and other relevant confounding. Higher maternal education modified the association between affordability and children's diet diversity. CONCLUSIONS This study suggests higher perceived food affordability was associated with better diet diversity in children. A higher level of maternal education had the potential to mitigate affordability challenges in meeting the children's dietary diversity needs. Our study emphasizes the need for inclusive food programs and nutrition interventions addressing social differences, intensifying efforts to make nutrient-rich diets affordable for the less privileged, and highlights the potential benefits of targeting maternal education in addressing child dietary diversity.
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Affiliation(s)
- Semira Abdelmenan
- Global Health and Migration Unit, Department of Women's and Children Health, Uppsala University, 751 85, Uppsala, Sweden.
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Hanna Y Berhane
- Global Health and Migration Unit, Department of Women's and Children Health, Uppsala University, 751 85, Uppsala, Sweden
- Department of Nutrition and Behavioral sciences, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Christopher Turner
- Department of Population Health, Faculty of Epidemiology and Population Health, School of Hygiene and Tropical Medicine, London, UK
| | - Alemayehu Worku
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Katarina Selling
- Global Health and Migration Unit, Department of Women's and Children Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Eva-Charlotte Ekström
- Global Health and Migration Unit, Department of Women's and Children Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Yemane Berhane
- Global Health and Migration Unit, Department of Women's and Children Health, Uppsala University, 751 85, Uppsala, Sweden
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Bernate Angulo SV, Nezami BT, Martin SL, Kay MC, Richardson TN, Wasser HM. Concordance in dietary intake among caregivers and infants during the period of complementary feeding: A scoping review. Appetite 2024; 194:107178. [PMID: 38141877 PMCID: PMC11027945 DOI: 10.1016/j.appet.2023.107178] [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: 08/22/2023] [Revised: 12/07/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
Dietary intake during infancy shapes later food preferences and is important for short- and long-term health and wellbeing. Although caregivers are thought to influence the developing food preferences of infants, children less than two years have been notably absent in existing meta-analyses on the topic. This scoping review seeks to fill this gap by using a systematic process to identify and summarize the published literature on the resemblance of caregiver and infant diet during the period of complementary feeding (6-23 months). Articles were included if they assessed intake of foods or beverages other than human milk or commercial milk formula and reported a test of association between the intake of caregivers and infants. Four electronic databases (PubMed, EMBASE, Scopus, and Global Health) were systematically searched for articles published since 2000. Thirty-three articles, representing 32 studies, were identified. The majority of studies examined infant intake of food groups/items (n = 20), seven studies examined infant dietary patterns, and six studies examined dietary diversity. Studies predominantly reported associations between diets of mothers and infants (n = 31); three studies reported associations for fathers. Most studies assessed infant diet at one timepoint (n = 26), with 12 studies combining the intakes of younger (0-11 months) and older infants (12-23 months). Food groups examined, in order of frequency, included 'non-core' foods and beverages (n = 14), vegetables (n = 13), fruits (n = 12), protein foods (n = 6), grains (n = 5), and dairy foods (n = 4). Definitions of variables for food groups and dietary patterns were highly heterogeneous, but consistent for dietary diversity. Nearly all studies (n = 31) reported significant associations between dietary intakes of caregivers and infants. Findings suggest caregiver diet may be a promising focus for interventions aiming to shape the food preferences and dietary intakes of infants.
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Affiliation(s)
- Sara V Bernate Angulo
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Brooke T Nezami
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Melissa C Kay
- Department of Pediatrics, Duke University, Durham, NC, 27708, USA
| | - Taylor N Richardson
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Heather M Wasser
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Kumar R, Mahmood T, Naeem N, Khan SA, Hanif M, Pongpanich S. Minimum dietary diversity and associated determinants among children aged 6-23 months in Pakistan. Sci Rep 2024; 14:2639. [PMID: 38302519 PMCID: PMC10834494 DOI: 10.1038/s41598-024-51705-4] [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] [Received: 04/14/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
Pakistan is facing a high prevalence of malnutrition and Minimum Dietary Diversity (MDD) is one of the core indicators that remain below the recommended level. This study assesses MDD and its associated factors among children aged 6 to 23 months in Pakistan. The study uses a cross-sectional study using the dataset of the latest available Multiple Indicators Cluster Survey (MICS) for all provinces of Pakistan. Multistage sampling is used to select 18,699 children aged 6 to 23 months. The empirical method is the Logistic Regression Analysis and Chi-Square Test. The dataset is freely and publicly available with all identifier information removed, and no ethics approvals are required. About one-fifth (20%) of infants and young children aged 6 to 23 months had met MDD, this number varies from 17 to 29%, highest in Baluchistan and lowest in Punjab province of Pakistan. The age group (18-23) indicates a 2.45 times greater chance of having MDD. Age (< 0.001), diarrhea (0.01), prenatal care (0.06), mother's education (< 0.001), computer access (< 0.001), wealth quantile (< 0.001), and residence (< 0.001) were significantly associated with meeting MDD. However, gender (0.6) and mother's age (0.4) both were statistically insignificant in meeting MDD. Regarding mothers' education, compared to no education, the chance of MDD is 1.45 times greater for highly educated mothers in the Punjab province. Dietary diversity among children aged 6 to 23 months in Pakistan is low. It is recommended that mothers should be aware and encouraged to use dietary diverse food for infants and younger children.
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Affiliation(s)
- Ramesh Kumar
- College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Tahir Mahmood
- Faculty of Business Administration, Sukkur IBA University, Sukkur, Pakistan
| | - Nawal Naeem
- Health Services Academy, Islamabad, Pakistan
| | | | - Mubashir Hanif
- Department of Medical Genetics, University of Helsinki, Helsinki, Finland
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Adeba A, Tamiru D, Belachew T. Healthy dietary practices and its' associated factors among adults of Nekemte dwellers, Oromia State, Western Ethiopia. Front Nutr 2024; 10:1259024. [PMID: 38328684 PMCID: PMC10847308 DOI: 10.3389/fnut.2023.1259024] [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: 07/18/2023] [Accepted: 12/22/2023] [Indexed: 02/09/2024] Open
Abstract
Background and purposes Appropriate healthy dietary practices are essential for well-being. Adopting of healthy lifestyle remains challenging worldwide. Ethiopia has an unacceptably high burden of malnutrition like other least developed countries. However, healthy dietary practices and their associated factors were not conducted in Nekemte town. Hence, the study was designed to assess healthy dietary practices and associated factors among middle-aged adults in Nekemte town from January 15 to February 30, 2019. Methods A community-based cross-sectional study design was applied in Nekemte town. Primary data were gathered using a questionnaire from 266 adults and checked for normality. In both bivariate and multivariate logistic regression analyses the association and significance were determined at P < 0.05. Results The Magnitude of dieting practice was 73.31% (unhealthy) and 26.69% (healthy), respectively. Being low-income households (P = 0.001), not married (p = 0.001), had a daily meal frequency [AOR: 1.91, 95% CI: (1.04, 2.71), and had poor knowledge of healthy diet AOR: 3.87, 95% CI: (3.23, 5.65)] were associated with unhealthy diets. Conclusion The researchers identified unhealthy diet practices were widespread in the study samples of Nekemte populations. Hereafter, community-based lifestyle and Nutrition education through intensive participation of community leaders is highly recommended.
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Affiliation(s)
- Alemu Adeba
- Human Nutrition Department, Wallaga University, Nekemte, Ethiopia
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Haque S, Salman M, Hossain MS, Saha SM, Farquhar S, Hoque MN, Zaman N, Hira FTZ, Hasan MM. Factors associated with child and maternal dietary diversity in the urban areas of Bangladesh. Food Sci Nutr 2024; 12:419-429. [PMID: 38268877 PMCID: PMC10804084 DOI: 10.1002/fsn3.3755] [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: 12/14/2022] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 01/26/2024] Open
Abstract
Dietary diversity is an indicator of nutrition that has been found positively associated with diet quality, micronutrient adequacy, and improved maternal health and child growth. Due to the cultural responsibility of women in providing food at the household level, their status is very important to perform this role. Hence, this study has been conducted on the status of dietary diversity of the mother and child to understand how it relates to various factors of women in urban settings. Data were obtained from 1978 mother-child pairs living in different cities in Bangladesh. The foods taken by the women and children were categorized into 10 and 7 groups to measure women's dietary diversity (WDD) and children's dietary diversity (CDD), respectively. The study found that more than three-fourths of the mothers and half of the children had low dietary diversity. The household wealth holdings and access to resources by the women were found inadequate, while two-thirds of them had the lowest to medium level of nutritional knowledge. The binomial logistic regression model was used to measure the factors influencing WDD and CDD. The findings also indicated that children's dietary diversity was influenced by the mother's age, education, supportive attitude and behavior of husband, and access to and control over resources. While the household wealth index can enhance both child and mother's dietary variety, nutrition knowledge, dietary counseling, and access to and control over resources can improve maternal dietary diversity. This study recommends improving women's socioeconomic status by increasing their wealth and access to resources and enhancing their nutrition knowledge by providing food and nutrition counseling.
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Affiliation(s)
- Sadika Haque
- Department of Agricultural EconomicsBangladesh Agricultural UniversityMymensinghBangladesh
| | - Md. Salman
- Department of Agricultural EconomicsBangladesh Agricultural UniversityMymensinghBangladesh
| | - Md. Shakhawat Hossain
- Southwest Area Integrated Water Resources Planning and Management (SAIWRPM) Project, Bangladesh Water Development BoardFaridpurBangladesh
| | - Sourav Mohan Saha
- Department of Agricultural Finance, Co‐operatives and BankingKhulna Agricultural UniversityKhulnaBangladesh
| | - Samantha Farquhar
- Integrated Coastal SciencesEast Carolina UniversityGreenvilleNorth CarolinaUSA
| | - Md. Nazmul Hoque
- Student Affairs DivisionBangladesh Agricultural UniversityMymensinghBangladesh
| | - Nafisa Zaman
- Department of Agricultural EconomicsBangladesh Agricultural UniversityMymensinghBangladesh
| | - Fatema Tuj Zohora Hira
- Faculty of Agricultural Economics & Rural SociologyBangladesh Agricultural UniversityMymensinghBangladesh
| | - Md. Mehedi Hasan
- Faculty of Agricultural Economics & Rural SociologyBangladesh Agricultural UniversityMymensinghBangladesh
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Ahmed KT, Karimuzzaman M, Pinky GN, Dasgupta DP, Rahman L, Hossain MM, Rahman A. Association of dietary diversity of 6-23 months aged children with prenatal and postnatal obstetric care: evidence from a nationwide cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:120. [PMID: 37932856 PMCID: PMC10629119 DOI: 10.1186/s41043-023-00470-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 11/01/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Dietary diversity is a key determinant of infant and young child eating patterns for a variety of food groups taken by children between the ages of 6-23 months. The study aimed to examine the association between prenatal and postnatal obstetric care factors of mother and child's dietary diversity, and specific food practices in Bangladesh. METHODS This study analyzed the data of 2497 children between the age of 6-23 extracted from the latest countrywide Bangladesh Demographic Health Survey 2017-2018 and explored relationships between prenatal and postnatal obstetric care received by mother and dietary diversity score (DDS), minimum dietary diversity (MDD), and introduction of solid, semi-solid, and soft foods (ISSSF) of their children. RESULTS Findings revealed that ≥ 4 antenatal care (ANC) visits care visits increased the DDS (adjusted [Formula: see text]: 0.32, 95% CI [0.21, 0.43]), increased the likelihood of MDD (AOR 1.54, 95% CI [1.23, 1.93]), and ISSSF (AOR 1.24, 95% CI [1.08, 1.48]), consuming eggs (AOR 1.47, 95% CI [1.23, 1.76]), and vitamin A vegetables and fruits (AOR 1.38, 95% CI [1.15, 1.66]). Moreover, DDS (adjusted β: 0.05, 95% CI [0.00, 0.11]) and MDD (AOR 1.66, 95% CI [1.31, 2.11]) are linked to childbirth in a medical facility. The C-section delivery influences the DDS (adjusted [Formula: see text]: 0.05, 95% CI [0.00, 0.10]), MDD (AOR 1.39, 95% CI [1.10, 1.75]), and ISSSF (AOR 1.22, 95% CI [1.02, 1.48]). Besides, postnatal visits within 48 h of delivery linked to MDD (AOR 0.66, 95% CI [0.49, 0.89]) and ISSSF (AOR 0.76, 95% CI [0.59, 0.97]), and physicians or professionals providing postnatal checkups were significantly associated with DDS (adjusted [Formula: see text]: 0.09, 95% CI [0.02, 0.16]), MDD (AOR 1.69, 95% CI [1.26, 2.26]), and ISSSF (AOR 1.30, 95% CI [1.04, 1.62]). CONCLUSION Knowledge of child nutritional feeding should emphasize during prenatal and postnatal obstetric care of mother, particularly during antenatal and postnatal visits, C-section delivery, and birth in a healthcare facility to eradicate malnutrition and establish healthy child feeding practices.
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Affiliation(s)
| | - Md Karimuzzaman
- DREXEL Dornsife School of Public Health, DREXEL University, Philadelphia, USA.
| | - Guliva Nazneen Pinky
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Dibbya Pravas Dasgupta
- Center for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Labiba Rahman
- Department of Statistics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Md Moyazzem Hossain
- Department of Statistics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
- School of Mathematics, Statistics, and Physics, Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK.
| | - Azizur Rahman
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW, 2678, Australia
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Jugha VT, Anchang JA, Taiwe GS, Kimbi HK, Anchang-Kimbi JK. Association between malaria and undernutrition among pregnant women at presentation for antenatal care in health facilities in the Mount Cameroon region. PLoS One 2023; 18:e0292550. [PMID: 37824491 PMCID: PMC10569528 DOI: 10.1371/journal.pone.0292550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/24/2023] [Indexed: 10/14/2023] Open
Abstract
In resource limited settings, malaria and undernutrition are major public health problems in pregnancy. Therefore, this study assessed the association between malaria infection and undernutrition among pregnant women in the Mount Cameroon area. This cross-sectional study enrolled 1,014 pregnant women consecutively over a year. A structured questionnaire was used to collect socio-demographic information and clinical data. Maternal nutrition was assessed using dietary diversity (DD). Peripheral blood samples collected were used for the diagnosis of malaria parasitaemia by microscopy whereas haemoglobin (Hb) levels were determined using an Hb meter. Logistic regression was used to determine factors associated with malaria and dietary diversity. The prevalence of malaria infection and undernutrition was 17.8% and 89.6% respectively. In addition, of those infected with malaria, geometric mean parasite density was 301/μL of blood (range: 40-9280) while mean DD score was 3.57±0.82 (range: 1-7). The odds of being infected with malaria parasitaemia was highest among women enrolled in the rainy season (OR = 1.58, P = 0.043), who were farmers (OR = 2.3, P = 0.030), had a household size of < 4 individuals (OR = 1.48, P = 0.026) and who were febrile (OR = 1.87, P < 0.001). Also, attending clinic visits in Mutengene Medical Centre (OR = 2.0, P = 0.012) or Buea Integrated Health Centre (OR = 2.9, P = < 0.001), being < 25 years (OR = 2.4, P = 0.002) and a farmer (OR = 10.6, P = 0.024) as well as < 4 clinic visits (OR = 1.62, P = 0.039) were identified as predictors of undernutrition. Furthermore, the association between malaria and DD was statistically significant (P = 0.015). In this study, undernutrition was highly frequent than malaria infection. Thus, there is an urgent need to improve maternal awareness through nutritional counselling and health campaigns on the benefits of consuming at least five food groups. Besides, improved maternal dietary nutrient intake is likely to have impact on the burden of malaria parasite infection.
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Affiliation(s)
- Vanessa Tita Jugha
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
| | - Juliana Adjem Anchang
- International Centre for Agricultural Research in the Dry Areas, ICARDA, Cairo, Eygpt
| | | | - Helen Kuokuo Kimbi
- Department of Animal Biology and Conservation, University of Buea, Buea, Cameroon
- Department of Biomedical Sciences, University of Bamenda, Bamenda, Cameroon
- Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
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Headey D, Ruel M. Food inflation and child undernutrition in low and middle income countries. Nat Commun 2023; 14:5761. [PMID: 37717010 PMCID: PMC10505228 DOI: 10.1038/s41467-023-41543-9] [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: 11/25/2022] [Accepted: 09/06/2023] [Indexed: 09/18/2023] Open
Abstract
The 21st Century has been marked by increased volatility in food prices, with global price spikes in 2007-08, 2010-11, and again in 2021-22. The impact of food inflation on the risk of child undernutrition is not well understood, however. This study explores the potential impacts of food inflation on wasting and stunting among 1.27 million pre-school children from 44 developing countries. On average, a 5 percent increase in the real price of food increases the risk of wasting by 9 percent and severe wasting by 14 percent. These risks apply to young infants, suggesting a prenatal pathway, as well as to older children who typically experience a deterioration in diet quality in the wake of food inflation. Male children and children from poor and rural landless households are more severely impacted. Food inflation during pregnancy and the first year after birth also increases the risk of stunting for children 2-5 years of age. This evidence provides a strong rationale for interventions to prevent food inflation and mitigate its impacts on vulnerable children and their mothers.
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Affiliation(s)
- Derek Headey
- Senior Research Fellow, The International Food Policy Research Institute (IFPRI), Colombo, Sri Lanka.
| | - Marie Ruel
- Senior Research Fellow, The International Food Policy Research Institute (IFPRI), Washington, DC, USA
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Haque S, Salman M, Rahman MS, Rahim ATM, Hoque MN. Mothers' dietary diversity and associated factors in megacity Dhaka, Bangladesh. Heliyon 2023; 9:e19117. [PMID: 37636472 PMCID: PMC10450986 DOI: 10.1016/j.heliyon.2023.e19117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023] Open
Abstract
Mothers in developing countries are nutritionally vulnerable due to an undiversified diet. Dietary diversity and healthy dietary patterns of mothers are necessary for the health and nutrition of both the mother and the child. Keeping these in mind, the study was designed to investigate the determinants of mothers' dietary diversity in the capital city (Dhaka) of Bangladesh. A total 613 mothers who had at least one child aged 6-59 months were surveyed in 2020. Dietary diversity (DD) was measured by 24 h recall period following the established guidelines. To explore the determinants of dietary diversity, a log linear regression model was employed. The findings revealed that the overall DD of mothers was low, with less than 15% of respondents consuming more than 5 of the 9 food groups. The study found that if a mother receives one more year of formal education, her DD, on average, would increase by 0.70%. Receiving antenatal care (ANC) for four or more times during pregnancy increases DD by 5.13% compared to mothers who receive ANC less than four times. The findings also showed that mothers with access to assets have 10.18% higher DD than mothers without access to assets. On the other hand, mothers' employment status was negatively associated with DD. Redistributing the household workload between mother and other household members can play a critical role in increasing mothers' DD. Providing care facilities and counseling to mothers about the nutritional value of consuming different food groups can substantially improve the situation.
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Affiliation(s)
- Sadika Haque
- Department of Agricultural Economics, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Md Salman
- Department of Agricultural Economics, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Md Sadique Rahman
- Department of Management and Finance, Sher-e-Bangla Agricultural University, Dhaka, Bangladesh
| | | | - Md Nazmul Hoque
- Students' Affairs Division, Bangladesh Agricultural University, Mymensingh, Bangladesh
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Akseer N, Tasic H, Adeyemi O, Heidkamp R. Concordance and determinants of mothers' and children's diets in Nigeria: an in-depth study of the 2018 Demographic and Health Survey. BMJ Open 2023; 13:e070876. [PMID: 37433728 DOI: 10.1136/bmjopen-2022-070876] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVES Improving the diversity of the diets in young children 6-23 months is a policy priority in Nigeria and globally. Studying the relationship between maternal and child food group intake can provide valuable insights for stakeholders designing nutrition programmes in low-income and middle-income countries. DESIGN We examined the relationship between maternal and child dietary diversity among 8975 mother-child pairs using the Nigeria 2018 Demographic and Health Survey (DHS). We assessed concordance and discordance between maternal and child food group intake using the McNemar's χ2 test, and the determinants of child minimum dietary diversity (MDD-C) including women MDD (MDD-W) using hierarchical multivariable probit regression modelling. SETTING Nigeria. PARTICIPANTS 8975 mother-child pairs from the Nigeria DHS. PRIMARY AND SECONDARY OUTCOME MEASURES MDD-C, MDD-W, concordance and discordance in the food groups consumed by mothers and their children. RESULTS MDD increased with age for both children and mothers. Grains, roots and tubers had high concordance in mother-child dyads (90%); discordance was highest for legumes and nuts (36%), flesh foods (26%), and fruits and vegetables (39% for vitamin-A rich and 57% for other). Consumption of animal source food (dairy, flesh foods, eggs) was higher for dyads with older mothers, educated mothers and more wealthy mothers. Maternal MDD-W was the strongest predictor of MDD-C in multivariable analyses (coef 0.27; 95% CI 0.25 to 0.29, p<0.000); socioeconomic indicators including wealth (p<0.000), mother's education (p<0.000) were also statistically significant in multivariable analyses and rural residence (p<0.000) was statistically significant in bivariate analysis. CONCLUSION Programming to address child nutrition should be aimed at the mother-child dyad as their food consumption patterns are related and some food groups appear to be withheld from children. Stakeholders including governments, development partners, non-governmental organizations, donors and civil society can act on these findings in their efforts to address undernutrition in the global child population.
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Affiliation(s)
- Nadia Akseer
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Hana Tasic
- Modern Scientist Global, St Catharines, Ontario, Canada
| | - Olutayo Adeyemi
- Department of Human Nutrition and Dietetics, University of Ibadan, Ibadan, Nigeria
| | - Rebecca Heidkamp
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Alam MJ, Begum IA, Mastura T, Kishore A, Woodhill J, Chatterjee K, Jackson T. Agricultural diversification and intra-household dietary diversity: Panel data analysis of farm households in Bangladesh. PLoS One 2023; 18:e0287321. [PMID: 37352323 PMCID: PMC10289449 DOI: 10.1371/journal.pone.0287321] [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: 12/11/2022] [Accepted: 06/04/2023] [Indexed: 06/25/2023] Open
Abstract
This paper investigates the associations between agricultural diversification and dietary diversity among men, women and children of farm households in Bangladesh. Using three waves of nationally representative Bangladesh Integrated Household Survey (BIHS- 2011-12, 2015 and 2018) data and a panel data model, the study found that agricultural production diversification can emphasize the dietary diversification across the life cycle of farm household members. The balanced panel data reveals that agricultural production diversification has a statistically significant and positive impact on dietary diversity of individual members (men, women and children) of farm households. Moreover, other important factors that impact on agricultural diversification and improve dietary diversity like women's education and employment, commercialization of farm households, access to non-farm income sources, and access to information facilities also have a strong association in improving dietary status, food and nutritional security as well. Although there is currently limited diversity in the diets of adult men, women and children of rural farm households, the situation can be improved over time with proper and consistent support. The findings suggest policy interventions should target not only agricultural diversification but also improve women's education and on and off farm employment opportunities and facilitate better access to information for rural households. These recommendations can support improved dietary diversity for all household members under different settings.
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Affiliation(s)
- Mohammad Jahangir Alam
- Department of Agribusiness and Marketing, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Ismat Ara Begum
- Department of Agricultural Economics, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Tamanna Mastura
- Department of Agribusiness and Marketing, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Avinash Kishore
- International Food Policy Research Institute, New Delhi, India
| | - Jim Woodhill
- Environmental Change Institute, University of Oxford, Oxford, United Kingdom
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Sarkar P, Rifat MA, Bakshi P, Talukdar IH, Pechtl SML, Lindström Battle T, Saha S. How is parental education associated with infant and young child feeding in Bangladesh? a systematic literature review. BMC Public Health 2023; 23:510. [PMID: 36927525 PMCID: PMC10022043 DOI: 10.1186/s12889-023-15173-1] [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: 10/14/2022] [Accepted: 01/31/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Education is expected to bring about positive behavioral changes which could lead to improved health behaviors. Parental education is a primary determinant of child health and development. However, some evidence showed inverse associations between high parental education and recommended infant and young child feeding (IYCF) in Bangladesh. How the association of parental education differs with specific IYCF components has not been reviewed. Therefore, the role of parental education on optimal IYCF practices in Bangladesh appears to be inconclusive. The objective of this review is to summarize how parental education is associated with IYCF practices in Bangladesh. METHOD This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. A systematic literature search was conducted in PubMed, Web of Science, Embase, and Google Scholar. Record searching, study selection, and data extraction was performed using Endnote online and Covidence tool, respectively. The Newcastle-Ottawa scale was used for quality assessment of the included studies. RESULTS Out of 414 initial hits, 34 studies were included for this review. Of the included studies, 32 were cross-sectional, one was a randomized controlled trial, and one was a retrospective cohort. Most of the studies (n = 24) were nationally representative whereas 10 studies had populations from district and sub-district level. Included studies considered different IYCF-related indicators, including breastfeeding (n = 22), complementary feeding (n = 8), both breastfeeding and complementary feeding (n = 2), both breastfeeding and bottle feeding (n = 1), and pre-lacteal feeding (n = 1). Parental education was found to be positively associated with complementary feeding practices. However, the role of parental education on breastfeeding, in general, was ambiguous. High parental education was associated with bottle-feeding practices and no initiation of colostrum. CONCLUSION Public health interventions need to focus not only on non- and/or low-educated parents regarding complementary feeding but also on educated mothers for initiation of colostrum and proper breastfeeding practices. TRIAL REGISTRATION This systematic review is registered to PROSPERO ( https://www.crd.york.ac.uk/prospero/ ) with registration ID: CRD42022355465.
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Affiliation(s)
- Plabon Sarkar
- Caritas Bangladesh, 2, Outer Circular Road, Shantibagh, Dhaka, 1217, Bangladesh
| | - M A Rifat
- Department of Global Public Health, Karolinska Institutet, Stockholm, 17177, Sweden.
| | - Progati Bakshi
- Department of Food and Agroprocess Engineering, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, 8100, Bangladesh
| | - Imdadul Haque Talukdar
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Sarah M L Pechtl
- Department of Global Public Health, Karolinska Institutet, Stockholm, 17177, Sweden
| | | | - Sanjib Saha
- Department of Clinical Sciences, Health Economics Unit, Lund University, 22381, Lund, Sweden
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14
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Okronipa H, Bageant ER, Baez J, Onyango HO, Aura CM, Fiorella KJ. COVID-19 experiences of small-scale fishing households: The case of Lake Victoria, Kenya. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2023. [DOI: 10.3389/fsufs.2022.987924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
IntroductionThe impact of COVID-19 on small-scale fishing communities is of great concern given the importance of aquatic foods in trade, nutrition and livelihoods. Using a case study of Lake Victoria, augmented by published literature, we examine the socioeconomic dynamics and severity of COVID-19 impacts on Kenyan fishing communities.MethodsA household level questionnaire was administered through phone interviews on a monthly basis from June 2020 to May 2021, including a focus group discussion in July 2021.ResultsWe find that multifold fear of COVID-19 infection and control measures were present and varied across case rates and stringency of control measures. Fishers and traders reported being affected by disease control measures that limited market access and their ability to fish overnight. In spite of these worries, and contrary to what has been reported in the published literature regarding impacts observed in the early months of the pandemic, we see stable participation in fishing and fish trading over time despite the pandemic. Food insecurity was high before and during the COVID-19 pandemic, but did not substantially shift with the pandemic.ConclusionOur findings suggest that Kenyan fishing and fish trading households adopted diverse strategies to cope and balance generating income to provide for their families and staying safe. Our results underscore the need to understand ways in which acute pandemic impacts evolve over time given that effects are likely heterogeneous across small-scale fishing communities.
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Le HN, Nguyen KV, Phung H, Hoang NTD, Tran DT, Mwanri L. Household Dietary Diversity among the Ethnic Minority Groups in the Mekong Delta: Evidence for the Development of Public Health and Nutrition Policy in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:932. [PMID: 36673687 PMCID: PMC9859100 DOI: 10.3390/ijerph20020932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Poor household dietary diversity has been linked to malnutrition in individuals, households, and cumulatively in populations. High rates of malnutrition among Khmer ethnic children aged five years and younger have been reported in Tri Ton district, Vietnam. This paper aims to further investigate household dietary diversity and associated factors among Khmer ethnic minority populations in Vietnam. A cross sectional study was conducted from October 2018 to April 2019 in Tri Ton District, An Giang Province. By employing a multistage sampling technique, a total of 402 (99.8% response rate) participants were interviewed to measure household dietary diversity using a structured and validated questionnaire developed by FAO. Both bivariate and multivariate logistic regression analyses were carried out to identify factors associated with household dietary diversity. The results showed that the prevalence of low, medium and high dietary diversity scores were 21.4%, 70.4% and 8.2%, respectively. Male-headed households, literacy level, household income, exposure to mass media on nutrition and health information, and frequency of eating were positively associated with household dietary diversity (p < 0.05). However, owning a vegetable and rice farm was not statistically related to households’ dietary diversification. The paper concludes that the magnitude of household diversified dietary intakes was essentially low to medium in participants’ households. These findings have provided evidence to inform the development of the National Nutrition Strategy—2021−2030 in Vietnam, to be revised in 2045. This national strategy proposes appropriate interventions, programs and policies to improve socioeconomic status in ethnic groups and in mountainous areas to enhance populations’ health and well-being including controlling childhood malnutrition. In order to improve population health and wellbeing in Tri Ton District, further actions to address effective dietary practices including strengthening nutrition and health communication about the need to improve household dietary diversity to high levels are recommended.
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Affiliation(s)
- Hiep N. Le
- Department of Food Technology, An Giang University, Long Xuyên 880000, Vietnam
- Center for Educational Testing and Quality Assessment, Vietnam National University HCMC, Ho Chi Minh City 700000, Vietnam
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222, Australia
- Health & Agricultural Policy Research Institute, University of Economics Ho Chi Minh City, Ho Chi Minh City 72516, Vietnam
| | - Kien V. Nguyen
- Health & Agricultural Policy Research Institute, University of Economics Ho Chi Minh City, Ho Chi Minh City 72516, Vietnam
- Climate Change Institute, An Giang University, Long Xuyên 880000, Vietnam
- Research School of Management, College of Business and Economics, The Australian National University, 26 Kingsley St., Acton, Canberra, ACT 2601, Australia
| | - Hai Phung
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222, Australia
| | - Ngan T. D. Hoang
- National Institute of Nutrition, 48B Tang Bat Ho, Pham Dinh Ho Ward, Hai Ba Trung District, Hanoi 100000, Vietnam
| | - Duong T. Tran
- National Institute of Nutrition, 48B Tang Bat Ho, Pham Dinh Ho Ward, Hai Ba Trung District, Hanoi 100000, Vietnam
| | - Lillian Mwanri
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide Campus, Adelaide, SA 5000, Australia
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Kundu S, Das P, Rahman MA, Al Banna MH, Fatema K, Islam MA, Srivastava S, Muhammad T, Dey R, Hossain A. Socio-economic inequalities in minimum dietary diversity among Bangladeshi children aged 6-23 months: a decomposition analysis. Sci Rep 2022; 12:21712. [PMID: 36522494 PMCID: PMC9755277 DOI: 10.1038/s41598-022-26305-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
This study aimed to measure the socio-economic inequalities in having minimum dietary diversity (MDD) among Bangladeshi children aged 6-23 months as well as to determine the factors that potentially contribute to the inequity. The Bangladesh Demographic and Health Survey (BDHS) 2017-2018 data were used in this study. A sample of 2405 (weighted) children aged 6-23 months was included. The overall weighted prevalence of MDD was 37.47%. The concentration index (CIX) value for inequalities in MDD due to wealth status was positive and the concentration curve lay below the line of equality (CIX: 0.1211, p < 0.001), where 49.47% inequality was contributed by wealth status, 25.06% contributed by the education level of mother, and 20.41% contributed by the number of ante-natal care (ANC) visits. Similarly, the CIX value due to the education level of mothers was also positive and the concentration curve lay below the line of equality (CIX: 0.1341, p < 0.001), where 52.68% inequality was contributed by the education level of mother, 18.07% contributed by wealth status, and 14.69% contributed by the number of ANC visits. MDD was higher among higher socioeconomic status (SES) groups. Appropriate intervention design should prioritize minimizing socioeconomic inequities in MDD, especially targeting the contributing factors of these inequities.
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Affiliation(s)
- Satyajit Kundu
- grid.443020.10000 0001 2295 3329Global Health Institute, North South University, Dhaka, 1229 Bangladesh ,grid.263826.b0000 0004 1761 0489School of Public Health, Southeast University, Nanjing, 210096 China ,grid.443081.a0000 0004 0489 3643Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Pranta Das
- grid.24434.350000 0004 1937 0060Department of Statistics, University of Nebraska–Lincoln, Lincoln, NE 68583-0963 USA ,grid.8198.80000 0001 1498 6059Department of Statistics, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Md. Ashfikur Rahman
- grid.412118.f0000 0001 0441 1219Development Studies Discipline, Khulna University, Khulna, 9208 Bangladesh
| | - Md. Hasan Al Banna
- grid.443081.a0000 0004 0489 3643Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Kaniz Fatema
- grid.8198.80000 0001 1498 6059Department of Statistics, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Md. Akhtarul Islam
- grid.412118.f0000 0001 0441 1219Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna, 9208 Bangladesh
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, 400088 India
| | - T. Muhammad
- grid.419349.20000 0001 0613 2600Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088 India
| | - Rakhi Dey
- grid.472353.40000 0004 4682 8196Department of Statistics, Government Brajalal College, National University of Bangladesh, Gazipur, 1704 Bangladesh
| | - Ahmed Hossain
- grid.412789.10000 0004 4686 5317College of Health Sciences, University of Sharjah, 27272 Sharjah, United Arab Emirates ,grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
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Sebai I, Decelles S, Batal M. Determinants of dietary diversity among children 6-23 months: a cross-sectional study in three regions of Haiti. J Hum Nutr Diet 2022; 36:833-847. [PMID: 36514214 DOI: 10.1111/jhn.13128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The prenatal, perinatal, postnatal and nutritional (A3PN) support study was a 4-year initiative aimed to reduce maternal mortality in Haiti. A cross-sectional study was developed to collect the baseline data for evaluation purposes of the A3PN. This study aimed to determine the factors contributing to dietary diversity (DD) in Haitian children aged 6-23 months. METHODS A cross-sectional study during two seasons (the lean season and the harvest season) was carried out in Haiti to assess the DD of children and their mothers using non-quantitative 24-h recalls. Indicators of DD were minimum dietary diversity for children (MDD-C) and minimum dietary diversity for women (MDD-W). Mid-upper arm circumference was measured in women and children, and food security was assessed using the Household Hunger Scale. Focus groups were also conducted to gain a better understanding of the quantitative findings. RESULTS Only 7.3% of the children included in this study met the MDD-C. Factors associated with MDD-C were the season (odds ratio [OR]: 0.141 [0.039-0.513]), land ownership or rental (OR: 4.603 [1.233-17.188]), maternal education (OR: 0.092 [0.011-0.749]), the mother's responsibility for the main or secondary source of income for the household (OR: 2.883 [1.030-8.069]) and her DD (OR: 5.690 [1.916-16.892]). Focus groups revealed the existence of various food restrictions. CONCLUSIONS The results indicated that the low prevalence of MDD-C in three regions of study in Haiti is indicative of a serious public health concern that might be further aggravated by local food taboos. They also suggest that to fight against hunger, it is necessary to focus on women's well-being.
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Affiliation(s)
- Ines Sebai
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Ottawa, Ontario, Canada.,TRANSNUT, Département de nutrition, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada.,Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Stéphane Decelles
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Ottawa, Ontario, Canada.,TRANSNUT, Département de nutrition, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Malek Batal
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Ottawa, Ontario, Canada.,TRANSNUT, Département de nutrition, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada.,Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
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Ngassa AB, Meriki HD, Mbanga CM, Nzefa LD, Mbhenyane X, Tambe AB. Key predictors of undernutrition among children 6-59 months in the Buea Health District of the Southwest region of Cameroon: a cross sectional community-based survey. BMC Nutr 2022; 8:148. [PMID: 36514089 PMCID: PMC9745983 DOI: 10.1186/s40795-022-00646-0] [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: 05/26/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND According to the 2018 Demographic and Health Survey, undernutrition remains a public health problem among Cameroonian children under-five. This varies across the country, greatest in areas with ongoing humanitarian crisis, such as the Southwest region. However, data on the burden of undernutrition in the Southwest region is sparse. This study aimed to assess the prevalence and predictors of undernutrition among children under-five in the Buea health district of the Southwest region of Cameroon. METHODS This was a community based cross-sectional study of 321 children under-five/caretaker pairs, surveyed from households selected using multistage randomized sampling. Data were collected by trained data collectors, with the aid of a structured, pre-tested questionnaire that captured information on sociodemographic characteristics, food security, dietary diversity and anthropometric measurements. The weight, height/length and mid upper arm circumference (MUAC) were measured using standardized instruments. Stunting, Wasting and Underweight of children were calculated from Z-scores of Height-for-age (HAZ), Weight-for-height (WHZ) and Weight-for-age (WAZ) based on 2006 WHO standards. Data was analysed using SPSS version 27.0. Predictors of malnutrition were obtained using multivariate logistic regression, adjusting for potential confounders. RESULTS Overall, 31.8% (102/321) of the children were undernourished (26.5% stunted, 1.6% underweight, 3.7% wasted). Drinking water from inappropriate sources (OR: 2.32, 95% CI: 1.30-4.15) and a Dietary Diversity Score < 4 (OR: 2.59, 95%CI: 1.46-4.61) were independently associated with increased risk of stunting. Children of the male sex were more likely to be wasted than females (OR: 5.34, 95%CI: 1.09-26.14). CONCLUSION Childhood undernutrition, particularly stunting is common in the Buea Health District. Risk factors of undernutrition identified are potentially modifiable, highlighting the need for nutrition specific and sensitive interventions to improve dietary diversity, and the need to improve access to safe drinking water, and educate caretakers on the importance of clean potable water, good sanitation and hygiene for the proper growth and development of their children.
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Affiliation(s)
- Andinwoh Betterdel Ngassa
- grid.29273.3d0000 0001 2288 3199Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, P.O. Box 063, Buea, Cameroon
| | - Henry Dilonga Meriki
- grid.29273.3d0000 0001 2288 3199Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, P.O. Box 063, Buea, Cameroon
| | - Clarence Mvalo Mbanga
- Clinton Health Access Innitiative, Cameroon office, 3rd Floor, Y-Building Rue 1775 Nouvelle Route Bastos, Yaounde, Cameroon
| | - Léonie Dapi Nzefa
- grid.8148.50000 0001 2174 3522Department of Social Work, Faculty of Social Sciences, Linnaeus University, Växjö, Sweden
| | - Xikombiso Mbhenyane
- grid.11956.3a0000 0001 2214 904XDivision of Human Nutrition, Department of Global Health, Stellenbosch University, P.O. Box 241, Cape Town, South Africa
| | - Ayuk Betrand Tambe
- grid.29273.3d0000 0001 2288 3199Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, P.O. Box 063, Buea, Cameroon ,grid.11956.3a0000 0001 2214 904XDivision of Human Nutrition, Department of Global Health, Stellenbosch University, P.O. Box 241, Cape Town, South Africa
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Amoah AN, Danquah AO, Stanislav TS, Drokow EK, Yacong B, Wang L, Lyu Q. Correlates of dietary diversity among children aged 6-23 months of head porters in Ghana. Front Public Health 2022; 10:1020265. [PMID: 36407999 PMCID: PMC9671282 DOI: 10.3389/fpubh.2022.1020265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Objective In many developing countries, most children cannot meet minimum dietary diversity (MDD), defined as the consumption of four or more of the seven food groups. In Ghana, only 35% of children met MDD nationwide in 2017, but rates are worse among the rural poor and resource-constrained individuals like Head Porters (HPs). The current study investigated the correlates of MDD in children of HPs aged 6-23 months old in Ghana. Methods and materials A cross-sectional survey was carried out in 2021 among 423 HPs selected purposively from eight market centers in two commercial cities. A multi-stage sampling method was used in obtaining the sample, while a structured interview guide was used to collect data from the caregivers. Stata version 15.1 and descriptive and inferential statistics like frequency, percentage, chi-square and logistic regression were used to analyze the data. All results were deemed significant if the p-value was < 0.05 and the odds ratios with a 95% confidence interval. Results The children had a mean age of 14.3 (±4.9) months, while half of the caregivers (48.2%) were between 15 and 25 years. Approximately 59% (251) had good knowledge of infant and young child feeding practices (IYCF). About 45% of the children consumed a diversified diet. The number of postnatal care (PNC) visits, delivery in a health facility, meeting minimum meal frequency (MMF), and the child's age was independently associated with MDD at the multivariate level. Conclusion Over a third of the caregivers had poor knowledge of IYCF practices. Furthermore, less than half of the children achieved MDD reflecting the need for more education by the stakeholders. Regular PNC visits and delivery in health facilities were independently associated with MDD; therefore, interventions to combat low MDD should prioritize the relevance of these predictors.
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Affiliation(s)
| | | | | | - Emmanuel Kwateng Drokow
- Department of Radiation Oncology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Yacong
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ling Wang
- Faculty of Medicine, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Quanjun Lyu
- School of Public Health, Zhengzhou University, Zhengzhou, China,*Correspondence: Quanjun Lyu
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Shumayla S, Irfan EM, Kathuria N, Rathi SK, Srivastava S, Mehra S. Minimum dietary diversity and associated factors among lactating mothers in Haryana, India: a community based cross-sectional study. BMC Pediatr 2022; 22:525. [PMID: 36057585 PMCID: PMC9440519 DOI: 10.1186/s12887-022-03588-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Food adequacy and dietary quality in the lactation period are fundamental for maternal and child health. Lactating mothers are vulnerable to malnutrition because of increased physiological demand, monotonous diet, lactogenesis process, and increased nutrient requirements. The micronutrient adequacy especially among women is not ensured in Indian diet. The dual course of gender bias and poverty, along with lack of knowledge about diet quality are significant impediments in maintaining minimum dietary diversity among Indian women. The study aimed to assess the prevalence of minimum dietary diversity and associated factors among lactating women. METHODOLOGY A community-based cross-sectional study was conducted among 1236 lactating women through a multistage sampling procedure in Haryana state, India. Data were collected in Computer-assisted personal interviewing (CAPI) using a pretested structured interview schedule. Minimum Dietary Diversity for Women by Food and Agriculture Organization (FAO) was used to calculate the minimum dietary diversity. RESULTS The mean dietary diversity score among lactating women from the ten food groups was 6.35 ± 2.57 and the prevalence of minimum dietary diversity was 77.1%. The complete model revealed that both individual and household factors can explain the variation in dietary diversity intake. Furthermore, the result of model 2 explained that women aged 31 to 35 years (AOR 5.92,95% (1.87-18.77), graduation and above qualified women (AOR 1.98, 95% (0.96-4.09) and lactating women with high knowledge on nutrition (AOR 2.00, 95% (1.34-4.57) were the significant factors promoting minimum dietary diversity. CONCLUSION Three-fourths of the lactating women reached adequate minimum dietary diversity. Younger age, low educational level, and poor nutritional knowledge were significant constraints to achieving minimum dietary diversity. Further improvement in the minimum dietary diversity among lactating women is very much required. It is also advised that exiting platforms dispersing awareness on nutrition should be supported and strengthened.
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Affiliation(s)
- Shumayla Shumayla
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - E M Irfan
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - Nishtha Kathuria
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - Suresh Kumar Rathi
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India.
| | - Shobhit Srivastava
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
| | - Sunil Mehra
- Mamta-Health Institute for Mother and Child, B-5, Greater Kailash-II, Delhi, 110048, India
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Between and Within-Country Variations in Infant and Young Child Feeding Practices in South Asia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074350. [PMID: 35410032 PMCID: PMC8998566 DOI: 10.3390/ijerph19074350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/13/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022]
Abstract
This study aimed to explore variations in Infant and Young Child Feeding (IYCF) practices between different South Asian Countries (SACs) and within their sociodemographic characteristics including place of residence, mother age, mother education, child sex, and wealth quintiles within the SACs. We extracted 0–23 months age children’s data from the nationally representative survey of Afghanistan, Bangladesh, India, Maldives, Nepal, and Pakistan. Among all SACs, the early initiation of breastfeeding (EIBF) practice was 45.4% with the highest prevalence in the Maldives (68.2%) and the lowest prevalence in Pakistan (20.8%). Exclusive breastfeeding (EBF) practice was 53.9% with the highest prevalence in Nepal (67%) and the lowest prevalence in Afghanistan (42%). Only 13% of children had a minimum acceptable diet (MAD), with the highest prevalence in the Maldives (52%) and the lowest prevalence in India (11%). We found higher IYCF practices among the mothers with secondary or higher levels of education (EIBF: 47.0% vs. 43.6%; EBF: 55.5% vs. 52.0%; MAD: 15.3% vs. 10.0%), urban mothers (MAD: 15.6% vs. 11.8%), and mothers from the richest households (MAD: 17.6% vs. 8.6%) compared to the mothers with no formal education or below secondary level education, rural mothers and mothers from the poorest households, respectively. Mothers from the poorest households had better EIBF, EBF, and continued breastfeeding at 1-year (CBF) practices compared to the mothers from the richest households (EIBF: 44.2% vs. 40.7%; EBF: 54.8% vs. 53.0%; CBF: 86.3% vs. 77.8%). Poor IYCF practices were most prevalent in Afghanistan, Pakistan, and India.
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Kumar A, Rajpal S, Alambusha R, Sharma S, Joe W. Can Anganwadi services strengthening improve the association between maternal and child dietary diversity? Evidence from Project Spotlight implemented in tribal dominated Gadchiroli and Chandrapur districts of Maharashtra, India. PLoS One 2022; 17:e0264567. [PMID: 35239688 PMCID: PMC8893689 DOI: 10.1371/journal.pone.0264567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/11/2022] [Indexed: 11/19/2022] Open
Abstract
Dietary intake is a fundamental determinant of maternal and child nutrition. This paper presents evidence on whether maternal and child dietary diversity can be improved with systemic improvements focused on strengthening training, capacity building, and behavior change communication among frontline workers to encourage improved nutritional practices among mothers and children in the intervention area. The evidence is derived from Project Spotlight intervention that was jointly implemented by Department of Women and Child Development, Government of Maharashtra and Tata Trusts in tribal dominated Gadchiroli and Chandrapur districts in Maharashtra. Based on a pre-post comparison of baseline (2019) and endline (2021) household survey data it is confirmed that there is a significant association between maternal and child dietary diversity in the study area. Notably, dietary diversity in mother-child dyads is marked with a higher consumption of fruits and vegetables as well as eggs and flesh foods. Econometric analysis further reveals that the association between maternal and child dietary diversity has improved after the systems strengthening interventions. The paper concludes that local interventions such as Project Spotlight for strengthening counselling services and coverage by frontline workers and enhancing knowledge and awareness on maternal and child dietary diversity among communities are important for improving maternal and child nutrition.
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Affiliation(s)
- Abhishek Kumar
- Centre for Studies in Economics and Planning, Central University of Gujarat, Gujarat, India
- * E-mail:
| | - Sunil Rajpal
- School of Liberal Education, FLAME University, Lavale, Maharashtra, India
| | - Ruby Alambusha
- Population Research Centre, Institute of Economic Growth, Delhi University Enclave (North Campus), Delhi, India
| | - Smriti Sharma
- Tata Trusts, R. K. Khanna Tennis Stadium, Africa Avenue, New Delhi, India
| | - William Joe
- Population Research Centre, Institute of Economic Growth, Delhi University Enclave (North Campus), Delhi, India
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Abi Khalil H, Hawi M, Hoteit M. Feeding Patterns, Mother-Child Dietary Diversity and Prevalence of Malnutrition Among Under-Five Children in Lebanon: A Cross-Sectional Study Based on Retrospective Recall. Front Nutr 2022; 9:815000. [PMID: 35299758 PMCID: PMC8922217 DOI: 10.3389/fnut.2022.815000] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/24/2022] [Indexed: 01/25/2023] Open
Abstract
Background Despite demonstrated benefits, most countries fall short of meeting international targets for breastfeeding patterns, optimal complementary feeding, mother-children's quality diet, and malnutrition among under-five children. Rationale Since mothers usually play the most vital role in the healthcare of their children, research is needed to illuminate maternal factors that might promote a child's health and nutritional status. Aim The purpose of this study is to retrospectively (1) examine the under-five children's (0–59 months) feeding habits including exclusive breastfeeding, exclusive bottle feeding, continued breastfeeding, and complementary feedings, (2) investigate the mother-child's dietary diversity, and (3) identify any factors that cause less optimal nutrition due to a lack of food diversity in children aged 6 to 59 months. Moreover, (4) the prevalence of wasting, stunting, underweight, and overweight in the under-five offspring living in households located in the main two provinces in Lebanon (Beirut and Mount Lebanon) was determined. Methods The data for this analysis were collected from a representative sample of 384 households [384 mothers (21–49 years old) and children (0–59 months)] between February 2019 and June 2019. A questionnaire was used to inquire mothers of children ages 0–23 months about exclusive breastfeeding (EBF), continuous breastfeeding (CBF), exclusive bottle feeding (EBOT), mixed feeding (MF), and complementary feeding patterns. Moreover, additional questions regarding dietary diversity were asked to mothers of children aged 6 to 59 months. This score was calculated based on the 24 h recall of the mother and her child's consumption of 7 food groups, during the 24 h prior to the survey. Moreover, stunting, wasting, overweight, and underweight were calculated using the z-score for height-for-age (HAZ), weight-for-height (WHZ), and weight-for-age (WAZ), respectively. Binary logistic regression was used to explore the dietary diversity among children (ages 6–59 months) adjusting for covariates at maternal and household levels. Results Around 44% of children (0–59 months) had normal body weight. In addition, 9.3% were underweight (WAZ < -2SD to −3SD), 6.5% were at risk of being overweight, 24.45% were overweight, 9.3% were stunted (HAZ < -2SD to −3SD), and 6.25% (WHZ < -2SD to −3SD) were wasted. In total, among under-five children, the prevalence of EBF at 40 d and 6 months was 27 and 30%, respectively. The prevalence of CBF was 23%. Around 60% of mothers breastfed their offspring between 0 and 6 months and half of them introduced infant formula at earlier stages between 0–6 months. Furthermore, 78.4% of mothers introduced food to their children between 4 and 6 months (of which 40% before 6 months) and 62.5% of them introduced sugary drinks before 6 months. As for dietary diversity (DD), one out of two mothers and one out of three children (ages 6–59 months) had a low DD score (DDS) (46 and 32%, respectively). The children's and mother's DD were strongly found to be correlated (p-value = 0.034). Regression analysis showed that children's DD increased around 2 times [AOR = 1.7; 95% CI (1.042–2.914)] in context of high maternal DDS, and about 12 times [AOR = 11.7; 95% CI (1.2–111)] when a member of the highest-income households. Conclusions Our findings demonstrated low rates of EBF and CBF, high prevalence of EBOT, and early introduction of complementary foods among children ages 0–59 months. Furthermore, for children ages 6–59 months, there was poor mother-child dietary diversity and a high prevalence of overweight and stunted children in the main two Lebanese provinces. This suggests the alarming need for continuous nutrition intervention to improve infant feeding patterns and dietary diversity to reduce the malnutrition rates.
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Affiliation(s)
| | - Mariam Hawi
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Maha Hoteit
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
- PHENOL Research Group (Public Health Nutrition Program-Lebanon), Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Lebanese University Nutrition Surveillance Center (LUNSC), Lebanese Food Drugs and Chemical Administrations, Lebanese University, Beirut, Lebanon
- *Correspondence: Maha Hoteit
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Seid A, Cherie HA. Dietary diversity, nutritional status and associated factors among lactating mothers visiting government health facilities at Dessie town, Amhara region, Ethiopia. PLoS One 2022; 17:e0263957. [PMID: 35176095 PMCID: PMC8853554 DOI: 10.1371/journal.pone.0263957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background Maternal undernutrition is one of the most common causes of maternal morbidity and mortality in developing countries. Severe undernutrition among mothers leads to reduced lactation performance which further contributes to an increased risk of infant mortality. However, data regarding nutritional status of lactating mothers at Dessie town and its surrounding areas is lacking. This study assessed dietary diversity, nutritional status and associated factors of lactating mothers visiting health facilities at Dessie town, Amhara region, Ethiopia. Methods Institutional based cross-sectional study was conducted from March to April, 2017 among 408 lactating mothers. Systematic random sampling technique was employed to select the study participants. Data on socio-demographic and economic characteristics, health related characteristics, dietary diversity and food security status of participants were collected using interviewer administered questionnaire. Data were entered into EPI-INFO and analyzed using SPSS Version 22. Bivariate and multivariate analyses were performed to identify factors associated with dietary diversity and nutritional status of lactating mothers. Results More than half (55.6%) of lactating mothers had inadequate dietary diversity (DDS<5.3) and about 21% were undernourished (BMI<18.5 kg/m2). Household monthly income [AOR = 2.0, 95% CI (1.15, 3.65)], type of house [AOR = 1.8, 95% CI (1.15, 2.94)], nutrition information [AOR = 1.6, 95% CI (1.05, 2.61)] and household food insecurity [AOR = 1.8, 95% CI (1.05, 3.06)] were factors associated with dietary diversity of lactating mothers. Being young in age 15–19 years [AOR = 10.3, 95% CI (2.89, 36.39)] & 20–29 years [AOR = 3.4, 95% CI (1.57, 7.36)], being divorced/separated [AOR = 10.1, 95% CI (1.42, 72.06)], inadequate dietary diversity [AOR = 3.8, 95% CI (2.08, 7.03)] and household food insecurity [AOR = 3.1, 95% CI (1.81, 5.32)] were factors associated with maternal undernutrition. Conclusion The dietary diversity of lactating mothers in the study area was sub optimal and the prevalence of undernutrition was relatively high. Public health nutrition interventions such as improving accessibility of affordable and diversified nutrient rich foods are important to improve the nutritional status of mothers and their children in the study area.
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Affiliation(s)
- Awel Seid
- Department of Applied Human Nutrition, Bahir Dar Institute of Technology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Hirut Assaye Cherie
- Department of Applied Human Nutrition, Bahir Dar Institute of Technology, Bahir Dar University, Bahir Dar, Ethiopia
- * E-mail:
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Nigussie E, Ferede A, Markos M. Diversified dietary intake and associated factors among pregnant mothers attending antenatal care follow-up in public health facilities of Dire Dawa, Eastern Ethiopia. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000002. [PMID: 36962246 PMCID: PMC10022029 DOI: 10.1371/journal.pgph.0000002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 06/01/2022] [Indexed: 11/18/2022]
Abstract
Poor diversity dietary intake has great significance to women, pregnancy outcome and on her fetus or the growing and development of their baby collectively. Uncertainty of studies to examine whether pregnant women have been utilizing diversity dietary in their frequent intake and this has changed nutritional status. Therefore, this study aims to assess diversified dietary intake and associated factors among pregnant mothers attending antenatal care follow-up in public health facilities of Dire Dawa, Eastern Ethiopia. A facility-based cross-sectional study was conducted among 453 pregnant mothers randomly selected from the antenatal care unit at public health facilities from November 1-30/2020. Study subjects were selected with a systematic random sampling method from randomly selected antenatal care unity of health facilities in Dire Dawa Administration. A structured questionnaire and anthropometric measurements were used to collect data. Data were entered with kobo software and exported to Statistical Package for Social Science statistical software version 20 for analysis. Binary and multiple logistic regression models were used to declare the significance of independent variables at P<0.05. This study shows 55% (95% CI = (50-59.5) were inadequate diversified dietary intake. Having lower monthly income (Adjusted Odds Raito [AOR] = 4.4, Confident interval [95%CI] = 1.3-14.6), elementary educational status of mothers (AOR = 3.8, 95%CI = 1.5-9.9), consumption of two meals per day (AOR = 16.6, 95% CI = 2.04-135.8), didn't get antenatal care counseling (AOR = 2.2, 95% CI = 1.1-2.8) were significantly associated with diversified dietary. The result revealed that around 55% of respondents had inadequate dietary diversity. low household income, had less maternal education level and, consuming two meals per day, and no information about dietary diversity has contributed to inadequate dietary diversity. Accordingly, go forward in the right side of those variables were the core recommendation of this study.
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Affiliation(s)
- Efrata Nigussie
- Public Health Expert at Ohio State Global One Health initiative, Dire Dawa City Administration, Dire Dawa, Ethiopia
| | - Abebe Ferede
- Department of Public Health, School of Health Science, Arsi University, Asella, Ethiopia
| | - Melese Markos
- Department of Public Health, College of Health and Medical Science, Wachemo University Durame Campus, Durame, Ethiopia
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Molla W, Mengistu N, Madoro D, Assefa DG, Zeleke ED, Tilahun R, Bayisa Y, Meshesha MD, Ayele GM, Kabthyme RH, Alemu A, Eshetu MA, Shumye S, Funga ML, Eritero AC, Aregawi S, Wodaynew T, Muche T, Wudneh A. Dietary diversity and associated factors among lactating women in Ethiopia: Cross sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Keno S, Bikila H, Shibiru T, Etafa W. Dietary diversity and associated factors among children aged 6 to 23 months in Chelia District, Ethiopia. BMC Pediatr 2021; 21:565. [PMID: 34895180 PMCID: PMC8665635 DOI: 10.1186/s12887-021-03040-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although minimum dietary diversity (MDD) is one of the core indicators of a high-quality diet for infants and young children, meeting this dietary diversity standard remains a challenge in Ethiopia. Therefore, adequate information on the status and factors affecting minimum dietary diversity is essential to identify potential strategic interventions. This study to study is to assess DD and associated factors among children aged 6 to 23 months in Chelia District, Ethiopia. METHODS A community-based cross-sectional study was conducted in the seven kebeles of Chelia District from 12th April to April 30th, 2020. Kebele is the smallest administrative unit in Ethiopia. Multistage sampling was used to select 631 participants who had a child aged 6 to 23 months. Data was entered into the Epi data version 3.1 and analyzed using Statistical Package for Social Science (SPSS) version 24. A binary logistic regression was fitted to identify significant factors associated with met MDD at 95% CI and a p-value < 0.05. RESULTS Less than one-quarter (17.32%) of infants and young children aged 6 to 23 months had met MDD. The dominant group of foods consumed was composed of grains, roots, and tubers. Children aged18-23 months (AOR = 3.26, 1.36-7.79), mothers aged 35-44 years (AOR = 3.25, 1.38-7.45), housewives as household heads (AOR = 3.41, 1.56-2.37), children of smaller family size (AOR = 3.89, 1.18-12.78), and caregivers who studied grade 9-12 (AOR = 9.98, 5.66-17.10), who received information about food diversity during ANC (AOR = 1.48, 2.21-11.23) and PNC (AOR = 3.94, 2.04-7.63) visit, who travels less than one hour to reach the market (AOR = 2.94, 1.24-6.91) and who had high family income (AOR = 4.12, 1.90-8.19) were significantly associated with meeting MDD. CONCLUSION Dietary diversity among children aged 6 to 23 months in Chelia District is low. It is proposed that caregivers on MDD be educated/trained and encouraged to share information during health service in order to increase the diverse diet and achieve a better dietary diversity score for infants and younger children.
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Affiliation(s)
- Shambel Keno
- West Shoa Zone Health Bureau, Oromia Region, Ethiopia
| | - Haile Bikila
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tesfaye Shibiru
- School of Medicine, Department of Pediatrics and Child Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Werku Etafa
- Department of Pediatrics and Neonatal Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
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Concordance of Mother-Child (6-23 Months) Dietary Diversity and Its Associated Factors in Kucha District, Gamo Zone, Southern Ethiopia: A Community-Based Cross-Sectional Study. J Nutr Metab 2021; 2021:8819846. [PMID: 34691779 PMCID: PMC8531763 DOI: 10.1155/2021/8819846] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 04/04/2021] [Accepted: 10/04/2021] [Indexed: 11/17/2022] Open
Abstract
Meeting minimum standards of dietary quality in mothers and children is a challenge in many developing countries including Ethiopia. Emerging evidence suggests that maternal and child dietary diversity is associated, but little is known about the associated factors of concordance of mother-child dietary diversity in Ethiopia and none is documented in the study area. This study examines the concordance between mother-child (6-23 months) dyads dietary diversity and the associated factors in Kucha District, Gamo Zone, Southern Ethiopia. A community-based cross-sectional study was conducted among 791 mother-child (6-23 months) pairs from 11 selected kebeles on March 6 to April 13, 2017. Multistage cluster sampling technique was used to select the study subjects. The sampling frame was obtained from the family folder of health posts in each kebele. The mother-child pairs were selected by the simple random sampling method. The 7 food groups of the World Health Organization (WHO) for children and the 10 food groups of FANTA/FAO 2016 for mothers were used to analyze the dietary diversity. Cohen's kappa statistics was calculated to see the strength of concordance. The multivariable logistic regression model was fitted to determine factors affecting mother-child dietary diversity concordance. A good concordance was noted between mother-child dietary diversity scores (Kappa = 0.43). Only 56 (7.1%) mothers were negative deviants, and 133 (16.8%) mothers were positive deviants in dietary diversity consumption. Rural residence (AOR = 3.49; 95% CI: 1.90-6.41), having no formal education (AOR = 1.8; 95% CI: 1.08-3.05), not owning milking cow (AOR = 1.7; 95% CI: 1.10-2.56), children with low dietary diversity (AOR = 8.23; 95% CI: 5.17-13.08), and mothers with low dietary diversity (AOR = 0.46; 95% CI: 0.29-0.74) were found to be factors associated with mother-child dietary diversity concordance. An increase in the percentage of children reaching the minimum dietary diversity was greater with a successive increase in maternal dietary diversity. Despite interesting similarities between mothers and children dietary consumption, more than three-quarters of concordants did not achieve the recommended dietary diversity score (were low concordants). Interventions targeting on rural women's access to high school education, home-based milking cow rearing, and promoting nutrition-sensitive agriculture to meet the dietary requirements of mothers and children in a sustainable manner and public health efforts to improve child nutrition may be strengthened by promoting maternal dietary diversity due to its potential effect on the entire family.
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Demisse B, Temesgen H, Dessie B, Kassa GM. Adherence status to iron with folic acid supplementation and associated factors among pregnant women receiving antenatal care at public health facilities in Northwest Ethiopia. SAGE Open Med 2021; 9:20503121211049934. [PMID: 34676074 PMCID: PMC8524691 DOI: 10.1177/20503121211049934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 09/09/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction: Iron and folic acid deficiency is among the most frequent nutrient
inadequacies in the world, affecting expected two billion people, and
causing nearly a million deaths. The adherence rate to iron with folic acid
supplements remains very low in Ethiopia. Therefore, this study aimed to
assess adherence status to iron with folic acid supplementation and
associated factors among pregnant women receiving antenatal care at public
health facilities in Northwest Ethiopia. Methods: A facility-based cross-sectional study was conducted among pregnant women at
public health facilities in the Debay Tilat Gen district from 27 February
2018 to 27 March 2018. Systematic random sampling was used to select
pregnant women. Data were entered into Epidata version 3.1 and analysis was
performed using SPSS version 20. Binary logistic regression was used to
predict the association of the dependent variable with independent
variables. Variables that showed association at a p-value
of less than 0.25 in the bivariable analysis were a candidate for
multivariable analysis. Finally, variables at a p-value
less than 0.05 with corresponding 95% confidence interval declared
statistically significant factors of iron with folic acid
supplementations. Results: A total of 400 participants were included in the study. The mean (± standard
deviation) age of study participants was 26.64 (±4.37 standard
deviation) years. This study revealed that about 52.8% of pregnant women
attending antenatal care clinics were adherent to iron with folic acid
supplementation. Counseling on iron with folic acid supplementations
(adjusted odd ratio = 2.53, 95% confidence interval = 1.37–4.66;
p-value < 0.003), having current anemia (adjusted
odd ratio = 4.21, 95% confidence interval = 1.77–9.94;
p-value < 0.001), and good knowledge of iron with folic
acid supplementations (adjusted odd ratio = 2.1, 95% confidence
interval = 1.29–3.44; p-value < 0.003) showed
statistically significant associations with adherence to iron with folic
acid supplementation. Conclusion: This study revealed that more than half of pregnant women were adherent to
iron with folic acid supplementation. Knowledge of iron with folic acid
supplementations, current anemia, and being counseled were factors
associated with pregnant women’s adherence to iron with folic acid
supplementation. Therefore, counseling and awareness creation should be
strengthened by health institutions.
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Affiliation(s)
- Birhanu Demisse
- Health Care Provider at Kuy Health Center, Debay Tilat Gen District, Debre Markos, Ethiopia
| | - Habtamu Temesgen
- Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Bekalu Dessie
- Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Getachew Mullu Kassa
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Bayesian Analysis of Dietary Diversity among Lactating Mothers in Finote Selam District, Northwest Ethiopia: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9604394. [PMID: 34497855 PMCID: PMC8421177 DOI: 10.1155/2021/9604394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/15/2021] [Indexed: 11/18/2022]
Abstract
Background Dietary diversity is an essential element of diet quality. Lactation is one of the most complex and nutritionally demanding phases of the human life cycle, and the breastfed infant is dependent on mother nutrition. The objective of this study was to assess the prevalence of dietary diversity and its predictors among lactating mothers. Methods A cross-sectional study design was employed in January 2020 among 416 lactating women using systematic sampling techniques. Data was collected using a structured interviewer-administered questionnaire. Bayesian estimation was used on logistic regression to identify the significant predictors of dietary diversity. Convergence of algorithm was assessed by using time series plot, density plot, and autocorrelation plot. Result The prevalence of adequate dietary diversity was 23.1%, and the significant predictors of dietary diversity were marital status of mother, education of spouse, occupation of mother and spouse, family size, gravidity, ANC follow up, nutritional education, wealth index, and food security status. Conclusion From the result, unmarried, having more family size, multigravidity, poor wealth indexed, and food in secured women were less likely to have adequate dietary diversity, whereas employed women, having ANC follow up and nutrition education, were strongly associated with adequate dietary diversity. Family planning should be given to minimize the impact of large family size of dietary diversity. Any concerned body should give attention to minimize food insecurity of lactating women. Attention should be given for ANC follow-up and nutritional education of mothers by health professional and policy maker.
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Fufa DA, Laloto TD. Assessment of dietary diversity and associated factors among lactating mothers in Debub Bench District. Heliyon 2021; 7:e07769. [PMID: 34458614 PMCID: PMC8379441 DOI: 10.1016/j.heliyon.2021.e07769] [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: 04/10/2021] [Revised: 06/09/2021] [Accepted: 08/10/2021] [Indexed: 12/05/2022] Open
Abstract
Objective To identify dietary diversity and its associated factors among lactating women in the Debub Bench district. Methods Cross-sectional study design was conducted among 836 lactating women from January 1st to March 31st, 2019, in Debub Bench district. The outcome variable of the study was determined based on the proportion of lactating mothers who fed less than five major food groups to mothers who fed more than five major food groups out of nine (9) food groups. Lactating mothers who fed less than five of the major food groups were categorized under unacceptable dietary diversity. Data were first collected through face-to-face interviews by validated structured questionerers and then entered in Epi-data version 4.6.0.2 software. A bivariate and multivariate logistic regression analysis were later conducted using IBM SPSS version 26 software. During the analysis, multicollinearity was check by using the tolerance test and variance inflation factors (VIF), Hosmer-Lemeshow goodness of fit test was used to see model fitness, and adjusted odds ratios and their 95% confidence interval at P values ≤0.05 were considered to determine statistically significant factors. Result A total of 836 lactating mothers had participated in the study. The response rate was 91.26%. The mean age of the participants was 29 years (SD ± 6.7). The study found that the magnitude of unacceptable dietary diversity score was 72.4% (95% CI: 69.5–75.5). The study also found that factors such as nutrition information (OR = 4, 95% CI: 2.64–6.08), absence of garden (OR = 2.35, 95% CI: 1.19–4.61), absence of latrine (OR = 6.86, 95% CI: 3.26–14.56) and household food insecurity (OR = 5.23, 95% CI: 3.64–7.46) were significantly associated with unacceptable dietary diversity. Conclusion The finding of this study showed that information about nutrition, absence of latrine, absence of garden, and household food insecurity were significantly associated with dietary diversity. Based on the finding of the study, the following recommendations are made. First, strategies and programs targeted towards promoting dietary diversity and good health among lactating women should be made at all levels. Second, lactating mothers should be adequately provided with nutritional information. Three, mothers should be empowered to alleviate household food insecurity by leveraging their premises for gardening diversified and nutritious vegetables.
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Affiliation(s)
- Dinaol Abdissa Fufa
- Department of Nutrition and Reproductive Health, School of Public Health, College of Health and Medical Sciences, Mizan-Aman, Mizan-Tepi University, Ethiopia
| | - Teshale Darebo Laloto
- Department of Nutrition and Reproductive Health, School of Public Health, College of Health and Medical Sciences, Mizan-Aman, Mizan-Tepi University, Ethiopia
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Examining the Dietary Diversity of Children in Niger. Nutrients 2021; 13:nu13092961. [PMID: 34578839 PMCID: PMC8467481 DOI: 10.3390/nu13092961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/19/2021] [Accepted: 08/22/2021] [Indexed: 11/16/2022] Open
Abstract
Malnutrition is a major public health concern in Niger. The stunting rate in children in Niger is over 50%, one of the highest in the world. The purpose of this cross-sectional study was to examine children’s dietary diversity (CDD) and the maternal factors that impact CDD. A total of 1265 mother–child pairs were analyzed. Descriptive analysis was conducted to present maternal and child characteristics. To compare the mean scores of CDD in relation to the region, an independent sample t-test was conducted. A one-way ANOVA test was conducted to evaluate the CDD score by different age groups. A linear regression model was estimated to identify household, maternal and child factors that affect the CDD score. Our results indicate that most of the participants of our survey resided in rural areas and the majority (80.7%) of the mothers had no education. Factors such as region, children’s age, woman’s empowerment, vitamin A intake and wealth index were significant predictors of CDD (p < 0.05). The children residing in rural areas were more likely to have lower CDD scores (p < 0.05) than the children in urban areas, therefore becoming more susceptible to malnutrition.
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Forsido SF, Tadesse F, Belachew T, Hensel O. Maternal dietary practices, dietary diversity, and nutrient composition of diets of lactating mothers in Jimma Zone, Southwest Ethiopia. PLoS One 2021; 16:e0254259. [PMID: 34252141 PMCID: PMC8274933 DOI: 10.1371/journal.pone.0254259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 06/24/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Optimal nutrition during lactation is essential for the well-being of the mother and the infant. Studies have shown that access to nutrient-rich foods during lactation is critical as minimal stores of nutrients can have adverse effects. This study aimed to investigate the diversity, composition, and nutrient adequacy of diets of lactating mothers in Southwest Ethiopia. METHODS A community-based cross-sectional survey was carried out in three districts of Jimma Zone, Southwest Ethiopia, in February 2014. A stratified multistage sampling technique was used to select 558 lactating mothers. Data were collected using a pre-tested and structured interviewer-administered questionnaire. Minimum dietary diversity for women (MDD-W) was computed from a single 24-h recall. A cut off value of 5 was used to classify the dietary diversity into achieving MDD-W or not. The proximate, mineral and anti-nutritional compositions of 12 commonly consumed foods were analysed using standard methods. Nutrient adequacy ratio (NAR) and Mean adequacy ratio (MAR) of these foods were estimated. RESULTS The mean (±SD) dietary diversity score (DDS) of the study participants was 3.73±1.03. Meeting MDD-W was positively associated with agricultural production diversity (P = 0.001) and educational level of the women (P = 0.04). Conversely, district of the study (P = 0.003) and place of residence (P = 0.019) were negatively associated with meeting MDD-W. The proximate composition (g/100g) of the sampled foods ranged between 24.8-65.6 for moisture, 7.6-19.8 for protein, 2.1-23.1 for crude fat, 2.0-27 for crude fibre, 1.0-21.2 for total ash, and 0.9-45.8 for total carbohydrate content. The calorific value ranged between 124.5-299.6 Kcal/100g. The mineral contents (mg/100g) ranged between 9.5-52.5 for iron, 2.2-4.2 for zinc, 42.6-318.2 for calcium, and 150.7-379.9 for phosphorus. The content of anti-nutritional factors (mg/100g) ranged between 11.1-178.9 for phytate and 3.7-315.9 for tannin. All the commonly consumed maternal foods were not sufficient to meet the energy, fat and protein requirements, (NAR<1). However, all diets provided adequate iron and most of the cereal-based foods provided adequate carbohydrate and minerals. The overall nutrient adequacy was below the cut-off point for all food types. CONCLUSIONS The diets of lactating mothers in Southwest Ethiopia lack diversity and nutrient adequacy. A community-based nutrition education program on the importance of diet diversity and nutrient intake during lactation based on a multi-sectoral approach is needed.
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Affiliation(s)
- Sirawdink Fikreyesus Forsido
- Department of Agricultural and Biosystems Engineering, Faculty of Organic Agricultural Sciences, University of Kassel, Nordbahnhofstraße 1a, Witzenhausen, Germany
- Department of Post-Harvest Management, Jimma University, Jimma, Ethiopia
| | - Frehiwot Tadesse
- Department of Post-Harvest Management, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Oliver Hensel
- Department of Agricultural and Biosystems Engineering, Faculty of Organic Agricultural Sciences, University of Kassel, Nordbahnhofstraße 1a, Witzenhausen, Germany
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Misgina KH, Boezen HM, van der Beek EM, Mulugeta A, Groen H. What factors are associated with pre-pregnancy nutritional status? Baseline analysis of the KITE cohort: a prospective study in northern Ethiopia. BMJ Open 2021; 11:e043484. [PMID: 34183336 PMCID: PMC8240578 DOI: 10.1136/bmjopen-2020-043484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 06/08/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To assess a broad range of factors associated with pre-pregnancy nutritional status, a key step towards improving maternal and child health outcomes, in Ethiopia. DESIGN A baseline data analysis of a population-based prospective study. SETTING Kilite-Awlaelo Health and Demographic Surveillance Site, eastern zone of Tigray regional state, northern Ethiopia. PARTICIPANTS We used weight measurements of all 17 500 women of reproductive age living in the surveillance site between August 2017 and October 2017 as a baseline. Subsequently, 991 women who became pregnant were included consecutively at an average of 14.8 weeks (SD: 1.9 weeks) of gestation between February 2018 and September 2018. Eligible women were married, aged 18 years or older, with a pre-pregnancy weight measurement performed, and a gestational age ≤20 weeks at inclusion. OUTCOME MEASURES The outcome measure was pre-pregnancy nutritional status assessed by body mass index (BMI) and mid-upper arm circumference (MUAC). Undernutrition was defined as BMI of <18.5 kg/m2 and/or MUAC of <21.0 cm. BMI was calculated using weight measured before pregnancy, and MUAC was measured at inclusion. Linear and spline regressions were used to identify factors associated with pre-pregnancy nutritional status as a continuous and Poisson regression with pre-pregnancy undernutrition as a dichotomous variable. RESULTS The mean pre-pregnancy BMI and MUAC were 19.7 kg/m2 (SD: 2.0 kg/m2) and 22.6 cm (SD: 1.9 cm), respectively. Overall, the prevalence of pre-pregnancy undernutrition was 36.2% based on BMI and/or MUAC. Lower age, not being from a model household, lower values of women empowerment score, food insecurity, lower dietary diversity, regular fasting and low agrobiodiversity showed significant associations with lower BMI and/or MUAC. CONCLUSION The prevalence of pre-pregnancy undernutrition in our study population was very high. The pre-pregnancy nutritional status could be improved by advancing community awareness on dietary practice and gender equality, empowering females, raising agricultural productivity and strengthening health extension. Such changes require the coordinated efforts of concerned governmental bodies and religious leaders in the Ethiopian setting.
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Affiliation(s)
- Kebede Haile Misgina
- Department of Epidemiology, University of Groningen, Groningen, The Netherlands
- Department of Public Health, Aksum University, Axum, Ethiopia
| | - H Marike Boezen
- Department of Epidemiology, University of Groningen, Groningen, The Netherlands
| | | | - Afework Mulugeta
- Department of Nutrition, University of Mekelle, Mekelle, Ethiopia
| | - Henk Groen
- Department of Epidemiology, University of Groningen, Groningen, The Netherlands
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Firdaus D, Anwar F, Khomsan A, Ashari CR. The Factors Associated with Consumption Diversity of Toddlers Aged 24-59 Months. AMERTA NUTRITION 2021. [DOI: 10.20473/amnt.v5i2.2021.98-104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Latar Belakang: Masa balita merupakan masa yang memerlukan asupan gizi optimal untuk pertumbuhan dan perkembangan serta mencegah terjadinya masalah gizi. Keragaman konsumsi adalah salah satu indikator yang digunakan untuk menilai kualitas konsumsi dan kebutuhan zat gizi. Kualitas konsumsi secara langsung dapat memengaruhi status gizi balita.Tujuan: Penelitian ini bertujuan untuk megidentifikasi keragaman konsumsi balita dan menganalisis faktor yang berhubungan dengan keragaman konsumsi balita usia 24-59 bulan di Kecamatan Gunung Halu Kabupaten Bandung Barat.Metode: Penelitian ini menggunakan desain cross-sectional studi dengan 97 balita usia 24-59 bulan. Penelitian ini dilaksanakan pada bulan November hingga Desember 2019. Balita dipilih secara acak menggunakan teknik random sampling. Keragaman konsumsi didapatkan dari konsumsi makanan sehari sebelumnya dan dianalisis berdasarkan standar FAO yang terdiri dari 9 kelompok pangan tanpa jumlah konsumsi minimal. Faktor yang berhubungan dengan keragaman konsumsi dianalisis menggunakan model regresi logistik. Jika total skor keragaman konsumsi ≤4 diklasifikasikan sebagai tidak beragam dan >4 beragam.Hasil: Sebanyak 76.3% balita pada penelitian ini mengonsumsi makan yang tidak beragam dan didominasi oleh makanan tinggi energi. Tidak terdapat hubungan yang signifikan antara keragaman konsumsi balita dengan kejadian stunting. Status pekerjaan ibu (OR:4,63;95%CI:1,1-18,9), jenis kelamin (OR:5,1;95%CI:1,7-15,7), dan pengetahuan gizi ibu (OR:3,4,95%CI1,1-10,3) berhubungan signifikan dengan keragaman konsumsi balita.Kesimpulan: Ibu yang bekerja, balita laki-laki, dan pengetahuan gizi ibu yang kurang secara signifikan menjadi faktor yang berhubungan dengan keragaman konsumsi balita yang rendah.
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Kundu S, Jharna DE, Banna MHA, Khan MSI. Factors associated with dietary diversity and physical activity of pregnant women in Bangladesh: A cross‐sectional study at an antenatal care setting. LIFESTYLE MEDICINE 2021. [DOI: 10.1002/lim2.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Satyajit Kundu
- Department of Biochemistry and Food Analysis Patuakhali Science and Technology University Patuakhali Bangladesh
| | - Dilruba Easmin Jharna
- Department of Biochemistry and Food Analysis Patuakhali Science and Technology University Patuakhali Bangladesh
| | - Md. Hasan Al Banna
- Department of Food Microbiology Patuakhali Science and Technology University Patuakhali Bangladesh
| | - Md Shafiqul Islam Khan
- Department of Food Microbiology Patuakhali Science and Technology University Patuakhali Bangladesh
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Bitew ZW, Alemu A, Ayele EG, Worku T. Dietary diversity and practice of pregnant and lactating women in Ethiopia: A systematic review and meta-analysis. Food Sci Nutr 2021; 9:2686-2702. [PMID: 34026082 PMCID: PMC8116864 DOI: 10.1002/fsn3.2228] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/21/2021] [Accepted: 02/25/2021] [Indexed: 11/17/2022] Open
Abstract
The dietary diversity of pregnant and lactating women remains unacceptably poor in resource-limited countries such as Ethiopia. Despite the presence of inconsistent and inconclusive small-scale studies, it is difficult to portray an actual picture of dietary diversity and dietary practices of women in Ethiopia. This study aimed to identify the prevalence of dietary diversity, dietary practice, and dietary patterns of pregnant and lactating women in Ethiopia. Electronic and gray literature sources were explored. A total of 3,256 articles were found, of which 38 were included in the final analysis. The data were analyzed by using STATA version 15. The pooled estimates were presented using random-effects models due to considerable heterogeneities among studies. In this study, 16,412 pregnant and lactating women were included. The pooled prevalence of low, medium, and high dietary diversity scores of pregnant women was 37.1%, 41.55%, and 39.3%, respectively. Likewise, low, medium, and high dietary diversity scores of lactating women were 50.31%, 41.22%, and 9.1%, respectively. The mean dietary diversity of pregnant and lactating women was 3.99 ± 0.20. Regarding the minimum dietary diversity, 56.6% of pregnant women and 50.21% of lactating women were found to have inadequate dietary diversities. Two-third (65.7%) of pregnant women were found to have poor dietary practice. Starchy foods were the main staple foods of study subjects, whereas organ meats were least consumed food types. The dietary diversity score, minimum dietary diversity, and dietary practices of women are suboptimal and below WHO and FAO recommendations. This could lead to both macro- and micronutrient deficiencies. Policymakers, program managers, healthcare workers, and stakeholders need to redesign nutrition promotion and intervention programs to alleviate this issue.
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Affiliation(s)
- Zebenay Workneh Bitew
- Department of Pediatric NursingSchool of NursingSt. Paul’s Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | | | - Ermias Getaneh Ayele
- Department of Pediatric NursingSchool of NursingSt. Paul’s Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | - Teshager Worku
- College of Health and Medical SciencesSchool of Nursing and MidwiferyHaramaya UniversityHararEthiopia
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Endalifer ML, Andargie G, Mohammed B, Endalifer BL. Factors associated with dietary diversity among adolescents in Woldia, Northeast Ethiopia. BMC Nutr 2021; 7:27. [PMID: 33926578 PMCID: PMC8082914 DOI: 10.1186/s40795-021-00430-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Consuming diversified food during the adolescent period is essential to build a healthy and active mind for their later life. Food prices increased in the local market due to fewer production of crops. Thus, exploring the dietary diversity of adolescents in this area is crucial to estimate diet quality. So the aim of the study was to identify determinant factors of dietary diversity. Methods An institution-based cross-sectional study was conducted among adolescent students in Woldia town. A total of four hundred eleven students were included in the study. A simple random sampling technique was used to select the participants. The outcome variable was dietary diversity; it was calculated by summing of the number of food group consumed by individuals in the given reference period. Bivariable and multivariable logistic analysis was done. The odds ratio with a 95% confidence interval was computed to measure an association. A variable with a P-value less than 0.05 is considered a significant factor. Results The proportion of inadequate dietary diversity was 49.1% (95% CI 44.5–53.8). Being female (AOR =5.53, 95% CI 3.447–8.859), secondary and above mothers’ education level (AOR=0. 27, 95%CI 0.153–0.477), living in a family size five and above (AOR= 2.09, 95CI% 1.31–3.34), and poor knowledge about nutrition (AOR=4.56, 95% CI 2.727–7.639) were significantly associated with inadequate dietary diversity. Conclusions and recommendations Inadequate dietary diversity was associated with sex, knowledge of nutrition, maternal education level, and family size. It is better to design a nutrition intervention program that focus on nutrition education to scale up diversified food consumption among adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-021-00430-6.
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Affiliation(s)
- Melese Linger Endalifer
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia.
| | - Gashaw Andargie
- Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bekri Mohammed
- Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bedilu Linger Endalifer
- Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Shrestha V, Paudel R, Sunuwar DR, Lyman ALT, Manohar S, Amatya A. Factors associated with dietary diversity among pregnant women in the western hill region of Nepal: A community based cross-sectional study. PLoS One 2021; 16:e0247085. [PMID: 33831015 PMCID: PMC8031299 DOI: 10.1371/journal.pone.0247085] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/01/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Dietary diversity can play an important role in providing essential nutrients for both mother and fetus during pregnancy. This study aimed to assess the factors associated with dietary diversity during pregnancy in the western hill region of Nepal. METHODS A cross-sectional study of 327 pregnant women was conducted in an urban municipality of Baglung district in the western hill region of Nepal. A semi-structured questionnaire was used to collect information on household demographic and socioeconomic status, food taboos, household food security status, nutrition-related knowledge in pregnancy, and women's empowerment. Women consuming ≥5 of 10 food groups in the past 24 hours were defined as consuming a diverse diet using the Minimum Dietary Diversity Score for Women (MDD-W) tool. Bivariate and multivariate logistic regression was used to estimate crude odds ratio (cOR) and adjusted odds ratios (aOR) and 95% confidence intervals (CIs) to understand factors associated with dietary diversity. RESULTS Almost 45% (95% CI: 39.6-50.4) of the participants did not consume a diverse diet and the mean dietary diversity score was 4.76 ± 1.23. Multivariable analysis revealed that women with greater empowerment (aOR = 4.3, 95% CI: 1.9-9.9), from wealthier households (aOR = 5.1, 95% CI: 2.7-9.3), joint families (aOR = 2.7, 95% CI: 1.4-5.1), employment (aOR = 2.2, 95% CI: 1.2-4.1), and had adequate nutrition knowledge (aOR: 1.9, 95% CI 1.1-3.4) had higher odds of dietary diversity. CONCLUSION Along with socioeconomic status, women's empowerment and nutrition knowledge were modifiable risk factors that should be considered as targets for programs to improve women's health during pregnancy.
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Affiliation(s)
- Vintuna Shrestha
- Department of Nursing, Dhaulagiri Prabhidhik Shikshya Pratisthan, Council for Technical Education and Vocational Training, Baglung, Nepal
| | - Rajan Paudel
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Dev Ram Sunuwar
- Department of Nutrition and Dietetics, Armed Police Force Hospital, Kathmandu, Nepal
| | - Andrew L. Thorne Lyman
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Swetha Manohar
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- International Development Program, Nitze School of Advanced of International Studies (SAIS), Johns Hopkins University, Washington DC, United States of America
| | - Archana Amatya
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Waswa LM, Jordan I, Krawinkel MB, Keding GB. Seasonal Variations in Dietary Diversity and Nutrient Intakes of Women and Their Children (6-23 Months) in Western Kenya. Front Nutr 2021; 8:636872. [PMID: 33763444 PMCID: PMC7982591 DOI: 10.3389/fnut.2021.636872] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/12/2021] [Indexed: 01/09/2023] Open
Abstract
Seasonal variations in food availability and access contributes to inadequate nutrient intakes, particularly in low income countries. This study assessed the effect of seasonality on dietary diversity (DD) and nutrient intakes of women and children aged 6–23 months in a rural setting in Western Kenya. A longitudinal study was conducted among 426 mother-child pairs during the harvest and post-harvest seasons in 2012. Dietary intakes were assessed using 24-h dietary recalls and dietary diversity scores (DDS) and nutrient intakes calculated for both seasons. Effect of seasonality on women dietary diversity scores (WDDS) and children's dietary diversity scores (CDDS) were assessed using generalised linear mixed models (GLMM). The proportion of women consuming diets with high DDS (>4 out of 9 food groups) increased from 36.4 to 52.4% between the two seasons, with mean WDDS being significantly higher in November compared to July/August (4.62 ± 1.43 vs. 4.16 ± 1.14, P < 0.001). A significantly higher proportion of children consumed foods from ≥4 out of 7 food groups in November compared to July/August (62.4 vs. 52.6%, P = 0.004). Mean CDDS (3.91 vs. 3.61, P = 0.004) was low but significantly higher in November compared to July/August. Estimated marginal mean WDDS increased from 4.17 to 4.38, and decreased for CDDS from 3.73 to 3.60 between the seasons. Seasonality had a small but significant effect on WDDS, P = 0.008 but not on CDDS, P = 0.293. Increase in CDDS in November was due to age and not seasonal effect. Higher women education and household food security were associated with higher WDDS and CDDS. Intakes of iron, calcium and vitamin E were higher among women in November and significantly different between the seasons. Agro-ecological zone, ethnic group and home gardening influenced nutrient intakes of the women. Seasonality had an effect on the DD of women but not of children, thus other factors apart from food availability influence the quality of children's diets during the complementary feeding period. With increasing age and transition to family foods, children's DD is expected to be affected by seasonality. Integrated interventions to alleviate seasonal food insecurity and strengthen rural households' resilience against seasonal deterioration in diet quality are recommended.
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Affiliation(s)
- Lydiah M Waswa
- Department of Human Nutrition, Faculty of Health Sciences, Egerton University, Egerton, Kenya
| | - Irmgard Jordan
- Center for international Development and Environmental Research, Justus Liebig University Giessen, Giessen, Germany
| | - Michael B Krawinkel
- Institute of Nutritional Sciences-International Nutrition, Justus Liebig University Giessen, Giessen, Germany
| | - Gudrun B Keding
- Division of Quality of Plant Products, Department of Crop Sciences, Faculty of Agricultural Sciences, George August University Goettingen, Goettingen, Germany
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Saaka M, Mutaru S, Osman SM. Determinants of dietary diversity and its relationship with the nutritional status of pregnant women. J Nutr Sci 2021; 10:e14. [PMID: 33889397 PMCID: PMC8057399 DOI: 10.1017/jns.2021.6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 12/23/2022] Open
Abstract
There is little information regarding factors that determine dietary diversity among pregnant women in Ghana. The present study, therefore, sought to assess the independent predictors of dietary diversity and its relationship with nutritional status of pregnant women in the Northern Region of Ghana. The present study was an analytical cross-sectional survey involving 423 pregnant women in different stages of gestation. The 24-h dietary recall method was used to assess minimum dietary diversity for women (MDD-W), and nutritional status was assessed using mid-upper arm circumference (MUAC) measurements. Binary logistic regression was performed to assess the association between maternal dietary diversity and maternal thinness and a P value of <0⋅05 was considered statistically significant. Of the 423 women, 79⋅9 % (95 % CI 76⋅1, 83⋅7) met the MDD-W and the prevalence of undernutrition among the pregnant women was 26⋅0 %. The analysis showed that women of low household wealth index were 48 % less likely (AOR 0⋅52, CI 0⋅31, 0⋅88) of meeting the MDD-W, whereas women from households of poor food insecurity were 88 % less likely (AOR 0⋅12, CI 0⋅05, 0⋅27) of achieving the MDD-W. Women of low household size were three times more likely of meeting the MDD-W (AOR 3⋅07, CI 1⋅13, 8⋅39). MDD-W was not associated with maternal underweight during pregnancy. In conclusion, the results of the present study showed that food insecurity and not low MDD-W, associated with mothers' thinness (underweight) during pregnancy in peri-urban setting of Northern Ghana.
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Affiliation(s)
- Mahama Saaka
- University for Development Studies, School of Allied Health Sciences, P O Box 1883, Tamale, Ghana
| | - Sofo Mutaru
- Ghana Health Service, Northern Region, Tamale, Ghana
| | - Shaibu Mohammed Osman
- University for Development Studies, School of Allied Health Sciences, P O Box 1883, Tamale, Ghana
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Sema A, Belay Y, Solomon Y, Desalew A, Misganaw A, Menberu T, Sintayehu Y, Getachew Y, Guta A, Tadesse D. Minimum Dietary Diversity Practice and Associated Factors among Children Aged 6 to 23 Months in Dire Dawa City, Eastern Ethiopia: A Community-Based Cross-Sectional Study. Glob Pediatr Health 2021; 8:2333794X21996630. [PMID: 33748344 PMCID: PMC7905725 DOI: 10.1177/2333794x21996630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 01/30/2021] [Indexed: 01/09/2023] Open
Abstract
Objective: Malnutrition because of poor dietary diversity contributing to child morbidity and mortality. Two-thirds of child mortality occurs within the first 2 years. However, there is limited data related to dietary diversity among children aged 6 to 23 months in Ethiopia. Thus, this study aimed to assess dietary diversity and factors among children aged 6 to 23 months in the study setting. Methods: A community-based cross-sectional study conducted on 438 children aged 6 to 23 months in Dire Dawa, 1-30/02/2019. Simple random sampling was used to select study subjects. Data collected using a structured and pretested interview administered questionnaire. Data entered using EpiData 4.2 and analyzed with SPSS Version 22. Multivariable logistic regression was used to examine associated factors. Adjusted odd-ratio with 95% confidence interval (CI) used, and P-value <.05 considered statistically significant. Results: The overall minimum dietary diversity practice was 24.4% (95% CI: 20.3, 28.5). Maternal education [AOR 2.20; 95% CI: 1.08, 4.52], decision-making [AOR = 2.5; 95% CI: 1.19, 5.29], antenatal care [AOR = 2.19; 95% CI: 1.20, 3.99], postnatal care [AOR = 6.4; 95% CI: 2.78, 14.94] and facility delivery [AOR = 2.66; 95% CI: 1.35, 5.25] were maternal factors. Moreover, child’s age [AOR = 2.84; 95% CI: 1.39, 5.83], and child’s sex [AOR = 2.85; 95% CI: 1.64, 4.94] were infant factors. Conclusion: One-fourth of children practiced minimum dietary diversity. Child’s age, birth interval, postnatal care, antenatal care, child’s sex, mothers’ decision-making, mothers’ education, and place of delivery were significant predictors. Therefore, maternal education, empowering women, and improve maternal service utilization are crucial to improving dietary diversity.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Alemu Guta
- Dire Dawa University, Dire Dawa, Ethiopia
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Madzorera I, Ghosh S, Wang M, Fawzi W, Isanaka S, Hertzmark E, Namirembe G, Bashaasha B, Agaba E, Turyashemererwa F, Webb P, Duggan C. Prenatal dietary diversity may influence underweight in infants in a Ugandan birth-cohort. MATERNAL AND CHILD NUTRITION 2021; 17:e13127. [PMID: 33595899 PMCID: PMC8189249 DOI: 10.1111/mcn.13127] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 11/06/2020] [Accepted: 12/02/2020] [Indexed: 12/18/2022]
Abstract
Growth faltering in early childhood is prevalent in many low resource countries. Poor maternal dietary diversity during pregnancy has been linked with increased risk of fetal growth failure and adverse birth outcomes but may also influence subsequent infant growth. Our aim is to assess the role of prenatal maternal dietary diversity in infant growth in rural Uganda. Data from 3291 women and infant pairs enrolled in a birth cohort from 2014 to 2016 were analysed (NCT04233944). Maternal diets were assessed using dietary recall in the second or third trimesters of pregnancy. Maternal dietary diversity scores (DDS) were calculated using the FAO Minimum Dietary Diversity for Women (MDD‐W). Cox regression models were used to evaluate associations of the DDS with the incidence of underweight, stunting and wasting in infants from 3 to 12 months, adjusting for confounding factors. The median DDS for women was low, at 3.0 (interquartile range 3.0–4.0), relative to the threshold of consuming five or more food groups daily. Infants of women in highest quartile of DDS (diverse diets) were less likely to be underweight (adjusted hazard ratio: 0.70, 95% confidence interval: 0.61, 0.80) compared with infants of women in Quartile 1 (p for trend <0.001) in models controlling for maternal factors. There was no significant association between DDS and stunting or wasting. Our findings suggest a relationship between higher maternal dietary diversity and lower risk of underweight in infancy. These findings suggest that programmes to improve infant growth could additionally consider strengthening prenatal dietary diversity to improve child outcomes globally.
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Affiliation(s)
- Isabel Madzorera
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Shibani Ghosh
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA.,USAID Feed the Future Innovation Lab for Nutrition, Tufts University, Boston, Massachusetts, USA
| | - Molin Wang
- Departments of Epidemiology and Biostatistics, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Wafaie Fawzi
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.,Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Sheila Isanaka
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.,Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Ellen Hertzmark
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Grace Namirembe
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Bernard Bashaasha
- Department of Agribusiness and Natural Resource Economics, College of Agricultural and Environmental Sciences, Makerere University, Kampala, Uganda
| | - Edgar Agaba
- USAID Feed the Future Innovation Lab for Nutrition, Tufts University, Boston, Massachusetts, USA
| | - Florence Turyashemererwa
- Department of Agribusiness and Natural Resource Economics, College of Agricultural and Environmental Sciences, Makerere University, Kampala, Uganda
| | - Patrick Webb
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA.,USAID Feed the Future Innovation Lab for Nutrition, Tufts University, Boston, Massachusetts, USA
| | - Christopher Duggan
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.,Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
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Anane I, Nie F, Huang J. Socioeconomic and Geographic Pattern of Food Consumption and Dietary Diversity among Children Aged 6-23 Months Old in Ghana. Nutrients 2021; 13:nu13020603. [PMID: 33673212 PMCID: PMC7918505 DOI: 10.3390/nu13020603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 12/04/2022] Open
Abstract
Dietary inadequacy is a major challenge among young children in Ghana. Nutritional policies are required for optimum child nutrition and development. This study explored food consumption and dietary diversity by socioeconomic status and geographical location among children aged 6–23 months in Ghana. We used the latest national representative, cross-sectional data from the Ghana Demographic and Health Survey (GDHS-2014). A total of 887 children aged 6–23 months were used in the final analysis. The survey collected data on children’s food consumption through their mothers in the 24 h recall method. Multiple logistic regression models were used to assess the relationship between socioeconomic status and geographical location with food consumption and adequate dietary diversity after adjusting for control variables. The study revealed an association between specific food item consumption, food groups, and dietary diversity by socioeconomic and geographic characteristics. However, dairy consumption increased faster than other nutritional foods when socioeconomic status increased. Furthermore, the study revealed that children’s chances of consuming particular food items and food groups differed across Ghana’s 10 regions. The average probabilities of consuming adequate dietary diversity between the Greater Accra region and Ashanti region were 43% vs. 8% (p < 0.001). Consumption of grains, root, and tubers were relatively higher but low for Vitamin A-rich fruits and vegetables and legumes and nuts for children aged 6–23 months in Ghana. Overall, the mean dietary diversity score was low (3.39; 95% CI: 3.30–3.49) out of eight food groups, and the prevalence of adequate dietary diversity was 22% only. There is a need for policy interventions to ensure appropriate dietary practices to promote healthy growth of children.
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Affiliation(s)
- Isaac Anane
- Agricultural Information Institute of Chinese Academy of Agricultural Sciences, Beijing 100081, China; (I.A.); (J.H.)
| | - Fengying Nie
- Agricultural Information Institute of Chinese Academy of Agricultural Sciences, Beijing 100081, China; (I.A.); (J.H.)
- Correspondence:
| | - Jiaqi Huang
- Agricultural Information Institute of Chinese Academy of Agricultural Sciences, Beijing 100081, China; (I.A.); (J.H.)
- Urban Economics Group, Department of Social Sciences, Wageningen University, 6706 KN Wageningen, The Netherlands
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Mottet A, Bicksler A, Lucantoni D, De Rosa F, Scherf B, Scopel E, López-Ridaura S, Gemmil-Herren B, Bezner Kerr R, Sourisseau JM, Petersen P, Chotte JL, Loconto A, Tittonell P. Assessing Transitions to Sustainable Agricultural and Food Systems: A Tool for Agroecology Performance Evaluation (TAPE). FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2020. [DOI: 10.3389/fsufs.2020.579154] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
There is increasing interest in agroecology as a way to move toward more sustainable agriculture and food systems. However, the evidence of agroecology's contribution to sustainability remains fragmented because of heterogeneous methods and data, differing scales and timeframes, and knowledge gaps. Facing these challenges, 70 representatives of agroecology-related organizations worldwide participated in the development of the Tool for Agroecology Performance Evaluation (TAPE), to produce and consolidate evidence on the multidimensional performances of agroecological systems. TAPE is composed of: Step 0, the preliminary step that includes a description of the main socio-economic and demographic characteristics of the agricultural and food systems and an analysis of the enabling environment in terms of relevant policy, market, technology, socio-cultural and/or historical drivers; Step 1, the Characterization of Agroecological Transitions (CAET), based on the 10 Elements of Agroecology adopted by FAO and its member countries, using descriptive scales to establish scores and assessing the degree of transition, with information from the farm/household and community/territory scale; Step 2, the Core Criteria of Performance listing the key dimensions considered relevant to address the Sustainable Development Goals (SDGs): Environment & climate change; Health & nutrition; Society & culture; Economy and Governance. Finally Step 3, a participatory validation of the results obtained from the previous steps with the producers and relevant stakeholders. TAPE can be used (i) to assess the extent of agroecological transition among agricultural producers in a community or a territory, (ii) to monitor and evaluate projects by characterizing the initial and subsequent steps in an agroecological transition, and/or (iii) to evaluate widely diverse agricultural systems against agroecological elements and how they contribute to the achievement of the SDGs. Its application can support the transition of all forms of agricultural systems toward more sustainable practices and the formulation of adequate policies to enable this transformation. Preliminary results from pilot applications show that TAPE can perform in a variety of geographic regions and agroecosystems and that it allows assessment of performances of various criteria that move beyond classic indicators to begin to build a global evidence base for agroecology and support transformation to sustainable agricultural production and food systems.
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Getacher L, Egata G, Alemayehu T, Bante A, Molla A. Minimum Dietary Diversity and Associated Factors among Lactating Mothers in Ataye District, North Shoa Zone, Central Ethiopia: A Community-Based Cross-Sectional Study. J Nutr Metab 2020; 2020:1823697. [PMID: 33520304 PMCID: PMC7817227 DOI: 10.1155/2020/1823697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 11/08/2020] [Accepted: 11/18/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Low dietary diversity superimposed with poor-quality monotonous diets is a major problem that often results in undernutrition, mainly micronutrient deficiencies. However, there is limited evidence on minimum dietary diversity and associated factors among lactating mothers in resource-poor settings, including the study area. Therefore, the objective of the study is to assess the prevalence of minimum dietary diversity and associated factors among lactating mothers in Ataye District, Ethiopia. METHODS A community-based cross-sectional study design was used among 652 lactating mothers aged 15-49 years from January 25 to April 30, 2018. Dietary diversity was measured by the minimum dietary diversity indicator for women (MDD-W) using the 24-hour dietary recall method. Data were entered into EpiData version 4.2.0.0 and exported to the statistical package for social science (SPSS) version 24 for analysis using the logistic regression model. RESULTS The prevalence of minimum dietary diversity among lactating mothers was 48.8% (95% CI: (44.7%, 52.9%). Having formal education ((AOR = 2.16, 95% CL: (1.14, 4.09)), a final say on household purchases ((AOR = 5.39, 95% CI: (2.34, 12.42)), home gardening practices ((AOR = 2.67, 95% CI: (1.49, 4.81)), a history of illness ((AOR = 0.47, 95% CI: (0.26, 0.85)), good knowledge of nutrition ((AOR = 5.11, 95% CI: (2.68, 9.78)), being from food-secure households ((AOR = 2.96, 95% CI: (1.45, 6.07)), and medium ((AOR = 5.94, 95% CI: (2.82, 12.87)) and rich wealth indices ((AOR = 3.55, 95% CI: (1.76, 7.13)) were significantly associated with minimum dietary diversity. CONCLUSION The prevalence of minimum dietary diversity among lactating mothers was low in the study area. It was significantly associated with mothers having a formal education, final say on the household purchase, home garden, good knowledge of nutrition, history of illness, food-secure households, and belonging to medium and rich household wealth indices. Therefore, efforts should be made to improve the mother's decision-making autonomy, nutrition knowledge, household food security, and wealth status.
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Affiliation(s)
- Lemma Getacher
- Department of Public Health, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Gudina Egata
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Alemayehu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Agegnehu Bante
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Abebaw Molla
- Department of Nursing, College of Medicine and Health Sciences, Mizan Tepi University, Tepi, Ethiopia
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Understanding Dietary Diversity, Dietary Practices and Changes in Food Patterns in Marginalised Societies in Sri Lanka. Foods 2020; 9:foods9111659. [PMID: 33202762 PMCID: PMC7696452 DOI: 10.3390/foods9111659] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/26/2020] [Accepted: 10/31/2020] [Indexed: 01/04/2023] Open
Abstract
Micronutrient malnutrition is a serious public health problem in developing countries, including Sri Lanka. Most frequently, micronutrient malnutrition is experienced by the poorest households due to cereal-based, monotonous diets that lack dietary diversity. Sri Lankan traditional food system is changing day by day. In parallel, nutrition deficiencies, malnutrition, and noncommunicable diseases are the most significant problems today in Sri Lanka. Therefore, understanding dietary diversity and dietary changes in Sri Lanka must be studied to address related public health issues. This study investigates nutrition adequacy, dietary diversity, dietary practice, and traditional food pattern changes in different marginalised areas in Sri Lanka. A cross-sectional survey was done using 24 h food recall and an administrative questionnaire for 400 women of reproductive age (WRA) (18-49 years old) in marginalised areas in Sri Lanka. The random sampling method was used for data collection. The research confirmed that different areas had poor dietary practices, with macronutrient imbalance and alarmingly low intakes of micronutrients. Interestingly, the diversity of food was higher in rural areas than in urban areas. Approximately 83% of women in urban areas did not meet minimum dietary diversity (MDD-W). Overall, about 63% of reproductive age women did not meet MDD-W and food security. The mean MDD-W for both areas was low. Significant differences in MDD-W levels were found in the two areas (F = 90.483, p < 0.05). The sample showed a significant positive correlation between MDD-W and area, monthly income, educational level, food source, BMI level and health status (R2 = 360; p < 0.01). This sample did not find that the consumption of traditional varieties of foods and agrobiodiversity are decreasing. Additionally, the study confirmed that low dietary diversity impacts nutrition status and health. The results highlight that the leading causes for low diet diversity are decreased dependence on own production, increased purchasing food at markets, lack of suitable lands to cultivate, agro-commercialisation, less knowledge of food and nutrition, loss of traditional food culture, low income and high prices of food. Inappropriate food patterns, nutrition policies and governance in Sri Lanka are the main factors to the nutrition findings. The study finding will help the decision-making authorities or policymakers to design suitable nutrition programs for vulnerable people in marginalised areas and to use these to strengthen a sustainable food and nutrition system in Sri Lanka.
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Nearly One in Three Lactating Mothers Is Suffering from Inadequate Dietary Diversity in Amhara Region, Northwest Ethiopia. J Nutr Metab 2020; 2020:7429034. [PMID: 33029395 PMCID: PMC7530474 DOI: 10.1155/2020/7429034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/14/2020] [Indexed: 11/18/2022] Open
Abstract
Background In developing countries, dietary diversity is a challenge for rural communities especially pregnancy and lactation. Malnourished mothers are unable to combat disease and feed adequate nutrients to their children, and this will in turn affect the socioeconomic development of the country. To date, there is paucity of evidence regarding predictors of dietary diversity among lactating mothers in developing countries. The main objective of this study was to determine the extent and predictors of dietary diversity among lactating mothers in Lay Gayint District, Amhara Region, Ethiopia. Methods A community-based cross-sectional study design was employed on 416 systematically selected lactating mothers from March 1–30, 2018. The data were collected using pretested interviews. Data were entered and analyzed using SPSS version 21 software. Bivariable and multivariable logistic regression models were used to determine the predictors of dietary diversity. Odds ratio with 95% confidence interval and p ≤ 0.05 were used to test the association. Result A total of 268 (65.7%) lactating mothers had inadequate dietary diversity. Adequate dietary diversity was significantly associated with mobile phone usage (OR: 2.3; 95% CI: 1.15–4.55); practice of home gardening (OR: 4.1; 95% CI: 1.71–9.87); pulses production (OR: 4.8; 95% CI: 2.50–9.32); delivery in health center (OR: 4.7; 95% CI: 1.80–12.25); food secured household (OR: 2.4; 95% CI: 1.25–4.62); three meals per day within the previous seven days (OR: 11.12; 95% CI: 2.74–45.24); and practice of income generating activity (OR: 4.00; 95% CI: 2–8.33). Conclusion Meal frequency, home gardening practices, pulses production, delivery at health center, practice of income generating activity, food insecurity, and mobile phone usage had significant association with dietary diversity. Therefore, concerned bodies should design multidimensional livelihood and health service programs to alleviate inadequate dietary diversity.
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Chowdhury ZT, Hurley KM, Campbell RK, Shaikh S, Shamim AA, Mehra S, Christian P. Novel Method for Estimating Nutrient Intakes Using a Semistructured 24-Hour Diet Recall for Infants and Young Children in Rural Bangladesh. Curr Dev Nutr 2020; 4:nzaa123. [PMID: 32875267 PMCID: PMC7447588 DOI: 10.1093/cdn/nzaa123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/07/2020] [Accepted: 07/10/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Nutrient-level intakes from home-prepared complementary foods are rarely estimated among infants and young children in low-income settings. The major constraints are related to lack of standard recipes and ingredients and portion sizes. OBJECTIVES This article describes the feasibility, applicability, and validity of a post hoc qualitative methodology to estimate nutrient intakes in children using 24-h dietary recall. METHODS Semistructured, interviewer-administered caregiver 24-h diet recalls were conducted to assess food intake among children participating in a randomized trial of complementary food supplementation at ages 6, 9, 12, 15, 18, and 24 mo in rural Bangladesh. At the end of the diet data collection, focus group discussions with mothers (n = 6) and cooking activities (n = 5) were conducted to obtain standard recipes (and ingredients) and portion sizes for reported foods given at different ages. Nutrient intakes were calculated for children in the control group (n = 1438), and convergent validity of the data was tested by examining the association of energy and protein intakes with child age and socioeconomic status (SES). RESULTS Focus group discussions generated standardized recipes for 21 commonly consumed mixed dishes being fed to children. These recipes were cooked, and portion sizes of standardized measures used in 24-h recalls were quantified in grams. For discrete foods, we quantified women's perceptions of "small," "medium," and "large" in grams. Across all ages, food groups consumed consisted mostly of staples, with the most common being rice, potatoes, and biscuits. Using portion size data and recipe ingredients, the 24-h dietary data, and Bangladeshi food composition tables, we successfully estimated nutrient intakes in children. Convergent validity analysis showed that energy and protein intakes were strongly associated with age and SES (both P < 0.001). CONCLUSIONS We demonstrated the use of a validated, qualitative methodology for estimating nutrient intakes in young children from complementary foods in undernourished contexts. This trial was registered at clinicaltrials.gov as NCT01562379.
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Affiliation(s)
- Zaynah T Chowdhury
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kristen M Hurley
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rebecca K Campbell
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Saijuddin Shaikh
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- JiVitA Project, Gaibandha, Bangladesh
| | | | - Sucheta Mehra
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Parul Christian
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Abstract
BACKGROUND It is widely considered that women have less diverse diets than other household members. However, it has been challenging to establish this empirically since women's diet diversity is measured differently from that of other household members. OBJECTIVE In this article, we compare women's dietary diversity with that of their respective households and thereby generate a measure of "dietary gap." METHODS We measure women's "dietary gap" by using the difference of homogenized household and woman dietary scores (using the same scales). This is done using primary data on 3600 households from 4 districts in India. Additionally, we show the robustness of our results to variations in scale and recall periods used to construct the diet diversity scores. RESULTS Mean difference tests indicate that women consistently consume 0.1 to 0.5 fewer food groups relative to other household members, with the results being statistically significant at the 1% level. The food groups driving this dietary gap are nonstaples like Vitamin A-rich fruits and vegetables, meat/fish/poultry, and dairy. CONCLUSIONS Results point toward the discrimination faced by women in the variety of the food consumed, the importance of considering comparability in creating indices of diet diversity, and the need to collect more detailed information on diets. To our knowledge, this is one of the first studies to examine dietary discrimination faced by women using common scales.
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Affiliation(s)
- Soumya Gupta
- Tata- Cornell Institute for Agriculture and Nutrition, Cornell University, Ithaca, NY, USA
| | - Naveen Sunder
- Department of Economics, Bentley University, Waltham, MA, USA
| | - Prabhu L. Pingali
- Tata- Cornell Institute for Agriculture and Nutrition, Cornell University, Ithaca, NY, USA
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