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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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Ararsa GG, Getachew MT, Diddana TZ, Alemayehu FR. Prevalence of undernutrition and associated factors among children aged 6-23 months: a cross-sectional analysis from South-East Ethiopia. J Nutr Sci 2023; 12:e127. [PMID: 38155807 PMCID: PMC10753458 DOI: 10.1017/jns.2023.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 11/03/2023] [Accepted: 11/16/2023] [Indexed: 12/30/2023] Open
Abstract
To meet the 2030 goal to end all types of malnutrition, thoroughly investigating and addressing context-specific factors of undernutrition is crucial. Therefore, this study assessed the prevalence of undernutrition and associated factors among children aged 6-23 months in South-East Ethiopia. A community-based cross-sectional study was conducted on 580 randomly sampled mother-child pairs in February 2022. Socio-demographic, dietary intake, household food security (HFS), maternal knowledge and practices of child feeding, and the child's weight and height data were collected. A multivariable logistic regression analysis was done. The prevalence of stunted, wasted, and underweight children was 32⋅1, 7, and 9 %, respectively. Being male (AOR = 1⋅75), not using the growth monitoring and promotion (GMP) service (AOR = 1⋅50), household food insecurity (HFI) (AOR = 1⋅67), lack of improved water (AOR = 2⋅26), and bottle-feeding (AOR = 1⋅54) were significantly associated with stunting. Being male (AOR = 3⋅02), having low maternal knowledge on child-feeding practices (AOR = 3⋅89), not listening to the radio/television (AOR = 3⋅69), having a history of fever (AOR = 3⋅39), bottle-feeding (AOR = 3⋅58), and HFI (AOR = 3⋅77) were significantly predicted wasting. Being male (AOR = 3⋅44), not using GMP service (AOR = 2⋅00), having a history of fever (AOR = 4⋅24), lack of knowledge on optimal breastfeeding duration (AOR = 3⋅58), low maternal knowledge on child feeding (AOR = 2⋅21), HFI (AOR = 2⋅04), and lack of improved water (AOR = 3⋅00) showed significant association with underweight. In conclusion, stunting is alarmingly common while wasting and underweight are sub-optimal. Prevention of infectious disease, providing basic education for fathers, ensuring HFS; enhancing media access, maternal knowledge about IYCFP and improving water access; and GMP service utilisation are crucial to improve child nutrition.
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Key Words
- 6–23 months aged children
- ANC, antenatal care
- AOR, adjusted odds ratio
- ARI, acute respiratory illness
- ASF, animal source food
- BF, breastfeeding
- CF, complementary feeding
- COR, crude odds ratio
- DDS, dietary diversity score
- EDHS, Ethiopian Demographic and Health Survey
- GMP, growth monitoring and promotion
- HAZ, height/length-for-age Z-score
- HIFAS, household food insecurity access score
- IYCFP, infant and young child feeding practices
- Lemubilbilo
- MAD, Minimum acceptable diet
- OFSP, orange fleshed sweet potato
- ORS, oral rehydration solution
- PNC, postnatal care
- South-east Ethiopia
- Undernutrition
- WAZ, weight-for-age Z-score
- WHO, World Health Organisation
- WHZ, weight-for-height/length Z-score
- mm, millimeter
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Affiliation(s)
- Gosa Girma Ararsa
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
| | - Meheret Tena Getachew
- Ethiopia Civil Society Coalition for Scaling Up Nutrition (ECSC-SUN), Scaling Up Nutrition (SUN), Civil Society Network, P.O. Box 384, Ethiopia Country Office, Addis Ababa, Ethiopia
| | - Tona Zema Diddana
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
| | - Fikadu Reta Alemayehu
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
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Lye CW, Sivasampu S, Mahmudiono T, Majid HA. A systematic review of the relationship between household food insecurity and childhood undernutrition. J Public Health (Oxf) 2023; 45:e677-e691. [PMID: 37291061 DOI: 10.1093/pubmed/fdad070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/21/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND This systematic review aims to investigate the association between household food insecurity (HFIS) and undernutrition in children under 5 years old, thereby informing policymakers on the vital factors needed to be considered in tailoring an effective strategy to tackle childhood undernutrition and ultimately HFIS. METHODS We performed a systematic review that examined household food insecurity among the undernourished under-five children. PubMed, Cochrane, EBSCO Host, Web of Science and Cumulative Index to Nursing and Allied Health Literature were searched from 1 January 2012 to 1 April 2022, for relevant articles. Outcome measures were stunting, underweight or wasting. Of the 2779 abstracts screened, 36 studies that fulfilled the inclusion and exclusion criteria were included. A range of tools had been used to measure HFIS, the most common being Household Food Insecurity Access Scale. HFIS has been found to be significantly associated with undernutrition, particularly stunting and underweight. This is observed proportionately across all national income levels. CONCLUSIONS Sustainable and inclusive economic growth, which aims to reduce income, education and gender inequality, should be a key policy goal in the minimizing food insecurity and childhood undernutrition. Multisectoral interventions are needed to address these issues.
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Affiliation(s)
- Chuan Way Lye
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Sheamini Sivasampu
- Centre for Clinical Outcome Research, Institute for Clinical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Trias Mahmudiono
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Hazreen Abdul Majid
- The Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
- School of Chiropractor, AECC University College, Parkwood Campus, Dorset BH5 2DF, UK
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Bwalya R, Chama-Chiliba CM, Malinga S, Chirwa T. Association between household food security and infant feeding practices among women with children aged 6-23 months in rural Zambia. PLoS One 2023; 18:e0292052. [PMID: 37782631 PMCID: PMC10545113 DOI: 10.1371/journal.pone.0292052] [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: 10/05/2022] [Accepted: 09/11/2023] [Indexed: 10/04/2023] Open
Abstract
Infant and young child feeding (IYCF) practices directly affect the nutritional status of children under two years of age, ultimately impacting their survival. However, ensuring that newborns and young children are fed according to the WHO-recommended practice has proven to be a challenge in many developing nations, especially in households that face food insecurity. This study aims to determine the association between IYCF practices and household food security's availability and access dimensions in rural Zambia. The study uses data from a cross-sectional survey of 2,127 mother-child pairs drawn from 28 rural districts in 8 out of the 10 Zambian provinces. Logistic regression analysis was used to examine the association of minimum dietary diversity, minimum meal frequency, and minimum acceptable diet with measures of household food security such as household dietary diversity score, and food insecurity experience scale, while controlling for confounding variables. The results show that children living in households classified as being food-secure based on the household dietary diversity score were significantly more likely to achieve appropriate feeding practices on all three IYCF measures, even after controlling for confounding factors. Notably, poor IYCF practices exist even in food-secure households, as most children in these households still need to receive a minimum acceptable diet. Although living in a household classified as food secure based on the access dimensions of household dietary diversity score and food insecurity experience scale is significantly associated with improvements in all three IYCF indicators even after controlling for confounding factors, the relationship does not hold for the availability measure of months of adequate household food provisioning. These findings highlight the need for targeting specific dimensions of household food security to solve child malnutrition, especially in rural areas. The focus should go beyond basic food availability, ensuring adequate diversity, and enhancing knowledge of appropriate feeding practices.
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Affiliation(s)
- Richard Bwalya
- Institute of Economic and Social Research, University of Zambia, Lusaka, Zambia
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Liu X, Liu C, Chen K. Agricultural production diversity, child dietary diversity and nutritional status in poor, rural Gansu Province of China. PLoS One 2023; 18:e0287000. [PMID: 37315059 DOI: 10.1371/journal.pone.0287000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 05/27/2023] [Indexed: 06/16/2023] Open
Abstract
Research has shown mixed findings on the link between production diversity and household dietary diversity. The question is whether this link holds for children. In this study we examine the relationship between household's agricultural production diversity and child dietary diversity, and between production diversity and child nutritional status. Smallholder farm households (n = 1067) and children (n = 1067) aged 3-16 years from two then nationally designated poverty counties in Gansu Province of China were interviewed in 2019. Production diversity was assessed with the production richness score and production diversity score. Production diversity was calculated from agricultural production data covering a period of 12 months. Child dietary diversity was assessed with food variety score (FVS) and dietary diversity score (DDS). DDS was calculated based on 9 food groups using a 30-day recall method. Data were analysed using Poisson and Probit regression models. We find that both agricultural production richness score and revenue generated from selling agricultural products are positively associated with food variety score, with the relationship being stronger for the latter. Moreover, production diversity score is positively associated with children's dietary diversity score whereas negatively associated with their probability of being stunted, but not with their probabilities of being wasted or zinc deficient. Household social economics status were also positively associated with child dietary diversity.
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Affiliation(s)
- Xinghua Liu
- China Academy for Rural Development, Zhejiang University, Hangzhou, China
| | - Chengfang Liu
- China Center for Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China
| | - Kevin Chen
- China Academy for Rural Development, Zhejiang University, Hangzhou, China
- International Food Policy Research Institute, East and Central Asia Office, Beijing, China
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Bangelesa F, Hatløy A, Mbunga BK, Mutombo PB, Matina MK, Akilimali PZ, Paeth H, Mapatano MA. Is stunting in children under five associated with the state of vegetation in the Democratic Republic of the Congo? Secondary analysis of Demographic Health Survey data and the satellite-derived leaf area index. Heliyon 2023; 9:e13453. [PMID: 36820029 PMCID: PMC9937978 DOI: 10.1016/j.heliyon.2023.e13453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Background The prevalence of stunting in the Democratic Republic of the Congo (DRC) is one of the highest globally. However, only a few studies have attempted to measure the association between stunting and vegetation, which is an important food source. The leaf area index (LAI) is an excellent measure for the vegetation state. Objective This paper intended to measure the association between the LAI and stunting among children under five years of age in the DRC. Its aim was to better understand the boundary conditions of stunting and explore potential links to climate and environmental change. Methods This paper adopts a secondary data analysis approach. We used data on 5241 children from the DRC Demographic Health Survey (DHS) 2013-2014, which was collected from a nationally representative cross-sectional survey. We used the satellite-derived LAI as a measure for the state of vegetation and created a 10-km buffer to extract each DHS cluster centroid's corresponding mean leaf-area value. We used a generalised mixed-effect logistic regression to measure the association between LAI and stunting, adjusting the model for mother's education, occupation and birth interval, as well as child's age and national wealth quintile. A height-for-age Z-score (HAZ) was calculated and classified according to WHO guidelines. Results Children in communities surrounded by high LAI values have lower odds of being stunted (OR [odds ratio] = 0.63; 95% CI [confidence interval] = 0.47-0.86) than those exposed to low LAI values. The association still holds when the exposure is analysed as a continuous variable (OR = 0.84; 95% CI = 0.74-0.95).When stratified in rural and urban areas, a significant association was only observed in rural areas (OR = 0.6; 95% CI = 0.39-0.81), but not in urban areas (OR = 0.9; 95% CI = 0.5-0.5). Furthermore, the study showed that these associations were robust to LAI buffer variations under 25 km. Conclusions Good vegetation conditions have a protective effect against stunting in children under five years of age. Further advanced study designs are needed to confirm these findings.
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Affiliation(s)
- Freddy Bangelesa
- Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo,Institute of Geography and Geology, University of Wuerzburg, Am Hubland, 97074, Wuerzburg, Germany
| | - Anne Hatløy
- Centre for International Health, University of Bergen, Bergen, Norway,Fafo Institute for Labour and Social Research, Oslo, Norway,Corresponding author.Centre for International Health, University of Bergen, Bergen, Norway.
| | - Branly Kilola Mbunga
- Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo
| | - Paulin B. Mutombo
- Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo
| | - Mwanack Kakule Matina
- Research Center of the CHU de Québec-Université Laval, Population Health and Optimal Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada
| | - Pierre Z. Akilimali
- Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo
| | - Heiko Paeth
- Institute of Geography and Geology, University of Wuerzburg, Am Hubland, 97074, Wuerzburg, Germany
| | - Mala Ali Mapatano
- Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo
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Dietary Diversity, Household Food Insecurity and Stunting among Children Aged 12 to 59 Months in N'Djamena-Chad. Nutrients 2023; 15:nu15030573. [PMID: 36771280 PMCID: PMC9920356 DOI: 10.3390/nu15030573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/17/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Household food insecurity is increasingly recognized as a global health problem, particularly in sub-Saharan Africa. This study aimed to contextualize the associations between household food insecurity, dietary diversity and stunting in N'Djamena. METHODS This study is a community-based cross-sectional study, and the SMART (Standardized Monitoring and Assessment of Relief and Transitions) methodology was used to calculate the sample size. A total of 881 households were selected for the survey. A 24-h recall evaluated the dietary diversity score (DDS), the Household Food Insecurity Access Scale (HFIAS) made it possible to assess household food insecurity (HFI), and stunting among children aged 12 to 59 months was assessed by anthropometric measurements. Logistic regression was constructed to determine the association between household food insecurity, dietary diversity, and stunting. The study was conducted from January to March 2022. RESULTS The prevalence of severe food insecurity was 16.6%, and that of stunting was 25.3%. The mean DDS was 6.5 ± 1.6. Severe food insecurity (OR 2.505, CI: 1.670-3.756) was significantly associated with stunting. The association between DDS and stunting was not significant. CONCLUSIONS This study's prevalence of household food insecurity and stunting was very high. Household food insecurity and household size were significantly associated with stunting.
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Anato A, Baye K, Stoecker BJ. Suboptimal feeding practices and impaired growth among children in largely food insecure areas of north Wollo, Ethiopia. J Nutr Sci 2022; 11:e81. [PMID: 36304818 PMCID: PMC9554422 DOI: 10.1017/jns.2022.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/01/2021] [Accepted: 08/24/2022] [Indexed: 12/14/2022] Open
Abstract
In Ethiopia, information is limited about energy and micronutrient intakes from complementary foods consumed by children in Productive Safety Net Program districts. Therefore, we assessed feeding practices and intakes of energy and selected micronutrients from complementary foods of children aged 6-23 months in a food insecure rural area of Ethiopia. Energy and micronutrient intakes were estimated from multiple-pass 24 h recall. Data were collected using a structured questionnaire. Only 1⋅9 % of children in the age range 6-8 months met recommended minimum dietary diversity of ≥5 food groups; this value slightly increased to 4 and 10⋅1 % in the older age groups (9-11 months and 12-23 months, respectively). Overwhelmingly, none of the children (9-11 months) did get the minimum acceptable diet (Children receiving minimum acceptable diet were 4 and 2⋅6 % in 6-8 months and 12-23 months, respectively). The overall prevalence of stunting was 34 % in younger children (6-8 months) and 51 % in older children aged 12-23 months. Median energy and selected micronutrient intakes from complementary foods were below corresponding WHO recommendations assuming average breast-milk amount and composition. The worst shortfalls were for vitamins A and C and for Ca. In contrast, median iron, protein and niacin intakes and densities were above the WHO recommendation. Caretakers and community leaders in the study setting need nutrition education on IYCF-related practices and on the importance of men's involvement in IYCF. Ensuring the accessibility and affordability of animal source foods (ASFs), fruits and vegetables, and feasible complementary foods is critical to address the quality of complementary feedings. This can be achieved through promoting nutrition-sensitive agriculture such as poultry and home gardening in this setting.
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Affiliation(s)
- Anchamo Anato
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
| | - Kaleab Baye
- Center for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia
| | - Barbara J. Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
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Harper A, Goudge J, Chirwa E, Rothberg A, Sambu W, Mall S. Dietary diversity, food insecurity and the double burden of malnutrition among children, adolescents and adults in South Africa: Findings from a national survey. Front Public Health 2022; 10:948090. [PMID: 36211708 PMCID: PMC9540989 DOI: 10.3389/fpubh.2022.948090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/10/2022] [Indexed: 01/21/2023] Open
Abstract
Childhood stunting remains a global public health problem. Many stunted children live in the same household as overweight or obese adults (the so-called double burden of malnutrition), evidence that quality as well as quantity of food is important. In recent years, food security measurement has shifted away from anthropometry (e.g., stunting) to experiential measures (e.g., self-reported hunger). However, given the continued problem of stunting, it is important that national surveys identify malnutrition. Objectives To examine the associations between a variety of food security indicators, including dietary diversity, with adult, child (0-4 years) (5-9 years) and adolescent (10-17 years) anthropometry. To estimate the prevalence of double burden households. Methods The study utilized cross-sectional data from the South African National Income Dynamics Survey NIDS (2008). We examined the associations between five food security indicators and anthropometry outcomes. The indicators were adult and child hunger in the household, self-reported household food sufficiency, food expenditure>60% of monthly expenditure and household dietary diversity. Multinomial and logistic regression models were employed to examine the associations with adult BMI categories and children's stunting and BMI. Results The prevalence of stunting was 18.4% and the prevalence of wasting and overweight was 6.8 and 10.4%, respectively. Children <5 and adolescents with medium dietary diversity were significantly more likely to be stunted than children with high dietary diversity. Among children <5, child hunger and medium dietary diversity were significantly associated with wasting. None of the food security indicators were associated with stunting in children aged 5-9. Among stunted children, 70.2% lived with an overweight or obese adult. Among adults, increased dietary diversity increased the risk of overweight and obesity. Conclusion Dietary diversity can be used as a proxy for poor nutritional status among children <5 years and adolescents but the relationship between dietary diversity and adult obesity is more complex. Given the double burden of malnutrition in many low- and middle-income countries, indicators of dietary quality remain important. These tools can be further refined to include an extra category for processed foods. Given the relative simplicity to collect this data, national surveys would be improved by its inclusion.
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Affiliation(s)
- Abigail Harper
- Division of Epidemiology and Biostatistics, University of the Witwatersrand, Johannesburg, South Africa,*Correspondence: Abigail Harper
| | - Jane Goudge
- Centre for Health Policy, University of the Witwatersrand, Johannesburg, South Africa
| | - Esnat Chirwa
- Gender and Health Research Division, The South African Medical Research Council, Johannesburg, South Africa
| | - Alan Rothberg
- School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Winnie Sambu
- School of Economics, The University of Cape Town, Cape Town, South Africa
| | - Sumaya Mall
- Division of Epidemiology and Biostatistics, University of the Witwatersrand, Johannesburg, South Africa
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Dietary Diversity and Dietary Patterns in School-Aged Children in Western Kenya: A Latent Class Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159130. [PMID: 35897495 PMCID: PMC9368572 DOI: 10.3390/ijerph19159130] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 01/25/2023]
Abstract
Inadequate diet among children has both immediate and long-term negative health impacts, but little is known about dietary diversity and dietary patterns of school-aged children in rural Kenya. We assessed dietary diversity and identified dietary patterns in school-aged children in Western Kenya using a latent class approach. We collected dietary intake using a 24 h dietary recall among students in elementary schools in two rural villages (hereafter village A and B) in Western Kenya in 2013. The mean (SD) age was 11.6 (2.2) years in village A (n = 759) and 12.6 (2.2) years in village B (n = 1143). We evaluated dietary diversity using the 10-food-group-based women’s dietary diversity score (WDDS) and found a mean (SD) WDDS of 4.1 (1.4) in village A and 2.6 (0.9) in village B. We identified three distinct dietary patterns in each village using latent class analysis. In both villages, the most diverse pattern (28.5% in A and 57.8% in B) had high consumption of grains, white roots and tubers, and plantains; dairy; meat, poultry, and fish; and other vegetables. Despite variation for some children, dietary diversity was relatively low for children overall, supporting the need for additional resources to improve the overall diet of children in western Kenya.
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Waha K, Accatino F, Godde C, Rigolot C, Bogard J, Domingues JP, Gotor E, Herrero M, Martin G, Mason-D’Croz D, Tacconi F, van Wijk M. The benefits and trade-offs of agricultural diversity for food security in low- and middle-income countries: A review of existing knowledge and evidence. GLOBAL FOOD SECURITY 2022. [DOI: 10.1016/j.gfs.2022.100645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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12
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Migliore E, Amaitsa VK, Mutuku FM, Malhotra IJ, Mukoko D, Sharma A, Kalva P, Kang AS, King CH, LaBeaud AD. Dietary Intake and Pneumococcal Vaccine Response Among Children (5–7 Years) in Msambweni Division, Kwale County, Kenya. Front Nutr 2022; 9:830294. [PMID: 35677545 PMCID: PMC9169235 DOI: 10.3389/fnut.2022.830294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundVaccine and sufficient food availability are key factors for reducing pneumonia outbreaks in sub-Saharan Africa.MethodsIn this study, the 10-valent pneumococcal conjugate vaccine (Synflorix® or PCV10) was administered to a child cohort (5–7 years old, n = 237) in Msambweni, Kenya, to determine relationships between dietary intake, nutritional/socioeconomic status of mothers/caregivers, and vaccine response. 7-day food frequency questionnaire (FFQ), dietary diversity score (DDS) and single 24-h dietary recall were used to address participants' dietary assessment and nutritional status. Individual food varieties were recorded and divided into 9 food groups as recommended by Food and Agriculture Organization. Anthropometric measurements, nasopharyngeal swabs and vaccine administration were performed at the initial visit. Participants were followed 4–8 weeks with a blood draw for pneumococcal IgG titers assessed by Luminex assay.FindingsChronic malnutrition was prevalent in the cohort (15% stunting, 16% underweight). Unbalanced dietary intake was observed, with mean energy intake 14% below Recommended Dietary Allowances (1,822 Kcal) for 5–7 years age range. 72% of the daily energy was derived from carbohydrates, 18% from fats and only 10% from proteins. Poor anthropometric status (stunting/underweight) was associated with low socioeconomic/educational status and younger mother/caregiver age (p < 0.002). Limited intake of essential micronutrients (vitamins A, E, K) and minerals (calcium, potassium) associated with low consumption of fresh fruits, vegetables, and animal source foods (dairy, meat) was observed and correlated with poor vaccine response (p < 0.001). In contrast, children who consumed higher amounts of dietary fiber, vitamin B1, zinc, iron, and magnesium had adequate vaccine response (p < 0.05). Correlation between higher dietary diversity score (DDS), higher Vitamin E, K, Zinc intake and adequate vaccine response was also observed (p < 0.03).InterpretationOverall, this study highlights ongoing food scarcity and malnutrition in Kenya and demonstrates the links between adequate socioeconomic conditions, adequate nutrient intake, and vaccine efficacy.
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Affiliation(s)
- Eleonora Migliore
- Division of Infectious Disease, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
- Eleonora Migliore
| | - Vivian K. Amaitsa
- Department of Community Health and Epidemiology, Kenyatta University, Nairobi, Kenya
| | - Francis M. Mutuku
- Department of Environment and Health Science, Technical University of Mombasa, Mombasa, Kenya
| | - Indu J. Malhotra
- Vector Borne Disease Control Unit, Ministry of Health, Nairobi, Kenya
| | - Dunstan Mukoko
- Vector Borne Disease Control Unit, Ministry of Health, Nairobi, Kenya
| | - Anika Sharma
- Division of Infectious Disease, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Prathik Kalva
- Division of Infectious Disease, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Amrik S. Kang
- Division of Infectious Disease, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - A. Desiree LaBeaud
- Division of Infectious Disease, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
- *Correspondence: A. Desiree LaBeaud
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Kabir MR, Halima O, Rahman N, Ghosh S, Islam MS, Rahman H. Linking farm production diversity to household dietary diversity controlling market access and agricultural technology usage: evidence from Noakhali district, Bangladesh. Heliyon 2022; 8:e08755. [PMID: 35071816 PMCID: PMC8762389 DOI: 10.1016/j.heliyon.2022.e08755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/07/2021] [Accepted: 01/10/2022] [Indexed: 11/28/2022] Open
Abstract
Background and objective Diversified agricultural production is considered a means to enhance food diversity at the household level, particularly in developing countries where subsistence farming is common. Given the importance of a diversified diet for human health and the persistent malnutrition problem in Bangladesh, a pressing issue is how different crops and livestock production affect household food diversification, and this study sought to answer that question. Methods Using a multistage sampling procedure, data were collected from 190 small farm holder households from Hatiya (a coastal rural sub-district of Noakhali, Bangladesh). Farm production diversity (FPD) is measured using the household biodiversity index (HBI), a simple count of all crops and livestock produced on the farm. The household dietary diversity score (HDDS) is calculated, according to Food and Agriculture Organization (FAO) guidelines, by counting 12 food groups consumed by the households in the last 24 h preceding the survey. Results On average, households consumed 6.49 food groups during the reference day, according to the household biodiversity index (HBI). The generalized Poisson log-linear regression results indicated that farm production diversity had a positive association with HDDS; one group of farm production increased the household dietary diversity (HDD) by 0.084 unit [β: 0.084, 95% CI: 0.064, 0.106; Exp (B): 1.087], an 8.7% increase in dietary diversity. Total land size, less time to reach the district market, and improved irrigation process affect dietary diversity in bivariate analysis. Farmer's reliance on production diversity reduces when the market is more accessible and improved irrigation is used for production. Conclusion Smallholder farm households in Bangladesh could benefit from context-specific, food-based nutrition-sensitive agriculture policies that focus on triangulation of diversified production, greater market access, and updated agricultural technology utilization. In subsistence farming, diverse agricultural production can play a vital role in ensuring diversified food consumption. In this study, a generalized Poisson regression estimator was used for modeling count data with under-dispersion. Study findings indicated that higher farm production diversity (FPD) was associated with higher dietary diversity. Farmer's reliance on FPD reduces when the market is more accessible and improved irrigation is used for production. Nutrition-sensitive agricultural practices aimed at subsistence farmers could help to achieve food diversity.
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Gassara G, Chen J. Household Food Insecurity, Dietary Diversity, and Stunting in Sub-Saharan Africa: A Systematic Review. Nutrients 2021; 13:4401. [PMID: 34959953 PMCID: PMC8707760 DOI: 10.3390/nu13124401] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The significant public health problem in Sub-Saharan Africa of household food insecurity is an underlying cause of malnutrition in Sub-Saharan Africa. This study aims to systematically study the association between household food insecurity, dietary diversity, and stunting. METHODS This review was carried out based on the recommendations of PRISMA (2015). We searched the literature in six bibliographic databases: PubMed, EMBASE, Science Direct, Web of Science, Google Scholar, and Scopus. The research was based on studies conducted in Sub-Saharan Africa about household food insecurity, dietary diversity, and stunting and was published between 2009 and 2020. RESULTS Out of 2398 original articles identified, only 21 articles met the specific requirements of this review. Two-thirds of the articles selected showed that stunting was linked to household food insecurity and dietary diversity. CONCLUSIONS This study found that household food insecurity and dietary diversity are significantly associated with stunting in Sub-Saharan Africa. This review recommends that in order to yield a sustainable fight against childhood malnutrition in Sub-Saharan Africa, reliable guidelines and strategies are needed to address these factors related to malnutrition.
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Affiliation(s)
| | - Jihua Chen
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410008, China;
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Piperata BA, Dufour DL. Food Insecurity, Nutritional Inequality, and Maternal–Child Health: A Role for Biocultural Scholarship in Filling Knowledge Gaps. ANNUAL REVIEW OF ANTHROPOLOGY 2021. [DOI: 10.1146/annurev-anthro-101819-110317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Food insecurity, a significant contributor to nutritional inequality, disproportionately affects women and children in low- and middle-income countries. The magnitude of the problem has inspired research on its impacts on health, especially on nutritional status and, more recently, mental well-being. Current research is dominated by surveillance-type studies that emphasize access, one of food security's four dimensions. Findings are inconclusive regarding the association between food insecurity and women and children's nutritional status, but some evidence indicates that it is a key contributor to mental distress in women. To understand these inconsistent findings, we emphasize the need for research on the strategies that people use to cope with inadequate access to food. We contend that biocultural approaches that recognize the importance of local contexts and the role of broader political-economic factors in shaping them are well suited for addressing current knowledge gaps.
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Affiliation(s)
- Barbara A. Piperata
- Department of Anthropology, The Ohio State University, Columbus, Ohio 43210, USA
| | - Darna L. Dufour
- Department of Anthropology, University of Colorado Boulder, Boulder, Colorado 80309, USA
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Hashmi S, Safdar NF, Zaheer S, Shafique K. Association between Dietary Diversity and Food Insecurity in Urban Households: A Cross-Sectional Survey of Various Ethnic Populations of Karachi, Pakistan. Risk Manag Healthc Policy 2021; 14:3025-3035. [PMID: 34305415 PMCID: PMC8294809 DOI: 10.2147/rmhp.s284513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 04/26/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Purpose The world is experiencing a nutritional transition, yet some regions of South East Asia are still living under the shadows of catastrophic nutritional indicators. Pakistan bears a high dual burden of both communicable and chronic diseases. However, a major contributing factor of both is poor diet and nutrition. The causal pathway of stunting, underweight, wasting, and micronutrient deficiencies has beginnings in less dietary diversity and food insecurity. Current literature on Pakistan and other South Asian countries regarding food insecurity and dietary diversity largely focus on women and children aged less than 5 years; however, ethnic and cultural dynamics of the populace concerning their food and dietary practices in Pakistan have not been well explored. It is essential to have a clear insight into the factors involving malnutrition in different clusters, especially different cultures and ethnicities to target specific areas of interventional strategies versus a uniform approach for all. This study aimed to explore the level of food insecurity and dietary diversity in all major ethnic groups of Karachi, the largest city of Pakistan. Methods Using the multistage random sampling, 535 households from five major ethnic groups residing in Karachi were included in the study. To measure food insecurity and dietary diversity (primary and secondary outcome, respectively), we used a FAO standardized questionnaire (version 3, 2007) that was translated first into local languages, piloted, and employed to collect information. Results Severe food insecurity levels had an inverse relationship with the household dietary diversity, which persisted even after adjusting for other variables (β=−0.31, 95% CI=−0.65, −0.07). There was no statistically significant association of age, marital status, or education level on food diversity. The most food secure cultural people were those whose ancestors had migrated from India and were Urdu speaking communities, while Sindhi speakers were the least food secure community. Conclusion It is imperative to investigate more on the cultural causal factors leading to food insecurity to address the root causes of malnutrition and design new cultural-specific interventions that should be employed in large urban centers where different communities reside together.
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Affiliation(s)
- Shahkamal Hashmi
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Sidra Zaheer
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | - Kashif Shafique
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
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Kundan I, Nair R, Kulkarni S, Deshpande A, Jotkar R, Phadke M. Assessment, outcomes and implications of multiple anthropometric deficits in children. BMJ Nutr Prev Health 2021; 4:267-274. [PMID: 34308135 PMCID: PMC8258094 DOI: 10.1136/bmjnph-2021-000233] [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: 01/21/2021] [Accepted: 05/14/2021] [Indexed: 11/29/2022] Open
Abstract
Background Malnutrition in children is widely prevalent around the world. It has been observed that malnourished children with multiple anthropometric deficits have higher mortality. However, adequate studies are not available on the outcome and recovery of these children. Nandurbar, a tribal district from Maharashtra, India, shows high prevalence of all three forms of malnutrition, often occurring simultaneously. A project previously undertaken in Nandurbar from July 2014 to June 2016 studied the effect of various therapeutic feeds in treatment of children with uncomplicated severe acute malnutrition (SAM). In this study, we analyse secondary data from it to correlate effects of stunting, wasting and underweight on treatment recovery. Methods Analysis was done on 5979 children with SAM using linear and logistic regression on R software for recovery rates and weight gain in children with SAM with single versus multiple anthropometric deficits, their relation to age, sex, and recovery from severe stunting by gain in height. Results The mean age of children was 35 months and 53.1% of the children were males. 2346 (39.2%) children recovered at the end of the 8-week treatment. 454 (7.6%) had single anthropometric deficit (SAM only), 3164 (52.9%) had two anthropometric deficits (SAM and severe underweight (SUW)) and 2355 (39.4%) children had three anthropometric deficits (SAM, SUW and severe stunting). Out of the 5979 children with SAM, only 52 (0.9%) of children were not underweight (severe or moderate). 44.94% of children with SAM who were severely stunted recovered, compared with 35.52% of children who were not (p<0.001). After controlling for confounders, severe stunting was found to increase the odds of recovery by 1.49. Severely stunted children with SAM also showed faster recovery and weight gain by 1.93 days (p<0.012) and 0.29 g/kg/day (p<0.001), respectively. Recovery was higher in females and younger age group. Recovery was also found to depend on the therapeutic feed, with children receiving medical nutrition therapy showing better recovery for severely stunted children. Conclusion Our findings corroborate previous literature that stunting is a way for the body to deal with chronic stress of nutritional deprivation and provides a survival advantage to a child.
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Affiliation(s)
- Idzes Kundan
- Department of Women and Child Development, Government of Maharashtra, Mumbai, Maharashtra, India
| | | | - Shashwat Kulkarni
- RJMC Health and Nutrition Mission, Department of Women and Child Development, Government of Maharashtra, Mumbai, Maharashtra, India
| | | | - Raju Jotkar
- RJMC Health and Nutrition Mission, Department of Women and Child Development, Government of Maharashtra, Mumbai, Maharashtra, India
| | - Mrudula Phadke
- Public Health, Government of Maharashtra, Mumbai, Maharashtra, India
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Nongrum MS, Pawera L, Mawroh B. Dietary diversity and its determinants among Khasi and Garo indigenous women (15 to 49 years) in Meghalaya, northeast India. Nutr Health 2021; 28:249-256. [PMID: 34082615 DOI: 10.1177/02601060211016629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Despite generally high agrobiodiversity, the Khasi and Garo indigenous people in Meghalaya have poor nutritional status among children and women. AIM To assess the dietary diversity of the Khasi and Garo indigenous women of reproductive age in Meghalaya, while examining the associated factors that affect it and to map the diversity of local food plants. METHODS A dietary survey was conducted through 24-hour recall with 276 women from 28 villages of Meghalaya. The mapping of local food plants was conducted through key informant interviews and focus group discussions in the same villages. RESULTS The mean minimum dietary diversity for women is 4.22 (SD ±1.26); with one-third (37%) of the women attaining a minimum dietary diversity of five or more food groups in a day. There were significant differences in the dietary diversity among the indigenous groups, the Garo community attaining higher minimum dietary diversity for women. There was also an inverse association between the number of land uses and dietary diversity. The mean number of food plants (including crop varieties) found in each village is 203 (SD±45.7). CONCLUSIONS There is potential to enhance dietary diversity through diversifying lesser consumed crops such as vitamin A-rich vegetables and fruits, nuts, seeds and green leafy vegetables in existing land holdings. Also, proper management and access to the commons will provide a sustainable resource base for diet and food security, enhance dietary diversity and bridge the hidden hunger among children and women.
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Affiliation(s)
| | - Lukas Pawera
- Department of Crop Sciences and Agroforestry, 48371Czech University of Life Sciences Prague, Czech Republic
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Byker Shanks C, Ahmed S, Dupuis V, Tryon M, Running Crane M, Houghtaling B, Garvin T. Dietary Quality Varies Among Adults on the Flathead Nation of the Confederated Salish and Kootenai Tribes in Montana. J Community Health 2021; 45:388-399. [PMID: 31602533 DOI: 10.1007/s10900-019-00753-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Diet-related chronic disease is among the most pressing public health issues and represents a health disparity among Native American communities. A community-based participatory approach was taken to evaluate dietary quality of adult residents of the Flathead Reservation of the Confederated Salish & Kootenai Tribes in Montana (the Flathead Nation). A survey was administered to collect basic demographic information and food security status (N = 80). Dietary quality was assessed using the 24-h dietary recall method with subsequent calculation of Healthy Eating Index 2010 (HEI-2010) scores, modified HEI without a dairy category, and the Dietary Diversity Scores (DDS). Participants included 80 adults from different households across eight communities (n = 10 per community) at the Flathead Nation. Approximately 50% of participants reported low or very low food security status while the remainder scored high or marginal food security. The mean total HEI-2010 score of study participants was 45.5 out of 100 points with a range between 20.0 and 78.1. The mean DDS of study participants was 4.6 (± 1.365) out of a total of 9 points. Participants with higher DDS had significantly higher intake of dietary fiber (p < 0.0003), potassium (0.0024), and cholesterol (p < 0.0048) compared to the lower DDS group. No significant correlations were found between HEI-2010 scores with DDS, demographic information, or food security status while significant differences were found between food security status and income (p < 0.01) and enrollment in nutrition assistance programs (p < 0.03). This study highlights the need to evaluate multiple parameters of dietary quality coupled with a community-based participatory approach in order for findings to be culturally relevant and support food and nutrition interventions.
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Affiliation(s)
- Carmen Byker Shanks
- Food and Health Lab, Food and Nutrition and Sustainable Food Systems Programs, Department of Health and Human Development, Montana State University, Bozeman, MT, 59717, USA
| | - Selena Ahmed
- Food and Health Lab, Food and Nutrition and Sustainable Food Systems Programs, Department of Health and Human Development, Montana State University, Bozeman, MT, 59717, USA.
| | | | - Mike Tryon
- Salish Kootenai College, Pablo, MT, 59855, USA
| | | | - Bailey Houghtaling
- Food and Health Lab, Food and Nutrition and Sustainable Food Systems Programs, Department of Health and Human Development, Montana State University, Bozeman, MT, 59717, USA
| | - Teresa Garvin
- Gretchen Swanson Center for Nutrition, Omaha, NE, 68114, USA
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Dinku AM, Mekonnen TC, Adilu GS. Child dietary diversity and food (in)security as a potential correlate of child anthropometric indices in the context of urban food system in the cases of north-central Ethiopia. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2020; 39:11. [PMID: 33298197 PMCID: PMC7771062 DOI: 10.1186/s41043-020-00219-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/16/2020] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To investigate the relation of child dietary diversity and household food insecurity along with other socio-demographic with child anthropometric indices in north-central Ethiopia, an area with a high level of food insecurity and inadequate diet quality. DESIGN A community-based cross-sectional study was used. SETTINGS The study was conducted in Dessie and Combolcha towns of north-central Ethiopia from April to May 2018. PARTICIPANTS Randomly selected 512 mother-child pairs with child's age range of 6-59 months. RESULTS The mean (± SD) scores of weight-for-height/length, height/length-for-age, weight-for-age, and BMI-for-age Z-scores were 1.35 (± 2.03), - 1.89 (± 1.79), 0.05 (± 1.54), and 1.39 (± 2.06), respectively. From all anthropometric indicators, stunting and overweight/obesity remained the severe public issues hitting 43% and 42% of the children, respectively. In the model, mothers' age and education and child's age, sex, and dietary diversity were significantly related with child height-for-age Z-score while place of residence, sex of household head, child's age, and dietary diversity score were the predictors of child BMI-for-age Z-score in the urban contexts of the study area. Nevertheless, food insecurity was not related to any of the child anthropometric indices. CONCLUSION The double burden of malnutrition epidemics (stunting and obesity) coexisted as severe public health concerns in urban settings. Anthropometric statuses of children were affected by multidimensional factors and seek strong integration and immediate intervention of multiple sectors.
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Affiliation(s)
- Amare Molla Dinku
- Researcher at the Department of Rural Development and Agricultural Extension, College of Agriculture, Wollo University, Dessie, Ethiopia
| | - Tefera Chane Mekonnen
- Researcher at the School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Getachew Shumye Adilu
- Researchr at the Department of Plant Science, College of Agriculture, Wollo University, Dessie, Ethiopia
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Ekesa B, Ariong RM, Kennedy G, Baganizi M, Dolan I. Relationships between land tenure insecurity, agrobiodiversity, and dietary diversity of women of reproductive age: Evidence from Acholi and Teso subregions of Uganda. MATERNAL & CHILD NUTRITION 2020; 16 Suppl 3:e12965. [PMID: 33347723 PMCID: PMC7752126 DOI: 10.1111/mcn.12965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 11/29/2022]
Abstract
Land tenure security is central to food security of rural agricultural-dependent communities, but there is limited evidence linking the state of agrobiodiversity to perception of land tenure security and access to and quality of food eaten. This study explores this relationship using data captured from 1,279 households in Acholi and Teso subregions of Uganda, and the relationships are established using a study sample of 1,227 women of reproductive age (WRA). Sixteen percent of respondents perceived themselves to be land tenure insecure. Although approximately 275 species were reported available for food, household access to a variety of plant and animal species is limited to <10 species by 69% of the study population. Dietary diversity was also low, with 53% of women meeting minimum diet diversity. Evidence from estimation of a generalized Poisson regression reveals that dietary diversity of WRA is consistently, positively correlated with species diversity available for food and negative with land tenure insecurity. A unit increase in species diversity led to 18% increase in dietary diversity of WRAs. Land tenure insecurity was likely to reduce dietary diversity of WRAs by 26% (p < .05). Interventions with an aim to increase species diversity can deliver positive dividends for food and nutrition security. Land policy reforms and interventions that strengthen land tenure security for both men and women are likely to contribute positively to dietary diversity leading to improved food and nutrition security of vulnerable communities in rural areas.
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Affiliation(s)
- Beatrice Ekesa
- Bioversity International, Healthy Diets from Sustainable Food Systems InitiativeKampalaUganda
| | - Richard M. Ariong
- Bioversity International, Healthy Diets from Sustainable Food Systems InitiativeKampalaUganda
| | - Gina Kennedy
- Bioversity International, Healthy Diets from Sustainable Food Systems InitiativeRomeItaly
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Intra-household decision-making, production diversity, and dietary quality: a panel data analysis of Ethiopian rural households. Food Secur 2020. [DOI: 10.1007/s12571-020-01098-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractConsidering that rural poor are mostly subsistence farmers, it seems plausible that production diversity could lead to better nutrition for these farmers. The association between production and dietary diversity is complex, and this complexity demands rigorous empirical analyses and more attention to gendered aspects of intra-household decision-making. We employ panel data analyses of 363 Ethiopian smallholders surveyed in 2014 and 2016 to test for this phenomenon, and to explore the association of women’s participation in decision-making with both production and consumption diversity. Results show that, diversification can be a strategy to improve the diets, but only of rural poor who have limited non-farm income, who are distant to the markets and mostly subsistence oriented. Moreover, female participation in decision-making associates with higher diversity both in terms of production and consumption, but it does not modify the magnitude of the association between production and dietary diversity. Our analyses contribute to the enriching literature on the linkage between production diversification and dietary diversity. We study this complex relationship in-depth and show that the gendered aspect of intra-household decision-making is an important covariate for both production diversity and dietary quality.
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Muthuuri JM, Some ES, Chege P. Adult characteristics of survivors of early life malnutrition in an impoverished population. Clin Nutr 2019; 39:2448-2454. [PMID: 31735539 DOI: 10.1016/j.clnu.2019.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 05/08/2019] [Accepted: 10/25/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND & AIMS To determine the characteristics of adults who survived early life malnutrition (ELM) and the possible associated factors. The setting is an impoverished community in Kenya. The coastal region of Kenya has a high prevalence of acute protein-energy-malnutrition and stunting. METHODS Observational cross-sectional survey where 872 skeletally mature adults of African origin, were surveyed in a period of three months. A discrimination tool to detect ELM survivors was created. Personal, historical and family data were collected in a semi-structured questionnaire. Various observations and body measurements were done. The subjects were grouped into two, those with ELM (Group1), and those without (Group2). RESULTS Group1 had 242 participants, 49.8% males, mean age of 49.1 ± 8.7 years. Group2 had 630 participants, 48.3% males, mean age 41.0 ± 9.7 years. The phenotypic characteristics included height, BMI, and head circumference (P < 0.05). Developmental characteristics were duration of schooling, occupation and income (P < 0.001). Factors associated with malnutrition were County of origin, parental education, parental occupation, and family size (P < 0.001). CONCLUSIONS There are discernible phenotypic and developmental characteristics associated with adult survivors of ELM. The predisposing factors for ELM are location of birth, parental education and occupation, and family size.
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Affiliation(s)
- J M Muthuuri
- The Mombasa Hospital, P.O Box 84074-80100, Mombasa, Kenya.
| | - Eliab Seroney Some
- United States International University, P.O Box 46092-00100, Nairobi, Kenya.
| | - Peter Chege
- Department of Food, Nutrition and Dietetics, Kenyatta University, P.O Box 43844-00100, Nairobi, Kenya.
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Innovative matrix for applying a food systems approach for developing interventions to address nutrient deficiencies in indigenous communities in India: a study protocol. BMC Public Health 2019; 19:944. [PMID: 31307415 PMCID: PMC6631988 DOI: 10.1186/s12889-019-6963-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Indigenous communities retain knowledge of the land and food resources rooted in historical continuity within their region of residence. Food systems research can be leveraged to identify strategies to encourage sustainable use of complex multi-species agroforestry systems by indigenous communities contributing to nutritional needs while simultaneously preserving the ecosystems and their benefits to society. Till date, the analyses of food systems have predominantly focused on high income countries often overlooking the alternatives (dietary and production) that would be most relevant to low and middle income countries (LMIC). Thus, innovative methodological approaches are needed to comprehensively characterize diverse food systems in LMICs with special reference to indigenous communities. DESIGN This protocol paper describes a food systems approach that will be employed to understand diverse and dynamic food systems of vulnerable tribal communities of Jharkhand, India and leverage their agroforestry systems to improve dietary diversity, nutrition status and address food security. Four tribal groups namely Santhal, Ho, Munda and Sauria Paharia of Godda, West Singhbhum and Khunti districts of Jharkhand would be studied. This will be an exploratory cross-sectional study design, along with a longitudinal component to capture seasonality in dietary intake and agricultural diversity. A mixed methods approach will be used based on a conceptual framework on drivers of food systems, food supply chain, food environment (both wild & cultivated, and market food environments), as well as consumer behaviour and maternal and child health outcomes in tribal communities. The quantitative surveys will be conducted on socio-economic, demographic profile of households, their availability of, access to and utilization of food environment and nutritional status of reproductive age group women and children under 5 years. Qualitative enquiries will examine barriers and facilitators to increase sustainable production, procurement and consumption of indigenous foods. The final outcome would be development of interventions to promote indigenous food consumption. DISCUSSION By utilizing a combination of value chain analysis and 'Optifoods linear programming software' that will use above information on indigenous community, dietary intake, nutritional status and food environment, evidence based interventions promoting indigenous food systems aimed at addressing food and nutritional security of tribal communities will be developed.
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Weatherspoon DD, Miller S, Ngabitsinze JC, Weatherspoon LJ, Oehmke JF. Stunting, food security, markets and food policy in Rwanda. BMC Public Health 2019; 19:882. [PMID: 31272435 PMCID: PMC6610945 DOI: 10.1186/s12889-019-7208-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/20/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Over the past two decades, Rwanda has experienced impressive economic growth, resulting in considerable improvements in living standards and poverty reduction. Despite these gains, progress on reducing the level of stunting in smallholder rural children, particularly boys, continues to be a serious concern. METHODS Policies, dietary diversity and socio-economic factors that may influence stunting in rural Rwandan children were evaluated using a logit model with clustered variance-covariance estimators based on village membership of the household. RESULTS Stunting of rural children was found to be multidimensionally related to the child's gender, weight and age; the dietary diversity, marriage status and education level of the head of household; mother's height; presence of a family garden or if they owned livestock; environmental factors such as altitude and soil fertility and location relative to a main road en route to a market; and a policy that promoted food production. CONCLUSIONS Findings suggest that agricultural policies may be subsidizing poor dietary behavior in that the aggregation of production encourages households to sell high quality nutritious food such as fruit and vegetables, for more voluminous amounts of nutritionally substandard goods, hence low dietary diversity. However, it is less clear if rural food markets are capable of supplying diverse and nutritious foods at affordable prices on a consistent basis, resulting in a lack of diversity and hence, low nutrient quality diets. Rwanda's next round of food security policies should focus on nutrition insecurity with special emphasis on the lack of protein, micronutrients and calories. Multipronged policies and programs focused on income growth, food security, enhanced access to markets and gender-related nutrition risks from inception through 2 years of age in the rural areas are required to improve rural household health outcomes, stunting in particular.
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Affiliation(s)
- Dave D. Weatherspoon
- Agricultural, Food & Resource Economics Department, Michigan State University, Rm. 213C Morrill Hall of Agriculture, 446 W. Circle Dr, East Lansing, MI 48824 USA
| | - Steve Miller
- Agricultural, Food & Resource Economics Department, Rm. 81 Morrill Hall of Agriculture, 446 W. Circle Dr, East Lansing, MI 48824 USA
| | - Jean Chrysostome Ngabitsinze
- Department of Rural Development and Agricultural Economics, College of Agriculture, Animal Sciences and Veterinary Medicine, University of Rwanda, P.O. Box 210, Musanze, 3971 Rwanda
| | - Lorraine J. Weatherspoon
- Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Road, Rm 140 Trout Food Science Bldg, East Lansing, MI 48824-1224 USA
| | - James F. Oehmke
- United States Agency for International Development, Bureau For Food Security, Ronald Reagan Bldg., 1300 Pennsylvania Ave. NW, Washington, DC 20229 USA
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Verger EO, Ballard TJ, Dop MC, Martin-Prevel Y. Systematic review of use and interpretation of dietary diversity indicators in nutrition-sensitive agriculture literature. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2019. [DOI: 10.1016/j.gfs.2019.02.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gitagia MW, Ramkat RC, Mituki DM, Termote C, Covic N, Cheserek MJ. Determinants of dietary diversity among women of reproductive age in two different agro-ecological zones of Rongai Sub-County, Nakuru, Kenya. Food Nutr Res 2019; 63:1553. [PMID: 30692880 PMCID: PMC6338663 DOI: 10.29219/fnr.v63.1553] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 11/20/2022] Open
Abstract
Background Empirical evidence on the link between agrobiodiversity and dietary diversity appears to be inconclusive. Thus, there arises a need to determine other factors that could significantly influence dietary diversity in different agro-ecological zones, as factors may vary from region to region. Objective The objective of this study was to document the status of agrobiodiversity and dietary diversity and to assess the determinants of dietary diversity among women of reproductive age in two different agro-ecological zones of Rongai Sub-County in Kenya. Design A cross-sectional study of 384 women aged 18-49 years was conducted. Agrobiodiversity was measured using the Shannon-Wiener index, species richness (count) and production diversity score. A 24-hour dietary recall was used to determine minimum dietary diversity for women (MDD-W) of reproductive age. Results Although the level of agrobiodiversity was different between the low and high agro-ecological zones (using Shannon-Wiener index); the women's dietary diversity was not different (p > 0.05) between low (3.78 ± 0.99) and high potential areas (3.84 ± 1.05). In multivariate logistic regression, there was no association (p > 0.05) between agrobiodiversity indicators and dietary diversity across the two agricultural zones. Factors influencing MDD-W in two agricultural zones were different. In low potential areas, woman's education level positively determined dietary diversity, while in high potential areas household gender, woman's education level, woman's age and family size influenced MDD-W. Conclusion The proportion of women who met minimum dietary diversity was low. Although agrobiodiversity was different in the two agro-ecological zones, women's dietary diversity scores were similar. In low agricultural potential areas, only education level influenced women's dietary diversity while household gender, education level, age and family size were the important determinants in high agricultural potential areas. Therefore, it is recommended that nutrition interventions focusing on lessening malnutrition and improving dietary quality should pay special attention to differences in agro-ecological zones to develop region-specific interventions instead of generalizing interventions.
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Affiliation(s)
- Maureen Wanjiru Gitagia
- Department of Human Nutrition, Faculty of Health Science, Egerton University, Rift Valley, Kenya
| | | | - Dorothy M Mituki
- Department of Human Nutrition, Faculty of Health Science, Egerton University, Rift Valley, Kenya
| | - Celine Termote
- Diets from Sustainable Food Systems Initiative, Bioversity International, Nairobi, Kenya
| | - Namukolo Covic
- International Food Policy Research Institute, Poverty Health and Nutrition Division, Agriculture for Nutrition and Health, Addis Ababa, Ethiopia
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Saaka M, Osman SM, Hoeschle-Zeledon I. Relationship between agricultural biodiversity and dietary diversity of children aged 6-36 months in rural areas of Northern Ghana. Food Nutr Res 2017; 61:1391668. [PMID: 29151832 PMCID: PMC5678439 DOI: 10.1080/16546628.2017.1391668] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 10/04/2017] [Indexed: 11/07/2022] Open
Abstract
In this study, we investigated the relationship between agricultural biodiversity and dietary diversity of children and whether factors such as economic access may affect this relationship. This paper is based on data collected in a baseline cross-sectional survey in November 2013.The study population comprising 1200 mother-child pairs was selected using a two-stage cluster sampling. Dietary diversity was defined as the number of food groups consumed 24 h prior to the assessment. The number of crop and livestock species produced on a farm was used as the measure of production diversity. Hierarchical regression analysis was used to identify predictors and test for interactions. Whereas the average production diversity score was 4.7 ± 1.6, only 42.4% of households consumed at least four food groups out of seven over the preceding 24-h recall period. Agricultural biodiversity (i.e. variety of animals kept and food groups produced) associated positively with dietary diversity of children aged 6–36 months but the relationship was moderated by household socioeconomic status. The interaction term was also statistically significant [β = −0.08 (95% CI: −0.05, −0.01, p = 0.001)]. Spearman correlation (rho) analysis showed that agricultural biodiversity was positively associated with individual dietary diversity of the child more among children of low socioeconomic status in rural households compared to children of high socioeconomic status (r = 0.93, p < 0.001 versus r = 0.08, p = 0.007). Socioeconomic status of the household also partially mediated the link between agricultural biodiversity and dietary diversity of a child’s diet. The effect of increased agricultural biodiversity on dietary diversity was significantly higher in households of lower socioeconomic status. Therefore, improvement of agricultural biodiversity could be one of the best approaches for ensuring diverse diets especially for households of lower socioeconomic status in rural areas of Northern Ghana.
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Affiliation(s)
- Mahama Saaka
- School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | | | - Irmgard Hoeschle-Zeledon
- Department of Research for Development, International Institute of Tropical Agriculture (IITA), Ibadan, Nigeria
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Situation and determinants of the infant and young child feeding (IYCF) indicators in Madagascar: analysis of the 2009 Demographic and Health Survey. BMC Public Health 2017; 17:812. [PMID: 29037229 PMCID: PMC5644246 DOI: 10.1186/s12889-017-4835-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 10/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies evaluating child feeding in Madagascar are scarce despite its importance in child growth during the first two years of life. This study assessed the associations between the WHO infant and young child feeding (IYCF) indicators and stunting and identified determinants of inappropriate child feeding practices. METHODS The most recent Demographic and Health Survey was used including a total of 1956 infants aged 0-23 months. Logistic regressions were performed for the association between IYCF indicators and stunting and for the determination of risk factors for inappropriate feeding practices. RESULTS The rates of initiation of breastfeeding within one hour after birth (77.2%), continued breastfeeding at one year (99.6%) and timely introduction of solid, semi-solid or soft foods at 6-8 months (88.3%) were high. Exclusive breastfeeding under 6 months (48.8%), attaining minimum dietary diversity (22.2%) and consumption of iron-rich foods (19.6%) were relatively low. Higher length-for-age was associated with achieving minimum dietary diversity (p<0.01). The other indicators assessed (early initiation of breastfeeding, exclusive breastfeeding under 6 months, timely introduction of complementary foods and consumption of iron-rich foods) were not associated with stunting. Infants born to mothers who had first given birth at an age younger than 19 were more likely not to be breastfed within one hour after birth, not to be exclusively breastfed and not to have the recommended dietary diversity. Infants whose mothers had low media exposure were at increased risk of being inappropriately fed. Low household wealth also was associated with higher odds of not meeting the minimum dietary diversity. CONCLUSIONS Despite almost total continued breastfeeding at one year and early initiation of breastfeeding by more than three-quarter of mothers, minimum dietary diversity scores were still low, confirming the need for more effective programs for improving child feeding practices in Madagascar. Improving dietary diversity in children aged 6-23 months may help reduce stunting. The identified risk factors for inappropriate feeding practices could be used in directing future nutrition sensitive interventions.
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Jones AD. Critical review of the emerging research evidence on agricultural biodiversity, diet diversity, and nutritional status in low- and middle-income countries. Nutr Rev 2017; 75:769-782. [PMID: 29028270 PMCID: PMC5914317 DOI: 10.1093/nutrit/nux040] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The declining diversity of agricultural production and food supplies worldwide may have important implications for global diets. The primary objective of this review is to assess the nature and magnitude of the associations of agricultural biodiversity with diet quality and anthropometric outcomes in low- and middle-income countries. A comprehensive review of 5 databases using a priori exclusion criteria and application of a systematic, qualitative analysis to the findings of identified studies revealed that agricultural biodiversity has a small but consistent association with more diverse household- and individual-level diets, although the magnitude of this association varies with the extent of existing diversification of farms. Greater on-farm crop species richness is also associated with small, positive increments in young child linear stature. Agricultural diversification may contribute to diversified diets through both subsistence- and income-generating pathways and may be an important strategy for improving diets and nutrition outcomes in low- and middle-income countries. Six research priorities for future studies of the influence of agricultural biodiversity on nutrition outcomes are identified based on gaps in the research literature.
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Affiliation(s)
- Andrew D Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Abebe Z, Haki GD, Baye K. Simulated effects of home fortification of complementary foods with micronutrient powders on risk of inadequate and excessive intakes in West Gojjam, Ethiopia. MATERNAL AND CHILD NUTRITION 2017; 14. [PMID: 28271631 DOI: 10.1111/mcn.12443] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 01/29/2017] [Accepted: 02/01/2017] [Indexed: 12/31/2022]
Abstract
Home fortification of complementary foods (CFs) with multiple micronutrient powders (MNPs) is being scaled up in various countries, but little is known about the prevailing complementary feeding practices and the type and nutrient gaps to be filled with MNPs. The present study evaluated the complementary feeding practices of young children and simulated the risk of inadequate and excessive intakes associated with home fortification with MNPs. We have assessed the sociodemographic status, anthropometry, and complementary feeding practices of young children (N = 122) in Mecha district, rural Ethiopia. Using a 2-day, quantitative 24-hr recall, usual intakes of energy, protein, iron, zinc, and calcium were estimated. The risks of inadequate and excessive iron and zinc intakes with or without home fortification scenarios were assessed. The simulations considered intakes from CFs assuming average breast milk contributions and additional nutrients provided by the MNPs. Stunting was highly prevalent (50%) and was associated with a lower dietary diversity (P = .009) and nutrient intakes from the CFs. Median energy, zinc, and calcium intakes were below the estimated needs from CFs; protein needs were met. Median dietary iron intake appeared adequate, but 76%, 95% CI [68%, 84%], of children had inadequate intake (assuming low bioavailability), whereas another 8%, 95% CI: [3%, 13%], had excessive intakes. Simulation of daily and alternative day's fortification with MNP decreased the prevalence of inadequate iron and zinc intake but significantly increased the risk of excessive intakes that remained unacceptably high for iron (>2.5%). Untargeted MNP interventions may lead to excessive intakes, even in settings where poor complementary feeding practices are prevalent.
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Affiliation(s)
- Zeweter Abebe
- Center for Food Science and Nutrition, College of Natural Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gulelat Desse Haki
- Department of Food Science and Technology, Botswana College of Agriculture, Gaborone, Botswana
| | - Kaleab Baye
- Center for Food Science and Nutrition, College of Natural Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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