1
|
Kihagi GW, Hansen LS, Agure E, Muok EMO, Mank I, Danquah I, Sorgho R. 'Counselling is not just providing information': perceptions of caregivers and stakeholders on the design of nutrition and health counselling interventions for families with young children in rural Kenya. BMC Health Serv Res 2024; 24:597. [PMID: 38715044 PMCID: PMC11077832 DOI: 10.1186/s12913-024-10872-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 03/14/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Globally, a fifth of the children continue to face chronic undernutrition with a majority of them situated in the Low- and Middle-Income Countries (LMIC). The rising numbers are attributed to aggravating factors like limited nutrition knowledge, poor feeding practices, seasonal food insecurity, and diseases. Interventions targeting behaviour change may reduce the devastating nutrition situation of children in the LMICs. OBJECTIVE For the co-design of a Behaviour Change Communication (BCC) intervention for young children in rural Kenya, we aimed to identify the experiences, barriers, facilitators, and preferences of caregivers and stakeholders regarding nutrition and health counselling. DESIGN We employed a qualitative study design and used a semi-structured interview guide. The in-depth interviews were recorded, transcribed, and analysed using content analysis, facilitated by the software NVivo. SETTING Health and Demographic Surveillance System (HDSS) area in Siaya County, rural Kenya. PARTICIPANTS We interviewed 30 caregivers of children between 6 and 23 months of age and 29 local stakeholders with experience in implementing nutrition projects in Kenya. RESULTS Nutrition and health counselling (NHC) was usually conducted in hospital settings with groups of mothers. Barriers to counselling were long queues and delays, long distances and high travel costs, the inapplicability of the counselling content, lack of spousal support, and a high domestic workload. Facilitators included the trust of caregivers in Community Health Volunteers (CHVs) and counselling services offered free of charge. Preferences comprised (1) delivering of counselling by CHVs, (2) offering individual and group counselling, (3) targeting male and female caregivers. CONCLUSION There is a disconnect between the caregivers' preferences and the services currently offered. Among these families, a successful BCC strategy that employs nutrition and health counselling should apply a community-based communication channel through trusted CHVs, addressing male and female caregivers, and comprising group and individual sessions.
Collapse
Affiliation(s)
- Grace Wothaya Kihagi
- Heidelberg Institute for Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany.
| | - Lea-Sophie Hansen
- Heidelberg Institute for Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Erick Agure
- Heidelberg Institute for Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | | | - Isabel Mank
- Heidelberg Institute for Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- German Institute for Development Evaluation (DEval), Bonn, Germany
| | - Ina Danquah
- Heidelberg Institute for Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- Hertz-Chair Innovation for Planetary Health and Center for Development Research (ZEF), University of Bonn, Bonn, Germany
| | - Raissa Sorgho
- Heidelberg Institute for Global Health (HIGH), Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- Centre for Wellness and Nutrition, Public Health Institute, Sacramento, CA, USA
| |
Collapse
|
2
|
Maugana VF, Kruger R, Kruger HS, Hanssen H, Smith W. Food intake in South African children and retinal microvascular health: The ExAMIN Youth SA study. Nutr Metab Cardiovasc Dis 2024; 34:188-197. [PMID: 37798229 DOI: 10.1016/j.numecd.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND AND AIMS Retinal arteriolar narrowing and venular widening are associated with increased cardiovascular risk, even at young ages. Whether diet contributes to early microvascular changes in children is not widely explored. We explored the associations of frequency of healthy and unhealthy food group intake with retinal vessel calibers in black and white children. METHODS AND RESULTS This study included school-aged (5-9 years) black (N = 433, 7.46 ± 0.98 years), and white (N = 403, 7.43 ± 0.82 years) children. Anthropometric and blood pressure measurements were taken, along with retinal vessel calibers (central retinal arteriolar (CRAE) and venular (CRVE) equivalents). Frequencies of food group intake were assessed using a food-frequency questionnaire. A factor analysis was performed to describe food group patters. Independent associations between retinal vessel calibers and frequencies of food group intake and food group patters were explored. In black children, cookies, cakes, and biscuits were associated with narrower arterioles (p < 0.05). In white children, cold sweetened beverages were associated with narrower arterioles (p = 0.02), whereas salty snacks were associated with narrower arterioles (p = 0.01) and wider venules (p < 0.05). Fruits were positively associated with CRAE (p = 0.03) in white children only. CONCLUSION A higher frequency of unhealthy food group consumption was associated with retinal arteriolar narrowing and venular widening in both black and white children. However, fruit intake was shown beneficial for retinal microvascular health in white children only. Our findings may highlight the importance of promoting healthy eating patterns from early childhood which may reduce the risk of premature cardiovascular disease development.
Collapse
Affiliation(s)
- Vuledzani F Maugana
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; SAMRC Extramural Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Herculina S Kruger
- SAMRC Extramural Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa; Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Henner Hanssen
- Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Switzerland
| | - Wayne Smith
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; SAMRC Extramural Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
| |
Collapse
|
3
|
Uusimäki K, Schneider L, Lubeka C, Kimiwye J, Mutanen M. Mothers' knowledge and practices on breastfeeding and complementary feeding in an urban slum area and rural area in Kenya: A cross-sectional interview study. J Child Health Care 2023; 27:612-627. [PMID: 35428403 PMCID: PMC10676620 DOI: 10.1177/13674935221083451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Maternal breastfeeding and complementary feeding knowledge is an important determinant of childrens' long-term health and development. This study aims to account for associations between knowledge and practices in Kenya and report the food consumption of children from birth to 18 months. In 2015 mother-child pairs were recruited from Mother-and-Child Health Centers; 415 in an urban slum in Nairobi and 364 in rural Machakos. Knowledge and practice scores were calculated from questionnaire variables and 24-h food frequency questionnaire. The associations of knowledge and practices were studied with regression analysis. Breastfeeding knowledge (Nairobi 6.3/9, Machakos 5.9/9) and practices (Nairobi 7.5/8, Machakos 7.2/8) were good in both areas. Complementary feeding knowledge was not as good (Nairobi 7.5/14, Machakos 7.1/14). Minimum meal frequency was reached by almost 80% of the children but dietary diversity was low (Nairobi 2.7 [SD 1.4], Machakos 2.4. [SD 1.3]). Only 27% of children in Nairobi and 13% in Machakos were fed a minimum acceptable diet. The complementary feeding knowledge score was associated only with minimum dietary diversity in Nairobi (OR: 1.29; 95% CI: 1.105-1.514). Infant and young child feeding knowledge and practices were on a similar level in both areas. Future interventions should focus on improving dietary diversity.
Collapse
Affiliation(s)
- Kerttu Uusimäki
- Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland
| | - Lauriina Schneider
- Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland
| | - Crippina Lubeka
- Department of Food, Nutrition and Dietetics, School of Applied Human Sciences, Kenyatta University, Nairobi, Kenya
| | - Judith Kimiwye
- Department of Food, Nutrition and Dietetics, School of Applied Human Sciences, Kenyatta University, Nairobi, Kenya
| | - Marja Mutanen
- Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland
| |
Collapse
|
4
|
Senekal M, Nel JH, Eksteen G, Steyn NP. Dietary Patterns, Socio-Demographic Predictors Thereof, and Associations of Dietary Patterns with Stunting and Overweight/Obesity in 1-<10-Year-Old Children in Two Economically Active Provinces in South Africa. Nutrients 2023; 15:4136. [PMID: 37836420 PMCID: PMC10574062 DOI: 10.3390/nu15194136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 10/15/2023] Open
Abstract
A review of the literature showed that there were only a few studies that reported on the dietary patterns of children in South Africa. The aim of the present study was to characterise the dietary patterns of children aged 1-<10 years who were studied during the Provincial Dietary Intake Survey (PDIS) in 2018 and to investigate the socio-demographic predictors thereof, as well as the associations with stunting and overweight/obesity. Dietary pattern analysis was conducted within three age groups, namely 1-<3-year-olds, 3-<6-year-olds, and 6-<10-year-olds using iterated principal factor analysis with varimax rotation and 24 h recall data from the PDIS. The dietary patterns that emerged seem to be far from ideal. Energy-dense, nutrient-poor patterns were included in the top three strongest patterns in all three age groupings that were investigated. Few of the dietary patterns included vegetables other than starchy vegetables, fruit, dairy, quality proteins, and unrefined carbohydrates. There were no associations between any of the dietary patterns and stunting or overweight/obesity in the children. Key predictors of greater adherence to the mostly unhealthy patterns included indicators of a higher socio-economic status in all three age groups, as well as having an obese mother in the 6-<10-year-old group. Key predictors of greater adherence to the mostly healthy patterns were a higher wealth index and having an obese mother in the two younger groups, with no predictors in the 6-<10-year-old group. We conclude that the dietary patterns of children in the Western Cape contain strong elements of the energy-dense, nutrient-poor dietary patterns. Interventions to improve the dietary intake of children should be directed at both poorer and higher income communities.
Collapse
Affiliation(s)
- Marjanne Senekal
- Department of Human Biology, University of Cape Town, Cape Town 7925, South Africa;
| | - Johanna H. Nel
- Department of Logistics, Stellenbosch University, Stellenbosch 7602, South Africa;
| | - Gabriel Eksteen
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium;
| | - Nelia P. Steyn
- Department of Human Biology, University of Cape Town, Cape Town 7925, South Africa;
| |
Collapse
|
5
|
Marume A, Archary M, Mahomed S. Dietary patterns and childhood stunting in Zimbabwe. BMC Nutr 2022; 8:111. [PMID: 36224638 PMCID: PMC9555084 DOI: 10.1186/s40795-022-00607-7] [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: 12/02/2021] [Accepted: 09/19/2022] [Indexed: 11/26/2022] Open
Abstract
Background Diet is one important predictor of children’s growth, and often dietary interventions can assist with reversing adverse nutrition outcomes. Traditionally research has focused on individual food items or food classes to generate an understanding of disease risk. Dietary patterns provide a holistic approach to understanding the relationship between exposure and outcome. Method A matched case-control study was conducted. Caregivers of 450 children (225 cases, 225 controls) aged 6–59 months were asked to describe the diet their children had consumed in the previous 7 days using a Food Frequency Questionnaire. Dietary patterns were developed using factor analysis and regression analysis was conducted to assess which dietary pattern was associated with childhood stunting. Results Three dietary patterns were identified: modern (n = 181), low animal-source (n = 158), and traditional (n = 111). Children with the low animal source dietary pattern had increased odds of being stunted (AOR 1.03, p < 0.05). Three demographic factors (Child’s age, father’s age and having a sibling < 24 months apart) were identified as significant predictors of consumption of any of the traditional and low animal source diet (P < 0.001). Conclusion Nutrition intervention such as health education, counselling and supplementary feeding should include a holistic approach to dietary education not only focusing on promoting a balanced diet but improvement strengthening the upgrading of child’s dietary pattern taking into cognisant both quantity, and quality of nutrients provided to the child. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00607-7.
Collapse
Affiliation(s)
- Anesu Marume
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,Ministry of Health and Child Care, Harare, Zimbabwe
| | - Moherndran Archary
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.,King Edward VIII Hospital, Durban, South Africa
| | - Saajida Mahomed
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
6
|
Association between Diet Quality and Health Outcomes among Children in Rural Areas of Northwest China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137803. [PMID: 35805462 PMCID: PMC9265919 DOI: 10.3390/ijerph19137803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 12/10/2022]
Abstract
This study aims to examine the relationship between diet quality and health outcomes among children in rural remote areas of China. We draw on a cross-sectional dataset of 1216 children from two counties in the Gansu Province in Northwest China. Child health outcomes were assessed with both anthropometric measurements and reports by primary caregivers of the children. Child diet quality was assessed with the diet quality score (DQS) using information from a food frequency questionnaire (FFQ). Our data show the prevalence of stunting and underweight among sample children were 12% and 11%, respectively; 27% of children were reported by their caregivers as unhealthy, and 60% of children had at least one of the seventeen selected non-communicable diseases (NCDs) over the past 14 days. Overall, 780 (72%) children have at least one of the four above-mentioned health problems. Results from logistic regression models show that a higher DQS was significantly associated with a lower likelihood of being stunted and a higher likelihood of being reported healthy after adjusting for confounders. These findings imply that improving child diet quality might be an option when designing interventions to improve child health.
Collapse
|
7
|
Cartmill MK, Blackmore I, Sarange C, Mbeyu R, Cheupe C, Cheupe J, Kamau-Mbuthia E, Iannotti L, Wamukota A, Humphries A, Lesorogol C. Fish and complementary feeding practices for young children: Qualitative research findings from coastal Kenya. PLoS One 2022; 17:e0265310. [PMID: 35286341 PMCID: PMC8920237 DOI: 10.1371/journal.pone.0265310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/28/2022] [Indexed: 11/23/2022] Open
Abstract
This study examines barriers to fish consumption during the complementary feeding period in two coastal counties of Kenya with high rates of child malnutrition. Study findings indicate that young child fish consumption is impacted by factors related to accessibility, food preferences, and caregiver's knowledge and beliefs about fish during the complementary feeding period. These factors are influenced by prominent community figures such as elder women and health workers, whose own beliefs and understandings are impacted by underlying cultural norms, potentially limiting fish consumption. To our knowledge, this is the first study conducted in the coastal region of Kenya to focus on understanding fish consumption attitudes and beliefs during the complementary feeding phase. Our findings represent a critical first step towards the creation of more effective policies and interventions to address the significant nutritional disparities that exist in the study population.
Collapse
Affiliation(s)
- Mary Kate Cartmill
- Brown School, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Ivy Blackmore
- Brown School, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | | | - Ruth Mbeyu
- Department of Human Nutrition, Egerton University, Nakuru, Kenya
| | | | - Joaquim Cheupe
- Department of Environmental Sciences, Pwani University, Kilifi, Kenya
| | | | - Lora Iannotti
- Brown School, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Andrew Wamukota
- Department of Environmental Sciences, Pwani University, Kilifi, Kenya
| | - Austin Humphries
- Department of Fisheries, Animal and Veterinary Sciences, University of Rhode Island, Kingston, Rhode Island, United States of America
- Graduate School of Oceanography, University of Rhode Island, Narragansett, Rhode Island, United States of America
| | - Carolyn Lesorogol
- Brown School, Washington University in St. Louis, St. Louis, Missouri, United States of America
| |
Collapse
|
8
|
Li H, Yuan S, Fang H, Huang G, Huang Q, Wang H, Wang A. Prevalence and associated factors for stunting, underweight and wasting among children under 6 years of age in rural Hunan Province, China: a community-based cross-sectional study. BMC Public Health 2022; 22:483. [PMID: 35277139 PMCID: PMC8917668 DOI: 10.1186/s12889-022-12875-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/28/2022] [Indexed: 11/29/2022] Open
Abstract
Background The existing epidemiological data cannot represent the situation of undernutrition among Chinese children, particularly those in rural China. Hence, in this community-based cross-sectional study, the prevalence and associated factors of stunting, underweight and wasting among children (age < 6 years) from rural Hunan Province were analyzed. Methods Totally 5529 children aged 0 to 71 months and their caregivers were randomly chosen by multistage stratified cluster sampling from 72 villages from rural Hunan, which were distributed in 24 towns of 12 counties. Data about the children and their mothers, caregivers and family conditions was acquired using unified questionnaire, and the length/height and weight of each child were measured using unified instruments. The prevalence of undernutrition among children was evaluated using the length/height for age, weight for age, weight for length/height, and body mass index for age z scores, which were computed according to the 2006 and 2007 WHO Child Growth Standards. Results The prevalence of stunting, underweight, and wasting among the 5529 children were 4.4% (241), 3.9% (217), and 4.0% (221), respectively. The significant associated factors on higher risks of undernutrition in the children were low birth weight, maternal gestational weight gain <10 kg (stunting); low birth weight, maternal gestational weight gain <10 kg, ethnicity of caregivers being minority, large family size (underweight); low birth weight, ethnicity of caregivers being minority, large family size (wasting). High education level of caregivers and high family food expenditure were common protective factors for all three types of undernutrition, except that high family food expenditure was not protective against wasting. Conclusions The prevalence of stunting, underweight and wasting is low among rural children under age of 6 years in Hunan. As for the measures, the gestational care and reasonable diet of mothers should be strengthened, and nutritional deficiency during pregnancy be avoided, which will prevent low birth weight. The local economic development and the education level of caregivers need to be further improved, especially for minorities.
Collapse
|
9
|
Walton M, Guest D, Raynes-Greenow C. One planet one health: What about the kids? J Paediatr Child Health 2021; 57:1741-1744. [PMID: 34792233 DOI: 10.1111/jpc.15758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/30/2022]
Abstract
Humans in their increasing numbers and wealth are changing ecosystems through accelerated consumption of food, natural resources and energy which continue to cause significant damage to the planet. Using 'stunting in children' as a case study, we show how the traditional siloed (specialist) approaches have failed to reduce stunting world-wide. Despite significant effort, traditional approaches fail to appreciate the interconnectedness of the multiple factors that underpin stunting. We will not improve the lives of the millions of children living in poverty by doing the same things we have always done, rather we need to adopt approaches that recognise the interconnectedness of all the component parts and apply One Health methods designed to solve these intractable problems.
Collapse
Affiliation(s)
- Merrilyn Walton
- Department of Medical Education (Patient Safety) Public Health, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - David Guest
- Department of Plant Pathology, Sydney Institute of Agriculture, School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia
| | | |
Collapse
|
10
|
Mahfouz EM, Sameh Mohammed E, Alkilany SF, Abdel Rahman TA. The relationship between dietary intake and stunting among pre-school children in Upper Egypt. Public Health Nutr 2021; 25:1-9. [PMID: 34496999 PMCID: PMC9991819 DOI: 10.1017/s136898002100389x] [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: 06/01/2020] [Revised: 08/11/2021] [Accepted: 09/06/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Linear growth is controlled by several factors, malnutrition is one of the leading causes of stunted child growth. The objective of this study was to determine the dietary intakes associated with stunting among pre-school children in rural Upper Egypt. DESIGN Community-based cross-sectional study. SETTING Data were collected by interviewing the children's caregivers in the rural household setting. PARTICIPANTS The study included 497 pre-school children aged 2-5 years in rural Upper Egypt. Food intake data were estimated using 24-h recall method. Anthropometric measurements of children were taken and then converted to z-scores for weight-for-age Z-score, height-for-age Z-score and weight-for-height Z-score. RESULTS The study included 497 children of which 19·1 % were stunted, 76·3 % did not meet recommended energetic intake and 13·7 % did not meet recommended protein intake and this was significantly higher than non-stunted children. Children who were stunted significantly consumed poultry, eggs and fruits less often than non-stunted children, by regression; male sex (adjusted odds ratio (aOR) = 1·91), mother's age (0·93), lower socio-economic status (SES); and not meeting recommended protein intake (aOR = 2·26) were found to be associated with stunting. CONCLUSION Male sex, younger mothers, lower SES and not meeting recommended energy and protein were statistically associated with stunting. Nutrition education messages encouraging adequate and healthy eating are recommended.
Collapse
Affiliation(s)
- Eman Mohamed Mahfouz
- Public Health and Preventive Medicine Department, Faculty of Medicine, Minia University, Minia61519, Egypt
| | - Eman Sameh Mohammed
- Public Health and Preventive Medicine Department, Faculty of Medicine, Minia University, Minia61519, Egypt
| | - Shaza Fadel Alkilany
- Public Health and Preventive Medicine Department, Faculty of Medicine, Minia University, Minia61519, Egypt
| | - Tarek Ahmed Abdel Rahman
- Public Health and Preventive Medicine Department, Faculty of Medicine, Minia University, Minia61519, Egypt
| |
Collapse
|
11
|
Flores ME, Rivera-Pasquel M, Macías N, Sánchez-Zamorano LM, Rodríguez-Ramírez S, Contreras-Manzano A, Denova-Gutiérrez E. Dietary patterns in Mexican preschool children are associated with stunting and overweight. Rev Saude Publica 2021; 55:53. [PMID: 34406279 PMCID: PMC8352562 DOI: 10.11606/s1518-8787.2021055002350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 12/20/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the association between dietary patterns, stunting, and overweight among Mexican preschoolers. METHODS This study was conducted with anthropometric (weight, height/length), sociodemographic (age, gender, education level of household head, socioeconomic status, country region and area, ethnicity, and beneficiary of social programs), and dietary data (Semiquantitative-food frequency questionnaire) on children aged from 1 to 4 years collected from the Mexican National Health and Nutrition Survey-2012. Dietary patterns were derived by principal components analysis. The association between dietary patterns, stunting, and overweight was assessed by prevalence ratios (PR), estimated by Poisson regression. RESULTS In total, 1,112 preschoolers (mean age 3.06 years, SD = 1.08 years; 48.8% females) were included in the study; 11.9% of whom presented stunting, and 6.7% overweight. We identified four dietary patterns: Fruits and Vegetables [F&V], Western [W], Traditional [T], and Milk and Liquids [M&L]. Considering the lowest tertile of each dietary pattern as reference, the prevalence of stunting was 2.04 times higher [95%CI: 1.17–3.56] among children in the highest tertile of the “F&V” pattern. The prevalence of stunting was lower among children in the highest tertile of the “W” pattern [PR = 0.48; 95%CI: 0.27–0.85]. Overweight was negatively associated with the “F&V” dietary pattern [PR = 0.37; 95%CI: 0.16–0.85 for its highest tertile], and children whose consumption was mostly equivalent to the “T” pattern showed higher prevalence of stunting [PR = 1.74; 95%CI: 1.01–3.00]. CONCLUSIONS The prevalence of stunting and overweight in a nationwide sample of Mexican preschoolers was associated with dietary patterns.
Collapse
Affiliation(s)
- Mario E Flores
- Nutrition and Health Research Center. National Institute of Public Health. Cuernavaca, México
| | - Marta Rivera-Pasquel
- Nutrition and Health Research Center. National Institute of Public Health. Cuernavaca, México
| | - Nayeli Macías
- Nutrition and Health Research Center. National Institute of Public Health. Cuernavaca, México
| | | | - Sonia Rodríguez-Ramírez
- Nutrition and Health Research Center. National Institute of Public Health. Cuernavaca, México
| | | | - Edgar Denova-Gutiérrez
- Nutrition and Health Research Center. National Institute of Public Health. Cuernavaca, México
| |
Collapse
|
12
|
Improvement of Dietary Diversity and Attitude toward Recommended Feeding through Novel Community Based Nutritional Education Program in Coastal Kenya-An Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197269. [PMID: 33027966 PMCID: PMC7579186 DOI: 10.3390/ijerph17197269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 12/11/2022]
Abstract
Community-based nutritional intervention to improve the practice of dietary diversity and child nutrition by community health workers (CHWs) involving Nyumba Kumi as small neighborhood units (SNUs) in communities has not yet been explored. This study was conducted in two villages in rural Kenya between 2018 and 2019. In total, 662 participants (control vs. intervention: n = 339 vs. n = 323) were recruited. The intervention group received education on maternal and child nutrition and follow-up consultations. The custom-tailored educational guidelines were made based on Infant and Young Child Feeding and the mother and child health booklet. The educational effects on household caregivers’ feeding practice attitude and child nutritional status were analyzed using multiple linear regression. After the intervention, a total of 368 household caregivers (187 vs. 181) and 180 children (113 vs. 67) were analyzed separately. Between the groups, no significant difference was found in their background characteristics. This study successfully improved the dietary diversity score (β = 0.54; p < 0.01) and attitude score (β = 0.29; p < 0.01). The results revealed that the interventions using CHWs and SNUs were useful to improve dietary diversity and caregivers’ attitudes toward recommended feeding. This research has the potential to be successfully applied in other regions where child undernutrition remains.
Collapse
|