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Shu L, Zhu H, Zhang L, Jia L, Zhang J, Wang L. Nutritional status of children left behind by migrant parents: Evidence from a survey in rural Anhui, eastern China. NUTR BULL 2024; 49:146-156. [PMID: 38363028 DOI: 10.1111/nbu.12666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/17/2024]
Abstract
We aimed to explore and analyse the dietary intake patterns of 3-6 year-old children left behind by one or both parents and to assess their associations with body mass index (BMI) and the prevalence of childhood anaemia in rural Anhui, eastern China. We used random cluster sampling to recruit rural children aged 3-6 years in two rural areas in Anhui province. Sociodemographic information and dietary intake were collected by self-reported questionnaires. Height, weight and prevalence of anaemia were measured by trained nurses blinded to parental migration status. Factor analysis was applied to determine that major dietary patterns, binary logistic regression and generalised linear regression were used to explore the associations between anaemia and BMI Z-score with dietary patterns. Of 1720 children aged 3-6 years, 236 were left by both parents and 388 were left by a single parent. The prevalence of stunting and underweight among left-behind children with migration of both parents (BLBC) was significantly higher than that of non-left-behind children (NLBC). Three dietary patterns-"grain-vegetable," "meat-egg" and "fast food-sweet"-were identified in our study, and the total variance explained was 46.9%. The meat-egg dietary pattern was associated with a decreased risk of anaemia after adjustment for confounding factors in the left-behind children with migration of both parents (BLBC), left-behind children with single parent migration (SLBC) and non-left-behind children (NLBC) groups. After adjusting for confounding factors, the fast food-sweet dietary pattern was found to be associated with an increased risk of anaemia (OR [95% CI]: Q4: 2.21 [1.14, 4.57], p = 0.034). In addition, children with obesity had a lower intake of vegetables and fruits (β = -0.08, 95% CI: -0.13, -0.02) compared with children with a normal weight. In conclusion, there are correlations between different types of parental migration and children's nutritional status in rural Anhui. The meat-egg dietary pattern may have a preventive effect on anaemia in comparison with other dietary patterns, irrespective of whether children are left behind or not. Children with overweight and obesity had a higher intake of pork and red meat and snacks compared with children with normal BMI.
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Affiliation(s)
- Li Shu
- Department of Nutrition and Food Hygiene, School of Public Health, Bengbu Medical University, Bengbu, Anhui Province, China
| | - Hao Zhu
- Department of Nutrition and Food Hygiene, School of Public Health, Bengbu Medical University, Bengbu, Anhui Province, China
| | - Li Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Bengbu Medical University, Bengbu, Anhui Province, China
| | - Linlin Jia
- Department of Nutrition and Food Hygiene, School of Public Health, Bengbu Medical University, Bengbu, Anhui Province, China
| | - Jiaye Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Bengbu Medical University, Bengbu, Anhui Province, China
| | - Liying Wang
- Bengbu Health Board, Bengbu, Anhui Province, China
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Talukdar R, Ravel V, Barman D, Kumar V, Dutta S, Kanungo S. Prevalence of undernutrition among migrant, refugee, internally displaced children and children of migrated parents in lower-middle-income countries: A meta-analysis of published studies from last twelve years. Diabetes Metab Syndr 2024; 18:102976. [PMID: 38508036 DOI: 10.1016/j.dsx.2024.102976] [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: 11/10/2023] [Revised: 03/03/2024] [Accepted: 03/05/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND AND AIMS This review aims to estimate the prevalence of undernutrition among migrants, refugees, internally displaced children, and children of migrated parents living in lower-middle-income countries. METHODS PubMed, Scopus, Science-Direct, CINAHL-Plus, & Google Scholar were searched for peer-reviewed evidence published between January 2010 to March 2023. Two researchers independently examined the studies and retrieved the data. The internal and external validity of the studies was assessed using the NIH quality assessment tool, and a checklist adapted from Downs & Black, Bracht & Glass, and Del Siegle's guidelines. A random effect model was chosen to pool the estimates. Subgroup analysis, Meta-regression, and sensitivity analysis were done to explore the source of heterogeneity and the robustness of estimates. RESULTS Among the 1978 records initially searched, 21 studies were selected for analysis. The pooled prevalence estimates for stunting, wasting, and underweight were estimated to be 29.39% (Confidence Interval [CI] 21.69-37.73; I2 99%; p < 0.01), 12.76% (CI 7.84-18.68; I2 99%; P < 0.01), and 24.05% (CI 16.17-32.94; I2 100%; p < 0.001) respectively. Among different WHO regions, all three undernutrition estimates were higher in LMICs belonging to the Southeast Asian region (Stunting 37.62%; wasting 14.28% and underweight 31.24%). Undernutrition among migrant Indian children was 43.55%, 18.71%, and 37.45% respectively. High heterogeneity was noted across all estimates with I2-value >90%. Sensitivity analysis across indicators showed the stability of our estimates. CONCLUSIONS The extent of undernutrition, particularly wasting was high among migrant/refugee children living in lower-middle-income countries. Measures should be taken to strengthen the government-subsidized public food distribution system, increase healthcare outreach, and ensure public health insurance coverage among the migrant population.
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Affiliation(s)
- Rounik Talukdar
- ICMR - National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
| | - Vanessa Ravel
- ICMR - National Institute of Epidemiology, Chennai, Tamil Nadu, India.
| | - Diplina Barman
- ICMR - National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
| | - Vivek Kumar
- Deepak Foundation, Katni, Madhya Pradesh, India.
| | - Shanta Dutta
- ICMR - National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
| | - Suman Kanungo
- ICMR - National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
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Ayling K, Li R, Muhardi L, Melse-Boonstra A, Sun Y, Chen W, Kudla U. Systematic Literature Review of the Nutrient Status, Intake, and Diet Quality of Chinese Children across Different Age Groups. Nutrients 2023; 15:1536. [PMID: 36986271 PMCID: PMC10057142 DOI: 10.3390/nu15061536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/23/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
There is a lack of comprehensive reports on nutrient deficiencies and dietary intake among various age groups of children in China. The objective of this review is to provide an overview of the nutrient status, intake, and diet adequacy of Chinese children (0-18 years old). PubMed and Scopus were searched for literature published between January 2010 and July 2022. A systematic review approach with a quality assessment was performed to analyze 2986 identified articles in English and Chinese. Eighty-three articles were included in the analysis. In younger children, anemia and iron and Vitamin A deficiencies remain severe public health problems, despite high Vitamin A and adequate iron intake. In older children, a high prevalence of selenium; Vitamin A and D deficiencies; and inadequate intakes of Vitamins A, D, B, C, selenium, and calcium were reported. Intakes of dairy, soybeans, fruits, and vegetables were below recommended levels. High intakes of iodine, total and saturated fat, and sodium and low dietary diversity scores were also reported. As nutritional concerns vary with age and region, future nutrition interventions should be tailored accordingly.
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Affiliation(s)
- Katie Ayling
- Friesland Campina, 3818 LA Amersfoort, The Netherlands;
| | - Rongrong Li
- Department of Clinical Nutrition, Peking Union Medical College Hospital (PUMCH), Beijing 100730, China
| | | | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University & Research, 6703 HE Wageningen, The Netherlands
| | - Ye Sun
- Friesland Campina Development Centre AMEA, Singapore 118261, Singapore
| | - Wei Chen
- Department of Clinical Nutrition, Peking Union Medical College Hospital (PUMCH), Beijing 100730, China
| | - Urszula Kudla
- Friesland Campina, 3818 LA Amersfoort, The Netherlands;
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Wang S, Zhao X, Yu Y, Tao F, Liu D, Sun Y. Prolonged Rather Than Early Childhood Parent-Child Separation Predicts Change in Molecular Markers of Cellular Aging: A Consideration of the Role of Adolescence. J Youth Adolesc 2023; 52:165-176. [PMID: 36149547 DOI: 10.1007/s10964-022-01681-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/09/2022] [Indexed: 01/07/2023]
Abstract
Early life adversity is a major risk factor for the onset of psychopathology, and cellular aging may be a mechanism underlying these associations. It is unknown whether and how the pattern (timing and duration) of parent-child separation is associated with accelerated cellular aging, particularly with respect to functional aging and replicative senescence, indexed by mitochondrial DNA copy number (mtDNAcn) elevation and telomere length (TL) attrition. This cohort study included 252 rural adolescents (mean age 11.62 years, SD: 1.56). Nearly one in five participants were persistently separated from both parents since birth. Compared with participants who never separated from their parents, adolescents with prolonged parent-child separation had higher acceleration both in functional aging and replicative senescence of cells. However, that was not the case in adolescents who experienced parent-child separation in early childhood but regained stable parental care during adolescence. These findings indicate that pubertal development reopens a window of opportunity for buffering the adverse biological effect based on significant improvements in the supportiveness of the caregiving environment relative to that in childhood. Translating such knowledge to inform intervention and prevention strategies for youths exposed to adversity is a critical goal for the field.
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Affiliation(s)
- Shihong Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China
| | - Xudong Zhao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China
| | - Yue Yu
- Department of Pediatrics, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui Province, China
| | - Deyun Liu
- Department of Pediatrics, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
| | - Ying Sun
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui Province, China. .,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui Province, China.
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The association between micronutrient powder delivery patterns and caregiver feeding behaviors in rural China. BMC Public Health 2022; 22:1366. [PMID: 35842633 PMCID: PMC9287899 DOI: 10.1186/s12889-022-13726-4] [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: 02/11/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022] Open
Abstract
Background High adherence and proper usage of micronutrient powder (MNP) influence child nutritional outcomes, yet few studies explore the role of delivery patterns. This study explores the association between MNP delivery patterns and MNP feeding behaviors among Han and minority caregivers in rural Western China. Methods In August 2019, a total of 1021 caregiver-child pairs were selected through a four-stage cluster sampling process. A cross-sectional survey collected information on caregiver demographics, MNP delivery patterns (channel and frequency), and MNP feeding behaviors (proper usage and adherence). Using logistic regression, we examined which delivery channels and delivery frequencies were associated with proper usage and high adherence. Results The results indicated that minority caregivers had lower levels of proper MNP usage than did Han caregivers (89.2%), with Tibetan caregivers’ reporting the lowest rates of adherence (32.6%). Logistic regression revealed that that township-based channel was significantly correlated with proper usage among Tibetan and Yi caregivers (Odds Ratio, OR = 2.0, p < 0.01; and OR = 3.5, p < 0.001). Overall, the township-based and home-visit channels were significantly correlated with high adherence (OR = 1.7 and OR = 2.3, respectively; p < 0.001); delivery frequency was significantly correlated with high adherence (2 months: OR = 2.2, p < 0.001 and ≤ 1 month: OR = 3.5, p < 0.001) but not correlated with proper usage among the whole sample and individual ethnic groups. Conclusions In conclusion, the study finds evidence of a correlation between MNP delivery channel and both proper usage and high adherence as well as a correlation between MNP delivery frequency and high adherence. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13726-4.
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Perceived Stress, Social Support, Emotional Intelligence, and Post-Stress Growth among Chinese Left-Behind Children: A Moderated Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031851. [PMID: 35162873 PMCID: PMC8834669 DOI: 10.3390/ijerph19031851] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 11/17/2022]
Abstract
Background: Several previous studies have revealed a negative impact of perceived stress on post-stress growth. Nevertheless, the potential mediating and moderating mechanisms are unclear, particularly for left-behind children in China. Therefore, this study aims to investigate the negative relationship between perceived stress and post-stress growth, the mediating effect of social support, as well as the moderating effect of emotional intelligence in a sample of Chinese left-behind children. Methods: A sample of 837 Chinese students in elementary and middle school was collected for this study. The Perceived Stress Scale, the Social Support Scale, the Emotional Intelligence Scale, and the Post-Stress Growth Scale were employed to examine them. The data were analyzed using SPSS 25.0 software. Results: The results indicate a significant negative association between perceived stress and post-stress growth. Among perceived stress and social support, the former acted as a mediator, while the latter as a moderator. This study sheds light on the post-stress growth of Chinese left-behind children. The findings validated a model of moderated mediation that shows the relationship between perceived stress, emotional intelligence, social support, and post-stress growth. Conclusion: This study confirmed that social support is one of the most important factors among left-behind children, from perceived stress to post-stress growth. Furthermore, the study reveals that emotional intelligence can adjust the relationship between perceived stress and social support to post-stress growth. Therefore, for both family education and school education, the result provides a new direction.
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Shi H, Wang Y, Li M, Tan C, Zhao C, Huang X, Dou Y, Duan X, Du Y, Wu T, Wang X, Zhang J. Impact of parent-child separation on children's social-emotional development: a cross-sectional study of left-behind children in poor rural areas of China. BMC Public Health 2021; 21:823. [PMID: 33926397 PMCID: PMC8082618 DOI: 10.1186/s12889-021-10831-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 04/13/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Parent-child separation is a considerable adversity for left-behind children (LBC), but there is little evidence on the association between detailed characteristics of parent-child separation and social-emotional development among LBC. This study examined the characteristics of parent-child separation and its impacts on developmental delay among under-3 LBC in poor rural China. METHODS We used data from 811 LBC surveyed in five poor counties in rural China in 2018. Detailed characteristics of their parental migration were recalled by their primary caregivers in face-to-face interviews. The children's social-emotional development was measured by using the Ages and Stages Questionnaire: Social-Emotional. Logistic regression was employed to examine the association of detailed characteristics of parent-child separation with early social-emotional problems after adjusting for the children's and primary caregivers' sociodemographic characteristics. RESULTS 287 (35.4%) children were left behind by fathers and cared for by mothers (FM-MC), while 524 (64.6%) were left behind by both parents and cared for by grandparents (PM-GC). The rate of social-emotional problems among LBC was 36.8% (PM-GC vs FM-MC: 40.6% vs 29.5%; aOR 1.51, 95% CI: 1.06 to 2.16). For paternal migration, the medians of the child's age at the first migration and average duration per migration were 3 months (IQR: 1 to 9 months) and 4.48 months (IQR: 2.38 to 7.54 months), respectively. For maternal migration, the corresponding values were 9 months (IQR: 6 to 13 months) and 4.65 months (IQR: 2.71 to 7.62 months), respectively. On average, LBC had been separated from fathers for 72% of their life due to paternal migration and from mothers for 52% of their life due to maternal migration. No significant association was found between the detailed characteristics of paternal migration and social-emotional development among LBC, while social-emotional problems among LBC were significantly associated with the proportion of cumulative duration of maternal migration in the child's lifetime (aOR 2.83; 95% CI: 1.13 to 7.10). CONCLUSIONS LBC under 3 years had a high risk of social-emotional problems in poor rural China. Cumulative exposure to maternal migration may be detrimental to LBC's early social-emotional development. Programs are necessary to support these children as well as their families.
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Affiliation(s)
- Huifeng Shi
- Department of Maternal and Child Health, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.,Department of Obstetrics and Gynecology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yuanyuan Wang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Mengshi Li
- Department of Maternal and Child Health, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Chang Tan
- Department of Maternal and Child Health, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Chunxia Zhao
- Department of Maternal and Child Health, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xiaona Huang
- Section of Health, Nutrition, and Water, Environment and Sanitation, UNICEF China, 12 Sanlitun Road, Chao Yang District, Beijing, 100600, China
| | - Yan Dou
- Department of Maternal and Child Health, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xiaoqian Duan
- Department of Maternal and Child Health, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yufeng Du
- Institute of Epidemiology and Statistics School of Public Health, Lanzhou University, 199 West Donggang Road, Lanzhou, 730000, China
| | - Tianchen Wu
- Department of Maternal and Child Health, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xiaoli Wang
- Department of Maternal and Child Health, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.,National Health Commission Key Laboratory of Reproductive Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jingxu Zhang
- Department of Maternal and Child Health, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China. .,National Health Commission Key Laboratory of Reproductive Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Sun F, Liang Z. Parental migration and anemia status of children in China. Soc Sci Med 2021; 270:113680. [PMID: 33433372 DOI: 10.1016/j.socscimed.2021.113680] [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] [Revised: 12/25/2020] [Accepted: 12/30/2020] [Indexed: 11/30/2022]
Abstract
Previous literature on parental migration and children's health outcomes mainly focuses on subjective measures and often omits the selectivity issue. Taking advantage of a unique nationally representative longitudinal dataset from the China Health and Nutrition Survey, this paper uses anemia status as an objective measure of children's health outcomes and examines the different effects of parents' current migration status, migration history, and migration duration. The results show that father's migration does not harm children's physical health, especially for children in rural areas, for whom father's migration decreases the likelihood of being anemic; while mother's migration increases the likelihood of being anemic. Importantly, children with return migrant mothers are less likely to experience anemia. We also find that the longer the father migrated, the better the child's health, but mother's longer migration duration is more detrimental. Our findings highlight the gender dimension in the migration story and indicate that policymakers should encourage the return migration of migrant mothers.
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Affiliation(s)
- Feinuo Sun
- Department of Sociology, University at Albany, State University of New York, 1400 Washington Ave, Albany, NY, 12222, United States.
| | - Zai Liang
- Department of Sociology, University at Albany, State University of New York, 1400 Washington Ave, Albany, NY, 12222, United States; Department of Sociology, School of Humanities and Social Science of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
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