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Indriasari R, Mansur MA, Rachmat M. Comprehensive knowledge and supports from closest relatives are crucial to improve awareness and participation of Indonesian adolescent girls in anemia prevention program. Int J Adolesc Med Health 2024:ijamh-2024-0064. [PMID: 39241191 DOI: 10.1515/ijamh-2024-0064] [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: 04/24/2024] [Accepted: 08/13/2024] [Indexed: 09/08/2024]
Abstract
OBJECTIVES This qualitative study explored perceptions of anemia prevention among adolescent girls from low- to mid-socioeconomic backgrounds to identify educational needs for effective intervention. METHODS This qualitative study employed focus group discussions (FGDs) for data collection. Participants were recruited through purposive sampling based on specific criteria, with each FGD comprising 7-9 participants. A total of 3 FGDs were conducted, involving 23 high school female students. The discussions, guided by an interview guide, took place in classrooms at two different schools. Verbatim transcripts were created from the FGD recordings and analyzed using a thematic analysis approach. RESULTS The study revealed several information gaps, including an incomplete understanding of anemia, prevention strategies, and its consequences. Comprehensive knowledge about the causes and effects of anemia, along with the importance of iron supplementation, was identified as essential educational needs for adolescent girls. Support from family members and teachers was deemed crucial during the implementation of anemia prevention strategies. The participants recognized anemia as a serious health issue and emphasized the importance of prevention. CONCLUSIONS Key aspects of anemia prevention need to be integrated into nutrition education programs for adolescents. Addressing these information gaps can enhance the promotion of anemia prevention strategies and improve adherence among adolescents.
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Affiliation(s)
- Rahayu Indriasari
- Department of Nutrition Science, Faculty of Public Health, 64739 Hasanuddin University , Makassar, Indonesia
| | - Marini Amalia Mansur
- Department of Nutrition Science, Faculty of Public Health, 64739 Hasanuddin University , Makassar, Indonesia
| | - Muhammad Rachmat
- Department of Health Promotion and Behaviour Science, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
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Morcel J, Béghin L, Michels N, De Ruyter T, Drumez E, Cailliau E, Polito A, Le Donne C, Barnaba L, Azzini E, De Henauw S, Miguel Berges ML, Cacau LT, Moreno LA, Gottrand F. Nutritional and physical fitness parameters in adolescence impact cardiovascular health in adulthood. Clin Nutr 2024; 43:1857-1864. [PMID: 38959665 DOI: 10.1016/j.clnu.2024.06.022] [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: 03/05/2024] [Revised: 05/30/2024] [Accepted: 06/21/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND & AIMS Cardiovascular diseases are the leading cause of mortality worldwide, originating in the first decades of life. A better understanding of their early determinants would allow for better prevention. This study aimed to evaluate the impact of nutritional and activity-related characteristics during adolescence on young adult cardiovascular risk factors. METHODS The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study included adolescents (aged 12.5-17.5 years) in 10 European centres. Four centres designed a nested cohort including 236 participants who were reassessed as young adults (21-32 years). Food consumption was evaluated by dietary recalls, physical activity by accelerometers, physical fitness using physical tests and nutritional knowledge by questionnaires. Cardiovascular health was assessed by Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Study risk scores and its components. Factors associated with cardiovascular risk were identified using a multivariable regression model. RESULTS Higher Diet Quality Index (DQI, P = 0.012) and nutritional knowledge (P = 0.015) were significantly associated with lower modified PDAY risk scores. Ultra-processed foods were associated with a lower non-high-density lipoprotein (non-HDL) cholesterol (P = 0.003), whereas DQI (P = 0.014) and Planetary Health Diet Index (P = 0.016) were associated with a higher HDL cholesterol. Higher DQI was also related to a lower body mass index (BMI, P = 0.006). In addition, cardiorespiratory fitness was related to a lower BMI (P = 0.004). CONCLUSIONS Nutritional knowledge, diet quality and adherence to a sustainable diet in adolescence decrease cardiovascular risk in adulthood, whereas ultra-processed food consumption increases risk. These factors appear as targeted prevention tools for promoting a healthier adolescent lifestyle to decrease long-term cardiovascular risk. CLINICAL TRIAL REGISTRY NUMBER Clinicaltrials.gov NCT02899416.
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Affiliation(s)
- Jules Morcel
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, and CIC 1403 - Clinical Investigation Center, F-59000 Lille, France.
| | - Laurent Béghin
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, and CIC 1403 - Clinical Investigation Center, F-59000 Lille, France
| | - Nathalie Michels
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Thaïs De Ruyter
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Elodie Drumez
- CHU Lille, Département de Biostatistiques, F-59000 Lille, France
| | - Emeline Cailliau
- CHU Lille, Département de Biostatistiques, F-59000 Lille, France
| | - Angela Polito
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Cinzia Le Donne
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Lorenzo Barnaba
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Elena Azzini
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Maria Luisa Miguel Berges
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Escuela Universitaria de Ciencas de la Salud, Universidad de Zaragoza, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Leandro Teixeira Cacau
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, 01246-904, Brazil
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Escuela Universitaria de Ciencas de la Salud, Universidad de Zaragoza, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, and CIC 1403 - Clinical Investigation Center, F-59000 Lille, France
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Barman M. Anaemia prevalence and socio-demographic factors among women of reproductive age (WRA): A geospatial analysis of empowered action group (EAG) states in India. Spat Spatiotemporal Epidemiol 2024; 49:100644. [PMID: 38876570 DOI: 10.1016/j.sste.2024.100644] [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: 03/24/2023] [Revised: 01/30/2024] [Accepted: 02/06/2024] [Indexed: 06/16/2024]
Abstract
Anaemia remains a major nutritional-related health concern for women under reproductive age (WRA) in developing nations like India as well as the Indian EAG states. According to NFHS round-5, EAG states constitute 57% of WRA having any form of anaemia, higher than many other states of India and other developed and developing nations. This study aimed to assess the frequency of anaemia among the WRA in India's eight EAG states. Also, it attempts to analyse the causes associated with anaemia by the women's background characteristics with spatial correlation with its co-variates across 291 districts of the EAG states. One of the most current Demographic and Health Survey's (DHS) cross-sectional data is the NFHS-5th (2019-21) round taken, conducted by the IIPS under the administration of MoHFW, India. This study only included 315,069 women under reproductive age (WRA). The variables related to anaemia among women's (WRA) background socio-demographic characteristics were assessed using bivariate statistics and multinominal logistic regression analysis to comprehend the spatial correlation between women and their determinant factors. Among the EAG states, the overall prevalence of anaemia was 57%, varying from 42.6% in Uttarakhand to 65.3% in Jharkhand. Multinominal logistic regression analyses reveal that the chances of anaemia are remarkably more prevalent in younger women (15-19 years of age), women living in rural areas, no educated and primary level educated women, women belonging to the middle to poorest wealth quintile, women no longer living together, women of the Christian religion, women who are not exposed to reading newspapers, underweight BMI women, and scheduled tribe women. Mainly, the prevalence is observed in the North-eastern and southeastern states of Bihar, Jharkhand, Odisha, Chhattisgarh, some parts of Madhya Pradesh, Uttar Pradesh, and Rajasthan, which is shown by the hotspot map. According to the findings of this study, numerous factors like family, socioeconomic, educational, awareness, and individual characteristics such as caste and domicile all lead to a risk of anaemia. The WRA suffers from anaemia as a result of their socioeconomic background and awareness, which leads to a lack of nourishment, and they seek nutrient deficiencies. To overcome this anaemia, multiple discipline policies and initiatives need to be taken targeting women's wellness and nutritional status by increasing women's education and socioeconomic status.
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Affiliation(s)
- Manabindra Barman
- Department of Geography & Applied Geography, University of North Bengal, 734013, Siliguri, West Bengal, India.
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Gemechu K, Asmerom H, Sileshi B, Belete R, Ayele F, Nigussie K, Bete T, Negash A, Sertsu A, Mekonnen S, Arkew M. Anemia and associated factors among under-five children attending public Hospitals in Harari Regional State, eastern Ethiopia: A cross-sectional study. Medicine (Baltimore) 2024; 103:e38217. [PMID: 38787999 PMCID: PMC11124665 DOI: 10.1097/md.0000000000038217] [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: 07/10/2023] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
Childhood anemia is a significant global public health problem. It influences the physical and cognitive development, as well as immunity of affected children. This in turn leads to poor academic performance, low working potential, and increased morbidity and mortality. There is limited facility-based data on the magnitude and predictors of anemia among under-five children. This study aimed to determine the prevalence and associated factors of anemia among under-five children attending public Hospitals in Harari Regional State, eastern Ethiopia. Institution-based cross-sectional study was conducted at Hiwot Fana Comprehensive Specialized University Hospital and Jugal Hospital from July 1, 2022, to August 31, 2022. A total of 330 under-five children were involved by systematic random sampling technique. Data on sociodemographic characteristics and other possible factors were collected through face-to-face interviews with children's parents/legal guardians. Four milliliters of venous blood samples were collected for a complete blood cell count. Collected data were checked for completeness, entered into Epi-Data Statistical Software Version 4.6, and exported into the Statistical Package for Social Sciences version 25 for analysis. Bivariable and multivariable logistic regression was conducted and P < .05 were considered statistically significant. The overall prevalence of anemia was 33% (95% confidence interval [CI]: 27.9%-37.9%). Age of children 6 to 11 months (adjusted odd ratio [AOR] = 3.94, 95% CI: 1.55-10.01) and 12 to 23 months (AOR = 2.93, 95% CI: 1.15-7.43), no maternal education (AOR = 4.34, 95% CI: 1.53-12.35), not exclusively breastfeeding (AOR = 1.98, 95% CI: 1.11-3.52), being severely stunted (AOR = 3.39, 95 CI: 1.70-6.75), and underweight (AOR = 2.1, 95% CI: 1.12-3.87) were significantly associated with anemia among under-five children. In this study, anemia among under-five children is a moderate public health problem. This study revealed that young child age, maternal education level, early initiation of complementary feeding, and child undernutrition were factors associated with anemia. Thus, efforts should be made to improve the child's nutritional status as well as enhance maternal awareness of nutrition and child-feeding practice through health education. Regular childhood nutritional screening and appropriate intervention for malnutrition are needed. Besides, further studies assessing serum micronutrient levels should be conducted to differentiate the specific cause and type of anemia.
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Affiliation(s)
- Kabtamu Gemechu
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Haftu Asmerom
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Beza Sileshi
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Rebuma Belete
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Firayad Ayele
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Nigussie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Bete
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abraham Negash
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Sertsu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Shambel Mekonnen
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mesay Arkew
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Shibeshi AH, Mare KU, Kase BF, Wubshet BZ, Tebeje TM, Asgedom YS, Asmare ZA, Asebe HA, Lombebo AA, Sabo KG, Fente BM, Seifu BL. The effect of dietary diversity on anemia levels among children 6-23 months in sub-Saharan Africa: A multilevel ordinal logistic regression model. PLoS One 2024; 19:e0298647. [PMID: 38771790 PMCID: PMC11108208 DOI: 10.1371/journal.pone.0298647] [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: 07/12/2023] [Accepted: 01/30/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Anemia is the most common hematologic disorder of children worldwide. Since dietary diversity is a main requirement of children is to get all the essential nutrients, it can thus use as one of the basic indicator when assessing the child's anemia. Although dietary diversity plays a major role in anemia among children in sub-Saharan Africa, there is little evidence of an association between the dietary diversity and anemia level to identified potential strategies for prevention of anemia level in sub-Saharan Africa. OBJECTIVE To examine the association between dietary diversity and anemia levels among children aged 6-23 months in sub-Saharan Africa. METHODS The most recent Demographic and Health Surveys from 32 countries in SSA were considered for this study, which used pooled data from those surveys. In this study, a total weighted sample of 52,180 children aged 6-23 months was included. The diversity of the diet given to children was assessed using the minimum dietary diversity (MDD), which considers only four of the seven food groups. A multilevel ordinal logistic regression model was applied due to the DHS data's hierarchical structure and the ordinal nature of anemia. With a p-value of 0.08, the Brant test found that the proportional odds assumption was satisfied. In addition, model comparisons were done using deviance. In the bi-variable analysis, variables having a p-value ≤0.2 were taken into account for multivariable analysis. The Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was presented for potential determinants of levels of anemia in the multivariable multilevel proportional odds model. RESULTS The overall prevalence of minimum dietary diversity and anemia among children aged 6-23 months were 43% [95% CI: 42.6%, 43.4%] and 72.0% [95% CI: 70.9%, 72.9%] respectively. Of which, 26.2% had mild anemia, 43.4% had moderate anemia, and 2.4% had severe anemia. MDD, being female child, being 18-23 months age, born from mothers aged ≥25, taking drugs for the intestinal parasite, higher level of maternal education, number of ANC visits, middle and richer household wealth status, distance of health facility and being born in Central and Southern Africa were significantly associated with the lower odds of levels of anemia. Contrarily, being 9-11- and 12-17-months age, size of child, having fever and diarrhea in the last two weeks, higher birth order, stunting, wasting, and underweight and being in West Africa were significantly associated with higher odds of levels of anemia. CONCLUSION Anemia was a significant public health issue among children aged 6-23 months in sub-Saharan Africa. Minimum dietary diversity intake is associated with reduced anemia in children aged 6 to 23 months in sub-Saharan Africa. Children should be fed a variety of foods to improve their anemia status. Reducing anemia in children aged 6-23 months can be achieved by raising mother education levels, treating febrile illnesses, and improve the family's financial situation. Finally, iron fortification or vitamin supplementation could help to better reduce the risk of anemia and raise children's hemoglobin levels in order to treat anemia.
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Affiliation(s)
- Abdu Hailu Shibeshi
- Department of Statistics, College of Natural and Computational Science, Samara University, Samara, Ethiopia
| | - Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Bizunesh Fantahun Kase
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Betel Zelalem Wubshet
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Tsion Mulat Tebeje
- School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Yordanos Sisay Asgedom
- Department of Epidemiology and Biostatics, College of Health Sciences and Medicine, Wolaita Sodo University, Soddo, Ethiopia
| | - Zufan Alamrie Asmare
- Department of Ophthalmology, School of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Hiwot Altaye Asebe
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Afework Alemu Lombebo
- School of Medicine, College of Health Science and Medicine, Wolaita Sodo University, Soddo, Ethiopia
| | - Kebede Gemeda Sabo
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Bezawit Melak Fente
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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Hasanah A, Kharisma B, Remi SS, Adam AM, Siregar AYM. Food diversity: its relation to children's health and consequent economic burden. BMC Public Health 2024; 24:1155. [PMID: 38658917 PMCID: PMC11044496 DOI: 10.1186/s12889-024-18530-w] [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: 06/02/2023] [Accepted: 04/05/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND This study investigates the impact of low food diversity on the health status of children using the Dietary Diversity Score (DDS) and Dietary Serving Score (DSS) in a sub-district with the highest percentage of poor households. The economic burden of low food diversity was observed by analysing the cost of illness in the children with low food diversity. METHODS Data from 329 children were collected. We determined the impact of DDS and DSS and other factors on the health status of children aged 2-14 years, using a probit model. The cost of illness (e.g., typhus, stomach ulcers, coughs, flu, and fever) due to low food diversity was calculated from medical registration fees, medical action costs, transportation costs, and other costs. RESULTS The results shows that a 1% point increase in DDS or DSS potentially decreases children's health complaints by 10% and 8%, respectively. Given the current 26% prevalence of health complaints among children with low DDS, the annual economic burden reaches US$75.72 per child per household. In addition, the current 41% prevalence of children with low DDS resulted in an annual cost to the government of US$153.45 per child. CONCLUSIONS The effect of inadequate dietary diversity on children's health is potentially high and contributes to the economic burden on households and the government.
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Affiliation(s)
- Alfiah Hasanah
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia.
| | - Bayu Kharisma
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia
| | - Sutyastie S Remi
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia
| | - Asep Muhammad Adam
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia
| | - Adiatma Y M Siregar
- Center for Economics and Development Studies, Department of Economics, Faculty of Economics and Business, Universitas Padjadjaran, Bandung, Indonesia
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Getnet M, Sisay WS, Alem AZ. Spatial distribution and associated factors of co-occurrence of overweight/obesity and Anemia among women in the reproductive age in sub-Saharan Africa: A multilevel analysis, DHS 2016-2021. PLoS One 2024; 19:e0299519. [PMID: 38635643 PMCID: PMC11025742 DOI: 10.1371/journal.pone.0299519] [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: 07/25/2023] [Accepted: 02/13/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Overweight/obesity is one of the major public health problems that affect both developed and developing nations. The co-occurrence of overweight/obesity and anemia is thought to be largely preventable if detected early. To date, no spatial analyses have been performed to identify areas of hotspots for the co-occurrence of overweight/obesity and anemia among reproductive women in sub-Saharan Africa. Therefore, this study aimed to assess the spatial distribution and associated factors of the co-occurrence of overweight/obesity and anemia among women of reproductive age. METHODS Data for the study were drawn from the Demographic and Health Survey, a nationally representative cross-sectional survey conducted in the era of Sustainable Development Goals, in which the World Health Assembly decided and planned to cease all forms of malnutrition by 2030. Seventeen sub-Saharan African countries and a total weighted sample of 108,161 reproductive women (15-49 years) were included in our study. The data extraction, recoding and analysis were done using STATA V.17. For the spatial analysis (autocorrelation, hot-spot and interpolation), ArcGIS version 10.7 software, and for the SaTScan analysis, SaTScan version 10.1 software was used. Descriptive statistics were presented using frequency tables and percentages. We employed multilevel logistic regression to investigate associated factors. In the multivariable analysis, variables with a p-value of ≤0.05 are considered as a significant factor associated with co-occurrence of overweight/obesity and anemia among women aged 15-49 years. RESULTS The overall co-occurrence of overweight/obesity and anemia among women in sub-Saharan Africa was 12% (95%CI: 9-14%). The spatial analysis revealed that the co-occurrence of overweight/obesity and anemia among women significantly varied across sub-Saharan Africa. (Global Moran's I = 0.583163, p<0.001). In the spatial window, the primary-cluster was located in Liberia, Guinea, Gambia, Sira Leon, Mauritania, Mali, Cameron and Nigeria with a Log-Likelihood Ratio (LRR) of 1687.30, and Relative Risk (RR) of 2.58 at a p-value < 0.001. In multilevel analysis, women aged 25-34 years (AOR = 1.91, 95%CI: 1.78, 2.04), women aged 35-49 years (AOR = 2.96, 95% CI: 2.76, 3.17), married (AOR = 1.36, 95% CI: 1.27, 1.46), widowed (AOR = 1.22, 95%CI: 1.06, 1.40), divorced (AOR = 1.36, 95% CI: 1.23, 1.50), media exposure (AOR = 1.31, 95%CI: 1.23, 1.39), middle income (AOR = 1.19, 95%CI: 1.11, 1.28), high income/rich (AOR = 1.36, 95%CI: 1.26, 1.46), not working (AOR = 1.13, 95% CI:1.07, 1.19), traditional contraceptive utilization (AOR = 1.39, 95%CI: 1.23, 1.58) and no contraceptive use (AOR = 1.27, 95%CI: 1.20, 1.56), and no health insurance coverage (AOR = 1.36, 95%CI: 1.25, 1.49), were individual level significant variables. From community-level variables urban residence (AOR = 1.61, 95%CI: 1.50, 1.73), lower middle-income country (AOR = 2.50, 95%CI: 2.34, 2.66) and upper middle-income country (AOR = 2.87, 95%CI: 2.47, 3.34), were significantly associated with higher odds of co-occurrence of overweight/ obesity and anemia. CONCLUSION AND RECOMMENDATIONS The spatial distribution of the co-occurrence of overweight/obesity and anemia was significantly varied across the sub-Saharan African country. Both individual and community-level factors were significantly associated with the co-occurrence of overweight/obesity and anemia. Therefore, public health programmers and other stalk holders who are involved in maternal healthcare should work together and give priority to hotspot areas of co-occurrence in sub-Saharan Africa.
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Affiliation(s)
- Mihret Getnet
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wullo Sisay Sisay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Atosona A, Mohammed JA, Issahaku H, Saani K, Addae HY, Azupogo F. Maternal employment status and child age are positive determinants of minimum dietary diversity among children aged 6-23 months in Sagnarigu municipality, Ghana: a cross-sectional study. BMC Nutr 2024; 10:57. [PMID: 38622652 PMCID: PMC11020657 DOI: 10.1186/s40795-024-00865-7] [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: 09/21/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Intake of a diversified diet is key to the prevention of malnutrition among children as it results in improved intake of energy and micronutrients, which are deemed critical for better nutritional status of children. This study assessed minimum dietary diversity (MDD) and its determinants among children aged 6-23 months in the Sagnarigu Municipality of Ghana. METHODS This was an analytical cross-sectional study, carried out in the Sagnarigu Municipality, Ghana and involved 369 mother-child pairs selected through a systematic random sampling. A semi-structured questionnaire was used to obtain respondents' socio-demographic characteristics, feeding practices, nutritional knowledge and anthropometry. MDD was assessed using a repeated 24-hour dietary recall method. Chi-square/Fisher exact test and binary logistic regression analysis were used to determine the factors associated with MDD. RESULTS The study found that 24.9% of the children were between the ages of 6-8 months and 75.1% were between the ages of 9-23 months. About 64.2% of the children met the MDD. Children of mothers who were self-employed were approximately 2 times more likely to meet the MDD as compared to children of mothers who were unemployed [Adjusted Odd Ratio (AOR): 1.93, 95% CI (1.13-3.31), P = 0.017]. Also, children aged 9-23 months were approximately 14 times more likely to meet MDD as compared to younger children aged 6-8 months [AOR: 13.98, 95% CI (7.54-25.91), P < 0.001]. CONCLUSION Our study suggests that maternal empowerment may have positive effects on improving the MDD of infants and young children.
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Affiliation(s)
- Ambrose Atosona
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.
| | - Jawahir Abukari Mohammed
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Huzaifa Issahaku
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Khadija Saani
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | | | - Fusta Azupogo
- Faculty of Agriculture, Department of Family and Consumer Sciences, Food and Consumer Sciences, University for Development Studies, Tamale, Ghana
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Asrullah M, Hositanisita H, L'Hoir M, Muslimatun S, Jm Feskens E, Melse-Boonstra A. Intra-uterine exposure to lower maternal haemoglobin concentration is associated with impaired cognitive function in stunted adolescents: results from a 17-year longitudinal cohort study in Indonesia. Int J Food Sci Nutr 2023; 74:826-835. [PMID: 37818825 DOI: 10.1080/09637486.2023.2267792] [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: 07/04/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023]
Abstract
The long-term impact of maternal anaemia on cognitive performance remains unknown. Indonesian longitudinal cohort data of 363 paired pregnant mothers and their 10-14-year-old offspring were used to investigate the association between maternal haemoglobin (Hb) concentration and their offspring's cognitive function (assessed by Raven's Progressive Matrices test) during adolescence. The weighted anaemia prevalence was 49.3% in pregnant mothers and 22.2% in adolescents. Adolescents who were stunted, anaemic, or living in a rural area had significantly lower cognitive scores than their counterparts. Maternal Hb was not associated with adolescent cognitive function (β: 0.14; 95%CI: -0.052-0.340). However, the effect of maternal Hb concentration on offspring's cognitive function was modified by stunting status (β, stunted: 0.44; 95%CI: 0.05-0.82; non-stunted: 0.01; 95%CI: -0.02-0.24). This study shows adverse cognitive outcomes at adolescent age are likely multi-causal and can be partially explained by intra-uterine exposure to low maternal Hb concentrations.
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Affiliation(s)
- Muhammad Asrullah
- Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
- Centre for Health Policy and Management, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Hastrin Hositanisita
- Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
- Departement of Nutrition, Faculty of Health Sciences, The University of Alma Ata, Yogyakarta, Indonesia
| | - Monique L'Hoir
- Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Siti Muslimatun
- Department of Food Science and Nutrition, Indonesia International Institute for Life Sciences, Jakarta, Indonesia
| | - Edith Jm Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
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Yusufu I, Cliffer IR, Yussuf MH, Anthony C, Mapendo F, Abdulla S, Masanja M, Tinkasimile A, Ali AS, Mwanyika-Sando M, Fawzi W. Factors associated with anemia among school-going adolescents aged 10-17 years in Zanzibar, Tanzania: a cross sectional study. BMC Public Health 2023; 23:1814. [PMID: 37723498 PMCID: PMC10508009 DOI: 10.1186/s12889-023-16611-w] [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: 12/13/2022] [Accepted: 08/24/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Anemia among adolescents (ages 10-19 years) is a leading cause of morbidity and mortality in low- and middle-income countries and carries long-term health and economic consequences. To address the issue, policymakers and programmers require evidence of the burden of anemia among adolescents in specific contexts, as well as an understanding of the factors associated with anemia in this population. METHODS We conducted a cross-sectional survey as a baseline assessment to determine the prevalence and factors associated with anemia in secondary school students, as part of a cluster-randomized effectiveness trial testing different micronutrient supplementation strategies in addressing anemia among adolescents in Zanzibar. Between March 7th to 25th, 2022 the survey was conducted on 2,479 school-going adolescents aged 10-17 years from 42 schools on the island of Zanzibar, Tanzania. Hemoglobin concentration was measured along with the collection of socio-demographics, health, food frequency, and water, sanitation and hygiene data. RESULTS Based on the World Health Organization cutoffs for anemia, 53.3% of the sample had anemia (mild, moderate, or severe). Using chi-square tests and logistic regressions, we determined that females had higher odds of anemia than males (Adjusted OR = 1.47; 95% CI: 1.24, 1.74), those in the highest wealth quintile had lower odds of anemia than those in the lowest wealth quintile (Adjusted OR = 0.7; CI: 0.54, 0.91), stunted adolescents had higher odds of anemia than non-stunted students (Adjusted OR = 1.38; 95% CI: 1.06,1.81), and those who used shared toilets had higher odds of moderate or severe anemia than those with private toilet access (Adjusted OR = 1.68; CI: 1.07, 2.64). CONCLUSIONS The high prevalence of anemia in this sample indicates an urgent need to address anemia among adolescents in Zanzibar, and the factors associated with anemia point to the importance of water, sanitation, and hygiene interventions in addition to dietary and nutritional support. TRIAL REGISTRATION NCT05104554, registered 03/11/2021.
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Affiliation(s)
| | - Ilana R Cliffer
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, 90 Smith Street, 3rd Floor, Boston, MA, United States of America.
| | | | | | - Frank Mapendo
- Africa Academy for Public Health, Dar es Salaam, Tanzania
| | - Seif Abdulla
- Zanzibar Association for People Living with HIV/AIDS, Unguja, Zanzibar, Tanzania
| | - Mary Masanja
- Africa Academy for Public Health, Dar es Salaam, Tanzania
| | | | - Ali Salim Ali
- Zanzibar Association for People Living with HIV/AIDS, Unguja, Zanzibar, Tanzania
| | | | - Wafaie Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, 90 Smith Street, 3rd Floor, Boston, MA, United States of America
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11
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Khusun H, Anggraini R, Februhartanty J, Mognard E, Fauzia K, Maulida NR, Linda O, Poulain JP. Breakfast Consumption and Quality of Macro- and Micronutrient Intake in Indonesia: A Study from the Indonesian Food Barometer. Nutrients 2023; 15:3792. [PMID: 37686824 PMCID: PMC10489646 DOI: 10.3390/nu15173792] [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: 07/18/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Breakfast is an important meal that has been shown to have a positive effect on health. The current study aimed to assess the patterns of breakfast consumption among adult Indonesians and to estimate the contribution of breakfast to their nutrient intake and dietary quality. The study used 24-h recall data from the 2018 Indonesian Food Barometer study to assess breakfast intake among 1333 adults aged 18 and above from six provinces in Indonesia. Diet quality was measured using the Nutrient Rich Food index (NRF) 9.3, and the nutritional profile of breakfast was compared across tertiles of NRF 9.3. In total, 5.2% of adults in Indonesia skipped breakfast. Breakfast contributed 26% to daily energy intakes and 22-28% to intakes of all reported nutrients, except for total sugar (12%), vitamin C (8%) and vitamin D (7%). With respect to daily requirements, breakfast contributed approximately 20% to energy, protein, fat and sodium requirements, 26% to saturated fat but <15% to the requirements for most micronutrients and only 5% for fiber. Among breakfast consumers, a higher NRF score was associated with higher daily intakes of protein, dietary fiber and micronutrients and lower intakes of sodium from breakfast. This study suggests that a balanced breakfast in Indonesia should aim to lower fat and saturated fat intake while increasing fiber, potassium, calcium and vitamin C and D intake. These findings could inform the development of nutrient-based guidelines for breakfast consumption in Indonesia.
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Affiliation(s)
- Helda Khusun
- Faculty of Health Sciences, University of Muhammadiyah Prof. Dr. HAMKA, Jakarta 12130, Indonesia; (N.R.M.); (O.L.)
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON)—Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta 13120, Indonesia; (R.A.); (J.F.); (K.F.)
- Nutrition Department, Faculty of Medicine, Universitas Indonesia—Dr. Cipto Mangunkusumo General Hospital, Jakarta 10430, Indonesia
| | - Roselynne Anggraini
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON)—Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta 13120, Indonesia; (R.A.); (J.F.); (K.F.)
| | - Judhiastuty Februhartanty
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON)—Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta 13120, Indonesia; (R.A.); (J.F.); (K.F.)
- Nutrition Department, Faculty of Medicine, Universitas Indonesia—Dr. Cipto Mangunkusumo General Hospital, Jakarta 10430, Indonesia
| | - Elise Mognard
- Chair “Food Studies: Food, Cultures & Health”, Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia; (E.M.)
- Centre for Asian Modernisation Studies (CAMS), Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia
- Faculty of Social Sciences and Leisure Management, Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia
- Centre d’Études et de Recherche: Travail, Organisation, Pouvoir (CERTOP) UMR CNRS 5044, Université de Toulouse (France), 31000 Toulouse, France
| | - Khalida Fauzia
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON)—Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta 13120, Indonesia; (R.A.); (J.F.); (K.F.)
| | - Nursyifa Rahma Maulida
- Faculty of Health Sciences, University of Muhammadiyah Prof. Dr. HAMKA, Jakarta 12130, Indonesia; (N.R.M.); (O.L.)
| | - Ony Linda
- Faculty of Health Sciences, University of Muhammadiyah Prof. Dr. HAMKA, Jakarta 12130, Indonesia; (N.R.M.); (O.L.)
| | - Jean-Pierre Poulain
- Chair “Food Studies: Food, Cultures & Health”, Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia; (E.M.)
- Centre for Asian Modernisation Studies (CAMS), Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia
- Faculty of Social Sciences and Leisure Management, Taylor’s University (Malaysia), Subang Jaya 47500, Malaysia
- Centre d’Études et de Recherche: Travail, Organisation, Pouvoir (CERTOP) UMR CNRS 5044, Université de Toulouse (France), 31000 Toulouse, France
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Mirrafiei A, Hasanzadeh M, Sheikhhossein F, Majdi M, Djafarian K, Shab-Bidar S. Association of main meal quality index with the odds of metabolic syndrome in Iranian adults: a cross-sectional study. BMC Nutr 2023; 9:55. [PMID: 36945062 PMCID: PMC10031905 DOI: 10.1186/s40795-023-00711-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 03/14/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a common global issue linked to the quality of one's eating occasions. The current cross-sectional study evaluates the association between a novel index, the Main Meal Quality Index (MMQI), and MetS among Iranian adults. METHODS A total of 824 men and women were recruited, and a 24-hour dietary recall assessed the dietary intake of the participants. Lunch was selected as the main meal based on energy density. The MMQI score was calculated based on ten components of dietary intake, with a higher score indicating more adherence to the index, with the final scores ranging from 0 to 100 points. The associations were assessed using binary logistic regression. RESULTS The mean age was 42.2 years and the range of the calculated MMQI was 22 to 86 (mean in total participants: 56.62, mean in women: 56.82, mean in men: 55.64). The total prevalence of MetS in the sample was 34%. After adjustments for potential confounders, the participants at the top quartile of MMQI had a lower odds ratio for hypertriglyceridemia and low high-density lipoprotein (HDL) level, and a higher odds ratio for hypertension, hyperglycemia, abdominal obesity, and MetS. The sex-specific analysis also did not show any significant associations between adherence to MMQI and MetS and its components. CONCLUSION Overall, MMQI is not associated with MetS and its components in a sample of Iranian men and women. More research is needed to examine MMQI and its possible association with current health-related problems including MetS.
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Affiliation(s)
- Amin Mirrafiei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), 14167-53955, Tehran, Iran
| | - Mohaddeseh Hasanzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), 14167-53955, Tehran, Iran
- Nutritional Health Team (NHT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), 14167-53955, Tehran, Iran
| | - Maryam Majdi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), 14167-53955, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), 14167-53955, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), 14167-53955, Tehran, Iran.
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, P. O. Box 14155/6117, Tehran, Iran.
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13
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Abebe T, Mezgebu GS, Feleke FW, Tamrat M. Dietary diversity and associated factors among adolescent girls in Nifas Silk Laphto sub city, Addis Ababa, Ethiopia, 2021. BMC Nutr 2023; 9:39. [PMID: 36882819 PMCID: PMC9990237 DOI: 10.1186/s40795-023-00693-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 02/24/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Addressing the nutritional problems of adolescent girls is important as their nutritional status has a negative effect on the future generation. However, the evidence revealed the variation and unrelated data on the prevalence of dietary diversity and lack of including all adolescent age and community groups in Ethiopia. Hence, this study assessed dietary diversity and associated factors among adolescent girls in Nifas Silk Laphto Sub-city, Addis Ababa Ethiopia, 2021. METHODS A community-based cross-sectional study was conducted among 475 adolescent girls at Nifas Silk Laphto sub-city, Addis Ababa Ethiopia from July 1 to 30, 2021. Multistage cluster sampling was employed to select adolescent girls. Pretested questionnaires were used to collect the data. The data were checked for completeness and entered by Epidata version 3.1 and cleaned and analyzed by SPSS version 21.0. A multivariable binary logistic regression model was fitted to identify factors associated with dietary diversity scores. The degree of association was assessed using an odds ratio with a 95% confidence interval and variables with p-value ≤ 0.05 were considered significant. RESULT The mean and the standard deviation of dietary diversity scores were 4.70 and 1.21 respectively. The proportion of low dietary diversity scores among adolescent girls was 77.2%. Adolescent girls' age, meal frequency, wealth index of household, and food insecurity were significant determinants of dietary diversity score. CONCLUSION The magnitude of low dietary diversity scores was significantly higher in the study area. Adolescent girls', meal frequency, wealth index, and food security status were predictors of dietary diversity score. School-based nutrition education and counseling and designing strategies for improving household food security programs are crucial.
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Affiliation(s)
- Tarik Abebe
- Faculity of Public Health, Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
| | - Getachew Sale Mezgebu
- Faculity of Public Health, Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia. .,School of Nutrition, Food Science and Technology, Hawassa, University, Hawassa, Ethiopia.
| | - Fentaw Wassie Feleke
- School of Nutrition, Food Science and Technology, Hawassa, University, Hawassa, Ethiopia.,College of Medicine and Health Science, Woldia University, Woldia, Ethiopia
| | - Meseret Tamrat
- Faculity of Public Health, Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
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14
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Teng Y, Jing H, Chacha S, Wang Z, Huang Y, Yang J, Yan H, Dang S. Maternal Dietary Diversity and Birth Weight in Offspring: Evidence from a Chinese Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3228. [PMID: 36833922 PMCID: PMC9960126 DOI: 10.3390/ijerph20043228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
Studies on the association between maternal dietary diversity and birth weight in offspring are limited, and the impact of such an adjustable factor on birth weight requires investigation to promote neonatal health. This study used data from a larger-scale population-based survey conducted in northwest China to evaluate the association of maternal dietary diversity with neonatal birth weight with a generalized estimating equation model. The results found that maternal dietary diversity was positively associated with neonate birth weight. Furthermore, a higher minimum dietary diversity for women (MDD-W) score during pregnancy was related to a lower risk of low birth weight (LBW) in offspring. The mothers with the highest MDD-W score had a 38% (OR = 0.62, 95% CI: 0.43-0.89) lower risk of LBW than those with the lowest score. Similarly, the mothers with the highest animal-based food dietary diversity score (DDS) had 39% (OR = 0.61, 95% CI: 0.38-0.98) lower risk of LBW in offspring compared with those with the lowest animal-based food DDS. Moreover, the ratio of animal-based food DDS to non-animal-based food DDS could play an important role in predicting neonate birth weight. In conclusion, increasing maternal dietary diversity would improve birth weight in offspring, especially by increasing the intake of animal-based foods among the Chinese population.
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Affiliation(s)
| | | | | | | | | | | | | | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China
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Tsegaye Negash B, Ayalew M. Trend and factors associated with anemia among women reproductive age in Ethiopia: A multivariate decomposition analysis of Ethiopian Demographic and Health Survey. PLoS One 2023; 18:e0280679. [PMID: 36689422 PMCID: PMC9870172 DOI: 10.1371/journal.pone.0280679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/20/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND In developing countries like Ethiopia, anemia is a public health problem. Unfortunately, the progress of anemia reduction has been slow. Although the issue of anemia has received considerable critical attention nowadays, trends and factors associated with anemia among women of reproductive age have not been explored in Ethiopia. OBJECTIVE This study aimed to determine trends and factors associated with anemia among women of reproductive age in Ethiopia from 2005 to 2016. METHOD Data from three consecutive Ethiopian Demographic and Health Survey (EDHS) from 2005-2016 were analyzed in this study. EDHS is a two-stage cluster sampling survey. Data were weighted to correct sampling bias in all surveys. A total of 46,268 samples were analyzed using a fixed effect model. For a measure of proportion, differences and slopes were computed. Bivariate and multivariable logistic regression analyses were done to identify predictors of the trend of anemia among women. Adjusted odds ratio (AOR) with a 95% Confidence Interval(CI) was computed, and the p-value < 0.05 is considered significant. RESULT Prevalence of anemia among women was 68%, 20.3%, and 27.3% in 2005, 2011 and 2016, respectively. The trend of anemia was reduced by 47.7 percentage points from 2005 to 2011; however, it increased by 7% points again from 2011 in 2016. Lack of mobile phones (AOR = 1.4, 95%CI, 1.2,1.6), Afar women (AOR = 1.5, 95%CI, 1.1,2.3) and Somali women (AOR = 1.5, 95%CI, 1.1,1.9) were associated with anaemia among women. On the contrary, the history of heavy menstruation in the last six months (AOR = 0.9; 95%CI, 0.85,0.98) was a factor negatively associated with anemia in 2005. In 2011, single women (AOR = 0.8,95%CI,0.7,0.9), watching TV less than once per wk (AOR = 0.9,95%CI,0.7,0.95), watching TV at least once per week (AOR = 0.8,95%CI,0.7,0.98) were variables associated with anemia. On the contrary, widowed women (AOR = 1.7,95%CI,1.4,2.0) were affected by anemia. In 2016, the richest women (AOR = 0.7, 95%CI, 0.6,0.8) and single (AOR = 0.8, 95%CI, 0.7,0.9) were affected little by anemia. Women of traditional belief followers (AOR = 2.2,95%CI,1.6,2.9) were more highly influenced by anemia than their counterparts. CONCLUSION The prevalence of anemia declined rapidly from 2005 to 2011, and increased from 2011 to 2016. Stakeholders should develop policies and programs to enhance the socio-demographic status of women and basic infrastructure for the community. Furthermore, they should design strategies for extensive media coverage of the prevention of anemia. The federal government should balance the proportion of anemia among regions by ensuring health equality.
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Affiliation(s)
- Berhan Tsegaye Negash
- Department of Midwifery, College of Medicine and Health sciences, Hawassa University, Hawassa, Ethiopia
| | - Mohammed Ayalew
- Department of Psychatric Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Kumar SB, Arnipalli SR, Mehta P, Carrau S, Ziouzenkova O. Iron Deficiency Anemia: Efficacy and Limitations of Nutritional and Comprehensive Mitigation Strategies. Nutrients 2022; 14:nu14142976. [PMID: 35889932 PMCID: PMC9315959 DOI: 10.3390/nu14142976] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 12/16/2022] Open
Abstract
Iron deficiency anemia (IDA) has reached epidemic proportions in developing countries and has become a major global public health problem, affecting mainly 0–5-year-old children and young women of childbearing age, especially during pregnancy. Iron deficiency can lead to life-threatening loss of red blood cells, muscle function, and energy production. Therefore, the pathogenic features associated with IDA are weakness and impaired growth, motor, and cognitive performance. IDA affects the well-being of the young generation and the economic advancement of developing countries, such as India. The imbalance between iron intake/absorption/storage and iron utilization/loss culminates into IDA. However, numerous strategic programs aimed to increase iron intake have shown that improvement of iron intake alone has not been sufficient to mitigate IDA. Emerging critical risk factors for IDA include a composition of cultural diets, infections, genetics, inflammatory conditions, metabolic diseases, dysbiosis, and socioeconomic parameters. In this review, we discuss numerous IDA mitigation programs in India and their limitations. The new multifactorial mechanism of IDA pathogenesis opens perspectives for the improvement of mitigation programs and relief of IDA in India and worldwide.
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Zou M, Northstone K, Perry R, Johnson L, Leary S. The association between later eating rhythm and adiposity in children and adolescents: a systematic review and meta-analysis. Nutr Rev 2022; 80:1459-1479. [PMID: 34643727 PMCID: PMC9086801 DOI: 10.1093/nutrit/nuab079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
CONTEXT Childhood adiposity, an important predictor of adult chronic disease, has been rising dramatically. Later eating rhythm, termed night eating, is increasing in adults but rarely studied in younger ages. OBJECTIVE The objective of this study was to review the association between later eating rhythm and adiposity in children and adolescents. The aspects of later eating being considered included: energy intake (for evening main meal, evening snack, whole evening period, and around bedtime); timing (any food eaten at later timing); and meal frequency in the evening/night (evening main meal skipping, evening snack consumption). DATA SOURCES Five databases (the Cochrane Library, CINAHL, Embase, MEDLINE (via OVID), and Web of Science) were searched for eligible articles published prior to and including August 2020. DATA EXTRACTION Data extraction and quality assessment were conducted by 2 reviewers independently. DATA ANALYSIS Forty-seven studies were included, all of which were observational. Meta-analysis showed positive associations between both higher energy intake around bedtime (odds ratio [OR] 1.19, 95% CI 1.06, 1.33) and evening main meal skipping (OR 1.30, 95% CI 1.14, 1.48), and adiposity. There was evidence to suggest that consuming evening snacks reduced adiposity, but it was very weak (OR 0.80, 95% CI 0.62, 1.05). No association was seen between eating later and adiposity (OR 1.04, 95% CI 0.68, 1.61). In the narrative analysis, approximately half of the studies suggested that there was no association between later eating rhythm and adiposity, either as a whole or within exposure subsets. CONCLUSION The magnitude of the relationship between later eating rhythm and adiposity is very small, and may vary depending on which aspects of later eating rhythm are under consideration; however, the evidence for this conclusion is of very low certainty . Further research with a more consistent definition of "later timing", and longitudinal studies in different populations, may lead to different conclusions. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42019134187.
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Affiliation(s)
- Mengxuan Zou
- NIHR Biomedical Research Centre Nutrition Theme, University of Bristol, Bristol, United Kingdom
| | - Kate Northstone
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Rachel Perry
- NIHR Biomedical Research Centre Nutrition Theme, University of Bristol, Bristol, United Kingdom
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Sam Leary
- NIHR Biomedical Research Centre Nutrition Theme, University of Bristol, Bristol, United Kingdom
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Lowe C, Sarma H, Kelly M, Kurscheid J, Laksono B, Amaral S, Stewart D, Gray D. Association of soybean-based food with the prevalence of anaemia among reproductive-aged men and women in rural Central Java, Indonesia. Public Health Nutr 2021; 25:1-9. [PMID: 34957940 PMCID: PMC9991750 DOI: 10.1017/s1368980021005000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/08/2021] [Accepted: 12/21/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the association between soybean consumption and anaemic status in Central Java, Indonesia. DESIGN As part of an overarching sanitation improvement intervention in Central Java, Indonesia, we conducted a cross-sectional study in four rural villages. The study consisted of a 24-h food recall, anthropometric measurements, blood Hb measurement and stool sampling to test for soil-transmitted helminth (STH) infection status. A binary logistic regression model was fitted to test the association between soybean consumption and anaemic status after adjusting for socio-demographic factors, STH infection, dietary diversity and anthropometric status. SETTING This study took place in four rural villages of Wonosobo regency, Central Java, Indonesia. PARTICIPANTS Participants were rural villagers aged between 15 and 49 years. RESULTS A total sample size of 763 was attained, of which 231 were anaemic. The prevalence of anaemia was 30·2 % among men and women of reproductive age, and highest among young males. Consumption of soybean was high (79·8 %). After adjusting for covariates, the protective association between soybean consumption and anaemia was statistically significant (AOR = 0·53, 95 % CI = 0·30, 0·95, P < 0·05). There was a positive association with anaemia among underweight (AOR = 2·75, 95 % CI = 1·13, 6·69, P < 0·05) and those with high diet diversity (AOR = 1·40, 95 % CI = 1·00, 1·97, P < 0·05). CONCLUSIONS Our results were consistent with studies from other countries finding a protective association between soybean consumption and anaemia. This association appeared stronger for tofu than for tempeh. The prevalence of anaemia in rural Central Java is relatively consistent with nation-wide statistics indicating that interventions targeting anaemia are still largely required.
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Affiliation(s)
- Callum Lowe
- Australian National University, Acton2601, Australia
| | | | - Matthew Kelly
- Australian National University, Acton2601, Australia
| | - Johanna Kurscheid
- Australian National University, Acton2601, Australia
- Swiss Tropical and Public Health Institute, Basel4051, Switzerland
| | - Budi Laksono
- Universitas Diponegoro, Semarang50275, Indonesia
| | | | - Donald Stewart
- Australian National University, Acton2601, Australia
- Griffith University, South Brisbane, QLD, Australia
| | - Darren Gray
- Australian National University, Acton2601, Australia
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19
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Agustina R, Rianda D, Setiawan EA. Relationships of Child-, Parents-, and Environment-Associated Determinants with Diet Quality, Physical Activity, and Smoking Habits among Indonesian Urban Adolescents. Food Nutr Bull 2021; 43:44-55. [PMID: 34670443 DOI: 10.1177/03795721211046145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The trend of unhealthy lifestyles is increasing among adolescents and has been associated with the rising burden of noncommunicable diseases (NCDs). However, specific determinants of unhealthy lifestyles among adolescents in low- and middle-income countries remain limited. OBJECTIVE To investigate the relationships of child-, parents-, and environment-associated determinants with diet quality, physical activity, and smoking habits among low-socioeconomic urban adolescents. METHODS A cross-sectional study involving 238 adolescents aged 11 to 17 years was conducted in Jakarta, Indonesia. Adolescents and their parents were interviewed to assess the determinants of healthy lifestyles that included diet quality, physical activity, and smoking habits. Diet and physical activity were quantified using the Diet Quality Index for Adolescents (DQI-A) and Physical Activity Questionnaire for Older Children (PAQ-C), respectively. Multiple regression was used to determine the β coefficients and odds ratios predictive of healthy lifestyles. RESULTS Mean scores of DQI-A and PAQ-C were considered low (33.5% ± 8.9% and 2.1 ± 0.5, respectively). Overall, 17.6% of adolescents were smokers, with 88% of these being males. Predictors of diet quality were child- (age, gender) and environment-associated (house size, access to a computer) determinants with β coefficients of -6.52 to 3.26. The PAQ-C score was associated with child- (female) and environment-associated (living area) determinants with β coefficients of -0.45 and 0.14, respectively. Younger adolescents and females were protective factors for smoking. Parents-associated determinants were not associated with any lifestyle indicators. CONCLUSIONS Child- and environment-associated determinants were predictors of healthy lifestyles among adolescents. Thus, personal empowerment and environment transformation are needed to facilitate a healthy lifestyle and reduce the burden of NCDs among adolescents.
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Affiliation(s)
- Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.,Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Davrina Rianda
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.,Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Evania Astella Setiawan
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
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20
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Shinde S, Madzorera I, Fawzi WW. Association of iron supplementation and dietary diversity with nutritional status and learning outcomes among adolescents: Results from a longitudinal study in Uttar Pradesh and Bihar, India. J Glob Health 2021; 11:04037. [PMID: 34386214 PMCID: PMC8325919 DOI: 10.7189/jogh.11.04037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Poor nutritional status and educational outcomes are associated with adverse health consequences throughout the life course. OBJECTIVES We examined the associations of sex, iron and folic acid (IFA) supplementation, deworming, and dietary diversity with nutritional status and learning outcomes among Indian adolescents. METHODS Data of 12 035 adolescents from two rounds (2015-16 and 2018-19) of the Understanding the Lives of Adolescents and Young Adults surveys in Uttar Pradesh and Bihar, India were used. Multivariate linear and logistic regression models were used to estimate the prospective relationships of explanatory variables in the first round of the survey with nutritional status (ie, hemoglobin, BMI- and height-for-age z-scores, and incidence of anemia, stunting, and underweight) and learning outcomes (ie, reading proficiency, math proficiency, and school dropout) in the second round of the survey. The multivariable models were adjusted for a range of confounders, clustering by the population sampling unit and sampling weights. RESULTS Girls had a lower hemoglobin (adjusted mean difference (aMD) = -2.07; 95% confidence interval (CI) = -2.20, -1.94; P < 0.001) and height-for-age z-score (aMD = -0.45; 95% CI = -0.53, -0.38; P < 0.001) and higher BMI-for-age z-score (aMD = 0.36; 95% CI = 0.27, 0.44; P < 0.001) compared to boys. Girls had poorer reading (adjusted odds ratio (aOR) = 0.81; 95% CI = 0.70, 0.95; P = 0.01) and math proficiency (adjusted odds ratio aOR = 0.36; 95% CI = 0.31, 0.42; P < 0.001), and increased risk of school dropout (aOR = 1.65; 95% CI = 1.40, 1.95; P < 0.001) than boys. Receiving IFA tablets was not significantly associated with hemoglobin levels of adolescents overall, however we noted a significant beneficial relationship among girls (aMD = 0.41; 95% CI = 0.00, 0.82) but not among boys (aMD = 0.02; 95% CI = -0.38, 0.43) (P for interaction = 0.09). Receiving IFA tablets was positively associated with reading proficiency (aOR = 1.47; 95% CI = 1.07, 2.01; P = 0.02), math proficiency (aOR = 1.51; 95% CI = 1.16, 1.98; P < 0.001) and a reduced risk of school dropout (aOR = 0.72; 95% CI = 0.54, 0.96; P = 0.03). Deworming was not associated with nutritional status and learning outcomes. Diverse dietary intake was positively associated with hemoglobin, height-for-age z-score and math proficiency, and a reduced risk of school dropout in adolescents. CONCLUSION Integrated nutritional and health interventions and strengthening the existing nutrition supplementation program are critical to address adolescents' nutritional needs and improve educational outcomes.
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Affiliation(s)
- Sachin Shinde
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Center for Inquiry into Mental Health, Pune, India
| | - Isabel Madzorera
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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21
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Rachmadewi A, Soekarjo D, Maehara M, Alwi B, Mulati E, Rah JH. School Canteens in Selected Areas in Indonesia: A Situation Analysis. Food Nutr Bull 2021; 42:225-246. [PMID: 34282661 DOI: 10.1177/03795721211008021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The school canteen has a massive impact on the dietary intake and nutritional status of school-age children and adolescents. This study aimed at assessing the current situation of school canteens in selected areas in Indonesia and relevant knowledge, attitudes, and behaviors of school-going children and adolescents. METHODS A qualitative study was implemented in a purposive sample of 18 schools in Klaten and West Lombok districts with 2 comparison schools in Jakarta and Klaten. Focus group discussions and in-depth interviews were conducted with a wide range of stakeholders to collect information on nutrition knowledge, food preferences, related policies and governance, and opinions toward school canteens. Data were analyzed using thematic synthesis and narrative analysis. RESULTS Specific government guidelines on healthy foods and beverages to be sold in canteens are not yet in place. Many canteens had inadequate infrastructure and were managed informally, with limited rules, monitoring, and supervision. Although healthy options including vegetables and fruits were available in most canteens, unhealthy foods and beverages were abundant and cheap. Lack of awareness of the importance of nutrition of school-age children and adolescents was pervasive among all stakeholders. Personal preference and availability were main drivers of the students' food choices. CONCLUSIONS Concerted multisectoral and multistakeholders' efforts are warranted to improve the quality of school canteens in Indonesia by developing a comprehensive relevant guideline, improving the capacity of related stakeholders and service providers, enhancing the implementation and monitoring, and generating demand for healthy canteens.
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Affiliation(s)
| | | | | | | | - Erna Mulati
- Directorate of Family Health, 106265Ministry of Health, Republic of Indonesia
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22
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Agustina R, Wirawan F, Sadariskar AA, Setianingsing AA, Nadiya K, Prafiantini E, Asri EK, Purwanti TS, Kusyuniati S, Karyadi E, Raut MK. Associations of Knowledge, Attitude, and Practices toward Anemia with Anemia Prevalence and Height-for-Age Z-Score among Indonesian Adolescent Girls. Food Nutr Bull 2021; 42:S92-S108. [PMID: 34282657 DOI: 10.1177/03795721211011136] [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: 11/17/2022]
Abstract
BACKGROUND Crucial gaps persist in knowledge, attitude, and practice (KAP) of adolescent girls that affect anemia and linear growth failure. OBJECTIVE To understand the role of KAP as a risk factor of anemia and linear growth problem in adolescent girls. METHODS We conducted a cross-sectional survey of 335 adolescent girls selected by clustered random sampling. The KAP questionnaire had 18 variables consisting of 9 knowledge, 3 attitude, and 6 practice components. Twelve variables addressed nutrition, dietary diversity, and health environments related to both anemia and stunting. The questionnaire was adapted from the 2014 Food and Agriculture Organization nutrition-related KAP guidelines for anemia. Dietary practice was evaluated from 2-day 24-hour recalls and a semi-quantitative food-frequency questionnaire. Associations between KAP and anemia, and height-for-age z-score (HAZ), were analyzed using multivariate logistic and linear regression models, respectively. RESULTS The mean hemoglobin (Hb) level was 119.7 g/L, with 44% of the adolescent girls being anemic (Hb < 120 g/L) and mean height was 151.0 cm with 25% being stunted (HAZ < -2 standard deviation [SD]). The median KAP score was 7 and ranged from 3 to 10. Low to moderate KAP scores were not significantly associated with being anemic (adjusted odds ratio [AOR] = 1.26; P = .43), however 1-point KAP score increment was associated with an increase of HAZ by 0.037 SD (P = .012). CONCLUSIONS The KAP related to diet and healthy environments was not associated with anemia prevalence, but was positively associated with increased HAZ among adolescent girls. Strategy to reduce anemia risk in this population should combine KAP improvement with other known effective nutrition interventions.
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Affiliation(s)
- Rina Agustina
- Department of Nutrition, 95338Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.,Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), 95338Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Fadila Wirawan
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), 95338Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Arini A Sadariskar
- Medical Study Program, 95338Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Ainanur A Setianingsing
- Medical Study Program, 95338Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Khairun Nadiya
- Medical Study Program, 95338Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Erfi Prafiantini
- Department of Nutrition, 95338Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.,Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), 95338Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Eriana K Asri
- Nutrition International Country Office, Jakarta, Indonesia
| | | | - Sri Kusyuniati
- Nutrition International Country Office, Jakarta, Indonesia
| | - Elvina Karyadi
- Former Nutrition International Country Office, Jakarta, Indonesia
| | - Manoj K Raut
- Nutrition International, Asia Regional Office, New Delhi, India
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23
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Hayuningtyas A, Dewi YA, Octavia L, Pulungan A, Agustina R. Dietary quality score is positively associated with serum adiponectin level in Indonesian preschool-age children living in the urban area of Jakarta. PLoS One 2021; 16:e0246234. [PMID: 33539478 PMCID: PMC7861444 DOI: 10.1371/journal.pone.0246234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 01/18/2021] [Indexed: 11/23/2022] Open
Abstract
An unhealthy diet during childhood directly impacts the risk of developing noncommunicable diseases (NCDs) later on in life. However, well-documented information on this issue is lacking. We investigated the dietary quality of young Indonesian children and assessed the relationship to serum adiponectin levels as an early marker of NCDs. Eighty-five (44 girls and 41 boys) Indonesian preschool-age children in East Jakarta were included in this study. Dietary intake data were gathered by collecting repeated 24-hour recalls for one weekday and one day during the weekend, which were then further converted into participants' Healthy Eating Index (HEI) 2015 scores. Meanwhile, an enzyme-linked immunosorbent assay was performed to determine the serum adiponectin level. A multiple regression analysis was performed to assess the association between the HEI 2015 score and serum adiponectin, adjusting for potential confounders. The mean HEI 2015 score was 33.2 ± 8.3 points, which was far below the recommended score of ≥ 80 points, while the mean serum adiponectin was 10.3 ± 4.1 μg/mL. Multiple linear regression testing showed that a one-point increase in the HEI 2015 score was significantly associated with an increase in the serum adiponectin level by 0.115 μg/mL after adjusting for exclusive breastfeeding history (β = 0.115; 95% CI = 0.010-0.221; p = 0.032). In conclusion, better adherence of young children to a healthy diet has a positive association with their adiponectin level. This result suggests that strengthening children's dietary quality from an early age by involving all parties in the children's environment (e.g., parents, teachers at school, policymakers) may help to reduce the risk of NCDs later on in childhood and during adult life.
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Affiliation(s)
- Anastasia Hayuningtyas
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia—Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Yayang Aditia Dewi
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia—Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Lestari Octavia
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia—Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Aman Pulungan
- Department of Child Health, Faculty of Medicine, Universitas Indonesia—Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia—Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Centre, Indonesia Medical Education and Research Institute Indonesia, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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24
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Associations of maternal diet quality with weight gain during pregnancy and obesity at three-year postpartum in Jakarta. PLoS One 2020; 15:e0244449. [PMID: 33382776 PMCID: PMC7775051 DOI: 10.1371/journal.pone.0244449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 12/10/2020] [Indexed: 11/24/2022] Open
Abstract
Dietary changes during pregnancy (DP) and post-partum are essential for women’s nutrition status and the health of their offspring. We compared the diet quality DP and at 3-year post-partum (3YPP) and assessed the relationship between maternal diet quality and nutritional status using a prospective cohort design among women in East Jakarta. In total, 107 women were recruited from the study in 2014 and followed up at 3YPP in 2018. The mid-upper arm circumference (MUAC), weight, and height were evaluated. Food consumption data were collected from repeated 24-h recalls. The validated US Diet Quality Index-Pregnancy (DQI-P) scores with eight components were calculated using the food consumption data and compared between DP and 3YPP. Associations of the DQI-P score with the MUAC and weight gain DP and body mass index (BMI) at 3YPP were analyzed using multivariable linear and logistic regression. The median of the DQI-P score DP was significantly higher than at 3YPP [35 (27; 42) versus 27 (19; 30); p-value <0.001, respectively]. The higher DQI-P score was associated with increased weight gain DP of 3.3 kg (adjusted β = 3.30, 95% confidence interval = 1.06–5.54) after adjusting for the mother's age and household income. The DQI-P score was not associated with an increased risk of chronic energy deficiency DP and overweight–obesity at 3YPP. Thus, the diet adequacy was associated with weight gain DP but did not affect the MUAC DP and BMI at 3YPP. The DQI-P score DP was slightly better than the diet at 3YPP; however, the overall diet quality was inadequate. In conclusion, a higher DQI-P score was associated with increased weight gain DP of 3.3 kg but was not associated with other nutritional status indices in DP and 3YPP. Innovative dietary quality improvement programs are required to reduce malnutrition risk in pregnant and reproductive-age women.
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