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Bell V, Rodrigues AR, Ferrão J, Varzakas T, Fernandes TH. The Policy of Compulsory Large-Scale Food Fortification in Sub-Saharan Africa. Foods 2024; 13:2438. [PMID: 39123628 PMCID: PMC11312076 DOI: 10.3390/foods13152438] [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: 07/05/2024] [Revised: 07/27/2024] [Accepted: 07/28/2024] [Indexed: 08/12/2024] Open
Abstract
Food fortification with micronutrients was initially justified in developed countries by a lack of availability of micronutrients in staple crops, mainly due to soil exhaustion. However, in Sub-Saharan arable lands, soil fatigue is not predominant, and communities consume mostly home-grown, organic, non-processed crops. Sub-Saharan food systems are nevertheless deeply entwined with food insecurity, driver of illnesses. Family production can promote subsistence, food stability, and self-sufficiency, the main SSA setback being the vicious cycle of poverty and the lack of dietary variety, contributing to malnutrition. Poverty reduction and women's education are significant strategies for reducing child and adolescent undernourishment. Fortification of foods consumed daily by individuals makes sense and can minimize, if not entirely, eliminate deficiencies. Compulsory mass fortification of foods in Sub-Saharan Africa (SSA) with single micronutrients is, however, controversial since they work in synergy among each other and with the food matrix, for optimal absorption and metabolism. Since the causes of malnutrition are many, caused by diverse, unequal, and unjust food distribution, interrelated with political, social, cultural, or economic factors, education status of the population, season and climatic changes, and effectiveness of nutrition programs, just food fortification cannot solve the composite of all these elements. Further, compulsory fortification is excessive, unproductive, and likely harmful to human health, while many challenges remain in assessing the quality of available premixes. Furthermore, aiming at dietary diversification is the best approach of increasing trace element intake from commonly accessible and easily available food sources.
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Affiliation(s)
- Victoria Bell
- Faculty of Pharmacy, University of Coimbra, Polo das Ciências da Saúde, Azinhaga de Stª Comba, 3000-548 Coimbra, Portugal; (V.B.)
- REQUIMTE/LAQV, Group of Pharmaceutical Technology, University of Coimbra, Polo das Ciências da Saúde, Azinhaga de Stª Comba, 3000-548 Coimbra, Portugal
| | - Ana Rita Rodrigues
- Faculty of Pharmacy, University of Coimbra, Polo das Ciências da Saúde, Azinhaga de Stª Comba, 3000-548 Coimbra, Portugal; (V.B.)
| | - Jorge Ferrão
- Vice-Chancellor Office, Universidade Pedagógica de Maputo, Rua João Carlos Raposo Beirão 135, Maputo 1000-001, Mozambique;
| | - Theodoros Varzakas
- Food Science and Technology, University of the Peloponnese, GR-22100 Kalamata, Greece
| | - Tito H. Fernandes
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
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Normande MMEM, da Silva LC, de Menezes RCE, Florêncio TMDMT, Clemente APG. Association of parental level of education and child factors on length-for-age indicator among socially vulnerable children aged 6-24 months from a Brazilian state using structural equation modelling. Br J Nutr 2024:1-8. [PMID: 38804182 DOI: 10.1017/s0007114524001119] [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: 05/29/2024]
Abstract
This cross-sectional study employs structural equation modelling (sEM) to explore both direct and indirect effects of parental level of education and child individual factors on the length-for-age outcomes in children aged 6-24 months assisted by the Bolsa Família Program in the State of Alagoas. A total of 1448 children were analysed by the sEM technique. A negative standardised direct effect (sDE) of the children's younger age (sDE: -0·06; P = 0·017), the use of bottle feeding (sDE: -0·11; P < 0·001) and lack of a minimum acceptable diet (sDE: -0·09; P < 0·001) on the length-for-age indicator was found. Being female (SDE: 0·08; P = 0·001), a higher birth weight (SDE: 0·33; P < 0·001), being ever breastfed (sdE: 0·07; P = 0·004) and a higher level of parental education (SDE: 0·09; P < 0·001) showed a positive SDE effect on the child's length-for-age. The model also demonstrated a negative standardised indirect effect (SIE) of the sweet beverage consumption (SIE: -0·08; P = 0·003) and a positive effect of being ever breastfed (SIE: 0·06; P = 0·017) on the child's length-for-age through parental level of education as a mediator. This research underscores the crucial role of proper feeding practices and provides valuable insights for the development of targeted interventions, policies and programmes to improve nutritional well-being and promote adequate linear growth and development among young children facing similar challenges.
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Affiliation(s)
| | | | | | - Telma Maria de Menezes Toledo Florêncio
- Nutrition Postgraduate Program, Federal University of São Paulo, Paulista School of Medicine, São Paulo, Brazil
- Faculty of Nutrition, Federal University of Alagoas, Maceió, AL, Brazil
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Kumala Putri DS, Sari K, Utami NH, Djaiman SPH. Influence of maternal and neonatal continuum of care on the risk of intergenerational cycle of stunting: a cross-sectional study. BMJ Open 2024; 14:e081774. [PMID: 38643007 PMCID: PMC11033657 DOI: 10.1136/bmjopen-2023-081774] [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: 11/06/2023] [Accepted: 04/11/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES This study aimed to analyse the influence of the continuum of care during pregnancy and neonatal periods on the risk of intergenerational cycle of stunting. DESIGN This study was a cross-sectional study, with data analysed from the 2018 Basic Health Research in Indonesia. SETTINGS Basic Health Research 2018 was conducted throughout 513 cities/regencies in 34 provinces in Indonesia. The households were selected through two-stage sampling methods. First, census blocks (CB) were selected using probability proportional to size methods in each urban/rural stratum from each city/regency. Ten households were then selected from each CB using systematic sampling methods. All family members of the selected households were measured and interviewed. PARTICIPANTS This study analyses 31 603 children aged 0-24 months. OUTCOMES MEASURES The dependent variable was the risk of the intergenerational cycle of stunting. Mothers who had a height less than 150.1 cm (short stature mothers) and had children (≤ 24 months of age) with length-for-age Z-score less than -2 Standard Deviation (SD) of the WHO Child Growth Standard (stunted children) were defined as at risk of the intergenerational cycle of stunting. RESULTS Mothers with incomplete maternal and neonatal care visits were 30% more likely to be at risk on the intergenerational cycle of stunting (OR (95% CI): 1.3 (1.00 to 1.63)) after adjusting for economic status. CONCLUSION The continuum of maternal and neonatal healthcare visits could potentially break the intergenerational cycle of stunting, especially in populations where stunted mothers are prevalent.
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Affiliation(s)
- Dwi Sisca Kumala Putri
- Health Research Organization, National Research and Innovation Agency Republic of Indonesia, Bogor, Indonesia
| | - Kencana Sari
- Health Research Organization, National Research and Innovation Agency Republic of Indonesia, Bogor, Indonesia
| | - Nur Handayani Utami
- Health Research Organization, National Research and Innovation Agency Republic of Indonesia, Bogor, Indonesia
| | - Sri Poedji Hastoety Djaiman
- Health Research Organization, National Research and Innovation Agency Republic of Indonesia, Bogor, Indonesia
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Suratri MAL, Putro G, Rachmat B, Nurhayati, Ristrini, Pracoyo NE, Yulianto A, Suryatma A, Samsudin M, Raharni. Risk Factors for Stunting among Children under Five Years in the Province of East Nusa Tenggara (NTT), Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1640. [PMID: 36674391 PMCID: PMC9865789 DOI: 10.3390/ijerph20021640] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 06/17/2023]
Abstract
In East Nusa Tenggara Province, Indonesia, 42.6% of children under five had stunted growth in 2018, which affects both individual and communal levels. The first step in creating effective interventions is identifying the risk factors for stunting. This study aims to pinpoint the stunting risk factors in East Nusa Tenggara Province, Indonesia, by incorporating secondary data from the 2018 Indonesia Basic Health Research (RISKESDAS). This study implemented a cross-sectional design by utilizing the data of individuals who were successfully visited during the survey. Initial data screening in East Nusa Tenggara Province based on the criteria for children aged 0−59 months and stunting showed as many as 1643. Multivariate logistic regression analysis was performed to evaluate the relationship between children’s characteristics and stunting. There was a significant relationship between age group variables for younger children (aged 12−23, 24−35, and 36−47 months), mothers with low education, and children living in rural areas with the incidence of stunting in children (p-value < 0.05). The dominant factors that caused stunting in this study were the children’s age of 24−35 months (OR = 2.08, 95% CI: 1.12−3.86), mothers with low education (OR = 1.57, 95% CI: 1.18−2.08), and children living in rural areas (OR = 1.39, 95% CI: 1.01−1.91). The highest prevalence of stunting was in the group of children aged 12−23 months (45.2%). To prevent child stunting, the government must intervene for mothers with low education and those living in rural areas. Intervention includes intensive socialization about improving nutritional status during pregnancy and practicing complementary feeding and breastfeeding habits until the child is 24 months old.
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Affiliation(s)
| | - Gurendro Putro
- Center for Public Health and Nutrition Research, Health Research Organization, National Research and Innovation Agency, Jakarta 10340, Indonesia
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Bogin B, Hermanussen M, Scheffler C. Bergmann’s rule is a “just-so” story of human body size. J Physiol Anthropol 2022; 41:15. [PMID: 35414036 PMCID: PMC9003984 DOI: 10.1186/s40101-022-00287-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/27/2022] [Indexed: 01/04/2023] Open
Abstract
Carl Bergmann was an astute naturalist and physiologist. His ideas about animal size and shape were important advances in the pre-Darwinian nineteenth century. Bergmann’s rule claims that that in cold climates, large body mass increases the ratio of volume-to-surface area and provides for maximum metabolic heat retention in mammals and birds. Conversely, in warmer temperatures, smaller body mass increases surface area relative to volume and allows for greater heat loss. For humans, we now know that body size and shape are regulated more by social-economic-political-emotional (SEPE) factors as well as nutrition-infection interactions. Temperature has virtually no effect. Bergmann’s rule is a “just-so” story and should be relegated to teaching and scholarship about the history of science. That “rule” is no longer acceptable science and has nothing to tell us about physiological anthropology.
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Mahriani Y, Indriyanti R, Musnamirwan IA, Setiawan AS. A cross-sectional study on dietary assessment, oral hygiene behavior, and oral health status of adolescent girls. Front Nutr 2022; 9:973241. [PMID: 36276832 PMCID: PMC9579310 DOI: 10.3389/fnut.2022.973241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 09/07/2022] [Indexed: 11/23/2022] Open
Abstract
Adolescents are a population group that is vulnerable to nutritional problems other than toddlers, especially young women. Special attention to the dietary issues of adolescent girls needs to be obtained along with the increase in the adolescent population in Indonesia because this affects the growth and development of the body and will impact adult nutrition problems. The purpose of the study was to analyze the relationship between diet assessment and oral health status of adolescent girls, the relationship between oral hygiene behavior and oral health status of adolescent girls, and the simultaneous relationship between dietary assessment and oral hygiene behavior with the oral health status of adolescent girls. Analytical research using the survey method was conducted on 96 young women in two junior high schools in Bandung. Assessment of diet seen from eating behavior and anthropometric examination. Eating behavior using the Adolescent Food Habit Checklist Index questionnaire and anthropometric investigations were carried out by looking at body height, body weight, and Mid Upper Arm Circumference using the standards from the Indonesian Minister of Health Regulation 2020. Oral hygiene behavior using the Oral Hygiene Behavior Index questionnaire. Oral health status using the Dental Health Status Assessment. The results were statistically analyzed with Spearman's Rank Correlation, and Multiple Linear Regression tests showed no significant relationship between dietary assessment and oral health status (eating behavior with a p-value = 0.429 and anthropometric examination with a p-value = 0.262). A significant association between oral hygiene behavior and oral health status, with a p-value of 0.003, while there is no simultaneous relationship between diet assessment and oral hygiene behavior with oral health status, with multiple r 2 = 13.2%.
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Affiliation(s)
- Yuni Mahriani
- Resident of Pediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Ratna Indriyanti
- Department of Paediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Iwan Ahmad Musnamirwan
- Department of Paediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Arlette Suzy Setiawan
- Department of Paediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
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Hermanussen M, Erofeev S, Scheffler C. The socio-endocrine regulation of human growth. Acta Paediatr 2022; 111:2077-2081. [PMID: 35908198 DOI: 10.1111/apa.16504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/01/2022] [Accepted: 07/29/2022] [Indexed: 11/26/2022]
Abstract
AIM Growth is a multifarious phenomenon that has been studied by nutritionists, economists, pediatric endocrinologists; archeologists, child psychologists and other experts. Yet, a unifying theory of understanding growth regulation is still lacking. METHOD Critical review of the literature. RESULTS We summarize evidence linking social competition and its effect on hierarchies in social structures, with the neuronal networks of the ventromedial hypothalamus and body size. The endocrine signaling system regulating growth hormone, Insulin-like-Growth-Factor1 and skeletal growth, is well conserved in the evolution of vertebrata for some 400 million years. The link between size and status permits adaptive plasticity, competitive growth and strategic growth adjustments also in humans. Humans perceive size as a signal of dominance with tallness being favored and particularly prevalent in the upper social classes. CONCLUSION Westernized societies are competitive. People are tall, and "open to change". Social values include striving for status and prestige implying socio-economic domination. We consider the transition of political and social values following revolutions and civil wars, as key elements that interact with the evolutionarily conserved neuroendocrine competence for adaptive developmental plasticity, overstimulate the hypothalamic growth regulation and finally lead to the recent historic increases in average height.
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Affiliation(s)
| | - Sergei Erofeev
- Rutgers University, 08901-8554, USA, Polish Institute of Advanced Studies, New Brunswick, NJ
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Scheffler C, Hermanussen M. Reply to the letter titled "Pathologizing normal height or identifying chronic malnutrition: Public health concerns of calling stunting normal" by Faizi, Zubair and Tasleem (2022). Am J Hum Biol 2022; 34:e23741. [PMID: 35218270 DOI: 10.1002/ajhb.23741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Michael Hermanussen
- Pediatrician, Aschauhof 3, 24340 Eckernförde, Altenhof, Germany.,Christian-Albrechts-University of Kiel, Kiel, Germany
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Oumer A, Fikre Z, Girum T, Bedewi J, Nuriye K, Assefa K. Stunting and Underweight, but not Wasting are Associated with Delay in Child Development in Southwest Ethiopia. Pediatric Health Med Ther 2022; 13:1-12. [PMID: 35046749 PMCID: PMC8761030 DOI: 10.2147/phmt.s344715] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Abdu Oumer
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
- Correspondence: Abdu Oumer Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, EthiopiaTel +251 966365785 Email
| | - Zinash Fikre
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Tadele Girum
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Jemal Bedewi
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Keyredin Nuriye
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Kenzudin Assefa
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
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Ramon-Muñoz R, Ramon-Muñoz JM, Candela-Martínez B. Sibship Size, Height and Cohort Selection: A Methodological Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13369. [PMID: 34948978 PMCID: PMC8703943 DOI: 10.3390/ijerph182413369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022]
Abstract
This article deals with the historical relationship between the number of siblings in a family or household and height, a proxy for biological living standards. Ideally, this relationship is better assessed when we have evidence on the exact number of siblings in a family from its constitution onwards. However, this generally requires applying family reconstitution techniques, which, unfortunately, is not always possible. In this latter case, scholars must generally settle for considering only particular benchmark years using population censuses, from which family and household structures are derived. These data are then linked to the height data for the young males of the family or household. Height data are generally obtained from military records. In this matching process, several decisions have to be taken, which, in turn, are determined by source availability and the number of available observations. Using data from late 19th-century Catalonia, we explore whether the methodology used in matching population censuses and military records as described above might affect the relationship between sibship size and biological living standards and, if so, to what extent. We conclude that, while contextual factors cannot be neglected, the methodological decisions made in the initial steps of research also play a role in assessing this relationship.
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Affiliation(s)
- Ramon Ramon-Muñoz
- Department of Economic History, Institutions, Politics and World Economy, Faculty of Economics and Business, University of Barcelona, Diagonal 690, 08034 Barcelona, Spain
| | - Josep-Maria Ramon-Muñoz
- Department of Applied Economics, Faculty of Economics and Business, University of Murcia, Campus de Espinardo, 30100 Murcia, Spain; (J.-M.R.-M.); (B.C.-M.)
| | - Begoña Candela-Martínez
- Department of Applied Economics, Faculty of Economics and Business, University of Murcia, Campus de Espinardo, 30100 Murcia, Spain; (J.-M.R.-M.); (B.C.-M.)
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Scheffler C, Hermanussen M. Stunting is the natural condition of human height. Am J Hum Biol 2021; 34:e23693. [PMID: 34761833 DOI: 10.1002/ajhb.23693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Human body height differs within a wide range and has conventionally been associated with genetic, nutritional, and environmental conditions. In this study, we try to broaden this perspective and add the evolutionary aspect of height differences. SAMPLE AND METHOD We revisited height from archeological data (10 000-1000 BC), and historical growth studies (1877-1913). We analyzed height, weight, and skinfold thickness of 1666 Indonesian schoolchildren from six representative rural and urban elementary schools in Bali and West Timor with a stunting prevalence of up to 50%. RESULTS Stature in the Holocene prehistory of the Near East and Europe varied with maxima for women usually ranging below 160 cm, and maxima for men between 165 and 170 cm. Stature never rose above 170 cm. European and white US-American schoolchildren of the 19th and 20th century were generally short with average height ranging between -1.5 and -2.2 hSDS, yet in the absence of any evidence of chronic or recurrent undernutrition or frequent illness, poverty, or disadvantageous living conditions. The same is found in contemporary Indonesian schoolchildren. CONCLUSION Stunting is frequently observed not only in the poor, but also in affluent and well-nourished social strata last 10 000 years. Only in very recent history, and only in a few democratic, modern societies, stature has increased beyond the long-lasting historic height average. Viewed from an evolutionary perspective, and considering adaptive plasticity of and community effects on growth, competitive growth and strategic growth adjustments, stunting appears to be the natural condition of human height.
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Bogin B. Fear, violence, inequality, and stunting in Guatemala. Am J Hum Biol 2021; 34:e23627. [PMID: 34125987 DOI: 10.1002/ajhb.23627] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/17/2021] [Accepted: 05/28/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Stunting is defined by the public health community as a length- or height-for-age <-2 SD of a growth standard or reference and is claimed to be caused by poor nutrition, repeated infection, and inadequate psychosocial stimulation. MATERIAL AND METHODS Stunting is common at all income levels in middle- and low-income countries. At the higher income levels, stunting is unlikely to be caused by nutrient deficiency or infectious disease. RESULTS In Guatemala, 17% of <5-year-olds in the highest family income quintile are stunted. Guatemala has a history of violence from armed conflict, current-day social and economic inequalities, government corruption, and threat of kidnapping for the wealthiest families. DISCUSSION AND CONCLUSION The high level of persistent violence creates an ecology of fear, an extreme range of inequalities in Social-Economic-Political-Emotional resources, and biosocial stress that inhibits skeletal growth and causes stunting for people of all income levels.
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Affiliation(s)
- Barry Bogin
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, UK.,UCSD/Salk Center for Academic Research and Training in Anthropogeny (CARTA), University of California San Diego, USA
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Longitudinal Associations between Intake of Fruit and Vegetables and Height Attainment from Preschool to School Entry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116106. [PMID: 34198900 PMCID: PMC8201233 DOI: 10.3390/ijerph18116106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 11/16/2022]
Abstract
To examine associations between fruit and vegetable intake in young childhood and height attainment during preschool and at school entry. Data for this study was based on "The Healthy Start" primary intervention study, which included 635 obesity-prone children, (58% boys), from the greater Copenhagen area, with a mean (SD) age of 4.0 (1.1) years (age range 2-6 years) at baseline. In the current study, 553 children (57% boys) were included with information on dietary intake at baseline and height measured at baseline (preschool age), and 511 children (56.8% boys) with the height measured at school entry (~6 years old). Height was measured by trained health professionals during the intervention and by school nurses at school entry. Information on intakes of fruit and vegetables, separately and combined, was gathered with four-day dietary records reported by parents. Participants were grouped into tertiles for their intakes at baseline. Compared to boys with low consumption, those with a moderate and high intakes of fruit and vegetables (F&V) had a greater attained height at preschool of 1.3 cm (95% confidence interval (CI): 0.3; 2.3) and at school entry of 2.4 cm (95% CI: 0.8; 3.9) and 1.8 cm (95% CI: 0.2; 3.4), respectively, also after adjustment for differences in age, body mass index (BMI), and total energy intake. Additional adjustment for mid-parental height and parents' education did not alter the significant associations between moderate consumption of F&V and attained height at preschool and school entry. There was no association among girls. Our results showed that a moderate consumption of F&V was directly associated with higher attainment in height at preschool and school entry in boys. From a public health perspective, it should be prioritized to continue developing intervention programs to improve fruit and vegetable intake.
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