Socio-economic disparity in food consumption among young children in eight South Asian and Southeast Asian countries

Socio-economic inequalities in and factors associated with minimum dietary diversity among children aged 6-23 months in South Asia: a decomposition analysis

OBJECTIVE

This study aimed to determine the factors associated with minimum dietary diversity (MDD) and estimate the socioeconomic inequalities in MDD among children from five South Asian countries.

DESIGN

Cross-sectional.

SETTING

The study used the most recent round of secondary databases of Demographic Health Survey data of Bangladesh (2017-2018), India (2019-2021), Maldives (2016-2017), Nepal (2018) and Pakistan (2017-2018).

PARTICIPANTS

This study used information on MDD and other explanatory variables from a total of 136 980 (weighted) children aged 6-23 months.

METHODS

Multivariable logistic regression was employed to identify the factors associated with MDD and concentration index (CIX) and Lorenz curve were used to measure the socioeconomic inequalities in MDD.

RESULTS

The overall weighted prevalence of MDD in South Asia was 23.37%. The highest prevalence of MDD was found among children from Maldives (70.7%), while the lowest was in Pakistan (14.2%). Living in affluent versus poor households, having a mother who is employed versus a mother who is unemployed, exposure to various forms of media (newspapers and magazines), seeking antenatal care (ANC) more than four times compared with those who sought ANC less than four times and having children older than 4 years old are the most common significant factors associated with MDD deficiency. This study found the value of the CIX for MDD (MDD: CI=0.0352; p<0.001) among children with a higher socioeconomic status, suggesting inequality in MDD in favour of the more among well-off households.

CONCLUSION

Inequality in the prevalence of MDD favours the affluent. Health policy and intervention design should prioritise minimising socioeconomic inequalities concerning the MDD. In addition, policy-makers should prioritise the associated factors of MDD such as education, wealth status, employment, media exposure while designing intervention or policies.

Association between short-term exposure to ambient PM1 and PM2.5 and forced vital capacity in Chinese children and adolescents

This study aims to examine the association between short-term exposure to ambient PM₁, PM_1-2.5, and PM_2.5 and forced vital capacity (FVC). Population data were obtained from a school-based cross-sectional survey in Shandong in 2014. Distributed lag non-linear models were used to examine the association between exposure to PM₁, PM_1-2.5, and PM_2.5 and FVC at the day of FVC measurement and the previous 6 days (lag 0 to 6 days). A total of 35,334 students aged 9 to 18 years were included in the study, and the mean exposure concentrations of ambient PM₁, PM_1-2.5, and PM_2.5 for them were 47.4 (standard deviation [SD] = 21.3) μg/m³, 32.8 (SD = 32.2) μg/m³, and 80.1 (SD = 47.7) μg/m³, respectively. An inter-quartile range (IQR, 24 μg/m³) increment in exposure to PM₁ was significantly associated with a lower FVC at lag 0 and lag 1 day (β =  - 80 mL, 95% CI =  - 119, - 42, and β =  - 37 mL, 95% CI =  - 59, - 16, respectively), and an IQR (54 μg/m³) increment in exposure to PM_2.5 was significantly associated with a lower FVC at lag 0 and lag 1 day (β =  - 57 mL, 95% CI =  - 89, - 18, and β =  - 34 mL, 95% CI =  - 56, - 12, respectively) after adjustment for gender, age, body mass index category, residence, month of the survey, intake of eggs, intake of milk, physical activity, and screen time. No significant associations were observed for PM_1-2.5. The inverse associations of PM₁ and PM_2.5 with FVC were larger in males, younger children, those overweight or obese, and those with insufficient physical activity levels. Short-term exposure to ambient PM₁ and PM_2.5 was associated with decreased FVC, and PM₁ may be the primary fraction of PM_2.5 causing the adverse pulmonary effects. Our findings emphasize the need to address ambient PM, especially PM₁, pollution for affecting pulmonary health in children and adolescents.