RESUMEN
To meet the 2030 goal to end all types of malnutrition, thoroughly investigating and addressing context-specific factors of undernutrition is crucial. Therefore, this study assessed the prevalence of undernutrition and associated factors among children aged 6-23 months in South-East Ethiopia. A community-based cross-sectional study was conducted on 580 randomly sampled mother-child pairs in February 2022. Socio-demographic, dietary intake, household food security (HFS), maternal knowledge and practices of child feeding, and the child's weight and height data were collected. A multivariable logistic regression analysis was done. The prevalence of stunted, wasted, and underweight children was 32â 1, 7, and 9 %, respectively. Being male (AOR = 1â 75), not using the growth monitoring and promotion (GMP) service (AOR = 1â 50), household food insecurity (HFI) (AOR = 1â 67), lack of improved water (AOR = 2â 26), and bottle-feeding (AOR = 1â 54) were significantly associated with stunting. Being male (AOR = 3â 02), having low maternal knowledge on child-feeding practices (AOR = 3â 89), not listening to the radio/television (AOR = 3â 69), having a history of fever (AOR = 3â 39), bottle-feeding (AOR = 3â 58), and HFI (AOR = 3â 77) were significantly predicted wasting. Being male (AOR = 3â 44), not using GMP service (AOR = 2â 00), having a history of fever (AOR = 4â 24), lack of knowledge on optimal breastfeeding duration (AOR = 3â 58), low maternal knowledge on child feeding (AOR = 2â 21), HFI (AOR = 2â 04), and lack of improved water (AOR = 3â 00) showed significant association with underweight. In conclusion, stunting is alarmingly common while wasting and underweight are sub-optimal. Prevention of infectious disease, providing basic education for fathers, ensuring HFS; enhancing media access, maternal knowledge about IYCFP and improving water access; and GMP service utilisation are crucial to improve child nutrition.
Asunto(s)
Desnutrición , Estado Nutricional , Femenino , Humanos , Masculino , Estudios Transversales , Delgadez/epidemiología , Etiopía/epidemiología , Prevalencia , Desnutrición/epidemiología , Trastornos del Crecimiento/epidemiología , AguaRESUMEN
Despite the high burden of neural tube defects (NTD) in eastern Ethiopia, there is no evidence that it is related to maternal dietary practice. The aim of the present study was to compare dietary practice between women who gave birth to newborns with and without NTDs. A comparative cross-sectional study was performed on a total of 276 (138 in each group) mothers who delivered neonates with or without NTD. Study participants were selected from three hospitals found in the eastern part of Ethiopia. The dietary practice was determined using the indicators including meal frequency, dietary diversity score (DDS), food variety score (FVS) and consumption of animal source food (ASF) generated from the dietary data collected using validated and pre-tested Food Frequency Questionnaire (FFQ). A multivariable logistic regression model was fitted to isolate independent predictors of dietary practices. The prevalence of good dietary practice was 29 % (95 % CI 23·6 %, 34·3 %). There was a significant difference in dietary practices (P = 0·034), in FVS (P = 0·01), in DDS (P = 0·045) between the two groups. In multivariable logistic regression, independent predictors of having good dietary practice were: not being the mother of a newborn with NTDs [adjusted odds ratio (AOR) 2·1, 95 % CI 1·07, 4·1], being from a rural residence area (AOR 0·29, 95 % CI 0·1, 0·7) and being illiterate (AOR 0·16, 95 % CI 0·03, 0·8). The present study found that dietary practice is associated with the development of NTDs. Nutrition education, food fortification and supplementation are needed to address this issue, and further research is needed to explore the mechanism.
Asunto(s)
Defectos del Tubo Neural , Mujeres Embarazadas , Estudios Transversales , Dieta , Femenino , Humanos , Recién Nacido , Comidas , Defectos del Tubo Neural/prevención & control , EmbarazoRESUMEN
The regulation of linear growth by nutritional and inflammatory influences is examined in terms of growth-plate endochondral ossification, in order to better understand stunted growth in children. Linear growth is controlled by complex genetic, physiological, and nutrient-sensitive endocrine/paracrine/autocrine mediated molecular signalling mechanisms, possibly including sleep adequacy through its influence on growth hormone secretion. Inflammation, which accompanies most infections and environmental enteric dysfunction, inhibits endochondral ossification through the action of mediators including proinflammatory cytokines, the activin A-follistatin system, glucocorticoids and fibroblast growth factor 21 (FGF21). In animal models linear growth is particularly sensitive to dietary protein as well as Zn intake, which act through insulin, insulin-like growth factor-1 (IGF-1) and its binding proteins, triiodothyronine, amino acids and Zn2+ to stimulate growth-plate protein and proteoglycan synthesis and cell cycle progression, actions which are blocked by corticosteroids and inflammatory cytokines. Observational human studies indicate stunting to be associated with nutritionally poor, mainly plant-based diets. Intervention studies provide some support for deficiencies of energy, protein, Zn and iodine and for multiple micronutrient deficiencies, at least during pregnancy. Of the animal-source foods, only milk has been specifically and repeatedly shown to exert an important influence on linear growth in both undernourished and well-nourished children. However, inflammation, caused by infections, environmental enteric dysfunction, which may be widespread in the absence of clean water, adequate sanitation and hygiene (WASH), and endogenous inflammation associated with excess adiposity, in each case contributes to stunting, and may explain why nutritional interventions are often unsuccessful. Current interventions to reduce stunting are targeting WASH as well as nutrition.
Asunto(s)
Fenómenos Fisiológicos Nutricionales Infantiles , Trastornos del Crecimiento , Infecciones , Inflamación/fisiopatología , Estado Nutricional/fisiología , Animales , Niño , Desarrollo Infantil , Proteínas en la Dieta/administración & dosificación , Sistema Endocrino/fisiopatología , Ingestión de Energía , Femenino , Humanos , Factor I del Crecimiento Similar a la Insulina/fisiología , Yodo/deficiencia , Micronutrientes/deficiencia , Osteogénesis , Embarazo , Efectos Tardíos de la Exposición Prenatal , Deficiencia de Proteína , Zinc/deficienciaRESUMEN
Dietary diversity involves adequate intake of macronutrient and micronutrient. The inclusion of animal source foods (ASF) in the diet helps prevent multiple nutrient deficiencies and any resultant, linear growth retardation. The objective of the current study was to assess the relationship between dietary diversity, ASF consumption and height-for-age z-score (HAZ) among children aged 12-59 months old across a 1-year observation. This longitudinal observational study without controls was conducted among four age groups: 12-23 months (n 57), 24-35 months (n 56), 36-47 months (n 58) and 48-59 months (n 56). Anthropometry and dietary intake were measured during each of four visits at 16-20-week intervals. The general characteristics and other observations were only collected at baseline and endline. During the year-long study period, approximately 27 % of the children ate a diverse diet (consumed ≥6 out of 9 food groups) according to ≥3 visits. ASF consumption was high, particularly for eggs, poultry, processed meats and liquid milk. Yet, micronutrient intake inadequacy, especially of Zn, Ca, Fe and vitamin A, was highly prevalent. A multivariate regression analysis showed that the consumption of a diverse diet and ASF was not significantly associated with the HAZ at endline, after controlling for demographic characteristics and the baseline HAZ. The consumption of a diverse diet was significantly associated with Ca intake adequacy. Moreover, ASF consumption was significantly associated with adequate intake of protein and micronutrients, particularly vitamin A, Ca and Zn. Thus, the recommendation is to continue and strengthen the promotion of consuming a diverse diet that includes ASF in supporting the linear growth of young children.
Asunto(s)
Encuestas sobre Dietas , Huevos , Alimentos/clasificación , Carne , Animales , Fenómenos Fisiológicos Nutricionales Infantiles , Preescolar , Dieta/normas , Registros de Dieta , Femenino , Humanos , Indonesia , Lactante , Fenómenos Fisiológicos Nutricionales del Lactante , Masculino , Micronutrientes , Necesidades Nutricionales , Valor NutritivoRESUMEN
Caregivers' nutrition knowledge and attitudes may influence the variety of foods available in the household and the quality of children's diets. To test the link, this study collected data on caregivers' (n 608) nutrition knowledge and feeding attitudes as well as the diets of their household and of their 2-5-year-old children in twelve rural communities nested in the three main agro-ecological zones of Ghana. Household foods and children's animal source foods (ASF) consumed in the past 7 d were categorised into one of fourteen and ten groups, respectively. About 28 % of caregivers believed that their children needed to be fed only 2-3 times/d. Reasons for having adult supervision during child meal times, feeding diverse foods, prioritising a child to receive ASF and the perceived child benefits of ASF differed across zones (P<0·001). Households with caregivers belonging to the highest tertile of nutrition knowledge and attitude scores consumed more diverse diets compared with those of caregivers in the lowest tertile group (11·2 (sd 2·2) v. 10·0 (sd 2·4); P<0·001). After controlling for the effect of agro-ecological zone, caregivers' nutrition knowledge and feeding attitudes positively predicted household dietary diversity and the frequency and diversity of children's ASF intakes (P<0·001). The number of years of formal education of caregivers also positively predicted household dietary diversity and children's ASF diversity (P<0·001). A key component to improving child nutrition is to understand the context-specific nutrition knowledge and feeding attitudes in order to identify relevant interventions.