Diet quality and risk of stunting among infants and young children in low- and middle-income countries
Diet quality and risk of stunting among infants and young children in low- and middle-income countries
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DOI：
10.1111/mcn.12430
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发表时间：
2017-10-01
影响因子：
3.4
通讯作者：
Frongillo, Edward A.
中科院分区：
文献类型：
--
作者：
Krasevec, Julia;An, Xiaoyi;Frongillo, Edward A.
根据现有数据，在低收入和中等收入国家中，适合儿童的补充喂养做法远非最佳。关于喂养方法和线性生长之间的关联的证据是混合的。我们试图利用39项人口与健康调查的现有数据，系统地研究饮食质量的两个指标饮食多样性和动物源性食品（ASF）消费（WHO，2008）和发育迟缓（年龄别身高z评分）之间的关系。收集了74，548名6- 23个月儿童的数据，并采用多元逻辑回归模型，调整儿童，母亲和家庭特征，以评估饮食质量和发育迟缓之间的关系。还采用了按儿童年龄和世界银行国家收入分类的分层模型（世界银行，2015年）。6- 23个月大的儿童在前一天食用零食物组与参考组（5个食物组）相比，发育迟缓的几率高1.345;那些在前一天没有食用任何ASF的儿童与食用所有三种ASF（鸡蛋，肉类和乳制品）的儿童相比，发育迟缓的几率高1.436。我们估计，如果所有儿童都食用五种或五种以上的食物，那么在研究的人群中，2,629例发育迟缓病例（占发育迟缓病例的12.6%）可以避免。按国家收入分组的结果显示，与低收入国家相比，中上收入国家的饮食多样性和ASF消费之间存在更大的关联。总之，饮食多样性和ASF消费与发育迟缓有关，分层组之间的关联各不相同。
Age-appropriate complementary feeding practices are far from optimal among low- and middle-income countries with available data. The evidence on the association between feeding practices and linear growth is mixed. We sought to systematically examine the association between two indictors of dietary qualitydietary diversity and animal source food (ASF) consumption (WHO, 2008)and stunting (length-for-age z-score) employing existing data from 39 Demographic and Health Surveys. Data on 74,548 children aged 6-23months were pooled and multiple logistic regression models, adjusting for child, maternal, and household characteristics, employed to assess the association between dietary quality and stunting. Stratified models by child age and by World Bank country-income classifications (World Bank, 2015) were also applied. Children aged 6-23months consuming zero food groups in the previous day had a 1.345 higher odds of being stunted when compared to the reference group (5 food groups); those who did not consume any ASF in the previous day had a 1.436 higher odds of being stunted compared to children consuming all three types of ASF (egg, meat, and dairy). We estimated that 2,629 cases of stunting would have been averted (12.6% of those stunted) among the population studied if all children had consumed five or more food groups. Outcomes by country-income groupings showed larger associations of diet diversity and ASF consumption for upper- and lower-middle income countries compared to low-income countries. In summary, dietary diversity and ASF consumption were associated with stunting, with associations varying by stratified groups.