Household food access and child malnutrition: results from the eight-country MAL-ED study

Population Health Metrics

Research

Sushil John¹  Zulfiqar A Bhutta²  Aldo Lima³  Mark Miller⁴  William Checkley⁵  Monica McGrath⁶  Jessica Seidman⁶  Stephanie Richard⁶  Stephanie Psaki⁶  Prakash Shrestha⁷  Shamsir Ahmed⁸  Munirul Islam⁸  Tahmeed Ahmed⁸  Margaret Kosek⁹  Laura Caulfield⁹  Erling Svensen^1,10  Cebisa Nesamvuni^1,11  Pascal Bessong^1,11 

[1] Christian Medical College, Vellore, India;Division of Women and Child Health, Aga Khan University, Karachi, Pakistan;Federal University of Ceara, Federal University of Ceara, Fortaleza, Brazil;Fogarty International Center, National Institutes of Health, Bethesda, USA;Fogarty International Center, National Institutes of Health, Bethesda, USA;Division of Pulmonary and Critical Care, Johns Hopkins University, Suite 9121 1800 Orleans Street, 21212, Baltimore, MD, USA;Program in Global Disease Epidemiology and Control and Division of Human Nutrition, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA;Fogarty International Center, National Institutes of Health, Bethesda, USA;Program in Global Disease Epidemiology and Control and Division of Human Nutrition, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA;Institute of Medicine, Kathmandu, Nepal;International Centers for Diarrheal Disease Research, Matlab, Bangladesh;Program in Global Disease Epidemiology and Control and Division of Human Nutrition, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA;University of Bergen, Bergen, Norway;University of Venda, Thohoyandou, South Africa;

关键词: Food Insecurity;    Household Food;    Food Access;    Sanitation Facility;    Child Malnutrition;   

DOI  :  10.1186/1478-7954-10-24

 received in 2012-03-21, accepted in 2012-11-13,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundStunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites.MethodsWe administered a socioeconomic survey to 800 households in research sites in eight countries, including a recently validated nine-item food access insecurity questionnaire, and obtained anthropometric measurements from children aged 24 to 60 months. We used multivariable regression models to assess the relationship between household food access insecurity and anthropometry in children, and we assessed the invariance of that relationship across country sites.ResultsAverage age of study children was 41 months. Mean food access insecurity score (range: 0–27) was 5.8, and varied from 2.4 in Nepal to 8.3 in Pakistan. Across sites, the prevalence of stunting (42%) was much higher than the prevalence of wasting (6%). In pooled regression analyses, a 10-point increase in food access insecurity score was associated with a 0.20 SD decrease in height-for-age Z score (95% CI 0.05 to 0.34 SD; p = 0.008). A likelihood ratio test for heterogeneity revealed that this relationship was consistent across countries (p = 0.17).ConclusionsOur study provides evidence of the validity of using a simple household food access insecurity score to investigate the etiology of childhood growth faltering across diverse geographic settings. Such a measure could be used to direct interventions by identifying children at risk of illness and death related to malnutrition.

【 授权许可】

Unknown   
© Psaki et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.