HOUSEHOLD FOOD INSECURITY ASSESSED BY THE FOOD ACCESS SURVEY TOOL (FAST) IN RURAL BANGLADESH AND MATERNAL AND INFANT NUTRITIONAL OUTCOMES

Household food insecurity;Maternal nutrition;Infant growth;Bangladesh;Food security assessment;not listed

Na, MuziLawrence, Robert Swan ;

Johns Hopkins University

关键词: Household food insecurity;    Maternal nutrition;    Infant growth;    Bangladesh;    Food security assessment;    not listed;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/40656/NA-DISSERTATION-2014.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Background: Food security is a major concern in South Asia, where it coexists with the highest prevalence of maternal and child malnutrition in the world. The goal of this research was to investigate associations between household food insecurity (HFI), measured on a behavior-based scale, and both maternal diet and nutritional status during pregnancy and lactation and infant growth to 6 months of age in rural Bangladesh. Methods: Subjects were enrolled from November 2009 to June 2011 into a large cluster-randomized prenatal supplementation trial. Prospective dietary and nutritional status data from a cohort of 18,841 mothers and infants were collected from early pregnancy to 6 months postpartum. HFI was assessed using a 9-item Food Access Survey Tool (FAST), from which validity of using a summative index of its scores to reflect latent HFI was first established. Multivariate linear regression models of HFI, adjusting for maternal and household factors, were performed to explain associated variation in a) maternal dietary diversity, b) change in maternal weight and mid-upper arm circumference (MUAC) in pregnancy and lactation, and c) infant size at 6 months of age. Results: Half of the households were food insecure. The HFI index was dose-responsively associated with poorer antenatal and early postnatal dietary quality, especially reduced consumption in animal-source foods.While maternal size early in pregnancy and seasonality were strongly associated with the level of HFI, changes in neither maternal weight nor MUAC during pregnancy and lactation were correlated with HFI status.With poorer HFI, infant sizes at 6 months decreased progressively. Maternal nutrition at 1st trimester and infant size at birth together explained 57-89% of the infant size deficits associated with HFI at six months.Postnatal feeding, morbidity, and socio-economic status accounted for less than a third of the variability in infant size at 6 month explained by HFI. Conclusions: Widespread food insecurity persists in rural Bangladesh. In a large materno-infant cohort, we found evidence supporting strong and persistent nutritional consequences of food insecurity. Policies that address both food insecurity and reduce maternal and infant malnutrition should focus in women early in, and likely long before, pregnancy.