Validation of selected 2021 infant and young child feeding indicators for appropriate complementary feeding in relation to dietary adequacy and anthropometric status

@#Introduction: With the new set of 2021 infant and young child feeding (IYCF) indicators released by WHO and UNICEF, there is a need for its validation in the Philippine setting. The study evaluated the validity of cut-off points used for minimum dietary diversity and minimum feeding frequency in terms of micronutrient and energy intake adequacy, respectively, and minimum acceptable diet (MAD) in relation to anthropometric status. Methods: The study covered 8360 infants and young children aged 6-23.9 months with complete information on IYCF, anthropometric measurements, maternal information, and household characteristics from the 2018-2019 Expanded National Nutrition Survey (ENNS). Bivariate and correlation analyses using STATA version 15 (Corp LLC, Texas, USA 2017) were performed to determine the association of specific IYCF indicators: dietary diversity and feeding frequency with nutrient and energy intake adequacy, and MAD with anthropometric status. Sensitivity and specificity analyses were performed to evaluate the accuracy of dietary diversity score (DDS) and feeding frequency in identifying children with adequate nutrient and energy intakes, respectively. Results: Significant associations were found between DDS and micronutrient adequacy, and between feeding frequency and energy intake adequacy, regardless of breastfeeding status. A DDS of 5 and 6 and feeding frequency of 4-5 and 8 maximised sensitivity and specificity in identifying breastfed and non-breastfed children meeting 100% nutrient and energy adequacy, respectively. Conclusion: The selected 2021 complementary feeding indicators are practical guidelines to reflect dietary adequacy, but may not capture the entire process related to nutritional outcomes, especially stunting.

Effect of Prenatal Dietary Pattern on Maternal Anemia and Low Birth Weight in Rural Areas of Kanpur

Background: In India, the dietary pattern of women from low socioeconomic status are almost same during pre-pregnant, pregnant and lactating periods. Additional foods are required to improve weight gain in pregnancy and birth weight of infants. Aim & Objective: To identify the impact of prenatal dietary pattern on maternal anemia and low birth weight in rural areas of Kanpur Nagar. Methods: This study was a cross sectional study conducted amongst mothers who recently delivered (RDW) in rural blocks of District Kanpur Nagar. Data was collected by interviewing study subjects using a semi-structured interview schedule after applying multistage random sampling technique. Results: Out of 102 women studied, 39.2% women had consumed >90 IFA tablets, 49.1% of mothers had practiced MMF and 47.1% of women practiced MDD during their prenatal period and 40.1% babies of current pregnancy were born as LBW. IFA consumption during pregnancy was significantly associated with maternal anemia. MMF during pregnancy was significantly associated with LBW. Conclusions: In our study it was found that IFA consumption, MMF and MDD during antenatal is a key preventive measure to reduce anemia status in pregnant females and birth weight of baby during prenatal period.

Mudanças na frequência do consumo de refeições em adolescentes residentes em área de vulnerabilidade social da região metropolitana do Rio de Janeiro, Brasil / Changes in meal frequency among adolescents living in a socially vulnerable area of the Rio de Janeiro metropolitan region, Brazil

Resumo O objetivo deste estudo foi descrever as mudanças na frequência do consumo de refeições de adolescentes residentes na região metropolitana do Rio de Janeiro, em período de 5 anos. Utilizaram-se dados de dois estudos transversais, de base populacional, que foram realizados por meio de visitas domiciliares. Em 2005, a amostra final foi de 1089 domicílios com 511 adolescentes (de 12 a 18 anos), e em 2010 de 1121 domicílios com 314 adolescentes. A frequência do consumo de refeições foi obtida por meio de questionário autopreenchido e a avaliação da adequação de peso dos adolescentes foi realizada com base nos pontos de corte do IMC por sexo e faixa etária. Houve aumento da substituição diária do almoço tradicional por lanche (3,7% para 13,7%) e no consumo do jantar tradicional (62,9% para 72,0%). Os adolescentes com sobrepeso consumiram o desjejum com menor frequência do que aqueles sem sobrepeso (2005: 68,3% vs 79,3% p=0,02, 2010: 59,5% vs 77,4% p=0,03). Conclui-se que houve aumento da substituição diária do almoço tradicional por lanche e no consumo do jantar tradicional no período de 5 anos. Ademais, a prática do desjejum diário se associou com a classificação de IMC nos dois momentos do estudo, de modo que aqueles com sobrepeso consomem o desjejum com menor frequência.

Abstract This study described changes in meal frequency over a 5-year period among adolescents living in the Rio de Janeiro metropolitan region. The data used were from two cross-sectional, population-based studies conducted by home visits. In 2005 the final sample was 1089 households with 511 adolescents (aged 12 to 18 years) and in 2010, 1121 households with 314 adolescents. Meal frequency was obtained through self-administered questionnaire and the adolescents were assessed for appropriate weight by BMI cut-off points, by sex and age group. Increasingly, traditional daily lunch was replaced by snacks (from 3.7% to 13.7%) and traditional dinner was eaten (62.9% to 72.0%). Overweight adolescents ate breakfast less often than those not overweight (in 2005, 68.3% and 79.3%, p=0.02 and, in 2010, 59.5% and 77.4%, p=0.03). Traditional daily lunch was increasingly replaced by snacks and consumption of traditional dinner increased over the 5-year period. Also, eating breakfast every day was associated with BMI classification at both study times: those who were overweight consumed breakfast less frequently.

Daily meal frequency and associated variables in children and adolescents / Frequência de refeições diárias e variáveis associadas em crianças e adolescentes

Abstract: Objective: To investigate the frequency distribution of daily meals and its relation to demographic, socioeconomic, behavioral, anthropometric and biochemical factors in children and adolescents. Methods: This was a cross-sectional study with a representative sample of 708 schoolchildren aged 7-14 years. Data on personal information, socioeconomic status, physical activity and number of meals were obtained through semi-structured questionnaire and consumption by 24-h recall and food record. Weight and height measurements were also performed to calculate the body mass index. Finally, blood samples were collected for analysis of total cholesterol, high- and low density lipoprotein, triglyceride, and glucose levels. Descriptive statistics, the Mann-Whitney test, and Poisson regression were used in statistical analysis. Results: Meal frequency <4 was associated in children, family income <3 Brazilian minimum wages (PR = 5.42; 95% CI: 1.29-22.77; p = 0.021) and adolescents, the number of sons in the family >2 (PR = 1.53; 95% CI: 1.11-2.11; p = 0.010). Even in the age group of 10-14 years, <4 meals was related to higher prevalence of body mass index (PR = 1.33; 95% CI: 1.02-1.74; p = 0.032) and low-density lipoprotein (PR = 1.39; 95% CI: 1.03-1.87; p = 0.030) higher after adjustments. Conclusion: Lower frequency of meals was related to lower income in children and adolescents, larger number of sons in the family, and increased values of body mass index and low-density lipoprotein.

Resumo: Objetivo: Investigar a distribuição da frequência de refeições diárias e sua relação com fatores demográficos, socioeconômicos, comportamentais, antropométricos e bioquímicos em crianças e adolescentes. Métodos: Estudo transversal feito com uma amostra representativa de 708 escolares 7 e 14 anos. Os dados sobre informações pessoais, nível socioeconômico, atividade física e número de refeições foram obtidos por meio de questionário semiestruturado e o consumo por meio de recordatório de 24 horas e registro alimentar. Medidas de peso e altura também foram feitas para cálculo do índice de massa corporal. Por fim, coletaram-se amostras de sangue para análises de colesterol total, lipoproteína de baixa e de alta densidade, triglicerídeos e glicemia. Análises descritivas, teste de Mann-Whitney e regressão de Poisson foram usados nas análises estatísticas. Resultados: Frequência de refeições < 4 se associou, em crianças, a renda familiar < 3 salários (RP = 5,42; IC 95%: 1,29-22,77; p = 0,021) e, em adolescentes, ao número de filhos na família > 2 (RP = 1,53; IC 95%: 1,11-2,11; p = 0,010). Ainda na faixa de 10 a 14 anos, < 4 refeições se relacionou a maior prevalência de índice de massa corporal (RP = 1,33; IC 95%: 1,02-1,74; p = 0,032) e lipoproteína de baixa densidade (RP = 1,39; IC 95%: 1,03-1,87; p = 0,030) elevados após ajustes. Conclusão: Menor frequência de refeições se associou a menor renda em crianças e em adolescentes a maior número de filhos na família e valores aumentados de índice de massa corporal e lipoproteína de baixa densidade.

Evaluation of diet quality and its associated factors among adolescents in Kuala Lumpur, Malaysia

BACKGROUND/OBJECTIVES: This study aims to determine contribution of meal frequency, self-efficacy for healthy eating, and availability of healthy foods towards diet quality of adolescents in Kuala Lumpur, Malaysia. SUBJECTS/METHODS: This study was conducted among 373 adolescents aged from 13 to 16 years old. Diet quality of the respondents was assessed using the Healthy Eating Index for Malaysians. Meal frequency, self-efficacy for healthy eating, and availability of healthy foods were assessed through the Eating Behaviours Questionnaire (EBQ), self-efficacy for healthy eating scale, and availability of healthy foods scale, respectively. RESULTS: The majority of the respondents (80.7%) were at risk of poor diet quality. Males (mean = 34.2 +/- 8.2%) had poorer diet quality than females (mean = 39.9 +/- 9.0%) (t = -5.941, P < 0.05). Malay respondents (mean = 36.9 +/- 8.7%) had poorer diet quality than Indian respondents (mean = 41.3 +/- 10.0%) (F = 2.762, P < 0.05). Age (r = 0.123, P < 0.05), self-efficacy for healthy eating (r = 0.129, P < 0.05), and availability of healthy foods (r = 0.159, P < 0.05) were positively correlated with the diet quality of the respondents. However, meal frequency was not correlated with the diet quality of the respondents. Multiple linear regression analysis showed that being a male, being a Malay, low self-efficacy for healthy eating, and low availability of healthy foods contributed significantly towards poor diet quality among respondents. CONCLUSIONS: In short, sex, ethnicity, self-efficacy for healthy eating, and availability of healthy foods were associated with diet quality among adolescents. Health practitioners should take into consideration of differences in sex and ethnicity during implementation of nutrition-related intervention programs. Self-efficacy for healthy eating and availability of healthy foods should be included as important components in improving diet quality of adolescents.

Mothers’ caregiving resources and practices for children under 5 years in the slums of Hyderabad, India: a cross-sectional study.

Background: The extended care model of the United Nations Children’s Fund (UNICEF) identifies knowledge/beliefs, nutritional status, mental health, control of resources/autonomy, workload/time constraints and social support as important caregiver resources for childcare. The aim of this paper is to examine the role of mothers’ caregiving resources in child-care practices in slums. Methods: A cross-sectional study was conducted in 10 slums of Hyderabad, to appraise the caregiving practices and health status of children under 5 years. Data were collected from 506 households, selected through multistage stratified random sampling, and data relating to 451 children aged 6–59 months were analysed. Four caregiving practices were studied: psychosocial stimulation, as assessed by the Home Observation Measurement of the Environment inventory; hygienic care rated by spot-check observation; and meal frequency and dietary diversity based on maternal recall. The role of the mother’s caregiving resources was examined using bivariate and multivariate logistic regression analyses. Results: More than 50% of the children received good psychosocial stimulation and close to 60% had good hygienic care. About 75% of the children aged 6–23 months had the recommended minimum meal frequency and 13% had the recommended dietary diversity. Mother’s media exposure (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.35–3.77), participation in household budgeting (OR 2.19, CI 1.25–3.83) and husband’s support (OR 2.04, CI 1.28–3.24) were predictors of psychosocial stimulation. Mother’s younger age (OR 1.11, CI 1.04– 1.18), poor media exposure (OR 1.95, CI 1.15–3.29), dissatisfaction with life (OR 1.84, CI 1.05–3.24), workload (OR 1.79, CI 1–3.18) and having no money for their own use (OR 1.52, CI 0.95–2.45) placed children at higher odds for receiving poor hygienic care. Leisure time (OR 2.75, CI 1.25–6.06) and participation in budgeting (OR 1.97, CI 1–3.86) were predictors of meal frequency. Conclusion: Mother’s workload, poor media exposure, dissatisfaction with life, lack of husband’s support and absence of economic autonomy are constraints to good child care in slums.

The Association Between Eating Frequency and Metabolic Syndrome

BACKGROUND: Metabolic syndrome increases the risk for cardiovascular diseases and type 2 diabetes mellitus. Many studies have revealed that eating frequency influences the total serum cholesterol level, glucose tolerance and obesity. Hypothesizing that an increase in eating frequency decreases the prevalence of metabolic syndrome with total energy intake adjusted, we evaluated the association between eating frequency and the risk of metabolic syndrome in Koreans aged more than 20 years old. METHODS: We used the data from the 2005 Korean National Health and Nutrition Examination Survey. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III and the Asia-Pacific regional obesity guidelines. To examine the association of metabolic syndrome with eating frequency, snack frequency and meal frequency, we performed multiple logistic regression analysis adjusting for age, sex, physical activity, daily caloric intake, smoking and drinking. RESULTS: Meal frequency was associated with metabolic syndrome in the 20-45 years group (P=0.011). Eating frequency was significantly related with metabolic syndrome in the group aged more than 45 years (P=0.025). Within the subgroup of subjects more than 45 years who had one or two meals a day, snack frequency showed a significant association with metabolic syndrome (P=0.038). CONCLUSIONS: These results suggest that a decreased eating frequency is associated with a risk of metabolic syndrome, although the causal relationship is not exactly known. It would be useful to pursue this question through further studies.