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

Psaki S, Bhutta ZA, Ahmed T, Ahmed S, Bessong P, Islam M, John S, Kosek M, Lima A, Nesamvuni C, Shrestha P, Svensen E, McGrath M, Richard S, Seidman J, Caulfield L, Miller M, Checkley W, for MALED Network Investigato - Popul Health Metr (2012)

Bottom Line: 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).Such a measure could be used to direct interventions by identifying children at risk of illness and death related to malnutrition.

View Article: PubMed Central - HTML - PubMed

Affiliation: Fogarty International Center, National Institutes of Health, Bethesda, USA. wcheckl1@jhmi.edu.

ABSTRACT

Background: Stunting 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.

Methods: We 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.

Results: Average 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).

Conclusions: Our 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.

No MeSH data available.


Related in: MedlinePlus

Barplots of food access insecurity score by country; 2009–10.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3584951&req=5

Figure 1: Barplots of food access insecurity score by country; 2009–10.

Mentions: Food access insecurity score distributions were skewed right, indicating a large subgroup of households reporting no food access insecure experiences in the preceding four weeks (Figure 1). Across sites, 37% of all households reported no food access insecurity in the last four weeks (score of 0). This value ranged from 18% of households in Peru to 72% in Nepal. Nepal (2.4) and Tanzania (2.6) had the lowest mean scores, as well as the smallest variability between households (SD = 4.8 for both), while Pakistan (8.3) and Brazil (7.9) had the highest mean scores. Nearly half (46.9%) of households in the Brazilian site reported severe food access insecurity, whereas the majority of households in Nepal (73.0%) and Tanzania (66.7%) indicated food access security.


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

Psaki S, Bhutta ZA, Ahmed T, Ahmed S, Bessong P, Islam M, John S, Kosek M, Lima A, Nesamvuni C, Shrestha P, Svensen E, McGrath M, Richard S, Seidman J, Caulfield L, Miller M, Checkley W, for MALED Network Investigato - Popul Health Metr (2012)

Barplots of food access insecurity score by country; 2009–10.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3584951&req=5

Figure 1: Barplots of food access insecurity score by country; 2009–10.
Mentions: Food access insecurity score distributions were skewed right, indicating a large subgroup of households reporting no food access insecure experiences in the preceding four weeks (Figure 1). Across sites, 37% of all households reported no food access insecurity in the last four weeks (score of 0). This value ranged from 18% of households in Peru to 72% in Nepal. Nepal (2.4) and Tanzania (2.6) had the lowest mean scores, as well as the smallest variability between households (SD = 4.8 for both), while Pakistan (8.3) and Brazil (7.9) had the highest mean scores. Nearly half (46.9%) of households in the Brazilian site reported severe food access insecurity, whereas the majority of households in Nepal (73.0%) and Tanzania (66.7%) indicated food access security.

Bottom Line: 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).Such a measure could be used to direct interventions by identifying children at risk of illness and death related to malnutrition.

View Article: PubMed Central - HTML - PubMed

Affiliation: Fogarty International Center, National Institutes of Health, Bethesda, USA. wcheckl1@jhmi.edu.

ABSTRACT

Background: Stunting 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.

Methods: We 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.

Results: Average 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).

Conclusions: Our 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.

No MeSH data available.


Related in: MedlinePlus