Agbadi Pascal, Urke Helga Bjørnøy, Mittelmark Maurice B
Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway.
PLoS One. 2017 May 11;12(5):e0177377. doi: 10.1371/journal.pone.0177377. eCollection 2017.
Adequate diet is of crucial importance for healthy child development. In food insecure areas of the world, the provision of adequate child diet is threatened in the many households that sometimes experience having no food at all to eat (household food insecurity). In the context of food insecure northern Ghana, this study investigated the relationship between level of household food security and achievement of recommended child diet as measured by WHO Infant and Young Child Feeding Indicators.
Using data from households and 6-23 month old children in the 2012 Feed the Future baseline survey (n = 871), descriptive analyses assessed the prevalence of minimum meal frequency; minimum dietary diversity, and minimum acceptable diet. Logistic regression analysis was used to examine the association of minimum acceptable diet with household food security, while accounting for the effects of child sex and age, maternal -age, -dietary diversity, -literacy and -education, household size, region, and urban-rural setting. Household food security was assessed with the Household Hunger Scale developed by USAID's Food and Nutrition Technical Assistance Project.
Forty-nine percent of children received minimum recommended meal frequency, 31% received minimum dietary diversity, and 17% of the children received minimum acceptable diet. Sixty-four percent of the children lived in food secure households, and they were significantly more likely than children in food insecure households to receive recommended minimum acceptable diet [O.R = 0.53; 95% CI: 0.35, 0.82]. However, in 80% of food secure households, children did not receive a minimal acceptable diet by WHO standards.
Children living in food secure households were more likely than others to receive a minimum acceptable diet. Yet living in a food secure household was no guarantee of child dietary adequacy, since eight of 10 children in food secure households received less than a minimum acceptable diet. The results call for research into factors besides household food security in the search for determinants of child diet adequacy. In this study at least, household food security was a very weak marker of child diet adequacy. This finding is of significance to public health practice, since it calls into question any assumption that having enough food in a household necessarily results in adequately fed children.
充足的饮食对儿童的健康发育至关重要。在世界粮食不安全地区，许多家庭有时根本没有食物可吃（家庭粮食不安全），这威胁到了为儿童提供充足的饮食。在粮食不安全的加纳北部，本研究调查了家庭粮食安全水平与根据世界卫生组织婴幼儿喂养指标衡量的推荐儿童饮食达标情况之间的关系。
利用2012年“保障未来粮食供应”基线调查中家庭和6至23个月儿童的数据（n = 871），描述性分析评估了最低进餐频率、最低饮食多样性和最低可接受饮食的流行情况。逻辑回归分析用于检验最低可接受饮食与家庭粮食安全之间的关联，同时考虑儿童性别和年龄、母亲年龄、饮食多样性、识字率和教育程度、家庭规模、地区以及城乡环境的影响。家庭粮食安全采用美国国际开发署粮食与营养技术援助项目制定的家庭饥饿量表进行评估。
49%的儿童达到了最低推荐进餐频率，31%的儿童达到了最低饮食多样性，17%的儿童达到了最低可接受饮食。64%的儿童生活在粮食安全家庭，与粮食不安全家庭的儿童相比，他们获得推荐的最低可接受饮食的可能性显著更高[比值比 = 0.53；95%置信区间：0.35, 0.82]。然而，在80%的粮食安全家庭中，按照世界卫生组织的标准，儿童并未获得最低可接受饮食。
生活在粮食安全家庭的儿童比其他儿童更有可能获得最低可接受饮食。然而，生活在粮食安全家庭并不能保证儿童饮食充足，因为粮食安全家庭中十分之八的儿童获得的饮食低于最低可接受水平。研究结果呼吁在寻找儿童饮食充足的决定因素时，除了家庭粮食安全之外，还要研究其他因素。至少在本研究中，家庭粮食安全是儿童饮食充足的一个非常弱的指标。这一发现对公共卫生实践具有重要意义，因为它质疑了任何认为家庭有足够食物就必然能使儿童获得充足喂养的假设。
