Department of Human and Organizational Development, Peabody College, Vanderbilt University, Vanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Nutrition Department, Medical Research Institute, Ministry of Health Sri Lanka, Colombo, Sri Lanka.
Nutrition. 2018 Nov;55-56:76-83. doi: 10.1016/j.nut.2018.03.049. Epub 2018 Mar 30.
We investigate the association between child dietary diversity and anthropometric status and failure in Sri Lanka while accounting for other child and household factors by employing multivariable logistic and linear regression analyses.
Using a nationally representative survey of children ages 6 mo to 59 mo, child dietary diversity was based on the 24-h recall of a child's food intake across seven food groups. The minimum dietary diversity was a score of four or above. Anthropometric status (i.e., height for age (HAZ), weight for age, and weight for height z-scores) and failure (i.e., stunting, wasting, and underweight) were calculated.
The prevalence of stunting, wasting, and underweight was 15%, 21%, and 26%, respectively. The prevalence of inadequate dietary diversity was 9%. Child dietary diversity was positively associated with HAZ (b = 0.02; standard error = 0.01; P = 0.04) but not with any indicator of anthropometric failure. However, low birth weight, wealth, and location were strong risk factors for anthropometric status and failure. Analyses stratified by child age indicated that dietary diversity was positively associated with anthropometric status for children ages 24 mo to 59 mo (HAZ: b = 0.03; standard error = 0.01; P = 0.02). Mixed associations were found for children ages 6 mo to 12 mo and there were no associations for children ages 12 mo to 24 mo.
Child dietary diversity predicted anthropometric status among children ages ≥24 mo. Interventions to address both proximal and distal risk factors for anthropometric status may be necessary in Sri Lanka to reduce anthropometric failure among infants and young children.
本研究旨在探讨斯里兰卡儿童饮食多样性与体格发育不良和失败之间的关系,同时通过多变量逻辑回归和线性回归分析考虑其他儿童和家庭因素。
本研究使用了一项针对 6 个月至 59 个月儿童的全国代表性调查,通过儿童 24 小时食物摄入回顾来评估儿童饮食多样性,涵盖七个食物组。最小饮食多样性得分为 4 或以上。采用身高别年龄(HAZ)、年龄别体重和身高别体重 z 分数来评估体格发育状况和失败情况。
发育迟缓、消瘦和体重不足的患病率分别为 15%、21%和 26%。饮食多样性不足的患病率为 9%。儿童饮食多样性与 HAZ 呈正相关(b=0.02;标准误=0.01;P=0.04),但与任何一项体格发育不良指标无关。然而,低出生体重、财富和地理位置是儿童体格发育不良和失败的强烈危险因素。根据儿童年龄进行的分层分析表明,饮食多样性与 24 个月至 59 个月儿童的体格发育状况呈正相关(HAZ:b=0.03;标准误=0.01;P=0.02)。对于 6 个月至 12 个月的儿童,相关性较为复杂,而对于 12 个月至 24 个月的儿童则没有相关性。
儿童饮食多样性可预测 24 个月以上儿童的体格发育状况。在斯里兰卡,为了减少婴幼儿的体格发育不良,可能需要针对体格发育不良的近端和远端危险因素进行干预。