School of Public Health, University of California, Berkeley, CA 94704, USA.
School of Medicine, University of California, San Francisco, CA 94143, USA.
Int J Environ Res Public Health. 2020 Nov 20;17(22):8629. doi: 10.3390/ijerph17228629.
In India, globalization has caused a nutrition transition from home-cooked foods to processed sugary snacks and drinks, contributing to increased early childhood caries (ECC). This mixed-methods study describes risk factors for ECC and associations with undernutrition in low-income communities in Mumbai. Interviews with mothers of 959 children, ages six-months through six-years, addressed maternal-child nutrition and oral health, and children received dental exams and anthropometric assessments. Focus groups with community health workers and mothers explored experiences and perceptions of oral health, nutrition, and ECC. Descriptive and logistic regression analyses of quantitative data, and content analysis of qualitative data were performed. Eighty percent of children lived 5 min from a junk-food store, over 50% consumed junk-food and sugary tea daily, 50% experienced ECC, 19% had severe deep tooth decay, 27% experienced mouth pain, and 56% experienced chronic and/or acute malnutrition. In children ages 3-6, each additional tooth with deep decay was associated with increased odds of undernutrition (Odds Ratio [OR] 1.10, Confidence Interval [CI] 1.02-1.21). Focus groups identified the junk-food environment, busy family life, and limited dental care as contributors to ECC. Policy interventions include limits on junk-food marketing and incorporating oral health services and counseling on junk-food/sugary drinks into maternal-child health programs.
在印度，全球化导致了从家庭烹饪食品到加工含糖零食和饮料的营养转变，这导致了婴幼儿龋（ECC）的增加。本混合方法研究描述了孟买低收入社区婴幼儿龋的危险因素及其与营养不良的关联。对 959 名 6 个月至 6 岁儿童的母亲进行了访谈，内容涉及母婴营养和口腔健康，同时对儿童进行了口腔检查和人体测量评估。社区卫生工作者和母亲的焦点小组探讨了口腔健康、营养和婴幼儿龋的经验和看法。对定量数据进行描述性和逻辑回归分析，并对定性数据进行内容分析。80%的儿童居住在距离垃圾食品店 5 分钟路程内，超过 50%的儿童每天食用垃圾食品和含糖茶，50%的儿童患有婴幼儿龋，19%的儿童患有严重的深龋，27%的儿童有口腔疼痛，56%的儿童患有慢性和/或急性营养不良。在 3-6 岁的儿童中，每颗有深龋的额外牙齿与营养不良的几率增加相关（比值比 [OR] 1.10，置信区间 [CI] 1.02-1.21）。焦点小组确定了垃圾食品环境、忙碌的家庭生活和有限的牙科护理是导致婴幼儿龋的因素。政策干预措施包括限制垃圾食品营销，并将口腔健康服务和关于垃圾食品/含糖饮料的咨询纳入母婴健康计划。
