International Center for Equity in Health, Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.
J Nutr. 2021 Jul 1;151(7):1956-1964. doi: 10.1093/jn/nxab088.
Adequate complementary feeding practices in early childhood contribute to better food preferences and health outcomes throughout the life course.
The aim of this study was to describe patterns and socioeconomic inequalities in complementary feeding practices among children aged 6-23 mo in 80 low- and middle-income countries.
We analyzed national surveys carried out since 2010. Complementary feeding indicators for children aged 6-23 mo included minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD). Between- and within-country inequalities were documented using relative (wealth deciles), gross domestic product (GDP) per capita, and absolute (estimated household income) socioeconomic indicators. Statistical analyses included calculation of the slope index of inequality, Pearson correlation and linear regression, and scatter diagrams.
Only 21.3%, 56.2%, and 10.1% of the 80 countries showed prevalence levels >50% for MDD, MMF, and MAD, respectively. Western & Central Africa showed the lowest prevalence for all indicators, whereas the highest for MDD and MAD was Latin America & Caribbean, and for MMF it was East Asia & the Pacific. Log GDP per capita was positively associated with MDD (R2 = 48.5%), MMF (28.2%), and MAD (41.4%). Pro-rich within-country inequalities were observed in most countries for the 3 indicators; pro-poor inequalities were observed in 2 countries for MMF, and in none for the other 2 indicators. Breast milk was the only type of food with a pro-poor distribution, whereas animal-source foods (dairy products, flesh foods, and eggs) showed the most pronounced pro-rich inequality. Dietary diversity improved sharply when absolute annual household incomes exceeded ∼US$20,000. All 3 dietary indicators improved by age and no consistent differences were observed between boys and girls.
Monitoring complementary feeding indicators across the world and implementing policies and programs to reduce wealth-related inequalities are essential to achieve optimal child nutrition.
婴幼儿时期适当的补充喂养实践有助于在整个生命周期中形成更好的食物偏好和健康结果。
本研究旨在描述 80 个低收入和中等收入国家 6-23 月龄儿童补充喂养实践的模式和社会经济不平等情况。
我们分析了自 2010 年以来进行的国家调查。用于 6-23 月龄儿童的补充喂养指标包括最低饮食多样性（MDD）、最低膳食频率（MMF）和最低可接受饮食（MAD）。使用相对（财富十分位数）、国内生产总值（人均 GDP）和绝对（估计家庭收入）社会经济指标记录国家间和国家内的不平等情况。统计分析包括计算不平等斜率指数、皮尔逊相关和线性回归以及散点图。
80 个国家中，仅有 21.3%、56.2%和 10.1%的国家 MDD、MMF 和 MAD 的流行率水平>50%。西非和中非地区所有指标的流行率最低，而 MDD 和 MAD 的最高流行率地区是拉丁美洲和加勒比地区，MMF 的最高流行率地区是东亚和太平洋地区。人均国内生产总值的对数与 MDD（R2=48.5%）、MMF（28.2%）和 MAD（41.4%）呈正相关。在大多数国家，3 个指标都存在有利于富人的国家内不平等现象；在 2 个国家，MMF 存在有利于穷人的不平等现象，而在其他 2 个指标中没有。母乳是唯一一种有利于穷人的食物类型，而动物源食品（乳制品、肉类食品和蛋类）则表现出最明显的有利于富人的不平等。当家庭年收入绝对超过约 20,000 美元时，饮食多样性会急剧改善。所有 3 个饮食指标都随年龄增长而改善，男孩和女孩之间没有观察到一致的差异。
监测全球补充喂养指标并实施政策和方案以减少与财富相关的不平等现象，对于实现儿童最佳营养至关重要。
