Development Strategy and Governance Division, International Food Policy Research Institute (IFPRI), Addis Ababa, Ethiopia.
Economics Department, State University of New York at Albany, Albany, New York, USA.
Matern Child Nutr. 2024 Jul;20 Suppl 5(Suppl 5):e13262. doi: 10.1111/mcn.13262. Epub 2021 Sep 15.
Child undernutrition disproportionally affects children in low- and middle-income countries. In Ethiopia, both wasting and stunting are serious public health concerns, with high human and economic costs. Understanding the dynamics in ponderal and linear growth faltering is critical to inform the design of innovative interventions that can prevent both wasting and stunting in poor and complex settings. Using two longitudinal studies conducted in 2017 and 2019 in four highland regions of Ethiopia, we evaluated the dynamics and drivers of child growth faltering in children 6-23 months of age (N = 5003). Child wasting prevalence peaked during the first 6 months of life, whereas stunting increased significantly after 6 months of age. Male sex, child illnesses (i.e., diarrhoea or fever) and low consumption of fruits and vegetables were associated with higher odds of acute undernutrition (P < 0.05). The consumption of animal source foods (ASF) was associated with increases (β: 95% CI) in weight-for-length Z-score (WLZ; 0.12: 0.0002; 0.242), whereas fruit or vegetables consumption was associated with increases in midupper arm circumference (MUAC; 0.11 cm: 0.003; 0.209). Only consumption of ASF was the statistically significant predictor of future linear growth (0.14: 0.029; 0.251). Distinct trends in WLZ and MUAC were observed by child sex and age. Improving diet quality through improved nutrition knowledge and increased access and affordability of ASFs, along with effective infection prevention/control measures could prevent both child wasting and stunting concurrently.
儿童营养不良不成比例地影响中低收入国家的儿童。在埃塞俄比亚，消瘦和发育迟缓都是严重的公共卫生问题，造成了高昂的人力和经济成本。了解体重和线性生长迟缓的动态变化对于设计创新干预措施至关重要，这些措施可以在贫困和复杂环境中预防消瘦和发育迟缓。本研究利用 2017 年和 2019 年在埃塞俄比亚四个高地地区进行的两项纵向研究，评估了 6-23 个月龄儿童生长迟缓的动态变化及其驱动因素（N=5003）。儿童消瘦的患病率在生命的头 6 个月达到峰值，而发育迟缓在 6 个月后显著增加。男性、儿童疾病（即腹泻或发热）和水果及蔬菜摄入量低与急性营养不良的发生风险较高相关（P<0.05）。动物源食品（ASF）的摄入与体重长度 Z 评分（WLZ）的增加（β：95%CI）有关（0.12：0.0002；0.242），而水果或蔬菜的摄入与中上臂围（MUAC）的增加有关（0.11cm：0.003；0.209）。只有 ASF 的摄入是未来线性生长的统计学显著预测因素（0.14：0.029；0.251）。WLZ 和 MUAC 随儿童性别和年龄的不同而呈现出不同的趋势。通过提高营养知识和增加 ASF 的可及性和可负担性，改善饮食质量，并采取有效的感染预防/控制措施，可以同时预防儿童消瘦和发育迟缓。
