Koyratty Nadia, Mbuya Mduduzi N N, Jones Andrew D, Schuster Roseanne C, Kordas Katarzyna, Li Chin-Shang, Tavengwa Naume V, Majo Florence D, Chasekwa Bernard, Ntozini Robert, Humphrey Jean H, Smith Laura E
Poverty, Health and Nutrition Department, International Food Policy Research Institute Washington DC, Washington, DC, USA.
Global Alliance for Improved Nutrition, Washington, DC, 20036, USA.
BMC Nutr. 2022 Nov 18;8(1):136. doi: 10.1186/s40795-022-00622-8.
Inadequate food and water resources negatively affect child health and the efficiency of nutrition interventions.
We used data from the SHINE trial to investigate the associations of food insecurity (FI) and water insecurity (WI) on mothers' implementation and maintenance of minimum infant dietary diversity (MIDD). We conducted factor analysis to identify and score dimensions of FI (poor access, household shocks, low availability & quality), and WI (poor access, poor quality and low reliability). MIDD implementation (n = 636) was adequate if infants aged 12 months (M12) ate ≥ four food groups. MIDD maintenance (n = 624) was categorized into four mutually exclusive groups: A (unmet MIDD at both M12 and M18), B (unmet MIDD at M12 only), C (unmet MIDD at M18 only), and D (met MIDD at both M12 and M18). We used multivariable-adjusted binary logistic and multinomial regressions to determine likelihood of MIDD implementation, and of belonging to MIDD maintenance groups A-C (poor maintenance groups), compared to group D, respectively.
Low food availability & quality were negatively associated with implementation (OR = 0.81; 0.69, 0.97), and maintenance (OR = 1.29; 1.07, 1.56). Poor water quality was positively associated with implementation (OR = 1.25; 1.08, 1.44), but inconsistently associated with maintenance, with higher odds of infants being in group C (OR = 1.39; 1.08, 1.79), and lower odds of being in group B (OR = 0.80; 0.66, 0.96).
Food security should be prioritized for adequate implementation and maintenance of infant diets during complementary feeding. The inconsistent findings with water quality indicate the need for further research on WI and infant feeding.
食物和水资源不足对儿童健康及营养干预效果产生负面影响。
我们利用“阳光”试验的数据，调查粮食不安全（FI）和水不安全（WI）与母亲实施及维持婴儿最低饮食多样性（MIDD）之间的关联。我们进行了因子分析，以确定FI（获取困难、家庭冲击、供应及质量低）和WI（获取困难、质量差和可靠性低）的维度并进行评分。如果12个月大（M12）的婴儿食用了≥4个食物类别，则MIDD实施情况（n = 636）为充足。MIDD维持情况（n = 624）分为四个相互排斥的组：A（M12和M18时MIDD均未达标）、B（仅M12时MIDD未达标）、C（仅M18时MIDD未达标）和D（M12和M18时MIDD均达标）。我们使用多变量调整后的二元逻辑回归和多项回归，分别确定MIDD实施的可能性以及与D组相比属于MIDD维持组A - C（维持情况差的组）的可能性。
低食物供应及质量与实施情况（比值比[OR] = 0.81；0.69，0.97）和维持情况（OR = 1.29；1.07，1.56）呈负相关。水质差与实施情况呈正相关（OR = 1.25；1.08，1.44），但与维持情况的关联不一致，婴儿处于C组的几率较高（OR = 1.39；1.08，1.79），处于B组的几率较低（OR = 0.80；0.66，0.96）。
在辅食喂养期间，为了充分实施和维持婴儿饮食，应优先保障粮食安全。水质方面不一致的研究结果表明，需要对水不安全和婴儿喂养进行进一步研究。
