Department of Environmental & Occupational Health, Indiana University Bloomington, Bloomington, IN, USA.
Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN, USA.
J Nutr Sci. 2023 Aug 1;12:e89. doi: 10.1017/jns.2023.70. eCollection 2023.
We investigated the association of household food insecurity (HFI) with developmental delays in 36-59-month-old preschool children ( 7005) using cross-sectional data from the 2018 Ecuadorian National Health and Nutrition Survey. HFI was assessed with the Food Insecurity Experience Scale and developmental delays with the Early Childhood Development Index. Log-binomial regression models estimated the association of HFI with global (overall) developmental delay (GDD) and delays in four individual developmental domains, adjusting for covariates. Nearly half of the children lived in households with marginal (24⋅5 %) or moderate-severe HFI (21⋅7 %). Eighteen percent were identified with GDD. Delays in the individual domains of literacy-numeracy, social-emotional, physical and cognitive development were identified for 64, 21⋅5, 3⋅3 and 3⋅1 %, respectively. GDD was more likely among preschool children from households with marginal (aPR = 1⋅29; 95 % C.I. = 1⋅10, 1⋅49) and moderate-severe HFI (aPR = 1⋅30; 95 % C.I. = 1⋅11, 1⋅51). Social-emotional development delays were also more likely among those from households with marginal (aPR = 1⋅36; 95 % C.I. = 1⋅19, 1⋅56) and moderate-severe HFI (aPR = 1⋅33; 95 % C.I. = 1⋅15, 1⋅54) different from the other three domains. Several other potentially modifiable risk (violent discipline, maternal depressive symptoms) and protective factors (adequate child stimulation, higher maternal education, handwashing with soap/detergent) were also independently associated with GDD and/or literacy-numeracy and cognitive delays. Our findings suggest that HFI is an independent risk factor for GDD and social-emotional developmental delays in Ecuadorian preschoolers. They underscore the importance of strengthening and expanding poverty reduction, food security and early childhood development policies and interventions to improve the opportunities for children to achieve their full developmental potential.
我们使用 2018 年厄瓜多尔国家健康和营养调查的横断面数据，调查了家庭粮食不安全（HFI）与 36-59 个月大的学龄前儿童（7005 名）发育迟缓之间的关系。HFI 采用食物不安全体验量表评估，发育迟缓采用幼儿期发展指数评估。对数二项式回归模型估计了 HFI 与全球（整体）发育迟缓（GDD）和四个个体发育领域延迟之间的关联，同时调整了协变量。近一半的儿童生活在粮食不安全程度为边际（24.5%）或中度严重（21.7%）的家庭中。18%的儿童被确定为 GDD。在读写能力、社会情感、身体和认知发展的个体领域，分别有 64%、21.5%、3.3%和 3.1%的儿童出现发育迟缓。与边际（调整后比值比[aPR]=1.29；95%置信区间[CI]=1.10，1.49）和中度严重（aPR=1.30；95%CI=1.11，1.51）HFI 家庭的学龄前儿童相比，GDD 更有可能发生。与其他三个领域相比，与边际（aPR=1.36；95%CI=1.19，1.56）和中度严重（aPR=1.33；95%CI=1.15，1.54）HFI 家庭的儿童更有可能出现社会情感发育迟缓。其他一些潜在的可改变风险（暴力管教、产妇抑郁症状）和保护因素（适当的儿童刺激、较高的母亲教育水平、用肥皂/洗涤剂洗手）也与 GDD 和/或读写能力和认知发育迟缓独立相关。我们的研究结果表明，HFI 是厄瓜多尔学龄前儿童 GDD 和社会情感发育迟缓的独立危险因素。它们强调了加强和扩大减贫、粮食安全和幼儿发展政策和干预措施的重要性，以改善儿童充分发挥发展潜力的机会。
