Determinants of Stunting and Overweight among Young Children and Adolescents in Sub-Saharan Africa

Keino, Susan; Plasqui, Guy; Ettyang, Grace; Borne, Bart van den

doi:10.1177/156482651403500203

Cited by 206 publications

(228 citation statements)

References 48 publications

(115 reference statements)

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“…Taken together, these results suggest that of the factors measured, parental anthropometry and birth or gestational factors are most important in determining both linear growth faltering and wasting in Ifanadiana. These results are consistent with international literature showing that demographic factors, particularly child age, maternal weight, and birth size are important determinants of both stunting and wasting [13,14,17,19,21]. Paternal nutritional status is both less studied and less strongly predictive of malnutrition in international literature [17]; its importance in determining stunting may be a unique feature of our study, which included a large set of matched fathers, or of this population.…”

Section: Discussionsupporting

confidence: 92%

“…These results are consistent with international literature showing that demographic factors, particularly child age, maternal weight, and birth size are important determinants of both stunting and wasting [13,14,17,19,21]. Paternal nutritional status is both less studied and less strongly predictive of malnutrition in international literature [17]; its importance in determining stunting may be a unique feature of our study, which included a large set of matched fathers, or of this population. This contrasts with previous studies in Madagascar which have attributed malnutrition to behavioral factors, poor maternal education, and male sex [25,27–29], and to international literature emphasizing parental education and behaviors [13,19] and male sex [13,17,21] as risk factors for malnutrition.…”

Section: Discussionsupporting

confidence: 92%

“…Gastrointestinal infection, even without symptoms such as diarrhea, is likely to play a role in stunting as well: a recent longitudinal study attributed linear growth faltering, which leads to stunting, to enteropathogen exposure, even in the absence of diarrheal illness [16]. Diet is also important, although it is less commonly associated with stunting or wasting in international literature, perhaps due to difficulties in studying nutritional intake [17]. However, some longitudinal research attributes both linear growth faltering and poor weight gain to low energy intake and low protein density [16].…”

Section: Introductionmentioning

confidence: 99%

“…However, some longitudinal research attributes both linear growth faltering and poor weight gain to low energy intake and low protein density [16]. Environmental factors such as rural residence [13,17], dry season, and local food shortages [18] all predict malnutrition in multiple studies. Maternal and paternal education have been associated with lower odds of malnutrition [13,19]; in one study in Indonesia, health-promoting parental behaviors such as vaccination and supplementation appeared to mediate this relationship [20], and in one study in Tanzania, maternal farming work appeared to worsen child nutritional status [18].…”

Section: Introductionmentioning

confidence: 99%

“…Maternal and paternal education have been associated with lower odds of malnutrition [13,19]; in one study in Indonesia, health-promoting parental behaviors such as vaccination and supplementation appeared to mediate this relationship [20], and in one study in Tanzania, maternal farming work appeared to worsen child nutritional status [18]. However across international literature, the strongest and most consistent risk factors for malnutrition are demographic: male sex [13,17,21], increasing child age [13,14,21], smaller birth size [13,14,19], and poor maternal nutritional status [13,14,17,19] all predicted malnutrition, particularly stunting, in multiple studies and reviews, leading some authors to conclude that many relevant determinants of growth faltering are already established at birth [19]. …”

Section: Introductionmentioning

confidence: 99%

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Child malnutrition in Ifanadiana district, Madagascar: associated factors and timing of growth faltering ahead of a health system strengthening intervention

McCuskee

Garchitorena

Miller

et al. 2018

Global Health Action

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Background: Child malnutrition, a leading cause of death and disability worldwide, is particularly severe in Madagascar, where 47% of children under 5 years are stunted (low height-for-age) and 8% are wasted (low weight-for-height). Widespread poverty and a weak health system have hindered attempts to implement life-saving malnutrition interventions in Madagascar during critical periods for growth faltering. Objective: This study aimed to shed light on the most important factors associated with child malnutrition, both acute and chronic, and the timing of growth faltering, in Ifanadiana, a rural district of Madagascar. Methods: We analyzed data from a 2014 district-representative cluster household survey, which had information on 1175 children ages 6 months to 5 years. We studied the effect of child health, birth history, maternal and paternal health and education, and household wealth and sanitation on child nutritional status. Variables associated with stunting and wasting were modeled separately in multivariate logistic regressions. Growth faltering was modeled by age range. All analyses were survey-adjusted. Results: Stunting was associated with increasing child age (OR = 1.03 (95%CI 1.02–1.04) for each additional month), very small birth size (OR = 2.32 (1.24–4.32)), low maternal weight (OR = 0.94 (0.91–0.97) for each kilogram, kg) and height (OR = 0.95 (0.92–0.99) for each centimeter), and low paternal height (OR = 0.95 (0.92–0.98)). Wasting was associated with younger child age (OR = 0.98 (0.97–0.99)), very small birth size (OR = 2.48 (1.23–4.99)), and low maternal BMI (OR = 0.84 (0.75–0.94) for each kg/m2). Height-for-age faltered rapidly before 24 months, then slowly until age 5 years, whereas weight-for-height faltered rapidly before 12 months, then recovered gradually until age 5 years but did not reach the median. Conclusion: Intergenerational transmission of growth faltering and early life exposures may be important determinants of malnutrition in Ifanadiana. Timing of growth faltering, in the first 1000 days, is similar to international populations; however, child growth does not recover to the median.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Child malnutrition in Ifanadiana district, Madagascar: associated factors and timing of growth faltering ahead of a health system strengthening intervention

McCuskee

Garchitorena

Miller

et al. 2018

Global Health Action

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Protective effects of diversified diets for dietary folate adequacy and serum homocysteine in breastfeeding mothers amid historic drought

Fujita,

Asthana,

Wamwere‐Njoroge

2024

American J Hum Biol

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ObjectivesThe United Nations recommends that women consume ≥5 food groups, also known as the minimum dietary diversity score for women (MDD‐W), for nutritional health. This is increasingly unattainable for populations in climate hot zones coping with food insecurity by prioritizing calories over dietary breadth. Breastfeeding mothers may be particularly vulnerable to adverse health impacts of low dietary diversity due to elevated nutritional requirements for lactation. We investigated how the protective effects of MDD‐W for folate adequacy varies by MDD‐W score and mother–infant life history characteristics.MethodsWe conducted a secondary analysis of cross‐sectional data from breastfeeding mothers (n = 228) in northern Kenya, surveyed during the 2006 Horn‐of‐Africa drought. Logistic regression models for adequate dietary folate (and vitamins B12 and B6) and normal homocysteine (folate‐replete status) evaluated the effect of MDD‐W alone and in interaction with infant/maternal characteristics.ResultsMDD‐W (as ordinal or dichotomous variable) was positively associated with adequate folate (and vitamin B12). Having male infant was inversely associated with adequate dietary folate. MDD‐W was generally unassociated with homocysteine. However, there was an interaction between MDD‐W and sex of the infant. Namely, MDD‐W ≥ 3 predicted increased probability of normal homocysteine among mothers with female infants but not male infants.ConclusionsDiets consisting of three or more food groups may protect adequate folate intake for many breastfeeding mothers. More research is needed to establish what level of dietary diversity would protect against hyperhomocysteinemia during breastfeeding and what factors promote or hinder the benefit of diversified diets on maternal folate nutrition.

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Childhood Threats to Adult Cognition in Sub-Saharan Africa: Malaria, Anemia, Stunting, Enteric Enteropathy, and the Microbiome of Malnutrition

Griffiths

Kikafunda

2015

Brain Degeneration and Dementia in Sub-Saharan Africa

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Determinants of Stunting and Overweight among Young Children and Adolescents in Sub-Saharan Africa

Cited by 206 publications

References 48 publications

Child malnutrition in Ifanadiana district, Madagascar: associated factors and timing of growth faltering ahead of a health system strengthening intervention

Child malnutrition in Ifanadiana district, Madagascar: associated factors and timing of growth faltering ahead of a health system strengthening intervention

Protective effects of diversified diets for dietary folate adequacy and serum homocysteine in breastfeeding mothers amid historic drought

Childhood Threats to Adult Cognition in Sub-Saharan Africa: Malaria, Anemia, Stunting, Enteric Enteropathy, and the Microbiome of Malnutrition

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