Diet quality over time is associated with better development in rural Nepali children

Abstract

Developmental delays affect between 150 and 200 million children <5 years of age worldwide. Outside of diet supplement studies, relatively little is known about the relationships between diet quality and developmental status in resource‐poor settings. We examined associations between different aspects of dietary quality (dietary diversity score [DDS] and animal‐source food [ASF] consumption) and child development (assessed using the Ages and Stages Questionnaire‐3 [ASQ‐3]) among children whose families were enrolled in a community development intervention trial (implemented by Heifer Nepal) in western Nepal. Two sets of analyses were performed: (a) cross‐sectional Sample (N = 629) seen at the endline survey and (b) longitudinal sample (N = 269) with complete dietary records (six surveys over 48 months). In both samples, child development was significantly related to household wealth, maternal education, and especially home environmental quality. In the cross‐sectional sample, greater consumption of eggs (adjusted odds ratio [aOR] 0.80, p = .04) or dairy products (aOR 0.95, p = .05) over the previous 7 days significantly reduced odds of low total ASQ score, by logistic regression analysis. In the longitudinal sample, only egg consumption and cumulative DDS and ASF scores were associated with significantly reduced odds of low total ASQ score (aORs 0.59–0.89). In adjusted linear regression analysis, both cumulative DDS (β [CI]: 1.92 [0.4, 3.5]) and ASF scores (2.46 [0.3, 4.7]) were significantly associated with greater continuous total child development. Programmes targeting child development must address home environmental quality as well as long‐term diet quality.

Dairy Animal Ownership and Household Milk Production Associated with Better Child and Family Diet in Rural Nepal during the COVID-19 Pandemic

“…We hypothesized that child and family diet quality would diminish during the pandemic, but that dairy animal ownership would buffer this decline. Prior to the pandemic, child and household diets were similar to what has been previously described in this area of Nepal [ 27 , 28 , 62 , 63 ], with low DDS and ASF consumption. Over the 21 months of the pandemic, both child and family diet quality declined.…”

Child Diet and Household Characteristics Relate Differently to Child Development at the Beginning and the End of the Second “1000 Days” in Rural Nepal

“…We have previously reported on the relationship between minimum dietary diversity, consumption of ASFs, fruits and vegetables, cumulative DDS, and ASQ results in young children. 38,39 In the present small sample, however, we found a stronger and more consistent relationship between child developmental performance and ASF consumption than with DDS. We are unaware of other studies that have directly compared the relation of child development to ASF sum and DDS.…”

“…This standardized screening instrument is used worldwide (including Nepal) to assess child development. 38,39,[51][52][53][54] Feasibility and construct validity in northern India 55,56 as well as in Nepal have recently been reported. 54,57 The test is scored by observation (or parent report) and consists of 30 age-specific items within 5 domains: communication (eg, at age 30 months, correctly naming pictures of items such as a ball, a hat), gross motor (able to jump with both feet leaving the ground at the same time), fine motor (able to string beads), problem-solving (identifying his/ her image in a mirror), and personal-social skills (able to put on a jacket or shirt independently).…”

“…6,12,23 We previously reported on the impact of diet on developmental performance of rural Nepali children. 38,39 The results indicated that consumption of a diverse diet and animal source foods (ASFs) was associated with better child developmental performance. These dietary measures reflect household wealth, as well as family feeding practices.…”

Levels of dietary diversity and its associated factors among children aged 6–23 months in West Shoa, Ethiopia: a comparative cross-sectional study

“…Studies in Ethiopia and the rest of the world showed several factors that would have increased IYCF practice indicators in general and dietary diversity in specific among children aged 6-23 months old. Increased maternal education, household monthly income, being urban resident, mothers' knowledge on dietary diversification and attending any growth monitoring programmes as well as cooking demonstration, proper and sufficient exposure to media, antenatal and postnatal care service utilisation, a household visit by health extension worker (HEW), husband involvement in IYCF programmes and mothers' decision-making ability and age of mother and child are some of the positively associated factors acquiring better and sufficient diet (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) . However, almost all of the studies attempted to find predictors (associated factors) of dietary diversity using maximum likelihood estimation that shows changes in the log odds of the dependent, not direct changes in the dependent itself.…”