FAILURE TO THRIVE, IN LEBANON II. An Investigation of the Causes

Abstract

In a previous paper (4) we reported our experience with the use of some simple somatic measurements made in 1231 Lebanese Moslem Arab children between the ages of 3 and 48 months from low socio-economic families. From the relationship of four measurements (weight, height, head circumference and midarm circumference) to international standards, an "Index of Thriving" (8) was developed. On this basis, two contrasting groups of children were distinguished in the 1231 children.of a similar percentage of the population of each of the three areas. (Jba'a: 18.9% Thriving, 21% Failing to Thrive; Bourj a1 Barajne: 62.2% and 58.0%; Basta 18.9% and 21.0%). In addition, 107 siblings (35 "Thriving" and 70 "Failing to Thrive") were measured and the Index of Thriving calculated.The investigations were conducted in the homes of the study children. Thorough medical, developmental and anthropometric evaluations were made. Separate questionnaires were completed on (a) socioeconomic factors, (b) household data, and (c) nutritional beliefs and practices. Preliminary accounts of some of these results have been reported elsewhere (1, 3, 5, 6). RESULTSThe data obtained have been divided into se-Vera1 categories: 1) Family, 2) Socio-economic, 3) ~i~i~~ conditions, 4) Health, and 5) Dietary. Analysis of the data according to location revealed few statistically significant differences.

Factors associated with nutritional status among young children in St. Vincent

“…This is in agreement with other studies (Morley, et al, 1968;Wray and Aguirre, 1969;Antrobus, 1971: Kanawati andMcLaren, 1973).…”

“…The age oisevrage was by far the most statistically significant variable in its association with weight for age, and was second to LIVINGLEVEL in the average magnitude of its effect on nutritional status of the sample population. Many other studies have found the age of sevrage to have an important bearing on nutritional status (Welbourn, 1958;French, 1967;Wray and Aguirre, 1969;Grantham-McGregor and Back, 1970;Antrobus, 1971;Kanaaneh, 1972;Kanawati and McLaren, 1973;Shanghai CHCCG, 1974;Mata, 1978). (Jelliffe, 1966).…”

“…This variable was relatively high in both its significance level and magnitude. Previous studies have had contradictory findings with regard to the effect of various measures of fertility or family size on nutritional status (Nicol, 1959;Desai, et al, 1968;Morley, Bicknell and Woodland, 1968;Desai, et al, 1970;Kanawati and McLaren, 1973;Grantham-McGregor, Desai, and Buchanan, 1977;Gibbons, 1977;Marchione, 1978;Almroth and Latham, 1980). One reason for this may be the fact that mothers with one or two children are likely to be teenagers (Antrobus, 1971).…”

“…The index for economic level of living had by far the greatest average magnitude of effect on the nutritional status of the sample population. Numerous other studies have found that nutritional status is lower among families at a lower economic level of living (Desai, Miall and Standard, 1968;Wray and Aguirre, 1969;Desai, Standard and Miall, 1970;Kanawati and McLaren, 1973;Levinson, 1974;Westcott and Stott, 1977;Marchione, 1978;Mata, 1978;Taha, 1979;Almroth and Latham, 1980).…”

“…However, there would be little chance of seeing an effect in a sample such as this one, where bottle feeding was introduced rather uniformly at a very early age (median, two weeks), rather distant in time from the survey. Other studies have found an association between the early introduction of bottle feeding and low nutritional status (Welbourn, 1958;Antrobus, 1971;Kanaaneh, 1972;Kanawati and McLaren, 1973).…”