Food insecurity and the risk of undernutrition complications among children and adolescents: A systematic review and meta-analysis

Moradi, Sajjad; Mirzaei, Khadijeh; Mohammadi, Hamed; Moosavian, Seyedeh Parisa; Arab, Arman; Jannat, Behrooz; Mirzaei, Khadijeh

doi:10.1016/j.nut.2018.11.029

Cited by 78 publications

(65 citation statements)

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“…The risk of stunting and wasting/thinness was higher among student above 10 years of age compared with lower age groups, which is in line with a meta-analysis reported from Iran [60] and sub-Saharan Africa [5]. Higher risk of stunting was reported from boys than girls in many African countries include Tanzania [64], Burkina Faso [65] and Uganda [62].…”

Section: Discussionsupporting

confidence: 81%

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Prevalence and determinants of undernutrition among school children of Ethiopia: a systematic review and meta-analysis

Hailegebreil¹

2019

Preprint

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Background: Ethiopia is the second populous countries in Africa where millions of children are affected by malnutrition. Several original works are available online about child malnutrition in Ethiopia. The aim of this study was to summarize the existing epidemiological data on undernutrition and possible determinants among school children in Ethiopia. Methods: We conducted a systematic review using open access articles which report prevalence of stunting and wasting/thinness from PubMed Central, Scopus and Science direct. From 358 articles accessed online, 39 of them were eligible for this meta-analysis. The heterogeneities among studies were evaluated using I2 test and the pooled prevalence was calculated using a random effect model. Results: A total of 24, 716 school children were included in 39 eligible articles for this meta-analysis. The pooled prevalence of stunting and wasting/thinness among school children in Ethiopia were 23.1% (95% CI: 19.0 - 27.0%) and 22% (95% CI: 17% - 26%), respectively. The risk of stunting was increased among the student with meal frequency ≤ 3 times a day (OR= 3.02, 95% CI: 1.90 - 4.14), age > 10 years (OR= 2.16, 95% CI: 1.47 - 2.85) and family size ≥ 5 (OR= 1.88, 95% CI: 1.40 - 2.35). Similarly, the risk of wasting/thinness was increased with male sex (OR= 2.06, 95% CI: 1.54 - 2.58), low family income (OR= 2.16, 95% CI: 1.30 - 3.01) and age > 10 years (OR= 1.78, 95% CI: 0.74 - 2.82). High heterogeneity about the prevalence of stunting and wasting/thinness was observed among studies included in this meta-analysis (I2 > 98.6). Conclusions: This study showed that stunting and wasting/thinness are common nutritional problems in school children in Ethiopia. Large family size, male sex and age above 10 years were consistently associated with stunting and wasting/thinness in children. The finding of this study highlights the importance of new strategies to reduce undernutrition in Ethiopia. Keywords: stunting, wasting, thinness, undernutrition, systematic review, meta-analysis

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Section: Discussionsupporting

confidence: 81%

“…It is clear that meal frequency is directly associated with family income. Children living in area where problems of food shortage or low family income, they have higher chance of being stunted and underweight [60]. The levels of family income dictate the provision of balanced diet as well as frequency of meal to their children.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of undernutrition among school children of Ethiopia: a systematic review and meta-analysis

Hailegebreil¹

2019

Preprint

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“…Scholars have previously described that a higher number of children aged <5 years per household may be associated with sub-optimal breastfeeding practices among younger siblings, as well as competition for food and other resources, which may ultimately lead to child undernutrition [21,27]. Food insecurity has been a strong predictor for child stunting in Mexico and other LMICs where children's diets face qualitative and quantitative deficiencies resulting in child undernutrition over time [37,38].…”

Section: Discussionmentioning

confidence: 99%

Association Between Breastfeeding and Child Stunting in Mexico

Campos

Vilar‐Compte

Hawkins

2020

Annals of Global Health

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Background: Globally, the prevalence of child stunting has been decreasing over the past decades. However, in low- and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breastfeeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed- and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breastfeeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.

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“…Children living in an area where there is a problem of food shortage and low family income may have a higher chance of being stunted and underweight. 64 The levels of family income dictate the provision of a balanced diet as well as the optimum frequency of meals to their children. Long-term exposure for food shortage early in life leads to chronic undernutrition namely stunting.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Determinants of Stunting and Thinness/Wasting Among Schoolchildren of Ethiopia: A Systematic Review and Meta-Analysis

Hailegebriel

2020

Food Nutr Bull

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Background: Several studies have been carried out on assessing the prevalence of undernutrition and possible determinants among schoolchildren in Ethiopia, but there is a lack of systematically gathered and analyzed information. Objective: This systematic review and meta-analysis aimed to summarize epidemiological data on undernutrition and possible determinants among schoolchildren in Ethiopia. Methods: We conducted a systematic review using open access articles that report the prevalence of stunting and wasting/thinness among schoolchildren from PubMed Central, Scopus, and Science direct. The pooled prevalence was determined using a random-effect model while heterogeneities between studies were evaluated by I 2 test. Results: A total of 24 716 schoolchildren were included in the 39 eligible articles. The prevalence of stunting and wasting/thinness among schoolchildren in Ethiopia were 23.1% (95% CI: 19.0-27.0) and 22% (95% CI: 17-26), respectively. There was a marked difference in the prevalence of stunting and wasting/thinness across regions of Ethiopia. The risk of stunting was increased with meal frequency ≤3 times a day (odds ratio [OR] = 3.02, 95% CI: 1.90-4.14), age >10 years (OR = 2.16, 95% CI: 1.47-2.85), and family size ≥5 (OR = 1.88, 95% CI: 1.40-2.35). Similarly, the risk of wasting/thinness was increased with male sex (OR = 2.06, 95% CI: 1.54-2.58), low family income (OR = 2.16, 95% CI: 1.30-3.01), and age >10 years (OR = 1.78, 95% CI: 0.74-2.82). Conclusion: This study revealed that more than one-fifth of schoolchildren are stunted or wasted/thinned in Ethiopia. Large family size, male sex, and student age were consistently associated with stunting and wasting/thinness among schoolchildren. This study highlights the importance of an integrated effort to reduce undernutrition in Ethiopia.

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Food insecurity and the risk of undernutrition complications among children and adolescents: A systematic review and meta-analysis

Cited by 78 publications

References 50 publications

Prevalence and determinants of undernutrition among school children of Ethiopia: a systematic review and meta-analysis

Prevalence and determinants of undernutrition among school children of Ethiopia: a systematic review and meta-analysis

Association Between Breastfeeding and Child Stunting in Mexico

Prevalence and Determinants of Stunting and Thinness/Wasting Among Schoolchildren of Ethiopia: A Systematic Review and Meta-Analysis

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