Associations of childhood, maternal and household dietary patterns with childhood stunting in Ethiopia: proposing an alternative and plausible dietary analysis method to dietary diversity scores

Abstract Background Identifying dietary patterns that consider the overall eating habits, rather than focusing on individual foods or simple counts of consumed foods, better helps to understand the combined effects of dietary components. Therefore, this study aimed to use dietary patterns, as an alt...

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Main Authors: Yohannes Adama Melaku, Tiffany K. Gill, Anne W. Taylor, Robert Adams, Zumin Shi, Amare Worku
Format: Article
Language:English
Published: BMC 2018-01-01
Series:Nutrition Journal
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12937-018-0316-3
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spelling doaj-f6113cc765434f3880805acc897eceae2020-11-25T00:03:25ZengBMCNutrition Journal1475-28912018-01-0117111510.1186/s12937-018-0316-3Associations of childhood, maternal and household dietary patterns with childhood stunting in Ethiopia: proposing an alternative and plausible dietary analysis method to dietary diversity scoresYohannes Adama Melaku0Tiffany K. Gill1Anne W. Taylor2Robert Adams3Zumin Shi4Amare Worku5Department of Public Health Sciences, Addis Continental Institute of Public HealthAdelaide Medical School, The University of AdelaideAdelaide Medical School, The University of AdelaideHealth Observatory, Discipline of Medicine, The Queen Elizabeth Hospital Campus, The University of AdelaideAdelaide Medical School, The University of AdelaideDepartment of Public Health Sciences, Addis Continental Institute of Public HealthAbstract Background Identifying dietary patterns that consider the overall eating habits, rather than focusing on individual foods or simple counts of consumed foods, better helps to understand the combined effects of dietary components. Therefore, this study aimed to use dietary patterns, as an alternative method to dietary diversity scores (DDSs), and investigate their associations with childhood stunting in Ethiopia. Methods Mothers and their children aged under 5 years (n = 3788) were recruited using a two-stage random cluster sampling technique in two regions of Ethiopia. Socio-demographic, dietary and anthropometric data were collected. Dietary intake was assessed using standardized dietary diversity tools. Household, maternal and child DDSs were calculated and dietary patterns were identified by tetrachoric (factor) analysis. Multilevel linear and Poisson regression analyses were applied to assess the association of DDSs and dietary patterns with height-for-age z score (HAZ) and stunting, respectively. Results The overall prevalence of stunting among children under-five was 38.5% (n = 1459). We identified three dietary patterns each, for households (“fish, meat and miscellaneous”, “egg, meat, poultry and legume” and “dairy, vegetable and fruit”), mothers (“plant-based”, “egg, meat, poultry and legume” and “dairy, vegetable and fruit” and children (“grain based”, “egg, meat, poultry and legume” and “dairy, vegetable and fruit”). Children in the third tertile of the household “dairy, vegetable and fruit” pattern had a 0.16 (β = 0.16; 95% CI: 0.02, 0.30) increase in HAZ compared to those in the first tertile. A 0.22 (β = 0.22; 95% CI: 0.06, 0.39) and 0.19 (β = 0.19; 0.04, 0.33) increase in HAZ was found for those in the third tertiles of “dairy, vegetable and fruit” patterns of children 24–59 months and 6–59 months, respectively. Those children in the second (β = −0.17; 95% CI: -0.31, −0.04) and third (β = −0.16; 95% CI: -0.30, −0.02) tertiles of maternal “egg, meat, poultry and legume” pattern had a significantly lower HAZ compared to those in the first tertile. No significant associations between the household and child “egg, meat, poultry and legume” dietary patterns with HAZ and stunting were found. Statistically non-significant associations were found between household, maternal and child DDSs, and HAZ and stunting. Conclusion A higher adherence to a “dairy, vegetable and fruit” dietary pattern is associated with increased HAZ and reduced risk of stunting. Dietary pattern analysis methods, using routinely collected dietary data, can be an alternative approach to DDSs in low resource settings, to measure dietary quality and in determining associations of overall dietary intake with stunting.http://link.springer.com/article/10.1186/s12937-018-0316-3Dietary data analysisDietary diversity scoreDietary patternStunting
collection DOAJ
language English
format Article
sources DOAJ
author Yohannes Adama Melaku
Tiffany K. Gill
Anne W. Taylor
Robert Adams
Zumin Shi
Amare Worku
spellingShingle Yohannes Adama Melaku
Tiffany K. Gill
Anne W. Taylor
Robert Adams
Zumin Shi
Amare Worku
Associations of childhood, maternal and household dietary patterns with childhood stunting in Ethiopia: proposing an alternative and plausible dietary analysis method to dietary diversity scores
Nutrition Journal
Dietary data analysis
Dietary diversity score
Dietary pattern
Stunting
author_facet Yohannes Adama Melaku
Tiffany K. Gill
Anne W. Taylor
Robert Adams
Zumin Shi
Amare Worku
author_sort Yohannes Adama Melaku
title Associations of childhood, maternal and household dietary patterns with childhood stunting in Ethiopia: proposing an alternative and plausible dietary analysis method to dietary diversity scores
title_short Associations of childhood, maternal and household dietary patterns with childhood stunting in Ethiopia: proposing an alternative and plausible dietary analysis method to dietary diversity scores
title_full Associations of childhood, maternal and household dietary patterns with childhood stunting in Ethiopia: proposing an alternative and plausible dietary analysis method to dietary diversity scores
title_fullStr Associations of childhood, maternal and household dietary patterns with childhood stunting in Ethiopia: proposing an alternative and plausible dietary analysis method to dietary diversity scores
title_full_unstemmed Associations of childhood, maternal and household dietary patterns with childhood stunting in Ethiopia: proposing an alternative and plausible dietary analysis method to dietary diversity scores
title_sort associations of childhood, maternal and household dietary patterns with childhood stunting in ethiopia: proposing an alternative and plausible dietary analysis method to dietary diversity scores
publisher BMC
series Nutrition Journal
issn 1475-2891
publishDate 2018-01-01
description Abstract Background Identifying dietary patterns that consider the overall eating habits, rather than focusing on individual foods or simple counts of consumed foods, better helps to understand the combined effects of dietary components. Therefore, this study aimed to use dietary patterns, as an alternative method to dietary diversity scores (DDSs), and investigate their associations with childhood stunting in Ethiopia. Methods Mothers and their children aged under 5 years (n = 3788) were recruited using a two-stage random cluster sampling technique in two regions of Ethiopia. Socio-demographic, dietary and anthropometric data were collected. Dietary intake was assessed using standardized dietary diversity tools. Household, maternal and child DDSs were calculated and dietary patterns were identified by tetrachoric (factor) analysis. Multilevel linear and Poisson regression analyses were applied to assess the association of DDSs and dietary patterns with height-for-age z score (HAZ) and stunting, respectively. Results The overall prevalence of stunting among children under-five was 38.5% (n = 1459). We identified three dietary patterns each, for households (“fish, meat and miscellaneous”, “egg, meat, poultry and legume” and “dairy, vegetable and fruit”), mothers (“plant-based”, “egg, meat, poultry and legume” and “dairy, vegetable and fruit” and children (“grain based”, “egg, meat, poultry and legume” and “dairy, vegetable and fruit”). Children in the third tertile of the household “dairy, vegetable and fruit” pattern had a 0.16 (β = 0.16; 95% CI: 0.02, 0.30) increase in HAZ compared to those in the first tertile. A 0.22 (β = 0.22; 95% CI: 0.06, 0.39) and 0.19 (β = 0.19; 0.04, 0.33) increase in HAZ was found for those in the third tertiles of “dairy, vegetable and fruit” patterns of children 24–59 months and 6–59 months, respectively. Those children in the second (β = −0.17; 95% CI: -0.31, −0.04) and third (β = −0.16; 95% CI: -0.30, −0.02) tertiles of maternal “egg, meat, poultry and legume” pattern had a significantly lower HAZ compared to those in the first tertile. No significant associations between the household and child “egg, meat, poultry and legume” dietary patterns with HAZ and stunting were found. Statistically non-significant associations were found between household, maternal and child DDSs, and HAZ and stunting. Conclusion A higher adherence to a “dairy, vegetable and fruit” dietary pattern is associated with increased HAZ and reduced risk of stunting. Dietary pattern analysis methods, using routinely collected dietary data, can be an alternative approach to DDSs in low resource settings, to measure dietary quality and in determining associations of overall dietary intake with stunting.
topic Dietary data analysis
Dietary diversity score
Dietary pattern
Stunting
url http://link.springer.com/article/10.1186/s12937-018-0316-3
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