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J Nutr. 2015 Aug;145(8):1924-33. doi: 10.3945/jn.115.210229. Epub 2015 Jun 17.

Cross-Sectional and Longitudinal Associations between Household Food Security and Child Anthropometry at Ages 5 and 8 Years in Ethiopia, India, Peru, and Vietnam.

Author information

1
Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, CT; debbie.humphries@yale.edu.
2
Department of Global Health, Boston University, Boston, MA;
3
Department of Health Science, Brigham Young University, Provo, UT;
4
School of Public Health, University of California at Berkeley, Berkeley, CA;
5
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA;
6
Department of Economics, Addis Ababa University, Addis Ababa, Ethiopia;
7
Nutrition Research Institute, Lima, Peru; and.
8
Departments of Economics and Sociology, University of Pennsylvania, Philadelphia, PA.

Abstract

BACKGROUND:

Poor childhood nutritional status has lifetime effects and food insecurity is associated with dietary practices that can impair nutritional status.

OBJECTIVES:

We assessed concurrent and subsequent associations between food insecurity and height-for-age z scores (HAZs) and body mass index-for-age z scores (BMI-Zs); evaluated associations with transitory and chronic food insecurity; and tested whether dietary diversity mediates associations between food insecurity and nutritional status.

METHODS:

We used data from the Young Lives younger cohort composed of children in Ethiopia (n = 1757), India (n = 1825), Peru (n = 1844), and Vietnam (n = 1828) recruited in 2002 (round 1) at ∼1 y old, with subsequent data collection at 5 y in 2006 (round 2) and 8 y in 2009 (round 3).

RESULTS:

Children from food-insecure households had significantly lower HAZs in all countries at 5 y (Ethiopia, -0.33; India, -0.53; Peru, -0.31; and Vietnam, -0.68 HAZ; all P < 0.001), although results were attenuated after controlling for potential confounders (Ethiopia, -0.21; India, -0.32; Peru, -0.14; and Vietnam, -0.27 HAZ; P < 0.01). Age 5 y food insecurity predicted the age 8 y HAZ, but did not add predictive power beyond HAZ at age 5 y in Ethiopia, India, or Peru. Age 5 y food insecurity predicted the age 8 y BMI-Z even after controlling for the 5 y BMI-Z, although associations were not significant after the inclusion of additional confounding variables (Ethiopia, P = 0.12; India, P = 0.29; Peru, P = 0.16; and Vietnam, P = 0.51). Chronically food-insecure households had significantly lower HAZs than households that were consistently food-secure, although BMI-Zs did not differ by chronic food-insecurity status. Dietary diversity mediated 18.8-30.5% of the association between food security and anthropometry in Vietnam, but mediated to a lesser degree (8.4-19.3%) in other countries.

CONCLUSIONS:

In 4 countries, food insecurity at 5 y of age was associated with both HAZ and BMI-Z at age 8 y, although the association was attenuated after adjusting for other household factors and anthropometry at age 5 y, and remained significant only for the HAZ in Vietnam.

KEYWORDS:

child growth; dietary diversity; household food security; longitudinal cohort study; weight gain

PMID:
26084361
PMCID:
PMC4516765
DOI:
10.3945/jn.115.210229
[Indexed for MEDLINE]
Free PMC Article
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