scholarly journals The Influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania

2019 ◽  
Author(s):  
Ahmed Gharib Khamis ◽  
Akwilina Wendelin Mwanri ◽  
Julius Edward Ntwenya ◽  
Katharina Kreppel
Keyword(s):  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Secondary Data ◽  
Food Group ◽  
Limited Information ◽  
Food Groups ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Nutritional Status Of Children ◽  
Minimum Dietary Diversity

Abstract Background Undernutrition poses a serious health challenge in developing countries. Tanzania has the highest undernutrition burdens in East and Southern Africa. Poor infant and young child feeding practices including consumption of undiversified diet are the main cause for undernutrition. There is limited information regarding the association between dietary diversity and undernutrition in Tanzania. The objective of this paper was to examine to what extent the dietary diversity is associated with undernutrition of children of 6 to 23 months in Tanzania.Methods This is a secondary data analysis from data collected by the Tanzania Demographic and Health Survey of 2015-2016. Stunting, wasting and underweight were calculated from Z-scores based on 2006 WHO standards. A dietary diversity score was created by summing the number of food groups reported for each child by the mother ranging from 0 to 7. Then, a Minimum Dietary Diversity (MDD) indicator was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the odds ratios of becoming undernourished.Results A total of 2,960 children were enrolled in this study. The majority (73.9%) of children did not reach the recommended Minimum Dietary Diversity (MDD). The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food group consumed increased. Children who did not received an MDD diet had a significantly higher likelihood of being stunted (AOR=1.37, 95% CI; 1.13-1.65) and underweight (AOR=1.49, 95% CI; 1.15-1.92), but this was not the case for wasting. Consumption of animal source foods has been found to be associated with reduced stunting among children.Conclusion Consumption of a diverse diet was associated with a reduction in undernutrition among children of 6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the energy and nutritional demands of children should be considered in Tanzania.

scholarly journals The Influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania

2019 ◽  
Author(s):  
Ahmed Gharib Khamis ◽  
Akwilina Wendelin Mwanri ◽  
Julius Edward Ntwenya ◽  
Katharina Kreppel
Keyword(s):  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Secondary Data ◽  
Food Groups ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Child Feeding Practices ◽  
Infant And Young Child ◽  
Eastern And Southern Africa ◽  
Nutritional Status Of Children

Abstract Background:Undernutrition poses a serious health challenge in developing countries and Tanzania has the highest undernutrition burden of Eastern and Southern Africa. Poor infant and young child feeding practices have been identified as the main causes for undernutrition. Here we examined to what extent dietary diversity is associated with undernutrition among children of 6 to 23 months in Tanzania. Methods: Using existing data from the Tanzania Demographic and Health Survey of 2015-2016, we carried out secondary data analysis. Stunting, wasting and underweight were calculated based on 2006 WHO standards. A composite dietary diversity score was created by summing the number of food groups eaten the previous day as reported for each child by the mother ranging from 0 to 7. Then, minimum dietary diversity (MDD) of 4 food groups out of seven was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the crude and adjusted odds ratios of stunting, wasting and being underweight. Results: A total of 2,960 children were enrolled in this study. The majority (74%) of children did not reach the MDD. The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food groups consumed increased. Children who did not receive the MDD had a significantly higher likelihood of being stunted (AOR=1.37, 95% CI; 1.13-1.65) and underweight (AOR=1.49, 95% CI; 1.15-1.92), but this was not the case for wasting. Consumption of animal-source foods has been found to be associated with reduced stunting among children. Conclusion: Consumption of a diverse diet is associated with a reduction in undernutrition among children of 6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the energy and nutritional demands of children should be considered in Tanzania.

scholarly journals The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ahmed Gharib Khamis ◽  
Akwilina Wendelin Mwanri ◽  
Julius Edward Ntwenya ◽  
Katharina Kreppel
Keyword(s):  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Secondary Data ◽  
Feeding Practices ◽  
Food Groups ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child ◽  
Eastern And Southern Africa ◽  
Nutritional Status Of Children

Abstract Background Undernutrition poses a serious health challenge in developing countries and Tanzania has the highest undernutrition burden of Eastern and Southern Africa. Poor infant and young child feeding practices have been identified as the main causes for undernutrition. As dietary diversity is a major requirement if children are to get all essential nutrients, it can thus be used as one of the core indicators when assessing feeding practices and nutrition of children. Therefore, adequate information on the association between dietary diversity and undernutrition to identify potential strategies for the prevention of undernutrition is critical. Here we examined to what extent dietary diversity is associated with undernutrition among children of 6 to 23 months in Tanzania. Methods Using existing data from the Tanzania Demographic and Health Survey of 2015–2016, we carried out secondary data analysis. Stunting, Wasting and Underweight of the surveyed children were calculated from Z-scores of Height-for-age (HAZ), Weight-for-height (WHZ) and Weight-for-age (WAZ) based on 2006 WHO standards. A composite dietary diversity score was created by summing the number of food groups eaten the previous day as reported for each child by the mother ranging from 0 to 7. Then, minimum dietary diversity (MDD) of 4 food groups out of seven was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the crude and adjusted odds ratios of stunting, wasting and being underweight. Results A total of 2960 children were enrolled in this study. The prevalence of stunting was 31%, wasting 6% and underweight 14%. Among all children, 51% were female and 49% male. The majority (74%) of children did not reach the MDD. The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). The remaining food groups were reported to be consumed by a much lower proportion of children, including eggs (7%), meat and fish (36%), milk and dairy products (22%), as well as legumes and nuts (35%), and other vegetables (21%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food groups consumed increased. Children who did not receive the MDD had a significantly higher likelihood of being stunted (AOR = 1.37, 95% CI; 1.13–1.65) and underweight (AOR = 1.49, 95% CI; 1.15–1.92), but this was not the case for wasting. Consumption of animal-source foods has been found to be associated with reduced stunting among children. Conclusion Consumption of a diverse diet is associated with a reduction in undernutrition among children of 6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the energy and nutritional demands of children should be considered in Tanzania.

scholarly journals The Influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania

2019 ◽  
Author(s):  
Ahmed Gharib Khamis ◽  
Akwilina Wendelin Mwanri ◽  
Julius Edward Ntwenya ◽  
Katharina Kreppel
Keyword(s):  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Secondary Data ◽  
Food Groups ◽  
Animal Source Foods ◽  
Z Scores ◽  
Regression Techniques ◽  
Eastern And Southern Africa ◽  
Nutritional Status Of Children ◽  
Minimum Dietary Diversity

Abstract Background: Undernutrition poses a serious health challenge in developing countries and Tanzania has the highest undernutrition burden of Eastern and Southern Africa. Here we examined to what extent dietary diversity is associated with undernutrition among children of 6 to 23 months in Tanzania. Methods: Using existing data from the Tanzania Demographic and Health Survey of 2015-2016, we carried out secondary data analysis. Stunting, Wasting and Underweight of the surveyed children were calculated from Z-scores based on 2006 WHO standards. A composite dietary diversity score was created by summing the number of food groups reported for each child by the mother ranging from 0 to 7. Then, minimum dietary diversity (MDD) of 4 food groups out of seven was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the crude and adjusted odds ratios of undernutrition. Results: A total of 2,960 children were enrolled in this study. The prevalence of stunting was 31%, wasting 6% and underweight 14%. Among all children, 51% were female and 49% male. The majority (74%) of children did not reach the MDD. The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food groups consumed increased. Children who did not received the MDD had a significantly higher likelihood of being stunted (AOR=1.37, 95% CI; 1.13-1.65) and underweight (AOR=1.49, 95% CI; 1.15-1.92), but this was not the case for wasting. Consumption of animal-source foods has been found to be associated with reduced stunting among children. Conclusion: Consumption of a diverse diet is associated with a reduction in undernutrition among children of 6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the energy and nutritional demands of children should be considered in Tanzania.

scholarly journals Dietary Variation among Children Meeting and Not Meeting Minimum Dietary Diversity: An Empirical Investigation of Food Group Consumption Patterns among 73,036 Children in India

2020 ◽  
Vol 150 (10) ◽  
pp. 2818-2824
Author(s):  
Jacob P Beckerman-Hsu ◽  
Rockli Kim ◽  
Smriti Sharma ◽  
S V Subramanian
Keyword(s):  
Breast Milk ◽  
Vitamin A ◽  
Food Consumption ◽  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Food Group ◽  
Food Groups ◽  
Group Data ◽  
Protein Rich ◽  
Minimum Dietary Diversity

ABSTRACT Background Minimum Dietary Diversity (MDD) is a widely used indicator of adequate dietary micronutrient density for children 6–23 mo old. MDD food-group data remain underutilized, despite their potential for further informing nutrition programs and policies. Objectives We aimed to describe the diets of children meeting MDD and not meeting MDD in India using food group data, nationally and subnationally. Methods Food group data for children 6–23 mo old (n = 73,036) from the 2015–16 National Family Health Survey in India were analyzed. Per WHO standards, children consuming ≥5 of the following food groups in the past day or night met MDD: breast milk; grains, roots, or tubers; legumes or nuts; dairy; flesh foods; eggs; vitamin A–rich fruits and vegetables; and other fruits and vegetables. Children not meeting MDD consumed <5 food groups. We analyzed the number and types of foods consumed by children meeting MDD and not meeting MDD at the national and subnational geographic levels. Results Nationally, children not meeting MDD most often consumed breast milk (84.5%), grains, roots, and tubers (62.0%), and/or dairy (42.9%). Children meeting MDD most often consumed grains, roots, and tubers (97.6%), vitamin A–rich fruits and vegetables (93.8%), breast milk (84.1%), dairy (82.1%), other fruits and vegetables (79.5%), and/or eggs (56.5%). For children not meeting MDD, district-level dairy consumption varied the most (6.4%–79.9%), whereas flesh foods consumption varied the least (0.0%–43.8%). For children meeting MDD, district-level egg consumption varied the most (0.0%–100.0%), whereas grains, roots, and tubers consumption varied the least (66.8%–100.0%). Conclusions Children not meeting MDD had low fruit, vegetable, and protein-rich food consumption. Many children meeting MDD also had low protein-rich food consumption. Examining the number and types of foods consumed highlights priorities for children experiencing the greatest dietary deprivation, providing valuable complementary information to MDD.

scholarly journals Using National Survey Data From Nigeria to Assess Maternal-Child Dietary Concordance and Inform Nutrition Program Strategy

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 389-389
Author(s):  
Nadia Akseer ◽  
Rebecca A Heidkamp ◽  
Andrew Thorne-Lyman
Keyword(s):  
Maternal Education ◽  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Maternal Diet ◽  
Food Group ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Food Groups ◽  
Diet Diversity ◽  
Maternal Child

Abstract Objectives Improving child diet diversity is a policy priority in many settings. Multiple factors influence complementary feeding practices in low-income countries including household food access, caregiver-level factors and cultural practices. Child's dietary data is often available in national surveys (i.e., Demographic and Health Surveys, DHS), but they typically lack diet data from adults. The 2018 Nigeria DHS was among the first to measure food group intake in both young children and women. We describe the relationship between child and maternal diet diversity in Nigeria and highlight implications for design of infant and young child feeding (IYCF) programs. Methods Using the Nigeria DHS 2018 dataset, we estimated consumption of individual food groups in the previous 24 hours as well as minimum dietary diversity for children 6–23 months (MDD-C) and their mothers, women 15–49 years (MDD-W) using WHO-UNICEF definitions. We compare rates of concordance and discordance between n = 8975 mother-child pairs for individual food groups and MDD using McNemar's tests. Probit regression was used to identify drivers of MDD-C. Results Nationally, 22% of children achieve MDD-C; 51% of mothers achieve MDD-W. For both populations, the most commonly consumed group is grains, roots and tubers (>80%) Dairy and eggs are the least consumed. Maternal-child (age 12–23 months) discordance is highest for consumption of legumes and nuts (36%), vitamin A rich fruits and vegetables (39%) and other fruits and vegetables (57%); mothers consume these more frequently. Children are more likely than mothers to consume dairy (19% vs 8%) and eggs (8% vs 4%). Maternal-child food group discordance is consistently higher for children 6–11months than children 12–23 months. Results vary at state level and by maternal age group. Children's MDD probability is increased by MDD-W (27%, P < 0.001), higher maternal education (8%, P < 0.01) and household wealth (7%, P < 0.01). Conclusions Maternal and child diet diversity is suboptimal in Nigeria. Maternal diet is a primary driver of child diet in Nigeria. Legumes and nuts and fruits and vegetables are available but not consistently fed to children; an important finding for IYCF program design. The forthcoming DHS-8 core questionnaire will provide child and maternal diet data for more than 90 countries. Funding Sources Bill & Melinda Gates Foundation.

scholarly journals Core and optional infant and young child feeding indicators in Sub-Saharan Africa: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023238 ◽  
Author(s):  
Samson Gebremedhin
Keyword(s):  
Young Child ◽  
Dietary Diversity ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Child Feeding ◽  
Cross Sectional ◽  
Young Child Feeding ◽  
Infant And Young Child ◽  
Sub Saharan ◽  
Minimum Dietary Diversity

ObjectiveThe objective of the study is to determine the status of infant and young child feeding (IYCF) in Sub-Saharan Africa (SSA) based on multiple indicators.DesignSecondary data analysis of 32 Demographic and Health Surveys conducted in SSA since 2010.SettingThirty-two countries in SSA.Participants151 575 infants and young children born in the preceding 2 years of the surveys.Indicators determinedEight core and six optional IYCF indicators.ResultsMajority (95.8%) of the children born in the preceding 24 months were ever breastfed, and 50.5% initiated breastfeeding within the first hour of birth. Among infants 0–5 months of age, 72.3% were predominantly breastfed and 41.0% were exclusively breastfed. Continued breastfeeding at 1 year (89.5%) was reasonably high, but only 53.7% continued breastfeeding at 2 years and 60.4% had age-appropriate breastfeeding. About two-thirds (69.3%) of infants 6–8 months of age received solid, semisolid or soft food over the previous day across the countries. Among children 6–23 months of age, 41.9% met the minimum recommended meal frequency, while smaller proportions satisfied the minimum dietary diversity (21.0%) and acceptable diet (9.8%). About one-third (37.6%) of children 6–23 months of age consumed iron-rich or iron-fortified food over the previous day. Among non-breastfed children, only 15.0% received the recommended two or more milk feedings. Thirteen per cent were fed with a bottle with a nipple in the previous day. Country-level estimates for most indicators showed remarkable variations. Yet the minimum dietary diversity and acceptable diet indicators were consistently low.ConclusionMost breastfeeding-related indicators, except exclusive and early initiation of breastfeeding, are in an acceptable level in SSA. However, complementary feeding indicators are generally low.

Influence of Infant and Young Child Feeding Practices on Stunting in Children Aged 6 – 23 Months in Zambia 

2021 ◽  
Author(s):  
Andrew Banda ◽  
Elizabeth T. Nyirenda ◽  
Chabila C. Mapoma ◽  
Bwalya B. Bwalya ◽  
Nkuye Moyo
Keyword(s):  
Child Nutrition ◽  
Dietary Diversity ◽  
Public Health Problem ◽  
Feeding Practices ◽  
Meal Frequency ◽  
Chi Square ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Main Determinants ◽  
Minimum Dietary Diversity

Abstract Background Infant and child nutrition in Zambia remains a pressing public health problem. The Zambia Demographic and Health Survey (ZDHS) indicates that 35% of children under-five and 36 % among those aged 6-23 months are stunted. This study set out to assess the influence of Infant and Child Feeding (IYCF) practices on child stunting (6-23 months) in Zambia. Methods The 2008 ZDHS children’s data were analysed to measure stunting among infants aged 6-23 months. We fitted a bivariate logistic regression to measure association between feeding practices and stunting in children. Pearson’s Chi-square test of proportions measuring differences in proportions and adjusted odd ratios (AOR) with confidence intervals at 95% are reported. Results Findings indicate that 36% were stunted. IYCF practices indicators remain relatively poor in Zambia with only 13% of children age 6-23 months having received minimum acceptable diet, 23% received minimum dietary diversity and 42% received minimum meal frequency. Breastfeeding and receipt of a minimum dietary diversity reduced the odds of stunting among children age 6-23 months by 38% and 33% respectively. A child's perceived low birth size, being male, maternal anaemia status and mother's use of the internet were significant predictors of stunting.Conclusion We conclude that IYCF practices have an influence on stunting in Zambia and that socio-economic and demographic factors are likewise associated with stunting although the main determinants are amendable to intervention. Promoting the recommended WHO IYCF practices; breastfeeding, minimum meal frequency, receiving foods with diverse dietary content and accelerated investment in nutrition programs is recommended.

scholarly journals Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) Data Collection: Validity of the List-Based and Open Recall Methods as Compared to Weighed Food Record

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2039 ◽  
Author(s):  
Giles T. Hanley-Cook ◽  
Ji Yen A. Tung ◽  
Isabela F. Sattamini ◽  
Pamela A. Marinda ◽  
Kong Thong ◽  
...  
Keyword(s):  
Data Collection ◽  
Dietary Diversity ◽  
Weighted Kappa ◽  
Food Group ◽  
Reproductive Age ◽  
Food Groups ◽  
Women Of Reproductive Age ◽  
Group Diversity ◽  
Minimum Dietary Diversity ◽  
Recall Methods

Minimum dietary diversity for women of reproductive age (MDD-W) was validated as a population-level proxy of micronutrient adequacy, with indicator data collection proposed as either list-based or open recall. No study has assessed the validity of these two non-quantitative proxy methods against weighed food records (WFR). We assessed the measurement agreement of list-based and open recall methods as compared to WFR (i.e., reference method of individual quantitative dietary assessment) for achieving MDD-W and an ordinal food group diversity score. Applying a non-inferiority design, data were collected from non-pregnant women of reproductive age in Cambodia (n = 430), Ethiopia (n = 431), and Zambia (n = 476). For the pooled sample (n = 1337), proportions achieving MDD-W from both proxy methods were compared to WFR proportion by McNemar’s chi-square tests, Cohen’s kappa, and receiver operating characteristic (ROC) analysis. Ordinal food group diversity (0–10) was compared by Wilcoxon matched-pairs signed-rank tests, intraclass correlation coefficients (ICC), and weighted kappa. MDD-W food groups that were most frequently misreported (i.e., type I and II errors) by the proxy methods were determined. Our findings indicate statistically significant differences in proportions achieving MDD-W, ordinal food group diversity scores, and ROC curves between both proxy methods and WFR (p < 0.001). List-based and open recall methods overreported women achieving MDD-W by 16 and 10 percentage points, respectively, as compared to WFR (proportion achieving MDD-W: 30%). ICC values between list-based or open recall and WFR were 0.50 and 0.55, respectively. Simple and weighted kappa values both indicated moderate agreement between list-based or open recall against WFR. Food groups most likely to be misreported using proxy methods were beans and peas, dark green leafy vegetables, vitamin A-rich fruit and vegetables, and other fruits. Our study provides statistical evidence for overreporting of both list-based and open recall methods for assessing prevalence of MDD-W or ordinal food group diversity score in women of reproductive age in low- and middle-income countries. Operationalizing MDD-W through qualitative recall methods should consider potential trade-offs between accuracy and simplicity.

scholarly journals A study on infant and young child feeding practices among mothers attending the immunisation clinic of a tertiary care hospital, Kolkata, West Bengal

2020 ◽  
Vol 7 (12) ◽  
pp. 4827
Author(s):  
Nabanita Chakraborty ◽  
Gautam Kumar Joardar
Keyword(s):  
Young Child ◽  
Breast Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Child Feeding Practices ◽  
Infant And Young Child ◽  
Appropriate Practices ◽  
Minimum Dietary Diversity

Background: Age appropriate feeding practices is an essential determinant of physical growth as well as mental health of under-five children. WHO and UNICEF have formulated the infant and young child feeding practices guidelines to enhance appropriate feeding practices in infants and young children.Methods: A descriptive, observational, cross-sectional study was conducted in the immunization clinic of KPC medical college and hospital from October to December 2018 among children in 0-23 months age group. The mothers were interviewed regarding their sociodemographic details as well as the IYCF practices as per WHO.Results: It was found that appropriate practices in terms of prelacteal feeding, colostrum feeding; early initiation of breast feeding and exclusive breast feeding was present in 78.4%, 80%, 77.5% and 50% children respectively. Timely initiation of complementary feeding was found in 81%, breast feeding was continued upto 1 year in 68.8% and consumption of iron rich or iron fortified food was found in 54.5% children. Appropriate practices in terms of minimum meal frequency, minimum dietary diversity and minimum appropriate diet were found in 49.7%, 27% and 32.3% children respectively. Sex wise distributions have found significant association with minimum dietary diversity and minimum acceptable diet. Age wise distribution revealed significant association with minimum dietary frequency, minimum dietary diversity and minimum acceptable diet (p<0.005).Conclusions: Thus infant and young child feeding practices were not satisfactory. Mothers should be made aware about the appropriate feeding practices and health education should be given regarding correct child feeding practices.

scholarly journals Nutrition education linked to agricultural interventions improved child dietary diversity in rural Cambodia

2016 ◽  
Vol 116 (8) ◽  
pp. 1457-1468 ◽  
Author(s):  
Anika Reinbott ◽  
Anna Schelling ◽  
Judith Kuchenbecker ◽  
Theresa Jeremias ◽  
Iean Russell ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Economic Status ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Child Feeding ◽  
Cross Sectional ◽  
Young Child Feeding ◽  
The Impact

AbstractPoor infant and young child feeding (IYCF) practices are major determinants of chronic malnutrition. The main objective of this study was to assess the impact of a nutrition education (NE) programme aimed at promoting improved IYCF behaviours in combination with an agriculture intervention on children’s dietary diversity and nutritional status. From 2012 to 2014, a cluster randomised trial was rolled out in Cambodia in the context of an agriculture and nutrition project of the FAO of the UN. The cross-sectional baseline study was carried out in sixteen pre-selected communes in 2012. Restricted randomisation allotted the communes to either intervention (NE and agriculture intervention) or comparison arms (agriculture intervention only). The impact survey was conducted as a census in all FAO project villages in 2014. Caregivers of children aged 0–23 months were interviewed using standardised questions on socio-economic status and dietary diversity (24-h recall). Anthropometric measurements were taken. A difference-in-differences model was applied. The sample comprised 743 households with children ≥6 months of age at baseline and 921 at impact. After 1 year of NE, 69 % of the intervention households reported to have participated in the NE. Estimated mean child dietary diversity was significantly different at impact between comparison and intervention (3·6 and 3·9, respectively). In particular, the consumption of pro-vitamin A-rich foods and other fruits and vegetables increased. No treatment effects on height-for-age Z-scores could be shown. NE led to improvements in children’s diets. For effects on growth, it is assumed that longer NE activities are required to achieve sustainable behaviour change of age-appropriate infant feeding.

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