scholarly journals Peer Review #1 of "Early childhood caries and its associations with sugar consumption, overweight and exclusive breastfeeding in low, middle and high-income countries: an ecological study (v0.1)"

Author(s):  
M Lagerweij
PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9413
Author(s):  
Morenike O. Folayan ◽  
Maha El Tantawi ◽  
Francisco Ramos-Gomez ◽  
Wael Sabbah

Aim This ecological study examined the associations between the prevalence of early childhood caries (ECC), overweight, country’s per capita sugar consumption and duration of exclusive breastfeeding. Methods Per capita consumption of sugar in kilograms, percentage of children exclusively breastfed until 6 months of age, percentage of 0–5-year-old children with overweight status, and percentage of 3–5-year-old children with ECC were compared among low-income countries (LICs), middle-income countries (MICs) and high-income countries (HICs). The association between the prevalence of ECC and the study variables, and the effect modification by income region were assessed using multivariable linear regression models. Regression coefficients, confidence intervals, partial eta squared and P-values for effect modification were calculated. Results The per capita sugar consumption in LICs was significantly lower than in MICs (P = 0.001) and HICs (P < 0.001). The percentage of infants who exclusively breastfed up to 6 months was significantly lower in HICs than in LICs (P < 0.001) and MICs (P = 0.003). The prevalence of overweight was significantly lower in LICs than in MICs (P < 0.001) and HICs (P = 0.021). The prevalence of ECC was significantly lower in HICs than in MICs (P < 0.001). Income was a significant modifier of the associations between the prevalence of ECC, per capita sugar consumption (P = 0.005), and exclusive breastfeeding up to 6 months (P = 0.03). The associations between the prevalence of ECC and per capita sugar consumption at the global level and for MICs were stronger (partial eta squared = 0.05 and 0.13 respectively) than for LICs and HICs (partial eta squared <0.0001 and 0.003 respectively). Only in MICs was there a significant association between the prevalence of ECC and per capita sugar consumption (P = 0.002), and between the prevalence of ECC and the percentage of children exclusively breastfed up to 6 months (P = 0.02). Conclusion Though the quantity of sugar consumption and exclusive breastfeeding may be a significant risk indicator for ECC in MICs, sugar consumption may be more of a risk indicator for ECC in HICs than in LICs, and vice versa for exclusive breastfeeding. Although ECC and overweight are both sugar-related diseases, we found no significant relationship between them.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Morenike Oluwatoyin Folayan ◽  
◽  
Maha El Tantawi ◽  
Jorma I. Virtanen ◽  
Carlos Alberto Feldens ◽  
...  

An amendment to this paper has been published and can be accessed via the original article.


2019 ◽  
Author(s):  
Morenike Oluwatoyin Folayan ◽  
Olujide Arije ◽  
Maha El Tantawi ◽  
Kikelomo Adebanke Kolawole ◽  
Mary Obiyan ◽  
...  

Abstract Background : To determine the association between malnutrition and early childhood caries (ECC) in children resident in sub-urban, Nigeria. Methods : This study is a secondary analysis of a larger cross-sectional data generated through a household survey. Variables (sex, frequency of sugar consumption, maternal knowledge of oral hygiene, oral hygiene status) associated with ECC in the primary study conducted in the Ile-Ife, Nigeria, were adjusted for in the models. We used Poisson regression analysis to determine the association between ECC and malnutrition (stunting, overweight and underweight). We reported the adjusted prevalence ratio (APR). Results: Of the 370 children, 20 (5.41%) were underweight, 20 (5.41%) were overweight, 67 (18.11%) were wasting, 120 (32.43%) were stunted and 18 (4.86%) had ECC. Factors associated with ECC were being stunted, underweight, overweight and fair oral hygiene. The prevalence of ECC was lower in children who were stunted (APR: 0.14; 95% CI: 0.03-0.69; p=0.02), almost seven times higher in children who were overweight (APR: 6.88; 95% CI: 1.83-25.85; p<0.001), and predictively absent in children who were underweight (APR: 0; 95% CI: 0-0; p<0.001) when compared with children who had normal weight. Non-significant risk indicators for ECC included consuming sugar between meals three times a day or more, having low socioeconomic status and being female. Conclusions : For this study population, the indicators of malnutrition – being stunted, underweight, overweight - and fair oral hygiene were risk indicators for ECC, while the frequency of sugar consumption was not a significant risk indicator. Further studies are needed to identify if there are other mediators of associations between ECC and nutrition status apart from sugar consumption.


2019 ◽  
Author(s):  
Morenike Oluwatoyin Folayan ◽  
Olujide Arije ◽  
Maha El Tantawi ◽  
Kikelomo Adebanke Kolawole ◽  
Mary Obiyan ◽  
...  

Abstract Background: To determine the association between malnutrition and early childhood caries (ECC) in children resident in sub-urban, Nigeria. Methods: This study is a secondary analysis of a larger cross-sectional data generated through a household survey. Variables (sex, frequency of sugar consumption, maternal knowledge of oral hygiene, oral hygiene status) associated with ECC in the primary study conducted in the Ile-Ife, Nigeria, were adjusted for in the models. We used Poisson regression analysis to determine the association between ECC and malnutrition (stunting, overweight and underweight). We reported the adjusted prevalence ratio (APR). Results: Of the 370 children, 20 (5.41%) were underweight, 20 (5.41%) were overweight, 67 (18.11%) were wasting, 120 (32.43%) were stunted and 18 (4.86%) had ECC. Factors associated with ECC were being stunted, underweight, overweight and fair oral hygiene. The prevalence of ECC was lower in children who were stunted (APR: 0.14; 95% CI: 0.03-0.69; p=0.02), almost seven times higher in children who were overweight (APR: 6.88; 95% CI: 1.83-25.85; p<0.001), and predictively absent in children who were underweight (APR: 0; 95% CI: 0-0; p<0.001) when compared with children who had normal weight. Non-significant risk indicators for ECC included consuming sugar between meals three times a day or more, having low socioeconomic status and being female. Conclusions: For this study population, the indicators of malnutrition – being stunted, underweight, overweight - and fair oral hygiene were risk indicators for ECC, while the frequency of sugar consumption was not a significant risk indicator. Further studies are needed to identify if there are other mediators of associations between ECC and nutrition status apart from sugar consumption.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Morenike Oluwatoyin Folayan ◽  
Olujide Arije ◽  
Maha El Tantawi ◽  
Kikelomo Adebanke Kolawole ◽  
Mary Obiyan ◽  
...  

Abstract Background To determine the association between malnutrition and early childhood caries (ECC) in children resident in sub-urban, Nigeria. Methods This study was a subset of a larger cross-sectional study the data of which was generated through a household survey conducted in Ile-Ife, Nigeria. The study’s explanatory variable was malnutrition (underweight, overweight, wasting and stunting) and the outcome variable was ECC. Poisson regression analysis was used to determine the association between ECC and malnutrition. Variables (sex, frequency of sugar consumption, maternal knowledge of oral hygiene, oral hygiene status) associated with ECC in the primary study were adjusted for to obtain the adjusted prevalence ratio (APR). Results Of the 370 children, 20 (5.41%) were underweight, 20 (5.41%) were overweight, 67 (18.11%) were wasting, 120 (32.43%) were stunted and 18 (4.86%) had ECC. Factors associated with ECC were being stunted, underweight, overweight and fair oral hygiene. The prevalence of ECC was lower in children who were stunted (APR: 0.14; 95% CI: 0.03–0.69; p = 0.02), almost seven times higher in children who were overweight (APR: 6.88; 95% CI: 1.83–25.85; p < 0.001), and predictively absent in children who were underweight (APR: 0; 95% CI: 0–0; p < 0.001) when compared with children who had normal weight. Non-significant risk indicators for ECC included consuming sugar between meals three times a day or more, having low socioeconomic status and being female. Conclusions For this study population, the indicators of malnutrition – being stunted, underweight, overweight - and fair oral hygiene were risk indicators for ECC. The frequency of sugar consumption was not a significant risk indicator when malnutrition was included as an explanatory variable for ECC in the study population.


2019 ◽  
Author(s):  
Morenike Oluwatoyin Folayan ◽  
Olujide Arije ◽  
Maha El Tantawi ◽  
Kikelomo Adebanke Kolawole ◽  
Mary Obiyan ◽  
...  

Abstract Background To determine the association between malnutrition and early childhood caries (ECC) in preschool children resident in sub-urban, Nigeria. Methods This is a secondary analysis of a cross sectional study with data generated through a household setting. Variables (sex, frequency of sugar consumption, maternal knowledge of oral hygiene, oral hygiene status) associated with ECC in a primary study conducted in the Ile-Ife, Nigeria, were adjusted for using Poisson regression analysis. Results Of the 370 pre-school children, 20 (5.4%) were underweight, 20 (5.4%) were overweight, 67 (18.1%) were wasting, and 120 (32.4%) were stunted. Factors associated positively or negatively with ECC were stunted, underweight, overweight and fair oral hygiene. The prevalence of ECC was lower in children who were stunted (APR: 0.16), almost seven times higher in children who were overweight (APR: 6.88), and predictively absent in children who were underweight (APR: 0) when compared with children who had normal weight. Non-significant risk indicators for ECC included consuming sugar between meals three times a day or more (APR: 2.18), having low socioeconomic status (APR: 2.4) and being female (APR: 2.9). Conclusions For this study population, the indicators of malnutrition – being stunted, underweight, overweight - and fair oral hygiene were risk indicators for ECC, while the frequency of sugar consumption was not a significant risk indicator. Further studies are needed to identify if there are other mediators of an association between ECC and nutrition apart from sugar consumption.


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