scholarly journals Early childhood caries and its associations with sugar consumption, overweight and exclusive breastfeeding in low, middle and high-income countries: an ecological study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9413
Author(s):  
Morenike O. Folayan ◽  
Maha El Tantawi ◽  
Francisco Ramos-Gomez ◽  
Wael Sabbah
Keyword(s):  
Early Childhood ◽  
Exclusive Breastfeeding ◽  
Early Childhood Caries ◽  
Ecological Study ◽  
Effect Modification ◽  
High Income ◽  
Risk Indicator ◽  
Sugar Consumption ◽  
Eta Squared ◽  
Per Capita

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.

scholarly journals Association Between Early Childhood Caries And Malnutrition In A Sub-Urban Population In Nigeria

2019 ◽  
Author(s):  
Morenike Oluwatoyin Folayan ◽  
Olujide Arije ◽  
Maha El Tantawi ◽  
Kikelomo Adebanke Kolawole ◽  
Mary Obiyan ◽  
...  
Keyword(s):  
Early Childhood ◽  
Oral Hygiene ◽  
Early Childhood Caries ◽  
Significant Risk ◽  
Risk Indicators ◽  
Nutrition Status ◽  
Primary Study ◽  
Risk Indicator ◽  
Sugar Consumption ◽  
Childhood Caries

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.

scholarly journals Association Between Early Childhood Caries And Malnutrition In A Sub-Urban Population In Nigeria

2019 ◽  
Author(s):  
Morenike Oluwatoyin Folayan ◽  
Olujide Arije ◽  
Maha El Tantawi ◽  
Kikelomo Adebanke Kolawole ◽  
Mary Obiyan ◽  
...  
Keyword(s):  
Early Childhood ◽  
Oral Hygiene ◽  
Early Childhood Caries ◽  
Significant Risk ◽  
Risk Indicators ◽  
Nutrition Status ◽  
Primary Study ◽  
Risk Indicator ◽  
Sugar Consumption ◽  
Childhood Caries

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.

scholarly journals The Burden of Early Childhood Caries in Children under 5 Years Old in the European Union and Associated Risk Factors: An Ecological Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 455
Author(s):  
Zsuzsa Bencze ◽  
Nour Mahrouseh ◽  
Carlos Alexandre Soares Andrade ◽  
Nóra Kovács ◽  
Orsolya Varga
Keyword(s):  
Risk Factors ◽  
European Union ◽  
Early Childhood ◽  
Early Childhood Caries ◽  
Poverty Rate ◽  
Gdp Per Capita ◽  
Sugar Consumption ◽  
Per Capita ◽  
Over Time ◽  
Children Under 5

The associations among early childhood caries (ECC), socioeconomic status, and sugar consumption are of the utmost importance, due to their potential policy implications. The purpose of this study was to identify trends in ECC burden in children under 5 years old among European Union (EU) member states over time and to evaluate the relationship with its risk factors. Global Burden of Disease 2019 data were analyzed to estimate the burden of ECC over time, specifically incidence, prevalence, and years lived with disability (YLDs) for children under 5 years old. Four ecological variables with a potential effect on YLDs for ECC were used to investigate the association between 2014 and 2017. The YLDs rate was consistently higher among Eastern EU countries over time. Univariate models showed a positive significant association between at-risk-of-poverty rate and YLDs rate, while GDP per capita and urbanization were inversely associated with YLDs rate. In the multivariate analysis, sugar consumption, GDP per capita and urbanization showed significant association with YLDs rate. After stratification by region, association remained significant only in the Eastern EU countries between GDP, urbanization, and YLDs rate, while sugar consumption and at-risk-of-poverty rate had no significant impact on YLDs rates. This study found increasing ECC burden in the EU. The complexity of the problem indicates the need for innovative and personalized policy approaches to tackle the disease.

scholarly journals ASSOCIATION BETWEEN EARLY CHILDHOOD CARIES AND MALNUTRITION IN A SUB-URBAN POPULATION IN NIGERIA

2019 ◽  
Author(s):  
Morenike Oluwatoyin Folayan ◽  
Olujide Arije ◽  
Maha El Tantawi ◽  
Kikelomo Adebanke Kolawole ◽  
Mary Obiyan ◽  
...  
Keyword(s):  
Early Childhood ◽  
Low Socioeconomic Status ◽  
Oral Hygiene ◽  
Early Childhood Caries ◽  
Significant Risk ◽  
Risk Indicators ◽  
Primary Study ◽  
Risk Indicator ◽  
Sugar Consumption ◽  
Childhood Caries

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.

scholarly journals Associations between early childhood caries, malnutrition and anemia: a global perspective

2020 ◽  
Author(s):  
Morenike Folayan ◽  
Maha El Tantawi ◽  
Robert J Schroth ◽  
Ana Vukovic ◽  
Authur Kemoli ◽  
...  
Keyword(s):  
Early Childhood ◽  
Early Childhood Caries ◽  
Linear Models ◽  
National Income ◽  
Global Perspective ◽  
Country Level ◽  
Eta Squared ◽  
The Mean ◽  
The Relationship ◽  
Childhood Caries

Abstract Background: Malnutrition is the main risk factor for most common communicable diseases. The aim of this study is to determine the relationship between country-level prevalence of early childhood caries (ECC), malnutrition and anemia in infants and preschool children. Methods: Matched country-level ECC, malnutrition and anemia prevalence were generated from databases covering the period 2000 to 2017. Multivariate general linear models were developed to assess the relationship between outcome variables (prevalence of stunting, wasting, overweight, and anemia) and the explanatory variable (ECC prevalence) adjusted for gross national income per capita. Adjusted regression coefficients (B) and partial eta squared were computed. Results: The mean (standard deviation (SD)) ECC prevalence was 23.8 (14.8)% for 0-2 year-olds and 57.3 (22.4)% for 3-5-year-olds. The mean (SD) prevalence of wasting was 6.3 (4.8)%, overweight 7.2 (4.9)%, stunting 24.3 (13.5)%, and anemia 37.8 (18.1)%. For 0-2-year-olds, the strongest and only significant association was between the prevalence of ECC and overweight (η2= 0.21): one percent higher ECC prevalence was associated with 0.12% higher prevalence of overweight (B= 0.12, P= 0.03). In 3-5-year-olds, the strongest and only significant association was between the prevalence of ECC and anemia (η2= 0.08): one percent higher prevalence of ECC was associated with 0.14% lower prevalence of anemia (B= -0.14, P= 0.048). Conclusion: Country-level prevalence of ECC was associated with malnutrition in 0-2-year-olds and with anemia in 3-5-year-olds. The pathway for the direct relationship between ECC and overweight may be diet related. The pathway for the inverse relationship between ECC and anemia is less clear and needs further investigations.

scholarly journals Is Physical Rehabilitation Need Associated With the Rehabilitation Workforce Supply? An Ecological Study Across 35 High-Income Countries

2020 ◽  
Author(s):  
Tiago S. Jesus ◽  
Michel D. Landry ◽  
Helen Hoenig ◽  
Gilles Dussault ◽  
Gerald C. Koh ◽  
...  
Keyword(s):  
Population Size ◽  
Health Expenditure ◽  
Ecological Study ◽  
National Income ◽  
Physical Rehabilitation ◽  
High Income ◽  
Outcome Variable ◽  
Significant Independent Predictor ◽  
Per Capita ◽  
Rehabilitation Need

Background: To determine whether population-adjusted rates of physical rehabilitation need (ie, disability-related epidemiological data) are associated with the workforce supply (ie, combined rates of practicing physical therapists (PTs) and occupational therapists (OTs) per 10 000 population) across high-income countries (HICs), adjusted for socio-demographic and economic covariates. Methods: This is a cross-national ecological study. Hierarchical, multiple linear regressions analyzed current international data across 35 HICs using: current PTs and OTs supply data obtained from the international professional federations (outcome variable); needs data obtained from the Global Burden of Disease 2017 (GBD 2017); and finally relevant socio-demographic variables and supply-side covariates extracted from the World Bank, GBD 2017, the supply data sources, and the Global Health Expenditure Database. Results: The PTs and OTs per capita varied greatly across the 35 HICs, differing by as much as 40-fold. Denmark had the greatest supply per capita. Physical rehabilitation need was not a significant, independent predictor of workforce supply regardless of the multiple regression model used (P >.10). In the final model, after Bonferroni correction, 3 covariates were significant, independent predictors of the supply variable: gross national income (GNI) per capita and the current health expenditure in % of gross domestic product (GDP) were positive factors for workforce supply, while population size was a negative factor (all P <.01). Conclusion: PT and OT workforce supply is highly variable across HICs. This variability is not accounted for by an indicator of population need but rather by financial indicators and population size.

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