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. 2019 Sep 1;10(5):827-847.
doi: 10.1093/advances/nmz018.

A Systematic Review Investigating the Relation Between Animal-Source Food Consumption and Stunting in Children Aged 6-60 Months in Low and Middle-Income Countries

Myra J Shapiro  1 , Shauna M Downs  2   3 , Haley J Swartz  2   4 , Megan Parker  5 , Diana Quelhas  5 , Katharine Kreis  5 , Klaus Kraemer  1   6 , Keith P West  1 , Jessica Fanzo  1   2
Affiliations

A Systematic Review Investigating the Relation Between Animal-Source Food Consumption and Stunting in Children Aged 6-60 Months in Low and Middle-Income Countries

Myra J Shapiro et al. Adv Nutr. .

Abstract

Animal-source foods (ASFs) are a food group of interest for interventions aimed at reducing stunting and other inadequate growth measures in early childhood. The aim of this systematic review was to examine the relation between ASF consumption and stunting in children aged 6-60 mo in low- and middle-income countries (LMICs). The secondary aim was to examine the relation between ASF consumption and other indicators of growth and development (length/height, weight, head circumference, and anemia). A search of the peer-reviewed and grey literature published from January 1980 to June 2017 was conducted. Databases searched included CINAHL, Embase, Global Index Medicus, PubMed, and Web of Science. There were 14,783 records and 116 full text articles dual screened; 21 studies were included in the review and were dual evaluated for risk of bias (RoB). The relation between ASF and stunting (length- or height-for-age z-score←2) was examined in randomized-controlled trials [(RCTs), n = 3] and cross-sectional studies (n = 4) only; ASF reduced stunting in 1 RCT and was associated with reduced stunting in 1 cross-sectional study. We did not identify any longitudinal cohorts that examined this relation. The relation between ASF and secondary indicators length/height, weight, head circumference, and anemia were largely nonsignificant across study designs. The intervention/exposure, comparator, outcome measures, methods, and analyses were highly heterogeneous. Although we did not find a consistent relation between ASF consumption and our primary and secondary outcomes, this may have been a function of inconsistencies in study design. Foods in the whole diet, particularly combination dishes, are inherently difficult to assess. To quantitatively assess the relation between ASF and stunting and other indicators of growth and iron status in early childhood, future research should provide consistency in the definition and quantification of the exposure and outcomes allowing for interstudy quantitative comparisons.

Keywords: animal-source food; children; growth; height; stunting; weight.

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Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
World map of included studies, by region, median age, and average sample size. Note: age listed is the median average age for all countries in the specified region. Sample size is the total number of participants in each region. Countries represented by >1 study in this review include: 2 in the Democratic Republic of the Congo (2 controlled interventions); 2 each in Indonesia and Peru (cross-sectional and prospective cohort); and 4 in Kenya (2 cross-sectional, 1 controlled, and 1 prospective cohort).
FIGURE 3
FIGURE 3
Child age at assessment in months.
See this image and copyright information in PMC

References

    1. Stevens GA, Finucane MM, Paciorek CJ, Flaxman SR, White RA, Donner AJ, Ezzati M, on behalf of Nutrition Impact Model Study Group (Child Growth). Trends in mild, moderate, and severe stunting and underweight, and progress towards MDG 1 in 141 developing countries: a systematic analysis of population representative data. Lancet. 2012;380(844):824–34. - PMC - PubMed
    1. Perumal N, Bassani DG, Roth DE. Use and misuse of stunting as a measure of child health. J Nutr. 2018;148(3):311–5. - PubMed
    1. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera J;. Maternal and Child Undernutrition Study Group. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371(9608):243–60. - PubMed
    1. WHO. Global nutrition targets 2025: stunting policy brief (WHO/NMH/NHD/14.3). Geneva: WHO; 2014.
    1. UNICEF, WHO, and the World Bank. Joint child malnutrition estimates - levels and trends: 2018 edition. May 2018. [Internet]. World Health Organization: Geneva: Available from: http://www.who.int/nutgrowthdb/2018-jme-brochure.pdf?ua=1, [updated 2018; cited 3 July 2018].

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