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. 2021 Jan 4;151(1):170-178.
doi: 10.1093/jn/nxaa271.

Higher Energy and Zinc Intakes from Complementary Feeding Are Associated with Decreased Risk of Undernutrition in Children from South America, Africa, and Asia

Bruna L L Maciel  1 , Priscila N Costa  1 , José Q Filho  2 , Samilly A Ribeiro  2 , Francisco A P Rodrigues  2 , Alberto M Soares  2 , Francisco S Júnior  2 , Ramya Ambikapathi  3 , Elizabeth T R McQuade  4 , Margaret Kosek  5 , Tahmeed Ahmed  6 , Pascal Bessong  7 , Gangadeep Kang  8 , Sanjaya Shresthra  9 , Estomih Mduma  10 , Eliwaza Bayo  10 , Richard L Guerrant  11 , Laura E Caulfield  12 , Aldo A M Lima  2
Affiliations

Higher Energy and Zinc Intakes from Complementary Feeding Are Associated with Decreased Risk of Undernutrition in Children from South America, Africa, and Asia

Bruna L L Maciel et al. J Nutr. .

Abstract

Background: Few studies have focused on quantitatively analyzing nutrients from infant diets, compromising complementary feeding evaluation and health promotion worldwide.

Objectives: This study aimed to describe dietary intake in infants from 9 to 24 mo of age, determining nutrient intakes associated with the risk of underweight, wasting, and stunting.

Methods: Usual nutrient intakes from complementary feeding were determined by 24-h recalls collected when infants were 9-24 mo of age in communities from 7 low- and middle-income countries: Brazil (n = 169), Peru (n = 199), South Africa (n = 221), Tanzania (n = 210), Bangladesh (n = 208), India (n = 227), and Nepal (n = 229), totaling 1463 children and 22,282 food recalls. Intakes were corrected for within- and between-person variance and energy intake. Multivariable regression models were constructed to determine nutrient intakes associated with the development of underweight, wasting, and stunting at 12, 18, and 24 mo of age.

Results: Children with malnutrition presented significantly lower intakes of energy and zinc at 12, 18, and 24 mo of age, ranging from -16.4% to -25.9% for energy and -2.3% to -48.8% for zinc. Higher energy intakes decreased the risk of underweight at 12 [adjusted odds ratio (AOR): 0.90; 95% CI: 0.84, 0.96] and 24 mo (AOR: 0.91; 95% CI: 0.86, 0.96), and wasting at 18 (AOR: 0.91; 95% CI: 0.83, 0.99) and 24 mo (AOR: 0.83; 95% CI: 0.74, 0.92). Higher zinc intakes decreased the risk of underweight (AOR: 0.12; 95% CI: 0.03, 0.55) and wasting (AOR: 0.19; 95% CI: 0.04, 0.92) at 12 mo, and wasting (AOR: 0.05; 95% CI: 0.00, 0.76) at 24 mo.

Conclusions: Higher intakes of energy and zinc in complementary feeding were associated with decreased risk of undernutrition in the studied children. Data suggest these are characteristics to be improved in children's complementary feeding across countries.

Keywords: child nutrition; dietary intake; energy; nutrient intake; zinc.

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Figures

FIGURE 1
FIGURE 1
Flow diagram of the study protocol.
See this image and copyright information in PMC

References

    1. WHO Indicators for assessing infant and young child feeding practices. Part 1: definitions. Geneva (Switzerland): WHO; 2008.
    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. de Onis M, Branca F. Childhood stunting: a global perspective. Matern Child Nutr. 2016;12(Suppl 1):12–26. - PMC - PubMed
    1. WHO Collaborative Study Team, Victora CG, Barros AJD. Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet. 2000;355:451–5. - PubMed
    1. Dewey KG, Huffman SL. Maternal, infant, and young child nutrition: combining efforts to maximize impacts on child growth and micronutrient status. Food Nutr Bull. 2009;30(2 Suppl):S187–9. - PubMed

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