Original Article

European Journal of Clinical Nutrition (2009) 63, 718–724; doi:10.1038/ejcn.2008.10; published online 13 February 2008

Association of a summary index of child feeding with diet quality and growth of 6–23 months children in urban Madagascar

Contributors: MM collected the data, performed the statistical analysis and wrote the first draft of the article. ST initiated and supervised data collection. ST, YM-P, BM and FD designed the study. All authors contributed to the interpretation of the results and preparation of the final version of the article.

M M Moursi1,2, S Trèche3, Y Martin-Prével4, B Maire1 and F Delpeuch1

  1. 1Research Unit 106 'Nutrition, Food, Societies' (WHO Collaborating Centre for Nutrition), Institut de Recherche pour le Développement (IRD), Montpellier Cedex 5, France
  2. 2Doctoral School 393 'Public Health: Epidemiology and Biomedical Information Science', Université Pierre et Marie Curie, Paris, France
  3. 3Research Unit 106 'Nutrition, Food, Societies', Institut de Recherche pour le Développement (IRD), Antananarivo, Madagascar
  4. 4Research Unit 106 'Nutrition, Food, Societies', Institut de Recherche pour le Développement (IRD), Ouagadougou, Burkina Faso

Correspondence: Dr MM Moursi, UR106, Centre IRD de Montpellier, BP 64501, 34394 Montpellier Cedex 5, France. E-mail: mourad.moursi@mpl.ird.fr

Received 26 June 2007; Revised 24 November 2007; Accepted 9 January 2008; Published online 13 February 2008.

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Abstract

Background/Objectives:

 

The assessment of child feeding practices has received renewed attention through the development of an infant and child feeding index (ICFI). However, the advantages and shortcomings of such a summary index are still not well known. The aim of this study was to assess the usefulness of ICFI as an analytical tool (1) by studying its association with complementary food energy intake and mean micronutrient density adequacy (MMDA) and (2) by testing whether ICFI and its components are associated with length-for-age z-score (LAZ) of 6–23 months children in urban Madagascar.

Subjects/Methods:

 

ICFI was constructed using data from questionnaires on feeding practices and quantitative 24-h recalls (n=1589). Multivariate analysis was used to control for household wealth and other confounding factors.

Results:

 

ICFI was positively correlated with complementary food energy intake (P<0.0001) and MMDA (P<0.0001). ICFI was associated with LAZ among 6–8 months children (P=0.02). For all ages combined, there was a tendency towards an association that did not reach statistical significance (P=0.08). Among feeding practices that formed ICFI, breastfeeding was associated with LAZ (P=0.03) but not in the expected direction with +0.16 z-score difference in favour of non-breast-fed children. When breastfeeding was removed and introduced separately into the multivariate model, the relationship between the modified ICFI and LAZ became significant (P=0.02).

Conclusions:

 

Findings suggest that the ICFI could be a useful analytical tool, which needs however to be constructed according to its final use and which should be adapted to each context.

Keywords:

index, child, feeding practices, growth, Madagascar

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