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.
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References
Arimond M, Ruel MT (2002). Progress in Developing an Infant and Child Feeding Index: An Example Using the Ethiopia Demographic and Health Survey 2000. FCND discussion paper no 143. IFPRI: Washington, DC.
Arimond M, Ruel MT (2004). Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. J Nutr 134, 2579–2585.
Dewey K, Cohen R, Arimond M, Ruel M (2005). Developing and Validating Indicators of feeding Frequency and Nutrient Density of Complementary Foods for the Breastfed Child in Developing Countries. International Food Policy Research Institute and University of California at Davis: Washington, DC/Davies, CA.
Dewey KG (2003). Guiding Principles for Complementary Feeding of the Breast-Fed Child. PAHO/WHO: Washington, DC.
Dop MC, Gomis MC, Gourdon M, Lesauvage S (2003). Outils d'enquête alimentaire par entretien: élaboration au Sénégal. (Tools for dietary surveys using interviews: development in Senegal). IRD Editions: Paris.
FAO/WHO (2002). Joint FAO/WHO Expert Consultation: Vitamin and Mineral Requirements in Human Nutrition. WHO: Geneva.
Hatloy A, Hallund J, Diarra MM, Oshaug A (2000). Food variety, socioeconomic status and nutritional status in urban and rural areas in Koutiala (Mali). Public Health Nutr 3, 57–65.
Institute of Medicine (1997). Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. National Academy Press: Washington, DC.
Institute of Medicine (2000). Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academy Press: Washington, DC.
Marquis GS, Habicht JP, Lanata CF, Black RE, Rasmussen KM (1997). Association of breastfeeding and stunting in Peruvian toddlers: an example of reverse causality. Int J Epidemiol 26, 349–356.
Ntab B, Simondon KB, Milet J, Cissé B, Sokhna C, Boulanger D et al. (2005). A young child feeding index is not associated with either height-for-age or height velocity in rural Senegalese children. J Nutr 135, 457–464.
Onyango A, Koski KG, Tucker KL (1998). Food diversity versus breastfeeding choice in determining anthropometric status in rural Kenyan toddlers. Int J Epidemiol 27, 484–489.
Piwoz EG, Huffman SL, Quinn VJ (2003). Promotion and advocacy for improved complementary feeding: can we apply the lessons learned from breastfeeding? Food Nutr Bull 24, 29–44.
Ruel MT, Menon P (2002). Child feeding practices are associated with child nutritional status in Latin America: innovative uses of the demographic and health surveys. J Nutr 132, 1180–1187.
Sawadogo PS, Martin-Prével Y, Savy M, Kameli Y, Traissac P, Traoré AS et al. (2006). An infant and child feeding index is associated with the nutritional status of 6- to 23-month-old children in rural Burkina Faso. J Nutr 136, 656–663.
Simondon KB, Simondon F (1998). Mothers prolong breastfeeding of undernourished children in rural Senegal. Int J Epidemiol 27, 490–494.
Steyn NP, Nel JH, Nantel G, Kennedy G, Labadarios D (2006). Food variety and dietary diversity scores in children: are they good indicators of dietary adequacy? Public Health Nutr 9, 644–650.
Traissac P, Delpeuch F, Maire B, Martin-Prével Y, Cornu A, Trèche S (1997). Construction d'un indice synthétique de niveau économique des ménages dans les enquêtes nutritionnelles. Exemples d'application au Congo. (Building a synthetic index of the household's economic level in nutritional surveys. Application examples in the Congo). Revue d'Epidemiologie et de Santé Publique 45, 114–115.
WHO (1998). Complementary Feeding of Young Children in Developing Countries—A Review of Current Scientific Knowledge. WHO/NUT.98.1. World Health Organization: Geneva.
WHO Multicentre Growth Reference Study Group (2006). WHO child Growth Standards: Length/Height for Age, Weight for Age, Weight for Length, Weight for Height and Body Mass Index for Age. Methods and Development. WHO: Geneva.
Acknowledgements
The Nutrimad project was funded by the French Ministry of Foreign Affairs and the European Union. We thank Luc Arnaud and Chantal Monvois from the GRET and Charlotte Ralison from University of Antananarivo. We gratefully acknowledge the contribution of Edwige Landais to the development of the food composition table used in this study.
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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.
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Moursi, M., Trèche, S., Martin-Prével, Y. et al. Association of a summary index of child feeding with diet quality and growth of 6–23 months children in urban Madagascar. Eur J Clin Nutr 63, 718–724 (2009). https://doi.org/10.1038/ejcn.2008.10
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DOI: https://doi.org/10.1038/ejcn.2008.10
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