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

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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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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Correspondence to M M Moursi.

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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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