Exploring the determinants of malnutrition in 2-5 year Iranian children using structural equation modeling: national food and nutrition surveillance.

Autor: Rabiei S; Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Ebrahimof S; Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Rasekhi H; Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Amini M; Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Ghodsi D; Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Yari Z; Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Abdollahi Z; Community Nutrition Office, Deputy of Health, Iran Ministry of Health and Medical Education, Tehran, Iran., Minaie M; Community Nutrition Office, Deputy of Health, Iran Ministry of Health and Medical Education, Tehran, Iran., Nikooyeh B; Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. nikooyeh11024@yahoo.com., Neyestani TR; Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. neytr@yahoo.com.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2024 Dec 18; Vol. 24 (1), pp. 3406. Date of Electronic Publication: 2024 Dec 18.
DOI: 10.1186/s12889-024-20931-w
Abstrakt: Background: Childhood malnutrition remains a critical public health challenge in low- and middle-income countries, contributing significantly to morbidity and mortality among children aged 2-5 years. This study was undertaken to assess the nutritional status of 2-5 y children and to explore the main determinants of child malnutrition in eight food insecure provinces of Iran.
Methods: In each province, participants were invited to attend the health house/center to complete the questionnaire on the pre-appointed day. In this study, an android application comprising electronic questionnaires was employed for data collection. Anthropometric, dietary, food security and socioeconomic status (SES) assessments were performed. Structural equation modeling (SEM) was done to assess the structural relationship of malnutrition indicators (z-score of height to age (HAZ), z-score of weight to age (WAZ) and z-score of weight to height (WHZ)) with other variables.
Results: Overall, 2247 children aged 42.2 ± 0.3 months were enrolled in the study, of whom 1048 (46.6%) were female and 1438 (64%) were urban residents. Based on Z score criteria, 216 (10.1%) of the studied children had less than - 2SD HAZ, 193 (8.4%) had lower than - 2SD WHZ and 188 (8.1%) had lower than - 2SD WAZ. The prevalence rates of stunting, wasting and underweight were not significantly different between boys and girls. Nevertheless, the occurrence of stunting was significantly higher in children residing in rural than in urban areas (p = 0.025). SEM analysis revealed that higher SES had a positive relationship with HAZ (0.089), WAZ (0.163) and WHZ (0.109). The effect of SES was greatest on WAZ, indicated by the highest absolute value of a path coefficient. There were specific indirect effects of father's education on HAZ (0.032, p = 0.001), WHZ (0.045, < 0.001) and WAZ (0.061, < 0.001) through effect on SES and DDS. SES had a direct effect on DDS (0.202).
Conclusions: Our findings using SEM approach provided more concrete evidence for the effect of the household's SES on child's nutritional status. Nevertheless, we still need to monitor the studied population in the context of our surveillance program to document more conclusive causal associations.
Competing Interests: Declarations. Ethics approval and informed consent to participate: All participant children’s parents signed a written informed consent. The ethical issues of this study were approved by the Ethics Committee of NNFTRI (code: ir.sbmu.nnftri.rec.1396.170). All methods were carried out in accordance with relevant guidelines and regulations or Declaration of Helsinki. Consent for publication: All participant children’s parents were informed that the results of this study would be published as reports and papers while keeping the confidentiality. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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