Debbie L Humphries1, Kirk A Dearden2, Benjamin T Crookston3, Lia C Fernald4, Aryeh D Stein5, Tassew Woldehanna6, Mary E Penny7, Jere R Behrman8. 1. Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, CT; debbie.humphries@yale.edu. 2. Department of Global Health, Boston University, Boston, MA; 3. Department of Health Science, Brigham Young University, Provo, UT; 4. School of Public Health, University of California at Berkeley, Berkeley, CA; 5. Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA; 6. Department of Economics, Addis Ababa University, Addis Ababa, Ethiopia; 7. Nutrition Research Institute, Lima, Peru; and. 8. Departments of Economics and Sociology, University of Pennsylvania, Philadelphia, PA.
Abstract
BACKGROUND: Poor childhood nutritional status has lifetime effects and food insecurity is associated with dietary practices that can impair nutritional status. OBJECTIVES: We assessed concurrent and subsequent associations between food insecurity and height-for-age z scores (HAZs) and body mass index-for-age z scores (BMI-Zs); evaluated associations with transitory and chronic food insecurity; and tested whether dietary diversity mediates associations between food insecurity and nutritional status. METHODS: We used data from the Young Lives younger cohort composed of children in Ethiopia (n = 1757), India (n = 1825), Peru (n = 1844), and Vietnam (n = 1828) recruited in 2002 (round 1) at ∼1 y old, with subsequent data collection at 5 y in 2006 (round 2) and 8 y in 2009 (round 3). RESULTS: Children from food-insecure households had significantly lower HAZs in all countries at 5 y (Ethiopia, -0.33; India, -0.53; Peru, -0.31; and Vietnam, -0.68 HAZ; all P < 0.001), although results were attenuated after controlling for potential confounders (Ethiopia, -0.21; India, -0.32; Peru, -0.14; and Vietnam, -0.27 HAZ; P < 0.01). Age 5 y food insecurity predicted the age 8 y HAZ, but did not add predictive power beyond HAZ at age 5 y in Ethiopia, India, or Peru. Age 5 y food insecurity predicted the age 8 y BMI-Z even after controlling for the 5 y BMI-Z, although associations were not significant after the inclusion of additional confounding variables (Ethiopia, P = 0.12; India, P = 0.29; Peru, P = 0.16; and Vietnam, P = 0.51). Chronically food-insecure households had significantly lower HAZs than households that were consistently food-secure, although BMI-Zs did not differ by chronic food-insecurity status. Dietary diversity mediated 18.8-30.5% of the association between food security and anthropometry in Vietnam, but mediated to a lesser degree (8.4-19.3%) in other countries. CONCLUSIONS: In 4 countries, food insecurity at 5 y of age was associated with both HAZ and BMI-Z at age 8 y, although the association was attenuated after adjusting for other household factors and anthropometry at age 5 y, and remained significant only for the HAZ in Vietnam.
BACKGROUND: Poor childhood nutritional status has lifetime effects and food insecurity is associated with dietary practices that can impair nutritional status. OBJECTIVES: We assessed concurrent and subsequent associations between food insecurity and height-for-age z scores (HAZs) and body mass index-for-age z scores (BMI-Zs); evaluated associations with transitory and chronic food insecurity; and tested whether dietary diversity mediates associations between food insecurity and nutritional status. METHODS: We used data from the Young Lives younger cohort composed of children in Ethiopia (n = 1757), India (n = 1825), Peru (n = 1844), and Vietnam (n = 1828) recruited in 2002 (round 1) at ∼1 y old, with subsequent data collection at 5 y in 2006 (round 2) and 8 y in 2009 (round 3). RESULTS:Children from food-insecure households had significantly lower HAZs in all countries at 5 y (Ethiopia, -0.33; India, -0.53; Peru, -0.31; and Vietnam, -0.68 HAZ; all P < 0.001), although results were attenuated after controlling for potential confounders (Ethiopia, -0.21; India, -0.32; Peru, -0.14; and Vietnam, -0.27 HAZ; P < 0.01). Age 5 y food insecurity predicted the age 8 y HAZ, but did not add predictive power beyond HAZ at age 5 y in Ethiopia, India, or Peru. Age 5 y food insecurity predicted the age 8 y BMI-Z even after controlling for the 5 y BMI-Z, although associations were not significant after the inclusion of additional confounding variables (Ethiopia, P = 0.12; India, P = 0.29; Peru, P = 0.16; and Vietnam, P = 0.51). Chronically food-insecure households had significantly lower HAZs than households that were consistently food-secure, although BMI-Zs did not differ by chronic food-insecurity status. Dietary diversity mediated 18.8-30.5% of the association between food security and anthropometry in Vietnam, but mediated to a lesser degree (8.4-19.3%) in other countries. CONCLUSIONS: In 4 countries, food insecurity at 5 y of age was associated with both HAZ and BMI-Z at age 8 y, although the association was attenuated after adjusting for other household factors and anthropometry at age 5 y, and remained significant only for the HAZ in Vietnam.
Authors: Inka Barnett; Proochista Ariana; Stavros Petrou; Mary E Penny; Le Thuc Duc; S Galab; Tassew Woldehanna; Javier A Escobal; Emma Plugge; Jo Boyden Journal: Int J Epidemiol Date: 2012-05-21 Impact factor: 7.196
Authors: Kuntal K Saha; Edward A Frongillo; Dewan S Alam; Shams E Arifeen; Lars A Persson; Kathleen M Rasmussen Journal: Public Health Nutr Date: 2009-02-23 Impact factor: 4.022
Authors: Gilberto Kac; Michael M Schlüssel; Rafael Pérez-Escamilla; Gustavo Velásquez-Melendez; Antônio Augusto Moura da Silva Journal: PLoS One Date: 2012-09-21 Impact factor: 3.240
Authors: Elizabeth A Lundeen; Aryeh D Stein; Linda S Adair; Jere R Behrman; Santosh K Bhargava; Kirk A Dearden; Denise Gigante; Shane A Norris; Linda M Richter; Caroline H D Fall; Reynaldo Martorell; Harshpal Singh Sachdev; Cesar G Victora Journal: Am J Clin Nutr Date: 2014-07-09 Impact factor: 7.045
Authors: Andrew M Prentice; Kate A Ward; Gail R Goldberg; Landing M Jarjou; Sophie E Moore; Anthony J Fulford; Ann Prentice Journal: Am J Clin Nutr Date: 2013-04-03 Impact factor: 7.045
Authors: Aryeh D Stein; Meng Wang; Reynaldo Martorell; Shane A Norris; Linda S Adair; Isabelita Bas; Harshpal Singh Sachdev; Santosh K Bhargava; Caroline H D Fall; Denise P Gigante; Cesar G Victora Journal: Am J Hum Biol Date: 2010 May-Jun Impact factor: 1.937
Authors: Carla E Tarazona-Meza; Andrew Nicholson; Karina M Romero; Suzanne L Pollard; Rocio M Gálvez-Davila; Nadia N Hansel; William Checkley Journal: J Asthma Date: 2019-08-16 Impact factor: 2.515
Authors: Erin M Milner; Kathryn J Fiorella; Brian J Mattah; Elizabeth Bukusi; Lia C H Fernald Journal: Matern Child Nutr Date: 2017-10-23 Impact factor: 3.092
Authors: Debbie L Humphries; Kirk A Dearden; Benjamin T Crookston; Tassew Woldehanna; Mary E Penny; Jere R Behrman Journal: Econ Hum Biol Date: 2017-02-14 Impact factor: 2.184
Authors: Yohannes Adama Melaku; Tiffany K Gill; Anne W Taylor; Robert Adams; Zumin Shi; Amare Worku Journal: Nutr J Date: 2018-01-29 Impact factor: 3.271