Paula L Griffiths1, Nagalla Balakrishna2, Sylvia Fernandez Rao2, William Johnson3. 1. a Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University , Loughborough , Leicestershire , UK . 2. b National Institute of Nutrition, Indian Council of Medical Research , Hyderabad , India , and. 3. c MRC Human Nutrition Research, Elsie Widdowson Laboratory , Cambridge , UK.
Abstract
BACKGROUND: In total, 3.1 million young children die every year from under-nutrition. Greater understanding of associations between socio-economic status (SES) and the biological factors that shape under-nutrition are required to target interventions. AIM: To establish whether SES inequalities in under-nutrition, proxied by infant size at 12 months, operate through maternal and early infant size measures. SUBJECTS AND METHODS: The sample comprised 347 Indian infants born in 60 villages in rural Andhra Pradesh 2005-2007. Structural equation path models were applied to decompose the total relationship between SES (standard of living index) and length and weight for age Z-scores (LAZ/WAZ) at 12 months into direct and indirect (operating through maternal BMI and height, birthweight Z-score and LAZ/WAZ at 6 months) paths. RESULTS: SES had a direct positive association with LAZ (Standardised coefficient = 0.08, 95% CI = 0.02-0.13) and WAZ at age 12 months (Standardised coefficient = 0.08, 95% CI = 0.02-0.15). It also had additional indirect positive associations through increased maternal height and subsequently increased birthweight and WAZ/LAZ at 6 months, accounting for 35% and 53% of the total effect for WAZ and LAZ, respectively. CONCLUSION: Findings support targeting evidence based growth interventions towards infants from the poorest families with the shortest mothers. Increasing SES can improve growth for two generations.
BACKGROUND: In total, 3.1 million young children die every year from under-nutrition. Greater understanding of associations between socio-economic status (SES) and the biological factors that shape under-nutrition are required to target interventions. AIM: To establish whether SES inequalities in under-nutrition, proxied by infant size at 12 months, operate through maternal and early infant size measures. SUBJECTS AND METHODS: The sample comprised 347 Indian infants born in 60 villages in rural Andhra Pradesh 2005-2007. Structural equation path models were applied to decompose the total relationship between SES (standard of living index) and length and weight for age Z-scores (LAZ/WAZ) at 12 months into direct and indirect (operating through maternal BMI and height, birthweight Z-score and LAZ/WAZ at 6 months) paths. RESULTS: SES had a direct positive association with LAZ (Standardised coefficient = 0.08, 95% CI = 0.02-0.13) and WAZ at age 12 months (Standardised coefficient = 0.08, 95% CI = 0.02-0.15). It also had additional indirect positive associations through increased maternal height and subsequently increased birthweight and WAZ/LAZ at 6 months, accounting for 35% and 53% of the total effect for WAZ and LAZ, respectively. CONCLUSION: Findings support targeting evidence based growth interventions towards infants from the poorest families with the shortest mothers. Increasing SES can improve growth for two generations.
Authors: K Michael Hambidge; Carla M Bann; Elizabeth M McClure; Jamie E Westcott; Ana Garcés; Lester Figueroa; Shivaprasad S Goudar; Sangappa M Dhaded; Omrana Pasha; Sumera A Ali; Richard J Derman; Robert L Goldenberg; Marion Koso-Thomas; Manjunath S Somannavar; Veena Herekar; Umber Khan; Nancy F Krebs Journal: Nutrients Date: 2019-10-21 Impact factor: 5.717
Authors: Ana Garces; Wilton Perez; Margo S Harrison; Kay S Hwang; Tracy L Nolen; Robert L Goldenberg; Archana B Patel; Patricia L Hibberd; Adrien Lokangaka; Antoinette Tshefu; Sarah Saleem; Shivaprasad S Goudar; Richard J Derman; Jacquelyn Patterson; Marion Koso-Thomas; Elizabeth M McClure; Nancy F Krebs; K Michael Hambidge Journal: Reprod Health Date: 2020-12-17 Impact factor: 3.223