TY - JOUR
T1 - Associations between feeding practices and growth and neurodevelopmental outcomes at 36 months among children living in low- And low-middle income countries who participated in the BRAIN-HIT trial
AU - Do, Barbara T.
AU - Hansen, Nellie I.
AU - Bann, Carla
AU - Lander, Rebecca L.
AU - Goudar, Shivaprasad S.
AU - Pasha, Omrana
AU - Chomba, Elwyn
AU - Dhaded, Sangappa M.
AU - Thorsten, Vanessa R.
AU - Wallander, Jan L.
AU - Biasini, Fred J.
AU - Derman, Richard
AU - Goldenberg, Robert L.
AU - Carlo, Waldemar A.
N1 - Funding Information:
This work was supported by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Global Network for Women’s and Children’s Health Research (HD034216), the National Institute of Neurological Disorders and Stroke (HD43464, HD42372, HD40607, and HD40636), the Fogarty International Center (TW006703), the Perinatal Health and Human Development Research Program, and the Children’s of Alabama Centennial Scholar Fund of the University of Alabama at Birmingham. W.C. is on the Mednax Board of Directors.
Funding Information:
As the BRAIN-HIT principal investigator, WC led the study conception and design, with support from the study investigators (EC, SSG, RD, SMD, OP, RG), child development specialists (JW, FB), and the data coordinating center (VRT). EC, SSG, OP, SMD supervised the collection of study data. BTD, NIH, CB, and RLL led the secondary analysis conception and design, and were supported by WC, JW, FB and VRT. BTD, NIH, CB, RLL, VRT completed the analysis and interpretation of data. BTD, NIH, CB and VRT had access to all the data in the study. BTD drafted the initial manuscript and NIH, CB, and RLL critically revised the text. All authors have read and approved the final manuscript.
Publisher Copyright:
© 2018 The Author(s).
PY - 2018/12/27
Y1 - 2018/12/27
N2 - Background: Feeding practices over the first several years of a child's life can critically influence development. The purpose of this study was to examine associations between feeding practices and growth and neurodevelopmental outcomes at 36 months of age among children from low- and low-middle-income countries (LMIC). Methods: We conducted a secondary analysis using data collected from children in India, Pakistan, and Zambia who were enrolled in a randomized controlled trial of a home-based early development intervention program called Brain Research to Ameliorate Impaired Neurodevelopment Home-based Intervention Trial. Qualitative dietary data collected at 36 months was used to assess the modified Minimum Acceptable Diet (mMAD), a measure based on a core indicator developed by the World Health Organization to measure whether young children receive the minimum number of meals recommended and adequate diversity of major food groups in their diet. Regression models were used to assess cross-sectional associations between diet and growth indices, including Z-scores for height-for-age (HAZ), weight-for-age (WAZ), weight-for-height (WHZ), head circumference (HCZ), and Bayley Scales of Infant Development II mental and psychomotor developmental measures at 36 months of age. Results: Of 371 children, 174 (47%) consumed the mMAD, with significantly higher mean adjusted WHZ than those who did not meet mMAD (0.20 vs - 0.08, p = 0.05). Egg consumption was found to be significantly associated with a decreased risk of wasting [adjusted RR (95% CI): 0.37 (0.15, 0.89), p = 0.03]. HCZ at 36 months did not differ significantly for children who did and did not receive the mMAD. Conclusion: Meeting the mMAD was associated with better weight-for-height outcomes at 36 months in children in these three LMIC, highlighting the importance of adequate food quantity and quality. Trial registration: NCT00639184 registered on March 20, 2008.
AB - Background: Feeding practices over the first several years of a child's life can critically influence development. The purpose of this study was to examine associations between feeding practices and growth and neurodevelopmental outcomes at 36 months of age among children from low- and low-middle-income countries (LMIC). Methods: We conducted a secondary analysis using data collected from children in India, Pakistan, and Zambia who were enrolled in a randomized controlled trial of a home-based early development intervention program called Brain Research to Ameliorate Impaired Neurodevelopment Home-based Intervention Trial. Qualitative dietary data collected at 36 months was used to assess the modified Minimum Acceptable Diet (mMAD), a measure based on a core indicator developed by the World Health Organization to measure whether young children receive the minimum number of meals recommended and adequate diversity of major food groups in their diet. Regression models were used to assess cross-sectional associations between diet and growth indices, including Z-scores for height-for-age (HAZ), weight-for-age (WAZ), weight-for-height (WHZ), head circumference (HCZ), and Bayley Scales of Infant Development II mental and psychomotor developmental measures at 36 months of age. Results: Of 371 children, 174 (47%) consumed the mMAD, with significantly higher mean adjusted WHZ than those who did not meet mMAD (0.20 vs - 0.08, p = 0.05). Egg consumption was found to be significantly associated with a decreased risk of wasting [adjusted RR (95% CI): 0.37 (0.15, 0.89), p = 0.03]. HCZ at 36 months did not differ significantly for children who did and did not receive the mMAD. Conclusion: Meeting the mMAD was associated with better weight-for-height outcomes at 36 months in children in these three LMIC, highlighting the importance of adequate food quantity and quality. Trial registration: NCT00639184 registered on March 20, 2008.
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U2 - 10.1186/s40795-018-0228-9
DO - 10.1186/s40795-018-0228-9
M3 - Article
AN - SCOPUS:85073313620
SN - 2055-0928
VL - 4
JO - BMC Nutrition
JF - BMC Nutrition
IS - 1
M1 - 19
ER -