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A sex- and gender-based analysis of factors associated with linear growth in infants in Ecuadorian Andes

Although female infants may have an early life biological advantage over males, gendered treatment can alter health outcomes. Ecuador has an unusually high ratio of male to female infant mortality, but gender norms have been reported to favor boys. This analysis of baseline data from the Lulun Proje...

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Autores principales: Evers, Emily C., Waters, William F., Gallegos-Riofrío, Carlos Andres, Lutter, Chessa K., Stewart, Christine P., Iannotti, Lora L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8885924/
https://www.ncbi.nlm.nih.gov/pubmed/35228574
http://dx.doi.org/10.1038/s41598-022-06806-3
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author Evers, Emily C.
Waters, William F.
Gallegos-Riofrío, Carlos Andres
Lutter, Chessa K.
Stewart, Christine P.
Iannotti, Lora L.
author_facet Evers, Emily C.
Waters, William F.
Gallegos-Riofrío, Carlos Andres
Lutter, Chessa K.
Stewart, Christine P.
Iannotti, Lora L.
author_sort Evers, Emily C.
collection PubMed
description Although female infants may have an early life biological advantage over males, gendered treatment can alter health outcomes. Ecuador has an unusually high ratio of male to female infant mortality, but gender norms have been reported to favor boys. This analysis of baseline data from the Lulun Project, a randomized controlled trial conducted in rural Andean communities of Ecuador, investigates the roles of sex and gender in undernutrition among infants 6 to 9 months of age. Twenty-four-hour recall frequencies were used to assess dietary intake. Food outcome models were analyzed as prevalence ratios calculated using a binomial distribution with a log link or robust Poisson regression. Linear regression was used to analyze the continuous growth outcome length-for-age z score. Socioeconomic and health history variables were comparable between male and female infants. Boys were more often fed liquids other than breastmilk within their first 3 days of life (17.1% vs. 5.2%, P = 0.026). Compared with girls, boys were less likely to be fed eggs by 33% (95% CI 0.46, 0.96), cheese, yogurt, or other milk products by 40% (95% CI 0.39, 0.92), yellow fruit by 44% (95% CI 0.33, 0.97), water by 37% (95% CI 0.45, 0.88), thin porridge by 29% (95% CI 0.56, 0.92), and tea without milk by 67% (95% CI 0.11, 0.99). Prevalence of boys with an adequate dietary diversity score (≥ 4) was reduced by 27% relative to girls (95% CI 0.54, 0.99). Males fared worse in length-for-age z scores (− 2.16 vs. − 1.56, P = 0.000), weight-for-age z scores (− 0.86 vs. − 0.33, P = 0.002), prevalence of stunting (50.6% vs. 23.4%, P = 0.000), and plasma concentrations of dimethylglycine (1.25 vs. 1.65 µg/mL, P = 0.021). After adjusting for demographic, caregiver perceptions of appetite, and biological factors, length-for-age z score for a male child was 0.62 units lower than for a female (95% CI − 0.98, − 0.26). Male infants were shown to receive lower quality complementary foods and have worse anthropometric measures than female infants. Trial registration clinicaltrials.gov, NCT02446873. Registered February 28, 2015, https://clinicaltrials.gov/ct2/show/NCT02446873.
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spelling pubmed-88859242022-03-03 A sex- and gender-based analysis of factors associated with linear growth in infants in Ecuadorian Andes Evers, Emily C. Waters, William F. Gallegos-Riofrío, Carlos Andres Lutter, Chessa K. Stewart, Christine P. Iannotti, Lora L. Sci Rep Article Although female infants may have an early life biological advantage over males, gendered treatment can alter health outcomes. Ecuador has an unusually high ratio of male to female infant mortality, but gender norms have been reported to favor boys. This analysis of baseline data from the Lulun Project, a randomized controlled trial conducted in rural Andean communities of Ecuador, investigates the roles of sex and gender in undernutrition among infants 6 to 9 months of age. Twenty-four-hour recall frequencies were used to assess dietary intake. Food outcome models were analyzed as prevalence ratios calculated using a binomial distribution with a log link or robust Poisson regression. Linear regression was used to analyze the continuous growth outcome length-for-age z score. Socioeconomic and health history variables were comparable between male and female infants. Boys were more often fed liquids other than breastmilk within their first 3 days of life (17.1% vs. 5.2%, P = 0.026). Compared with girls, boys were less likely to be fed eggs by 33% (95% CI 0.46, 0.96), cheese, yogurt, or other milk products by 40% (95% CI 0.39, 0.92), yellow fruit by 44% (95% CI 0.33, 0.97), water by 37% (95% CI 0.45, 0.88), thin porridge by 29% (95% CI 0.56, 0.92), and tea without milk by 67% (95% CI 0.11, 0.99). Prevalence of boys with an adequate dietary diversity score (≥ 4) was reduced by 27% relative to girls (95% CI 0.54, 0.99). Males fared worse in length-for-age z scores (− 2.16 vs. − 1.56, P = 0.000), weight-for-age z scores (− 0.86 vs. − 0.33, P = 0.002), prevalence of stunting (50.6% vs. 23.4%, P = 0.000), and plasma concentrations of dimethylglycine (1.25 vs. 1.65 µg/mL, P = 0.021). After adjusting for demographic, caregiver perceptions of appetite, and biological factors, length-for-age z score for a male child was 0.62 units lower than for a female (95% CI − 0.98, − 0.26). Male infants were shown to receive lower quality complementary foods and have worse anthropometric measures than female infants. Trial registration clinicaltrials.gov, NCT02446873. Registered February 28, 2015, https://clinicaltrials.gov/ct2/show/NCT02446873. Nature Publishing Group UK 2022-02-28 /pmc/articles/PMC8885924/ /pubmed/35228574 http://dx.doi.org/10.1038/s41598-022-06806-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Evers, Emily C.
Waters, William F.
Gallegos-Riofrío, Carlos Andres
Lutter, Chessa K.
Stewart, Christine P.
Iannotti, Lora L.
A sex- and gender-based analysis of factors associated with linear growth in infants in Ecuadorian Andes
title A sex- and gender-based analysis of factors associated with linear growth in infants in Ecuadorian Andes
title_full A sex- and gender-based analysis of factors associated with linear growth in infants in Ecuadorian Andes
title_fullStr A sex- and gender-based analysis of factors associated with linear growth in infants in Ecuadorian Andes
title_full_unstemmed A sex- and gender-based analysis of factors associated with linear growth in infants in Ecuadorian Andes
title_short A sex- and gender-based analysis of factors associated with linear growth in infants in Ecuadorian Andes
title_sort sex- and gender-based analysis of factors associated with linear growth in infants in ecuadorian andes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8885924/
https://www.ncbi.nlm.nih.gov/pubmed/35228574
http://dx.doi.org/10.1038/s41598-022-06806-3
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