Cargando…
The Role of Food Insecurity and Dietary Diversity on Recovery from Wasting among Hospitalized Children Aged 6–23 Months in Sub-Saharan Africa and South Asia
Background: Current guidelines for the management of childhood wasting primarily focus on the provision of therapeutic foods and the treatment of medical complications. However, many children with wasting live in food-secure households, and multiple studies have demonstrated that the etiology of was...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9460249/ https://www.ncbi.nlm.nih.gov/pubmed/36079736 http://dx.doi.org/10.3390/nu14173481 |
_version_ | 1784786700751339520 |
---|---|
author | Tsegaye, Adino Tesfahun Pavlinac, Patricia B. Turyagyenda, Lynnth Diallo, Abdoulaye H. Gnoumou, Blaise S. Bamouni, Roseline M. Voskuijl, Wieger P. van den Heuvel, Meta Mbale, Emmie Lancioni, Christina L. Mupere, Ezekiel Mukisa, John Lwanga, Christopher Atuhairwe, Michael Chisti, Mohammod J. Ahmed, Tahmeed Shahid, Abu S.M.S.B. Saleem, Ali F. Kazi, Zaubina Singa, Benson O. Amam, Pholona Masheti, Mary Berkley, James A. Walson, Judd L. Tickell, Kirkby D. |
author_facet | Tsegaye, Adino Tesfahun Pavlinac, Patricia B. Turyagyenda, Lynnth Diallo, Abdoulaye H. Gnoumou, Blaise S. Bamouni, Roseline M. Voskuijl, Wieger P. van den Heuvel, Meta Mbale, Emmie Lancioni, Christina L. Mupere, Ezekiel Mukisa, John Lwanga, Christopher Atuhairwe, Michael Chisti, Mohammod J. Ahmed, Tahmeed Shahid, Abu S.M.S.B. Saleem, Ali F. Kazi, Zaubina Singa, Benson O. Amam, Pholona Masheti, Mary Berkley, James A. Walson, Judd L. Tickell, Kirkby D. |
author_sort | Tsegaye, Adino Tesfahun |
collection | PubMed |
description | Background: Current guidelines for the management of childhood wasting primarily focus on the provision of therapeutic foods and the treatment of medical complications. However, many children with wasting live in food-secure households, and multiple studies have demonstrated that the etiology of wasting is complex, including social, nutritional, and biological causes. We evaluated the contribution of household food insecurity, dietary diversity, and the consumption of specific food groups to the time to recovery from wasting after hospital discharge. Methods: We conducted a secondary analysis of the Childhood Acute Illness Network (CHAIN) cohort, a multicenter prospective study conducted in six low- or lower-middle-income countries. We included children aged 6–23 months with wasting (mid-upper arm circumference [MUAC] ≤ 12.5 cm) or kwashiorkor (bipedal edema) at the time of hospital discharge. The primary outcome was time to nutritional recovery, defined as a MUAC > 12.5 cm without edema. Using Cox proportional hazards models adjusted for age, sex, study site, HIV status, duration of hospitalization, enrollment MUAC, referral to a nutritional program, caregiver education, caregiver depression, the season of enrollment, residence, and household wealth status, we evaluated the role of reported food insecurity, dietary diversity, and specific food groups prior to hospitalization on time to recovery from wasting during the 6 months of posthospital discharge. Findings: Of 1286 included children, most participants (806, 63%) came from food-insecure households, including 170 (13%) with severe food insecurity, and 664 (52%) participants had insufficient dietary diversity. The median time to recovery was 96 days (18/100 child-months (95% CI: 17.0, 19.0)). Moderate (aHR 1.17 [0.96, 1.43]) and severe food insecurity (aHR 1.14 [0.88, 1.48]), and insufficient dietary diversity (aHR 1.07 [0.91, 1.25]) were not significantly associated with time to recovery. Children who had consumed legumes and nuts prior to diagnosis had a quicker recovery than those who did not (adjusted hazard ratio (aHR): 1.21 [1.01,1.44]). Consumption of dairy products (aHR 1.13 [0.96, 1.34], p = 0.14) and meat (aHR 1.11 [0.93, 1.33]), p = 0.23) were not statistically significantly associated with time to recovery. Consumption of fruits and vegetables (aHR 0.78 [0.65,0.94]) and breastfeeding (aHR 0.84 [0.71, 0.99]) before diagnosis were associated with longer time to recovery. Conclusion: Among wasted children discharged from hospital and managed in compliance with wasting guidelines, food insecurity and dietary diversity were not major determinants of recovery. |
format | Online Article Text |
id | pubmed-9460249 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94602492022-09-10 The Role of Food Insecurity and Dietary Diversity on Recovery from Wasting among Hospitalized Children Aged 6–23 Months in Sub-Saharan Africa and South Asia Tsegaye, Adino Tesfahun Pavlinac, Patricia B. Turyagyenda, Lynnth Diallo, Abdoulaye H. Gnoumou, Blaise S. Bamouni, Roseline M. Voskuijl, Wieger P. van den Heuvel, Meta Mbale, Emmie Lancioni, Christina L. Mupere, Ezekiel Mukisa, John Lwanga, Christopher Atuhairwe, Michael Chisti, Mohammod J. Ahmed, Tahmeed Shahid, Abu S.M.S.B. Saleem, Ali F. Kazi, Zaubina Singa, Benson O. Amam, Pholona Masheti, Mary Berkley, James A. Walson, Judd L. Tickell, Kirkby D. Nutrients Article Background: Current guidelines for the management of childhood wasting primarily focus on the provision of therapeutic foods and the treatment of medical complications. However, many children with wasting live in food-secure households, and multiple studies have demonstrated that the etiology of wasting is complex, including social, nutritional, and biological causes. We evaluated the contribution of household food insecurity, dietary diversity, and the consumption of specific food groups to the time to recovery from wasting after hospital discharge. Methods: We conducted a secondary analysis of the Childhood Acute Illness Network (CHAIN) cohort, a multicenter prospective study conducted in six low- or lower-middle-income countries. We included children aged 6–23 months with wasting (mid-upper arm circumference [MUAC] ≤ 12.5 cm) or kwashiorkor (bipedal edema) at the time of hospital discharge. The primary outcome was time to nutritional recovery, defined as a MUAC > 12.5 cm without edema. Using Cox proportional hazards models adjusted for age, sex, study site, HIV status, duration of hospitalization, enrollment MUAC, referral to a nutritional program, caregiver education, caregiver depression, the season of enrollment, residence, and household wealth status, we evaluated the role of reported food insecurity, dietary diversity, and specific food groups prior to hospitalization on time to recovery from wasting during the 6 months of posthospital discharge. Findings: Of 1286 included children, most participants (806, 63%) came from food-insecure households, including 170 (13%) with severe food insecurity, and 664 (52%) participants had insufficient dietary diversity. The median time to recovery was 96 days (18/100 child-months (95% CI: 17.0, 19.0)). Moderate (aHR 1.17 [0.96, 1.43]) and severe food insecurity (aHR 1.14 [0.88, 1.48]), and insufficient dietary diversity (aHR 1.07 [0.91, 1.25]) were not significantly associated with time to recovery. Children who had consumed legumes and nuts prior to diagnosis had a quicker recovery than those who did not (adjusted hazard ratio (aHR): 1.21 [1.01,1.44]). Consumption of dairy products (aHR 1.13 [0.96, 1.34], p = 0.14) and meat (aHR 1.11 [0.93, 1.33]), p = 0.23) were not statistically significantly associated with time to recovery. Consumption of fruits and vegetables (aHR 0.78 [0.65,0.94]) and breastfeeding (aHR 0.84 [0.71, 0.99]) before diagnosis were associated with longer time to recovery. Conclusion: Among wasted children discharged from hospital and managed in compliance with wasting guidelines, food insecurity and dietary diversity were not major determinants of recovery. MDPI 2022-08-24 /pmc/articles/PMC9460249/ /pubmed/36079736 http://dx.doi.org/10.3390/nu14173481 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Tsegaye, Adino Tesfahun Pavlinac, Patricia B. Turyagyenda, Lynnth Diallo, Abdoulaye H. Gnoumou, Blaise S. Bamouni, Roseline M. Voskuijl, Wieger P. van den Heuvel, Meta Mbale, Emmie Lancioni, Christina L. Mupere, Ezekiel Mukisa, John Lwanga, Christopher Atuhairwe, Michael Chisti, Mohammod J. Ahmed, Tahmeed Shahid, Abu S.M.S.B. Saleem, Ali F. Kazi, Zaubina Singa, Benson O. Amam, Pholona Masheti, Mary Berkley, James A. Walson, Judd L. Tickell, Kirkby D. The Role of Food Insecurity and Dietary Diversity on Recovery from Wasting among Hospitalized Children Aged 6–23 Months in Sub-Saharan Africa and South Asia |
title | The Role of Food Insecurity and Dietary Diversity on Recovery from Wasting among Hospitalized Children Aged 6–23 Months in Sub-Saharan Africa and South Asia |
title_full | The Role of Food Insecurity and Dietary Diversity on Recovery from Wasting among Hospitalized Children Aged 6–23 Months in Sub-Saharan Africa and South Asia |
title_fullStr | The Role of Food Insecurity and Dietary Diversity on Recovery from Wasting among Hospitalized Children Aged 6–23 Months in Sub-Saharan Africa and South Asia |
title_full_unstemmed | The Role of Food Insecurity and Dietary Diversity on Recovery from Wasting among Hospitalized Children Aged 6–23 Months in Sub-Saharan Africa and South Asia |
title_short | The Role of Food Insecurity and Dietary Diversity on Recovery from Wasting among Hospitalized Children Aged 6–23 Months in Sub-Saharan Africa and South Asia |
title_sort | role of food insecurity and dietary diversity on recovery from wasting among hospitalized children aged 6–23 months in sub-saharan africa and south asia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9460249/ https://www.ncbi.nlm.nih.gov/pubmed/36079736 http://dx.doi.org/10.3390/nu14173481 |
work_keys_str_mv | AT tsegayeadinotesfahun theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT pavlinacpatriciab theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT turyagyendalynnth theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT dialloabdoulayeh theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT gnoumoublaises theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT bamouniroselinem theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT voskuijlwiegerp theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT vandenheuvelmeta theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT mbaleemmie theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT lancionichristinal theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT mupereezekiel theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT mukisajohn theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT lwangachristopher theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT atuhairwemichael theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT chistimohammodj theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT ahmedtahmeed theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT shahidabusmsb theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT saleemalif theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT kazizaubina theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT singabensono theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT amampholona theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT mashetimary theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT berkleyjamesa theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT walsonjuddl theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT tickellkirkbyd theroleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT tsegayeadinotesfahun roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT pavlinacpatriciab roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT turyagyendalynnth roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT dialloabdoulayeh roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT gnoumoublaises roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT bamouniroselinem roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT voskuijlwiegerp roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT vandenheuvelmeta roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT mbaleemmie roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT lancionichristinal roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT mupereezekiel roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT mukisajohn roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT lwangachristopher roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT atuhairwemichael roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT chistimohammodj roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT ahmedtahmeed roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT shahidabusmsb roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT saleemalif roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT kazizaubina roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT singabensono roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT amampholona roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT mashetimary roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT berkleyjamesa roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT walsonjuddl roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia AT tickellkirkbyd roleoffoodinsecurityanddietarydiversityonrecoveryfromwastingamonghospitalizedchildrenaged623monthsinsubsaharanafricaandsouthasia |