Association between diet quality and risk of stunting among school-aged children in Schistosoma mansoni endemic area of western Kenya: a cross-sectional study.
Diet quality
Dietary guideline
Dietary habit
Food Frequency Questionnaires
Kenya
Malnutrition
Parasite infection
School-aged children
Journal
Tropical medicine and health
ISSN: 1348-8945
Titre abrégé: Trop Med Health
Pays: Japan
ID NLM: 101215093
Informations de publication
Date de publication:
17 Jan 2024
17 Jan 2024
Historique:
received:
05
09
2023
accepted:
16
12
2023
medline:
18
1
2024
pubmed:
18
1
2024
entrez:
17
1
2024
Statut:
epublish
Résumé
Healthy eating habits are essential for improving nutritional status and strengthening immunity against infectious diseases. This study examined the relationship between diet quality and stunting in school-aged children in an infectious disease-endemic area of western Kenya. This cross-sectional study included 260 school-aged children (age 9-17 years) enrolled in primary schools in Mbita Sub-county, western Kenya. The nutritional status was assessed using anthropometric measurements. Dietary intake was measured using food frequency questionnaires and evaluated using the Food Pyramid (FP) score, which indicates adherence to the Kenyan food-based dietary guideline. Information on the children's age, sex, maternal education, and household wealth index was collected using a household-based questionnaire. Infections with the predominant parasites, such as Schistosoma (S.) mansoni, were detected via microscopy. The trend associations of the FP score with food group intake were examined to characterize the dietary intake of this population. Logistic regression analysis was performed to investigate the relationship between stunting and FP score tertiles, adjusted for sociodemographic and economic indicators and parasitic infection status. Among the studied schoolchildren, 15.0% exhibited stunting, while 76.2% were infected with S. mansoni. The mean FP score was 25.6 out of 50 points. A higher FP score was characterized by a high intake of roots and tubers, dairy products, pulses, and fruits and a low intake of cereals and animal-source foods. The analysis revealed a trend: a lower risk of stunting was evident in groups with elevated FP scores (p for trend = 0.065). However, these trend associations were observable among subjects with either negative or light S. mansoni infection (p for trend = 0.016). A higher quality diet, as evaluated by FP scores, was associated with a low risk of stunting among school-aged children. Notably, this association seemed to weaken in the presence of a high burden of S. mansoni infection. It highlights the importance of enhancing dietary quality through the promotion of diverse nutrient-dense foods alongside effective S. mansoni infection control for improved growth. This study contributes fundamental knowledge for understanding the diet-malnutrition relationship in areas endemic for S. mansoni infection.
Sections du résumé
BACKGROUND
BACKGROUND
Healthy eating habits are essential for improving nutritional status and strengthening immunity against infectious diseases. This study examined the relationship between diet quality and stunting in school-aged children in an infectious disease-endemic area of western Kenya.
METHODS
METHODS
This cross-sectional study included 260 school-aged children (age 9-17 years) enrolled in primary schools in Mbita Sub-county, western Kenya. The nutritional status was assessed using anthropometric measurements. Dietary intake was measured using food frequency questionnaires and evaluated using the Food Pyramid (FP) score, which indicates adherence to the Kenyan food-based dietary guideline. Information on the children's age, sex, maternal education, and household wealth index was collected using a household-based questionnaire. Infections with the predominant parasites, such as Schistosoma (S.) mansoni, were detected via microscopy. The trend associations of the FP score with food group intake were examined to characterize the dietary intake of this population. Logistic regression analysis was performed to investigate the relationship between stunting and FP score tertiles, adjusted for sociodemographic and economic indicators and parasitic infection status.
RESULTS
RESULTS
Among the studied schoolchildren, 15.0% exhibited stunting, while 76.2% were infected with S. mansoni. The mean FP score was 25.6 out of 50 points. A higher FP score was characterized by a high intake of roots and tubers, dairy products, pulses, and fruits and a low intake of cereals and animal-source foods. The analysis revealed a trend: a lower risk of stunting was evident in groups with elevated FP scores (p for trend = 0.065). However, these trend associations were observable among subjects with either negative or light S. mansoni infection (p for trend = 0.016).
CONCLUSIONS
CONCLUSIONS
A higher quality diet, as evaluated by FP scores, was associated with a low risk of stunting among school-aged children. Notably, this association seemed to weaken in the presence of a high burden of S. mansoni infection. It highlights the importance of enhancing dietary quality through the promotion of diverse nutrient-dense foods alongside effective S. mansoni infection control for improved growth. This study contributes fundamental knowledge for understanding the diet-malnutrition relationship in areas endemic for S. mansoni infection.
Identifiants
pubmed: 38233936
doi: 10.1186/s41182-023-00566-0
pii: 10.1186/s41182-023-00566-0
doi:
Types de publication
Journal Article
Langues
eng
Pagination
12Subventions
Organisme : Nagasaki University
ID : 2023-Kyoten-07
Organisme : Nagasaki University
ID : 2023-Kyoten-03
Organisme : Japan Society for the Promotion of Science
ID : 14J10486
Organisme : Japan Society for the Promotion of Science
ID : 19K14188
Organisme : Japan Society for the Promotion of Science
ID : S2509
Organisme : Japan Society for the Promotion of Science
ID : 17H01684
Organisme : Japan Society for the Promotion of Science
ID : 21H04852
Informations de copyright
© 2024. The Author(s).
Références
World Health Organization. Global Accelerated action for the health of adolescents (AA-HA!): guidance to support country implementation. Geneva: World Health Organization; 2017.
Canavan CR, Fawzi WW. Addressing knowledge gaps in adolescent nutrition: toward advancing public health and sustainable development. Curr Dev Nutr. 2019;3(7):nzz062.
doi: 10.1093/cdn/nzz062
pubmed: 31218273
pmcid: 6571436
Lehtimaki S, Schwalbe N. Adolescent health the missing population in universal health coverage. 2018.
Friedman JF, Phillips-Howard PA, Mirel LB, Terlouw DJ, Okello N, Vulule JM, et al. Progression of stunting and its predictors among school-aged children in western Kenya. Eur J Clin Nutr. 2005;59(8):914–22.
doi: 10.1038/sj.ejcn.1602161
pubmed: 15928684
World Health Organization. Schistosomiasis and soil-transmitted helminthiases: progress report, 2021. Contract No.: 48. 2022.
World Health O. Helminth control in school-age children: a guide for managers of control programmes. 2nd ed. Geneva: World Health Organization; 2011.
Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367(9521):1521–32.
doi: 10.1016/S0140-6736(06)68653-4
pubmed: 16679166
Mnkugwe RH, Minzi OS, Kinung’Hi SM, Kamuhabwa AA, Aklillu E. Prevalence and correlates of intestinal schistosomiasis infection among school-aged children in North-Western Tanzania. PLoS ONE. 2020;15(2):e0228770.
doi: 10.1371/journal.pone.0228770
pubmed: 32023307
pmcid: 7001966
Al-Haidari SA, Mahdy MAK, Al-Mekhlafi AM, Al Murisi WMS, Thabit AAQ, Al-Amad MA, et al. Intestinal schistosomiasis among schoolchildren in Sana’a Governorate, Yemen: prevalence, associated factors and its effect on nutritional status and anemia. PLoS Negl Trop Dis. 2021;15(9):e0009757.
doi: 10.1371/journal.pntd.0009757
pubmed: 34547034
pmcid: 8454980
Mekonnen Z, Meka S, Zeynudin A, Suleman S. Schistosoma mansoni infection and undernutrition among school age children in Fincha’a sugar estate, rural part of West Ethiopia. BMC Res Notes. 2014;7(1):763.
doi: 10.1186/1756-0500-7-763
pubmed: 25348748
pmcid: 4216851
Koukounari A, Estambale BBA, Kiambo Njagi J, Cundill B, Ajanga A, Crudder C, et al. Relationships between anaemia and parasitic infections in Kenyan schoolchildren: a Bayesian hierarchical modelling approach. Int J Parasitol. 2008;38(14):1663–71.
doi: 10.1016/j.ijpara.2008.05.013
pubmed: 18621051
pmcid: 2649416
Assis AMO, Prado MS, Barreto ML, Reis MG, Conceição Pinheiro SM, Parraga IM, et al. Childhood stunting in Northeast Brazil: the role of Schistosoma mansoni infection and inadequate dietary intake. Eur J Clin Nutr. 2004;58(7):1022–9.
doi: 10.1038/sj.ejcn.1601926
pubmed: 15220944
Gakidou E, Afshin A, Abajobir AA, Abate KH, Abbafati C, Abbas KM, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1345–422.
doi: 10.1016/S0140-6736(17)32366-8
2021 Global Nutrition Report: the state of global nutrition. Bristol: Development Initiatives. https://globalnutritionreport.org/ . Accessed 1 Sep 2023.
John S, Mchau G, Ayubu H, Ainan S, Kyatikila W, Lyimo E, et al. Diet and nutrition status among school-age children and adolescents in Tanzania. 2021;66:72. https://www.ennonline.net/fex/66/dietnutritionschoolagechildren . Accessed 1 Sep 2023.
Ochola S, Masibo PK. Dietary intake of schoolchildren and adolescents in developing countries. Ann Nutr Metab. 2014;64(Suppl. 2):24–40.
doi: 10.1159/000365125
pubmed: 25341871
Miller V, Webb P, Micha R, Mozaffarian D. Defining diet quality: a synthesis of dietary quality metrics and their validity for the double burden of malnutrition. Lancet Planet Health. 2020;4(8):e352–70.
doi: 10.1016/S2542-5196(20)30162-5
pubmed: 32800153
pmcid: 7435701
Bromage S, Batis C, Bhupathiraju SN, Fawzi WW, Fung TT, Li Y, et al. Development and validation of a novel food-based global diet quality score (GDQS). J Nutr. 2021;151(Suppl_2):75S-92S.
doi: 10.1093/jn/nxab244
pubmed: 34689200
pmcid: 8542096
Bromage S, Andersen CT, Tadesse AW, Passarelli S, Hemler EC, Fekadu H, et al. The Global Diet Quality Score is associated with higher nutrient adequacy, midupper arm circumference, venous hemoglobin, and serum folate among urban and rural Ethiopian adults. J Nutr. 2021;151(Suppl_2):130S-S142.
doi: 10.1093/jn/nxab264
pubmed: 34689198
pmcid: 8564694
Bromage S, Zhang Y, Holmes MD, Sachs SE, Fanzo J, Remans R, et al. The global diet quality score is inversely associated with nutrient inadequacy, low midupper arm circumference, and anemia in rural adults in ten Sub-Saharan African Countries. J Nutr. 2021;151(Suppl_2):119S-S129.
doi: 10.1093/jn/nxab161
pubmed: 34689197
pmcid: 8542095
Trijsburg L, Talsma EF, De Vries JHM, Kennedy G, Kuijsten A, Brouwer ID. Diet quality indices for research in low- and middle-income countries: a systematic review. Nutr Rev. 2019;77(8):515–40.
doi: 10.1093/nutrit/nuz017
pubmed: 31127835
pmcid: 6609420
Ministry of Medical Services. Kenya national clinical nutrition and dietetics reference manual. 1st ed. Nairobi: Government of Kenya; 2010.
Ministry of Health. National guidelines for healthy diets and physical activity. Nairobi: Government of Kenya; 2017.
Kishino M, Hida A, Hara K, Mungai DN, Opiyo RO, Matsuda H, et al. High adherence to the food pyramid’s recommendations avoids the risk of insufficient nutrient intake among farmers in Peri-Urban Kenya. Nutrients. 2021;13(12):4470.
doi: 10.3390/nu13124470
pubmed: 34960020
pmcid: 8707577
Papier K, Williams GM, Luceres-Catubig R, Ahmed F, Olveda RM, McManus DP, et al. Childhood malnutrition and parasitic helminth interactions. Clin Infect Dis. 2014;59(2):234–43.
doi: 10.1093/cid/ciu211
pubmed: 24704723
Nagi S, Chadeka EA, Sunahara T, Mutungi F, Justin YKD, Kaneko S, et al. Risk factors and spatial distribution of Schistosoma mansoni infection among Primary School Children in Mbita District, Western Kenya. PLoS Negl Trop Dis. 2014;8(7):e2991.
doi: 10.1371/journal.pntd.0002991
pubmed: 25058653
pmcid: 4109881
Odiere MR, Rawago FO, Ombok M, Secor WE, Karanja DM, Mwinzi PN, et al. High prevalence of schistosomiasis in Mbita and its adjacent islands of Lake Victoria, western Kenya. Parasites Vectors. 2012;5(1):278.
WHO. Anthroplus: growth reference 5–19 years. Geneva: WHO; 2007.
FAO Government of Kenya. Kenya food composition tables. Nairobi: FAO; 2018. p. 254.
WE Committee. Prevention and control of schistosomiasis and soil-transmitted helminthiasis. World Health Organ Tech Rep Ser. 2002;912:i.
World Health Organization. Basic malaria microscopy: Part I Learner’s guide. Geneva: World Health Organization; 2010.
World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva: World Health Organization; 2011.
Fauziah N, Aviani JK, Agrianfanny YN, Fatimah SN. Intestinal parasitic infection and nutritional status in children under five years old: a systematic review. Trop Med Infect Dis. 2022;7(11):371.
doi: 10.3390/tropicalmed7110371
pubmed: 36422922
pmcid: 9697828
Mwandawiro C, Okoyo C, Kihara J, Simiyu E, Kepha S, Campbell SJ, et al. Results of a national school-based deworming programme on soil-transmitted helminths infections and schistosomiasis in Kenya: 2012–2017. Parasit Vectors. 2019;12(1):1–8.
doi: 10.1186/s13071-019-3322-1
World Health Organization. Ending the neglect to attain the sustainable development goals: a rationale for continued investment in tackling neglected tropical diseases 2021–2030. Geneva: World Health Organization; 2020.
Yang W, Li S, Guo Y, Bai Y, Liu C. Association between diet quality and health outcomes among children in rural areas of Northwest China. Int J Environ Res Public Health. 2022;19(13):7803.
doi: 10.3390/ijerph19137803
pubmed: 35805462
pmcid: 9265919
Liu T, Broverman S, Puffer ES, Zaltz DA, Thorne-Lyman AL, Benjamin-Neelon SE. Dietary diversity and dietary patterns in school-aged children in Western Kenya: a latent class analysis. Int J Environ Res Public Health. 2022;19(15):9130.
doi: 10.3390/ijerph19159130
pubmed: 35897495
pmcid: 9368572
Darling AM, Sunguya B, Ismail A, Manu A, Canavan C, Assefa N, et al. Gender differences in nutritional status, diet and physical activity among adolescents in eight countries in sub-Saharan Africa. Trop Med Int Health. 2020;25(1):33–43.