Abstract
Identifying the influence of socioeconomic, care, and feeding factors on children's nutritional status is important for the evaluation and targeting of public policies based on nutritional interventions. We investigated the sociodemographic and biological factors associated with children aged 6 to 23 months leaving the low weight-for-age condition (weight-for-age z-score < -2) during their participation in a supplementary feeding program (SFP). This is a cohort study with 327 low-income children living in the inland of the state of São Paulo, who joined the SFP with low weight-for-age when they were six months old. The dependent variable was "maintained low weight-for-age during participation in the program" (dichotomous), and the independent variables related to: 1) maternal characteristics: marital status, schooling, age, and work situation; 2) child characteristics: being weaned, gender, birth weight, and age at weighing. We used a multiple multilevel logistic regression for the modeling. Factors positively associated with children's weight gain were higher age at weighing (OR = 1.20; 95%CI 1.08 - 1.34; p = 0.001); higher birth weight (OR = 1.0011; 95%CI 1.0001 - 1.0019; p = 0.022), and being weaned when joining the program (OR = 0.20; 95%CI 0.08 - 0.52; p = 0.001). Actions focused on promoting appropriate birth weight and breastfeeding, and on adequate and timely introduction to healthy complementary feeding are important strategies to maximize the effects of the SFP on weight gain in the first two years of life of children from low-income families.
Highlights
Identifying the influence of socioeconomic, care, and feeding factors on children’s nutritional status is important for the evaluation and targeting of public policies based on nutritional interventions[1].The assessment of the nutritional status of children younger than two years is most commonly conducted using three anthropometric indexes: weight-for-age (W/A), lengthfor-age (L/A), and weight-for-length (W/L)
We investigated the sociodemographic and biological factors associated with children aged 6 to 23 months leaving the low weightfor-age condition during their participation in a supplementary feeding program (SFP)
Actions focused on promoting appropriate birth weight and breastfeeding, and on adequate and timely introduction to healthy complementary feeding are important strategies to maximize the effects of the Supplementary Feeding Program (SFP) on weight gain in the first two years of life of children from low-income families
Summary
The assessment of the nutritional status of children younger than two years is most commonly conducted using three anthropometric indexes: weight-for-age (W/A), lengthfor-age (L/A), and weight-for-length (W/L). The difficulty in measuring the length of small children in the routine of health care services is one of the main obstacles in using the W/L and L/A indexes. The W/A index is the most appropriate to evaluate the effect of dietary interventions on the nutritional status of children in a short period of time[3]. Data from the National Demographic and Health Survey[5] showed that low W/A in children younger than five years decreased from 4.2 to 1.8% between 1996 and 2006. Socioeconomic and demographic differences persist, as younger children with lower purchasing power have worse nutritional status, and low W/A is about five times higher among them
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