Triple Burden Of Malnutrition Research Articles

Triple burden of malnutrition among Vietnamese 0·5-11-year-old children in 2020-2021: results of SEANUTS II Vietnam.

SEANUTS II Vietnam aims to obtain an in-depth understanding of the nutritional status and nutrient intake of children between 0.5-11.9 years old. Cross-sectional survey. A multistage cluster systematic random sampling method was implemented in different regions in Vietnam: North Mountainous, Central Highlands, Red River Delta, North Central and Coastal Area, Southeast and Mekong River Delta. 4001 children between 6 months and 11.9 years of age. Prevalence of stunting and underweight was higher in rural than in urban children, whereas overweight and obese rates were higher in urban areas. 12.0% of the children had anemia and especially children 0.5-1-year-old were affected (38.6%). Low serum retinol was found in 6.2% of children ≥ 4 years old. Prevalence of vitamin D insufficiency was 31.1% while 60.8% had low serum zinc. For nutrient intake, overall, 80.1% of the children did not meet the estimated energy requirements. For calcium intake, ∼60% of the younger children did not meet the RNI while it was 92.6% in children >7 years old. For vitamin D intake, 95.0% of the children did not meet RNI. SEANUTS II Vietnam indicated that overnutrition was more prevalent than undernutrition in urban areas, while undernutrition was found more in rural areas. The high prevalence of low serum zinc, vitamin D insufficiency and the inadequate intakes of calcium and vitamin D are of concern. Nutrition strategies for Vietnamese children should consider three sides of malnutrition and focus on approaches for the prevention malnutrition.

Co-existence of maternal overweight/obesity, child undernutrition, and anaemia among mother-child pairs in Ethiopia.

Ethiopia is currently known to be the most food-insecure country in sub-Saharan Africa, where childhood undernutrition remains endemic. While attention is increasingly being paid to childhood undernutrition in Ethiopia, a current surge of "triple burden of malnutrition" (TBM) has received less attention. The purpose of this study was to determine the prevalence of TBM and identify the associated factors in Ethiopia. Data were from the Ethiopian Demographic and Health Surveys (2005-2016) and a total of 20,994 mother-child pairs were examined in this study. The TBM was our primary outcome variable, which encompasses three types of nutritional problems-when a mother may be overweight/obese, while her child is stunted, wasted, or underweight plus has anaemia under the same roof. A multilevel logistic regression explored the individual- and community-level factors associated with TBM. Our study indicated that children under-five years of age were anaemic, stunted, wasted, and underweight [49.3% (95% CI: 48.7-49.9), 43.1% (95% CI: 42.4-43.7), 10.3% (95% CI: 9.9-10.7), and 27.6% (95% CI: 27.0-28.1)] respectively. The overall prevalence of TBM was 2.6% (95% CI: 2.39-2.83). Multilevel analyses revealed that TBM was more likely to occur among children aged 12-23 months (AOR: 2.54, 95% CI: 1.68-3.83), 24-35 months (AOR: 1.54, 95% CI: 1.03-2.29), children perceived by their mothers to be smaller than normal at birth (AOR: 1.94, 95% CI: 1.48-2.56), who experienced fever in the past 2 weeks (AOR: 1.58, 95% CI: 1.24-2.01), and lived in urban settings (AOR: 1.79, 95% CI: 1.13-2.86). Lower odds of TBM were reported among female children (AOR: 0.59, 95% CI: 0.47-0.72), and those who lived in rich households (AOR: 0.69: 95% CI: 0.49-0.98). TBM was found to be present in almost three percent of households in Ethiopia. Addressing the TBM through double-duty actions will be of critical importance in achieving malnutrition in all its forms in Ethiopia.

Understanding the Food Environment and Its Impact on Diet and Health in Asia: A Scoping Review.

Food environment (FE), an interface where people interact with a broader food system, is critical to health. Understanding the Asian FE may help to tackle the "triple burden of malnutrition" through informed research and policy. This review identifies FE domains assessed in the Asian context and collates the tools/measures used in these evaluations. We further synthesized the reported associations of FE with diet and health outcomes and identified knowledge gaps. Forty-two articles were reviewed (East Asia, n = 25, 60%; South Asia, n = 8, 19%; and Southeast Asia, n = 9, 21%). The results showed that FE was frequently examined in children, adolescents, or adults, but data were scarce in older adults. Food availability (n = 30) and accessibility (n = 19) were popularly studied domains. Furthermore, FE was measured using geographic information systems (n = 18), market (n = 7), or stakeholder (n = 21) surveys. Twenty-eight (67%) articles assessed associations of FE exposures with diet (n = 12) and health (n = 21). Increased food availability and accessibility were associated with poorer dietary and health outcomes despite nonexisting validity and reliability reporting in 62% of articles. Limited high-quality studies emphasize the need for harmonized definitions, better study designs, and validated FE measures/tools in Asia. Improving the quality of FE research is critical to designing effective interventions to improve public health nutrition in Asia.

South East Asian Nutrition Surveys II (SEANUTS II) Thailand: Triple burden of malnutrition among Thai children aged 6 months to 12 years.

This study assessed nutritional status among Thai children using anthropometry, dietary intakes, and micronutrient status. Cross-sectional survey with multi-stage cluster sampling. Body weight and height were measured in all children. Dietary intakes were assessed using 24-hour dietary recall. Biochemical assessment was performed in one-third of the children. The study was conducted in Thailand's four geographical regions and Bangkok. 3478 Thai children aged 0.5-12.9 years. Stunting showed a downward trend by age group and was most prevalent among infants and toddlers. Overweight and obesity showed a significant upward trend by age group, location, and sex, and was highest among children aged 7-12.9 years. Risks of inadequate micronutrient intakes (calcium, iron, zinc, vitamins A, C, and D) were high (53.2-93.6%). Prevalence of zinc and mild vitamin A deficiencies were low; vitamin D and B12 deficiencies were nil. Vitamin D insufficiency was significantly higher in the urban area and among girls aged 7-12.9 years. Anemia was very high in infants and toddlers (56.6 and 35.2%), but showed a significant downward trend by age group. There was an overall high prevalence of iron deficiency without anemia (25%) versus iron deficiency anemia (4.2%) among children aged 4-12.9 years old. The high prevalence of stunting and anemia among children aged 1-3.9 years and overweight and obesity among children aged 7-12.9 years requires continued attention. While prevalence of biochemical micronutrient deficiencies was not high (except for iron), high prevalence of dietary inadequacies for several micronutrients warrants further in-depth investigations.

Prevention of childhood overweight and obesity in Mongolia, the Philippines and Vietnam: identifying priority actions.

Low- and middle-income countries are increasingly faced with a triple burden of malnutrition: endemic underweight, micronutrient deficiencies and rising prevalence of overweight. This study aimed to address existing knowledge gaps and to identify priority policy options in Mongolia, the Philippines and Vietnam. A landscape analysis approach was adopted using methods set out in a UNICEF global toolkit. Quantitative and qualitative data were compiled from a range of global and national sources on childhood overweight and obesity, risk factors and policy responses. Key informant interviews and validation workshops were undertaken with key food and nutrition stakeholders from government and non-government organizations to identify priority policy options for the prevention of overweight and obesity among children. Overweight and obesity among children are increasing in all three countries. Associated risk factors are related to maternal nutrition, birthweight, breastfeeding, as well as diets and physical activity shaped by increasingly obesogenic environments. Key informants identified undefined policy approaches, poor community understanding and food and beverage industry influence as barriers to addressing overweight and obesity. Key policy priorities include restricting the marketing of unhealthy food and beverages, unhealthy food and beverage taxation, introduction of front-of-pack nutrition labels and improving school nutrition environments. Mongolia, the Philippines and Vietnam are all facing an increasing burden of childhood overweight and obesity. Despite differing national contexts, similar environmental factors are driving this rise. A suite of evidence-based policies can effectively be introduced to address obesogenic environments.

Co-occurrence of Overweight, Stunting, and Anemia among Adolescents (10–19 Years) in Tanzania Mainland: A School-Based Cross-Sectional Study

BackgroundEvidence on double and triple burdens of malnutrition among adolescents is an essential key to informing policy design, implementation, and tracking progress of adolescent nutritional programs. Tanzania has a scarcity of studies on the double and triple burden of malnutrition among adolescents. ObjectiveThe aim of this study was to assess the co-occurrence of malnutrition (overweight, stunting, and anemia) among adolescents (10–19 y) in mainland Tanzania. MethodsA school-based cross-sectional study was conducted among 44,120 primary school adolescents aged 10 to 19 y in mainland Tanzania. Anthropometric assessments (weight, height, and body mass index), dietary assessments, and hemoglobin levels were used to calculate the single, double, and triple burden of malnutrition. Data were analyzed using Stata software 15. The chi-square test was used to test the association between the nutrition condition and social demographic variables, physical activity, and dietary quality. Log-binomial models were used to determine factors associated with stunting, overweight, and anemia. Multivariable log-binomial models were used to control confounders. All analyses were 2-tailed, and the significance level was set at 5%. ResultsThe prevalence of anemia was 34.1%, while stunting and overweight had a prevalence of 32% and 4.2%, respectively. Approximately 41.7%, 13.5%, and 0.3% had single, double, and triple burden malnutrition-related conditions, respectively. Females were found to have a higher risk of being overweight compared with males (relative risk [RR]: 1.33; 95% confidence interval [CI]: 1.21, 1.45), while engaging in moderate to low levels of physical activity was associated with a decreased risk of being overweight. Additionally, residing in urban areas was linked to a decreased risk of stunting (RR: 0.78; 95% CI: 0.75, 0.80) and a 27% lower risk of anemia when compared with participants from rural areas. ConclusionThe findings from this study suggest that the complex nature of malnutrition among school adolescents warrants consideration when designing policies and interventions to reduce the burden of malnutrition.

A multilevel analysis of the triple burden of malnutrition in Indonesia: trends and determinants from repeated cross-sectional surveys

BackgroundAlthough child malnutrition has been reducing, the coexistence in mothers and children of various forms of malnutrition has continued to rise around the world. In the Indonesian context, a knowledge gap exists on the coexistence of multiple malnutrition burdens. This study examines trends in the coexistence of the triple burden of malnutrition (TBM) among mother–child pairs living in the same house and explores multilevel (individual, household, and community) factors associated with TBM in Indonesia.MethodsWe used data from the 2013 and 2018 Indonesia Basic Health Research, the nationally representative survey of the Indonesian population, as repeated cross-sectional surveys. Study samples were mothers and children (0–59 months old), who resided in the same household and indicated by the same identifier number. The anthropometric measurements of the mothers and children, and the hemoglobin levels of the children were collected. We employed a multilevel mixed-effects model to consider the hierarchical data structure. The model captured the role of cluster, district, provincial differences, and the individual, household, community-level, and TBM status characteristics.ResultsOf 3,891 mother–child pairs analyzed, 24.9% experienced TBM. Girls had 63% higher odds than boys of TBM (aOR: 1.63; 95% CI: 1.30 to 2.03). Significantly lower odds were found in children of mothers who had a gestational age lower than 37 weeks (aOR: 0.72; 95% CI: 0.55 to 0.94). At the household level, children with a father who had a high-school, primary-school, or no school education had significantly higher odds of TBM than children of fathers who had graduated from academy. Children of mothers who visited Antenatal Care (ANC) no more than 6 times had significantly lower odds (aOR: 0.65; 95% CI: 0.47 to 0.88). Children of mothers who consumed Iron and Folic Acid (IFA) supplements had significantly lower odds.ConclusionTBM is related to characteristics at not just the individual level but also the family and community levels. To achieve significant outcomes, integrated nutrition interventions in Indonesia should also consider family and community factors.

Prevalence and Factors Associated with the Double and Triple Burden of Malnutrition in Mother-Child Pairs in Guinea

Prevalence and Factors Associated with the Double and Triple Burden of Malnutrition in Mother-Child Pairs in Guinea

Nutritional status and dietary intake of the population aged 1-60 years during the COVID-19 Pandemic in Sri Lanka.

There is a co-existence of different forms of malnutrition leading to a Triple Burden of Malnutrition (TBM) in Sri Lanka. Accessing basic needs and services was a challenge during COVID-19 pandemic, which led to issues in food security with an effect on nutrition status of the population. To estimate the prevalence of malnutrition and dietary intakes of the population aged 1 to 60 years. Methods: This study was conducted in 2021. A multistage cluster sample was drawn to represent households at national level using 75 clusters, and 24-hour dietary recalls were compared with estimated average requirements of different age groups. Height and weight of all selected participants were measured. A total of 1776 households and 2991 individuals were studied. The prevalence of wasting, stunting and overweight of children aged 1-4 years (n=486) was 14%, 16.3% and 0.8% respectively. Thinness, stunting, overweight and obesity of children aged 5-9 years (n=388) was 21.4%, 8.5%, 5.2%, 5.1%; children aged 10-17 years (n=355) was 21.1%, 14.1%,11%, 8.2%; and adults aged 18-60 years (n=1762) was 9.9%, 5.4%, 32.6% and 11.5% respectively. Dietary intake gaps were minimal with energy and protein while it was wider with majority of vitamins, iron and calcium. Stunting of children aged 1-4 years was significantly associated with the low calcium and iron intakes. The presence of TBM amongst children and adults were observed with a dietary gap of essential micronutrients. This study highlights the need to re-orient the nutritional interventions to control TBM at population level.

What is missing in our understanding of urban slum environments and maternal, infant and young child nutrition from publicly available data in Asia and the Pacific?

Given the recent, rapid urbanisation in Asia and the Pacific region, coupled with increases in the triple burden of malnutrition, we need to better understand maternal, infant and young child nutrition (MIYCN) for populations living in urban slum environments. This research used existing large-scale datasets to explore MIYCN indicators for those living in urban slum, compared with urban nonslum, areas. Data since 2015 from available Demographic and Health Surveys (DHS; Afghanistan, India, Indonesia, Myanmar, Pakistan and the Philippines) and Multiple Indicator Cluster Surveys (MICS; Bangladesh, Fiji, Kiribati, Mongolia, Nepal, Thailand and Tuvalu) were analysed. Most urban children in the 13 countries from the region were breastfed within 24 h of birth, with slightly higher rates for those living in slums. Conversely, almost all indicators of infant and young child malnutrition were worse for those in urban slums. For mothers living in slums, underweight prevalence and iron deficiency anaemia were higher while maternal overweight and obesity prevalence were lower. Analysis revealed disparities across countries in the wealth status of those living in slum versus nonslum areas. What is currently missing is representative sampling of households, adequate collection of data both within and across countries, and accurate representation of slum-dwellers in large-scale surveys. Given that limited data for the region show urban poor slum populations are vulnerable to poor nutrition indicators, more data are needed on the poorest urban slum populations to enable effective resource allocation to support optimal MIYCN.

Triple Burden of Malnutrition among Children in India: Current Scenario and the Way Forward.

The triple burden of malnutrition (undernutrition, overnutrition and micronutrient deficiency) or TBM among under-five (U5) children is an increasingly recognised public health challenge. A literature search was conducted to identify studies published from 1976 to 2022, which had focused on information regarding different factors of child malnutrition. The findings were analysed and contextualised from policy and programmatic perspective. There is a high burden of various forms of malnutrition in India. Insufficient dietary intake and illnesses are immediate and most common causes of triple burden of malnutrition(TBM): (undernutrition, overnutritionand micronutrient deficiency). The other key factors associated with the TBM are lifestyle, nutritional practices, unsafe water, food insecurity, lack of sanitation & basic hygiene, unhealthy feeding & caring practices, inadequate health infrastructure, and suboptimal implementation of government nutrition schemes etc. There is scientific evidence that TBM has long term consequences on physical and mental development of children and has high cost to any society. The situation of TBM persists inspite of multiple ongoing government programs to tackle these challenges. The health service provision needs to move from the first 1,000 d to the first 3,000 d as well as focus on the interventions aimed at early childhood development. Multi-sectoral interventions through Anganwadi centres and schools (through education department) need to be conducted. The public health programs and primary healthcare services need to be realigned and health interventions should be implemented along with tackling social determinants of health and sustained community engagement and participation. Tackling TBM should be made a political priority. The life cycle approach for healthier children and society needs tobe fully implemented.

Prevalence and Determinants Of Nutritional Status Among Preschoolers in a Rural Area Of Thiruvananthapuram District, Kerala

Malnutrition among preschoolers is of grave concern and it lingers unabated in India, despite nutritional intervention policies of the State. Though Kerala is far ahead of other States in health outcomes, the triple burden of malnutrition is rampant. A micro-level analysis is conducted to assess the prevalence and determinants of stunting and underweight among 189 preschool children in Vithura, a tribal-dominated rural Panchayat in Thiruvananthapuram district of Kerala. In the study area, 38 per cent of children are stunted, which is higher among children belonging to tribal communities, and 19 per cent of preschool children are underweight. The occurrence of underweight is 27 per cent among tribal children, whereas it is 17 per cent among non-tribals. Caste, asset ownership status and maternal height are significantly associated with stunting, whereas underweight is significantly associated with asset ownership. In the logit model, caste significantly contributes to normal height for age. It is found that high asset group and age of the child being ‘13-36’ months increase the probability of being not underweight.

Parenting Style Related to Stunting Incidents in Toddlers Aged 24-59 Months

Indonesia is a country with a triple burden of malnutrition which is characterized by a high prevalence of stunting and anemia in pregnant women. This study aimed to determine the relationship between parenting styles for toddlers 24-59 months of age on the incidence of stunting in Majene district in 2022. This study used an observational study with a cross-sectional design with a population of 236 children under five with a sample of 70 children who were taken using the purposive sampling technique. Data was collected using a questionnaire and data analysis statistics using the chi-square test. The results of statistical tests showed that 52,9% had good parenting and did not experience stunting and 75% had poor parenting with stunting status, there was alsoan association between maternal parenting and stunting in children aged 24 to 59 months with a p-value of 0,023. The conclusionof this study is that there is an association between maternal parenting and the incidence of infant stunting between 24 and 59 months of age.

Pelatihan Skrining Gizi bagi Pengelola Usaha Kesehatan Sekolah di SMP Negeri 13 Kota Semarang

Adolescence is a period of transition or transition from childhood to adulthood. At that time, teenagers are often overwhelmed by a lot of ignorance about their development which can cause their own problems. One of the health problems that are most often experienced by adolescents today is the triple burden of malnutrition, namely undernutrition, excess nutrition (obesity), and iron deficiency anemia. Anthropometric nutritional status measurement is one way of early detection of growth retardation for children. Routinely under the coordination of the Puskesmas, measuring the weight and or height of new school children is one of the screening tools for children's health. Insufficient height is assumed to be the result of long-term malnutrition that can interfere with student learning achievement and low body resistance to disease and child mortality. One of the efforts to minimize this problem is to monitor nutritional status early, especially in the school environment. The School Health Effort (SHE) is the spearhead of the “health promotion school” effort. With the training on nutritional status assessment for the UKS managers/officers of the State Junior High School (SMPN) 13 Semarang City, it can help partners find out an early picture of the nutritional status of students. The method of implementing nutrition screening training activities consists of 4 stages, namely planning, implementation assisted by powerpoint media, and anthropometric measurement tools, evaluation (pre-test and post-test), and reflection. The training participants were students from SHE management, totaling 30 people. Based on the results of the evaluation by comparing the pre-test and post-test results, the participants after being given training understood and were able to practice anthropometric measurements of weight and height, and were able to determine nutritional status by looking at the BMI/U index table.

Triple Burden of Malnutrition among Preschool Children in India: Age Stratifed Analysis

In spite of the implementation of several nutrition specifc initiatives in the country, India is still struggling to limit burden of malnutrition among preschool children. The aim of this study was to identify the correlates of the Double (DBM) and Triple (TBM) Burden of Malnutrition among children in India. Information about 1,99,534 children in the age group 6-59 months was obtained from the fourth round of the National Family Health Survey (NFHS - 4). For age stratifed analysis, age groups were created as 6-23 months, 24-35 months and 35+ months. The prevalence of DBM and TBM was found to be 40% and 16% respectively. All children who belonged to Scheduled Caste (SC) or Scheduled Tribe (ST) and to poorest household and born at higher birth orders, etc were found to be signifcantly affected with DBM and TBM. The study recommends that government policies need to specifcally address nutritional needs of socially disadvantaged children. Also, policies should acknowledge the importance of women’s education and awareness about family planning practices to control its effect on child malnutrition.

Triple Burden of Malnutrition: A Reminder to Reform

The Triple Burden of Malnutrition is one of the most alarming issues of the current world. The current study focuses on the occurrence of triple burden of malnutrition in young adult women and impact of personalized nutrition education on the nutritional status of young adult women in the age group of 18- 21 years. The subjects were provided with questionnaire to collect the demographic and dietary data and also to screen the subjects for nutritional deficiencies. The study was conducted on 200 students and were assessed their nutritional status using ABCD technique such as Anthropometric Measurements (height, weight, BMI, waist and hip circumference, waist and hip ratio), Biochemical Estimation, Clinical Examination and Dietary pattern (24 hour recall method, Food frequency table).The subjects were categorised into under nutrition, over nutrition and micronutrient deficiencies. They were provided with personalised nutrition education on the basis of their nutritional status and requirements.

Climate Change and Nutrition: Implications for the Eastern Mediterranean Region.

The Eastern Mediterranean Region (EMR) is considered among the world's most vulnerable to the dire impacts of climate change. This review paper aims at (1) characterizing climate change in countries of the EMR; (2) examining the potential effects of climate change on the nutritional and health status of the population; and (3) identifying the most vulnerable population groups. The paper explored several climate change indicators including daily temperatures, extreme temperature, daily precipitation, extreme precipitation (flooding, drought, storms, etc.), humidity, CO2 concentrations and sea surface temperature in EMR countries. Findings suggest that climate change will exert a significant adverse effect on water and food security and showed that the nutritional status of the population, which is already characterized by the triple burden of malnutrition, is likely to worsen via three main pathways mediated by climate change, namely, its impact on food security, care and health. Women, infants, children, those living in poor households and those experiencing displacement will be among the most vulnerable to the nutritional impacts of climate change. The paper concludes with a set of recommendations from the Initiative on Climate Action and Nutrition, which can support the region in tackling the critical nexus of climate change and nutrition.

Mid-term evaluation of Maternal and Child Nutrition Programme (MCNP II) in Kenya

BackgroundKenya is faced with a triple burden of malnutrition which is multi-faceted with health and socio-economic implications. Huge geographical disparities exist, especially, in the arid and semi-arid lands exacerbated by inadequate resource allocation to the nutrition sector and challenges in multi-sectoral coordination and nutrition governance. UNICEF’s Maternal and Child Nutrition Programme is a four-year (2018–2022) resilience-building, multi-sectoral program focused on pregnant and lactating women, mothers of children under five years and children under five years. The objective of the mid-term evaluation was to establish the relevance, effectiveness, efficiency, and sustainability of the programme.MethodsThe field evaluation conducted between June and July 2021, adopted a concurrent mixed-methods approach, where qualitative information was gathered through 29 key informant interviews and 18 focus group discussions (6 FGDs per population group; women of reproductive age, adolescent girls and men). Quantitatively, data were obtained through desk review of secondary data from programme reports, budgets, and project outputs where descriptive analysis was undertaken using Excel software. Qualitative information was organized using Nvivo software and analyzed thematically.ResultsThe findings provide evidence of the relevance of the Maternal and Child Nutrition Programme II to the nutrition situation in Kenya and its alignment with the Government of Kenya and donor priorities. Most planned programme targets were achieved despite operating in a COVID-19 pandemic environment. The use of innovative approaches such as family mid-upper arm circumference, integrated management of acute malnutrition surge model, Malezi bora and Logistic Management Information Management System contributed to the realization of effective outputs and outcomes. Stringent financial management strategies contributed toward programme efficiencies; however, optimal utilization of the resources needs further strengthening. The programme adopted strategies for strengthening local capacity and promoting ownership and long-term sustainability.ConclusionThe programme is on track across the four evaluation criteria. However, a few suggestions are recommended to improve relevance, effectiveness, efficiency, and sustainability. A formal transition strategy needs to be developed in consultation with multi-stakeholder groups and implemented in phases. UNICEF Nutrition section should explore a more integrated programming mode of delivery through joint initiatives with other agencies under the Delivery as One UN agenda, along the more gender transformative approaches with more systematic involvement of males and females in gender-based discussions.

The Correlation Between Consuming High-Risk Foods and Sedentary Activities with Nutritional Status at SMAN 1 Uluan of Toba Regency in 2021

Currently, Indonesian adolescents are facing three nutritional issues (triple burden of malnutrition), namely malnutrition, overweight, and micronutrient deficiencies with anaemia. This study was aimed to discover the correlation between consuming high-risk foods and sedentary activities with nutritional status at SMAN 1 Uluan of Toba Regency. A correlational study with cross-sectional design was the method used in the study. This study took 61 students of XI class as the sample selected through proportional stratified random sampling technique. The data were analysed through the Chi-Square Statistical Test. The study results indicated that the high-risk foods which were categorized as frequently consumed encompassed high-fat/high-cholesterol/fried foods (50.8%), grilled foods (55.7%), processed foods with preservatives (55.7%), flavour-enhanced foods (57.4%), soft drinks (54.1%), energy drinks (55.77%), and instant foods (63.9%). While the foods that were categorized as rarely consumed encompassed sweet foods and beverages (50.8%) and salty foods (50.8%). On the sedentary activity variable, the majority of respondents conducted sedentary activities with high intensity (>5 hours/day) (47.5%), while the nutritional status variable showed overnutrition (32.8%). According to the results of statistical test, a significant correlation between consuming high-risk foods (sweet foods and beverages (p = 0.000), salty foods (p = 0.003), high-fat/high-cholesterol/fried foods (p = 0.000), grilled foods (p = 0.004), processed foods with preservatives (p = 0.003), flavour-enhanced foods (p = 0.002), soft drinks (p = 0.003), energy drinks (p = 0.042), and instant foods (p = 0.007)) and sedentary activities (p = 0.000) with nutritional status. Good and healthy consumption patterns in addition to proper physical activities/exercises are expected.

ENVIRONMENTAL SANITATION AT HOME AND HISTORY OF INFECTION DISEASES AS RISK FACTORS FOR STUNTING IN TODDLERS IN DROKILO VILLAGE, KEDUNGADEM DISTRICT, BOJONEGORO REGENCY

Introduction: Stunting is one of the nutritional issues that becomes the triple burden of malnutrition and affects the world, especially in almost every nation. Indonesia is listed as the third country with the greatest stunting prevalence in the Southeast Asia/South-East Asia Regional (SEAR) areas. This study aimed to examine the connections between stunting incidence a history of infectious diseases, as well as the connections between toddlers who experience stunting events a history of infectious diseases among toddlers in Drokilo Village. Methods: This study used a case-control research design and an analytical observational approach. It involved 51 toddlers samples and included dependent variables i.e., stunting incidence and independent variables i.e., environmental sanitation at home and a history of infectious diseases. Bivariate analysis was utilized together with Chi-square test to examine the variables. Results and Discussion: Male toddlers over the age of two years frequently experienced stunting. With a p-value of 0.046, environmental sanitation at home was associated with a lower stunting incidence. With a p-value of 0.037, a history of infectious diseases was associated with higher stunting incidence. Conclusion: Environmental sanitation at home a history of infectious diseases had significant relationships with stunting incidence in toddlers. In short, these two factors may cause stunting in toddlers in Drokilo Village, Kedungadem District, Bojonegoro Regency.