Effect of Nutrition Intervention on Indices of Growth in Day Care Centers of the city of Birjand, Iran
Nutrition Intervention in Day Care Centers
Background: Childhood malnutrition is the main risk factor for impaired mental and physical growth and several diseases and leads to premature death worldwide. Therefore, reducing childhood malnutrition is a top priority in most countries. In this regard, several studies have explored the effects of nutritional intervention on reducing childhood malnutrition, although mostly in controlled conditions and with small sample sizes; data on community-based interventions are limited. In this study we investigated the effects of a nutritional intervention on the growth of children in day-care centers in rural areas of the city of Birjand, Iran, the intervention being offering warm food at lunch-time.
Subjects and Methods: This was a quasi-experimental study. Warm food was offered for a period of 6 months to all the children (n=1809) in rural day care centers of Birjand. Height and weight of the children were measured before and after the intervention. Z-score indicators were estimated using WHO Software as Anthro and Anthro plus. SPSS Software was used for data analyses.
Results: Prevalence of wasting and stunting decreased after the intervention in both sexes. The decrease in stunting prevalence was significantly higher in boys than in girls. However, the rate of height for age Z-score (HAZ) did not change significantly in either sex. In both sexes, weight, height, body mass index, and weight for age improved significantly after the intervention. Prevalence of obesity and overweight did not change after the intervention.
Conclusion: Based on the findings, offering warm food at lunch-time in day-care centers can reduce wasting and stunting in children in rural regions of Birjand, Iran.
2. Moridi, G. and M. Fathi, Malnutrition in children under five in Iran. Advances in Nursing & Midwifery, 2009. 19(64): p. 49-56.
3. Mehta, N.M., et al., Defining pediatric malnutrition: a paradigm shift toward etiology‐related definitions. Journal of Parenteral and Enteral Nutrition, 2013. 37(4): p. 460-481.
4. Waterlow, J., Linear growth in children, in Nutrition in Pregnancy and Growth. 1996, Karger Publishers. p. 45-54.
5. WHO, MDG1:eradicate extreme poverty and hunger 2014. 2014.
6. WHO, Global health observatory (GHO) data 2015.
7. Black, R.E., S.S. Morris, and J. Bryce, Where and why are 10 million children dying every year? The lancet, 2003. 361(9376): p. 2226-2234.
8. UNICEF, the state of the world`s children 2014. 2014.
9. De Onis, M. and F. Branca, Childhood stunting: a global perspective. Maternal & child nutrition, 2016. 12: p. 12-26.
10. Mohseni, M., A. Aryankhesal, and N. Kalantari, Prevalence of Malnutrition Among Iran’s Under Five-Year-Old Children and the Related Factors: A Systematic Review and Meta-Analysis. Iranian Journal of Pediatrics, 2018. 28(1).
11. Aboud, F.E. and A.K. Yousafzai, Global health and development in early childhood. Annual Review of Psychology, 2015. 66: p. 433-457.
12. Engle, P.L., et al., Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries. The Lancet, 2011. 378(9799): p. 1339-1353.
13. Grantham‐McGregor, S.M., et al., Effects of integrated child development and nutrition interventions on child development and nutritional status. Annals of the New York Academy of Sciences, 2014. 1308(1): p. 11-32.
14. Larson, L. and A. Yousafzai, Impact of nutritional interventions on mental development of children under-two in developing countries: a systematic review of randomized controlled trials. Eur J Nutr Food Saf, 2015. 5: p. 549-550.
15. Rivera, J.A. and J. Sepúlveda Amor, Conclusions from the Mexican National Nutrition Survey 1999: translating results into nutrition policy. Salud pública de México, 2003. 45: p. 565-575.
16. Rivera, J.A., et al., Impact of the Mexican program for education, health, and nutrition (Progresa) on rates of growth and anemia in infants and young children: a randomized effectiveness study. Jama, 2004. 291(21): p. 2563-2570.
17. Burza, S., et al., Community-based management of severe acute malnutrition in India: new evidence from Bihar–. The American journal of clinical nutrition, 2015. 101(4): p. 847-859.
18. Sabermahani, A., et al., Provincial human development index, a guide for efficiency level analysis: the case of Iran. Iranian journal of public health, 2013. 42(2): p. 149.
19. Abolhallaje, M., et al., Assessing health inequalities in Iran: a focus on the distribution of health care facilities. Global journal of health science, 2014. 6(4): p. 285.
20. Organization, W.H. and Unicef, WHO child growth standards and the identification of severe acute malnutrition in infants and children: joint statement by the World Health Organization and the United Nations Children's Fund. 2009.
21. Bhutta, Z.A., et al., Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? The lancet, 2013. 382(9890): p. 452-477.
22. Fesharakinia, A. and G. Sharifzadeh, Prevalence of malnutrition in under 5-year old children in Birjand city in 2011. JBUMS, 2013. 20(1): p. 77-84.
23. Payandeh, A., et al., Prevalence of malnutrition among preschool children in northeast of Iran, a result of a population based study. Global journal of health science, 2013. 5(2): p. 208.
24. Ghodsi, D., et al., Impact of the national food supplementary program for children on household food security and maternal weight status in Iran. International journal of preventive medicine, 2016. 7.
25. Roberts, J.L. and A.D. Stein, The Impact of Nutritional Interventions beyond the First 2 Years of Life on Linear Growth: A Systematic Review and Meta-Analysis–. Advances in Nutrition, 2017. 8(2): p. 323-336.
26. Fatemeh, T., et al., Prevalence of overweight and obesity in preschool children (2–5 year-olds) in Birjand, Iran. BMC research notes, 2012. 5(1): p. 529.
27. Salehiniya, H., et al., The Prevalence of Overweight and Obesity in Children Under 5 Years in Tehran, Iran, in 2012: A Population-Based Study. Research in cardiovascular medicine, 2016. 5(1).
28. Shafieian, T., et al., Determinants of Nutritional Status in Children living in Mashhad, Iran. International Journal of Pediatrics, 2013. 1(2): p. 9-18.
29. Shrimpton, R., et al., Worldwide timing of growth faltering: implications for nutritional interventions. Pediatrics, 2001. 107(5): p. e75-e75.
30. Devakumar, D., et al., Effects of antenatal multiple micronutrient supplementation on lung function in mid-childhood: follow-up of a double-blind randomised controlled trial in Nepal. European Respiratory Journal, 2015: p. ERJ-01889-2014.
31. Wu, T., et al., Iodised salt for preventing iodine deficiency disorders. Cochrane Database Syst Rev, 2002. 3: p. CD003204.
32. Imdad, A., et al., Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age. Cochrane Database Syst Rev, 2010. 12.
33. Sachdev, H., T. Gera, and P. Nestel, Effect of iron supplementation on mental and motor development in children: systematic review of randomised controlled trials. Public health nutrition, 2005. 8(2): p. 117-132.
34. Imdad, A. and Z.A. Bhutta, Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries: a meta-analysis of studies for input to the lives saved tool. BMC public health, 2011. 11(3): p. S22.
35. Awasthi, S., et al., Vitamin A supplementation every 6 months with retinol in 1 million pre-school children in north India: DEVTA, a cluster-randomised trial. The Lancet, 2013. 381(9876): p. 1469-1477.
36. Bhatia, J., Z.A. Bhutta, and S.C. Kalhan, Maternal and Child Nutrition: The First 1,000 Days. Vol. 74. 2013: Karger Medical and Scientific Publishers.
37. Elmadfa, I. and A.L. Meyer, Vitamins for the first 1000 days: preparing for life. Int J Vitam Nutr Res, 2012. 82(5): p. 342-7.
38. Ghosh, S., Protein quality in the first thousand days of life. Food and nutrition bulletin, 2016. 37(1_suppl): p. S14-S21.
39. Singh, M., Role of micronutrients for physical growth and mental development. The Indian journal of pediatrics, 2004. 71(1): p. 59-62.