Higher Energy and Zinc Intakes from Complementary Feeding Are Associated with Decreased Risk of Undernutrition in Children from South America, Africa, and Asia

Abstract

Background Few studies have focused on quantitatively analyzing nutrients from infant diets, compromising complementary feeding evaluation and health promotion worldwide. Objectives This study aimed to describe dietary intake in infants from 9 to 24 mo of age, determining nutrient intakes associated with the risk of underweight, wasting, and stunting. Methods Usual nutrient intakes from complementary feeding were determined by 24-h recalls collected when infants were 9–24 mo of age in communities from 7 low- and middle-income countries: Brazil (n = 169), Peru (n = 199), South Africa (n = 221), Tanzania (n = 210), Bangladesh (n = 208), India (n = 227), and Nepal (n = 229), totaling 1463 children and 22,282 food recalls. Intakes were corrected for within- and between-person variance and energy intake. Multivariable regression models were constructed to determine nutrient intakes associated with the development of underweight, wasting, and stunting at 12, 18, and 24 mo of age. Results Children with malnutrition presented significantly lower intakes of energy and zinc at 12, 18, and 24 mo of age, ranging from −16.4% to −25.9% for energy and −2.3% to −48.8% for zinc. Higher energy intakes decreased the risk of underweight at 12 [adjusted odds ratio (AOR): 0.90; 95% CI: 0.84, 0.96] and 24 mo (AOR: 0.91; 95% CI: 0.86, 0.96), and wasting at 18 (AOR: 0.91; 95% CI: 0.83, 0.99) and 24 mo (AOR: 0.83; 95% CI: 0.74, 0.92). Higher zinc intakes decreased the risk of underweight (AOR: 0.12; 95% CI: 0.03, 0.55) and wasting (AOR: 0.19; 95% CI: 0.04, 0.92) at 12 mo, and wasting (AOR: 0.05; 95% CI: 0.00, 0.76) at 24 mo. Conclusions Higher intakes of energy and zinc in complementary feeding were associated with decreased risk of undernutrition in the studied children. Data suggest these are characteristics to be improved in children's complementary feeding across countries.

Accuracy of declared nutrient content on labels of commercial complementary food products in Cambodia, Indonesia and Senegal

“…Older infants and young children are reliant on zinc‐rich complementary foods to meet their needs (Daniels et al, 2018 ) since breastmilk zinc concentration declines as an infant ages (Pan American Health Organization; WHO, 2003 ). Higher zinc intake has been found to be protective against underweight and wasting in the complementary feeding period in LMIC contexts (Maciel et al, 2021 ). Calcium, iron and zinc intakes were also observed to be lower among underweight, wasted, and stunted children at 12 months of age (Maciel et al, 2021 ).…”

“…Higher zinc intake has been found to be protective against underweight and wasting in the complementary feeding period in LMIC contexts (Maciel et al, 2021 ). Calcium, iron and zinc intakes were also observed to be lower among underweight, wasted, and stunted children at 12 months of age (Maciel et al, 2021 ). These three nutrients are a priority in the diets of older infants and young children in Cambodia, Indonesia and Senegal, contexts where undernutrition is prevalent and where nutrient density of general diets is limited, and label value accuracy for these key micronutrients in these contexts is therefore critical.…”

Nutritional inequalities among under-five children: a geospatial analysis of hotspots and cold spots in 73 low- and middle-income countries

“…A balanced diet, with an adequate intake of fruit and vegetables and poultry products, is not accessible for most people in LMICs. Evidence suggests that complementary feeding (consumption of solid, semi-solid, or soft foods in addition to breastmilk after six months of birth) has also a significant role in preventing undernutrition [61][62][63]. However, to realize full health benefits, complementary feeding must be initiated in the sixth month of a child's life [64].…”

The Effectiveness Of Giving Angkak And Bananas Against Anemia In Children

“…These four factors affect the nutritional intake and health status of mothers and children. Interventions against these four factors are expected to prevent nutritional problems, both undernutrition and excess nutrition (3).Iron metabolism is an important nutrient for making Hb, which is a protein in red blood cells that carries oxygen throughout the body's tissues and organs. Iron deficiency can be treated easily and cheaply.…”