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Factors associated with dietary diversity and length-for-age z-score in rural Ethiopian children aged 6-23 months: A novel approach to the analysis of baseline data from the Sustainable Undernutrition Reduction in Ethiopia evaluation.

Authors
  • Kuche, Desalegn1
  • Moss, Cami2
  • Eshetu, Solomon1
  • Ayana, Girmay1
  • Salasibew, Mihretab2
  • Dangour, Alan D2
  • Allen, Elizabeth2
  • 1 Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia. , (Ethiopia)
  • 2 London School of Hygiene and Tropical Medicine, London, UK.
Type
Published Article
Journal
Maternal & child nutrition
Publication Date
Jan 01, 2020
Volume
16
Issue
1
Identifiers
DOI: 10.1111/mcn.12852
PMID: 31124274
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Infants and young children need diets high in nutrient density and diversity to meet the requirements of rapid growth and development. Our aim was to evaluate sociodemographic, agricultural diversity, and women's empowerment factors associated with child dietary diversity and length-for-age z-score (LAZ) in children 6-23 months using data collected as part of the Sustainable Undernutrition Reduction in Ethiopia (SURE) evaluation study baseline survey in May-June 2016. We here present a novel analysis using directed acyclic graphs (DAGs) to represent our assumptions about the causal influences between the factors of interest and the outcomes. The causal diagrams enabled the identification of variables to be included in multivariable analysis to estimate the total effects of factors of interest using ordinal logistic/linear regression models. We found that child dietary diversity was positively associated with LAZ with children consuming 4 or more food groups having on average an LAZ score 0.42 (95% CI [0.08, 0.77]) higher than those consuming no complementary foods. Household production of fruits and vegetables was associated with both increased child dietary diversity (adjusted OR 1.16; 95% CI [1.09, 1.24]) and LAZ (adjusted mean difference 0.05; 95% CI [0.005, 0.10]). Other factors positively associated with child dietary diversity included age in months, socio-economic status, maternal education, women's empowerment and dietary diversity, paternal childcare support, household food security, fruit and vegetable cultivation, and land ownership. LAZ was positively associated with age, socio-economic status, maternal education, fruit and vegetable production, and land ownership. © 2019 The Authors Maternal & Child Nutrition Published by John Wiley & Sons Ltd.

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