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      Assessment of the knowledge and attitude of infants’ mothers from Bushehr (Iran) on food security using anthropometric indicators in 2016: a cross-sectional study

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          Abstract

          Background

          Among the main elements of food security, in terms of food usage, are knowledge and attitude. These are particularly important during the initial two years of a child’s life. The present study was conducted in 2016 and aimed to assess the knowledge and attitude of infants’ mothers from Bushehr (Iran) towards food security using anthropometric indicators.

          Methods

          The present cross-sectional, descriptive-analytical study was performed on 400 mothers of children aged 1-2 years in Bushehr, Iran. Data were collected using a 20-item knowledge questionnaire (CVR = 0.95, CVI = 0.95, and reliability 0.7), a 26-item attitude questionnaire (CVI = 0.94, CVR = 0.91, and reliability 0.76), and a 16-item Radimer/Cornell questionnaire, which were completed by all mothers. Anthropometric indicators of children, including height-for-age, weight-for-age, and weight-for-height were also measured in accordance with the z-score benchmark of the World Health Organization.

          Results

          A positive and significant relationship was found between knowledge and attitude ( r = 0.26, P = 0.0001) as well as between knowledge and household food security ( r = 0.11, P = 0.02) in complementary feeding. Approximately 26% of the studied children fell under the risk category of overweight to obese. A significant relationship was found between inadequate knowledge of the mothers and height-for-age (OR = 4.87, P = 0.001) and weight-for-height (OR = 2.33, P = 0.04) indices, as well as between the negative attitude of the mothers and weight-for-height index (OR = 2.91, P = 0.03).

          Conclusions

          The knowledge of food security purely relates to the dimension of the household food security of a family and not to the individual/child level of food security. It seems that the knowledge of a mother, as a positive factor, does not support child’s food security when the severity of household insecurity triggers the child’s hunger and food inaccessibility. Also, inappropriate knowledge and negative attitude towards food security were associated with an increased risk of obesity. Increased weight, in addition to being affected by the knowledge and attitude of the mothers, is probably also influenced by the incorrect conduct of the mothers. Further investigation on this topic is recommended.

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          Most cited references30

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          Effect of mother’s education on child’s nutritional status in the slums of Nairobi

          Background Malnutrition continues to be a critical public health problem in sub-Saharan Africa. For example, in East Africa, 48 % of children under-five are stunted while 36 % are underweight. Poor health and poor nutrition are now more a characteristic of children living in the urban areas than of children in the rural areas. This is because the protective mechanism offered by the urban advantage in the past; that is, the health benefits that historically accrued to residents of cities as compared to residents in rural settings is being eroded due to increasing proportion of urban residents living in slum settings. This study sought to determine effect of mother’s education on child nutritional status of children living in slum settings. Methods Data are from a maternal and child health project nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). The study involves 5156 children aged 0–42 months. Data on nutritional status used were collected between October 2009 and January 2010. We used binomial and multiple logistic regression to estimate the effect of education in the univariable and multivariable models respectively. Results Results show that close to 40 % of children in the study are stunted. Maternal education is a strong predictor of child stunting with some minimal attenuation of the association by other factors at maternal, household and community level. Other factors including at child level: child birth weight and gender; maternal level: marital status, parity, pregnancy intentions, and health seeking behaviour; and household level: social economic status are also independently significantly associated with stunting. Conclusion Overall, mothers’ education persists as a strong predictor of child’s nutritional status in urban slum settings, even after controlling for other factors. Given that stunting is a strong predictor of human capital, emphasis on girl-child education may contribute to breaking the poverty cycle in urban poor settings.
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            Development of indicators to assess hunger.

            Despite widespread concern about hunger in America, efforts to monitor and assess the extent of hunger have been hampered by lack of consensus on an appropriate meaning for the term hunger and by the lack of valid indicators to assess it. The first phase of the research used qualitative methods to derive a socially-appropriate definition of hunger. Thirty-two women in Upstate New York were interviewed regarding their experience with food problems and hunger. The interviews were analyzed using the constant comparative method. Results indicated that women had a narrow and a broad concept of hunger. The narrow concept focused on going without food for a specified period of time and the physical sensation of hunger. The broad one included two dimensions: household and individual hunger. Each had quantitative, qualitative, psychological, and social components. The second phase of the research used survey methodology to examine the validity and reliability of items designed to measure the conceptual definition of hunger. The survey was administered to 189 women in Upstate New York who participated in programs designed for low-income households or households in need of food. The second phase confirmed the conceptualization of hunger developed in the first phase. A subset of valid and reliable items that represented each of the major dimensions and components of hunger was identified as being useful for monitoring and assessing hunger.
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              Nutritional status and dietary intakes of children aged 6 months to 12 years: findings of the Nutrition Survey of Malaysian Children (SEANUTS Malaysia).

              The dual burden of malnutrition reportedly coexists in Malaysia; however, existing data are scarce and do not adequately represent the nutritional status of Malaysian children. The Nutrition Survey of Malaysian Children was carried out with the aim of assessing the nutritional status in a sample of nationally representative population of children aged 6 months to 12 years. A total of 3542 children were recruited using a stratified random sampling method. Anthropometric measurements included weight, height, mid-upper arm circumference, and waist and hip circumferences. Blood biochemical assessment involved analyses of Hb, serum ferritin, and vitamins A and D. Dietary intake was assessed using semi-quantitative FFQ, and nutrient intakes were compared with the Malaysian Recommended Nutrient Intakes (RNI). The prevalence of overweight (9·8%) and obesity (11·8%) was higher than that of thinness (5·4%) and stunting (8·4%). Only a small proportion of children had low levels of Hb (6·6%), serum ferritin (4·4%) and vitamin A (4·4%), but almost half the children (47·5%) had vitamin D insufficiency. Dietary intake of the children was not compatible with the recommendations, where more than one-third did not achieve the Malaysian RNI for energy, Ca and vitamin D. The present study revealed that overnutrition was more prevalent than undernutrition. The presence of high prevalence of vitamin D insufficiency and the inadequate intake of Ca and vitamin D are of concern. Hence, strategies for improving the nutritional status of Malaysian children need to consider both sides of malnutrition and also put emphasis on approaches for the prevention of overweight and obesity as well as vitamin D insufficiency.
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                Author and article information

                Contributors
                +98 7733450187 , sedighe.yegane@yahoo.com
                +98 7733320657 , motamedn@bpums.ac.ir
                +98 7733450134 , najafpour@bpums.ac.ir
                +98 7733450187 , ravanipour@bpums.ac.ir , ravanipour@gmail.com , http://www.linkedin.com/in/maryam-ravanipour-79330976
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                11 May 2018
                11 May 2018
                2018
                : 18
                : 621
                Affiliations
                [1 ]GRID grid.411832.d, Department of Nursing, , School of Nursing and Midwifery, Bushehr University of Medical Sciences, ; Rishehr Street, PO Box 7518759577, Bushehr, Iran
                [2 ]GRID grid.411832.d, Department of Community Medicine, School of Medicine, , Bushehr University of Medical Sciences, ; Moallem Street, PO Box 7514763448, Bushehr, Iran
                [3 ]GRID grid.411832.d, Department of Nutrition, School of Health and Nutrition, , Bushehr University of Medical Sciences, ; Rishehr Street, PO Box 7518759577, Bushehr, Iran
                [4 ]GRID grid.411832.d, The Persian Gulf Tropical Medicine Research Centre, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, ; Bushehr, Iran
                [5 ]GRID grid.411832.d, Department of Nursing, , School of Nursing and Midwifery, Bushehr University of Medical Sciences, ; Rishehr Street, PO Box 7518759577, Bushehr, Iran
                Author information
                http://orcid.org/0000-0002-3421-4512
                Article
                5531
                10.1186/s12889-018-5531-5
                5948760
                29751757
                bbc23ac4-42d9-4ae4-8572-acf77d8e3dd2
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 September 2017
                : 1 May 2018
                Funding
                Funded by: Research Council of Bushehr University of Medical Sciences
                Award ID: 2015.5624
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Public health
                anthropometry,complementary feeding,food security,obesity,stunting,iran
                Public health
                anthropometry, complementary feeding, food security, obesity, stunting, iran

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