title: Low intake of vitamin A-rich foods among children, aged 12-35 months, in India: association with malnutrition, anemia, and missed child survival interventions.
abstract: OBJECTIVE
  To determine whether children in India who have a low intake of vitamin A-rich foods are at higher risk of malnutrition, anemia, and not receiving child health interventions.
  
  
  METHODS
  We analyzed data from the India National Family Health Survey, 2005-2006.
  
  
  RESULTS
  Of 17 847 children (41.9%), aged 12-35 months, 7020 did not receive vitamin A-rich foods, based on 24-h recall. The prevalence of stunting, severe stunting, underweight, and severe underweight among children who did and did not receive vitamin A-rich foods was, respectively, 52.5% versus 59.0%, 26.7% versus 32.9%, 43.8% versus 48.5%, and 17.9% versus 21.6% (all P<0.0001). Children who did not receive vitamin A-rich foods were more likely to be anemic, not have completed childhood immunizations, and not to have received vitamin A supplementation in the previous 6 mo (all P<0.0001). Maternal education of ≥10, 7-9, and 1-6 y, respectively, compared with no formal education was associated with the child receiving vitamin A-rich foods (odds ratio 1.41, 95% confidence interval 1.20-1,67, P<0.0001; odds ratio 1.20, 95% confidence interval 1.04-1.37, P=0.01; odds ratio 1.16, 95% confidence interval 1.02-1.32, P=0.02) in a multivariate logistic regression model adjusting for maternal age, household size, socioeconomic status, and location.
  
  
  CONCLUSIONS
  Children who did not receive vitamin A-rich foods were more likely to be malnourished and to have missed basic child health interventions, including vitamin A supplementation. Children were more likely to receive vitamin A-rich foods if their mothers had previously achieved higher primary or secondary education levels.
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. rdsemba@jhmi.edu
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
authors.forename: Saskia
authors.initials: S
authors.lastname: de Pee
authors.forename: Kai
authors.initials: K
authors.lastname: Sun
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Campbell
authors.forename: Martin W
authors.initials: MW
authors.lastname: Bloem
authors.forename: V K
authors.initials: VK
authors.lastname: Raju
mesh_terms: D000740:Anemia / Q000209:etiology*; D002675:Child, Preschool; D004032:Diet; D019587:Dietary Supplements; D004522:Educational Status; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology / Q000209:etiology*; D006306:Health Surveys; D006801:Humans; D007114:Immunization; D007194:India / Q000453:epidemiology; D007223:Infant; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000209:etiology*; D009035:Mothers; D016017:Odds Ratio; D013851:Thinness / Q000453:epidemiology / Q000209:etiology; D014801:Vitamin A / Q000008:administration & dosage*; D014802:Vitamin A Deficiency / Q000150:complications*; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D014815:Vitamins; D014801:Vitamin A