title: Meat consumption is associated with less stunting among toddlers in four diverse low-income settings.
abstract: BACKGROUND
  Early growth faltering is common but is difficult to reverse after the first 2 years of life.
  
  
  OBJECTIVE
  To describe feeding practices and growth in infants and young children in diverse low-income settings prior to undertaking a complementary feeding trial.
  
  
  METHODS
  This cross-sectional study was conducted through the Global Network for Women's and Children's Health Research in Guatemala, Democratic Republic of Congo, Zambia, and Pakistan. Feeding questionnaires were administered to convenience samples of mothers of 5- to 9-month old infants and 12- to 24-month-old toddlers. After standardized training, anthropometric measurements were obtained from the toddlers. Following the 2006 World Health Organization Growth Standards, stunting was defined as length-for-age < -2SD, and wasting as weight-for-length < -2SD. Logistic regression was applied to evaluate relationships between stunting and wasting and consumption of meat (including chicken and liver and not including fish).
  
  
  RESULTS
  Data were obtained from 1,500 infants with a mean (+/- SD) age of 6.9 +/- 1.4 months and 1,658 toddlers with a mean age of 17.2 +/- 3.5 months. The majority of the subjects in both age groups were breastfed. Less than 25% of the infants received meat regularly, whereas 62% of toddlers consumed these foods regularly, although the rates varied widely among sites. Stunting rate ranged from 44% to 66% among sites; wasting prevalence was less than 10% at all sites. After controlling for covariates, consumption of meat was associated with a reduced likelihood of stunting (OR = 0.64; 95% CI, 0.46 to 0.90).
  
  
  CONCLUSIONS
  The strikingly high stunting rates in these toddlers and the protective effect of meat consumption against stunting emphasize the need for interventions to improve complementary feeding practices, beginning in infancy.
authors.affiliation: University of Colorado Denver, Aurora, Colorado 80045, USA. Nancy.Krebs@ucdenver.edu
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Krebs
authors.forename: Manolo
authors.initials: M
authors.lastname: Mazariegos
authors.forename: Antoinette
authors.initials: A
authors.lastname: Tshefu
authors.forename: Carl
authors.initials: C
authors.lastname: Bose
authors.forename: Neelofar
authors.initials: N
authors.lastname: Sami
authors.forename: Elwyn
authors.initials: E
authors.lastname: Chomba
authors.forename: Waldemar
authors.initials: W
authors.lastname: Carlo
authors.forename: Norman
authors.initials: N
authors.lastname: Goco
authors.forename: Mark
authors.initials: M
authors.lastname: Kindem
authors.forename: Linda L
authors.initials: LL
authors.lastname: Wright
authors.forename: K Michael
authors.initials: KM
authors.lastname: Hambidge
mesh_terms: D000818:Animals; D001835:Body Weight; D001942:Breast Feeding; D002645:Chickens; D002657:Child Development; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo; D004032:Diet; D005260:Female; D006166:Guatemala; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D016015:Logistic Models; D008297:Male; D008460:Meat; D010154:Pakistan; D010865:Pilot Projects; D011203:Poverty; D015995:Prevalence; D011795:Surveys and Questionnaires; D015024:Zambia
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