title: Factors associated with early growth in Egyptian infants: implications for addressing the dual burden of malnutrition.
abstract: Optimal nutrition is critical to the attainment of healthy growth, human capital and sustainable development. In Egypt, infants and young children face overlapping forms of malnutrition, including micronutrient deficiencies, stunting and overweight. Yet, in this setting, little is known about the factors associated with growth during the first year of life. A rise in stunting in Lower Egypt from 2005 to 2008 prompted this implementation research study, which followed a longitudinal cohort of infants from birth to 1 year of age within the context of a USAID-funded maternal and child health integrated programme. We sought to determine if growth patterns and factors related to early growth differed in Lower and Upper Egypt, and examined the relationship between weight loss and subsequent stunting at 12 months of age. Growth patterns revealed that length-for-age z-score (LAZ) decreased and weight-for-length z-score (WLZ) increased from 6 to 12 months of age in both regions. One-quarter of infants were stunted and nearly one-third were overweight by 12 months of age in lower Egypt. Minimum dietary diversity was significantly associated with WLZ in Lower Egypt (β = 0.22, P < 0.05), but not in Upper Egypt. Diarrhoea, fever and programme exposure were not associated with any growth outcome. Weight loss during any period was associated with a twofold likelihood of stunting at 12 months in Lower Egypt, but not Upper Egypt. In countries, like Egypt, facing the nutrition transition, infant and young child nutrition programmes need to address both stunting and overweight through improving dietary quality and reducing reliance on energy-dense foods.
authors.affiliation: Maternal and Child Survival Program (MCSP), Washington, District of Columbia, USA.|Maternal, Newborn, Child Health and Nutrition Division, PATH, Washington, District of Columbia, USA.|Department of Prevention and Community Health, George Washington University, Milken Institute School of Public Health, Chapel Hill, North Carolina, USA.
authors.forename: Justine A
authors.initials: JA
authors.lastname: Kavle
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Valerie L
authors.initials: VL
authors.lastname: Flax
authors.affiliation: Maternal and Child Survival Program (MCSP), Washington, District of Columbia, USA.|SMART Project, MCHIP, Cairo, Egypt.|Jhpiego, Baltimore, Maryland, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Abdelmegeid
authors.affiliation: SMART Project, MCHIP, Cairo, Egypt.
authors.forename: Farouk
authors.initials: F
authors.lastname: Salah
authors.affiliation: SMART Project, MCHIP, Cairo, Egypt.
authors.forename: Seham
authors.initials: S
authors.lastname: Hafez
authors.affiliation: National Nutrition Institute of Egypt, Cairo, Egypt.
authors.forename: Magda
authors.initials: M
authors.lastname: Ramzy
authors.affiliation: National Nutrition Institute of Egypt, Cairo, Egypt.
authors.forename: Doaa
authors.initials: D
authors.lastname: Hamed
authors.affiliation: SMART Project, MCHIP, Cairo, Egypt.|National Nutrition Institute of Egypt, Cairo, Egypt.
authors.forename: Gulsen
authors.initials: G
authors.lastname: Saleh
authors.affiliation: Maternal and Child Survival Program (MCSP), Washington, District of Columbia, USA.|Maternal, Newborn, Child Health and Nutrition Division, PATH, Washington, District of Columbia, USA.
authors.forename: Rae
authors.initials: R
authors.lastname: Galloway
mesh_terms: D000465:Algorithms; D001827:Body Height; D001835:Body Weight; D002657:Child Development; D015331:Cohort Studies; D003677:Deficiency Diseases / Q000150:complications / Q000178:diet therapy / Q000453:epidemiology; D004032:Diet / Q000009:adverse effects*; D004534:Egypt / Q000453:epidemiology; D005260:Female; D063105:Food Assistance; D006130:Growth Disorders / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D019456:Health Transition; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000178:diet therapy / Q000453:epidemiology* / Q000503:physiopathology; D018977:Micronutrients / Q000172:deficiency; D050177:Overweight / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D015995:Prevalence
chemical_list: D018977:Micronutrients
keywords: double burden of malnutrition; growth; infant; infant and young child nutrition; overweight; stunting