In Ethiopia, India, and Peru, Household Expenditures on Fats Are More Strongly Associated with Children’s Future Heights Than Expenditures on Other Food Groups (P10-006-19)

We hypothesized that household food expenditures on 7 key dietary food groups—starches, fruits & vegetables, legumes, eggs, dairy, meat and fat—woul differentially affect future child height-for-age z scores (HAZ), after adjusting for household, parental and community characteristics. We investigated the associations of household food group expenditures at 5 years (y) and 8y with child HAZ at 8y and 12y, respectively. We used data from 6993 children, born around 2001, from Ethiopia, India, Peru and Vietnam, collected at ages 5, 8, and 12y from the Young Lives younger cohort. We compared associations between two weeks of household food expenditures (in Purchasing Power Parity adjusted dollars (PPP$) to allow meaningful cross-country comparisons) on food groups and child HAZ at subsequent rounds of collection to assess longitudinal relations. Total food expenditures, rural/urban residence, maternal and paternal education, and child sex were controlled for in our models. In Ethiopia, results pointed to total food expenditure as one of the critical and significant components associated with subsequent child HAZ; and among the food groups, expenditures on fats had the largest associations with future child HAZ. In India and Peru, expenditure on one specific food group—fats—seemed to be the most important significant predictor of future HAZ in children from among food expenditures. In Vietnam, starches were a significant negative predictor of future HAZ, which may relate to the significance of dietary diversity and prediction of future HAZ for this country’s cohort. Our results pinpoint specific facets of the diet that may have had the greatest impact on child growth for each country. They also point to the importance of examining country-level context, and caution about generalizing from one context to others. These results, moreover, highlight the usefulness of household food expenditure survey data in analyzing children’s nutrition at the country level, and may help to influence child food and nutrition policies in these four unique countries. This study is based on research funded by the Bill & Melinda Gates Foundation, Eunice Shriver Kennedy National Institute of Child Health and Development and Grand Challenges Canada.

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