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http://dx.doi.org/10.4162/nrp.2015.9.5.547

Nutritional status of toddlers and preschoolers according to household income level: overweight tendency and micronutrient deficiencies  

Kim, Kirang (Department of Food Science and Nutrition, Dankook University)
Shin, Sam Cheol (Administration Affairs, Dankook Universtiy Hospital)
Shim, Jae Eun (Department of Food and nutrition, Daejeon University)
Publication Information
Nutrition Research and Practice / v.9, no.5, 2015 , pp. 547-553 More about this Journal
Abstract
BACKGROUNDS/OBJECTIVES: The effects of malnutrition on growth of toddlers and preschoolers by socioeconomic status are not well known. This study aimed to examine the effects of dietary intake on growth outcomes in toddlers and preschoolers by household income level. SUBJECTS/METHODS: The study population was a total of 1,687 children aged 1 to 5 years that participated in the KNHANES from 2009 to 2011. Growth of children was assessed by height for age (HFA) and weight for height (WFH). Children were classified into three groups according to children's HFA and WFH compared to the $10^{th}$ and $90^{th}$ percentiles of the 2007 Korean Children and Adolescent Growth Standard. Average monthly household income was divided into quartile groups. Dietary intake data were obtained by using the one day 24-hr recall method. Risks of inadequate intake of nutrients and unfavorable growth were estimated by using a multiple logistic regression model adjusted for sex, age, region, and energy intake. RESULTS: The low HFA group (<$10^{th}$ percentile) had significantly lower intakes of energy, carbohydrate, and thiamin as compared with the high group (${\geq}90^{th}$ percentile). For WFH status, vitamin C intake was lower in the low group than in the high group. Household income level was related to WFH status but not HFA. Children from lower income households were more likely to have high WFH than those from higher income households (P for trend = 0.038). Household income status was also significantly related with risk of inadequate intake of micronutrients such as thiamin (P for trend = 0.032) and vitamin C (P for trend = 0.002), showing higher odds of inadequate intakes in children from lower income households. CONCLUSIONS: Children from lower income households were prone to be overweight and to have inadequate intakes of micronutrients such as thiamin and vitamin C. To reduce nutritional and health disparities, collective action in the public sector is required from early life.
Keywords
Malnutrition; growth; household income; KNHANES;
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1 World Health Organization (CH). Physical Status: the Use and Interpretation of Anthropometry. Report of a WHO Expert Committee. Technical Report Series No. 854. Geneva: World Health Organization; 1995.
2 WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl 2006;450:76-85.
3 Drewnowski A, Specter SE. Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr 2004;79:6-16.   DOI
4 Food and Agriculture Organization of the United Nations (IT). The Double Burden of Malnutrition: Case Studies from Six Developing Countries. FAO Food and Nutrition Paper 84. Rome: Food and Agriculture Organization of the United Nations; 2006.
5 Corvalan C, Kain J, Weisstaub G, Uauy R. Impact of growth patterns and early diet on obesity and cardiovascular risk factors in young children from developing countries. Proc Nutr Soc 2009;68:327-37.   DOI
6 Rolland-Cachera MF, Deheeger M, Maillot M, Bellisle F. Early adiposity rebound: causes and consequences for obesity in children and adults. Int J Obes (Lond) 2006;30 Suppl 4:S11-7.   DOI
7 Souganidis E. The importance of early nutritional intervention. How maternal and child undernutrition in early life can affect health in later years. Sight Life 2011;25:30-6.
8 Fernald LC, Neufeld LM. Overweight with concurrent stunting in very young children from rural Mexico: prevalence and associated factors. Eur J Clin Nutr 2007;61:623-32.   DOI
9 Sawaya AL, Dallal G, Solymos G, de Sousa MH, Ventura ML, Roberts SB, Sigulem DM. Obesity and malnutrition in a Shantytown population in the city of Sao Paulo, Brazil. Obes Res 1995;3 Suppl 2:107s-115s.   DOI
10 Kim K, Park SM, Oh KW. The impact of nutritional policy on socioeconomic disparity in the unhealthy food intake among Korean adolescents. Appetite 2013;71:388-95.   DOI
11 Oh SY, Hong MJ. Food insecurity is associated with dietary intake and body size of Korean children from low-income families in urban areas. Eur J Clin Nutr 2003;57:1598-604.   DOI
12 Kim HR, Lee SH, Choi JM, Oh YI. Children's Obesity and Underweight among Low Income Families in Korea: Status, Implications and Policy Options. Seoul: Korea Institute for Health and Social Affairs; 2011.
13 Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, Chun C, Khang YH, Oh K. Data resource profile: the Korea national health and nutrition examination survey (KNHANES). Int J Epidemiol 2014;43:69-77.   DOI
14 Sandjaja, Poh BK, Rojroonwasinkul N, Le Nyugen BK, Budiman B, Ng LO, Soonthorndhada K, Xuyen HT, Deurenberg P, Parikh P; SEANUTS Study Group. Relationship between anthropometric indicators and cognitive performance in Southeast Asian schoolaged children. Br J Nutr 2013;110 Suppl 3:S57-64.   DOI
15 Dinour LM, Bergen D, Yeh MC. The food insecurity-obesity paradox: a review of the literature and the role food stamps may play. J Am Diet Assoc 2007;107:1952-61.   DOI
16 Frongillo EA. Understanding obesity and program participation in the context of poverty and food insecurity. J Nutr 2003;133:2117-8.   DOI
17 Kim K, Kim MK, Shin YJ. The concept and measurement of food security. J Prev Med Public Health 2008;41:387-96.   DOI
18 Larson NI, Story MT. Food insecurity and weight status among U.S. children and families: a review of the literature. Am J Prev Med 2011;40:166-73.   DOI
19 Sawaya AL, Martins PA, Grillo LP, Florencio TT. Long-term effects of early malnutrition on body weight regulation. Nutr Rev 2004;62:S127-33.   DOI
20 Laitinen J, Ek E, Sovio U. Stress-related eating and drinking behavior and body mass index and predictors of this behavior. Prev Med 2002;34:29-39.   DOI
21 Dietz WH. Does hunger cause obesity? Pediatrics 1995;95:766-7.
22 Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middleincome countries. Lancet 2007;370:1929-38.   DOI
23 Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R, Uauy R; Maternal and Child Nutrition Study Group. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013;382:427-51.   DOI
24 Pomeroy E, Stock JT, Stanojevic S, Miranda JJ, Cole TJ, Wells JC. Stunting, adiposity, and the individual-level "dual burden" among urban lowland and rural highland Peruvian children. Am J Hum Biol 2014;26:481-90.   DOI
25 Darmon N, Drewnowski A. Does social class predict diet quality? Am J Clin Nutr 2008;87:1107-17.   DOI
26 Power C, Manor O, Matthews S. Child to adult socioeconomic conditions and obesity in a national cohort. Int J Obes Relat Metab Disord 2003;27:1081-6.   DOI
27 James WP, Nelson M, Ralph A, Leather S. Socioeconomic determinants of health. The contribution of nutrition to inequalities in health. BMJ 1997;314:1545-9.   DOI
28 Vereecken CA, Inchley J, Subramanian SV, Hublet A, Maes L. The relative influence of individual and contextual socio-economic status on consumption of fruit and soft drinks among adolescents in Europe. Eur J Public Health 2005;15:224-32.   DOI
29 Demment MM, Haas JD, Olson CM. Changes in family income status and the development of overweight and obesity from 2 to 15 years: a longitudinal study. BMC Public Health 2014;14:417.   DOI
30 Poulton R, Caspi A, Milne BJ, Thomson WM, Taylor A, Sears MR, Moffitt TE. Association between children's experience of socioeconomic disadvantage and adult health: a life-course study. Lancet 2002;360:1640-5.   DOI
31 Delisle HF. Poverty: the double burden of malnutrition in mothers and the intergenerational impact. Ann N Y Acad Sci 2008;1136:172-84.   DOI
32 Sawaya AL, Martins P, Hoffman D, Roberts SB. The link between childhood undernutrition and risk of chronic diseases in adulthood: a case study of Brazil. Nutr Rev 2003;61:168-75.   DOI
33 Administrative Committee on Coordination/Subcommittee on Nutrition (CH). Ending Malnutrition by 2020: an Agenda for Change in the Millennium. Final Report to the ACC/SCN by the Commission on the Nutrition Challenges of the 21st Century. Geneva: Administrative Committee on Coordination/Subcommittee on Nutrition; 2000.
34 Popkin BM, Richards MK, Montiero CA. Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. J Nutr 1996;126:3009-16.   DOI
35 World Health Organization (CH), Commission on Social Determinants of Health. Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Commission on Social Determinants of Health Final Report. Geneva: World Health Organization; 2008.