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Assessment of child feeding practices using a summary index: stability over time and association with child growth in urban Madagascar^1,2,3,4

¹ From Research Unit 106 "Nutrition, Food, Societies" (World Health Organization Collaborating Centre for Nutrition), Institut de Recherche pour le Développement (IRD), Montpellier, France (MMM, Y-MP, SE-D, GC, BM, and FD); Doctoral School 393 "Public Health: Epidemiology and Biomedical Information Science, " Université Pierre et Marie Curie, Paris, France (MMM); and Research Unit 106 "Nutrition, Food, Societies" (World Health Organization Collaborating Centre for Nutrition), Institut de Recherche pour le Développement (IRD), IRD Representation at Madagascar, Antananarivo, Madagascar (ST)

Background: Previous studies investigating the association between an infant and child feeding index (ICFI) and length-for-age were based on a cross-sectional design and on the assumption that data collected with brief recalls could provide information about more enduring processes.

Objectives: The objectives were to test the stability of the individual ICFI values over time and to investigate how they relate to length-for-age z score (LAZ) and weight-for-length z score (WLZ) at the end of the study.

Design: This prospective cohort study included 363 children aged 6–17 mo who were visited 3 times over 6 mo. A cross-sectional ICFI (CS-ICFI) was constructed for each visit by using data on feeding practices and data from quantitative 24-h recalls. A longitudinal ICFI (L-ICFI) was constructed with use of the 3 CS-ICFIs. The stability of the CS-ICFI was assessed by using the variance of the repeatability coefficient (s²r).

Results: Stability of the CS-ICFI was shown by the value of 0.704 (95% CI: 0.625, 0.805) of the s²r, which differed significantly from 1 (P < 0.0001). There was no significant association between the CS-ICFIs and LAZ or WLZ at visit 3. In contrast, when moving from low to high L-ICFI, there was a highly significant 0.5 z score difference in mean LAZ at visit 3 (P = 0.0008). The L-ICFI was not associated with WLZ.

Conclusions: The ICFI constructed by using data collected with brief recalls can provide information about feeding in the long term. However, the absence of association with LAZ suggests a lack of precision that can be reduced by using an ICFI based on repeated measurements.

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				M. M. Moursi, M. Arimond, K. G. Dewey, S. Treche, M. T. Ruel, and F. Delpeuch Dietary Diversity Is a Good Predictor of the Micronutrient Density of the Diet of 6- to 23-Month-Old Children in Madagascar J. Nutr., December 1, 2008; 138(12): 2448 - 2453. [Abstract] [Full Text] [PDF]