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Complementary Feeding Pattern Reduces the Impact of Diarrhea on Relative Weight: A Longitudinal Analysis of the Interaction of Diet and Diarrhea on Weight‐for‐length in Cebu Infants
Author(s) -
Wright Melecia,
Adair Linda
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.404.2
Subject(s) - diarrhea , medicine , breastfeeding , longitudinal study , acute diarrhea , malnutrition , pediatrics , pathology
Undernutrition and diarrheal disease are major contributors to infant morbidity and mortality worldwide. We investigated the combined roles of infant feeding and diarrhea on relative weight (weight‐for‐length z scores or WFL) in 2814 infants from the Cebu Longitudinal Health and Nutrition Survey. Indicator coding was used to create eight primary predictors based on combinations of current breastfeeding status (breastfed/BF vs non‐breastfed/NBF), high or low diversity score (DDS) in the complementary feeding diet (consumption of 4+ or <4 of 7 possible food groups) and presence of diarrheal disease (sick vs healthy with respect to diarrheal disease). WFL was predicted using sex‐stratified, fixed‐effects longitudinal models that also adjusted for age and energy from complementary foods.Table 1 Results of longitudinal regression of WFL on dietary and diarrhea patterns during infancy Boys' Beta 95% CI p Girls' Beta 95% CI p Diet x diarrhea pattern Healthy + NBF + Low DDS ‐0.141* (‐0.221, ‐0.062) 0.001 ‐0.114* (‐0.208, ‐0.020) 0.018 Healthy + BF + Low DDS 0.009 (‐0.062,0.080) 0.801 0.048 (‐0.035,0.132) 0.257 Healthy + NBF + High DDS ‐0.127* (‐0.216, ‐0.037) 0.006 ‐0.093 + (‐0.195,0.009) 0.073 Healthy + BF + High DDS Referent n/a n/a Referent n/a n/a Sick + NBF + Low DDS ‐0.319* (‐0.404, ‐0.235) <0.001 ‐0.224* (‐0.324, ‐0.125) <0.001 Sick + BF + Low DDS ‐0.148* (‐0.228, ‐0.069) <0.001 ‐0.064 (‐0.155,0.026) 0.164 Sick + NBF + High DDS ‐0.224* (‐0.332, ‐0.116) <0.001 ‐0.152* (‐0.276, ‐0.029) 0.016 Sick + BF + High DDS ‐0.101 (‐0.241,0.038) 0.154 ‐0.091 (‐0.237,0.056) 0.224 Age ‐2.232* (‐2.402, ‐2.062) <0.001 ‐2.090* (‐2.263, ‐1.917) <0.001 Age‐squared 0.770* (0.700,0.840) <0.001 0.708* (0.638,0.778) <0.001 Energy intake ‐0.286* (‐0.428, ‐0.143) <0.001 ‐0.427* (‐0.573, ‐0.281) <0.001 Age x energy intake 0.375* (0.275,0.475) <0.001 0.481* (0.378,0.584) <0.001 Intercept 0.719* (0.593,0.845) <0.001 0.627* (0.495,0.759) <0.001Within strata of diarrhea status or diet diversity, non‐breastfed babies were thinner than their breastfed counterparts. Interestingly, regardless of breastfeeding status, diarrhea was consistently related to lower WFL in babies with low diet diversity but diarrhea did not significantly reduce the WFL of babies with high diet diversity. Furthermore, amongst non‐breastfed boys with diarrheal disease, infants with high diet diversity had significantly higher relative weight than those with low diet diversity.These findings suggest that high diversity in the complementary diet may mitigate the detrimental impact of diarrhea on infant nutritional status.