Search

Background: Stunting is highly prevalent in developing countries and is associated with greater morbidity and mortality. Micronutrient deficiencies contribute to stunting, and micronutrient-fortified foods are a potential strategy to reduce child stunting.Objective: To examine the relationship between the use of fortified powdered milk and noodles and child stunting in a large, population-based sample of Indonesian children.Methods: Consumption of fortified milk and fortified noodles was assessed in children 6 to 59 months of age from 222,250 families living in rural areas and 79,940 families living in urban slum areas in Indonesia.Results: The proportions of children who consumed fortified milk and fortified noodles were 34.0% and 22.0%, respectively, in rural families, and 42.4% and 48.5%, respectively, in urban families. The prevalence of stunting among children from rural and urban families was 51.8% and 48.8%, respectively. Children from rural and urban families were less likely to be stunted if they consumed fortified milk (in rural areas, OR = 0.87; 95% CI, 0.85 to 0.90; p < .0001; in urban areas, OR = 0.80; 95% CI, 0.76 to 0.85; p < .0001) or fortified noodles (in rural areas, OR = 0.95; 95% CI, 0.91 to 0.99;p = .02; in urban areas, OR = 0.95; 95% CI, 0.91 to 1.01; p = .08) in multiple logistic regression models adjusted for potential confounders. In both rural and urban families, the odds of stunting were lower when a child who consumed fortified milk also consumed fortified noodles, or when a child who consumed fortified noodles also consumed fortified milk.Conclusions: The consumption of fortified milk and noodles is associated with decreased odds of stunting among Indonesian children. These findings add to a growing body of evidence regarding the potential benefits of multiple micronutrient fortification on child growth. [ABSTRACT FROM AUTHOR]

Background. Food insecurity is common in developing countries and is related to the physical well-being of families. Household food insecurity is intended to reflect a household's access, availability, and utilization of food, but its relationship with child mortality has not been well characterized. Objective. To examine the relationship of a modified household food insecurity score with a history of neonatal, infant, and under-five child mortality. Methods. In a cross-sectional study of 26,339 rural households in the Indonesian Nutrition Surveillance System, 2000-03, household food insecurity was measured with the use of a modified nine-item food security questionnaire. A simple food insecurity score of 0 to 9 was calculated based on responses and related to mortality history in the family. Results. The proportion of households with neonatal, infant, and under-five child mortality was 4.6%, 8.8%, and 10.6%, respectively. In households with and without neonatal, infant, and under-five child mortality, the mean (± SD) food insecurity scores were 2.19 ± 1.89 vs. 1.72 ± 1.65, 2.29 ± 1.94 vs. 1.69 ± 1.63, and 2.29 ± 1.93 vs. 1.68 ± 1.62 (all p < .0001), respectively. The food insecurity score was related to mortality among neonates (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02 to 1.09; p = .003), infants (OR, 1.06; 95% CI, 1.03 to 1.09; p < .0001), and children under five (OR, 1.07; 95% CI, 1.04 to 1.10; p < .0001) after adjustment for potential confounders. Conclusions. Higher household food insecurity score is associated with greater neonatal, infant, and under-five child mortality among rural families in Indonesia. Greater household food insecurity may signify a higher risk of infant and young child mortality. [ABSTRACT FROM AUTHOR]