| Summary: | MSc (Med), Epidemiology and Biostatistics, Faculty of Health Sciences, University of the Witwatersrand, 2009 === Introduction Malnutrition remains the major cause of child mortality and an essential component in child development and future productivity of the child in the world. With the increasing prevalence of undernutrition, micronutrient deficiencies, and over nutrition in South Africa, it calls for interventions which will help reduce malnutrition since child‟s growth is partly dependant on their diet. This study aimed at determining the association between post-weaning dietary patterns at age one and growth at age two among children from the Birth-To-Twenty cohort in Johannesburg, South Africa.
Specific objectives: To describe dietary intake patterns (Diet Diversity Score and Food Variety Score) growth at age one and two among boys and girls in BT20, the prevalence of malnutrition (Stunting, wasting and underweight) among boys and girls in BT20, and to determine the association between dietary patterns at age one and growth at age two. Hypothesis There is no association between post-weaning dietary patterns at age one and growth at age two in the Birth-To-Twenty Cohort study. Study design: Prospective longitudinal study. Setting; Birth-To-Twenty Cohort study Johannesburg, South Africa. Inclusion criteria –Must have complete data on dietary questionnaires and growth data at age two. Data Collection data was collected on following variables; dietary patterns, socio-economic status, growth (height and weight), complimentary feeding, birthweight and gestational age. Anthropometric data (height and weight) was collected at age one and two. Food frequencies questionnaires were used for data collection. Data Analysis STATA 10 was used for data cleaning and analysis. Descriptive and inferential analysis was carried out. Multiple regression analysis was used to assess the association between outcome variable (growth at age 2) and dietary patterns at age 1(12months) and growth at age 2 (24months), and dietary patterns at age 1 controlling for confounders. P-values were calculated to test for
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statistical significance at 5% significance level. Results: Ninety six percent of the infants were introduced to solid foods when they were less than 6 months. The Food Variety Score (FVS) was 32.4 and 32.6 for boys and girls respectively; Diet Diversity Score (DDS) was 9.7 and 9.8 for boys and girls respectively. A proportion of 20.5% (n=164) infants were underweight at birth, the prevalence of stunting among the boys rose from 8% at year one to 19% at year two, wasting demonstrated a slight increase from 5% to 8%, underweight too showed a sharp increase from 11% to 25%. Among the girls stunting prevalence increased from 6% at year one to 20% at year 2, wasting slightly rose from 3% to 4% and underweight from 6% to 11%. There was 7.7% (n=35) catch up growth and 20.7% (n=94) catch down with regard to stunting. A proportion of 3.3% (n=15) infants had catch up for weight-for-height and 5.5% (n=25) had a catch down growth. 3.7% (n=17) had catch up growth with regard to weight-for- age and 11.2% (n=51) had catch down growth. Birthweight, underweight and stunting at age one, gender and ethnicity were associated with growth at age two. There was no association between dietary patterns at age one and growth at age two. Conclusion: Diet diversity is good within Soweto and consequently food diversity is not associated with infant growth, however other factors such as macronutrient intake and morbidity maybe important in the Soweto context. Inappropriate feeding practices such as feeding the infant with high sugar diet, high fat and refined foods should be addressed so as to curb the increasing catch down growth at age two. Introduction of solid foods at less than 6 months of age should also be addressed; this can be done by emphasising that exclusive breastfeeding in community health programs for the first 6 months.
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