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Drivers of food consumption among overweight mother-child dyads in Malawi.

ABSTRACT: To address the increase in overweight and obesity among mothers and children in sub-Saharan Africa, an understanding of the factors that drive their food consumption is needed. We hypothesized food consumption in Malawi is driven by a combination of factors, including season, food accessibility (area of residence, convenience of purchasing food, female autonomy), food affordability (household resources, food expenditures, household food insecurity), food desirability (taste preferences, body size preferences), demographics, and morbidity. Participants in Lilongwe and Kasungu Districts were enrolled across three types of mother-child dyads: either the mother (n = 120), child (n = 80), or both (n = 74) were overweight. Seven-day dietary intake was assessed using a quantitative food frequency questionnaire during the dry and rainy seasons. Drivers associated with intake of calories, macronutrients, and 11 food groups at p<0.1 in univariate models were entered into separate multivariate linear regression models for each dietary intake outcome. Mother-child dyads with an overweight child had a higher percent of calories from carbohydrates and lower percent of calories from fat compared to dyads with a normal weight child (both p<0.01). These mothers also had the highest intake of grains (p<0.01) and their children had the lowest intake of oil/fat (p = 0.01). Household food insecurity, maternal taste preferences, and maternal body size preferences were the most consistent predictors of food group consumption. Household food insecurity was associated with lower intake of grains, fruits, meat and eggs, oil/fat, and snacks. Maternal taste preferences predicted increased consumption of grains, legumes/nuts, vegetables, fish, and oil/fat. Maternal body size preferences for herself and her child were associated with consumption of grains, legumes/nuts, dairy, and sweets. Predictors of food consumption varied by season, across food groups, and for mothers and children. In conclusion, indicators of food affordability and desirability were the most common predictors of food consumption among overweight mother-child dyads in Malawi.

SUBMITTER: Thakwalakwa C

PROVIDER: S-EPMC7745992 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Drivers of food consumption among overweight mother-child dyads in Malawi.

Thakwalakwa Chrissie C Flax Valerie L VL Phuka John C JC Garcia Harrison H Jaacks Lindsay M LM

PloS one 20201217 12

To address the increase in overweight and obesity among mothers and children in sub-Saharan Africa, an understanding of the factors that drive their food consumption is needed. We hypothesized food consumption in Malawi is driven by a combination of factors, including season, food accessibility (area of residence, convenience of purchasing food, female autonomy), food affordability (household resources, food expenditures, household food insecurity), food desirability (taste preferences, body siz ...[more]

PMID: 33332387

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Project description:BackgroundIn utero or early-life exposure to aflatoxin, which contaminates staple crops in disadvantaged settings, may compromise pregnancy and infant outcomes, but investigations into the extent, persistence, and determinants of aflatoxin exposure at these life stages have lacked longitudinal data collection and broad geographic representation.ObjectivesAflatoxin exposure and selected determinants thereof were characterized in mother-child dyads with serial plasma/serum samples in prenatal, perinatal, and early life in Malawi and Bangladesh.MethodsCirculating aflatoxin B1 (AFB1)-lysine albumin adducts were measured in dyads from Bangladesh (n = 573; maternal first and third trimester, 3 mo postpartum, cord blood, infant 24 mo) and Malawi (n = 255; maternal second and third trimester, 6 mo postpartum, infant 6 and 18 mo) with isotope dilution mass spectrometry. We examined AFB1-lysine adduct magnitude, persistence, seasonality, and associations with infant feeding, and estimated daily AFB1 intake.ResultsMaternal AFB1-lysine was higher in Malawi (98% detectable; median: 0.469, IQR: 0.225-1.027 pg/µL) than in Bangladesh (59%; 0.030, nondetectable [nd]-0.077 pg/µL). Although estimated dietary exposure in Malawi was temporally stable (648 ng AFB1/day), estimated intake in Bangladesh was reduced by 94% between rainy and winter seasons (98 to 6 ng/day). AFB1-lysine was low in cord blood from Bangladesh (15% detectable; 0.045, 0.031-0.088 pg/µL among detectable) and in Malawian infants at 6 mo of age (0.072, nd-0.236 pg/µL), but reached maternal concentrations by 18 or 24 mo (Bangladesh: 0.034, nd-0.063 pg/µL; Malawi: 0.370, 0.195-0.964 pg/µL). In Malawian infants, exclusive breastfeeding at 3 mo was associated with 58% lower AFB1-lysine concentrations at 6 mo compared with other feeding modes (P = 0.010).ConclusionsAmong pregnant women, aflatoxin exposure was persistently high in Malawi, while lower and seasonal in Bangladesh. Infants were partially protected from exposure in utero and with exclusive breastfeeding, but exposures reached adult levels by 18-24 mo of age. The Bangladesh and Malawi trials are registered at clinicaltrials.gov as NCT00860470 and NCT01239693.

Project description:BACKGROUND:Responsive caregiving, or interactions in which caregivers give appropriate responses to a child's signals, is linked to improved psychosocial, cognitive and physical outcomes in children. However, much remains unknown about how responsive caregiving affects child development across cultural and socioeconomic contexts. The purpose of this study is to examine predictors of maternal responsive caregiving and investigate how these interactions are associated with children's development. METHODS:Data for the current analyses came from a longitudinal study designed to follow mothers from the third trimester through the first three years of the child's life. To assess responsive caregiving, the Observation of Mother-Child Interaction (OMCI) measure was used to examine maternal and child behaviors during a 5-min picture book activity at 24?months. Outcomes included child height-for-age z-score and child socioemotional development, using the Ages and Stages Questionnaire-Socioemotional (ASQ-SE) in which lower scores demonstrated better development. Using mean comparisons, the effects of baseline sociodemographic factors and maternal depression on responsive caregiving were tested. Analyses utilized hierarchical linear regressions to examine cross-sectional associations between responsive caregiving and child development outcomes at 24?months. Additional analyses controlled for the Home Observation for Measurement of the Environment (HOME), a common measure in low-income contexts of caregiving, to assess whether OMCI was uniquely predictive of child outcomes. RESULTS:Higher maternal education attainment, lower number of children, greater socioeconomic assets, and lack of maternal depression were associated with higher levels of observed responsive caregiving behaviors. Higher total OMCI scores were associated with positive child socioemotional outcomes in adjusted models (?: -0.84, 95% CI [-?1.40, -?0.29]). The finding was statistically significant, even after controlling for HOME score (?: -0.83, 95% CI [-?1.38, -?0.27]). There was no association between OMCI scores and child linear growth. CONCLUSIONS:Responsive caregiving is linked to positive child socioemotional development in rural Pakistan. Our findings suggest that incorporating responsive caregiving into child health interventions in LMIC may have valuable impacts on child socioemotional development. The OMCI may be useful in identifying important pathways for change to responsive caregiving behaviors and may be of service for future interventions that optimize child development through responsive caregiving. TRIAL REGISTRATION:NCT02111915 (09/18/2015); NCT02658994 (01/22/2016). Trials were prospectively registered.

Project description:BackgroundThe associations among maternal depressive symptoms (MDS), mother-child interactions and early child development are poorly understood. This study aimed to explore the role of mother-child interactions on the associations between MDS and child development.MethodsA cross-sectional study with a multistage sampling method was conducted in rural areas of Central and Western China. MDS, child development outcomes (communication, gross motor function, fine motor function, problem solving and personal social skills) and mother-child interactions were assessed by The Edinburgh Postpartum Depression Scale, the Chinese version of the Ages and Stages Questionnaires and the Multiple Indicator Cluster Surveys, respectively. Regression-based statistical mediation and moderation were conducted using the PROCESS macro for SPSS.ResultsA total of 2,548 participants (mothers: 1,274; children: 1,274) were included in our analyses. MDS was negatively associated with child development outcomes and mother-child interactions partly mediated these associations. The proportion of the mediating effect of mother-child interactions was 7.7% for communication, 8.2% for gross motor, 10.3% for fine motor, 10.1% for problem-solving and 9.5% for personal social domains. In addition, the interaction effects of MDS and mother-child interactions on the communication domain were significant (β = 0.070, 95% CI 0.016, 0.124; p = 0.011). The associations between MDS and child communication abilities were weaker at the high level (simple slope = -0.019, t = - 0.458, p = 0.647) of mother-child interactions than at the mean level (simple slope = -0.089, t = - 3.190, p = 0.002) and the low level (simple slope = -0.158, t = - 4.231, p < 0.001). Similar moderating effects were not observed in the other child development outcomes.ConclusionOur results suggest the important role of mother-child interactions on the associations between MDS and early childhood development. Due to the cross-sectional design of this study, these associations require further investigation in prospective studies.

Project description:BackgroundA healthy lifestyle during pregnancy is important for the health of mother and child. However, unfavorable physical activity (PA) and dietary changes are observed in pregnant women and their partner. Partner's influence on lifestyle has been reported by expectant women and men. The first aim was to analyze associations between perceived partner support on expectant parents own as well as their partner's moderate-to-vigorous intensity PA (MVPA) levels and dietary intake. Secondly, this study aimed to investigate intra-couple associations of MVPA, dietary intake and perceived support.MethodsA total of 152 heterosexual couples were recruited between week 8 and 10 of gestation by means of convenience sampling. Objective anthropometric and 7-day MVPA measurements were performed at 12 weeks of gestation. An online questionnaire was used to assess dietary intake, perceived partner support and socio-demographic characteristics. An Actor-Partner Interdependence Model for distinguishable dyads was constructed to examine the relationship between perceived partner support and both own's (i.e., actor-effect) and the partner's (i.e., partner-effect) MVPA levels, intake of fruits and vegetables, and an "avoidance food group."ResultsFor pregnant women, perceived support from their partner was significantly associated with women's own MVPA levels (i.e., actor-effect; estimate = 0.344, SE = 0.168, p = 0.040) as well as the MVPA levels of the men (i.e., partner-effect; estimate = 0.717, SE = 0.255, p = 0.005). No significant actor- nor partner-effects were found for the expectant fathers. For none of the sexes significant actor-effects were found for fruit/vegetables and "avoidance food group" intake. For pregnant women, there was a positive partner-effect for fruit and vegetable intake (estimate = 7.822, SE = 1.842, p < 0.001) and a negative partner-effect for the "avoidance food group" intake (estimate = -16.115, SE = 3.629, p < 0.001). Positive correlations were found for perceived MVPA support (r = 0.40, p < 0.001), MVPA levels (r = 0.24, p = 0.007) and food intake from the "avoidance food group" (r = 0.28, p = 0.005) between partners.ConclusionThis study shows that male partners can act as significant facilitators for women. Partners may be an important target when promoting MVPA during pregnancy. Additionally, supportive couples seem to strengthen each other in keeping a healthy lifestyle in early pregnancy. These results justify couple-based interventions in the promotion of a healthy lifestyle during the transition to parenthood.Clinical trial registrationClinicaltrials.gov, identifier: NCT03454958.

Dataset Information

Drivers of food consumption among overweight mother-child dyads in Malawi.

Publications

Drivers of food consumption among overweight mother-child dyads in Malawi.

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