TY - JOUR
T1 - A Systematic Review Investigating the Relation between Animal-Source Food Consumption and Stunting in Children Aged 6-60 Months in Low and Middle-Income Countries
AU - Shapiro, Myra J.
AU - Downs, Shauna M.
AU - Swartz, Haley J.
AU - Parker, Megan
AU - Quelhas, Diana
AU - Kreis, Katharine
AU - Kraemer, Klaus
AU - West, Keith P.
AU - Fanzo, Jessica
N1 - Funding Information:
This work was supported by PATH and the Sight and Life Foundation. Author disclosures: MJS, SMD, HJS, MP, DQ, KK, KK, KPW Jr., and JF, no conflicts of interest. Supplemental Material 1 and Supplemental Tables 1–4 are available from the “Supplementary data”link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/advances/. Address correspondence to MJS (e-mail: myrajoyshapiro@gmail.com). Abbreviations used: ASF, animal-source food; BMIz, body mass index z-score; DRC, Democratic Republic of the Congo; EoF, end of follow-up; HAZ, height for age z-score; HCz, head circumference z-score; IDA, iron deficiency anemia; IYCF, Infant and Young Child Feeding Indicators; LAZ, length for age z-score; LMIC, low-and middle-income country; MDD, minimum diet diversity; MUACz, midupper arm circumference z-score; PSF, plant-source food; RoB, risk of bias; RCT, randomized controlled trial; WAZ, weight for age z-score; WHZ, weight for height z-score; WLZ, weight for length z-score.
Publisher Copyright:
Copyright © American Society for Nutrition 2019.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Animal-source foods (ASFs) are a food group of interest for interventions aimed at reducing stunting and other inadequate growth measures in early childhood. The aim of this systematic review was to examine the relation between ASF consumption and stunting in children aged 6-60 mo in low- and middle-income countries (LMICs). The secondary aim was to examine the relation between ASF consumption and other indicators of growth and development (length/height, weight, head circumference, and anemia). A search of the peer-reviewed and grey literature published from January 1980 to June 2017 was conducted. Databases searched included CINAHL, Embase, Global Index Medicus, PubMed, and Web of Science. There were 14,783 records and 116 full text articles dual screened; 21 studies were included in the review and were dual evaluated for risk of bias (RoB). The relation between ASF and stunting (length- or height-for-age z-score 2) was examined in randomized-controlled trials [(RCTs), n = 3] and cross-sectional studies (n = 4) only; ASF reduced stunting in 1 RCT and was associated with reduced stunting in 1 cross-sectional study. We did not identify any longitudinal cohorts that examined this relation. The relation between ASF and secondary indicators length/height, weight, head circumference, and anemia were largely nonsignificant across study designs. The intervention/exposure, comparator, outcome measures, methods, and analyses were highly heterogeneous. Although we did not find a consistent relation between ASF consumption and our primary and secondary outcomes, this may have been a function of inconsistencies in study design. Foods in the whole diet, particularly combination dishes, are inherently difficult to assess. To quantitatively assess the relation between ASF and stunting and other indicators of growth and iron status in early childhood, future research should provide consistency in the definition and quantification of the exposure and outcomes allowing for interstudy quantitative comparisons.
AB - Animal-source foods (ASFs) are a food group of interest for interventions aimed at reducing stunting and other inadequate growth measures in early childhood. The aim of this systematic review was to examine the relation between ASF consumption and stunting in children aged 6-60 mo in low- and middle-income countries (LMICs). The secondary aim was to examine the relation between ASF consumption and other indicators of growth and development (length/height, weight, head circumference, and anemia). A search of the peer-reviewed and grey literature published from January 1980 to June 2017 was conducted. Databases searched included CINAHL, Embase, Global Index Medicus, PubMed, and Web of Science. There were 14,783 records and 116 full text articles dual screened; 21 studies were included in the review and were dual evaluated for risk of bias (RoB). The relation between ASF and stunting (length- or height-for-age z-score 2) was examined in randomized-controlled trials [(RCTs), n = 3] and cross-sectional studies (n = 4) only; ASF reduced stunting in 1 RCT and was associated with reduced stunting in 1 cross-sectional study. We did not identify any longitudinal cohorts that examined this relation. The relation between ASF and secondary indicators length/height, weight, head circumference, and anemia were largely nonsignificant across study designs. The intervention/exposure, comparator, outcome measures, methods, and analyses were highly heterogeneous. Although we did not find a consistent relation between ASF consumption and our primary and secondary outcomes, this may have been a function of inconsistencies in study design. Foods in the whole diet, particularly combination dishes, are inherently difficult to assess. To quantitatively assess the relation between ASF and stunting and other indicators of growth and iron status in early childhood, future research should provide consistency in the definition and quantification of the exposure and outcomes allowing for interstudy quantitative comparisons.
KW - animal-source food
KW - children
KW - growth
KW - height
KW - stunting
KW - weight
UR - http://www.scopus.com/inward/record.url?scp=85072233902&partnerID=8YFLogxK
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U2 - 10.1093/advances/nmz018
DO - 10.1093/advances/nmz018
M3 - Review article
C2 - 31177279
AN - SCOPUS:85072233902
SN - 2161-8313
VL - 10
SP - 827
EP - 847
JO - Advances in Nutrition
JF - Advances in Nutrition
IS - 5
ER -