Baseline Nutritional Status of Mother-Child Dyads in Urban Slums: Pre-Intervention Analysis for a Nutrition Informatics Intervention

Shyamli Thakur; Samir  Bhargava; Mansi Gauniyal

doi:10.55489/njcm.160120254787

Authors

Shyamli Thakur School of Pharmaceutical & Population Health Informatics, DIT University, Dehradun, India
Samir Bhargava School of Pharmaceutical & Population Health Informatics, DIT University, Dehradun, India https://orcid.org/0000-0002-9694-4617
Mansi Gauniyal Foundation of Healthcare Technologies Society, Delhi, India https://orcid.org/0009-0006-7404-3865

DOI:

https://doi.org/10.55489/njcm.160120254787

Keywords:

Double burden of malnutrition, Feeding and Dietary practices, Nutritional Assessment and Intervention Kiosk, Nutrition Informatics, Population Health Informatics

Abstract

Background: Urban slums are critical for public health intervention due to high population density, poor living conditions, and limited healthcare access. This study examines baseline nutritional and lifestyle patterns among mother-child dyads in the urban slums of Uttar Pradesh. The dyads were recruited for Nutritional Assessment and Intervention Kiosk (NAIK), a Population Health Informatics platform to address double burden of malnutrition.

Methodology: This cross-sectional, pre-intervention study involved 406 mother-child dyads with children aged 2-5 years. Data on socio-demographic variables, anthropometric measurements, nutrient intake and lifestyle patterns were collected. Descriptive statistics summarized baseline characteristics.

Results: The demographic profile showed predominantly low-income mothers with 43.34% without primary education. The mean ages of mothers and children were 33.98 ± 5.9 years and 46.91 ± 10.89 months, respectively. The waist-to-hip ratio was 0.92 ± 0.76 indicating cardiovascular risk factors with significant maternal obesity (47.78%). Education of the mother was found to be significantly associated with Mid Upper Arm Circumference (MUAC) of the child. The findings highlight the overnutrition in mothers and nutrient inadequacy in children, influenced by inadequate dietary intake and unhealthy lifestyle.

Conclusions: This paper will comprehensively overview baseline population status, setting the stage for further analysis and evaluation of the intervention.

References

The Challenge of Slums - Global Report on Human Settlements 2003 | UN-Habitat [Internet]. unhabitat.org. 2003. Available from: https://unhabitat.org/the-challenge-of-slums-global-report-on-human-settlements-2003

Agarwal S, Sangar K. Need for dedicated focus on urban health within National Rural Health Mission. Indian Journal of Public Health [Internet]. 2005;49(3):141-51. Available from: https://pubmed.ncbi.nlm.nih.gov/16468278/

Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. The Lancet. 2008 Jan;371(9608):243-60. DOI: https://doi.org/10.1016/S0140-6736(07)61690-0 PMid:18207566

World Health Organization. Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks [Internet]. www.who.int. 2009. Available from: https://www.who.int/publications/i/item/9789241563871

Haycraft E, Chandrasenage D, Wambui D, Goudet S, Rousham E, Stanley M, Murira Z, Griffiths P. What is missing in our understanding of urban slum environments and maternal, infant and young child nutrition from publicly available data in Asia and the Pacific? Matern Child Nutr. 2023 Aug 8:e13551. DOI: https://doi.org/10.1111/mcn.13551. Epub ahead of print. PMID: 37551637. PMid:37551637

Ghosh S, Shah D. Nutritional problems in urban slum children. [Internet]. Indian Pediatrics. 2017 [cited 2024 Oct 18]. Available from: https://www.semanticscholar.org/paper/Nutritional-problems-in-urban-slum-children.-Ghosh-Shah/f46d452214e674c010a40c43e2d7e79f85a000b1

Gupta MC, Mehrotra M, Arora S, Saran M. Relation of childhood malnutrition to parental education and mothers' nutrition related KAP. The Indian Journal of Pediatrics. 1991 Mar;58(2):269-74. DOI: https://doi.org/10.1007/BF02751136 PMid:1879910

Popkin BM, Corvalan C, Grummer-Strawn LM. Dynamics of the double burden of malnutrition and the changing nutrition reality. The Lancet. 2020 Jan;395(10217):65-74. DOI: https://doi.org/10.1016/S0140-6736(19)32497-3 PMid:31852602

Popkin BM. The Nutrition Transition and Obesity in the Developing World. The Journal of Nutrition. 2001 Mar;131(3):871S873S. DOI: https://doi.org/10.1093/jn/131.3.871S PMid:11238777

Steyn NP, Mchiza ZJ. Obesity and the nutrition transition in Sub-Saharan Africa. Annals of the New York Academy of Sciences. 2014 Apr;1311(1):88-101. DOI: https://doi.org/10.1111/nyas.12433 PMid:24725148

Misra A, Singhal N, Khurana L. Obesity, the Metabolic Syndrome, and Type 2 Diabetes in Developing Countries: Role of Dietary Fats and Oils [Internet]. Journal of the American College of Nutrition. 2016 [cited 2024 Oct 18]. Available from: https://www.semanticscholar.org/paper/Obesity%2C-the-Metabolic-Syndrome%2C-and-Type-2-in-Role-Misra-Singhal/28d2fb24cf04c99f2fbffb86d72eed1491523692

Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and National Prevalence of Overweight and Obesity in Children and Adults during 1980-2013: a Systematic Analysis for the Global Burden of Disease Study 2013. Lancet (London, England). 2014;384(9945):766-81. DOI: https://doi.org/10.1016/S0140-6736(14)60460-8

Kapil, Umesh and Vani Sethi. "Prevalence of undernutrition amongst children (6-9 years) in Delhi." Indian pediatrics 41 6 (2004): 628-9

Victora CG, Habicht JP, Bryce J. Evidence-Based Public Health: Moving Beyond Randomized Trials. American Journal of Public Health [Internet]. 2004 Mar [cited 2019 Dec 12];94(3):400-5. DOI: https://doi.org/10.2105/AJPH.94.3.400 PMid:14998803 PMCid:PMC1448265

World Medical Association. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA [Internet]. 2013 Nov 27;310(20):2191-4. DOI: https://doi.org/10.1001/jama.2013.281053 PMid:24141714

Thakur S, Gauniyal M, Bhargava S, Joshi A, Chitme H, Singhal M. Designing and evaluating a Nutritional Assessment and Intervention Kiosk for mother-child dyad to combat double burden of malnutrition. International Journal of Food Sciences and Nutrition [Internet]. 2024 Jan 11 [cited 2024 Oct 18];75(2):227-38. DOI: https://doi.org/10.1080/09637486.2024.2303024 PMid:38213010

STEPwise Approach to NCD Risk Factor Surveillance (STEPS) [Internet]. www.who.int. Available from: https://www.who.int/teams/noncommunicable-diseases/surveillance/systems-tools/steps

Misra A. Ethnic-Specific Criteria for Classification of Body Mass Index: A Perspective for Asian Indians and American Diabetes Association Position Statement. Diabetes Technology & Therapeutics [Internet]. 2015 Sep 1 [cited 2020 Mar 27];17(9):667-71. DOI: https://doi.org/10.1089/dia.2015.0007 PMid:25902357 PMCid:PMC4555479

James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: Report 70 from the panel members appointed to the Eight Joint National Committee (JNC 8) JAMA. 2014; 311:507-20. DOI: https://doi.org/10.1001/jama.2013.284427 PMid:24352797

Global Strategy for Infant and Young Child Feeding. Geneva: World Health Organization; 2003.

Brown KH, Stallings RY, de Kanashiro HC, Lopez de Romana G, Black RE. Effects of common illnesses on infants' energy intakes from breastmilk and other foods during longitudinal community-based studies in Huascar (Lima), Peru. Am J Clin Nutr. 1990;52(6):1005-13. DOI: https://doi.org/10.1093/ajcn/52.6.1005 PMid:2239775

Complementary feeding of young children in developing countries: a review of current scientific knowledge. Geneva: World Health Organization; 1998.

Guiding principles for complementary feeding of the breastfed child. Washington: Pan American Health Organization-World Health Organization; 2003. Available from: https://www.who.int/publications/i/item/9275124604

Papanikolaou Y; Fulgoni VL. Egg Consumption in Infants is Associated with Longer Recumbent Length and Greater Intake of Several Nutrients Essential in Growth and Development. Nutrients. 2018;10(6):e719. DOI: https://doi.org/10.3390/nu10060719 PMid:29867006 PMCid:PMC6024369

Krebs N et al. High protein intake from meat as complementary food increases growth but not adiposity in breastfed infants: a randomized trial. Am J Clin Nutr. 2014;100(5):1322-28. DOI: https://doi.org/10.3945/ajcn.114.088807 PMid:25332329 PMCid:PMC4196483

Krebs, N.F., Westcott, J.E., Butler, N., Robinson, C., Bell, M. and Hambidge, K.M. Meat as a First Complementary Food for Breastfed Infants: Feasibility and Impact on Zinc Intake and Status. J Pediatr Gastr Nutr. 2006;42(2):207-14. DOI: https://doi.org/10.1097/01.mpg.0000189346.25172.fd

White JM, Begin F, Kumapley R, Murray C, Krasevec J. Complementary feeding practices: Current global and regional estimates. Matern Child Nutr. 2017;13(2):e12505. DOI: https://doi.org/10.1111/mcn.12505 PMid:29032623 PMCid:PMC6865887

Ventura AK, Mennella JA. Innate and learned preferences for sweet taste during childhood. Curr Opin Clin Nutr Metab Care. 2011;14(4):379-84. DOI: https://doi.org/10.1097/MCO.0b013e328346df65 PMid:21508837

Nicklaus S, Boggio V, Chabanet C, Issanchou S. A prospective study of food preferences in childhood. Food Qual Pref. 2004;15(7):805-18. DOI: https://doi.org/10.1016/j.foodqual.2004.02.010

Indicators for assessing infant and young child feeding practices: definitions and measurement methods. Geneva: World Health Organization and the United Nations Children's Fund (UNICEF), 2021. Available from: https://www.who.int/publications/i/item/9789240018389

GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;393(10184):1958-72. DOI: https://doi.org/10.1016/S0140-6736(19)30041-8 PMid:30954305

Grimm KA, Kim SA, Yaroch AL, Scanlon KS. Fruit and Vegetable Intake During Infancy and Early Childhood. PEDIATRICS [Internet]. 2014 Sep 1 [cited 2019 Sep 5];134(Supplement):S63-9. DOI: https://doi.org/10.1542/peds.2014-0646K PMid:25183758 PMCid:PMC4258845

Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R, Uauy R; Maternal and Child Nutrition Study Group. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013 Aug 3;382(9890):427-451. DOI: https://doi.org/10.1016/S0140-6736(13)60937-X. Epub 2013 Jun 6. Erratum in: Lancet. 2013. 2013 Aug 3;382(9890):396. PMID: 23746772.

Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, Webb P, Lartey A, Black RE; Lancet Nutrition Interventions Review Group, the Maternal and Child Nutrition Study Group. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet. 2013 Aug 3;382(9890):452-477. DOI: https://doi.org/10.1016/S0140-6736(13)60996-4. Epub 2013 Jun 6. Erratum in: Lancet. 2013 Aug 3;382(9890):396. PMID: 23746776.

Gibbs BG, Forste R. Breastfeeding, Parenting, and Early Cognitive Development. The Journal of Pediatrics. 2014 Mar;164(3):487-93. DOI: https://doi.org/10.1016/j.jpeds.2013.10.015 PMid:24268637