OBJECTIVE: Few studies have examined whether infant dietary diversity is prospectively associated with malnutrition risk in young children. We sought to assess whether dietary diversity and animal-source food consumption were associated with malnutrition and body composition among children younger than 2 years at high risk of malnutrition. DESIGN: Longitudinal cohort of HIV-exposed uninfected (HEU) or HIV-unexposed children with repeated measures of weight, length, circumferences, and skinfold thicknesses from age 9 to 23 months from which WHO z-scores were calculated. Food frequency questionnaire assessed infants' dietary diversity, flesh foods and egg intake. Cox proportional hazards were used to examine whether minimum dietary diversity (MDD, dietary diversity scores ≥5) and consumption of animal-source foods were associated with malnutrition, defined as z-score <-2. SETTING: western Kenya. PARTICIPANTS: Infants (n=232; 48% female; 49% HEU; growth z-scores above -2 at 9 months). RESULTS: At 9 months, 42% of infants met MDD, and mean z-scores were above -1 SD. Meeting MDD at 9 months was associated with a lower risk of stunting from 9 to 23 months (HR 0.51; 95% CI:0.33,0.80) but not wasting or underweight. MDD at 9 months was associated with 86% (95%CI 0.11,0.51) lower risk of low subscapular skinfolds; similar trends were observed for flesh foods. CONCLUSIONS: In a cohort of Kenyan infants, MDD at 9 months was associated with reduced risk of stunting through the second year of life. Flesh food intake was associated with lower risk of low trunk adiposity. Improving dietary diversity during infancy may protect against early-life stunting.
Foster et al. (Fri,) studied this question.