Stunting is a long-term nutritional issue and a serious public health issue, especially for young children under two. In order to meet nutrient requirements and promote linear growth, dietary diversification is crucial. This study aimed to determine the relationship between dietary diversity, measured using the Dietary Diversity Score (DDS), and stunting among children aged 6–24 months in the working area of Bagu Primary Health Center, Central Lombok Regency. An analytic observational study with a cross-sectional design was conducted among 43 mothers of children aged 6–24 months using total sampling. Dietary diversity was assessed using a structured questionnaire based on nine food groups recommended by the FAO, while stunting status was determined from anthropometric records in the Maternal and Child Health handbook. Data were analyzed using the Chi-square test. Of the 43 children, 62.8% were stunted and 37.2% were severely stunted. Most children (58.1%) had low dietary diversity, while 41.9% had diverse diets. No significant association was found between dietary diversity and stunting severity (p = 0.655). However, diverse diets showed a lower tendency toward severe stunting (OR = 0.750; 95% CI: 0.212–2.656). The findings highlight the need to improve dietary diversity through locally available food sources.
Baiq Nur Lathifatuzzahrah, Lina Nurbaiti, Wiwin Lastyana et al.
Public health nutrition is shaped by the environments in which people obtain food, make dietary choices, experience nutritional vulnerability, and respond to changing health and social conditions.This third issue of Volume 17 of World Nutrition brings together 21 contributions spanning original research, reviews, commentaries, opinion, and policy perspectives, reflecting the breadth and interconnectedness of contemporary nutrition challenges.Collectively, these contributions emphasise the importance of context, equity, accountability, and evidence-informed action in improving nutrition and health outcomes.A prominent theme is the food environment and the accountability of institutions that influence dietary choices.Sezaki et al., in Access to Nutrition Initiative Global Index and Spotlight Index comparisons: Promoting nation-led frameworks for nutrition accountability, examine the evolution of corporate nutrition accountability frameworks and the growing role of country-specific approaches.Complementing this work, du Plessis et al., in Food and non-alcoholic beverage marketing and sponsorship at secondary schools in the City of Cape Town, South Africa, document extensive food and beverage marketing within schools.Riofrio Jacinto et al., in Food access, purchasing habits, and dietary diversity of peri-urban households in Hanoi, Vietnam, further demonstrate how purchasing behaviour, affordability, proximity, and food assortment can shape dietary diversity.Together, these studies illustrate why nutrition policy must consider not only individual choices but also the environments in which those choices are made.The issue gives considerable attention to nutrition across the life course.Ali et al., in From Breast to Bowl: A quasi-experimental, mixed-methods evaluation of peer learning to improve complementary feeding in rural northeastern Ghana, demonstrate the potential of peer learning to strengthen complementary feeding practices.Kamda et al., in Factors associated with diet adequacy among women attending antenatal care in the conflict-affected Kumba Municipalities, Cameroon, examine the nutritional vulnerabilities women experience in conflict-affected settings.Funduluka et al., in Unveiling dietary patterns among children aged 6-23 months: A framework analysis for perspectives in Chinyunyu Community, Rufunsa District, Zambia, identify poverty, household decision-making, workload, and food availability as important influences on infant and young child feeding.Pencil et al., in Anaemia among in-school adolescents from Harare, Zimbabwe: Prevalence and key drivers, highlight the burden of anaemia among adolescents and the relevance of household education, nutrition knowledge, and dietary practices.Onyeanwu, in Food insecurity among older adults in the United States: A systematic review through the gerontological public health framework, extends attention to older adults, highlighting the interconnected economic, social, environmental, and healthcare determinants of food insecurity and its consequences.
Background/Objectives: Bangladesh carries one of the world's highest estimated childhood lead burdens alongside a substantial undernutrition burden, yet no nationally representative study has examined the association of blood lead levels (BLLs) with anthropometric failure. Methods: We analysed data from the 2025 Bangladesh Multiple Indicator Cluster Survey, including 10,495 children aged 12–59 months with BLLs and anthropometric measurements. Venous blood lead, arsenic, cadmium, and mercury were measured alongside anthropometry. Associations of BLLs with height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ) z-scores were estimated using linear regression; associations with stunting, wasting, underweight, and the Composite Index of Anthropometric Failure (CIAF, comprising six disaggregated failure categories) were estimated using modified Poisson regression yielding adjusted prevalence ratios (APRs). Models considered continuous standardised log-transformed BLLs and elevated BLLs (≥5 µg/dL), with and without adjustment for arsenic, cadmium, mercury, and covariates. Results: The prevalence of stunting, wasting, underweight, and CIAF was 25.9%, 14.1%, 26.6%, and 38.2%, respectively. Elevated blood lead prevalence was 38.6 Higher BLLs were significantly associated with lower HAZ (β=-0.075), WAZ (β=-0.062), and WHZ (β=-0.029), and with higher prevalence of stunting (APR=1.09), wasting (APR=1.08), underweight (APR=1.08), and CIAF (APR=1.07), largely unchanged after adjustment for co-exposure. The association of WHZ was not significant with elevated BLLs. BLLs were associated with several CIAF patterns, most strongly the combined stunting-wasting-underweight category (APR =1.18), with significant associations present across every category involving stunting. In exploratory analyses, elevated BLLs were also significantly associated with household soil lead concentration (APR=1.20), occupational contact with lead-related work (APR=1.08), and child pica behaviour (APR=1.18), and were inversely associated with solid fuel use for cooking (APR=0.78). Elevated BLL prevalence varied substantially by district (range 4.4–93.7%), with higher burden concentrated in the central-eastern region. Conclusions: BLLs are independently associated with impaired growth and specific patterns of CIAF among Bangladeshi children. These findings support prioritising lead-specific source control and integrating growth monitoring with environmental exposure surveillance in national child health programming, and suggest CIAF-based surveillance may capture lead's population-level nutritional burden more fully than single indicators alone. Household soil lead, occupational exposure, and child pica behaviour represent modifiable targets for source-control interventions.
Rafid Hassan, Ahadul Hassan Bhuiyan Konok, Tanjina Akter et al.
Early childhood development (ECD) is the foundation for health, cognitive ability, and social and economic productivity throughout life. Nutritional deprivation and socio-economic inequality continue to constrain developmental potential in low- and middle-income countries. This study aimed to assess the nutritional, socio-economic, and caregiving factors associated with early childhood development among children aged 3–4 years in Bangladesh. Data from the 2019 Bangladesh Multiple Indicator Cluster Survey (MICS), a nationally representative survey, were analyzed. The Early Childhood Development Index (ECDI) was constructed across four domains: literacy-numeracy, physical, social-emotional, and learning. A three-level ordinal outcome (not on track, partially on track, and on track) was derived. Survey-adjusted partial proportional odds models were estimated using Stata 17 to account for the complex sampling design. The proportional odds assumption was evaluated using a design-adjusted Wald test. Among the 8,752 children included in the analysis, 73.3% were developmentally on track, 23.6% were partially on track, and 3.2% were not on track. After adjustment, children without functional disabilities had substantially higher odds of being developmentally on track (AOR = 3.93). Stunted children had 17% lower odds of optimal developmental outcomes (AOR = 0.83). Higher maternal education (AOR = 1.17 per level increase), greater household wealth (AOR = 1.11 per quintile increase), attendance in early childhood education programs (AOR = 1.53), female sex (AOR = 1.40), and increasing age were positively associated with developmental attainment. The interplay of nutritional, socio-economic, and caregiving factors significantly shapes early childhood development in Bangladesh. Developmental outcomes can be improved through interventions addressing child undernutrition, educational inequality, and disability inclusion. A comprehensive and equitable policy framework is necessary to maximize opportunities for children's early development.
Introduction: Stunting is a major public health problem that affects the growth and development of children under five. Functional foods in child-friendly forms may provide an alternative nutritional approach to support linear growth and stunting prevention. Objective: This study aimed to evaluate the potential of red ginger extract gummy candy as a functional food to support linear growth and stunting prevention among children under five. Method: This quasi-experimental study used intervention and control groups. Children in the intervention group received red ginger extract gummy candy, while those in the control group received a placebo for one month. Changes in height and weight were assessed before and after the intervention. Result: The Shapiro–Wilk test showed that the anthropometric data were not normally distributed (p<0.05). In the intervention group, height increased significantly after the intervention (p=0.005), whereas the change in body weight was not statistically significant (p=0.161). In the control group, neither body weight (p=0.138) nor height (p=0.059) showed statistically significant changes. However, the Mann–Whitney U test showed no statistically significant difference between the intervention and control groups in changes in body weight (p=0.970) or height (p=0.701).. Conslusion: Red ginger gummy candy was associated with a significant increase in height within the intervention group, but the change was not significantly different from the control group. Further studies with larger samples and longer interventions are needed to determine its potential in supporting linear growth.
Introduction: Appropriate complementary feeding from 6–23 months is essential for child growth and development, yet dietary diversity remains inadequate in many resource-constrained settings. Understanding contextual influences on feeding practices is important for improving child nutrition. Objective: This study examined qualitative evidence to identify dietary patterns and factors shaping complementary feeding among children aged 6–23 months in Chinyunyu, Rufunsa District, Zambia. Methods: This Framework Analysis applied Gale et al. (2013) and the WHO Infant and Young Child Feeding framework to interpret qualitative data. The study was conducted in drought-prone Chinyunyu Ward, Rufunsa District, Zambia. Participants included 24 women aged 18–49 years with a child under two years and seven mothers-in-law who participated in Photovoice and focus group discussions, alongside three husbands and four community leaders who participated in in-depth interviews. Results: Caregivers generally described awareness of recommended feeding practices; however, poverty, limited maternal decision-making power, and heavy workloads were perceived to constrain adherence. Diets cited were dominated by cereal-based porridges prepared with groundnuts, sugar, or salt. Groundnuts were reported as the main protein source, and reliance on them may have limited dietary diversity. Furthermore, increasing dependence on commercial foods was also perceived to undermine optimal complementary feeding. Conclusions: Despite awareness of recommended feeding practices, poverty, gendered resource control, and heavy workloads were reported to constrain adherence to WHO recommendations. Empowering women, improving livelihoods, and promoting affordable dietary diversity, including legumes beyond groundnuts, may strengthen complementary feeding and child nutrition.
Priscilla Funduluka, Mercy Mukuma, Regina Murphy Keith et al.
OBJECTIVE: This study aims to examine the experiences of Rohingya migrant mothers residing in the Kutupalong Refugee Camp in Bangladesh. The research focuses on understanding the challenges these mothers face during the migration process, the barriers they encounter in accessing healthcare services, their experiences related to child care, and the psychosocial stressors they are exposed to in the camp environment. Additionally, the study seeks to develop policy recommendations to enhance their living conditions. METHODS: This study was conducted using a qualitative research design with a phenomenological approach. Semi-structured, in-depth interviews were conducted with 15 Rohingya mothers residing in the Kutupalong Refugee Camp. Participants were selected through purposive sampling based on the criteria of having at least one child, having personally experienced the migration process, and having lived in the camp for at least one year. The interviews were conducted in the Rohingya language with the assistance of a local translator and focused on themes such as migration-related trauma, access to healthcare services, childcare, and psychosocial challenges. The data were analyzed using thematic analysis, and main themes and subthemes were identified. RESULTS: The study identified four main themes. Migration Process and Trauma includes the physical and psychological hardships endured by mothers during migration, as well as violence, losses, and dangerous journeys. Challenges in Accessing Healthcare Services emphasizes the inadequacy of healthcare services within the camp, barriers to accessing external healthcare services, and frequent misdiagnoses and incomplete treatments. Childcare and Nutrition covers issues such as inadequate hygiene conditions, problems with access to clean water, malnutrition, and the struggle against common illnesses in children. Psychosocial Issues and Security Concerns include trauma and psychological problems stemming from incidents such as child abductions, fires, violence, and economic difficulties within the camp. Mothers have significant concerns about ensuring the safety of their children and meeting their basic needs. CONCLUSION: This study highlights the significant challenges faced by Rohingya mothers in refugee camps. Barriers to accessing healthcare services, inadequate childcare and nutrition conditions, psychosocial stressors, and security concerns clearly illustrate the extent of the humanitarian crisis experienced by Rohingya refugees. The research emphasizes the need for comprehensive policies to improve living conditions in refugee camps for both the international community and local governments. Enhancing healthcare services, improving hygiene and nutrition conditions, providing psychosocial support services, and addressing security concerns are essential for enhancing the well-being of Rohingya refugees. This study makes a valuable contribution to the literature on refugee experiences and provides a foundation for future research.
Musa Özsavran, Tülay Kuzlu Ayyıldız, SUMAYA SIDDIQUE AHMED et al.
Stunting is a chronic nutritional problem characterized by impaired linear growth and influenced by multiple factors, including inadequate energy intake. This study aimed to determine the association between average energy intake and stunting severity among children aged 6–24 months in the working area of Bagu Public Health Center, Central Lombok Regency, in 2025. An analytic observational study with a cross-sectional design was conducted among 43 mothers of stunted children selected using total sampling. Stunting status was obtained from Maternal and Child Health (KIA) handbooks, while energy intake was assessed using a 24-hour food recall and categorized according to intake adequacy. Fisher’s Exact Test was used for bivariate analysis because the data did not meet the assumptions of the Chi-square test. Of the 43 children, 40 (93.0%) had deficient energy intake and 3 (7.0%) had adequate intake. A total of 27 children (62.8%) were classified as stunted and 16 (37.2%) as severely stunted. The mean energy intake was 592.8 kcal/day. Fisher’s Exact Test showed no significant association between energy intake and stunting severity (p = 0.385). Although no significant association was observed, inadequate energy intake remains an important nutritional concern among children aged 6–24 months.
This study evaluates the impact of Village Fund allocation for health on stunting reduction as an investment in human capital in Lamongan Regency. Using village-level data for 2023–2024, the study applies Propensity Score Matching (PSM) and Ordinary Least Squares (OLS) to examine supporting factors. The PSM results indicate that villages receiving the intervention experienced a statistically significant reduction in stunting prevalence of approximately 1.2 percentage points compared with non-treated villages. The OLS results show that the Village Fund intervention has a negative but marginally significant association with stunting prevalence, while posyandu activity, supplementary feeding, child immunization, and basic-service access are statistically insignificant. These findings highlight the importance of targeted and integrated village-level interventions.
Background Nigeria ranks second globally in the burden of stunted children, with 40% of children under five affected and poor infant and young child feeding (IYCF) practices as a primary contributor. This study assessed mothers' knowledge, attitudes, and feeding practices related to IYCF in Plateau State, Nigeria, comparing beneficiaries and non-beneficiaries of the Accelerating Nutrition Results in Nigeria (ANRiN) project, and identifying sociodemographic predictors associated with these outcomes. Methods A mixed-methods cross-sectional design was employed. A total of 503 mothers of children aged 6–23 months completed structured questionnaires for quantitative analysis, while 8 focus group discussions and 12 key informant interviews provided qualitative data. Knowledge, attitude, and practice scores were computed with categorization (adequate/inadequate, positive/negative, good/poor). Data were analyzed using chi-square tests, independent t -tests, and multivariable logistic regression stratified by beneficiary status. Results The overall prevalence of adequate knowledge was 21.1%, positive attitudes 91.4%, and good feeding practices 55.7%. Beneficiaries demonstrated significantly better practice scores than non-beneficiaries (mean 6.95 ± 1.42 vs. 6.34 ± 1.57, p < 0.001), while non-beneficiaries showed slightly higher attitude scores (3.68 ± 0.64 vs. 3.52 ± 0.77, p = 0.012). No significant difference in knowledge scores was observed. Maternal tertiary education was significantly associated with adequate knowledge in both groups ( p < 0.01), while healthcare provider information was the strongest predictor of knowledge and attitudes among beneficiaries ( p < 0.001 and p = 0.019, respectively). Qualitative findings identified poverty, food insecurity, and cultural norms as barriers to applying knowledge, while hands-on food demonstrations improved practical skills. Conclusion The study highlights a persistent knowledge-practice gap and demonstrates that ANRiN participation is associated with improved feeding practices. The distinct predictors between beneficiaries and non-beneficiaries suggest that tailored interventions accounting for these differential factors could strengthen IYCF program effectiveness in Nigeria.
Demilade Osoteku, Abdulateef Salisu, Muyi Aina et al.
