We investigated the relationship between socio-economic status and child undernutrition in West Africa (WA), and further examined the mediating role of dietary practices (measured as minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)) and household environmental quality (HEQ) in the observed relationship.

Thirteen countries were included in the study. We leveraged the most recent Demographic and Health Surveys datasets ranging from 2010 to 2019. Poisson regression model with robust standard errors was used to estimate prevalence ratios and their corresponding 95 % CI. Structural equation modelling was used to conduct the mediation analysis.

West Africa.

132 448 under-five children born within 5 years preceding the survey were included.

Overall, 32·5 %, 8·2 %, 20·1 % and 71·7 % of WA children were stunted, wasted, underweight and anaemic, respectively. Prevalence of undernutrition decreased with increasing maternal education and household wealth (Trend P-values < 0·001). Secondary or higher maternal education and residence in rich households were associated with statistically significant decrease in the prevalence of stunting, wasting, underweight and anaemia among children in WA. MAD was found to mediate the association of low maternal education and poor household wealth with childhood stunting and underweight by 35·9 % to 44·5 %. MDD, MMF and HEQ did not mediate the observed relationship.

The study findings enables an evaluation and improvement of existing intervention strategies through a socio-economic lens to help address the high burden of child undernutrition in WA and other developing regions.

To assess the association between dietary diversity and development among children under 24 months in rural Uganda and to establish other factors that could be associated with development among these children.

A secondary data analysis of a cluster-randomised controlled maternal education trial (n 511) was conducted on a sub-sample of 385 children. We used adjusted ORs (AORs) to assess the associations of dietary diversity scores (DDS) and other baseline factors assessed at 6–8 months with child development domains (communication, fine motor, gross motor, personal–social and problem solving) at 20–24 months of age.

Rural areas in Kabale and Kisoro districts of south-western Uganda.

Children under 24 months.

After multivariable analysis, DDS at 6–8 months were positively associated with normal fine motor skills development at 20–24 months (AOR = 1·18; 95 % CI 1·01, 1·37; P = 0·02). No significant association was found between DDS and other development domains. Children who were not ill at 6–8 months had higher odds of developing normal communication (AOR = 1·73; 95 % CI 1·08, 2·77) and gross motor (AOR = 1·91; 95 % CI 1·09, 3·36) skills than sick children. Girls had lower odds of developing normal gross motor skills compared with boys (AOR = 0·58; 95 % CI 0·33, 0·98). Maternal/caregiver nutritional education intervention was positively associated with development of gross motor, fine motor and problem-solving skills (P-values < 0·05).

We found an association between child DDS at 6–8 months and improvement in fine motor skills development at 20–24 months. Child illness status, maternal/caregiver nutritional education intervention and sex were other significant baseline predictors of child development at 20–24 months.

Breast-feeding is an important determinant of health of mothers and their offspring. The present study aimed to compare breast-feeding rates across Europe disaggregated by maternal education and establish what proportion achieves at least 50 % exclusive breast-feeding (EBF) at 6 months.

Secondary analysis of national or sub-national studies’ breast-feeding data for EU Member States plus Norway and Iceland, published in 2006–2016. Nineteen EU Member States plus Norway reported rates of EBF and any breast-feeding disaggregated by maternal education, of which only thirteen could be matched to the International Standard Classification of Education.

Mothers and their infants aged 0–12 months.

Data on EBF rates at 6 and 4 months were found in only four and six countries, respectively. At 6 months, EBF rates of 49 % in Slovakia and 44 % in Hungary were closest to WHO’s target of at least 50 % EBF. At 4 months, mothers with high education level in Denmark, the Netherlands and Germany had the highest EBF rates (71, 52 and 50 %, respectively). Mothers with low education level were less likely to initiate breast-feeding and cessation occurred early. The inequality gap ranged from 63 % in Irish mothers to no gap or very low levels of inequality in Poland, Sweden and Norway.

More mothers with high, compared with low, education initiate breast-feeding and practise EBF for longer. More European policies should be targeted to protect, support and promote breast-feeding, especially among mothers with only mandatory education.

To estimate the determinants of stunting using rich data from a birth cohort study from urban South Africa and to examine the various mechanisms, both proximate and distal, through which maternal education affects stunting.

Multivariate regression analysis using birth cohort data, where the outcome variable was stunting at age 2 years, and multiple mediator analysis to identify pathways from maternal education to stunting.

South Africa’s largest metropolitan area, Soweto-Johannesburg.

Participants of Birth to Twenty Plus, a longitudinal cohort study of children born in 1990 (n 691).

In multivariate analysis, the birth weight Z-score (−0·084; P<0·001; 95 % CI −0·11, −0·06), the mother’s openness towards modern health care, captured by a vaccination score (−0·05; P=0·04; 95 % CI −0·10, −0·00), and a better-quality care environment (−0·015; P=0·04; 95 % CI −0·03, −0·00) were found to be negatively associated with stunting. Having experienced symptoms of illness related to ears and eyes increased the risk of stunting (0·038; P=0·01; 95 % CI 0·01, 0·07). Results of the mediation analysis showed that maternal education had an indirect effect on stunting largely through socio-economic status and the antenatal environment (measured by the birth weight Z-score).

Overall, many of the factors that were protective against stunting in the final analysis, whether they operated through maternal education or not, were related to the mother’s contribution to the child’s life. This reinforces the idea that to minimise stunting, enhanced antenatal and postnatal services to better support and empower mothers may be important.

The present study examined the prevalence of underweight and overweight in a group of primary-school children in Zahedan, south-east Iran.

A cross-sectional study in a randomly selected population of schoolchildren.

Primary-school children in Zahedan city.

A random sample of 1079 students (boys = 500 and girls = 579). Data on child’s age, parental educational levels, body weight and height were collected.

The rate of overweight/obesity among boys and girls was 8·9 % and 10·3 %, respectively; and of underweight among boys and girls was 22·8 % and 19·9 %, respectively. Prevalence of overweight increased as the boys and girls approached adolescence and it was more prevalent among girls than boys. Prevalence of overweight was directly related to maternal education in this population.

High prevalence of underweight in young children as well as increase in the prevalence of overweight in girls and boys near adolescence are of concern. Early poor growth and subsequent rapid weight gain near to adolescent stage is related to adulthood obesity.

The present study aimed to investigate the determinants of overweight and obesity among 6- to 11-year-old schoolchildren in Rasht, Iran.

Cross-sectional survey. Data on age, weekly frequency of skipping breakfast, physical activity and hours of television viewing were collected. Information on birth weight, parental age, parental educational levels, parental weight and height, and mother’s employment status were gathered through self-administrated questionnaires given to the parents.

Elementary schools in Rasht.

A total of 6635 children (3551 boys and 3084 girls) attending elementary schools in Rasht were studied.

The overall prevalence of overweight was 11·5 % and 15·0 % for boys and girls, respectively; while the overall prevalence of obesity was 5·0 % and 5·9 %, respectively. Children with more educated mothers had a higher prevalence of overweight than children with less educated mothers. Logistic regression analysis showed that children with overweight/obese parents, children with more educated mothers and children who often skipped breakfast were more prone to overweight and obesity.

These data suggest that overweight and obesity is a public health concern in this age group in Rasht. The observed sex and social differences in the prevalence of overweight and obesity call for policy makers’ attention.

The objective of this study was to assess the prevalence of vitamin A deficiency (VAD) in children under 6 years old in China and to identify risk groups for VAD.

A cross-sectional survey was conducted in 14 provinces from coastal, inland and western geographic areas in China.

One city (urban) and two counties (rural) were randomly selected from each province as survey areas.

About 200 children aged 0–6 years were randomly selected in each survey area. A blood sample was collected from each child. Data on sociodemographics and nutrition were obtained by interview of the mother or principal caregiver. Fluorescence microanalysis was used to analyse serum retinol concentration.

VAD (serum retinol < 0.7 μmol l− 1) was observed in 957 out of 7826 children aged 0–6 years (12.2% of the entire study population), whereas severe VAD (serum retinol < 0.35 μmol l− 1) was found in 39 children (0.5%). The highest prevalences of VAD at >1 year of age were observed among children of mothers with minority ethnicity (22.7%) or poor education (19.8%) and in the poor western area (17.4%).

VAD is a nutritional problem in children in China. Children living in the poor western area, having a mother with minority ethnicity or a mother with poor education have a high risk of VAD.