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Major Dietary Patterns in Relation to Stunting among Children in Tehran, Iran
Esfarjani, Fatemeh; Roustaee, Roshanak; Mohammadi-Nasrabadi, Fatemeh & Esmaillzadeh, Ahmad
Abstract
To the best of our knowledge, no information is available to link major dietary patterns to stunting during
childhood, although dietary patterns are associated with chronic diseases. This study was conducted to
determine the relationship between major dietary patterns and stunting in the first grade pupils of Tehran
in 2009. In this case-control study, 86 stunted children (defined as height-for-age of less than the 5th
percentile of CDC2000 cutoff points) were enrolled from among 3,147 first grade pupils of Tehran, selected
using a multistage cluster random-sampling method. Participants for the control group (n=308) were
selected randomly from non-stunted children (height-for-age more than the 5th percentile of CDC2000
cutoff points), after matching for age, sex, and area of residence. Dietary data were collected using two 24-
hour dietary recalls through face-to-face interview with mothers. Factor analysis was used for identifying
major dietary patterns. Mean consumption of dairy products (308±167 vs 382±232 g/day, p<0.05), dried
fruits and nuts (2.58±9 vs 7.15±26 g/day, p<0.05) were significantly lower among stunted children than
those in the control group. Three major dietary patterns were identified: ‘traditional dietary pattern’ that
was dominated by bread, potato, fats, eggs, flavours, vegetables other than leafy ones, sugar, drinks, and
fast food; ‘mixed dietary pattern’ that was dominated by leafy vegetables, fast foods, nuts, fats, cereals other
than bread, fruits, legumes, visceral meats, sugars, eggs, and vegetables other than leafy vegetables; and
‘carbohydrate-protein pattern’ that was dominated by sweets and desserts, poultry, dairy, fruits, legumes,
and visceral meats. No significant relationships were found between traditional and mixed dietary patterns
and stunting. Individuals in the third quartile of carbohydrate-protein dietary pattern were less likely to
be stunted compared to those in the bottom quartile (OR: 0.31, 95% CI 0.13-0.78, p<0.05). Adherence to
dietary patterns high in protein (e.g. dairy, legumes, and meat products) and carbohydrates (e.g. fruits,
sweets, and desserts) might be associated with reduced odds of being stunted among children.
Keywords
Child; Dietary pattern; Factor analysis; Stunting; Iran
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