PMID- 38260069
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240124
IS  - 2296-861X (Print)
IS  - 2296-861X (Electronic)
IS  - 2296-861X (Linking)
VI  - 10
DP  - 2023
TI  - Developing and demonstrating an atomistic and holistic model of anthropometric 
      failure among children under five years of age using the National Family Health 
      Survey (NFHS)-5 data from India.
PG  - 1280219
LID - 10.3389/fnut.2023.1280219 [doi]
LID - 1280219
AB  - INTRODUCTION: Composite Index of Anthropometric Failure (CIAF) and its further 
      modifications have not incorporated all the combinations of malnutrition. We 
      propose a new model incorporating all the forms of malnutrition among children 
      under five years of age. However, the current models might misclassify a growing 
      child as malnourished. Our objective is to develop a comprehensive scoring system 
      using the three anthropometric Z-scores [height-for-age (HAZ), weight-for-age 
      (WAZ), and weight-for-height (WHZ) Z-scores] and demonstrate the proposed CIAF 
      model using the National Family Health Survey-5 (NFHS-5) data from India. 
      METHODS: A new scoring system was developed using the WAZ, HAZ, and WHZ scores to 
      determine the child's nutritional status. We also proposed a new CIAF model by 
      including all possible categories of malnutrition and practically demonstrated it 
      using the NFHS-5 dataset after applying the new scoring system. Under-five 
      children with heights, weights, and ages available were included in the analysis. 
      The groups of malnutrition are presented as weighted proportions before and after 
      applying the new score to the proposed model. RESULTS: Our final analysis 
      included individual-level data of 198,802 children under five years of age 
      (weighted N = 195,197). After applying the new scoring system to the proposed 
      model, the prevalence of stunting has reduced to 11.8% (95% CI 11.66-11.94) from 
      13.2% (95% CI 13.09-13.39) and wasting prevalence has reduced to 4.9% (95% CI 
      4.85-5.04) from 6.4% (95% CI 6.29-6.51). The most common forms of anthropometric 
      failures among Indian children by using the newly developed CIAF model are: 
      "Stunting and underweight" (30,127; 15.4%), Stunting only (23,035; 11.8%), and 
      "wasting and underweight" (14,698; 7.5%). We found a new category called 
      "Stunting, underweight, and overweight" (stunting = HAZ < -2SD, underweight = WAZ 
      < -2SD, overweight = WHZ > +2SD). It constituted 0.1% (220 children) of the total 
      sample. CONCLUSION: When the new scoring system is applied to the proposed CIAF 
      model, it captures all forms and combinations of malnutrition among under-five 
      children without overlap and prevents misclassifying a growing child as 
      malnourished. The newly identified category shows that stunting (HAZ < -2SD), 
      overweight (WHZ > +2SD) and underweight (WAZ < -2SD) can co-exist in the same 
      child.
CI  - Copyright (c) 2024 Nandeep, Jaleel, Reddy, Geddam, Reddy and Hemalatha.
FAU - Nandeep, E R
AU  - Nandeep ER
AD  - Clinical Epidemiology Division, Indian Council of Medical Research 
      (ICMR)-National Institute of Nutrition, Hyderabad, Telangana, India.
FAU - Jaleel, Abdul
AU  - Jaleel A
AD  - Public Health Nutrition Division, Indian Council of Medical Research 
      (ICMR)-National Institute of Nutrition, Hyderabad, Telangana, India.
FAU - Reddy, P Bhaskar
AU  - Reddy PB
AD  - Nutrition Information, Communication & Health Education (NICHE) Division, Indian 
      Council of Medical Research (ICMR)-National Institute of Nutrition, Hyderabad, 
      Telangana, India.
FAU - Geddam, J J Babu
AU  - Geddam JJB
AD  - Clinical Epidemiology Division, Indian Council of Medical Research 
      (ICMR)-National Institute of Nutrition, Hyderabad, Telangana, India.
FAU - Reddy, Samarasimha N
AU  - Reddy SN
AD  - Clinical Epidemiology Division, Indian Council of Medical Research 
      (ICMR)-National Institute of Nutrition, Hyderabad, Telangana, India.
FAU - Hemalatha, Rajkumar
AU  - Hemalatha R
AD  - Indian Council of Medical Research (ICMR)-National Institute of Nutrition, 
      Hyderabad, Telangana, India.
LA  - eng
PT  - Journal Article
DEP - 20240108
PL  - Switzerland
TA  - Front Nutr
JT  - Frontiers in nutrition
JID - 101642264
PMC - PMC10800737
OTO - NOTNLM
OT  - National Family Health Survey-5
OT  - Z-score
OT  - anthropometric failure
OT  - malnutrition
OT  - under-five children
OT  - undernutrition
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2024/01/23 12:42
MHDA- 2024/01/23 12:43
PMCR- 2023/01/01
CRDT- 2024/01/23 10:34
PHST- 2023/08/19 00:00 [received]
PHST- 2023/12/11 00:00 [accepted]
PHST- 2024/01/23 12:43 [medline]
PHST- 2024/01/23 12:42 [pubmed]
PHST- 2024/01/23 10:34 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fnut.2023.1280219 [doi]
PST - epublish
SO  - Front Nutr. 2024 Jan 8;10:1280219. doi: 10.3389/fnut.2023.1280219. eCollection 
      2023.