Predictors of Stunting among Children Attending the National Nutrition Institute in Egypt

Back ground: Child malnutrition is a major public health problem in low income and middle
income countries especially among marginalized populations. Stunting contributes to 14.5%
of annual deaths and 12.6% of disability adjusted life years (DALYS) in under-5 years
children. Objective: To identify factors contributing to stunting among a sample of children.
Methods: A case control study was conducted at the National Nutrition Institute, Egypt. The
study recruited 300 children aged 2-8 years, 148 stunted children as cases and 152 nonstunted
as control. Anthropometric measurements were assessed, socio economic status was
evaluated, dietary assessment was done using 24 hours recall and food frequency
questionnaire, previous feeding practices, and morbidities in the last two weeks were
assessed. Results: Four logistic regression models were developed to predict stunting based
on the framework developed by the WHO. Mothers’ education was the only socioeconomic
predictor of stunting where low maternal education attainment was associated with stunting.
Formula feeding during first six moth of life was associated with reduced stunting. Children
with history of delayed milestones were 2.4 times more likely to be stunted (p=0.002) while
children with history of rickets were four times more likely to be stunted (p=0.007). Both
anemia and chest infection increased the risk of being stunting by two folds. Dietary
predictors included milk, meat and calcium consumption where meeting milk and meat
groups recommendation reduced risk of being stunted by 80% and 40% while reduced
calcium intake by 1 mg increase risk of being stunting by 1%. Conclusion: maternal
education, previous formula feeding, previous morbidities and decrease intake of milk and
meat groups are significant predictors for stunting.