Relationship between major dietary patterns and stunting in Tehrani school children

This study was conducted to determine the relationship between stunting and major dietary patterns among the first-grade pupils in Tehran in 2008. In this case-control study, children’s height (n=3147) was measured in 5 areas of Tehran by expeienced nutritionists using standard protocols. Children with a height lower than the 5th percentile of height for age of the CDC2000 standard were considered as stunted (n = 86, the case group). Control children were selected randomly from among healthy, non-stunted children with the same age and sex (n=308). Data on demographic characteristics, socio-economic status, birth weight and length, and duration of breast feeding were collected using standard questionnaires. In addition, two 24-hour dietary recall questionnaires were completed for each subject on 2 cosecutive days by interviewing their mothers. Factor analysis was used to identify major dietary patterns. Logistic regression models were adjusted for sex, mother's age and education, father's education, birth weight, family size, and energy intake. There were significant differences between the stunted children and their control group with regard to sex, birth weight, age of mother, and parent's education of (P<0.05). Based on the 24-hour dietary recalls, the mean consumptions of dairy products (308±167 g/day) and dried fruits and nuts (2.58±9 g/day) in the case group were significantly lower than the respective control values (7.15±26 and 382±232 g/day, respectively; p<0.05). However, consumption of the fat and oils group in the case group (37.85±29 g/day) was higher than in the control group (30.94±22 g/day; P< 0.05). Three dietary patterns were identified using factor analysis: dietary pattern 1, high in bread, potatoes, fats, eggs, relish, other vegetables, sugar, and soft drinks; dietary pattern 2, high in leafy vegetables, fast foods, nuts, other cereals, fruits, legumes, and offal; and dietary pattern 3, high in biscuits and cakes, chicken, dairy products, fruits, etc. Dietary patterns 1 and 2 were not significantly associated with stunting, while children in the third quartile of dietary pattern 3 had a lower risk for stunting as compared to those in the first quartile of that dietary pattern (p<0.05). It seems that following dietary patterns high in protein (e.g., dairy and meat products) and carbohydrate (e.g., fruits and biscuits/cakes) may reduce the risk of stunting in children.