Predictive Utility of Composite Child Feeding Indices (CCFIs) for Child Nutritional Status: Comparative Analyses for the Most Suitable Formula for Constructing an Optimum CCFI

Stephen Kofi Anin, Richard Stephen Ansong, Florian Fischer and Alexander Kraemer
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Stephen Kofi Anin: School of Public Health, Bielefeld University, Universitätsstraße 25, 33615 Bielefeld, Germany
Richard Stephen Ansong: Department of Nutrition and Food Science, University of Ghana, Accra P.O. Box LG 134, Ghana
Florian Fischer: Institute of Public Health, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
Alexander Kraemer: School of Public Health, Bielefeld University, Universitätsstraße 25, 33615 Bielefeld, Germany

IJERPH, 2022, vol. 19, issue 11, 1-22

Abstract: Composite child feeding indices (CCFIs) developed from various relevant measures of dietary intake by infants and young children have several potential applications in nutritional epidemiological studies for the development and deployment of precise public health nutrition interventions against child undernutrition. The predictive utility of some CCFIs (computed from varying formulation components) for child nutritional status (stunting, wasting, and underweight) were compared. The purpose of the study was to identify the most suitable among them for possible standardization, validation, and adoption by nutritional health researchers. Using cluster sampling, data from 581 mother–child pairs were collected. Multivariable regression analyses were applied to the data obtained through a community-based analytical cross-sectional survey design. Three of the CCFIs were found to be significantly associated with only wasting (WHZ) from the linear regression models after adjusting for potential confounders and/or correlates. None of the CCFIs (whether in the continuous nor categorical form) was consistently predictive of all three measures of child nutritional status, after controlling for potential confounders and/or correlates, irrespective of the choice of regression method. CCFI 5 was constructed using a dimension reduction technique—namely principal component analysis (PCA)—as the most optimal summary index in terms of predictiveness for child wasting status, validity, and reliability (Cronbach’s α = 0.80) that captured relevant dimensions of optimal child food intake. The dimension reduction approach that was used in constructing CCFI 5 is recommended for standardization, validation, and possible adoption for wider applicability across heterogeneous population settings as an optimum CCFI usable for nutritional epidemiological studies among children under five years.

Keywords: feeding practice; infant; feeding index; summary index; nutritional status; undernutrition; wasting; pediatric populations; Ghana (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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