HOUSEHOLD FOOD SECURITY, DIETARY INTAKE, AND ANTHROPOMETRIC ASSESSMENT OF DOMINICAN CHILDREN

The purpose of this study was to assess nutrition and food security status of Dominican school children and their families. Anthropometric measures, diet recalls, and household food security surveys were used as tools in this assessment. This assessment may assist in prioritizing programs for the transitioning country of the Commonwealth of Dominica. In year 1, 199 children and 197 children in year 2 from 10 primary schools in 3 regions participated in the study. Four of the schools were involved with school feeding programs while six were not involved in school feeding programs. Weight was measured on an electric scale; height was measured with a portable stadiometer; and triceps skinfold was measured with skinfold calipers. BMI was calculated from height and weigh measurements. Children\u27s weight-for-age, height-for-age, BMI, and triceps skinfold thickness measures were compared to WHO growth standards for children. Twenty-four hour diet recall interviews were conducted with 198 children in year 1 and 196 children in year 2 by paper-and-pencil approach using standardized probes, food models, and coding. Intakes of food energy, macronutrients, vitamins, and minerals were compared to US and WHO reference intakes. Food items also were categorized into one of the six food groups of the Caribbean and as either traditional or non-traditional. Two hundred fifty-seven parents of children at the participating schools completed a food security questionnaire modeled after the USDA Household Food Security Survey. Questions were analyzed to determine levels of household food security as well as food security at the child level. Statistical analysis was performed using SAS (SAS version 9.1; SAS Institute, Inc., Cary, NC). Descriptive statistics, frequencies, correlations, mixed procedures, and chi-square goodness of fit analyses were utilized. The probability of a type I error was set at 5%. Children in the Southeast region were significantly taller and heavier than children in either the north or Carib regions. Carib children were the smallest in comparison to children in the North or Southeast regions. Carib children also had significantly lower BMI than children in the North and Southeast regions in year 2. Overall, 12% of children were below the 3rd percentile while 23% were above the 97th percentile in year 1. In year 2, over half of the children were between the 3rd and 97th percentiles. Children in the Southeast region had significantly higher intake of several nutrients, including fiber, fat, vitamin A, vitamin C, folate, calcium, phosphorus, and zinc. More than half of the children consumed less than 67% DRI for fiber, calcium, and potassium and 55% of children consumed less than the DRV for calcium and zinc. On a weight basis, children\u27s food came mostly from fruits, foods from animals, sweets, non-caloric beverages, mixed dishes, and staples than from other food groups. The food groups consumed by the greatest number of children in both years were staples, foods from animals, and fruits. The foods consumed by the fewest number of children were vegetables, mixed dishes, and soups, sauces, and gravies. Children consumed significantly fewer grams of non-traditional foods than traditional foods in both years. Few non-traditional and traditional foods were high in protein. Eleven percent of respondents had high household food security, 16% had marginal household food security; 31% had low household food security; and 42% had very low household food security. More households from the Southeast region had high food security (48%) than from the other two regions while more than half of the households in the Carib region had low to very low household food security status. Forty three percent of respondents had high or marginal food security status at the child level; 32% had low food security at the child level; and 25% had very low food security at the child level. Respondents from the north had the highest percentage of high child food security. Nutrient intake and anthropometric data of Dominican children compared closely to children in developed countries. Children were growing appropriately for their age, eating nutrient dense foods, eating appropriately from the food groups, and consuming more traditional than non-traditional foods. Nutrients of concern were calcium and folate; intakes of these nutrients should continue to be monitored. There were no significant correlations between the availability of school feeding programs and anthropometric measures, nutrient intake or food security status. This may reflect the lack of standardization in the school feeding programs. With further development of the school feeding programs in schools throughout Dominica, positive impacts may be seen. Given the mostly traditional and varied diet consumed by the children in this study and the overall adequacy of intake, school feeding programs could help this population maintain a healthy lifestyle