Drivers of food consumption among overweight mother-child dyads in Malawi

PLoS One. 2020 Dec 17;15(12):e0243721. doi: 10.1371/journal.pone.0243721. eCollection 2020.

Abstract

To address the increase in overweight and obesity among mothers and children in sub-Saharan Africa, an understanding of the factors that drive their food consumption is needed. We hypothesized food consumption in Malawi is driven by a combination of factors, including season, food accessibility (area of residence, convenience of purchasing food, female autonomy), food affordability (household resources, food expenditures, household food insecurity), food desirability (taste preferences, body size preferences), demographics, and morbidity. Participants in Lilongwe and Kasungu Districts were enrolled across three types of mother-child dyads: either the mother (n = 120), child (n = 80), or both (n = 74) were overweight. Seven-day dietary intake was assessed using a quantitative food frequency questionnaire during the dry and rainy seasons. Drivers associated with intake of calories, macronutrients, and 11 food groups at p<0.1 in univariate models were entered into separate multivariate linear regression models for each dietary intake outcome. Mother-child dyads with an overweight child had a higher percent of calories from carbohydrates and lower percent of calories from fat compared to dyads with a normal weight child (both p<0.01). These mothers also had the highest intake of grains (p<0.01) and their children had the lowest intake of oil/fat (p = 0.01). Household food insecurity, maternal taste preferences, and maternal body size preferences were the most consistent predictors of food group consumption. Household food insecurity was associated with lower intake of grains, fruits, meat and eggs, oil/fat, and snacks. Maternal taste preferences predicted increased consumption of grains, legumes/nuts, vegetables, fish, and oil/fat. Maternal body size preferences for herself and her child were associated with consumption of grains, legumes/nuts, dairy, and sweets. Predictors of food consumption varied by season, across food groups, and for mothers and children. In conclusion, indicators of food affordability and desirability were the most common predictors of food consumption among overweight mother-child dyads in Malawi.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Body Mass Index
  • Body Size
  • Child, Preschool
  • Diet Surveys / statistics & numerical data*
  • Feeding Behavior / physiology
  • Feeding Behavior / psychology*
  • Female
  • Food Insecurity
  • Food Preferences
  • Humans
  • Infant
  • Malawi / epidemiology
  • Male
  • Middle Aged
  • Mothers / psychology
  • Mothers / statistics & numerical data
  • Obesity, Maternal / epidemiology*
  • Obesity, Maternal / etiology
  • Overweight / epidemiology*
  • Overweight / etiology
  • Pediatric Obesity / epidemiology*
  • Pediatric Obesity / etiology
  • Pregnancy
  • Prevalence
  • Risk Factors
  • Seasons
  • Socioeconomic Factors
  • Young Adult

Grants and funding

This research was funded by the Drivers of Food Choice (DFC) Competitive Grants Programs, which is funded by the UK Government’s Department for International Development and the Bill & Melinda Gates Foundation, and managed by the University of South Carolina, Arnold School of Public Health, USA; however, the views expressed do not necessarily reflect the UK Government’s official policies. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.