Deciphering the concurrent phenomenon of childhood malnutrition by using the extended composite index of anthropometric failure (ECIAF): facts from the BESLEN project

Objective: To investigate the co-existence of single and multiple anthropometric failures among children using an extended composite index of anthropometric failure (ECIAF). This study aims to elucidate the complex interplay between child-specific and maternal factors, highlighting the multifaceted nature of childhood malnutrition. Design: A multicentre cross-sectional study as part of the BESLEN project Setting: Mother-Child Education Centre in the Pendik district of Istanbul, TÜrkiye Participants: 1283 children (preschool children, n 822, school-aged children, n 462) and 1044 mothers Results: Almost 1/3 of the children included in the study had an anthropometric failure as determined by ECIAF. Weight excess was the leading cause of the total anthropometric failures, most of which were observed to be slightly higher in boys, except for stunting only and co-occurrence of stunting and underweight. Among the mother-related factors, including higher BMI and waist circumference, low maternal age at delivery, low number of children in the household and being a single parent may be considered predisposing factors to any phenomenon of childhood malnutrition. Among child-related factors, birth weight being ≥ 3500 g had a higher risk for ECIAF failure, and children aged ≥ 60 months were more likely to experience stunting and underweight, while those < 60 months had a higher prevalence of weight excess. Conclusions: The co-existence of stunting and overweight, the occurrence of weight excess in one in three stunted children and the high risk of central obesity are public health concerns. Also, ECIAF can better assess all aspects of childhood malnutrition than conventional measures.