Prediction and analysis of trends in the nutritional status of children under 5 years in Iran: reanalysis of the results of national surveys conducted between 1998 and 2020.

Background and aim: Malnutrition is a major public health problem, especially in developing countries. The aim of this study was to analyze the trend in malnutrition among children under 5 years of age in Iran over recent decades and to estimate malnutrition status for 2020. Methods: This study took the form of a secondary analysis of the reports and data from three cross-sectional national surveys on children's nutritional status conducted between 1998 and 2017. Anthropometric indices, including markers of underweight, wasting, stunting, overweight, and obesity, were used as indicators of the nutritional status of children under 5 years. Malnutrition indicators are reported separately based on regional food security status. Linear mixed-effects modeling was used to predict the status of malnutrition indicators for 2020. Results: The results of this study indicated a downward trend in the prevalence of stunting, underweight, and wasting, from 15.4 to 4.8%, 10.9 to 4.3%, and 4.9 to 4.3%, respectively, between 1998 and 2017. The proportion of children at risk of overweight and prevalence of childhood overweight/obesity showed a downward trend between 2010 and 2017, from 3.73 to 3.02% and from 12.1 to 10.3%, respectively. However, the trend varied between different provinces. Estimates of the prevalence of malnutrition in 2020 also indicated a decrease in the prevalence of all indicators among children. Conclusion: Despite the decreasing trend in malnutrition over the past three decades, the prevalence of stunting, underweight, and wasting is still high in food-insecure provinces. Moreover, following the COVID-19 pandemic and its economic consequences, an increase in the prevalence of malnutrition, especially in food-insecure provinces, is plausible.

Food Security and Its Association with Social Support in the Rural Households: A Cross-Sectional Study.

Food insecurity is a major and multidimensional global problem, particularly in rural and vulnerable areas. In this cross-sectional study, we aimed to identify the relationship between social support and food insecurity in 404 Iranian rural households. We selected the sample by cluster random sampling and collected data using three questionnaires [demographic, Multidimensional Perceived Social Support Scale (MSPSS), and United States Department of Agriculture food security questionnaires] and analyzed data using chi-square tests and logistic regression (using SPSS version 19.0). Of the 404 Iranian households, 168 (41.6%) were classified as food secure. The logistic regression analysis revealed that education and job status of the household heads and household income were significantly associated with food security status. Additionally, perceived social support was protective against food insecurity after adjusting for confounding factors [compared with the first quartile, second quartile odds ratio (OR)=1.76, 95% confidence interval (CI): 0.94∼3.3 and fourth quartile OR=2.21, 95% CI: 1.13∼4.33]. This study indicated that social support contributes to a reduced chance of food insecurity in rural households. These results suggest that policy makers should focus on strengthening social support in vulnerable communities to help protect against hunger and poverty.