Indicadores de alimentación complementaria de la Organización Mundial de la Salud y del Ministerio de Salud: análisis de concordancia y comparación de prevalencias estimadas en una cohorte de niños del suroeste de Bahía, Brasil, 2018

Barbosa, Clessiane de Brito; Magalhães, Elma Izze da Silva; Rocha, Daniela da Silva

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 33 • 2024 • https://doi.org/10.1590/S2237-96222024v33e2023556.en copiar

Indicadores de alimentación complementaria de la Organización Mundial de la Salud y del Ministerio de Salud: análisis de concordancia y comparación de prevalencias estimadas en una cohorte de niños del suroeste de Bahía, Brasil, 2018

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo

evaluar la concordancia entre indicadores de alimentación complementaria definidos por la Organización Mundial de la Salud (OMS) y el Ministerio de Salud (MS), y comparar la prevalencia entre estos indicadores en niños de un año.

Métodos

estudio transversal en una cohorte de 286 niños de Vitória da Conquista, Bahía, Brasil; se calculó la prevalencia de “introducción de alimentos complementarios” (IAC), “diversidad dietética mínima” (DMD), “frecuencia mínima de comidas” (FMR) y “dieta mínima aceptable” (DMA); para evaluar la concordancia y comparar prevalencias se utilizó el índice Kappa y la prueba de McNemar.

Resultados

cuatro indicadores mostraron un acuerdo pobre y sólo uno moderado; las prevalencias fueron mayores según la definición de la OMS (IAC, 94,3% vs 20,7%; DMD, 75,2% vs 50,7%; FMR, 97,2% vs 44,8%; DMA, 96,8% vs 26,9%).

Conclusión

la mayoría de las concordancias entre los indicadores fueron deficientes, con prevalencias más altas según las definiciones de la OMS.

Palabras clave
Alimentación Complementaria; Nutrición del Lactante; Organización Mundial de la Salud; Estudios Transversales

Indicator	Definition		Adaptation made
Indicator	World Health Organization (2021)	Ministry of Health (2015)	Adaptation made
Introduction of complementary feeding^a	Percentage of children who consumed solid, semi-solid, or mashed foods on the previous day.	Percentage of children who consumed two fruits and one savory meal (cooked meal, porridge, or soup) on the previous day.
Minimum dietary diversity^b	Percentage of children who, on the previous day, consumed foods and drinks from at least five of the seven defined food groups: 1. breast milk; 2. grains, roots e tubers; 3. legumes; 4. dairy products; 5. meat; 6. eggs; and 7. fruits and vegetables.	Percentage of children who consumed the five related food groups the day before: 1. breast milk or milk other than breast milk; 2. fruits and vegetables; 3. meat and eggs; 4. beans; and 5. cereals and tubers.	The original definition from the World Health Organization, WHO (2021), required the consumption of at least five out of eight defined food groups, while the original definition from the Ministry of Health, MoH (2015), adopted the consumption of six related groups. For this study, the WHO definition (2021) did not include the food group “fruits and vegetables rich in vitamin A”; and the MoH (2015) definition did not include the food group “orange and dark green leafy vegetables or fruits”, due to the limitations of the food consumption questionnaire, which does not include specific types of fruits and vegetables.
Minimum meal frequency^b	Percentage of children who, on the previous day, ate at least three meals with solid, semi-solid or pureed foods, in the case of breastfed children; or four meals with solid, semi-solid or pureed foods or dairy products (with at least one of the meals being solid, semi-solid or pureed), in the case of non-breastfed children.	Percentage of children who, on the previous day, ate savory food with a regular (in pieces) or pureed consistency at least twice a day.
Minimum acceptable diet^b	Percentage of children with a minimum dietary diversity and minimum meal frequency the previous day, according to WHO definitions (2021).	Percentage of children with a minimum dietary diversity and minimum meal frequency the previous day, according to MoH definitions (2015). Note: Although it is not an indicator listed in the document of indicators from this reference, it can be created from the indicators of minimum dietary diversity and minimum meal frequency, which are recommended by the MoH (2015).

Indicator	World Health Organization (2021) versus Ministry of Health (2015)
Indicator	Agreement (%)	Expected agreement (%)	Kappa	p-value
Introduction of complementary feeding	26.3	24.0	0.03	0.015^a
Minimum dietary diversity	75.5	50.4	0.51	< 0.000^a
Minimum meal frequency	47.6	45.1	0.05	0.005^b
Minimum acceptable diet	29.4	28.4	0.01	0.139

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[1] Correspondence: Daniela da Silva Rocha | drochaufba@gmail.com