Body composition and associated factors among 5-7-year-old children with moderate acute malnutrition in Jimma town in southwest Ethiopia: A comparative cross-sectional study

Abstract

Acute malnutrition affects not only the growth and development but also the body composition of children. However, its specific effects have not yet been characterized. This study aims to compare the body composition of 5-7-year-old children with moderate acute malnutrition (MAM) to that of their well-nourished (WN) peers and identify associated factors. A school-based comparative cross-sectional study was conducted from June to July 2022 in Jimma town, southwest Ethiopia. The study participants were selected from eight kindergartens and eight primary schools using a simple random sampling technique based on the proportional allocation of the sample to the size of the population in the respective school. Descriptive statistics and multivariable linear regression analyses were used to assess the mean differences and associations between variables and isolate independent predictors of body composition, respectively. The statistical significance was determined using ss-coefficients with 95% confidence intervals and a p value of <= 0.05. Data were captured from 388 (194 MAM and 194 WN) children with a response rate of 97.9%. The mean fat-free mass of WN children was significantly higher compared with those with MAM (p < 0.001). The mean (SD) of fat mass of MAM children was 4.23 +/- 0.72 kg, 4.36 +/- 0.88 kg and 4.08 +/- 0.89 kg for 5, 6 and 7-year-olds, respectively. For WN children, the mean (SD) of fat mass was 4.92 +/- 0.88 kg for 5 years old, 5.64 +/- 1.01 kg for 6 years old and 5.75 +/- 1.26 kg for 7 years old (p < 0.001). On the multivariable linear regression analysis after controlling for background variables, WN children exhibited 1.51 times higher fat-free mass compared with MAM children (beta = 1.51, p = 0.003). A unit increase in age of the study participants was associated with a 1.37 increment in fat-free mass (beta = 1.37, p < 0.001). WN children had 1.07 times higher fat mass compared with children with MAM (beta = 1.07, p < 0.001). A unit increase in the age of the child resulted in 0.15 times increment in fat mass (beta = 0.15, p = 0.020), and being female was associated with a 0.37 increase in fat mass (beta = 0.37, p < 0.001). The results showed that the mean fat mass and fat-free mass were significantly lower among moderately acute malnourished children than in WN children showing the loss of both body compartments due to malnutrition. The body mass index for age, age of the child and sex of the child were significantly linked to both fat-free mass and fat mass.