Multiple influences on children's nutritional deficiencies: A systems perspective

• Published in: Physiology & behavior Vol. 94; no. 1; pp. 48 - 60
• Main Author: Wachs, Theodore D
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Cambridge Elsevier Inc 22-04-2008; New York, NY Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Behavioral psychophysiology; Biological and medical sciences; Child; Child Nutrition Disorders - economics; Child Nutrition Disorders - epidemiology; Child Nutrition Disorders - etiology; Child Nutrition Disorders - physiopathology; Child Nutritional Physiological Phenomena; Depression; Education; Female; Fundamental and applied biological sciences. Psychology; Health Education; Humans; Infant; Infant Nutritional Physiological Phenomena; Intelligence; Malnutrition; Maternal; Medical sciences; Metabolic diseases; Micronutrient deficiencies; Mood disorders; Mothers; Obesity; Obesity - therapy; Other nutritional diseases (malnutrition, nutritional and vitamin deficiencies...); Poverty; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychopathology. Psychiatry; Systems theory; Temperament, Extended care model; Maternal; Obesity; Intelligence; Education; Depression; Systems theory; Temperament, Extended care model; Malnutrition; Child; Micronutrient deficiencies; Human; Mood disorder; Systemic theory; Extended care model; Obesity; Malnutrition; Micronutrient deficiencies; Child; Systems theory; Education; Intelligence; Depression; Maternal; Temperament; Nutrition disorder; Temperament; Micronutrient; Models; Nutritional status; Nutritional deficiency
• ISSN: 0031-9384; 1873-507X
• DOI: 10.1016/j.physbeh.2007.11.018

Abstract Under-nutrition and obesity are multi-determined. The multiple determinants of either under-nutrition or obesity are linked, thus forming a system of influences. How a system of linked multiple influences functions is illustrated with specific reference to early nutritional deficiencies. The traditional explanation that child nutritional deficiencies are due to food scarcity or a lack of family economic resources has been increasingly questioned. In the UNICEF extended care model, deficiencies in children's nutritional intake are due to family economic and food resources and to specific caregiver resources. The role of three caregiver resources, maternal education, intelligence and depression are reviewed. Evidence also is presented on the need to take into account child characteristics, as an additional set of influences on nutritional deficiencies. Using a systems perspective this review documents how the relation to nutrition of family and caregiver resources and child characteristics can be mediated or moderated by alternative linked influences such as cultural characteristics, maternal input into family economic decisions and social support networks. Based on this review a revised extended care model is presented, explicitly integrating child characteristics and specific mediating and moderating links between multiple predictors of child nutritional deficiencies. This is followed by a brief discussion on how a systems perspective can also apply to the study of childhood obesity.