Reduced rank regression-derived dietary patterns related to climate-sensitive micronutrients and their associations with child undernutrition among young children in rural Kenya: findings from the ALIMUS study

Undernutrition among children remains a global public health challenge in sub-Saharan Africa. This study examined the associations of dietary patterns related to climate-sensitive micronutrients with undernutrition among children aged 6–23 months in Siaya County, Kenya. We used cross-sectional baseline data of 626 mother-child pairs from a cluster-randomized controlled trial on nutrition counselling and home gardening. Dietary patterns and food intake were derived from a semi-quantitative food frequency questionnaire and identified using Reduced-Rank Regression (RRR) with the response variables of iron, zinc, selenium, and vitamin A (climate-sensitive micronutrients). Their associations with anthropometric z-scores [weight-for-age (WAZ), weight-for-height (WHZ), height-for-age (HAZ)] were calculated by regression models. In this study population (median age: 15 months; 54.2% boys), boys had a lower median of WAZ (-0.47 vs. -0.20), WHZ (-0.02 vs. 0.18), and HAZ (-0.88 vs. -0.54) than girls (p < 0.05). RRR-derived dietary patterns were similar between boys and girls, explaining 68% and 65% of the variations in micronutrient intakes, respectively. These patterns, characterized by high consumption of vegetables, fish, potatoes, coffee and tea, white bread and cereals, fruits, rice and pasta, fermented food, and legumes, were positively associated with WAZ and WHZ but not with HAZ, only among girls. A diet rich in protein sources and fruits and vegetables is associated with better general and acute nutritional status among young girls in rural Kenya.