Eating from a Shared Plate Affects Food Consumption in Vitamin A-Deficient Nepali Children

Manuscript received 19 September 1997. Initial reviews completed 29 October 1997. Revision accepted 16 February 1998.

A. V. Shankar^*, , J. Gittelsohn^*, K. P. West Jr.^*, R. Stallings^*, T. Gnywali^**, and F. Faruque

^* Center for Human Nutrition and Division of Human Nutrition;  Department of International Health, School of Public Health, Johns Hopkins University, Baltimore, MD 21205; and ^** Nepal Nutrition Intervention Project-Sarlahi, Nepal Eye Hospital, Kathmandu, Nepal

This case-control study evaluates the relationship between shared-plate eating behavior in young Nepali children (aged 1-6 y) and risk of vitamin A deficiency. Day-long observations of dietary practices were conducted on 7 d over a 15-mo period in 162 households: 81 households with a child with a known history of mild xerophthalmia (cases) were matched with 81 having a non-xerophthalmic child of similar age (controls). Shared-plate eating occurred in 25% of all feeding episodes and at least once in 65% of all days observed. Overall, children engaging in shared-plate eating were significantly more likely to consume grains, vegetables, carotenoid-rich vegetables, pulses, fruits, meats and fish, and dairy products and had significantly larger portion sizes for grains, vegetables, fruits, pulses and dairy products, compared with children who ate alone. In general, feeding behaviors between case and control children tended to be similar. However, shared-plate feeding episodes among case children were significantly less likely to include meats or fish [odds ratio (OR) = 0.5, confidence interval (CI) = 0.3-0.8], dairy products (OR = 0.6, CI = 0.4-0.9) or pulses (OR = 0.7, CI = 0.5-1.0). Individual-plate feeding episodes among case children were more likely to include vegetables (OR = 1.3, CI = 1.0-1.6) than those of control children. Case children were more likely to share a plate with a male adult (OR = 1.7, CI = 1.0-2.8), but less likely to eat from a plate shared with females of any age compared with controls (female adult: OR = 0.6, CI = 0.4-0.9; female child: OR = 0.6, CI = 0.4-1.0). Shared-plate eating may benefit a young child's dietary intake, but the identity of the food sharer may modify this influence.

The Journal of Nutrition Vol. 128 No. 7 July 1998, pp. 1127-1133
Copyright ©1998 by the American Society for Nutritional Sciences