Factors related to Nutritional Status in School-Age Children with Stunting and Thinness and Those with Normal Height A Comparative Study

Main Article Content

Nattaya Duangbupha
Apawan Nookong
Arunrat Srichantaranit

Abstract

Purpose: This study aimed to compare children’s consumption behaviors, physical activity behaviors, sleep duration, and household second-hand smoke exposure of children; and parent’s food preparation behaviors between school-age children with stunting and thinness; and those with normal height.


Design: Descriptive comparative study.


Methods: The sample consisted of parents and school-age children aged 9-12 years, enrolled in grades 4-6, at 11 primary schools in Chiang Rai Province. A total of 144 children and parents were included, divided into two groups: 48 pairs of parents and children with stunting and thinness, and 96 pairs of parents and children with normal height. Data were collected using questionnaires and analyzed using descriptive statistics, independent t-test, and Mann-Whitney U test.


Main findings: The results showed significant differences between children with stunting and thinness and those with normal height in terms of consumption behaviors (t = 10.88, p < .001), physical activity behaviors (z = 8.95, p < .001), sleep duration (t = 3.46, p < .001) and short and long-term duration of household second-hand smoke exposure (z = 5.38, p < .001; z = 5.41, p < .001, respectively). Parent’s food preparation behaviors between both groups were significantly different (t = 6.34, p < .001).


Conclusion and recommendations: Healthcare personnel should cooperate with school staff to implement programs aimed at preventing undernutrition in school-aged children. School policies addressing this issue should be developed. Health promotion programs should be integrated into the school curriculum, and nutritional improvement initiatives for parents of undernourished children should be tailored to the specific nutritional needs of their children and related factors.

Article Details

How to Cite
Duangbupha, N., Nookong, A., & Srichantaranit, A. (2025). Factors related to Nutritional Status in School-Age Children with Stunting and Thinness and Those with Normal Height: A Comparative Study. Nursing Science Journal of Thailand, 43(2), 126–140. retrieved from https://he02.tci-thaijo.org/index.php/ns/article/view/274662
Section
Research Articles

References

World Health Organization. Malnutrition [Internet]. Geneva: WHO; 2024 [cited 2024 Jun 12]. Available from: https://www.who.int/news-room/fact-sheets/detail/malnutrition.

United Nations Children’s Fund (UNICEF), World Health Organization, World Bank Group. Levels and trends in child malnutrition [Internet]. Geneva: WHO; 2023 [cited 2024 Jun 12]. Available from: https://iris.who.int/bitstream/handle/10665/368038/9789240073791-eng.pdf?sequence=1.

Department of Medical Services, Ministry of Public Health. Health Data Center (HDC): health region [Internet]. Bangkok: Department of Health; 2024 [cited 2024 Jun 12]. Available from: https://hdcservice.moph.go.th/hdc/reports/report_student. (in Thai).

Morales F, Montserrat PS, Leon MJ, Rivero-Pino F. Effects of malnutrition on the immune system and infection and the role of nutritional strategies regarding improvements in children’s health status: a literature review. Nutrients. 2023;16(1):1. doi: 10.3390/nu16010001.

Erfanti DO, Setiabudi D, Rusmil K. The relationship of psychosocial dysfunction and stunting of adolescents in Suburban, Indonesia. Open J Med Psychol. 2016;5(4):57-65. doi: 10.4236/ojmp.2016.54007.

Aurora W, Sitorus RJ, Flora R. Effect of stunting on intelligence quotient (IQ) of school-age children. Advanced Engineering Informatics. 2020;205:176-80. doi: 10.2991/aer.k.210825.032.

Metwally M, El-Sonbaty M, El Etreby A, El-Din S, Hamid A, Hussien A, et al. Stunting and its determinants among governmental primary school children in Egypt: a school-based cross-sectional study. Open Access Maced J Med Sci. 2020;8(B):650-7. doi: 10.3889/oamjms.2020.4757.

Ahmed SM, Shine S, Asefa G, Belay M. Prevalence and associated factors of stunting among school age children in Addis Ababa City, Ethiopia 2021. Ann Glob Health. 2022;88(1):57. doi: 10.5334/aogh.3751.

AL-Qurashi MA, Almuhaydib MN, Alfaqih AE, Albalawi DR, Alshehri AY, Qattan KM, et al. Environmental risk factors associated with stunting in pediatric. International Journal of Medicine in Developing Countries. 2024;8(9):2492-8. doi: 10.24911/IJMDC.51-1724783737.

Department of Health, Ministry of Public Health. Prevalence of smokers in the Thai population aged 15 years and over [Internet]. Nonthaburi: Department of Health; 2021 [cited 2024 Jul 28]. Available from: https://cri.hdc.moph.go.th/hdc/reports/report.php. (in Thai).

Nurmalasari Y, Utami D, Perkasa B. Picky eating and stunting in children aged 2 to 5 years in central Lampung, Indonesia. Malahayati International Journal of Nursing and Health Science. 2020;3(1):29-34. doi: 10.20961/placentum.v12i1.83139.

Amornsriwatanakul A, Lester L, Bull F C, Rosenberg M. “Are Thai children and youth sufficiently active? prevalence and correlates of physical activity from a nationally representative cross-sectional study”. Inter J Behav Nutr Phys Act. 2017;14(1):72. doi: 10.1186/s12966-017-0529-4.

El Halal CDS, Nunes ML. Sleep and weight-height development. J Pediatr (Rio J). 2019;95 Suppl 1:2-9. doi: 10.1016/j.jped.2018.10.009.

Gebru NW, Gebreyesus SH, Yirgu R, Habtemariam E, Abebe DS. The relationship between caregivers' feeding practices and children's eating behaviours among preschool children in Ethiopia. Appetite. 2021;157:104992. doi: 10.1016/j.appet.2020.104992.

Zhuge Y, Qian H, Zheng X, Huang C, Zhang Y, Li B, et al. Effects of parental smoking and indoor tobacco smoke exposure on respiratory outcomes in children. Sci Rep. 2020;10(1):4311. doi: 10.1038/s41598-020-60700-4.

Tongtee T, Srisorrachatr S, Rawiworrakul T. Factors related to eating patterns among stunting children age 10-12 years. Journal of Health Education. 2018;41(1):138-53. (in Thai).

Fikawati S, Syafiq A, Ririyanti K, Gemily C. Energy and protein intakes are associated with stunting among preschool children in Central Jakarta, Indonesia: a case-control study. Malays J Nutr. 2021;27(1):81-91. doi: 10.31246/mjn-2020-0074.

Department of Health, Ministry of Public Health. Food consumption behavior assessment form [Internet]. Nonthaburi: Department of Health; 2024 [cited 2024 Jul 12]. Available from https://nutrition2.anamai.moph.go.th/th/book/206999. (in Thai).

Kowalski KC, Crocker PRE, Donen RM. The physical activity questionnaire for older children (PAQ-C) and adolescents (PAQ-A) manual. Saskatchewan: College of Kinesiology, University of Saskatchewan; 2004. 37 p.

Pratanaphon S, Longlalerng K, Jitmana J, Chaikla K, Nankanya T, Pirunsan U, et al. Content validity and psychometric characteristics of the Thai translated version of the physical activity questionnaire for children (PAQ-C) and adolescents (PAQ-A). Journal of Associated Medical Sciences. 2020;53(3):84-91. doi: 10.14456/jams.2020.21. (in Thai).

Singh R, Upadhyai N, Ohri P, Luthra M. Assessment of nutritional and physical activity status of children in a selected school of district Dehradun. Int J Community Med Public Health. 2020;7(2). doi: 10.18203/2394-6040.ijcmph20200443.

Cao S, Xie M, Jia C, Zhang Y, Gong J, Wang B, et al. Household second-hand smoke exposure and stunted growth among Chinese school-age children. Environ Technol Innov. 2022;27:102521. doi: 10.1016/j.eti.2022.102521.

Thienphuridej T, Sangperm P, Sanasutthiphun W. A comparative study of parental factors between thin and normal pre-school children in Warinchamrap District, Ubonratchathani Province. Journal of Nursing Science and Health. 2019;42(3):75-83. (in Thai).

Bureau of Nutrition, Department of Health, Ministry of Public Health. Dietary reference intake for Thais 2020 [Internet]. Bangkok: A.V. Progessive Ltd., Part; 2020 [cited 2024 Jul 24]. Available from https://www.thaidietetics.org/wp-content/uploads/2020/04/dri2563.pdf. (in Thai).

Gwelo NB, Sumankuuro J, Akintola O, Brieger WR. Factors associated with underweight, overweight, stunting and wasting among primary school-going children participating in a school health initiative in South Africa. BMC Nutr. 2023;9(1):119. doi: 10.1186/s40795-023-00778-x.

Qureshi S, Iqbal M, Rafiq A, Ahmed H, Malik T, Kalam MN, et al. Dietary habits and physical activity patterns in relation to nutritional status among school-aged children in Pakistan: a cross-sectional study. AIMS Public Health. 2023;10(3):553-67. doi: 10.3934/publichealth.2023039.

Koa TB, Seah JX, Ong JW, Lo JC. Short sleep duration in school-age children: differential factors on weekdays and weekends. Behav Sleep Med. 2023;21(6):774-86. doi: 10.1080/15402002.2022.2164001.

Dranesia A, Wanda D, Hayati H. Pressure to eat is the most determinant factor of stunting in children under 5 years of age in Kerinci region, Indonesia. Enfermería Clínica. 2019;29(2):81-6. doi: 10.1016/j.enfcli.2019.04.013.

Morowatisharifabad MA, Khankolabi M, Mozaffari-Khosravi H, Fallahzade H, Gerami MH, Salehi-Abargouei A. Parenting style, parental feeding practices and children’s nutritional status in authoritative parenting style model: a structural equation modeling. The Iranian Red Crescent Medical Journal. 2017;19(3):e41401. doi: 10.5812/ircmj.41401.