Junk Food Consumption and Effects on Growth Status among Children Aged 6-24 Months in Mashhad, Northeastern Iran

Abstract

Introduction
Junk food, due to the lack of vitamins, minerals and trace amounts of energy and protein, there is the risk that the child's stomach filled and by reducing her/his appetite, reduce the chance of nutritious foods. So it is necessary to determine the relationship between using of junk food with growth rate in children.
Materials and Methods
This cross-sectional descriptive-analytic study was conducted on 300 mothers and their babies
, who were referring to 10 selected Mashhad health-care centers for monitoring their 6-24 months children. Participants were selected by cluster and simple random sampling and valid and reliable questionnaire was used to collect data. Data were analyzed by descriptive- analytic statistics and using SPSS version 16.
Results
In growth chart, 86.7 percent of children showed appropriate growth, 10.3 percent had delayed growth and 3 percent had horizontal growth curve. In 11.3 percent of families, the junk food has been used for children regularly, 44.7 percent did not believe in these snacks and 44 percent of mothers sometimes used this junk food for their children. Results showed the statistical correlation between junk food consumption and growth status of children was significant, so children whom haven’t had junk food, have grown more favorable than the other kids (P<0.05).
Conclusion
Use snacks interfere with the child's growth. Junk food consumption among the study population was high relatively. Mothers need to be aware of the effects of junk food to children's development.

Full text

Int J Pediatr, Vol.3, Serial No.20, Aug 2015 809
Original Article (Pages:809 -814)
http:// ijp.mums.ac.ir
Junk Food Consumption and Effects on Growth Status among
Children Aged 6-24 Months in Mashhad, Northeastern Iran
*Rahim Vakili
1
1, Mohammad Ali Kiani1, Masumeh Saeidi2, Bibi Leila Hoseini3, Mansoure
Alipour Anbarani4
1Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3Midwifery MSc, Instructor, Midwifery Department, Sabzevar University of Medical Sciences, Sabzevar, Iran.
4Students Research Committee, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
Introduction
Junk food, due to the lack of vitamins, minerals and trace amounts of energy and protein, there is the
risk that the child's stomach filled and by reducing her/his appetite, reduce the chance of nutritious
foods. So it is necessary to determine the relationship between using of junk food with growth rate in
children.
Materials and Methods
This cross-sectional descriptive-analytic study was conducted on 300 mothers and their babies
, who were referring to 10 selected Mashhad health-care centers for monitoring their 6-24 months
children. Participants were selected by cluster and simple random sampling and valid and reliable
questionnaire was used to collect data. Data were analyzed by descriptive- analytic statistics and using
SPSS version 16.
Results
In growth chart, 86.7 percent of children showed appropriate growth, 10.3 percent had delayed growth
and 3 percent had horizontal growth curve. In 11.3 percent of families, the junk food has been used
for children regularly, 44.7 percent did not believe in these snacks and 44 percent of mothers
sometimes used this junk food for their children. Results showed the statistical correlation between
junk food consumption and growth status of children was significant, so children whom haven’t had
junk food, have grown more favorable than the other kids (P<0.05).
Conclusion
Use snacks interfere with the child's growth. Junk food consumption among the study population was
high relatively. Mothers need to be aware of the effects of junk food to children's development.
Key Words: Children, Growth status, Junk food, Mashhad.
* Corresponding Author:
Masumeh Saeidi, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran.
Email: Masumeh_Saeedi@yahoo.com
Received date: Jun 15, 2015; Accepted date: Jul 22, 2015

Junk food and Children Growth
Int J Pediatr, Vol.3, Serial No.20, Aug 2015 810
Introduction
Present children are the investments of
community in the future. The present
physical and psychotic health prepares
them for managing future society.
Accurate nutrition in the 2 first years of
life will be the most important factor in
preparing health, growth and development
of children in the future. In the third world
countries, mortality of children under 5
years includes significant rate of total
mortality. The most important factor of
mortality in these groups include:
respiratory infections, diarrhea diseases
and malnutrition. Children who had
improper nutrition, would be more ill and
their disease would be longer. Growth rate in
primary years of life and lack of necessary
knowledge about proper nutrition of child
are influencing factors in malnutrition
incidence in children under 5 year. Children,
who had improper and insufficient diet in
the first years of life, had lower IQ and were
unable to do their homework in school
(1, 2).
Assessments showed that Iranian children
have appropriate birth weight, but they
lose their weight slowly between 4-6
months of life. This is probably due to
child's need to supplementary food,
inappropriate pattern of supplementary
nutrition and inaccurate habits of nutrition.
Weight loss continues till 18 months of life
due to insufficient health care and lack of
necessary knowledge, after that although
increasing weight parallels to reference
percentile, growth curve always passes in
lower level than middle curve (3).
Consuming a healthy diet throughout the
life course helps prevent malnutrition in all
its forms as well as a range of
noncommunicable diseases and conditions.
But the increased production of processed
food, rapid urbanization and changing
lifestyles have led to a shift in dietary
patterns. People are now consuming more
foods high in energy, fats, free sugars or
salt/sodium; and many do not eat enough
fruit, vegetables and dietary fiber such as
whole grains. The exact make-up of a
diversified, balanced and healthy diet will
vary depending on individual needs (e.g.
age, gender, lifestyle and degree of
physical activity), cultural context, locally
available foods and dietary customs. But
the basic principles of what constitutes a
healthy diet remain the same (4, 5).
Infants and young children
In the first 2 years of a child’s life, optimal
nutrition fosters healthy growth and
improves cognitive development. It also
reduces the risk of becoming overweight
or obese and developing NCDs later in
life. Advice on a healthy diet for infants
and children is similar to that for adults,
but the following elements are also
important:
 Infants should be breastfed
exclusively during the first 6
months of life.
 Infants should be breastfed
continuously until 2 years of age
and beyond.
 From 6 months of age, breast milk
should be complemented with a
variety of adequate, safe and
nutrient dense complementary
foods. Salt and sugars should not
be added to complementary foods.
As a result of changing dietary patterns in
recent decades, nutritious snacks are
substituted by junk food. Television
advertising, attractive packaging, and lack
of parental awareness are the major cause
of junk food consumption (7, 8). In this
regard, physicians and health care givers
and more importantly mothers should have
deep and sufficient understanding and
knowledge about different stages of
children growth and development and their
influencing factors. So this study aimed to

Vakili et al.
Int J Pediatr, Vol.3, Serial No.20, Aug 2015 811
assess the relationship between using junk
food with growth status of children.
Materials and Methods
This cross-sectional descriptive-
analytic study was conducted on mothers
and their babies who were referring to
Mashhad health-care centers for
monitoring their 6-24 months infants. The
sample size according to previous studies
in this area calculated 300 mothers (9).
Participants were selected by cluster and
simple random among 10 selected health-
care centers. 30 mothers entered the study
randomly in each health care center.
This study was approved by the Research
Ethics Committee of Mashhad University
of Medical Sciences. The researchers were
referring to the research settings and after
coordination with the center’s manager,
introduced the research for the participants
and obtained informed consents. Then they
obtained required data by completing
research tools. Research tool was a reliable
and valid questionnaire which was
confirmed by content validity and internal
consistency Cronbach's alpha (α=0.86)
reliability.
The questionnaire consists of 2 parts: A:
personal characteristics and demographic
information, and B: questions relating to
knowledge assessment about influencing
factors on child growth. After gathering
data, they were coded and analyzed by
descriptive and analytic test such as:
ANOVA, t-test, chi-square statistics and
confidence interval 95% by SPSS-16.
P<0.05 was considered significant.
Results
A total of 300 mothers who had children
aged 6 to 24 months, participated in this
study. 49% of the sample size’s children
were male and 51% were female.
Educational levels of mother were as
follows: 15.3% primary education, 16.3%
junior education, 50% high school
graduates and 18.3% university education.
Families size were as follows: 45.7% of
families had one child, 46% 2 children,
7.3% 3 children and 1% of families had
more than 3 children. Child nutrition status
was as follows: 77.3% breastfeeding, 5.3%
artificial milk, 11% breast milk and cow,
and 6.3% breast milk and artificial baby
food. Table.1, shows the frequency of
participants' demographic variables.
Results showed in 11.3 percent of families,
the junk food has been used for children
regularly, 44.7 percent did not believe in
these snacks and 44 percent of mothers
sometimes used this junk food for their
children, also, 66.8% of mothers using
junk food for children once a day, 31.9%
twice a day and 1.1% using junk food
three times a day. Growth status of
children was as follows: Optimal growth
in 86.7 percent, low growth in 10.3 percent
and 3 percent had horizontal growth curve.
1.3 percent of children weighted less than
2,500 grams (g) and 98.7 percent more
than 2500 g. 35% of mothers started
supplemental feeding before 6 months and
65% after 6 months.
There was a significant correlation
between the consumption of junk food
with children's growth, so the prevalence
of growth retardation was more
extensively in children who ate snacks
(P<0.01) (Table.2). Results showed using
the junk food consumption, were more in
mothers with primary education than the
others (P<0.01) (Table.3). There was a
significant relationship between use of junk
food and maternal referring to health care
centers for child growth monitoring of their
babies, so mothers with diploma level more
than other mothers used drops for children
(iron and multivitamin) (P<0.001), (Table.4).

Junk Food and Children Growth
Int J Pediatr, Vol.3, Serial No.20, Aug 2015 812
Table 1: Frequency of demographic variables in participating mothers
Variables
Frequency
Percent
Child growth status
Desirable
Growth retardation
Horizontal
260
31
9
86.7
10.3
3
Mother's literacy
Primary
Junior high school
High school
Academic
46
49
150
55
15.3
16.3
50
18.3
Family income
Low
Moderate
good
Very good
41
248
11
13.7
82.7
3.7
4
Baby's birth ranking
first
second
third
3 <
157
121
19
3
52.3
40.3
6.3
1
Table 2: Distribution of use of junk food consumption in children according to maternal literacy levels
State growth
percentiles
Using junk food
Total
Number (%)
Yes
Number (%)
No
Number (%)
Sometimes
Number (%)
Good
27(10.4)
120(46.2)
113(43.5)
260(100)
Gowth delay
7(22.6)
5(16.1)
19(61.3)
31(100)
Horizontal
0
9(100)
0
9(100)
Total
34(11.3)
134(44.7)
132(44)
300(100)
P value< 0.001.
Table 3: Distribution of use of junk food consumption in children according to maternal literacy levels
Using junk
food
Maternal education
Total
Primary
education
Junior high
school
Diploma
Academic
Yes
10(29.4%)
0
20(58.8%)
4(11.8%)
34(100%)
No
19(14.2%)
7(5.2%)
65(48.5%)
43(32.1%)
134(100%)
Sometimes
17(15.3%)
42(31.8%)
65(49.2%)
8(6.1%)
132(100%)
Total
46(15.3%)
49(16.3%)
150(50%)
55(18.3%)
300(100%)
P value< 0.001.

Vakili et al
Int J Pediatr, Vol.3, Serial No.20, Aug 2015 813
Table 4: Frequency of mothers referring to
health care centers for child growth monitoring
according to using junk food
Using junk
food for
child
Participate in training
classes
Total
Yes
No
Sometimes
Yes
19
(55.9)
13
(38.2)
2
(5.9)
34
(100)
No
58
(43.3)
41
(30.6)
35
(26.1)
134
(100)
Sometimes
26
(19.7)
69
(52.3)
37
(28)
132
(100)
Total
103
(34.3)
123
(41)
74
(24.7)
300
(100)
P<0.01
Discussion
In the present study, 11.3% of mothers
had been used junk food for their children
on a regular basis and 44% had been used
junk food for sometimes. Since brain
growth after fetal period occurs most in the
first year of life, the importance of
appropriate and accurate nutrition in
children's growth, mental and physical
health, learning and their efficacy is
undeniable. So it is necessary to consider
more importance to nutrition and nutrient
types which are available for children in
order to preparing children security and
health (1, 2, 4). This study showed that the
consumption of junk foods in the diet of
children less than 2 years is high and with
increasing age, it is also increasing. The
potential consequences of excessive
consumption of junk food is nutritional
deficiencies, obesity, or both of them (2,
10, 11). Studies have shown feeding early
in life, played a major role in shaping
children's tastes and food habits to saline,
can be a risk factor for hypertension in
adulthood (2, 7). Dental problems are one
of the side effects of sugar snacks (2, 7).
On the other hand, based on scientific
literature, junk food which often contain
large amounts of fat, calorie and high
energy density, can be one of the causes of
obesity (1, 2, 7), also, the presence of
preservatives and chemical additives are
often added to junk food, provides grounds
allergies in children (2). The present
study's findings showed a significant
relationship between parents' literacy
level and using junk food for children.
This finding is in accordance with
Halakouyi's findings (12).
Our findings showed no significant
relationship between birth weight, age of
initiating supplementary nutrition and
child gender with children growth status,
which is inconsistent with Alavi Naeini's
findings about child gender and family
income (13) and Keighobadi's findings
about birth weight (14), and Teimouri's
findings about adding oil to child's food
(15), and Kabiri's study about child gender
and economic status (16). The present
study showed that 34.3% of mothers had
been participating in the educational
programs of health care centers regularly,
which is inconsistent with Barzegar's
findings who reported just 2.3% of
families attended in these programs (17).
These differences may be due to the
presentation of new and various
information by a modern educational
method in health care centers of Mashhad,
and more interest of mothers to these
programs.
Conclusion
The consumption of junk foods to
children studied was relatively high. Due
to the adverse effects of junk foods, the
necessity for research to examine the
strengthening of educational programs to
promote the use of traditional snacks
nutrition, is clear. The point is that
educational for mothers, should be
considered that junk food which are used
among meal, should be nutrition and

Junk Food and Children Growth
Int J Pediatr, Vol.3, Serial No.20, Aug 2015 814
healthy for children. Healthy eating means
eating a variety of foods so that the child
gets the nutrients (such as protein,
carbohydrate, fat, vitamins, and minerals)
he or she needs for normal growth. If the
child regularly eats a wide variety of basic
foods, he or she will be well-nourished.
Acknowledgment
The researchers appreciate the
cooperation of all staff of 10 Mashhad
Health Care Centers (Shahid Ghodsi, Shahid
Motahhari, Khaje rabi center, Danesh
amouz, Abo Bargh, Shahid Saffari,
Alteimour, Chahar dah Ma'soum, Emam
Hasan Mojtaba, Shahid Hashrmi Nejad) and
dear participating mothers.
Conflict of interest: None.
References
1. Robert M Kliegman. Nelson Textbook of
Pediatrics. 18th Edition & Atlas of Pediatric
Physical Diagnosis. Philadelphia:W.B. Saunders
Company; 2007.
2. Vakili R. Child Development. Mashhad:
Mashhad University of Medical Sciences; 2006.
3. Ministry of Health and Medical Education in
collaboration with United Nations Children's
Fund (UNICEF). Children feeding systems in
the province.Tehran: Ministry of Health and
Medical Education; 2000.
4. Hooper L, Abdelhamid A, Moore HJ,
Douthwaite W, Skeaff CM, Summerbell CD.
Effect of reducing total fat intake on body
weight: systematic review and meta-analysis
of randomised controlled trials and cohort
studies. BMJ 2012; 345: e7666.
5. Comprehensive implementation plan on
maternal, infant and young child nutrition.
Geneva: World Health Organization; 2014.
6. World Health Organization. Healthy diet.
Available at:
http://www.who.int/mediacentre/factsheets/fs3
94/en/. Assessed in May 2015.
7. Sayayri A, Sheykholeslam R, Naghavi M,
Kolahdouz F, Abdollahi Z. Surveying the
amount of junk food consumption in under-3-
year-old children of rural and urban areas, 1998 .
KAUMS Journal ( FEYZ ) 2002; 6 (1) :71-5.
8. Darvishi L, Ghiasvand R, Ashrafi M,
Ashrafzadeh E, Askari G, Shiranian A, et
al.Relationship between junk foods intake and
weight in 6-7 years old children, Shahin Shahr
and Meymeh, Iran. J Educ Health Promot
2013; 2 (3):2-5.
9. Saeidi M, Vakili R, Khakshour A,
Taghizadeh Moghaddam H, Kiani MA. Iron
and Multivitamin Supplements in Children and
its Association with Growth rate. Int J Pediatr
2013: 1(1): 13-17.
10. Saeidi Z, Vakili R, Ghazizadeh Hashemi
Ah, Saeidi M. The Effect of Diet on Learning
of Junior High School Students in Mashhad,
North-east of Iran. Int J Pediatr 2015;3(2.2):
517-26.
11. Hoseini BL, Vakili R, Khakshour A,
Saeidi M, Zarif B, Nateghi S. Maternal
Knowledge and Attitude toward Exclusive
Breast Milk Feeding (BMF) in the First 6
Months of Infant Life in Mashhad. Int J
Pediatr 2014; 2(1): 63-9.
12. Holakouie Naieni K, Fotouhi A, Borhani M,
Pooya B. Risk Factors for Malnutrition in 6- to
30-Months Old Children Seen at Health Centers
in Hormozgan Province. irje 2006; 1 (3 and 4) :
27-32.
13. Alavi Naeini M. Prevalence of malnutrition
and factors affecting in children under five in
health house covers the city of Birjand. TUMJ
2000; 59(1): 99-103.
14. Keighobadi K, Siasi F, Malekafzali H,
Jarolahi N, Sadrzadeh H. The effect of maternal
education on nutritional status of marginalized
families in Kerman. Hakim 2000; 5(1): 49-55.
15. Teimuri P, Rashadmanesh N. The effect of
nutrition knowledge of mothers of children 2-0
years of growth in women attending urban health
centers in Kurdestan. SJKU 1999; 2(7): 20-25.
16. Kabiri M, Parsinia M, Godarzi M, Babaei
GR. Study of relationship between physical
growth of children 0 to 2 years old were referred
to health centers in the city of Karaj with
economic, social, cultural in parents with using a
logistic regression model. Iran J Pediatr 2004;
13(1): 47-52.
17. Barzegar M, Amini A, Hanaei J, Yaghubi
AR, Sadr K, Mohammadzadeh H. Knowledge,
attitude and practice of mothers living in North
West Iran about Care children under 6 years.
MJTUOMS 2000; 59(3): 23-8.