Marife D. Sevilla, RND, MSc, Cecile Leah T. Bayaga, RND, PhD, Maria Sofia V. Amarra, RND, PhD, Ebner Bon G. Maceda, MD, Francisco N. De Los Reyes, MSc, Leniza de Castro-Hamoy, MD, MSGC

Relationship of Filipino MSUD Children’s Nutrient Intake, Nutritional Status, and Leucine Level, and Caregiver's Nutrition Knowledge, Attitudes, and Practices

Introduction

Relationship of filipino msud children’s nutrient intake, nutritional status, and leucine level, and caregiver's nutrition knowledge, attitudes, and practices. Study reveals how caregiver nutrition knowledge, attitudes & practices affect Filipino MSUD children's nutrient intake, status, and leucine levels. Critical for diet compliance.

Abstract

Background and Objectives. Diet compliance is critical in managing Maple Syrup Urine Disease (MSUD) to prevent physiological and neurological damage. However, there is a lack of studies looking at factors critical to diet compliance. This study determined the caregivers’ nutrition knowledge, attitudes, and feeding practices (KAP); and its relationship to Filipino MSUD children’s leucine level, nutritional status, and nutrient intake. Methods. A cross-sectional, sequential explanatory research approach using survey was utilized. Data tools were questionnaires and food records. Results. The participants were 20 caregivers and 21 MSUD children (aged 6 to 83 months). Caregivers had moderately high feeding practices and knowledge scores and had positive attitudes towards providing adequate nutritional care; still, they were struggling with diet compliance. Their nutrition knowledge was related to their attitude (p-value: 0.021), feeding practices (p-value: 0.037), and their children’s weight-for-age (p-value: 0.036). Furthermore, knowledge and feeding practices were related to the children’s natural-protein status (p-value: 0.043 and 0.006, respectively). The caregivers’ sex was related to the children’s leucine (p-value=0.010), those with female caregivers had lower leucine by 470 μmol/L on average. Moreover, children with good leucine control belonged to higher-income households (p-value=0.049). Conclusion. With caregiver's nutrition knowledge having been possibly associated with the children’s weight-forage, and their knowledge and feeding practices with the children's natural protein status, as well as knowledge positively affecting both attitude and feeding practice, interventions for improving all caregivers’ nutrition knowledge and feeding practices are recommended. Additionally, with caregivers’ sex and income having been found to be related to metabolic control, it is suggested that strategies to better manage these barriers be carried out. These may include improving support for male caregivers, with children under their care having higher leucine than those cared for by their female counterparts. Added provisions may likewise be planned for further reducing the impact of income-related barriers.

Review

This study provides valuable initial insights into the complex interplay of caregiver factors and outcomes in Filipino children with Maple Syrup Urine Disease (MSUD), a critical area given the life-long dietary demands of the condition. By exploring the relationships between caregiver nutrition knowledge, attitudes, and feeding practices (KAP) and children's leucine levels, nutritional status, and nutrient intake, the research sheds light on potential points of intervention. The finding that caregiver nutrition knowledge is associated with both their attitude and feeding practices, as well as the child's weight-for-age and natural protein status, underscores the fundamental role of education. Furthermore, the identification of caregiver sex and household income as significant factors influencing metabolic control offers a more nuanced understanding of the challenges faced, particularly highlighting potential disparities in support needs. Despite its valuable contribution, the study is limited by several methodological considerations. The relatively small sample size of 20 caregivers and 21 children raises concerns about the generalizability of the findings and the statistical power to detect robust associations. While the abstract mentions a "cross-sectional, sequential explanatory" approach, the inherent nature of cross-sectional design means that causal relationships cannot be definitively established, only associations. The abstract notes that caregivers, despite moderately high KAP scores, were "struggling with diet compliance," which warrants further qualitative exploration to understand the specific barriers they face beyond what quantitative scores might capture. Additionally, relying solely on self-reported questionnaires and food records carries the risk of recall and social desirability biases, which could influence the accuracy of the KAP and nutrient intake data. Nevertheless, this study lays important groundwork for future research and targeted interventions. The recommendations to improve caregiver nutrition knowledge and feeding practices are well-founded, aligning with the identified associations. Critically, the findings related to caregiver sex and household income demand practical, socio-culturally sensitive strategies, such as developing tailored support programs for male caregivers and addressing income-related barriers to optimal MSUD management in the Philippines. Future studies should aim for larger, more diverse cohorts and employ longitudinal designs to establish causality. Integrating qualitative methods could also provide deeper insights into the "struggles with diet compliance" and the specific challenges faced by different caregiver groups, ultimately informing more effective and equitable support systems for children with MSUD and their families.

Full Text

Comments

You need to be logged in to post a comment.