{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:59:41Z","timestamp":1785405581104,"version":"3.56.0"},"reference-count":46,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Universidad de Las Am\u00e9ricas","award":["577.A.XVII.25"],"award-info":[{"award-number":["577.A.XVII.25"]}]},{"award":["577.A.XVII.25"],"award-info":[{"award-number":["577.A.XVII.25"]}],"id":[{"id":"https:\/\/ror.org\/0198j4566","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010654","name":"Universidad San Francisco de Quito USFQ","doi-asserted-by":"publisher","award":["41991"],"award-info":[{"award-number":["41991"]}],"id":[{"id":"10.13039\/501100010654","id-type":"DOI","asserted-by":"publisher"}]},{"award":["41991"],"award-info":[{"award-number":["41991"]}],"id":[{"id":"https:\/\/ror.org\/01r2c3v86","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"publisher","award":["420148\/2023-0"],"award-info":[{"award-number":["420148\/2023-0"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"award":["420148\/2023-0"],"award-info":[{"award-number":["420148\/2023-0"]}],"id":[{"id":"https:\/\/ror.org\/03swz6y49","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Fundo de Apoio ao Ensino, Pesquisa e Extens\u00e3o da UNICAMP","award":["2198\/25"],"award-info":[{"award-number":["2198\/25"]}]},{"name":"Fundo de Apoio ao Ensino, Pesquisa e Extens\u00e3o da UNICAMP","award":["2621\/25"],"award-info":[{"award-number":["2621\/25"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Chronic undernutrition in the first 1000 days continues to be a significant public health concern in Ecuador. This study examined associations between infant feeding practices, maternal supplementation, socioeconomic factors, and stunting in the first two years of life using explainable machine-learning methods. Methods: The analysis was based on 8613 eligible children aged 0\u201323 months from the Ecuadorian National Child Malnutrition Survey (Encuesta Nacional sobre Desnutrici\u00f3n Infantil, ENDI) 2023\u20132024, of whom 8344 had non-missing stunting status and were included in the final modelling sample. Results: Among the children included in the modelling sample, stunting was observed in 18.7%. Maternal iron and folic-acid supplementation were associated with lower stunting prevalence, while breastfeeding and complementary feeding indicators showed weak linear associations but contributed to model predictions in explainability analyses. SHapley Additive exPlanations (SHAP) additionally highlighted geographic and socioeconomic variation, with province, area of residence, and socioeconomic indicators ranking among the features contributing to model prediction. Predictive performance was modest to moderate across models, with area under the receiver operating characteristic curve (AUC) values ranging approximately from 0.62 to 0.66 across the main model specifications. Model performance remained stronger for the majority non-stunted class than for the minority stunted class, highlighting the challenge of detecting stunted children in an imbalanced analytic ENDI sample. Conclusions: Overall, the results suggest that stunting in the analytic sample was represented by multidimensional predictive patterns involving prenatal, nutritional, socioeconomic, and geographic factors, and illustrate the potential value of explainable machine learning for identifying multidimensional risk patterns in child nutrition research.<\/jats:p>","DOI":"10.3390\/nu18142232","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T10:16:22Z","timestamp":1783592182000},"page":"2232","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Communication and Health in Chronic Childhood Undernutrition: Explainable Ensemble Learning to Identify Dietary Predictors of Infant Feeding Practices and Maternal Supplementation in Ecuador"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1973-0101","authenticated-orcid":false,"given":"Karen","family":"C\u00e1ceres-Ben\u00edtez","sequence":"first","affiliation":[{"name":"School of Science Biological and Engineering, Yachay Tech University, Urcuqu\u00ed 100119, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6999-7664","authenticated-orcid":false,"given":"Ana","family":"Marcillo-Vera","sequence":"additional","affiliation":[{"name":"School of Mathematical and Computational Sciences, Yachay Tech University, Hacienda San Jos\u00e9 s\/n, Urcuqu\u00ed 100119, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9196-335X","authenticated-orcid":false,"given":"Diego","family":"Almeida-Gal\u00e1rraga","sequence":"additional","affiliation":[{"name":"School of Science Biological and Engineering, Yachay Tech University, Urcuqu\u00ed 100119, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5232-7529","authenticated-orcid":false,"given":"Nathaly","family":"Orozco Garz\u00f3n","sequence":"additional","affiliation":[{"name":"ETEL Research Group, Faculty of Engineering and Applied Sciences, Networking and Telecommunications Engineering, Universidad de Las Am\u00e9ricas (UDLA), Quito 170503, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0529-8224","authenticated-orcid":false,"given":"Henry","family":"Carvajal Mora","sequence":"additional","affiliation":[{"name":"Colegio de Ciencias e Ingenier\u00edas \u201cEl Polit\u00e9cnico\u201d, Universidad San Francisco de Quito USFQ, Diego de Robles S\/N, Quito 170157, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2200-3101","authenticated-orcid":false,"given":"Edgar Eduardo","family":"Benitez Olivo","sequence":"additional","affiliation":[{"name":"Department of Communications, School of Electrical and Computer Engineering, University of Campinas (UNICAMP), Campinas 138083-852, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5368-4122","authenticated-orcid":false,"given":"Andr\u00e9s","family":"Tirado-Esp\u00edn","sequence":"additional","affiliation":[{"name":"School of Mathematical and Computational Sciences, Yachay Tech University, Hacienda San Jos\u00e9 s\/n, Urcuqu\u00ed 100119, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2026, May 29). 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