Milk products in the dietary management of childhood undernutrition - a historical review.

The present narrative review outlines the use of milk products in infant and young child feeding from early history until today and illustrates how research findings and technical innovations contributed to the evolution of milk-based strategies to combat undernutrition in children below the age of 5 years. From the onset of social welfare initiatives, dairy products were provided by maternal and child health services to improve nutrition. During the last century, a number of aetiological theories on oedematous forms of undernutrition were developed and until the 1970s the dogma of protein deficiency was dominant. Thereafter, a multifactorial concept gained acceptance and protein quality was emphasised. During the last decades, research findings demonstrated that the inclusion of dairy products in the management of severe acute malnutrition is most effective. For children suffering from moderate acute malnutrition the evidence for the superiority of milk-based diets is less clear. There is an unmet need for evaluating locally produced milk-free alternatives at lower cost, especially in countries that rely on imported dairy products. New strategies for the dietary management of childhood undernutrition need to be developed on the basis of research findings, current child feeding practices, socio-cultural conditions and local resources. Exclusive and continued breast-feeding supported by community-based nutrition programmes using optimal combinations of locally available complementary foods should be compared with milk product-based interventions.

Malnutrition and skin disease in Far East prisoners-of-war in World War II.

During the Second World War, thousands of captured British and Commonwealth troops were interned in prisoner-of-war (POW) camps in the Far East. Imprisonment was extremely harsh, and prisoners developed multiple pathologies induced by physical hardship, tropical infections and starvation. Immediately after the war, several POW doctors published their clinical experiences, including reports of skin disease caused by malnutrition. The most notable deficiency dermatoses seen in Far East POWs were ariboflavinosis (vitamin B2 or riboflavin deficiency) and pellagra (vitamin B3 or niacin deficiency). A lack of vitamin B2 produces a striking inflammatory disorder of scrotal skin. Reports of pellagra in POWs documented a novel widespread eruption, developing into exfoliative dermatitis, in addition to the usual photosensitive dermatosis. A review of the literature from 70 years ago provides a reminder of the skin's response to malnutrition.

Historical Perspective on the Rise and Fall and Rise of Antibiotics and Human Weight Gain.

In recent medical and popular literature, audiences have been asked to consider whether antibiotics have contributed to the rising obesity epidemic. Prominent magazines have stated that weight may be adversely affected by antibiotics that destroy existing microbiomes and replace them with less helpful ones. However, there is a long history of efforts to investigate the relationship between antibiotics and human weight gain. In the early 1950s, amid initial findings that low doses of antibiotics served as growth promoters in animal livestock, investigators explored the role of antibiotics as magic bullets for human malnutrition. Nevertheless, early enthusiasm was tempered by controlled studies showing that antibiotics did not serve as useful, nonspecific growth promoters for humans. In subsequent decades, against the backdrop of rising concern over antibiotic resistance, investigators studying the role of antibiotics in acute malnutrition have had to navigate a more complicated public health calculus. In a related historical stream, scientists since the 1910s have explored the role of the intestinal microflora in human health. By the 2000s, as increasing resources and more sophisticated tools were devoted to understanding the microbiome (a term coined in 2001), attention would turn to the role of antibiotics and the intestinal microflora in the rising obesity epidemic. Despite scientific and commercial enthusiasm, easy answers (whether about antibiotics or probiotics) have again given way to an appreciation for the complexity of human growth. History encourages caution about our hopes for simplistic answers for presumed "fat drugs" and slimming probiotics alike.

[The fight against malnutrition of the medical community between 1860 and 1940]. / La comunidad médica y su lucha en contra de la desnutrición en Chile (1860-1940).

The aim of this manuscript is to highlight the contribution of the first two generations of physicians who faced malnutrition in Chile, between the end of nineteenth century and the first decades of the twentieth century. In the history of Chilean medicine, there is a paucity of research about the role of these physicians in the fight against malnutrition. The main interest was centered in the forties of the twentieth century and the first policies and actions for the working class feeding have been overlooked. The existence of two pioneering groups that have common elements and differences to face the problem of under nutrition is established.

The Study on the Lives and Health Conditions of Internees in Santo Thomas Camp of Philippines - Based on McAnlis's The War in Manila (1941-1945).

When Japan invaded the Philippines, two missionary dentists (Dr. McAnlis and Dr. Boots) who were forced to leave Korea were captured and interned in the Santo Thomas camp in Manila. Japan continued to bombard and plunder the Philippines in the wake of the Pacific War following the Great East Asia policy, leading to serious inflation and material deficiency. More than 4,000 Allied citizens held in Santo Thomas camp without basic food and shelter. Santo Thomas Camp was equipped with the systems of the Japanese military medical officers and Western doctors of captivity based on the Geneva Conventions(1929). However, it was an unsanitary environment in a dense space, so it could not prevent endemic diseases such as dysentery and dengue fever. With the expansion of the war in Japan, prisoners in the Shanghai and Philippine prisons were not provided with medicines, cures and food for healing diseases. In May 1944, the Japanese military ordered the prisoners to reduce their ration. The war starting in September 1944, internees received 1000 kcal of food per day, and since January 1945, they received less than 800 kcal of food. This was the lowest level of food rationing in Japan's civilian prison camps. They suffered beriberi from malnutrition, and other endemic diseases. An averaged 24 kg was lost by adult men due to food shortages, and 10 percent of the 390 deaths were directly attributable to starvation. The doctors demanded food increases. The Japanese Military forced the prisoner to worship the emperor and doctors not to record malnourishment as the cause of death. During the period, the prisoners suffered from psychosomatic symptoms such as headache, diarrhea, acute inflammation, excessive smoking, and alcoholism also occurred. Thus, the San Thomas camp had many difficulties in terms of nutrition, hygiene and medical care. The Japanese military had unethical and careless medical practices in the absence of medicines. Dr. McAnlis and missionary doctors handled a lot of patients focusing mainly on examination, emergency treatment and provided the medical services needed by Philippines and foreigners as well as prisoners. Through out the war in the Great East Asia, the prisoners of Santo Thomas camp died of disease and starvation due to inhumane Japanese Policy. Appropriate dietary prescriptions and nutritional supplements are areas of medical care that treat patients' malnutrition and disease. It is also necessary to continue research because it is a responsibility related to the professionalism and ethics of medical professionals to urge them to observe the Geneva Convention.

Early-life conditions and adult mortality decline in Dutch cohorts born 1812-1921.

Mounting evidence suggests that early-life conditions have an enduring effect on an individual's mortality risks as an adult. The contribution of improvements in early-life conditions to the overall decline in adult mortality, however, remains a debated issue. We provide an estimate of the contribution of improvements in early-life conditions to mortality decline after age 30 in Dutch cohorts born between 1812 and 1921. We used two proxies for early-life conditions: median height and early-childhood mortality. We estimate that improvements in early-life conditions contributed more than five years or about a third to the rise in women's life expectancy at age 30. Improvements in early-life conditions contributed almost three years or more than a quarter to the rise in men's life expectancy at age 30. Height appears to be the more important of the two proxies for early-life conditions.

Bone porosity and longevity in early medieval Southern Croatia.

Porosity of the skull and skeletal remains, especially of the orbital roof, are one of the most frequent pathological findings on ancient human skeletal remains. There are several presumed causes of this condition and anthropologists consider skull porosities as a marker of physical and nutritional stress. A total of 115 graves were discovered at the early-medieval graveyard near Zadar (Croatia) that contained 128 partially preserved skeletons. Average estimated age at death was 37.2 ± 12.6 years for men, 31.9 ± 13.9 for women, and 5.3 ± 3.6 years for subadults. Pathological bone porosity was analysed. Cribra orbitalia was observed on 21 skulls (28.7%), signs of temporal porosity were noticed on six skulls and signs of subperiosteal bleeding on three skulls. Nineteen skulls had bone porosities in other areas. There was a significant difference (p = 0.039) in achieved age of adults with and without cribra orbitalia as those with cribra orbitalia lived on average 8.1 years longer. The bone porosity was probably caused by malnutrition that might have had a beneficial effect on longevity of adults, similar to effects of restricted food intake on extending lifespan through epigenetic signatures influencing gene expression.

A brief history of fatal child maltreatment and neglect.

Child abuse encompasses four major forms of abuse: physical abuse, sexual abuse, psychological abuse, and neglect. The United States retains one of the worst records of child abuse in the industrialized world. It has also been determined that a large portion of these cases are missed and go undocumented in state and federal reporting agencies. In addition, disparate risk factors have been identified for physical abuse and neglect cases, but substance abuse has been found to be a significant factor in all forms of abuse. Fatal child maltreatment and neglect investigations require a multi-pronged and multidisciplinary approach requiring the coordination and information gathering from various agencies. A major difficulty in determining the accidental or non-accidental nature of these cases is that the account surrounding the events of the death of child is acquired from the caretaker. In this review, we outline common diagnostic characteristics and patterns of non-accidental injuries and neglect as a result of nutritional deprivation.

[Traditional diet in Southern Italy, between myth and reality]. / L'alimentazione tradizinale nel Meridione d'Italia, tra mito e realtà.

"Mediterranean diet" is commonly defined as a type of diet based on traditional foods of the Southern Italian regions, assuming that in the past the southern populations enjoyed a balanced and healthy diet. In fact, up to the middle of the twentieth century, widespread poverty in large parts of the population led to malnutrition due to lack of calories and essential nutrients. Only among the upper classes consumption of food was reasonable and respectful of the recommendations of the "Mediterranean diet pyramid". The fact remains that many traditional dishes can be recommended because they are well balanced on nutrients, tasty and appetizing.

On hunger and child mortality in India.

Despite accelerated growth there is pervasive hunger, child undernutrition and mortality in India. Our analysis focuses on their determinants. Raising living standards alone will not reduce hunger and undernutrition. Reduction of rural/urban disparities, income inequality, consumer price stabilization, and mothers' literacy all have roles of varying importance in different nutrition indicators. Somewhat surprisingly, public distribution system (PDS) do not have a significant effect on any of them. Generally, child undernutrition and mortality rise with poverty. Our analysis confirms that media exposure triggers public action, and helps avert child undernutrition and mortality. Drastic reduction of economic inequality is in fact key to averting child mortality, conditional upon a drastic reordering of social and economic arrangements.

Infectious disease and nutritional deficiencies in early industrialized South Africa.

OBJECTIVE: Real industrialization was late to arrive in South Africa and was associated with the development of mining in its northern regions. This paper explores the development and spread of infectious diseases (particularly tuberculosis), against the backdrop of metabolic disease. MATERIALS: Published data regarding skeletons from various mining sites and historical information are collated, including information from the early accessions into the Raymond A. Dart Collection. METHODS: While findings from several sites (e.g., Gladstone at Kimberley, Koffiefontein, Witwatersrand Deep Mine and Lancaster Mine) have been described individually, they have not been assessed collectively. This paper provides a broad overview by collating information from these sites, in comparison with a rural, pre-industrialized population. RESULTS: Malnutrition, including scurvy, was common in most mining groups. Tuberculosis was rare in earlier mining groups, and the first possible skeletal cases only occurred after the establishment of closed housing compounds. From there it spread rapidly across the subcontinent. CONCLUSIONS: Nutritional insufficiencies / metabolic disease and high death rates, due to trauma and infectious diseases, were common. Tuberculosis in South Africa is closely associated with development of the mining industry. SIGNIFICANCE: This research highlights the development of tuberculosis in South Africa and its association with the mining industry. The role of migrant labor and the associated housing practices is elucidated. LIMITATIONS: Sample sizes are limited, but the findings of this study are supported by documentary evidence. FUTURE RESEARCH: Sample sizes should be increased, and the association between closed compound living and the development of disease further explored.

Adolescent birth and child undernutrition: an analysis of demographic and health surveys in Bangladesh, 1996-2017.

Adolescent birth is a major global concern owing to its adverse effects on maternal and child health. We assessed trends in adolescent birth and examined its associations with child undernutrition in Bangladesh using data from seven rounds of Demographic and Health Surveys (1996-2017, n = 12,006 primiparous women with living children <5 years old). Adolescent birth (10-19 years old) declined slowly, from 84% in 1996 to 71% in 2017. Compared with adult mothers (≥20 years old), young adolescent mothers (10-15 years old) were more likely to be underweight (+11 pp), have lower education (-24 pp), have less decision-making power (-10 pp), live in poorer households (-0.9 SD) with poorer sanitation (-15 pp), and have poorer feeding practices (10 pp), and were less likely to access health and nutrition services (-3 to -24 pp). In multivariable regressions controlled for known determinants of child undernutrition, children born to adolescents had lower height-for-age Z-scores (-0.29 SD for young and -0.10 SD for old adolescents (16-19 years old)), weight-for-age Z-score (-0.18 and -0.06 SD, respectively) as well as higher stunting (5.9 pp) and underweight (6.0 pp) than those born to adults. In conclusion, birth during adolescence, a common occurrence in Bangladesh, is associated with child undernutrition. Policies and programs to address poverty and improve women's education can help delay marriage, reduce early childbearing, and improve child growth.

Re-examining chemically defined liquid diets through the lens of the microbiome.

Trends in nutritional science are rapidly shifting as information regarding the value of eating unprocessed foods and its salutary effect on the human microbiome emerge. Unravelling the evolution and ecology by which humans have harboured a microbiome that participates in every facet of health and disease is daunting. Most strikingly, the host habitat has sought out naturally occurring foodstuff that can fulfil its own metabolic needs and also the needs of its microbiota, each of which remain inexorably connected to one another. With the introduction of modern medicine and complexities of critical care, came the assumption that the best way to feed a critically ill patient is by delivering fibre-free chemically defined sterile liquid foods (that is, total enteral nutrition). In this Perspective, we uncover the potential flaws in this assumption and discuss how emerging technology in microbiome sciences might inform the best method of feeding malnourished and critically ill patients.