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1.
Pan Afr Med J ; 38: 352, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34367431

RESUMEN

Introduction: despite increasing research interest on Indigenous peoples´ health worldwide, the nutritional status of Indigenous children in Cameroon remains unknown. This study was conducted to assess the prevalence of stunting, wasting, and underweight among under-five Indigenous Mbororo children in the Foumban and Galim health districts of the West Region. Methods: a cross-sectional study was conducted involving 472 child-caregiver pairs from 16 Mbororo Communities in the Foumban and Galim health districts. Interviewer-administered questionnaires were used for data collection. Anthropometric measurements were collected using standard procedures. Socio-demographic data were analyzed using descriptive statistics. Anthropometric indices: height-for-age, weight-for-height, and weight-for-age - z-scores were analyzed using z-score 06 Stata version 11 and compared with World Health Organization growth reference standards. Ethical approval was obtained from the Faculty of Health Sciences Institutional Review Board of the University of Buea. Results: overall prevalence of stunting, wasting and underweight were 55.08% (95% CI: 50.5-59.58), 13.77% (95% CI: 10.65-16.89), and 31.99% (95% CI: 27.76-36.21), respectively. Severe stunting, wasting and underweight were 34.53% (95% CI: 30.22-38.83), 3.18% (95% CI: 1.58-4.76), and 10.59% (95% CI: 7.80-13.37), respectively. Rates of stunting, wasting and underweight for female and male were: 56.88% and 52.71%; 12.38% and 14.72%; and 30.73% and 32.55%, respectively. Stunting, wasting and underweight rates varied with child age. Conclusion: the prevalence of undernutrition was high, indicating a serious public health problem and the necessity for strategies to ensure the optimal health of the target population.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Trastornos del Crecimiento/epidemiología , Delgadez/epidemiología , Síndrome Debilitante/epidemiología , Adolescente , Adulto , Camerún/epidemiología , Trastornos de la Nutrición del Niño/etnología , Preescolar , Estudios Transversales , Femenino , Trastornos del Crecimiento/etnología , Humanos , Pueblos Indígenas , Lactante , Recién Nacido , Masculino , Estado Nutricional , Prevalencia , Distribución por Sexo , Delgadez/etnología , Síndrome Debilitante/etnología , Adulto Joven
2.
Pan Afr Med J ; 38: 374, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34367453

RESUMEN

Introduction: the problem of malnutrition among children is a phenomenon associated with a rapid nutrition transition in Morocco and all developing countries. The objective of this study is to evaluate the nutritional status by anthropometry, food consumption and iron deficiency anemia among primary school children aged 6-12 years in Kenitra city (Morocco). Methods: the survey covered 271 students (55% of boys and 45% girls) aged 6 to 12. Information concerning food consumption patterns, socioeconomic status and other lifestyle factors was obtained using questionnaires and interviews. Anemia was defined when haemoglobin < 11.5 g/dl. Results: the results showed that, 6.3%, 2.2% and 17.3% children were stunted, thin and overweight respectively. No significant association was found between gender and nutritional status of children. 16.2% children were anemic and food consumption found not to be varied and below recommendations. Conclusion: the finding in this study showed that overweight and obesity occurred more frequently than the various forms of under nutrition in the population studied. The finding support the urgent need to improve the nutritional status of children by implementing preventive strategy for the problem of malnutrition among school-aged children.


Asunto(s)
Anemia Ferropénica/epidemiología , Trastornos de la Nutrición del Niño/epidemiología , Conducta Alimentaria , Estado Nutricional , Adolescente , Antropometría , Niño , Femenino , Humanos , Estilo de Vida , Masculino , Marruecos/epidemiología , Obesidad Pediátrica/epidemiología , Factores Socioeconómicos , Estudiantes , Encuestas y Cuestionarios
3.
BMC Pediatr ; 21(1): 332, 2021 07 31.
Artículo en Inglés | MEDLINE | ID: mdl-34332585

RESUMEN

BACKGROUND: Malnutrition is the most common cause of mortality and morbidity of children in low and middle income countries including Ethiopia and household wealth index shares the highest contribution. Thus, in this study it is aimed to conduct bivariate binary logistic regression analysis by accounting the possible dependency of child composite index anthropometric failure and household wealth index. METHODS: In this study the data from Ethiopian Demographic and Health Survey (EDHS) 2016 involved 9411 under five children was considered. Child Composite Index Anthropometric Failure (CIAF) measures the aggregate child undernourished derived from the conventional anthropometric indices (stunting, underweight and wasting). The correlation between CIAF and wealth index was checked and significant correlation found. To address the dependency between the two outcome variables bivariate binary logistic regression was used to analyze the determinants of child CAIF and household wealth index jointly. RESULTS: Study results show that region, place of residence, religion, education level of women and husband/partner, sex of child, source of drinking water, household size and number of under five children in the household, mothers body mass index, multiple birth and anemia level of child had significant association with child CIAF. Female children were 0.82 times less likely to be CIAF compared to male and multiple birth children were more likely to be CIAF compared to single birth. Children from Oromia, Somalie, Gambela, SNNPR, Harari and Addis Ababa region were 0.6, 0.56, 0.67, 0.52, 0.6 and 0.44 times less likely to be CIAF compared to Tigray. A household from rural area were 15.49 times more likely poor compared to a household. The estimated odds of children whose mothers attended primary, and secondary and higher education was 0.82, and 0.52 times respectively the estimated odds of children from mothers who had never attended formal education. CONCLUSION: The prevalence of children with composite index anthropometric failure was high and closely tied with the household wealth index. Among the determinants, region, religion, family education level, and anemia level of child were statistically significant determinants of both CIAF and household wealth index. Thus, the authors recommend to concerned bodies and policymakers work on household wealth index to reduce the prevalence of child composite anthropometric failure.


Asunto(s)
Trastornos de la Nutrición del Niño , Antropometría , Niño , Trastornos de la Nutrición del Niño/diagnóstico , Trastornos de la Nutrición del Niño/epidemiología , Estudios Transversales , Etiopía/epidemiología , Femenino , Humanos , Masculino , Madres
4.
Nutrients ; 13(8)2021 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-34444697

RESUMEN

BACKGROUND: The study aimed to define the burden and underlying risk factors of malnutrition among children with cerebral palsy (CP) in Gorkha district, Nepal. METHODS: The first population-based register of children with CP in Gorkha, Nepal (i.e., Nepal CP Register-NCPR) was established in 2018. Children aged <18 years with confirmed CP were registered following standard protocol. Nutritional status was determined based on anthropometric measurements (height/length, weight, mid-upper-arm-circumference) following WHO guidelines. Descriptive analyses and adjusted logistic regression were completed. RESULTS: Between June-October 2018, 182 children with CP were registered into the NCPR (mean (SD) age at assessment: 10.3 (5.0) years, 37.4% female). Overall, 51.7%, 64.1%, and 29.3% children were underweight, stunted, and thin, respectively. Furthermore, 14.3% of children with CP aged <5 years had severe wasting. Underweight and stunting were significantly higher among children with spastic CP (p = 0.02, p < 0.001) and/or Gross Motor Function Classification System (GMFCS) level (III-V) (p = 0.01, p < 0.001) and/or who were not enrolled in school (p = 0.01, p < 0.001). In adjusted analysis, GMFCS level III-V and non-attendance to school significantly increased the odds of stunting by 8.2 (95% CI 1.6, 40.8) and 4.0 (95% CI 1.2, 13.2) times, respectively. CONCLUSIONS: the high rate of different forms of undernutrition among children with CP in Gorkha, Nepal is concerning. Need-based intervention should be taken as priority to improve their nutritional outcome.


Asunto(s)
Parálisis Cerebral/fisiopatología , Trastornos de la Nutrición del Niño/epidemiología , Trastornos del Crecimiento/epidemiología , Estado Nutricional , Delgadez/epidemiología , Adolescente , Antropometría , Parálisis Cerebral/complicaciones , Niño , Trastornos de la Nutrición del Niño/etiología , Preescolar , Femenino , Trastornos del Crecimiento/etiología , Humanos , Modelos Logísticos , Masculino , Nepal/epidemiología , Evaluación Nutricional , Sistema de Registros , Factores de Riesgo , Índice de Severidad de la Enfermedad , Delgadez/etiología
5.
Nutrients ; 13(8)2021 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-34444887

RESUMEN

Malnutrition continues to threaten the lives of millions across the world, with children being hardest hit. Although inadequate access to food and infectious disease are the primary causes of childhood malnutrition, the gut microbiota may also contribute. This review considers the evidence on the role of diet in modifying the gut microbiota, and how the microbiota impacts childhood malnutrition. It is widely understood that the gut microbiota of children is influenced by diet, which, in turn, can impact child nutritional status. Additionally, diarrhoea, a major contributor to malnutrition, is induced by pathogenic elements of the gut microbiota. Diarrhoea leads to malabsorption of essential nutrients and reduced energy availability resulting in weight loss, which can lead to malnutrition. Alterations in gut microbiota of severe acute malnourished (SAM) children include increased Proteobacteria and decreased Bacteroides levels. Additionally, the gut microbiota of SAM children exhibits lower relative diversity compared with healthy children. Thus, the data indicate a link between gut microbiota and malnutrition in children, suggesting that treatment of childhood malnutrition should include measures that support a healthy gut microbiota. This could be of particular relevance in sub-Saharan Africa and Asia where prevalence of malnutrition remains a major threat to the lives of millions.


Asunto(s)
Trastornos de la Nutrición del Niño/microbiología , Fenómenos Fisiológicos Nutricionales Infantiles , Microbioma Gastrointestinal , Estado Nutricional , Desnutrición Aguda Severa/microbiología , Niño , Preescolar , Diarrea/microbiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino
6.
Nutrients ; 13(7)2021 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-34371805

RESUMEN

Trace elements are vital components for healthy growth, development, and physical activity. The aim of this study was to investigate the relationship between trace element (iron, zinc, copper) deficiencies and picky eating behavior, development level, and physical activity level. This cross-sectional study involved 203 children aged 4-7 years; picky eating behavior, development level, and physical activity level were assessed through questionnaires. Zinc deficiency has the highest prevalence (37.4%); 67.5% of the children were assessed as picky eaters. Children with picky eating behaviors, poor development level, or poor physical activity level have significantly lower zinc levels, and higher prevalence of zinc deficiency. Pearson's correlation coefficient indicated a positive correlation between serum zinc level and development scores (r = 0.221, p = 0.002) and physical activity scores (r = 0.469, p < 0.001). In multivariate analysis, zinc deficiency independently related to picky eating (OR = 2.124, p = 0.037, CI = 1.042-4.312), developmental level (OR = 0.893, p = 0.022, CI = 0.810-0.984), and physical activity level (OR = 0.785, p < 0.001, CI = 0.700-0.879). In conclusion, the prevalence of zinc deficiency in children aged 4-7 was high, especially in picky eaters. Zinc deficiency was significantly associated with low development and poor physical activity in early childhood.


Asunto(s)
Desarrollo Infantil , Trastornos de la Nutrición del Niño/sangre , Ejercicio Físico , Irritabilidad Alimentaria , Oligoelementos/sangre , Niño , Trastornos de la Nutrición del Niño/epidemiología , Trastornos de la Nutrición del Niño/psicología , Fenómenos Fisiológicos Nutricionales Infantiles , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Análisis Multivariante , Estado Nutricional , Prevalencia , Zinc/sangre , Zinc/deficiencia
7.
Front Public Health ; 9: 667502, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34395360

RESUMEN

Background: Despite several programs and policies to turn down the burden of malnutrition in the country, the rank of India in the Global Hunger Index (GHI) is 102 among 117 countries, which indicates a serious hunger situation. It is essential to design more specific interventions by focusing on the key determinants that may directly or indirectly influence malnutrition in India. Methods: Utilizing data from the National Family and Health Survey-4 (NFHS) (2015-16), we developed a structural equation model to find the direct, indirect, and total effect of various determinants on stunting, wasting, and underweight. We used spatial analysis to identify local occurrences of factors that are critical in controlling malnutrition. A p-value of 0.05 was considered to be significant throughout the study. Analysis was performed using STATA (version 15.1MP) and GeoDa software (version 1.14). Results: A final sample of 90, 842 children of 0-24 months of age was selected for the analysis. The CFI and TLI values of 0.98 and 0.93, respectively, are indicative of a good fit model. Moran's I value of global spatial autocorrelation for the widespread presence of diarrhea, poor drinking water source, exclusive breastfeeding, low birth weight, no prenatal visits, poor toilet facility was observed to be 0.446, 0.638, 0.345, 0.439, 0.620, and 0.727, respectively. Conclusion: A robust direct relation was observed for diarrhea, exclusive breastfeeding, and children born with stunting, underweight, and wasting. The variables associated indirectly with the outcome variables were the education of the mother, residence, and desired pregnancy. The identification of hotspots through spatial analysis would help revive control strategies in the affected area according to geographical needs. It is extensively addressed that interventions related to health and nutrition during the first 1, 000 days of life is crucial to seize the upshoot of growth floundering among children.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Niño , Trastornos de la Nutrición del Niño/epidemiología , Femenino , Trastornos del Crecimiento/epidemiología , Humanos , India/epidemiología , Desnutrición/diagnóstico , Embarazo , Delgadez
8.
Nutrients ; 13(7)2021 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-34371871

RESUMEN

Coronary Heart Disease (CHD) is a major mortality and morbidity cause in adulthood worldwide. The atherosclerotic process starts even before birth, progresses through childhood and, if not stopped, eventually leads to CHD. Therefore, it is important to start prevention from the earliest stages of life. CHD prevention can be performed at different interventional stages: primordial prevention is aimed at preventing risk factors, primary prevention is aimed at early identification and treatment of risk factors, secondary prevention is aimed at reducing the risk of further events in those patients who have already experienced a CHD event. In this context, CHD risk stratification is of utmost importance, in order to tailor the preventive and therapeutic approach. Nutritional intervention is the milestone treatment in pediatric patients at increased CHD risk. According to the Developmental Origin of Health and Disease theory, the origins of lifestyle-related disease is formed in the so called "first thousand days" from conception, when an insult, either positive or negative, can cause life-lasting consequences. Nutrition is a positive epigenetic factor: an adequate nutritional intervention in a developmental critical period can change the outcome from childhood into adulthood.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Trastornos de la Nutrición del Niño/dietoterapia , Desnutrición/dietoterapia , Terapia Nutricional , Adolescente , Desarrollo del Adolescente , Factores de Edad , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/fisiopatología , Niño , Desarrollo Infantil , Trastornos de la Nutrición del Niño/diagnóstico , Trastornos de la Nutrición del Niño/fisiopatología , Fenómenos Fisiológicos Nutricionales Infantiles , Preescolar , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Lactante , Recién Nacido , Desnutrición/diagnóstico , Desnutrición/fisiopatología , Estado Nutricional , Prevención Primaria , Medición de Riesgo , Resultado del Tratamiento
9.
BMJ Open ; 11(8): e048644, 2021 08 13.
Artículo en Inglés | MEDLINE | ID: mdl-34389574

RESUMEN

OBJECTIVES: This study aims to compare the developmental profile of severe acute malnourished (SAM) and normal under-five children and to find sociodemographic determinants accountable for their developmental disabilities. SETTING: We conducted a multi-centre cross-sectional study in three basic health units and one rural health centre in Pakistan. PARTICIPANTS: 200 children (SAM and healthy) aged 6-59 months. PRIMARY AND SECONDARY MEASURES: We screened for nutritional status and clinical complications. Children underwent for developmental assessment by Denver Development Screening Tool II. A pretested structured questionnaire on sociodemographic characteristics and nutrition was used for collecting data about determinants of developmental delay. RESULTS: We observed statistically significant differences in anthropometric measurements among SAM compared with normal nourished in weight, height, mid-upper arm circumference and weight-for-height z-scores. SAM serves as a significant risk factors (p<0.001) for delayed personal or social development (69% vs 11%; OR (95% CI)=18.01 (8.45 to 38.37)), delayed fine motor development (39% vs 8%; OR (95% CI)=7.35 (3.22 to 16.81)), delayed language development (32% vs 8%; OR (95% CI)=5.41 (2.35 to 12.48)), delayed gross motor development (34% vs 10%; OR (95% CI)=4.64 (2.14 to 10.05)) and delayed global development (66% vs 20%; OR (95% CI)=7.77 (4.09 to 14.74)). Applying logistic regression, personal or social development (p<0.001) and language development (p<0.05), under-five siblings was a risk factor, while among gross motor development, mother's educational status (p<0.05) was a significant risk factor for developmental delay. CONCLUSIONS: Our analysis indicates that children with malnutrition have a high frequency of developmental delays. Missing maternal education and a higher number of under-five siblings are also potential risk factors for developmental delay.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Desnutrición Aguda Severa , Niño , Trastornos de la Nutrición del Niño/epidemiología , Estudios Transversales , Humanos , Lactante , Pakistán/epidemiología
10.
Matern Child Nutr ; 17 Suppl 1: e13123, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34241954

RESUMEN

Child malnutrition is an enormous public health problem in low- and middle-income countries (LMICs). In this paper, we study the relationship between non-maternal adult female household members (AFHMs) and under-5 child nutritional outcomes using nationally representative Ethiopian Demographic and Health Survey data, 2016. Because most of the primary inputs that go into the production of child health are intensive in maternal time, having additional AFHMs may ease the time constraints of the child's mother. We use anthropometric measures such as height-for-age z-scores (HAZ) and weight-for-age z-scores (WAZ) to measure stunting and underweight, respectively, as objective indicators of child nutritional status. Among our sampled households, we find that 40% of the children are stunted, 18% severely stunted, 27% underweight and 8% severely underweight. Furthermore, about 20% of the sampled children live with at least one extra non-maternal AFHM. The multivariate regression results suggest that an additional AFHM is associated with significantly higher HAZ and WAZ scores and less likelihood of severe stunting compared with children living with fewer AFHMs. Finally, the paper discusses the potential pathways through which non-maternal AFHMs can influence child nutritional status.


Asunto(s)
Trastornos de la Nutrición del Niño , Estado Nutricional , Adulto , Niño , Fenómenos Fisiológicos Nutricionales Infantiles , Etiopía/epidemiología , Femenino , Humanos , Prevalencia
11.
Artículo en Inglés | MEDLINE | ID: mdl-34300158

RESUMEN

BACKGROUND: Child malnutrition is a major epidemiological problem in developing countries, especially in African countries. Nutrition education for mothers can alleviate this malnutrition in their young children. The objective of this study was to make a systematic review to assess the effect of intervention programs in nutrition education for African mothers on the nutritional status of their infants. METHODS: A bibliographic search was carried out in the PubMed database for clinical trials between November 2012 and 2021. The studies should contain educational programs to evaluate the impact on the infant's nutritional indicators in children under 5 years (food consumption, anthropometry and/or knowledge of nutrition in caretakers). RESULTS: A total of 20 articles were selected, of which 53% evaluated infant's food consumption, 82% anthropometric measurements and 30% nutritional knowledge. In general, nutritional education programs are accredited with some significant improvements in food and nutrient consumption, knowledge and dietary practices in complementary feeding, but only those studies that implemented strategies in agriculture, educational workshops and supplementation obtained reductions in chronic malnutrition figures. LIMITATIONS: There is high heterogeneity in the articles included, since the intervention programs have different approaches. CONCLUSIONS: Programs that implemented actions of national agriculture or nutritional supplementation reap the greatest benefits in curbing infant malnutrition.


Asunto(s)
Trastornos de la Nutrición del Niño , Madres , África/epidemiología , Niño , Preescolar , Suplementos Dietéticos , Femenino , Humanos , Lactante , Estado Nutricional
12.
Artículo en Inglés | MEDLINE | ID: mdl-34203109

RESUMEN

Adequate child nutrition is critical to child development, yet child malnutrition is prevalent in crisis settings. However, the intersection of malnutrition and disasters is sparse. This study reviews existing evidence on nutrition responses and outcomes for infants and young children during times of crisis. The scoping review was conducted via two approaches: a systematic search and a purposive search. For the systematic search, two key online databases, PubMed and Science Direct, were utilized. In total, data from 32 studies were extracted and included in the data extraction form. Additionally, seven guidelines and policy documents were included, based on relevance to this study. Overall, the existing evidence demonstrates the negative impacts of crises on nutritional status, diet intake, anthropometric failure, and long-term child development. On the other hand, crisis-related interventions positively affected nutrition-related knowledge and practices. Further studies should be carried out to explore the sustainability of the interventions and the success of existing guidelines. Since this study focuses only on nutrition among children under three, further studies should likewise consider an extended age range from three to five years.


Asunto(s)
Trastornos de la Nutrición del Niño , Desnutrición , Niño , Desarrollo Infantil , Trastornos de la Nutrición del Niño/epidemiología , Fenómenos Fisiológicos Nutricionales Infantiles , Preescolar , Humanos , Lactante , Estado Nutricional
13.
Forensic Sci Int ; 325: 110896, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34243037

RESUMEN

Fatal starvation is rarely seen in developed countries; when it occurs, it may be associated with medicolegal problems. Forensic pathologists are required to determine leading causes of death and provide opinions on the influence of starvation, especially in cases of suspected child abuse. Recently, starvation-induced steatosis was suggested to be regulated by lipophagy. Here, we report an extremely rare case of death by malnutrition of a 10-year-old boy, who was fed only infant formula throughout his life. The deceased presented with severe hepatic steatosis, probably related to prolonged malnutrition. Fatty liver changes, with deposition of small lipid droplets deposited in the peripheral lobules. High levels of P62 protein (overexpression of which indicates an autophagy impairment) were seen around the central vein region, whereas light-chain-3 (LC3) protein (an indicator of lipophagy activation) was unremarkable. Thus, in our case, impaired lipophagy influenced starvation-induced steatosis. To our knowledge, this article is the first to evaluate the application of lipophagy in forensic investigations as an objective diagnostic criterion.


Asunto(s)
Trastornos de la Nutrición del Niño/etiología , Fórmulas Infantiles/efectos adversos , Inanición , Autofagia , Niño , Trastornos de la Nutrición del Niño/complicaciones , Deshidratación/complicaciones , Resultado Fatal , Hígado Graso/patología , Glucógeno/análisis , Humanos , Lactante , Hígado/química , Hígado/patología , Masculino , Proteínas de Unión al ARN/sangre
14.
Nutrients ; 13(5)2021 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-34063613

RESUMEN

The current study sought to investigate the joint effect of maternal marital status and type of household cooking fuel on child nutritional status in sub-Saharan Africa. Data in the children's files of 31 sub-Saharan African countries were pooled from the Demographic and Health Surveys collected between 2010 and 2019. The outcome variables were three child anthropometrics: stunting (height-for-age z-scores); wasting (weight-for-height z-scores); and underweight (weight-for-age z-scores). The joint effect of maternal marital status and type of household cooking fuel on child nutritional status was examined using multilevel regression models. The results were presented as adjusted odds ratios (aORs) at p < 0.05. The percentages of children who were stunted, wasted and underweight in the 31 countries in sub-Saharan Africa were 31%, 8% and 17%, respectively. On the joint effect of maternal marital status and type of household cooking fuel on stunting, we found that compared to children born to married mothers who used clean household cooking fuel, children born to single mothers who use unclean household cooking fuel, children born to single women who use clean household cooking fuel, and children born to married women who used unclean household cooking were more likely to be stunted. With wasting, children born to single mothers who used unclean household cooking fuel and children born to married women who used unclean household cooking fuel were more likely to be wasted compared to children born to married mothers who used clean household cooking fuel. With underweight, we found that compared to children born to married mothers who used clean household cooking fuel, children born to single mothers who used unclean household cooking fuel, children born to single women who used clean household cooking fuel and children born to married women who used unclean household cooking were more likely to be underweight. It is imperative for the governments of the 31 sub-Saharan African countries to double their efforts to end the use of unclean household cooking fuel. This goal could be achieved by promoting clean household cooking fuel (e.g., electricity, gas, ethanol, solar, etc.) through effective health education, and promotion programmes. The attention of policymakers is drawn to the urgent need for children's nutritional status policies and programmes (e.g., dietary supplementation, increasing dietary diversity, improving agriculture and food security) to be targeted towards at-risk sub-populations (i.e., single mothered households).


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Culinaria/estadística & datos numéricos , Composición Familiar , Estado Civil/estadística & datos numéricos , Madres/estadística & datos numéricos , África del Sur del Sahara/epidemiología , Antropometría , Trastornos de la Nutrición del Niño/etiología , Fenómenos Fisiológicos Nutricionales Infantiles , Preescolar , Análisis por Conglomerados , Culinaria/métodos , Estudios Transversales , Demografía , Femenino , Trastornos del Crecimiento/epidemiología , Trastornos del Crecimiento/etiología , Humanos , Lactante , Recién Nacido , Masculino , Estado Nutricional , Oportunidad Relativa , Análisis de Regresión , Delgadez/epidemiología , Delgadez/etiología , Síndrome Debilitante/epidemiología , Síndrome Debilitante/etiología
15.
Salud Publica Mex ; 63(3 May-Jun): 339-349, 2021 May 03.
Artículo en Español | MEDLINE | ID: mdl-34098606

RESUMEN

Objetivos. Actualizar la prevalencia de desnutrición y sus tendencias en los últimos 30 años e identificar factores asociados con la baja talla en una muestra representativa nacional de niños <5 años en México. Material y méto-dos. Se estimaron prevalencias de desnutrición en <5 años en 2018-19 y se compararon con prevalencias de los últimos 30 años. Se estudiaron asociaciones de factores geográficos, del hogar, maternos e individuales con baja talla, utilizando regresión logística múltiple. Resultados. El 4.8% de los <5 años presentó bajo peso, 14.2% baja talla y 1.4% emaciación. Entre 1988-2012 hubo un descenso en baja talla interrum-pido entre 2012-2018. La baja talla se asoció positivamente con residencia rural, región sur, hogares más pobres, madres indígenas y mayor número de hijos, y negativamente con diversidad dietética. Conclusiones. La desnutrición cró-nica es un problema persistente asociado con factores de vulnerabilidad social, cuya tendencia descendente de 30 años se interrumpió entre 2012-2018. Es imperativo implementar una estrategia nacional de prevención de baja talla.


Asunto(s)
Trastornos de la Nutrición del Niño , Trastornos del Crecimiento , Trastornos de la Nutrición del Niño/epidemiología , Preescolar , Trastornos del Crecimiento/epidemiología , Humanos , Lactante , México/epidemiología , Factores de Riesgo
16.
Salud Publica Mex ; 63(3 May-Jun): 371-381, 2021 May 03.
Artículo en Español | MEDLINE | ID: mdl-34098610

RESUMEN

OBJECTIVE: To describe trends in zinc deficiency (ZD) prevalence among preschool-age Mexican children, and explore differences in this trend among beneficiaries of the conditional cash transfer program Progresa/Oportunidades/ Prospera (CCT-POP). MATERIALS AND METHODS: The serum zinc information of children aged 1-4 who participa-ted in the ENN 1999, Ensanut 2006 and Ensanut 2018-19 was analyzed. ZD was categorized according to IZiNCG cutoff values. Logistic regression models were used to iden-tify personal participant characteristics associated with ZD trends, and tests for interactions between survey CCT-POP beneficiaries were applied. RESULTS: ZD decreased by 22.3 percentage points (pp) between ENN 1999 and Ensanut 2018-19; among CCT-POP beneficiaries, the decrease was 58.6 pp. Overweight was associated with higher odds of ZD (OR=2.18, p=0.023). CONCLUSIONS: In the last 19 years, ZD declined significantly among preschool-age Mexican children. Child beneficiaries of the social program CCT-POP showed the largest reduction of ZD.


Asunto(s)
Trastornos de la Nutrición del Niño , Zinc , Trastornos de la Nutrición del Niño/epidemiología , Preescolar , Humanos , Lactante , México/epidemiología , Encuestas Nutricionales , Zinc/deficiencia
17.
Nutrients ; 13(5)2021 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-34066577

RESUMEN

Prevalence of anaemia among Nigerian toddlers is reported to be high, and may cause significant morbidity, affects brain development and function, and results in weakness and fatigue. Although, iron fortification can reduce anaemia, yet the effect on gut microbiota is unclear. This open-label randomised study in anaemic malnourished Nigerian toddlers aimed to decrease anaemia without affecting pathogenic gut bacteria using a multi-nutrient fortified dairy-based drink. The test product was provided daily in different amounts (200, 400 or 600 mL, supplying 2.24, 4.48 and 6.72 mg of elemental iron, respectively) for 6 months. Haemoglobin, ferritin, and C-reactive protein concentrations were measured to determine anaemia, iron deficiency (ID) and iron deficiency anaemia (IDA) prevalence. Faecal samples were collected to analyse gut microbiota composition. All three dosages reduced anaemia prevalence, to 47%, 27% and 18%, respectively. ID and IDA prevalence was low and did not significantly decrease over time. Regarding gut microbiota, Enterobacteriaceae decreased over time without differences between groups, whereas Bifidobacteriaceae and pathogenic E. coli were not affected. In conclusion, the multi-nutrient fortified dairy-based drink reduced anaemia in a dose-dependent way, without stimulating intestinal potential pathogenic bacteria, and thus appears to be safe and effective in treating anaemia in Nigerian toddlers.


Asunto(s)
Anemia Ferropénica/prevención & control , Bebidas , Trastornos de la Nutrición del Niño/prevención & control , Compuestos Ferrosos/administración & dosificación , Alimentos Fortificados , Micronutrientes/administración & dosificación , Anemia Ferropénica/epidemiología , Anemia Ferropénica/microbiología , Trastornos de la Nutrición del Niño/epidemiología , Trastornos de la Nutrición del Niño/microbiología , Preescolar , Productos Lácteos , Relación Dosis-Respuesta a Droga , Femenino , Microbioma Gastrointestinal/efectos de los fármacos , Humanos , Lactante , Masculino , Nigeria/epidemiología , Prevalencia
18.
Nutrients ; 13(6)2021 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-34063783

RESUMEN

The paucity of adequate data on dietary and nutrient intakes of school-age children is a barrier to addressing malnutrition and associated risks in Nigeria. This study included 955 children aged 4-13 years from Ibadan, Nigeria, using a stratified random sampling design. Information on family socio-demographic characteristics was reported, and child anthropometrics were measured. Dietary intake data were collected using a multi-pass 24 h dietary recall method; 20% of subjects completed a second 24 h recall to estimate usual nutrient intakes. Means and distributions of usual intakes of energy and nutrients as well as prevalence of inadequacy were estimated. Usual energy intake (kcal/day) was 1345 and 1590 for younger (4-8 years) and older (9-13 years) age groups, respectively. The macronutrient intakes of most children did not conform to Adequate Macronutrient Distribution Ranges (AMDRs), which were characterized by a higher proportion of energy from carbohydrates and lower proportion from total fats. Protein intake was largely within the AMDR. Compared to recommendations, over 60% of 4-8-year-old children had inadequate intakes of calcium, copper, iron, folate, and vitamins A, D, and E. There were more micronutrient inadequacies in the older children. This study identifies nutrition gaps and suggests future research and education to improve child nutrition in Nigeria.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Dieta/estadística & datos numéricos , Ingestión de Alimentos , Adolescente , Antropometría , Niño , Fenómenos Fisiológicos Nutricionales Infantiles , Preescolar , Encuestas sobre Dietas , Femenino , Humanos , Masculino , Nigeria/epidemiología , Evaluación Nutricional , Necesidades Nutricionales , Estado Nutricional , Prevalencia
19.
BMJ Open ; 11(6): e044263, 2021 06 09.
Artículo en Inglés | MEDLINE | ID: mdl-34108160

RESUMEN

INTRODUCTION: There is growing interest in assessing the impact of health interventions, particularly when women are the focus of the intervention, on women's empowerment. Globally, research has shown that interventions targeting nutrition, health and economic development can affect women's empowerment. Evidence suggests that women's empowerment is also an underlying determinant of nutrition outcomes. Depending on the focus of the intervention, different domains of women's empowerment will be influenced, for example, an increase in nutritional knowledge, or greater control over income and access to resources. OBJECTIVE: This study evaluates the impact of the Shonjibon Cash and Counselling (SCC) Trial that combines nutrition counselling and an unconditional cash transfer, delivered on a mobile platform, on women's empowerment in rural Bangladesh. METHODS AND ANALYSIS: We will use a mixed-methods approach, combining statistical analysis of quantitative data from 2840 women in a cluster randomised controlled trial examining the impact of nutrition behaviour change communications (BCCs) and cash transfers on child undernutrition. Pregnant participants will be given a smartphone with a customised app, delivering nutrition BCC messages, and will receive nutrition counselling via a call centre and an unconditional cash transfer. This study is a component of the SCC Trial and will measure women's empowerment using a composite indicator based on the Project-Level Women's Empowerment in Agriculture Index, with quantitative data collection at baseline and endline. Thematic analysis of qualitative data, collected through longitudinal interviews with women, husbands and mothers-in-law, will elicit a local understanding of women's empowerment and the linkages between the intervention and women's empowerment outcomes. This paper describes the study protocol to evaluate women's empowerment in a nutrition-specific and sensitive intervention using internationally validated, innovative tools and will help fill the evidence gap on pathways of impact, highlighting areas to target for future programming. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the International Centre for Diarrhoeal Disease Research (Ref. PR 17106) and The University of Sydney (Ref: 2019/840). Findings from this study will be shared in Bangladesh with dissemination sessions in-country and internationally at conferences, and will be published in peer-reviewed journals.


Asunto(s)
Trastornos de la Nutrición del Niño , Estado Nutricional , Bangladesh , Niño , Consejo , Femenino , Humanos , Embarazo , Ensayos Clínicos Controlados Aleatorios como Asunto , Población Rural
20.
Clin Nutr ; 40(5): 2784-2790, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33933744

RESUMEN

INTRODUCTION: In coeliac disease (CD) micronutrient deficiencies may occur due to malabsorption in active disease and diminished intake during treatment with a gluten-free diet (GFD). This study assessed the micronutrient status in children with CD at diagnosis and follow-up. METHODS: Fifteen micronutrients were analysed in 106 blood samples from newly diagnosed CD and from patients on a GFD for <6 months, 6-12 months and with longstanding disease (>12 months). Predictors of micronutrient status included: demographics, disease duration, anthropometry, gastrointestinal symptoms, raised tissue transglutaminase antibodies (TGA), multivitamin use and faecal gluten immunogenic peptide (GIP). Micronutrient levels were compared against laboratory reference values. RESULTS: At CD diagnosis (n = 25), low levels in ≥10% of patients were observed for: vitamins E (88%), B1 (71%), D (24%), K (21%), A (20%) and B6 (12%), ferritin (79%), and zinc (33%). One year post-diagnosis, repletion of vitamins E, K, B6 and B1 was observed (<10% patients). In contrast, deficiencies for vitamins D, A and zinc did not change significantly post-diagnosis. Copper, selenium and magnesium did not differ significantly between diagnosis and follow-up. All samples for B2, folate, vitamin C (except for one sample) and B12 were normal. A raised TGA at follow-up was associated with low vitamins A and B1 (raised vs normal TGA; vitamin A: 40% vs 17%, p = 0.044, vitamin B1: 37% vs 13%, p = 0.028). Low vitamin A (p = 0.009) and vitamin D (p = 0.001) were more common in samples collected during winter. There were no associations between micronutrient status with GIP, body mass index, height, socioeconomic status, or gastrointestinal symptom. Multivitamin use was less common in patients with low vitamin D. CONCLUSIONS: Several micronutrient deficiencies in CD respond to a GFD but others need to be monitored long-term and supplemented where indicated.


Asunto(s)
Enfermedad Celíaca/dietoterapia , Micronutrientes/deficiencia , Adolescente , Enfermedad Celíaca/metabolismo , Enfermedad Celíaca/patología , Niño , Trastornos de la Nutrición del Niño , Dieta Sin Gluten , Femenino , Humanos , Masculino , Factores de Riesgo
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