evidence-based blog of Filippo Dibari

Concurrent wasting and stunting among under‐five children in Niakhar, Senegal

In Under-nutrition on November 27, 2018 at 12:59 pm

by Garenne M, Myatt M, Khara T, Dolan C, Briend A.

2018 Oct 26:e12736

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Abstract

Senegal; anthropometry; child survival; concurrent wasting & stunting; stunting; wasting

The study describes the patterns of concurrent wasting and stunting (WaSt) among children age 6-59 months living in the 1980s in Niakhar, a rural area of Senegal under demographic surveillance.

Wasting and stunting were defined by z scores lower than -2 in weight for height and height for age. Both conditions were found to be highly prevalent, wasting more so before age 30 months, stunting more so after age 30 months. As a result, concurrent WaSt peaked around age 18 months and its prevalence (6.2%) was primarily the product of the two conditions, with an interaction term of 1.57 (p < 10-6 ).

The interaction was due to the correlation between both conditions (more stunting if wasted, more wasting if stunted). Before age 30 months, boys were more likely to be concurrently wasted and stunted than girls (RR = 1.61), but the sex difference disappeared after 30 months of age.

The excess susceptibility of younger boys could not be explained by muscle mass or fat mass measured by arm or muscle circumference, triceps, or subscapular skinfold.

Concurrent WaSt was a strong risk factor for child mortality, and its effect was the product of the independent effect of each component, with no significant interaction.

 

 

Children who are both wasted and stunted are also underweight and have a high risk of death: a descriptive epidemiology of multiple anthropometric deficits using data from 51 countries

In Under-nutrition on October 9, 2018 at 7:04 pm

from BioMedCentral

By: Mark Myatt, Tanya Khara, Simon Schoenbuchner, Silke Pietzsch, Carmel Dolan, Natasha Lelijveld and André Briend.

Archives of Public Health201876:28

Background

Wasting and stunting are common. They are implicated in the deaths of almost two million children each year and account for over 12% of disability-adjusted life years lost in young children. Wasting and stunting tend to be addressed as separate issues despite evidence of common causality and the fact that children may suffer simultaneously from both conditions (WaSt). Questions remain regarding the risks associated with WaSt, which children are most affected, and how best to reach them.

Methods

A database of cross-sectional survey datasets containing data for almost 1.8 million children was compiled. This was analysed to determine the intersection between sets of wasted, stunted, and underweight children; the association between being wasted and being stunted; the severity of wasting and stunting in WaSt children; the prevalence of WaSt by age and sex, and to identify weight-for-age z-score and mid-upper arm circumference thresholds for detecting cases of WaSt. An additional analysis of the WHO Growth Standards sought the maximum possible weight-for-age z-score for WaSt children.

Results

All children who were simultaneously wasted and stunted were also underweight. The maximum possible weight-for-age z-score in these children was below − 2.35. Low WHZ and low HAZ have a joint effect on WAZ which varies with age and sex. WaSt and “multiple anthropometric deficits” (i.e. being simultaneously wasted, stunted, and underweight) are identical conditions. The conditions of being wasted and being stunted are positively associated with each other. WaSt cases have more severe wasting than wasted only cases. WaSt cases have more severe stunting than stunted only cases. WaSt is largely a disease of younger children and of males. Cases of WaSt can be detected with excellent sensitivity and good specificity using weight-for-age.

Conclusions

The category “multiple anthropometric deficits” can be abandoned in favour of WaSt. Therapeutic feeding programs should cover WaSt cases given the high mortality risk associated with this condition. Work on treatment effectiveness, duration of treatment, and relapse after cure for WaSt cases should be undertaken. Routine reporting of the prevalence of WaSt should be encouraged. Further work on the aetiology, prevention, case-finding, and treatment of WaSt cases as well as the extent to which current interventions are reaching WaSt cases is required.

Composition and Properties of Aquafaba: Water Recovered from Commercially Canned Chickpeas.

In Over-nutrition, Under-nutrition on September 30, 2018 at 4:37 am

by Shim YY1, Mustafa R2, Shen J2, Ratanapariyanuch K2, Reaney MJT3.

J Vis Exp. 2018 Feb 10;(132). doi: 10.3791/56305.

Abstract

Chickpea and other pulses are commonly sold as canned products packed in a thick solution or a brine. This solution has recently been shown to produce stable foams and emulsions, and can act as a thickener.

Recently interest in this product has been enhanced through the internet where it is proposed that this solution, now called aquafaba by a growing community, can be used a replacement for egg and milk protein.

As aquafaba is both new and being developed by an internet based community little is known of its composition or properties. Aquafaba was recovered from 10 commercial canned chickpea products and correlations among aquafaba composition, density, viscosity and foaming properties were investigated.

Proton NMR was used to characterize aquafaba composition before and after ultrafiltration through membranes with different molecular weight cut offs (MWCOs of 3, 10, or 50 kDa). A protocol for electrophoresis, and peptide mass fingerprinting is also presented. Those methods provided valuable information regarding components responsible for aquafaba functional properties.

This information will allow the development of practices to produce standard commercial aquafaba products and may help consumers select products of superior or consistent utility.

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