evidence-based blog of Filippo Dibari

Archive for the ‘Under-nutrition’ Category

Prenatal malnutrition and adult cognitive impairment: a natural experiment from the 1959–1961 Chinese famine

In Under-nutrition on May 10, 2018 at 8:39 pm

from British Journal of Nutrition – link

by Ping He, Li Liu, J. M. Ian Salas, Chao Guo, Yunfei Cheng, Gong Chen and Xiaoying Zheng 

Abstract

The current measures of cognitive functioning in adulthood do not indicate a long-term association with prenatal exposure to the Dutch famine. However, whether such association emerges in China is poorly understood.

We aimed to investigate the potential effect of prenatal exposure to the 1959–1961 Chinese famine on adult cognitive impairment. We obtained data from the Second National Sample Survey on Disability implemented in thirty-one provinces in 2006, and restricted our analysis to 387 093 individuals born in 1956–1965.

Cognitive impairment was defined as intelligence quotient (IQ) score under 70 and IQ of adults was evaluated by the Wechsler Adult Intelligence Scale – China Revision. Famine severity was defined as excess death rate. The famine impact on adult cognitive impairment was estimated by difference-in-difference models, established by examining the variations of famine exposure across birth cohorts.

Results show that compared with adults born in 1956–1958, those who were exposed to Chinese famine during gestation (born in 1959–1961) were at greater risk of cognitive impairment in the total sample. Stratified analyses showed that this effect was evident in males and females, but only in rural, not in urban areas.

In conclusion, prenatal exposure to famine had an enduring deleterious effect on risk of cognitive impairment in rural adults.

Impact on birth weight and child growth of Participatory Learning and Action women’s groups with and without transfers of food or cash during pregnancy: Findings of the low birth weight South Asia cluster-randomised controlled trial (LBWSAT) in Nepal

In Under-nutrition on May 10, 2018 at 8:31 pm

from PlosOne website

(download)

Abstract

Background

Undernutrition during pregnancy leads to low birthweight, poor growth and inter-generational undernutrition. We did a non-blinded cluster-randomised controlled trial in the plains districts of Dhanusha and Mahottari, Nepal to assess the impact on birthweight and weight-for-age z-scores among children aged 0–16 months of community-based participatory learning and action (PLA) women’s groups, with and without food or cash transfers to pregnant women.

Methods

We randomly allocated 20 clusters per arm to four arms (average population/cluster = 6150). All consenting married women aged 10–49 years, who had not had tubal ligation and whose husbands had not had vasectomy, were monitored for missed menses. Between 29 Dec 2013 and 28 Feb 2015 we recruited 25,092 pregnant women to surveillance and interventions: PLA alone (n = 5626); PLA plus food (10 kg/month of fortified wheat-soya ‘Super Cereal’, n = 6884); PLA plus cash (NPR750≈US$7.5/month, n = 7272); control (existing government programmes, n = 5310). 539 PLA groups discussed and implemented strategies to improve low birthweight, nutrition in pregnancy and hand washing. Primary outcomes were birthweight within 72 hours of delivery and weight-for-age z-scores at endline (age 0–16 months). Only children born to permanent residents between 4 June 2014 and 20 June 2015 were eligible for intention to treat analyses (n = 10936), while in-migrating women and children born before interventions had been running for 16 weeks were excluded. Trial status: completed.

Results

In PLA plus food/cash arms, 94–97% of pregnant women attended groups and received a mean of four transfers over their pregnancies. In the PLA only arm, 49% of pregnant women attended groups. Due to unrest, the response rate for birthweight was low at 22% (n = 2087), but response rate for endline nutritional and dietary measures exceeded 83% (n = 9242). Compared to the control arm (n = 464), mean birthweight was significantly higher in the PLA plus food arm by 78·0 g (95% CI 13·9, 142·0; n = 626) and not significantly higher in PLA only and PLA plus cash arms by 28·9 g (95% CI -37·7, 95·4; n = 488) and 50·5 g (95% CI -15·0, 116·1; n = 509) respectively. Mean weight-for-age z-scores of children aged 0–16 months (average age 9 months) sampled cross-sectionally at endpoint, were not significantly different from those in the control arm (n = 2091). Differences in weight for-age z-score were as follows: PLA only -0·026 (95% CI -0·117, 0·065; n = 2095); PLA plus cash -0·045 (95% CI -0·133, 0·044; n = 2545); PLA plus food -0·033 (95% CI -0·121, 0·056; n = 2507). Amongst many secondary outcomes tested, compared with control, more institutional deliveries (OR: 1.46 95% CI 1.03, 2.06; n = 2651) and less colostrum discarding (OR:0.71 95% CI 0.54, 0.93; n = 2548) were found in the PLA plus food arm but not in PLA alone or in PLA plus cash arms.

Interpretation

Food supplements in pregnancy with PLA women’s groups increased birthweight more than PLA plus cash or PLA alone but differences were not sustained. Nutrition interventions throughout the thousand-day period are recommended.

Trial registration

ISRCTN75964374

Child growth monitor app: a game-changer?

In Over-nutrition, Under-nutrition on May 9, 2018 at 12:52 am

from Welt Hunger Hilfe webpage

Food Environment Working Group (FEWG): An introduction to food environments research

In Over-nutrition, Under-nutrition on April 25, 2018 at 4:44 am

from Agriculture, Nutrition and Health Academy web site.

TED Talk: ‘What if we incentivized doctors (and nutritionists) to keep us healthy instead of paying them only when we’re already sick?’

In Over-nutrition, Under-nutrition on April 5, 2018 at 11:46 am

from TED talk

November 2017

528,506 views

 

 

NO WASTED LIVES: the research agenda

In Under-nutrition on April 3, 2018 at 8:20 pm

from the webpage of No Wasted Lives

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The No Wasted Lives Coalition is investing in cutting edge ideas to drive forward global learning and action on acute malnutrition. As part of this effort, in 2018, No Wasted Lives and the Council of Research & Technical Advice (CORTASAM) launched the global Research Agenda for Acute Malnutrition and a call for Expressions of Interest from organisations working in research and programming for acute malnutrition and who want to support this effort. Our aim is to support coordination and concrete action across the sector, filling critical gaps and scaling-up evidence-based prevention and treatment of acute malnutrition.

 

Prioritising Research for Impact

The Council for Research and Technical Advice on Acute Malnutrition (CORTASAM) was assembled under No Wasted Lives with the goal to drive the use of evidence for action, in order to ultimately reach more children with effective treatment and prevention programmes.

Over the course of 2017, CORTASAM and No Wasted Lives launched a research prioritisation exercise, with the involvement and contribution of over 300 individuals from national governments, NGOs, academia, UN agencies and technical experts from around the world. In line with the priority research areas identified and a review of the existing evidence, CORTASAM has identified the following research areas with high potential impact on the effective management of acute malnutrition at scale but where further research and evidence generation is critically needed in order to achieve this:

  1. Effective approaches to detect, diagnose, and treat acute malnutrition in the community: taking community detection using mid-upper arm circumference (MUAC) to scale while building the evidence on diagnosis and treatment of acute malnutrition in the community across contexts and health platforms.
  2. Appropriate entry and discharge criteria for treatment of acute malnutrition to ensure optimum outcomes: building the evidence base on expanded MUAC thresholds for treatment to improve treatment outcomes for all children with acute malnutrition. Also needed is research to explore different options to identify high-risk children not selected by MUAC<115mm and analysis on the impact on burden estimates and operational feasibility, including supply and supply chain.
  3. Optimum dosage of ready-to-use food (RUF) for treatment of acute malnutrition:  investigating the safety, effectiveness, and cost-effectiveness of reduced dosage of RUF for treatment of acute malnutrition.
  4. Effective treatment of diarrhoea in children with severe acute malnutrition (SAM): using evidence to streamline guidance and generating implementation research to understand how the operational application of guidelines can inform improved practice and better treatment outcomes.
  5. Rates and causal factors of post-treatment relapse across contexts: understanding the burden of relapse post-treatment and, if found to be high, effective solutions to reduce relapse across contexts.
  6. Identification and management of at-risk mothers and of infants <6 months of age: generating the evidence required to influence country-level policies and implementation at scale.
  7. Alternative formulations for ready-to-use foods for acute malnutrition: continuation of the large amount of ongoing research to investigate the effectiveness, and cost-effectiveness, of formulas using alternative and local ingredient.

More details about the evidence gaps and CORTASAM’s call for more research can be found in the Research Agenda. Download it below.

 

 

In January 2018 we ran a call for Expressions of Interest in response to the Research Agenda. The call closed in February 2018 and applications are now being considered for possible donor funding. Download an overview of the submissions received here.

People-in-Need/Nutrition: (free) operational resources for not-necessarily nutritionists

In Under-nutrition on April 2, 2018 at 9:40 am

from People-in-Need webpage

(click on the covers of the publications to download them)

Nutrition Surveys


Nutrition programming
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SBCC toolkit
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What should I eat today?

In Over-nutrition, Uncategorized, Under-nutrition on April 1, 2018 at 4:03 pm

dr-greger_83799539

From NutritionFacts.org web site from Dr Greger

 

Dr. Greger’s Daily Dozen Checklist

DOCTOR’S NOTE

Whoa, that was quite the departure from our regular videos! Normally, we just show you the science from the primary sources in the peer-reviewed medical literature, but I want NutritionFacts.org to be more than just a reference site. I want it to be a practical guide on translating this mountain of data into day-to-day decisions. So that’s where my Daily Dozen slips into the mix. It’s available for free on iTunes as well as an Android app, thanks to an amazing group of volunteers through our Open Source Initiative.

If this video sounded familiar, it’s the same narration as the video posted months ago, but utilizing the talents of a new animator as an experiment: the video production company Purposeful Films, who heavily discounted their rates in support of our work. It’s more of a playful style, which I thought might be a good match for the content.

If this video inspired you to try eating the Daily Dozen, join our Daily Dozen Challenge! Learn more here.

Here are direct links to the two videos I referenced in the video: How Many Glasses of Water Should We Drink a Day? and How Much Should You Exercise?

For more intro-type videos, check out:

Okay, but how do you actually incorporate those Daily Dozen foods into your diet? Check out my How Not to Die Cookbook (all the proceeds I receive from that and all my books goes to the 501c3 nonprofit that runs this site), and my “In the Kitchen” videos: My New Favorite Dessert and My New Favorite Beverage.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

FAO: A report by The High Level Panel of Experts on Food Security and Nutrition (2017)

In Over-nutrition, Under-nutrition on April 1, 2018 at 3:26 pm

From  FAO webpage

The High Level Panel of Experts on Food Security and Nutrition (HLPE) was established in 2010 as the science-policy interface of the UN Committee on World Food Security (CFS).  The HLPE aims to improve the robustness of policy making by providing independent, evidence-based analysis and advice at the request of CFS.

26/03/2018 – Translations of the 12th HLPE report Nutrition and food systems are now available in all UN official languages!

Please click on the link below to download the document in your preferred language.

[AR][CH][EN][ES][FR][RU]

 

Urgent: WFP Mozambique looks for Nutritionist with experience in Nutrition-in-Emergency

In Under-nutrition on March 11, 2018 at 4:28 pm

Afbeeldingsresultaat voor wfp logo

WFP Mozambique looks for a Nutritionist with experience in Community-based Management of Acute Malnutrition, for an immediate placement.

Key elements for the candidature:

  • Duty station: Maputo, with frequent travels in the field
  • Duration of the assignment: at least 5 months
  • Language skills: Portuguese, or at least Spanish or Italian
  • Familiarity with WFP operations
  • Availability: immediate

Please, kindly disseminate the Terms of Reference available on this link. Thanks.

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