evidence-based blog of Filippo Dibari

Posts Tagged ‘children’

Chile declares war on junk food

In Over-nutrition on June 27, 2016 at 7:06 pm
Aljazeera – Politics & Law

02:22Jun 26, 2016

Chileans are ranked as the number one consumers of junk food. Chile is also in the top three in the world for obesity. Now government leaders are trying to change people’s poor eating habits by changing the law.

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WFP: nutrient gap explained in 3 min youtube (fun-to-watch) video

In Over-nutrition, Under-nutrition on February 4, 2016 at 10:18 am

 

Exploring the paradox: double burden of malnutrition in rural South Africa

In Over-nutrition, Under-nutrition on April 18, 2014 at 7:11 am

by Kimani-Murage EW.

Glob Health Action. 2013 Jan 24;6:19249

(download)

Abstract

BACKGROUND:

This article is a review of the PhD thesis by Elizabeth Kimani-Murage that explores the double burden of malnutrition in rural South Africa. This is in the context of a worryingly rapid increase in obesity and obesity-related diseases in low- and middle-income countries (LMICs) including South Africa, and in the wake of on-going nutrition transition and lifestyle changes in these countries.

OBJECTIVE:

To understand the profiles of malnutrition among children and adolescents in a poor, high HIV prevalent, transitional society in a middle-income country.

METHODS:

A cross-sectional growth survey was conducted in 2007 targeting 4,000 children and adolescents aged 1-20 years. In addition, HIV testing was carried out on children aged 1-5 years and Tanner pubertal assessment among adolescents aged 9-20 years.

RESULTS:

The study shows stunting at an early age and adolescent obesity, particularly among girls, that co-exists in the same socio-geographic population. The study also shows that HIV is an independent modifiable risk factor for poor nutritional outcomes in children and makes a significant contribution to nutritional outcomes at the individual level. Significant predictors of undernutrition at an early age, documented at individual, household, and community levels, include child’s HIV status, age and birth weight, maternal age, age of household head, and area of residence. Significant predictors of overweight/obesity and risk for metabolic disease during adolescence, documented at individual and household levels include child’s age, sex, and pubertal development, household-level food security, socio-economic status, and household head’s highest education level.

CONCLUSIONS:

The combination of early stunting and adolescent obesity raises critical concerns in the wake of the rising public health importance of metabolic diseases in LMICs. This is because, both paediatric obesity and adult short stature are risk factors for metabolic syndrome and metabolic diseases in adulthood. Clearly, policies and interventions to address malnutrition in this and other transitional societies need to be double-pronged and gender-sensitive.

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International Symposium on Understanding Moderate Malnutrition in Children for Effective Interventions

In Under-nutrition on March 30, 2014 at 8:56 am

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Vienna 20 – 29 May 2014

I will be there. If you also participate and wish to link up in Vienna,

send an email to this email address.

(for detailed info see the conference web site or download the flyer)

Objectives of the conference
The symposium will have the following objectives:
• To share experience related to the implementation and evaluation of programmes to prevent and treat MAM in infants and children, particularly during the first 1000 days;
• To support overall policy and specific evidence-based programmes dealing with the management of MAM;
• To identify knowledge gaps and define needs for future research to improve the management of MAM;
• To issue recommendations on how to improve the monitoring and evaluation of programmes dealing with the management of MAM; and
• To identify the role of the IAEA in addressing knowledge gaps and evaluating programmes to prevent and treat MAM.

 

 

 

Effect of Supplementation with a Lipid-Based Nutrient Supplement on the Micronutrient Status of Children Aged 6-18 Months Living in the Rural Region of Intibucá, Honduras.

In Under-nutrition on March 26, 2014 at 4:35 pm

Siega-Riz AM1, Estrada Del Campo Y, Kinlaw A, Reinhart GA, Allen LH, Shahab-Ferdows S, Heck J, Suchindran CM, Bentley ME.

Paediatr Perinat Epidemiol. 2014 Mar 13

 

Abstract

 

BACKGROUND:

Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children.

METHODS:

A 12-month randomised controlled trial was conducted among children aged 6-18 months living in Intibucá, Honduras. Communities (n = 18) were randomised into clusters matched by poverty indicators (9 intervention, n = 160 and 9 controls, n = 140). Intervention participants received LNS. All children received food vouchers and nutrition education. Primary outcomes included measures of micronutrient status: at baseline, 6 and 12 months’ blood were collected for assessment of folate, iron, zinc, riboflavin, and vitamin B12 status; haemoglobin was measured every 3 months; and dietary and anthropometry collected monthly. Longitudinal analyses were based on intent to treat and LNS adherence. Generalised estimating equations were used in the estimation of generalised linear regression models specified for the data.

RESULTS:

At 6-month follow-up, children in the intervention group had a lower proportion classified as deficient for B12 (43.6%) compared with the control (67.7%; P = 0.03). The intervention group had a higher mean concentration for folate at 6 months (P = 0.06), and improvements continued through 12 months for folate (P = 0.002) and vitamin A deficiency (P = 0.03). This pattern of results, with improved significance, remained in subanalysis based on LNS adherence.

CONCLUSION:

These data demonstrate that LNS improved select micronutrient status in young non-malnourished Honduran children.

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Interventions to improve water quality and supply, sanitat ion and hygiene practices, and their effects on the nutritional status of children (Review)

In Under-nutrition on October 5, 2013 at 1:07 pm

by Dangour AD, Watson L, Cumming O, Boisson S, Che Y, Velleman Y, Cavill S, Allen E, Uauy R

Editorial group: Cochrane Public Health Group. Issue 8, 2013.

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(download here)

Plain Language Summary

The effect of interventions to improve water quality and supply, provide sanitation and promote handwashing with soap on physical growth in children
In low-income countries an estimated 165 million children under the age of five years suffer from chronic undernutrition causing them to be short in height and 52 million children suffer from acute undernutrition causing them to be very thin. Poor growth in early life increases the risks of illness and death in childhood. The two immediate causes of childhood undernutrition are inadequate dietary intake and infectious diseases such as diarrhoea. Water, sanitation and hygiene (WASH) interventions are frequently imp
lemented to reduce infectious diseases; this review evaluates the effect that WASH interventions may have on nutrition outcomes in children. The review includes evidence from randomised and non-randomised interventions designed to (i) improve the microbiological quality of drinking water or protect the microbiological quality of water prior to consumption; (ii) introduce new or improved water supply or improve distribution; (iii) introduce or expand the coverage and use of facilities designed to improve sanitation; or (iv) promote handwashing with soap after defecation and disposal of child faeces, and prior to preparing and handling food, or a combination of these interventions, in children aged under 18 years.
We identified 14 studies of such interventions involving 22,241 children at baseline and nutrition outcome data for 9,469 children. Meta-analyses of the evidence from the cluster-randomised trials suggests that WASH interventions confer a small benefit on growth in children under five years of age. While potentially important, this conclusion is based on relatively short-term studies, none of which is of high methodological quality, and should therefore be treated with caution. There are several large, robust studies underway in low-income country settings that should provide evidence to inform these findings.
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Maize porridge enriched with a micronutrient powder containing low-dose iron as NaFeEDTA, but not amaranth grain flour, reduces anemia and iron deficiency in Kenyan preschool children.

In Under-nutrition on October 6, 2012 at 6:06 am

Macharia-Mutie CW, Moretti D, Van den Briel N, Omusundi AM, Mwangi AM, Kok FJ, Zimmermann MB, Brouwer ID

J Nutrition 142: 1756-1763, 2012

Abstract 

Few studies have evaluated the impact of fortification with iron-rich foods such as amaranth grain and multi-micronutrient powder (MNP) containing low doses of highly bioavailable iron to control iron deficiency anemia (IDA) in children.

We assessed the efficacy of maize porridge enriched with amaranth grain or MNP to reduce IDA in Kenyan preschool children. In a 16-wk intervention trial, children (n = 279; 12-59 mo) were randomly assigned to: unrefined maize porridge (control; 4.1 mg of iron/meal; phytate:iron molar ratio 5:1); unrefined maize (30%) and amaranth grain (70%) porridge (amaranth group; 23 mg of iron/meal; phytate:iron molar ratio 3:1); or unrefined maize porridge with MNP (MNP group; 6.6 mg iron/meal; phytate:iron molar ratio 2.6:1; 2.5 mg iron as NaFeEDTA).

Primary outcomes were anemia and iron status with treatment effects estimated relative to control. At baseline, 38% were anemic and 30% iron deficient.

Consumption of MNP reduced the prevalence of anemia [-46% (95% CI: -67, -12)], iron deficiency [-70% (95% CI: -89, -16)], and IDA [-75% (95% CI: -92, -20)]. The soluble transferrin receptor [-10% (95% CI: -16, -4)] concentration was lower, whereas the hemoglobin (Hb) [2.7 g/L (95% CI: 0.4, 5.1)] and plasma ferritin [40% (95% CI: 10, 95)] concentrations increased in the MNP group. There was no significant change in Hb or iron status in the amaranth group.

Consumption of maize porridge fortified with low-dose, highly bioavailable iron MNP can reduce the prevalence of IDA in preschool children. In contrast, fortification with amaranth grain did not improve iron status despite a large increase in iron intake, likely due to high ratio of phytic acid:iron in the meal.

London: HUNGER TALKS (Fri, 19th Oct 2012) – open to public

In Under-nutrition on October 1, 2012 at 8:42 am

From the Conference Brochure:

Action Against Hunger and Birkbeck University are pleased to welcome you to HUNGER TALKS, a one day event that we hope will become a regular feature in the nutrition calendar.

“The aim of HUNGER TALKS is to bring together leading voices from the frontlines of the fight against hunger.

“In this first instalment, HUNGER TALKS will look at hunger from a broad perspective; not only from a Nutrition or Food Security & Livelihoods perspective, but by exploring ways in which these two come together.

“This year’s HUNGER TALKS will focus on what it means to integrate Nutrition and Food Security & Livelihoods in the 21st century, where the opportunities lie and where the challenges may lie.

“To do so, we have invited a panel of fi very experienced and innovative speakers:

Saul Guerrero – Chair man

Abigail Perry – DFID

Stephen Spratt – Research Fellow, IDS

Mark Davies – Programme Manager Social Protection, IDS

Filippo Dibari – Valid International/UCL (Institute of Global Health)

Leena Camadoo – TWIN

Click here  for the bio of the speakers, the programme details and the location.

The participation is OPEN to anybody interested.

Breastfeeding: NOT good news in developing countries

In Under-nutrition on September 30, 2012 at 6:13 am

Global trends in exclusive breastfeeding

by Xiaodong Cai, Tessa Wardlaw and David W Brown

International Breastfeeding Journal 2012, 7:12 

(entire doc)

 

Abstract

Background

Infant and young child feeding is critical for child health and survival. Proportion of infants 0–5 months who are fed exclusively with breast milk is a common indicator used for monitoring and evaluating infant and young child feeding in a given country and region. Despite progress made since 1990, a previous review in 2006 of global and regional trends found improvement to be modest. The current study provides an update in global and regional trends in exclusive breastfeeding from 1995 to 2010, taking advantage of the wealth of data from recent household surveys.

Methods

Using the global database of infant and young child feeding maintained by the United Nations Children’s Fund, the authors examined estimates from 440 household surveys in 140 countries over the period between 1995 and 2010 and calculated global and regional averages of the rate of exclusive breastfeeding among infants 0–5 months for the two time points to assess the trends.

Results

Trend data suggest the prevalence of exclusive breastfeeding among infants younger than six months in developing countries increased from 33% in 1995 to 39% in 2010. The prevalence increased in almost all regions in the developing world, with the biggest improvement seen in West and Central Africa.

Conclusions

In spite of the well-recognized importance of exclusive breastfeeding, the practice is not widespread in the developing world and increase on the global level is still very modest with much room for improvement. Child nutrition programmes worldwide continue to require investments and commitments to improve infant feeding practices in order to have maximum impact on children’s lives.

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Famine Exposure in the Young and the Risk of Type 2 Diabetes in Adulthood (n=7,837)

In Under-nutrition on September 28, 2012 at 9:26 am

Annet F.M. van AbeelenSjoerd G. EliasPatrick M.M. BossuytDiederick E. GrobbeeYvonne T. van der SchouwTessa J. Roseboom and Cuno S.P.M. Uiterwaal

in Diabetes. 2012 Sep;61(9):2255-60

Abstract

The developmental origins hypothesis proposes that undernutrition during early development is associated with an increased type 2 diabetes risk in adulthood.

We investigated the association between undernutrition during childhood and young adulthood and type 2 diabetes in adulthood. We studied 7,837 women from Prospect-EPIC (European Prospective Investigation Into Cancer and Nutrition) who were exposed to the 1944-1945 Dutch famine when they were between age 0 and 21 years. We used Cox proportional hazards regression models to explore the effect of famine on the risk of subsequent type 2 diabetes in adulthood. We adjusted for potential confounders, including age at famine exposure, smoking, and level of education.

Self-reported famine exposure during childhood and young adulthood was associated with an increased type 2 diabetes risk in a dose-dependent manner. In those who reported moderate famine exposure, the age-adjusted type 2 diabetes hazard ratio (HR) was 1.36 (95% CI [1.09-1.70]); in those who reported severe famine exposure, the age-adjusted HR was 1.64 (1.26-2.14) relative to unexposed women. These effects did not change after adjustment for confounders.

This study provides the first direct evidence, using individual famine exposure data, that a short period of moderate or severe undernutrition during postnatal development increases type 2 diabetes risk in adulthood.

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