evidence-based blog of Filippo Dibari

Posts Tagged ‘stunting’

Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems

In Over-nutrition, Under-nutrition on March 23, 2019 at 8:22 pm

Published: January 16, 2019 on The Lancet

Executive Summary 

Food systems have the potential to nurture human health and support environmental sustainability, however our current trajectories threaten both. The EAT–Lancet Commission addresses the need to feed a growing global population a healthy diet while also defining sustainable food systems that will minimise damage to our planet.   

The Commission quantitively describes a universal healthy reference diet, based on an increase in consumption of healthy foods (such as vegetables, fruits, whole grains, legumes, and nuts), and a decrease in consumption of unhealthy foods (such as red meat, sugar, and refined grains) that would provide major health benefits, and also increase the likelihood of attainment of the Sustainable Development Goals.

This is set against the backdrop of defined scientific boundaries that would ensure a safe operating space within six Earth systems, towards sustaining a healthy planet.  

The EAT–Lancet Commission is the first of a series of initiatives on nutrition led by The Lancet in 2019, followed by the Commission on the Global Syndemic of obesity, undernutrition, and climate change. Find out more in our Editorial.

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

(download)

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.

 

 

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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UN: Levels and trends in child malnutrition – 2017

In Over-nutrition, Under-nutrition on March 11, 2018 at 11:03 am

Source: World Bank webpage

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(download)

In May 2017, UNICEF, WHO and World Bank Group released the 2017 edition of the joint child malnutrition estimates for the 1990–2016 period, representing the most recent global and regional figures. A suite of on-line interactive dashboards were developed to enable users to explore the entire time-series (1990 – 2016) of global and regional estimates of prevalence and number affected for stunting, overweight, wasting and severe wasting. These estimates are presented by various regional and income group country classifications used by various agencies including the United Nations, UNICEF, WHO and The World Bank Group.

Note: Global estimates refer to the aggregate of the UN regions.

UNICEF/WHO/WB: Levels and Trends in Child Malnutrition

In Over-nutrition, Under-nutrition on June 7, 2017 at 7:02 pm

source: World Bank webpage

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(download)

In May 2017, UNICEF, WHO and World Bank Group released the 2017 edition of the joint child malnutrition estimates for the 1990–2016 period, representing the most recent global and regional figures. A suite of on-line interactive dashboards were developed to enable users to explore the entire time-series (1990 – 2016) of global and regional estimates of prevalence and number affected for stunting, overweight, wasting and severe wasting. These estimates are presented by various regional and income group country classifications used by various agencies including the United Nations, UNICEF, WHO and The World Bank Group.

Note: Global estimates refer to the aggregate of the UN regions.

Nutrition Key to Developing Africa’s “Grey Matter Infrastructure”

In Over-nutrition, Under-nutrition on May 29, 2017 at 6:13 am

from IPSnews

AfDB President Akinwumi Adesina adressing delegates at the nutrition event while Ambassador Kenneth Quinn, World Food Prize Foundation, listens. Credit: Friday Phiri/IPS


AHMEDABAD, India, May 24 2017 (IPS) – Developing Africa’s ‘grey matter infrastructure’ through multi-sector investments in nutrition has been identified as a game changer for Africa’s sustainable development.

Experts here at the 2017 African Development Bank’s Annual Meetings say investing in physical infrastructure alone cannot help Africa to move forward without building brainpower.

“We can’t say Africa is rising when half of our children are stunted.” –Muhammad Ali Pate

“We can repair a bridge, we know how to do that, we can fix a port, we know how to do it, we can fix a rail, we know how to do that, but we don’t know how to fix brain cells once they are gone, that’s why we need to change our approach to dealing with nutrition matters in Africa,” said AfDB President, Akinwumi Adesina, pointing out that stunting alone costs Africa 25 billion dollars annually.

Malnutrition – the cause of half of child deaths worldwide – continues to rob generations of Africans of the chance to grow to their full physical and cognitive potential, hugely impacting not only health outcomes, but also economic development.

Malnutrition is unacceptably high on the continent, with 58 million or 36 percent of children under the age of five chronically undernourished (suffering from stunting)—and in some countries, as many as one out of every two children suffer from stunting. The effects of stunting are irreversible, impacting the ability of children’s bodies and brains to grow to their full potential.

On a panel discussion Developing Africa’s Grey Matter Infrastructure: Addressing Africa’s Nutrition Challenges” moderated by IFPRI’s Rajul Pandya-Lorch, experts highlighted the importance of urgently fighting the scourge of malnutrition.

Laura Landis of the World Food Programme (WFP) said the cost of inaction is dramatic. “We have to make an economic argument on why we need action,” she said. “The WFP is helping, in cooperation with the African Union and the AfDB, to collect the data that gets not just the Health Minister moving, but also Heads of State or Ministers of Finance.”

The idea is to get everyone involved and not leave nutrition to agriculture and/or health ministries alone. And panelists established that there is indeed a direct link between productivity and growth of the agriculture sector and improved nutrition.

Baffour Agyeman of the John Kuffuor Foundation puts it simply: “It has become evident that it is the quality of food and not the quantity thereof that is more important,” calling for awareness not to end at high level conferences but get to the grassroots.

Assisting African governments to build strong and robust economies is accordingly a key priority for the AfDB. But recognizing the potential that exists in the continent’s vast human capital, the bank included nutrition as a focus area under its five operational priorities – the High 5s.

And to mobilise support at the highest level, the African Leaders for Nutrition (ALN) initiative was launched last year, bringing together Heads of State committed to ending malnutrition in their countries.

As a key partner of this initiative, the Bill and Melinda Gates Foundation foresees improved accountability with such an initiative in place. “ALN is a way to make the fight against malnutrition a central development issue that Ministers of Finance and Heads of State take seriously and hold all sectors accountable for,” said Shawn Baker, Nutrition Director at the Foundation.

However, African Ministers of Finance want to see better coordination and for governments to play a leading role in such initiatives to achieve desired results. “Cooperation and coordination are key between government and development partners,” said Sierra Leone’s Finance and Economic Development Minister Momodu Kargbo. “Development partners disregard government systems when implementing programmes whereas they should align and carefully regard existing government institutions and ways of working.”

Notwithstanding the overarching theme of Africa rising, Muhammad Ali Pate, CEO of Big Win Philanthropy, says, “We can’t say Africa is rising when half of our children are stunted.” He pointed out the need to close the mismatch between the continent’s sustained GDP growth and improved livelihood of its people.

With the agreed global SDG agenda, Gerda Verburg, Scaling Up Nutrition Movement Coordinator sees nutrition as a core of achieving the goals. “Without better nutrition you will not end poverty, without better nutrition you will not end gender inequality, without better nutrition you will not improve health, find innovative approaches, or peace and stability, better nutrition is the core,” she says.

Therefore, developing Grey Matter Infrastructure is key to improving the quality of life for the people of Africa. But it won’t happen without leadership to encourage investments in agriculture and nutrition, and more importantly, resource mobilization for this purpose.

Unmissable – The 2017 Atlas of Sustainable Development Goals: a new visual guide to data and development

In Over-nutrition, Under-nutrition on April 20, 2017 at 7:48 am
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from the World Bank website

Atlas-Cover

The 2017 Atlas of Sustainable Development Goals: a new visual guide to data and development.

<!– /sites/all/themes/blogs/templates/header/js/jquery-1.4.4.min.js –>The World Bank is pleased to release the 2017 Atlas of Sustainable Development Goals. With over 150 maps and data visualizations, the new publication charts the progress societies are making towards the 17 SDGs.

The Atlas is part of the World Development Indicators (WDI) family of products that offer high-quality, cross-country comparable statistics about development and people’s lives around the globe. You can:

The 17 Sustainable Development Goals and their associated 169 targets are ambitious. They will be challenging to implement, and challenging to measure. The Atlas offers the perspective of experts in the World Bank on each of the SDGs.

Characteristics and determinants of child malnutrition in Mozambique, 2003–11

In Uncategorized on December 19, 2016 at 1:36 pm

Cardoso, J., Allwright, L. & Salvucci, V. (2016) Characteristics and determinants of child malnutrition in Mozambique, 2003–11. 2016/147. Helsinki: UNU-WIDER.

(download pdf)

Child malnutrition continues to be a serious impediment to development both at the individual and national levels in many developing countries. In Mozambique, despite a high and sustained GDP growth, child malnutrition has been decreasing at a rather slow pace over the past 15 years.

In this study, using the Mozambican Demographic and Health Surveys 2003 and 2011 we find that household wealth, mother’s education, area of residence, and access to safe water and improved sanitation facilities have a strong relation with different measures of chronic child malnutrition.

Also, the relative importance of these variables remained mostly unchanged over time.

We conclude that continued and more focused and effective interventions aimed at directly reducing child malnutrition should be undertaken by all public and private actors involved.

Food systems and diets: facing the challenges of the 21st century

In Over-nutrition, Under-nutrition on September 27, 2016 at 7:26 am

from the webpage of the Global Panel on Agriculture and Food Systems for Nutrition

(download the report here)

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The Global Panel on Agriculture and Food Systems for Nutrition published its new Report, Food systems and diets: Facing the challenges of the 21st century on the 23rd September 2016.

This evidence-based Report is designed to help policymakers make their food systems more supportive of high quality diets.

The need for action on malnutrition

Poor diet is the number one risk factor driving the world’s disease burden.

Three billion people from 193 countries now have low quality diets and nearly half of all countries are experiencing the simultaneous problem of serious levels of undernutrition, overweight and obesity. Yet our global understanding about the quality of our diets is limited.

The Report

Using modelling and trend analysis, the Report generates a new understanding of diets and food systems, and how they could change by 2030.

The analysis shows that if current trends continue, by 2030 nearly half of the world’s adult population will be overweight or obese, up from one third today. The poorest countries are not immune to these trends.

It also shows how these trends have enormous economic impacts at the macro and micro levels, as well major consequences for mortality and morbidity. For example, at the macro level, cost are estimated to represent an annual loss of 10% global GDP, equivalent to a global financial crisis every year.

Drawing on over 250 data sources and peer-reviewed articles, the Report lists a series of recommendations for policymakers in low and middle income countries through a ‘Call to Action’.

The Report presents evidence showing that the risk that poor diets pose to mortality and morbidity is now greater than the combined risks of unsafe sex, alcohol, drug and tobacco use.

But, as the Report shows that there are many opportunities for action within the food system.

A Call to Action

This Report identifies decisions that policymakers need to take in the coming decade, particularly for women and children, to invest in effective policies to reduce all forms of malnutrition, repositioning food systems from feeding people to nourishing people.

Actions which go beyond agriculture to encompass trade, the environment and health, harnessing the power of the private sector and empowering consumers to demand better diets.

Enhancing the ability of food systems to deliver high quality diets is a choice that is well within the grasp of policymakers.  It is a choice that will help achieve the SDG goal of ending malnutrition in all its forms by 2030. It is a choice that will reap benefits for decades to come, for all people, in all countries.

Only a response on the scale and commitment used to tackle HIV/AIDS and malaria will be sufficient to meet the challenge, particularly in low- and middle-income countries.

“This Report makes clear the enormous challenge posed by malnutrition and poor diets generally to the detriment of many millions of individuals and indeed whole economies.”

Sir John Beddington, Co-Chair of the Global Panel, and former UK Chief Scientific Advisor

Associations of Suboptimal Growth with All-Cause and Cause-Specific Mortality in Children under Five Years: A Pooled Analysis of Ten Prospective Studies

In Under-nutrition on June 3, 2016 at 3:38 pm

Olofin I, McDonald CM, Ezzati M, Flaxman S, Black RE, et al. (2013) Associations of Suboptimal Growth with All-Cause and Cause-Specific Mortality in Children under Five Years: A Pooled Analysis of Ten Prospective Studies. PLoS ONE 8(5): e64636.

(download)

Abstract

 

Background

Child undernutrition affects millions of children globally. We investigated associations between suboptimal growth and mortality by pooling large studies.

Methods

Pooled analysis involving children 1 week to 59 months old in 10 prospective studies in Africa, Asia and South America. Utilizing most recent measurements, we calculated weight-for-age, height/length-for-age and weight-for-height/length Z scores, applying 2006 WHO Standards and the 1977 NCHS/WHO Reference. We estimated all-cause and cause-specific mortality hazard ratios (HR) using proportional hazards models comparing children with mild (−2≤Z<−1), moderate (−3≤Z<−2), or severe (Z<−3) anthropometric deficits with the reference category (Z≥−1).

Results

53 809 children were eligible for this re-analysis and contributed a total of 55 359 person-years, during which 1315 deaths were observed. All degrees of underweight, stunting and wasting were associated with significantly higher mortality. The strength of association increased monotonically as Z scores decreased. Pooled mortality HR was 1.52 (95% Confidence Interval 1.28, 1.81) for mild underweight; 2.63 (2.20, 3.14) for moderate underweight; and 9.40 (8.02, 11.03) for severe underweight. Wasting was a stronger determinant of mortality than stunting or underweight. Mortality HR for severe wasting was 11.63 (9.84, 13.76) compared with 5.48 (4.62, 6.50) for severe stunting. Using older NCHS standards resulted in larger HRs compared with WHO standards. In cause-specific analyses, all degrees of anthropometric deficits increased the hazards of dying from respiratory tract infections and diarrheal diseases. The study had insufficient power to precisely estimate effects of undernutrition on malaria mortality.

Conclusions

All degrees of anthropometric deficits are associated with increased risk of under-five mortality using the 2006 WHO Standards. Even mild deficits substantially increase mortality, especially from infectious diseases.

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