Child Anthropometry Research Articles

Validation of the Child Feeding Questionnaire among Saudi pre-schoolers in Jeddah city.

To examine the psychometric properties of an Arabic version of the Child Feeding Questionnaire (CFQ-A) in a sample of Saudi pre-schoolers and their mothers. Cross-sectional study. Mothers completed questionnaires over the telephone and child anthropometry was measured objectively using standardized procedures; BMI Z-scores (BMIZ) were calculated based on the age- and sex-specific WHO growth standards and reference data. Confirmatory factor analysis was used to examine the original seven-factor CFQ model, as well as a modified nine-factor model. Cronbach's α was calculated to examine the internal consistency of each factor; Spearman correlation was used to examine 2-week retest reliability. Factor-factor and factor-child BMIZ correlations were examined. Jeddah, Kingdom of Saudi Arabia. A total of 209 mothers and children were recruited from eight different pre-schools. Both the original seven-factor and modified nine-factor CFQ-A exhibited good fit (root-mean-square-error of approximation < 0·05). Six out of nine factors had excellent internal consistency and all factors showed excellent 2-week test-retest reliability. There were significant correlations between child BMIZ and five out of the nine factors; Perceived Child Weight, Perceived Parent Weight, Restriction and Monitoring were each positively correlated with child BMIZ, while Concern about Child's Diet was negatively correlated with child BMIZ. The study provided evidence supporting the validity and reliability of the original seven-factor and modified nine-factor CFQ-A. Future studies are needed to further establish the psychometric properties of the CFQ-A in addition to other feeding assessment tools.

Associations of maternal and fetal SCD-1 markers with infant anthropometry and maternal diet: Findings from the ROLO study.

Elevated stearoyl-CoA desaturase 1 (SCD-1) activity showed associations with obesity in cross-sectional studies. In non-pregnant populations, nutrition regulates SCD-1 transcription and activity. To investigate the longitudinal associations of maternal and fetal SCD-1 activity markers with infant anthropometry up to 2 years of age, and to explore how selected dietary intakes modulate SCD-1 activity in pregnancy. As a secondary analysis from the ROLO intervention study, which was conducted in a population at risk for macrosomia, non-esterified fatty acids (NEFA) from maternal plasma at 13 and 28 weeks' gestation and in cord blood were measured via liquid-chromatography-mass-spectrometry. Fatty acid ratios 18:1/18:0 and 16:1/16:0 were used as markers for SCD-1 activity ('desaturation indices', DIs). Relationships of DIs with infant anthropometry up to 2 years of age and maternal dietary parameters during pregnancy were investigated using adjusted linear regression models and p-values correction for multiple testing. 18:1/18:0, but not 16:1/16:0, was associated with measures of infant anthropometry at birth (maternal and fetal markers) and up to 2 years of age (maternal markers only). Dietary intakes did not show strong associations with 18:1/18:0, but 16:1/16:0 was associated with absolute and relative dietary intakes. In a population at risk for macrosomia, maternal SCD-1 activity measured via 18:1/18:0 was involved in the fetal programming of infant obesity, but could not be substantially modulated by short-term diet in pregnancy. ISRCTN Registration number: ISRCTN54392969 (http://www.isrctn.com/ISRCTN54392969).

Steady Growth in Early Infancy Is Associated with Greater Anthropometry in Indian Children Born Low Birth Weight at Term

ABSTRACTBackgroundPatterns of early growth are associated with later body composition and risk of adult noncommunicable disease but information from low-income countries is limited.ObjectivesThe aim of this study was to investigate early growth trajectories and later anthropometric and bone density outcomes among children born term low birth weight (LBW: 1.8–2.5 kg).MethodsWe used data from 902 children from the Delhi Infant Vitamin D Supplementation study of LBW term infants (which collected monthly anthropometry from birth to 6 mo) and who had height, weight, midupper arm circumference (MUAC), midupper arm muscle circumference (MUAMC), subscapular and triceps skinfold thicknesses, tibia and radius bone density measured at age 4–6 y. We investigated how growth in the first 6 mo of life, modeled using the SuperImposition by Translation and Rotation (SITAR) growth curve model, was related to these outcomes. SITAR summarizes each infant's weight and length trajectory in terms of a population mean curve and child-specific growth parameters: size, timing, and intensity. These were included as explanatory variables in linear regression models for the childhood outcomes.ResultsConsidering the infant weight and length SITAR parameters jointly, childhood weight was strongly associated with infant length timing [estimated regression coefficient β = 0.25 (95% CI: 0.10, 0.39)] and with weight size, timing, and intensity [β = 9.01 (6.75, 11.27), β = −0.25 (−0.43, −0.07), β = 5.03 (3.22, 6.84), respectively]. Childhood height was associated only with the length parameters [β = 0.97 (0.71, 1.23), β = −0.43 (−0.77, −0.09), β = 11.68 (8.60, 14.75), respectively]; childhood MUAC, MUAMC, and skinfolds with all parameters; and bone density with none. Overall, delayed and sustained growth in infant weight and length resulted in higher values of all outcomes except bone density, with the period up to 15 wk of age appearing critical for setting childhood anthropometry in this population.ConclusionsThe explanation for the effects of delayed growth and length of the period in which trajectories are set is unclear; however, sustained and delayed growth in early infancy appears to be beneficial for these LBW children at least in the short-term. The trial was registered at clinicaltrials.gov as BT/PR7489/PID/20/285/2006.

Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health.

ObjectivesThe Norwegian randomized controlled trial Early Food for Future Health provided parental anticipatory guidance on early protective feeding practices from child age 6 to 12 months through an eHealth intervention. Previously published outcomes at child age 12 months indicated that the eHealth intervention increased daily vegetable/fruit intake and promoted more beneficial mealtime routines. The objective of the current paper is to evaluate the effects of the intervention at child age 24 months, one year after cessation.MethodsParents of infants aged 3–5 months were recruited via social media and child health clinics during spring 2016. At child age 5.5 months, 715 mothers were randomized to either control (n = 358) or intervention (n = 360) arm. Primary study-outcomes were child eating behaviors, dietary intake, mealtime routines and maternal feeding practices and feeding styles. Secondary outcome was child anthropometry.ResultsIn total 295 mothers (41%) completed the follow-up questionnaire at child age 24 months. Regarding fruit intake, 54.3% in the intervention group had a high score compared with 48.3% of the control group (p = 0.29). For intake of vegetables, 54.5% in the intervention group had a high score compared with 50.7% in the control group (p = 0.49). A total of 65.7% of the children in the intervention group were eating breakfast together with family ≥ 4 times per week, compared with 57.3% of the children in the control group (p = 0.12). There was no difference between the groups for child anthropometric outcomes at child age 24 months.ConclusionsAt child age 24 months, we found no evidence of sustained intervention-effects. Although dietary patterns and mealtime routines at child age 24 months were reasonably consistent and in the same directions as at child age 12 months, the between-group differences were not significant. The large loss to follow-up may have limited power and validity and makes it difficult to draw overall conclusions. Future research is needed to improve knowledge of how short-time effects could be retained over longer term, taking into account that larger samples are necessary when planning longer-term follow-up studies.Trial registrationISRCTN, ISRCTN13601567.

A School Meals Program Implemented at Scale in Ghana Increases Height-for-Age during Midchildhood in Girls and in Children from Poor Households: A Cluster Randomized Trial

ABSTRACTBackgroundAttention to nutrition during all phases of child and adolescent development is necessary to ensure healthy physical growth and to protect investments made earlier in life. Leveraging school meals programs as platforms to scale-up nutrition interventions is relevant as programs function in nearly every country in the world.ObjectiveThe aim of this study was to evaluate the impact of a large-scale school meals program in Ghana on school-age children's anthropometry indicators.MethodsA longitudinal cluster randomized control trial was implemented across the 10 regions of Ghana, covering 2869 school-age children (aged 5–15 y). Communities were randomly assigned to 1) control group without intervention or 2) treatment group providing the reformed national school feeding program, providing 1 hot meal/d in public primary schools. Primary outcomes included height-for-age (HAZ) and BMI-for-age (BAZ) z scores. The analysis followed an intention-to-treat approach as per the published protocol for the study population and subgroup analysis by age (i.e., midchildhood for children 5–8 y and early adolescence for children 9–15 y), gender, poverty, and region of residence. We used single-difference ANCOVA with mixed-effect regression models to assess program impacts.ResultsSchool meals had no effect on HAZ and BAZ in children aged 5–15 y. However, in per-protocol subgroup analysis, the school feeding intervention improved HAZ in 5- to 8-y-old children (effect size: 0.12 SDs), in girls (effect size: 0.12 SDs)—particularly girls aged 5–8 y living in the northern regions, and in children aged 5–8 y in households living below the poverty line (effect size: 0.22 SDs). There was also evidence that the intervention influenced food allocation and sharing at the household level.ConclusionSchool meals can provide a platform to scale-up nutrition interventions in the early primary school years, with important benefits accruing for more disadvantaged children. This trial was registered at www.isrctn.com as ISRCTN66918874.

Relative importance of prenatal and postnatal determinants of stunting: data mining approaches to the MINIMat cohort, Bangladesh

IntroductionWHO has set a goal to reduce the prevalence of stunted child growth by 40% by the year 2025. To reach this goal, it is imperative to establish the relative...

Suboptimal feeding and caring practices among young Indian children ages 12 to 24 mo living in the slums of New Delhi.

Inappropriate infant and young child feeding and caring practices affect nutritional status, increases the risk for growth faltering, and ultimately, affect child survival. The aim of this study was to characterize the feeding and caring practices of disadvantaged urban Indian children 12 to 24 mo of age in relation to the World Health Organization (WHO) and Pan American Health Organization (PAHO) recommendations. This cross-sectional study was conducted in self-selected households in a South Delhi slum. A household survey was administered to the mother/primary caregiver of 120 eligible children. We collected child anthropometry, 2-d weighed food records (n = 69), and compliance to WHO and PAHO recommended feeding, caring, food safety, and hygiene practices. Of the children, 39% were stunted, 31% underweight, and 10% wasted; none were overweight. Despite 88% achieving minimum meal frequency (more than three to four meals daily), only 50% consumed at least four food groups (minimum dietary diversity), and 44% a minimum acceptable diet (composite score of minimum meal frequency and minimum dietary diversity). Consumption of iron-rich or iron-fortified foods, vitamin A-rich fruits and vegetables, and eggs was low (<25%) and flesh foods were negligible (1.4%), whereas consumption of both sugary and snack foods was >60%. Reported compliance to responsive feeding indicators was generally ∼50%, but there was a wide range (13-98%) for food safety and hygiene practices, which were not always consistent with home observations. Complementary feeding and caregiving practices were suboptimal among these disadvantaged young Indian children and education interventions focused on infant and young child feeding, responsive feeding, food safety, and hygiene practices are urgently needed.

Early Life Exposures to Perfluoroalkyl Substances in Relation to Adipokine Hormone Levels at Birth and During Childhood.

Birth cohort studies have linked exposure to perfluoroalkyl substances (PFASs) with child anthropometry. Metabolic hormone dysregulation needs to be considered as a potential adverse outcome pathway. We examined the associations between PFAS exposures and concentrations of adipokine hormones from birth to adolescence. We studied 80 mother-child pairs from a Faroese cohort born in 1997 to 2000. Five PFASs were measured in maternal pregnancy serum and in child serum at ages 5, 7, and 13 years. Leptin, adiponectin, and resistin were analyzed in cord serum and child serum at the same ages. We fitted multivariable-adjusted generalized estimating equations to assess the associations of PFASs at each age with repeated adipokine concentrations at concurrent and subsequent ages. We observed tendencies of inverse associations between PFASs and adipokine hormones specific to particular ages and sex. Significant associations with all adipokines were observed for maternal and child 5-year serum PFAS concentrations, whereas associations for PFASs measured at ages 7 to 13 years were mostly null. The inverse associations with leptin and adiponectin were seen mainly in females, whereas the inverse PFAS associations with resistin levels were seen mainly in males. Estimates for significant associations (P value <0.05) suggested mean decreases in hormone levels (range) by 38% to 89% for leptin, 16% to 70% for adiponectin, and 33% to 62% for resistin for each twofold increase in serum PFAS concentration. These findings suggest adipokine hormone dysregulation in early life as a potential pathway underlying PFAS-related health outcomes and underscore the need to further account for susceptibility windows and sex-dimorphic effects in future investigations.

Anthropometric, cognitive, and schooling benefits of measles vaccination: Longitudinal cohort analysis in Ethiopia, India, and Vietnam

ObjectiveTo estimate the associations between measles vaccination and child anthropometry, cognition, and schooling outcomes in Ethiopia, India, and Vietnam. MethodsLongitudinal survey data from Young Lives were used to compare outcomes at ages 7–8 and 11–12 years between children who reported receipt or non-receipt of measles vaccine at 6–18 months-of-life (n = ∼2000/country). Z-scores of height-for-age (HAZ), BMI-for-age (BMIZ), weight-for-age (WAZ), Peabody Picture Vocabulary Test (PPVT), early grade reading assessment (EGRA), language and mathematics tests, and attained schooling grade were examined. Propensity score matching was used to control for systematic differences between measles-vaccinated and measles-unvaccinated children. FindingsUsing age- and country-matched measles-unvaccinated children as comparisons, measles-vaccinated children had better anthropometrics, cognition, and schooling. Measles-vaccinated children had 0.1 higher HAZ in India and 0.2 higher BMIZ and WAZ in Vietnam at age 7–8 years, and 0.2 higher BMIZ at age 11–12 years in Vietnam. At ages 7–8 years, they scored 4.5 and 2.9 percentage points (pp) more on PPVT and mathematics, and 2.3 points more on EGRA in Ethiopia, 2.5 points more on EGRA in India, and 2.6 pp, 4 pp, and 2.7 points more respectively on PPVT, mathematics, and EGRA in Vietnam. At ages 11–12 years, they scored 3 pp more on English and PPVT in India, and 1.7 pp more on PPVT in Vietnam. They also attained 0.2–0.3 additional schooling grades across all ages and countries. ConclusionOur findings suggest that measles vaccination may have benefits on cognitive gains and school-grade attainment that can have broad educational and economic consequences which extend beyond early childhood.

Haemophilus influenzae type b vaccination and anthropometric, cognitive, and schooling outcomes among Indian children.

Haemophilus influenzae type b (Hib) affects 337,000 Indian children every year. A vaccine against Hib was introduced in 2011 as part of the pentavalent vaccine and scaled up nationwide. This study investigated the associations between Hib vaccination and child anthropometry, cognition, and schooling outcomes in India. We used longitudinal survey data and employed propensity score matching to control for observed systematic differences between children who reported receipt or nonreceipt of Hib vaccine before age 6 years (n = 1824). Z‐scores of height‐for‐age (HAZ) and BMI‐for‐age (BMIZ), percentage scores of English, mathematics, reading, and Peabody Picture Vocabulary tests, and attained schooling grade of children were examined. Hib‐vaccinated children had 0.25 higher HAZ, scored 4.09 percentage points (pp) higher on the English test and 4.78 pp higher on the mathematics test, and attained 0.16 more schooling grades than Hib‐unvaccinated children at age 11–12 years. At age 14–15 years, they had 0.18 higher HAZ, scored 3.63 pp higher on the reading test and 3.22 pp higher on the mathematics test, and attained 0.15 more schooling grades than Hib‐unvaccinated children. The findings indicate potential long‐term health, cognitive, and schooling benefits of the Hib vaccine, subject to the effect of unobserved confounding factors.

Father Engagement in Improving Infant and Young Child Feeding (IYCF) Practices: Evidence from a Clustered Randomized Controlled Trial in Ethiopia (P11-112-19)

ObjectivesWe identified lack of knowledge and lack of paternal support as barriers to improved IYCF practices in Ethiopia, the focus of this study. Behavior change communication (BCC) strategies are often used to improve knowledge, but BCC programs commonly target only mothers. The objective of this study is to assess the impact of both paternal and maternal BCC program on complementary feeding practices compared to maternal BCC program alone. MethodsThis study is a community-based, clustered randomized controlled trial conducted in Ejere district, Ethiopia. We randomly selected three rural kebeles (ward) and three urban kebeles within the Ejere district. 63 garees (villages) were identified and randomly assigned within selected kebeles into treatment and control groups: T1, maternal BCC only; T2, both maternal BCC and paternal BCC; and C, control. The maternal BCC program and paternal BCC program consisted of weekly one-hour long group sessions for the duration of 16 and 12 weeks, respectively. Both BCC program included messages on improved IYCF practices. In addition, paternal BCC program included messages on gender roles. ResultsFather’s IYCF knowledge increased by 0.31SD when BCC was provided to mothers and by 0.62SD when provided to both mothers and fathers. Although we see spillover of knowledge from BCC from BCC-attending mothers to their partners in maternal BCC group, we see paternal BCC additionally increase father’s knowledge by 0.36SD. The provision of both maternal and paternal BCC group improves child dietary diversity score (CDDS) by 0.64 food groups and increases the likelihood they meet minimum diet diversity by 18 percentage points. However, the additional impact of paternal BCC on child diets is not statistically significant at the 5% level. We see no differential impact on child anthropometry. ConclusionsNutrition BCC program that targets both fathers and mothers have greater impact on father’s knowledge, compared to nutrition BCC program that targets mothers only. However, additional knowledge gain has limited impact on IYCF practices. Funding SourcesAfrica Future Foundation. Supporting Tables, Images and/or Graphs▪▪▪▪

Young Mom, Short Kid: Examining Social, Biological and Health and Nutrition Service Factors Linking Adolescent Pregnancy to Early Childhood Undernutrition in India (P10-011-19)

ObjectivesAdolescent pregnancy is a global public health concern and one in five adolescents live in India, where early marriage is widely practiced. We sought to examine linkages between adolescent pregnancy and child undernutrition using a holistic approach. MethodsData were from India’s 2015–2016 National Family Health Surveys. Primiparous women aged 15–49 years who gave birth between 2010 and 2015 (n = 60,096) were classified based on age at first birth: ≤19 years (adolescence), 20–24 years (young adulthood), and ≥25 years (adulthood). Multivariable regression and structural equation models were used to understand how adolescent pregnancy is linked to child undernutrition through women’s education and bargaining power, nutritional status, health service use, child feeding and living conditions. ResultsOverall, 24% of first births among Indian women aged 15–49 years in 2016 occurred during adolescence, with large state and district variability (from 4% to 45% for states and 1% to 62% for districts). Compared to children born to adult mothers, those born to adolescent mothers had lower z-scores for height-for-age (mean difference: -0.53 SD), weight-for-age (-0.40 SD), and weight-for-height (-0.16 SD). Compared to adult mothers, adolescent mothers were shorter (-1.2 cm), more likely to be underweight (+ 18%) and anemic (+ 8%), had lower education (-3.0 years), less bargaining power (-7% to -15%), and lived in poorer households (-0.66 SD) with poorer sanitation (-28%). Adolescent mothers were less likely to access health services (-4% to -15%) and had poorer complementary feeding practices (-3% to -9%). These intermediate factors were predictive of child anthropometry, with the strongest links being women’s education, socioeconomic status, and weight. ConclusionsAdolescent pregnancy is related to maternal nutritional status, education, access to nutrition and health services, complementary feeding practices, and living conditions; together, these are associated with child undernutrition. Policies and programs to delay marriage are likely to help break the intergenerational cycle of poverty and undernutrition in India. Funding SourcesBill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute.

Social, biological, and programmatic factors linking adolescent pregnancy and early childhood undernutrition: a path analysis of India's 2016 National Family and Health Survey

SummaryBackgroundAdolescent pregnancy and child undernutrition are major social and public health concerns. We aimed to examine associations between adolescent pregnancy and child undernutrition in India, where one in five adolescents live, and one in three of the world's stunted children.MethodsData were from India's fourth National Family Health Survey, 2015–16. Primiparous women aged 15–49 years who gave birth between 2010 and 2016 were classified on the basis of age at first birth: 10–19 years (adolescence), 20–24 years (young adulthood), and 25 years or older (adulthood). Primary outcomes were anthropometric measures of offspring undernutrition. Multivariable regression and structural equation models were used to understand the extent to which these measures were linked to adolescent pregnancy and the potential social, biological, and programmatic pathways.FindingsOf the 60 096 women in the sample, 14 107 (25%) first gave birth during adolescence. Children born to adolescent mothers had lower Z scores for length or height-for-age (mean difference −0·53 SD), weight-for-age (–0·40 SD), and weight-for-length or height (–0·16 SD) than children born to adult mothers. Compared with adult mothers, adolescent mothers were shorter (–1·21 cm, 95% CI −1·78 to −0·65), more likely to be underweight (18 percentage points, 15–21) and anaemic (8 percentage points, 6–11), less likely to access health services (–4 to −15 percentage points), and had poorer complementary feeding practices (–3 to −9 percentage points). Adolescent mothers also had less education (–3·30 years, 95% CI −3·68 to −2·91), less bargaining power (–7 to −15 percentage points), and lived in poorer households (–0·66 SD, 96% CI −0·82 to −0·50) with poorer sanitation (–28 percentage points, −32 to −24). In the path analysis, these intermediate factors predicted child anthropometry, with the strongest links being mother's education (18%), socioeconomic status (13%), and weight (15%).InterpretationChildren born to adolescent mothers are at risk of being undernourished. Adolescent pregnancy is related to child undernutrition through poor maternal nutritional status, lower education, less health service access, poor complementary feeding practices, and poor living conditions. Policies and programmes to delay pregnancy and promote women's rights could help break the intergenerational cycle of undernutrition through many routes.FundingBill & Melinda Gates Foundation through Partnerships and Opportunities to Strengthen and Harmonize Actions for Nutrition in India, led by the International Food Policy Research Institute.

Adaptation of a mental development assessment tool for the evaluation of the long-term effect of a successful nutrition intervention in Ghana.

This study adapted a cognitive assessment tool to be used in evaluating nutrition interventions in developing countries and assessed its reliability and validity in Ghana. The tool was used to evaluate the long-term effect of the Enhancing Child Nutrition through Animal Source Food Management (ENAM) project. The former ENAM participants' children were contacted (now 13 to 15years old). The items in the Wechsler Abbreviated Scale of Intelligence-II were adapted, pretested, refined, and pretested again. Cross-sectional data collection was conducted with former ENAM participants (60 interventions and 51 comparison families) in one of ENAM's three sites (the Guinea Savanna zone). Data on participants' socio-economic status and food insecurity were collected, along with their children's intellectual functioning, dietary intake, school attainment, anthropometry, and symptoms of depression. Alpha coefficient of the verbal subscale improved between the first and second pretest (from .34 to .80). After controlling for age, the intelligence scores of the children were associated with their grade (r=.35, p=.001) and academic performance (r=.26 to .33, p<.05). The verbal scale was associated with their anthropometry (r=.24 to .27, p<.05). The intervention children still recorded a better dietary diversity score than controls (6.8 vs 5.8, p=.0001); however, significance was lost after adjusting for confounders. There were no significant group differences in growth or intellectual functioning. The adapted Wechsler Abbreviated Scale of Intelligence-II tool performed well in evaluating adolescent intellectual functioning in rural Ghana, and there were no long-term effects of ENAM intervention on child growth and development.

Effect of enhanced homestead food production on anaemia among Cambodian women and children: A cluster randomized controlled trial.

There is inconsistent evidence on the efficacy of agriculture programmes at improving women and children's anaemia and nutritional status. The primary aim of this study was to evaluate the impact of a nutrition‐sensitive enhanced homestead food production (EHFP) programme on anaemia in women (18–45 years) and children (6–59 months) in rural Cambodia. Secondary outcomes were women's micronutrient status and women and children's anthropometry. In this cluster‐randomized controlled trial, 900 households from 90 villages (clusters) were randomized to either (a) home gardens and behaviour change communication (BCC) on nutrition, hygiene, women's empowerment, and marketing (EHFP); (b) home gardens plus fishponds and BCC (EHFP + F); or (c) control (no intervention). Haemoglobin concentration and anthropometry were measured in women and children at baseline and at 22 months. Venous blood samples were collected in a subset of women (n = 450) at baseline and at 22 months. Generalized linear mixed effect models with repeated measures were used to evaluate the difference across groups and the change from baseline to end of study. Ninety clusters, 552 women, and 754 children completed the trial. Compared with control, we found a statistically significant impact on anaemia prevalence in children (−14.0 percentage points; P = 0.02) and retinol binding protein concentrations in women (difference in difference: 0.34; P = 0.02) randomized to EHFP and EHFP + F groups, respectively. No other statistically significant effects on anaemia, nutritional biomarker concentrations, or anthropometry were observed. Future research is needed to examine longer term impacts of EHFP on anthropometry in women and children and into the nutritional causes of anaemia among children in Cambodia.

Poultry husbandry, water, sanitation, and hygiene practices, and child anthropometry in rural Burkina Faso.

Poultry production in low income countries provides households with nutrient‐rich meat and egg products, as well as cash income. However, traditional production systems present potential health and nutrition risks because poultry scavenging around household compounds may increase children's exposure to livestock‐related pathogens. Data from a cross‐sectional survey were analysed to examine associations between poultry, water, sanitation, and hygiene practices, and anthropometric indicators in children (6–59 months; n = 3,230) in Burkina Faso. Multilevel regression was used to account for the hierarchical nature of the data. The prevalence of stunting and wasting in children 6–24 months was 19% and 17%, respectively, compared with a prevalence of 26% and 6%, respectively, in children 25–60 months. Over 90% of households owned poultry, and chicken faeces were visible in 70% of compounds. Caregivers reported that 3% of children consumed eggs during a 24‐hr recall. The presence of poultry faeces was associated with poultry flock size, poultry‐husbandry and household hygiene practices. Having an improved water source and a child visibly clean was associated with higher height‐for‐age z scores (HAZ). The presence of chicken faeces was associated with lower weight‐for‐height z scores, and no associations were found with HAZ. Low levels of poultry flock size and poultry consumption in Burkina Faso suggest there is scope to expand production and improve diets in children, including increasing chicken and egg consumption. However, to minimize potential child health risks associated with expanding informal poultry production, research is required to understand the mechanisms through which cohabitation with poultry adversely affects child health and design interventions to minimize these risks.

Impact of Crude Palm Oil Fortified Cookies Supplementation on Anthropometry, Vitamin A and Hematological Status of School Children in India.

Objectives: Food-based strategies remain the most sustainable solutions for combating micronutrient deficiencies. Crude palm oil being the richest natural source of β-carotene, the study aimed to assess the impact of crude palm oil fortified cookies supplementation on anthropometry, vitamin A and hematological status of school children. Methods: 444 children (boys-226, girls-218), aged 5-13years from two Municipal Corporation of Delhi primary schools were enrolled. By draw of lot, children from one of the schools formed the experimental (n=224; boys-119, girls-105) while other formed the placebo group (n=220; boys-107; girls-113). Children from the experimental group received six crude palm oil fortified cookies providing 2152μg of β-carotene while the placebo group received similar but non-fortified cookies each day for 50 school days. Anthropometry, vitamin A, and hematological status were assessed at baseline and post supplementation. Results: Post supplementation, the number of stunted subjects reduced significantly (p<0.05) in the experimental group. There was a significant increase in plasma retinol (170.9%; mean change: 1.55±1.30μmol/L - experimental group vs. 0.45±0.99μmol/L - placebo group) and β-carotene (p<0.01; median change from 0.55 to 0.76μmol/L - experimental group vs. 0.59 to 0.55μmol/L -placebo group) concentrations of the experimental group. The increase in hematological parameters (mean change in Hemoglobin: 1.64g/dL in experimental group vs. 2.10g/dL in placebo group) of both the groups were however, comparable. Conclusion: To address micronutrient deficiencies particularly in developing nations, the use of crude palm oil should be encouraged through supplementary feeding programs by way of ready-to-eat snacks.

Do Parent's Lifestyle Factors and Their Socioeconomic-Food Security Status Affected Children's Growth in Pre-Crisis Venezuela?

Life conditions are key factors for defining growth and development of future generation. Exposure to drugs, alcohol, use of tobacco and other substances in parents as part of their lifestyle, have been reported to affect children's health and wellbeing. Prenatal exposures have been documented, but less is known about influences from parental harmful habits during children 's school years. The aim of this study is to examine potential associations between parental habits and anthropometric characteristics of their children. Parental smoking, alcohol intake, food security, and socioeconomic status (SES) were explored in 1730 children recruited at private and public schools in eight Venezuelan cities. These qualitative variables were collected through a semi-structured questionnaire. Weight, height and body mass index were measured using standardized methods. Height and BMI were converted to z-scores according to WHO international growth reference. Low BMI z-scores in children were significantly associated with mothers consuming alcohol. The frequency of children with short height was higher in households with impaired access to quality foods and where mothers reported low and very low food security status. In brief, our study indicates that social environment could have detrimental effects on child anthropometry, and on adequacy of food intake affecting their wellbeing. Funding: This study was supported by an award given by Caracas’ Insurance Foundation ( from Liberty Mutual Venezuela) as the awarded best Project in 2010. The funders had no role in study design, data collection, analysis, the decision to publish, or the preparation of this manuscript. Declaration of Interest: The authors declare no conflict of interest. Ethical Approval: The study was approved by the ethics committee of the Venezuelan Scientific Society for Obesity, and conducted in accordance with the ethical standards specified in the World Medical Association (2000) Declaration of Helsinski. Informed consent was obtained from a parent or legal guardian of each participating child.

Nutritional status assessment by anthropometry in children with chronic liver disease aged 6 months to 12 years

Background: In spite of distinctive improvements in nutritional therapy, malnutrition and growth retardation remained as challenging significances of chronic liver disease (CLD) in children. The present study was done to evaluate the severity and frequency of malnutrition using anthropometry in CLD children.Methods: The study included 50 children with CLD attending the OPD of Institute of Child Health and Hospital for Children, Egmore, Chennai during the period from April 2016 to September 2016. Physical growth and nutritional status in the patients were evaluated using anthropometric parameters and Z-scores.Results: The incidence of malnutrition in the children using height for age was found to be 90%, weight for age- 84%, BMI for age- 40%, MAC for age- 88%, TST for age- 88%. SGA showed 96% malnutrition. Weight for age and body mass index were influenced by this fluid retention (P=0.002 and P=0.007 respectively). Whereas height for age, MAC and TST were not influenced by fluid retention (P=0.321, P=0.371 and P=0.031 respectively).Conclusions: Assessment of nutritional status in CLD children can be easily diagnosed by anthropometric measurements. Early diagnosis of malnutrition will decrease the related morbidity and mortality in children.

Heterogeneity in the effect of mid-childhood height and weight gain on human capital at age 14-15 years: Evidence from Ethiopia, India, Peru, and Vietnam.

BackgroundUnder-nutrition in early childhood has harmful impacts on human capital formation in children, with implications for educational, adult health, and labor market outcomes. We investigate the association of linear growth and weight gain in mid-childhood with years of schooling, the Peabody Picture Vocabulary Test score, and math test score during the adolescent age of 14–15 years.MethodsData were derived from the Young Lives study conducted in four low- and middle-income countries (Ethiopia, India, Peru, and Vietnam). The data had detailed information on the children anthropometry and characteristics of the child, household, and community. Multivariate regression analysis, adjusted for the confounding variables, was used to investigate the association between mid-childhood health, measured by conditional linear growth and relative weight gain, and human capital outcomes in adolescent age.ResultsAfter controlling for several confounders, one cm increase in conditional linear growth increased years of schooling by 0.034 years and the Peabody Picture Vocabulary Test score and math test score by 0.474 and 0.083 points respectively. Relative weight gain was negatively associated with years of schooling and math test score. There is no evidence of heterogeneous effects by rural, gender, and household wealth. In the quantile regression analyses, the association between conditional linear growth and outcomes is stronger at the lower level of years of schooling and the Peabody Picture Vocabulary Test score.ConclusionOur study highlights that mid-childhood nutritional intervention targeted for students at the lower level of education distribution can accelerate the rate of human capital accumulation in low- and middle-income countries.