Causes Of Malnutrition Research Articles

Survey of obesity among school children in rural Kerala, India

Background: Childhood obesity is a risk factor for subsequent development of diabetes mellitus, hypertension etc. Rural children show lower levels of obesity and higher rates of malnutrion. Objectives: Study seeks to access the prevalence of obesity and overweight among higher secondary students in rural Kerala).Methods: 1577 students were selected from schools picked randomly in and around vadavukode block in Ernakulam district, Kerala, of which 761 from private and 816 from government and aided school. Their height, weight and BMI was recorded and plotted in WHO growth charts to assess stunting, wasting, overweight and obesity.Results: No difference was found among the government and private schools. The finding from the data tally with the results from other parts of rural India with overweight and obese children (around 10%). The study found 44% children were found to be undernourished. Malnutrition was noted in both private and public schools possible highlighting knowledge deficit on Nutrition may be the cause of malnutrition. Only 47% students were in the normal range.Conclusions: Rural Kerala is afflicted with a serious problem of undernutrition and lower levels of obesity. There was striking prelidiction for obesity was noted among stunted children in the study highlighting the complex nature of the nutrition problem in India where malnutrition and obesity coexist and cause double burden of diseases. The solution is to encourage the message of healthy living, equally to the over nourished and the undernourished, where balanced diet and exercise as a way of life is encouraged.

Immune Responses Alter Taste Perceptions: Immunomodulatory Drugs Shape Taste Signals during Treatments.

Considering that nutrients are required in health and diseases, the detection and ingestion of food to meet the requirements is attributable to the sense of taste. Altered taste sensations lead to a decreased appetite, which is usually one of the frequent causes of malnutrition in patients with diseases. Ongoing taste research has identified a variety of drug pathways that cause changes in taste perceptions in cancer, increasing our understanding of taste disturbances attributable to aberrant mechanisms of taste sensation. The evidence discussed in this review, which addresses the implications of innate immune responses in the modulation of taste functions, focuses on the adverse effects on taste transmission from taste buds by immune modulators responsible for alterations in the perceived intensity of some taste modalities. Another factor, damage to taste progenitor cells that directly results in local effects on taste buds, must also be considered in relation to taste disturbances in patients with cancer. Recent discoveries discussed have provided new insights into the pathophysiology of taste dysfunctions associated with the specific treatments. SIGNIFICANCE STATEMENT: The paradigm that taste signals transmitted to the brain are determined only by tastant-mediated activation via taste receptors has been challenged by the immune modification of taste transmission through drugs during the processing of gustatory information in taste buds. This article reports the findings in a model system (mouse taste buds) that explain the basis for the taste dysfunctions in patients with cancer that has long been observed but never understood.

Diagnosis of Celiac Disease and Environmental Enteropathy on Biopsy Images Using Color Balancing on Convolutional Neural Networks.

Celiac Disease (CD) and Environmental Enteropathy (EE) are common causes of malnutrition and adversely impact normal childhood development. CD is an autoimmune disorder that is prevalent worldwide and is caused by an increased sensitivity to gluten. Gluten exposure destructs the small intestinal epithelial barrier, resulting in nutrient mal-absorption and childhood under-nutrition. EE also results in barrier dysfunction but is thought to be caused by an increased vulnerability to infections. EE has been implicated as the predominant cause of under-nutrition, oral vaccine failure, and impaired cognitive development in low-and-middle-income countries. Both conditions require a tissue biopsy for diagnosis, and a major challenge of interpreting clinical biopsy images to differentiate between these gastrointestinal diseases is striking histopathologic overlap between them. In the current study, we propose a convolutional neural network (CNN) to classify duodenal biopsy images from subjects with CD, EE, and healthy controls. We evaluated the performance of our proposed model using a large cohort containing 1000 biopsy images. Our evaluations show that the proposed model achieves an area under ROC of 0.99, 1.00, and 0.97 for CD, EE, and healthy controls, respectively. These results demonstrate the discriminative power of the proposed model in duodenal biopsies classification.

THE EFFECT OF NUTRITION ASSISTANCE PROGRAMS ON EATING ORDER PATTERNS AND NUTRITIONAL STATUS IN KALIBUNTU VILLAGE

The problem of malnutrition in children under five is still a major health problem in the world, including Indonesia. Indonesia is a developing country that still faces considerable problems of malnutrition. Nutritional problems nationally are under-five and under-nutrition children under five. Poor nutritional status is a condition of the body experiencing nutritional deficiencies or below standard. Based on the nutritional status monitoring (PSG) survey in Probolinggo District, there was an increase in cases of malnutrition, obtained in the prevalence of non-compliance with the weight per year in 2017 of 9.44%, an increase compared to 2016, namely 8.65% under-five children under five. Toddlers are considered the biggest nutritional risk because patterns of poor feeding have an impact on growth and development. This causes the toddler age group to increase the risk of morbidity and mortality. Based on a preliminary study in April 2018, data was obtained that Probolinggo was ranked second in the area of ​​malnutrition in East Java. In 2017 there are 130 toddlers who experience malnutrition in the Kalibuntu Coast of Probolinggo Regency. The cause of malnutrition is due to the pattern and intake of toddlers' food which contains less nutrition.The purpose of this study was to analyze the effect of nutritional support programs on feeding patterns and nutritional status of the Kalibuntu Coastal Children in Probolinggo Regency. This research is an experimental study, namely by measuring the increase / comparison of feeding patterns and nutritional status before and after the nutrition companion program. The population in this study were all toddlers with malnutrition in the Kalibuntu Coast of 130 people in Probolinggo Regency. Sampling uses Total Sampling. Samples are all mothers who have underweight and malnourished children under the age of 130 people in the Kalibuntu Coast of Probolinggo Regency. Data collection using observation sheets and interviews. Analysis of univariate data using frequency distribution, bivariate analysis using Wilcoxon match paired test and multivariate analysis using multiple linear regression then drawn conclusions. The results of the Wilcoxon match paired test between nutritional companions on feeding patterns obtained a p value of 0,000 <α 0,05, so ha was accepted so that there was an effect of nutritional companion on feeding patterns. The value of Exp (B) in the logistic regression analysis of eating parenting has a value of 85.008, which means that parenting has a chance of 85,008 times to change. While the nutritional status variable in multiple logistic regression has an Exp (B) value of 3.663, from these results it can be explained that nutritional status has an opportunity to increase 3.663 times.

Prevalence of Malnutrition in Children with Congenital Heart Disease

Background: Congenital heart defect (CHD) is the most common congenital anomaly in infants and is known to be a leading cause of malnutrition. Objectives: This study aimed to provide insights into the prevalence of malnutrition in children with CHD in Iran. Methods: The study enrolled 515 under-five children with CHD. The diagnosis was based on the definitive result of cardiac catheterization report. They were divided into the subgroups of cyanotic with pulmonary hypertension (PH), acyanotic with PH, cyanotic without PH, and acyanotic without PH according to their diagnosis. The degree of growth failure and the severity of malnutrition were evaluated based on the WHO standards (z-score criteria) in three categories as mild (-1.1 to -2.0 SD), moderate (-2.1 to -3.0 SD), and severe (≤ 3 SD). Results: Among the studied groups, the most prevalent CHDs were ventricular septal defect (VSD; 42.9%) and tetralogy of Fallot (TOF; 17.3%). Severe malnutrition was significantly more prevalent in cyanotic patients with and without PH (n = 23; 63.9% and n = 89; 51.1%, respectively). Normal nutritional status was significantly more in acyanotic patients without PH (P < 0.001). Overall, malnutrition in this study was mild in 16.3%, moderate in 24.1%, and severe in 39.8% of cases. Conclusions: The study showed that the prevalence of malnutrition in children with CHD aged under 5 years was noticeably high at this center in Iran. The administration of nutritional requirements such as low-volume and high-calorie diets should be considered for these vulnerable children.

COCCIDIAN INTESTINAL PARASITES AMONG CHILDREN IN AL-TORBAH CITY IN YEMEN: IN COUNTRY WITH HIGH INCIDENCE OF MALNUTRITION

Diarrhoea is an important cause of malnutrition, morbidity and mortality among children in Yemen. Coccidian parasitic infections are an important cause of diarrhea in children particularly malnutrition and immune-compromised patients, but their investigations are rarely required by the treating physicians in apparently immunocompetent children. This study was aimed to find the prevalence of intestinal coccidian parasites in country with high incidence rate of malnutrition. Between May 2016 and October 2016, 228 fecal samples from 228 selected school children in Al Turbah city, Taiz governorate, Yemen, aged between 6 and 15 years were examined using wet-mount preparations and formal concentration method then films stained by modified acid-fast staining. Also data of children were collected including demographic data, and sources of water. Findings of positive intestinal coccidian parasites were analyzed in relation with demographic data, and sources of water. The prevalence of Cryptosporidium species, Cyclospora species and Isospora belli were 75.9%, 45.6% and 1.75% respectively. There was significant association between positive of Cryptosporidium species and females (OR= 2.1 times, P=0.01), and spring water source (OR=4 times, P=0.04), while there was no significant association between positive of Cryptosporidium species and others factors studied. Also there was no significant association between positive of Cyclospora species and Isospora belli and children sex, age groups, or different sources of water. In conclusion the study highlights the high prevalence of coccidian parasites among immunocompetent school children in Yemen. The clinicians in Yemen need to be aware that coccidian parasites are a potential cause of childhood diarrhea even in immunocompetent children.

Effect of Some Weaning Foods on Weanling Albino Rats

Inadequate intake of essential nutrients to replace breast milk during weaning is a major cause of malnutrition in the young ...

Requerimientos ajustados a la Desnutrición del Paciente Oncológico

Propósito de la revisión: Este artículo explica las causas de desnutrición en el paciente con cáncer y los requerimientos de energía y nutrientes específicos para esta población.&#x0D; Recientes Hallazgos: En la caquexia cancerosa del paciente tumoral existe una incrementada lipólisis, favorecida por una disminución de la actividad de la Lipoproteína Lipasa (LPL) del Tejido Adiposo Blanco (TAB) y que propicia un aumento de niveles de Triacilgliceroles (TAG) circulantes. No existe evidencia de que el soporte nutricional incremente el crecimiento tumoral.&#x0D; Extracto: La desnutrición en los pacientes con cáncer se debe a tres grandes grupos, el primero relacionado a nutrientes (su déficit, metabolismo, alteraciones de absorción), el segundo grupo por la presencia de la Caquexia Cancerosa y el tercer grupo relacionado con el tumor, el paciente y los tratamientos recibidos. De acuerdo a las Guías de la Sociedad Europea de Nutrición para pacientes con cáncer, se recomienda que si el gasto de energía en pacientes oncológicos no es medido específicamente a cada paciente se haga un cálculo de 25 - 30 Kcal/Kg de peso/día.

PEMBERDAYAAN KADER POSYANDU MELALUI PENERAPAN METODE KONSELING GIZI DAN KOMUNIKASI EFEKTIF PADA KADER POSYANDU KELURHAN PADEMANGAN BARAT JAKARTA UTARA

Kelurahan Pademangan Barat is one of the areas of malnutrition enclosed in the city of North Jakarta. Toddlers with malnutrition are recorded in the kelurahan. The level of education of the population as well as knowledge and public awareness in the field of health is relatively low suspected to be the main cause of the problem of malnutrition. One of the steps that can be done to help the nutritional problem is through nutrition counseling on posyandu cadres in the kelurahan. Nutrition counseling is a two-way communication process between counselor and client to help clients recognize and overcome nutritional problems. This program aims to increase knowledge of nutrition cadres of malnourished children under five. The outcomes of this program are the improvement of mother's nutritional knowledge and weight gain. Counseling was conducted several times, at each visit given by leaflet as a tool in delivering the material to the cadre. The visit time is approximately fifty hours. In addition, an informal mother and toddler approach is also used to identify parenting patterns, family characteristics, and children, as well as causes of malnutrition. As many as 88%,the cadre has increased the understanding and self confidence after following the nutrition counseling program.

Analysis of Variables Causing Bad Nutrition in East Java Province in 2015

The East Java Province has successfully overcome the incidences of malnutrition. In 2015, the number of malnutrition cases was 6,745 (1.8 percent), which was lower than the targets of MDGs (15.0 percent) and the Strategic Plans of the Ministry of Health of the Republic of Indonesia (15.0 percent). However, according to National data (Dinkes, 2015), East Java was the second largest province with the highest cases of child malnutrition after the East Nusa Tenggara Province. The study aims to explain the direct and indirect causes of malnutrition among children under five years of age in the East Java Province in 2015. Using secondary data from the 2015 National Economic Social Survey in the East Java Province, the subjects of this research consisted of 38 districts and municipalities in the East Java Province. The results showed that the p values for each variable are: the length of breastfeeding in infants aged 0–23 months (X1) was 0.007, the percentage of completed immunization children under five years (X2) was 0.011, the percentage of the population consumption below 1400 kcal (X3) was 0.960, the proportion of households with adequate sanitation (X4) was 0.198, and the ratio of Enrolment Rates in Senior High Schools between female and male (X5) was 0.439. The conclusion of this study is that the independent variables were the time length of mothers in breastfeeding their infants aged 0–23 months and the percentage of children under five years of age who were fully immunized which had a negative correlation with malnutrition experinced by children under five years of age in the East Java Province in 2015.

Analysis of Variables Causing Bad Nutrition in East Java Province in 2015

The East Java Province has successfully overcome the incidences of malnutrition. In 2015, the number of malnutrition cases was 6,745 (1.8 percent), which was lower than the targets of MDGs (15.0 percent) and the Strategic Plans of the Ministry of Health of the Republic of Indonesia (15.0 percent). However, according to National data (Dinkes, 2015), East Java was the second largest province with the highest cases of child malnutrition after the East Nusa Tenggara Province. The study aims to explain the direct and indirect causes of malnutrition among children under five years of age in the East Java Province in 2015. Using secondary data from the 2015 National Economic Social Survey in the East Java Province, the subjects of this research consisted of 38 districts and municipalities in the East Java Province. The results showed that the p values for each variable are: the length of breastfeeding in infants aged 0–23 months (X1) was 0.007, the percentage of completed immunization children under five years (X2) was 0.011, the percentage of the population consumption below 1400 kcal (X3) was 0.960, the proportion of households with adequate sanitation (X4) was 0.198, and the ratio of Enrolment Rates in Senior High Schools between female and male (X5) was 0.439. The conclusion of this study is that the independent variables were the time length of mothers in breastfeeding their infants aged 0–23 months and the percentage of children under five years of age who were fully immunized which had a negative correlation with malnutrition experinced by children under five years of age in the East Java Province in 2015.

KARAKTERISTIK MAKANAN PENDAMPING ASI INSTAN LOKAL MENGGUNAKAN CAMPURAN TEPUNG BERAS MERAH DAN TEPUNG DAUN KELOR (Moring olifera)

One of the causes of malnutrition in children is a habitual pattern of complementary feeding of breast milk is inappropriate, the ignorance about the ways of feeding in infants and the low quantity and quality of the complementary food that given to children. The purpose of the research is to find out the characteristics of quality of chemical (nutrient), physical, acceptability of complementary food by using local uses instant Brown rice flour and moringa leaf flour. The research method is postest only, formulations namely F1 (75: 5), F2 (72.5: 7.5), F3 (70:10), and F4 (67, 5: 12,5) to supply per 100 g of ingredients and complete the nutritional content using full cream powder 15 g and sugar 5 g. The nutrient content of the raw material of brown rice and moringa leaf flour was analyzed proximate in the laboratory, full cream milk powder and sugar using the nutrient composition of the literature source. The best product analysis uses the De Garmo effectiveness method. The results showed that formula of complementary food with the best local Instant value 0.59, namely Formula 1 with consecutive energy nutrient 393.2 kcal, protein 9.3 g, fat 9.4 g, carbohydrate 56.3 g, fiber 16.33 g, moisture content 5.4%, grey levels 8.5%.Characteristics of the physical density of kamba 0.5 g/ml and water absorption 1 ml/g. Physical characteristics based on the density of 0.5 g / ml and water absorption 1 ml / g. The power to receive the best formula based on aspects of color, aroma, texture, taste is received (liked) by the panellists

HUBUNGAN TINGKAT KECUKUPAN ENERGI DAN ZAT GIZI MAKRO DENGAN KETAHANAN PANGAN SISWA SEKOLAH DASAR DARI KELUARGA PETANI &lt;br&gt;&lt;i&gt;[Correlation of Energy and Macronutrient Adequacy Level and Food Security among Elementary School Children from Farmers Family]&lt;/i&gt;&lt;/br&gt;

Food security is an underlying cause of malnutrition in children. Food security affects children’s quality and quantity of food consumption. Food quantity are refl ected by energy and macronutrient adequacy level (protein, fat, carbohydrate). This study aimed to analyze the association between the energy and macronutrient adequacy level with food security among elementary school children from farmer family. Study was a cross sectional study with simple random sampling. Total samples are 60 elementary school students from grade 1 to 6 at SDN Jombatan 1, SDN Jombatan 2, and SDN Jombatan 3 Jombatan Village, Kesamben Sub-district, Jombang Regency, and their parents are paddy rice farmers. Data collected by samples characteristics questionnaire, 2x24 hours food recall form, and United States – Household Food Security Survey Modul (US-HFSSM) questionnaire. Spearman correlation test were used to analyze the correlation between variables. Most of school children had insuffi cient energy and macronutrients adequacy level energy (91.7%), protein (54.2%), fat (84.8%), and carbohydrate (86.4%) respectively. More than half of farmer family were included in food insecurity without hunger (58.3%). There was signifi cant association between energy adequacy level with food security among elementary school students from farmer family (p=0.039). Nonetheless, there were no signifi cant correlation between macronutrient adequacy level such as protein (p=0.931), fat (p=0.189), and carbohydrate (p=0.104) with food security among elementary school student from farmer family. Family food security associated with the quantity of family food consumption. Increasing food security to increase energy adequacy level can be done by increasing income from non-agricultural sector.

A study on prevalence of symptomatic not confirmed pulmonary tuberculosis under 5 to 15 years of age in protein energy malnutrition children in a tertiary care centre

Background: Tuberculosis (TB) and malnutrition are important causes of morbidity and mortality in children, in developing countries. Tuberculosis can be a cause of malnutrition in children and also a common cause of pneumonia in such malnourished children. In the present study ,our aim is to know the prevalence and early clinical diagnosis of symptomatic not confirmed TB, in recent challenging environment, in protein energy malnutrition children, this information would certainly help clinicians in early detection, diagnosis and management of PTB (Pulmonary Tuberculosis) in such populations ,to reduce morbidity and mortality.Methods: We prospectively investigated protein energy malnutrition children, with clinical features of tuberculosis, between 5 to 15 years of age , admitted during 18 months of study period. Clinical and demographic data of studied children were collected. Anthropometric (Height and Weight) measurement and physical examination were made. PEM (Protein energy malnutrition) children were classified according to Indian academy of pediatric classification. History of BCG vaccination and exposure to contact were inquired. Chest radiography was done for all children in our study.Results: A total of 150 protein energy malnutrition children, between 5 to 15 years, admitted over 18 months period were studied. Majority of children were female as compared to male and under 5 to 10 years of age. Out of these, symptomatic not confirmed pulmonary TB 93 (62%) and Extra pulmonary TB 18 (12%) and Non TB cases were 39 (26%). According to Grade of PEM, symptomatic not confirmed pulmonary TB cases under grade III were 45 (48.5%) and 35 (37.6%) were under grade II .Conclusions: Pulmonary tuberculosis may be a common cause of pneumonia in malnourished children and the cause of death in these population. So Its frequency and early clinical detection ,even without microbiological confirmation and supportive evidence and treatment guideline should be made by more further study. So that, it will help clinicians to treat these population to reduce morbidity and mortality.

Identifying Malnutrition in PALTC Communities

Identifying Malnutrition in PALTC Communities

Seroprevalence of celiac diseases in children suffering from severe acute malnutrition in age group of 1–5 years

Introduction: Celiac disease (CD) may be an underlying cause of malnutrition. Aim: The objective of this study was to find out the seroprevalence of CD in children suffering from severe acute malnutrition (SAM) in age group of 1–5 years. Materials and Methods: This was a prospective, observational, hospital-based study carried out at Malnutrition Treatment Centre attached with tertiary care pediatric hospital associated with the medical college of southern Rajasthan, from December 2017 to November 2018. A total of 110 children with SAM were enrolled and screened for CD on the basis of celiac serology (tissuetransglutaminase [tTg]-immunoglobulin A/G [IgA/IgG]). Results: Celiac serology was positivity in 30 (27.28%) cases; out of total 30 seropositive cases, 14 (46.66%) cases were seropositive for both tTg-IgA and IgG, while only tTg-IgA and only tTg-IgG were positive in 9 (30%) and 7 (23.33%) cases, respectively. Mean serotiter of serum tTg-IgA and IgG in seropositive cases was 134.01±198.74 and 49.05±25.74 unit/ml. Conclusions: High seroprevalence of CD in SAM should be taken as alert as CD may be an underlying cause and responsible for malnutrition. These children should be screened by celiac serology (tTg-IgA/IgG) to rule out CD.

MON-373 Pseudohypoaldosteronism Type 1, a Masquerader: Case Study

Background: Pseudohypoaldosteronism (PHA) Type 1 usually present in the newborn period as failure to thrive, hyponatremia and hyperkalemia. The spectrum of manifestation however ranges from asymptomatic to severe. Initial presentation may be easily confused with more common disease process like poor feeding with inadequate calorie intake, dehydration, Congenital Adrenal Hyperplasia (CAH), adrenal insufficiency (AI), urinary tract abnormality and hypoaldosteronism. Patients with PHA Type 1 have supraphysiological aldosterone and renin levels appropriate for the electrolyte abnormality but ineffective due to an abnormality in mineralocorticoid receptor or epithelial sodium channel (ENaC). Clinical case: We present a Caucasian female who was admitted for failure to thrive. At 3 weeks of age, she was found to have lost 14.5% of birth weight. She was afebrile and there was no vomiting. She had hyperkalemia, hyponatremia, hypercalcemia, and mild transaminitis (Na 129mmol/L (134-142mmol/L), K 6.8mmol/L (4-6.2mmol/L), Cl 91mmol/L (96-110mmol/L), Ca 11.8mg/dl (9-10.9mg/dl), ALT 35unit/L (8-32 units/L) with increased urine output (6-6.5ml/kg/hr (4-5ml/kg/hr). Genital examination, newborn screen, ECG, renal US, thyroid function, 17-OH progesterone, and ACTH stimulation tests were normal. No family history of similar electrolyte abnormalities. Treatment with sodium containing IVF and kayexalate improved her electrolytes. Her diagnosis at discharge was inadequate calorie intake and dehydration. Increased calorie intake resulted in continuous weight gain and resolution of electrolyte abnormality at discharge (Na 137mmol/L, K 5.6mmol/L, Cl 97, Ca 10.8mg/dl). Despite improvement in weight gain and being asymptomatic, follow up outpatient monitoring of electrolyte levels showed persistent hyponatremia and hyperkalemia (Na 129 mmol/L, K 7.8mmol/L). No gastrointestinal symptoms or skin abnormalities. Given her electrolyte abnormalities, the differential diagnoses included SIADH, Adrenal Insufficiency and hypoaldosteronism. The diagnosis of PHA Type 1 was made based on increased aldosterone and renin levels (Aldosterone 1031ng/dl (5-90ng/dl), Renin 277pmol/L (2-37pmol/L). She was started on oral Nacl supplement and high dose fludrocortisone resulting in resolution of electrolyte abnormality. Genetic evaluation is underway. Conclusion: PHA Type 1 is a rare clinical entity that can masquerade as other more common causes of malnutrition and electrolyte abnormality. Delay in prompt diagnosis and treatment of PHA Type 1 can be associated with morbidity and mortality. Follow up monitoring of serum and urine electrolyte levels is important in children presenting with malnutrition and electrolyte abnormalities to enable early recognition and adequate treatment initiation.

Malnutrition in Elderly Patients as a Complication of a Drug Therapy: Clinical Pharmacologist’s Point of View

Malnutrition is a patient’s condition with high relevance and importance for elderly patients (most often seen in very old patients &gt;80 years old), since it is associated with a high risk of progressive worsening of their state, prolongation of hospitalization and death. Exposure to some drugs may increase the risk of malnutrition, especially in elderly patients. The purpose of this work is to provide an overview of the causes of malnutrition, focusing on the pharmacological risk factors, as well as to highlight the existing methods of correction of this condition. The authors show that one of the key reasons for developing drug-induced malnutrition is the patients exposure to drugs, that reduce appetite, cause nausea and vomiting, change taste and olfactory sensations, and have anticholinergic effects. Use of pharmacological (additional prescription of drugs for symptomatic therapy, changing the dose, deprescribing drugs, etc.), and nonpharmacological (diet therapy, adding artificial and natural identical flavors, etc.) treatment methods may help to improve state of patients with already developed pathological condition.

Determinants of Undernutrition among Young Children Living in Soth Nikum District, Siem Reap, Cambodia.

Background: Child undernutrition is of public concern in Cambodia. An understanding of factors influencing child nutritional status is essential to design programs that will reduce undernutrition. Using the UNICEF conceptual framework of causes of malnutrition, our research investigates the relationship between nutritional status of children aged 6–23 months and its immediate and underlying determinants. Methods: Baseline data from a cluster-randomized controlled trial aiming to assess the impact of the promotion of optimal feeding practices combined or not with the provision of local foods among 360 children 6–23 months of age were used. Anthropometry and biochemical measurements were performed at baseline. Data on each determinant of undernutrition were collected through interviews and direct observations. Results: Our results show that the degree of satisfaction of proteins and zinc requirements as well as the access to improved water sources and sanitation were positively associated with length-for-age, while having a better health status and a higher degree of satisfaction of energy, protein, zinc, and iron requirements were associated to an improved weight-for-length. Only child health status was associated to ferritin. Conclusion: Our results reiterate the importance of improving child diet and health status, but also the access to a healthy environment to ensure an optimal nutritional status.

Hypothalamic Energy Regulatory Peptides in Chronic Kidney Disease.

Loss of appetite affects one-third of patients with CKD and is the leading cause of malnutrition in this population. Orexigenic Agouti-related peptide (AgRP) with neuropeptide-Y (NPY) and anorexigenic melanocyte-stimulating hormone-α (MSH-α) with cocaine- and amphetamine-regulated transcript (CART) are known to regulate appetite. In this study, we aimed to evaluate the levels of these peptides in CKD patients compared to healthy subjects and demonstrate the effects of dialysis treatment and erythropoiesis-stimulating agent (ESA) therapy. The cross-sectional study is composed of consecutive inclusion of 20 healthy individuals, 20 predialysis CKD patients, 20 HD, and 20 peritoneal dialysis (PD) patients. Exclusion criteria were an active infection, history of malignancy, hypo- or hyperthyroidism, and diabetes. Patients on dialysis had targeted Kt/Vs. Demographic features and BMIs of the four groups were similar. Levels of AgRP, NPY, AMSH, and CART were significantly different between groups. Nondialysis CKD patients had significantly lower hypothalamic hormones compared to healthy individuals, HD and PD patients (P = 0.02, P = 0.03, and P = 0.07 for AgRP; P = 0.02, P = 0.01, and P = 0.09 for NPY; P = 0.02, P = 0.02, and P = 0.03 for AMSH; P = 0.02, P = 0.005, and P = 0.030 for CART). Dialysis patients with or without ESA treatment had similar hormone levels (P = 0.13 for AgRP; P = 0.11 for NPY; P = 0.23 for AMSH, and P = 019 for CART). Predialysis CKD patients have lower orexigenic and presumably indirectly lower anorexigenic peptides compared to healthy subjects and dialysis patients. ESA treatment does not affect these hypothalamic peptides in dialysis patients.