Chronic Undernutrition Research Articles

Determinants of stunting among adolescent girls in schools of Digo Tsion Town, Northwest Ethiopia: Unmatched case control study.

Stunting is a height-for-age (Z-score) less than minus two standard deviations below the mean of reference standard. It is the most important sign of long-term chronic undernutrition and public health problem in Ethiopia. However, little information was known regarding determinants of stunting among adolescents since it had mostly been investigated in late infancy, especially among children under the age of five. Therefore, identifying determinants of stunting among adolescent girl is still crucial. To identify determinants of stunting among adolescent girls in schools of Digo Tsion Town, Northwest Ethiopia, 2022. Case-control study was conducted among 417 adolescent girls (104 cases and 313 controls) in schools of Digo Tsion Town with computer generated simple random sampling technique. World Health Organization Anthroplus 2007 software was used for analyzing anthropometrics data. Data was collected by epicollect5 mobile application through interview by using structured questionnaire. The data was entered in epi data 4.6 and exported into Statistical Package for Social Science version 26. Variables with p- value ≤ 0.25 in bivariable analysis were candidate for multivariable analysis. Model fitness was checked by Hosmer and Lemon Show fitness of test. Variables having a P-value < 0.05 in multivariable analysis were declared as statistically significant at 95% Cl. The result was presented by statement, figures, and tables. A total of 409 (100 cases and 309 controls) adolescent girls participated, with a response rate of 96% for cases and 98.72% for controls. Food insecurity (AOR = 2.13, CI [1.15, 3.93]), low dietary diversity score (AOR = 1.99, CI [1.06, 3.73]), drinking coffee/tea immediately while eating meals (AOR = 2.19, CI [1.22, 3.95]), not getting nutritional counsel (AOR = 2.07, CI [1.17, 3.66]), chronic illness (AOR = 3.78, CI [1.16, 12.3]), and not visited by health extension workers at home (AOR = 1.85, CI [1.03, 3.31]) were statistically significant determinants of stunting. Stunting among adolescents is influenced by a low dietary diversity score, a food-insecure household, drinking coffee or tea immediately while eating a meal, not receiving nutritional counseling, having a chronic illness, and not being visited by health extension workers at home. Future researchers would do better to undertake prospective studies. Health extension workers are better able to provide nutritional counsel for adolescent.

Bifidobacterium longum and microbiome maturation modify a nutrient intervention for stunting in Zimbabwean infants

Small-quantity lipid-based nutrient supplements (SQ-LNS), which has been widely tested to reduce child stunting, has largely modest effects to date, but the mechanisms underlying these modest effects are unclear. Child stunting is a longstanding indicator of chronic undernutrition and it remains a prevalent public health problem. The infant gut microbiome may be a key contributor to stunting; and mother and infant fucosyltransferase (FUT) phenotypes are important determinants of infant microbiome composition. We investigated whether mother-infant FUT status (n=792) and infant gut microbiome composition (n=354 fecal specimens from 172 infants) modified the impact of an infant and young child feeding (IYCF) intervention, that included SQ-LNS, on stunting at age 18 months in secondary analysis of a randomized trial in rural Zimbabwe. We found that the impact of the IYCF intervention on stunting was modified by: (i) mother-infant FUT2+/FUT3- phenotype (difference-in-differences-32.6% [95% CI:-55.3%,-9.9%]); (ii) changes in species composition that reflected microbiome maturation (difference-in-differences-68.1% [95% CI:-99.0%,-28.5%); and (iii) greater relative abundance of B.longum (differences-in-differences 49.1% [95% CI: 26.6%, 73.6%]). The dominant strains of B.longum when the intervention started were most similar to the proficient milk oligosaccharide utilizer subspecies infantis, which decreased with infant age and differed by mother-infant FUT2+/FUT3- phenotypes. These findings indicate that a persistently "younger" microbiome at initiation of the intervention reduced its benefits on stunting in areas with a high prevalence of growth restriction. Bill and Melinda Gates Foundation, UK DFID/Aid, Wellcome Trust, Swiss Agency for Development and Cooperation, US National Institutes of Health, UNICEF, and Nutricia Research Foundation.

Chronic undernutrition impairs renal mitochondrial respiration accompanied by intense ultrastructural damage in juvenile rats

This study investigated whether chronic undernutrition alters the mitochondrial structure and function in renal proximal tubule cells, thus impairing fluid transport and homeostasis. We previously showed that chronic undernutrition downregulates the renal proximal tubules (Na++K+)ATPase, the main molecular machine responsible for fluid transport and ATP consumption. Male rats received a multifactorial deficient diet, the so-called Regional Basic Diet (RBD), mimicking those used in impoverished regions worldwide, from weaning to a juvenile age (3 months). The diet has a low content (8 %) of poor-quality proteins, low lipids, and no vitamins compared to control (CTR). We investigated citrate synthase activity, mitochondrial respiration (oxygraphy) in phosphorylating and non-phosphorylating conditions with different substrates/inhibitors, potential across the internal membrane (Δψ), and anion superoxide/H2O2 formation. The data were correlated with ultrastructural alterations evaluated using transmission electron microscopy (TEM) and focused ion beam scanning electron microscopy (FIB-SEM). Citrate synthase activity decreased (∼50 %) in RBD rats, accompanied by a similar reduction in respiration in non-phosphorylating conditions, maximum respiratory capacity, and ATP synthesis. The Δψ generation and its dissipation after carbonyl cyanide-4-(trifluoromethoxy) phenylhydrazone remained unmodified in the survival mitochondria. H2O2 production increased (∼100 %) after Complex II energization. TEM demonstrated intense matrix vacuolization and disruption of cristae junctions in a subpopulation of RBD mitochondria, which was also demonstrated in the 3D analysis of FIB-SEM tomography. In conclusion, chronic undernutrition impairs mitochondrial functions in renal proximal tubules, with profound alterations in the matrix and internal membrane ultrastructure that culminate with the compromise of ATP supply for transport processes.

Factors affecting nutritional status among children aged below five years in Rwanda’s Western and Southern Provinces

BackgroundThe state of a child’s nutrition is a critical indicator of their overall health and wellbeing. Public health still faces challenges from undernutrition, especially in developing nations across the globe. In Rwanda, around 33% of children aged under five years suffer from chronic undernutrition. Many factors, such as poverty, illiteracy, poor WASH practices, improper child feeding practices, and insufficient healthcare, are the leading causes of undernutrition. The study aims to assess infant and young child feeding practices, WASH, food security, and their association with the nutritional status of children under five years in Rwanda’s Western and Southern provinces.MethodsA community-based cross-sectional study design was applied to study factors affecting the nutritional status of children under five years in 439 households in the Karongi, Nyabihu, and Nyamagabe districts of Rwanda. The study assessed anemia, stunting, underweight, and wasting indicators, and collected data was analyzed using SPSS version 25.ResultsThe study findings indicate that among the children surveyed, 29.2% (128) were identified as stunted, 5.9% (26) were underweight, 2.3% (10) suffered from wasting, and 20.9% (31) had anemia. Factors associated with these conditions included larger household size [AOR = 2.108; 95% CI (1.016–4.371)], positively associated with stunting. Additionally, children from households where the head was above 60 years old were more likely to exhibit stunting [AOR = 4.809; 95% CI (1.513, 15.283)]. Furthermore, a high household dietary diversity score was positively linked to being underweight [AOR = 6.061; 95% CI (1.535,23.942)].ConclusionHousehold characteristics like size, dietary diversity, and the age of the household head affect children’s nutritional status. Improving these conditions would enhance children’s nutritional status.

Diet at birth is critical for healthy growth, independent of effects on the gut microbiota

BackgroundColostrum is the first milk for a newborn. Its high content in microbiota shaping compounds and its intake at the time of gut microbiota seeding suggests colostrum may be critical in the establishment of a healthy microbiota. There is also accumulating evidence on the importance of the gut microbiota for healthy growth. Here, we aimed to investigate the contribution of colostrum, and colostrum-induced microbiota to growth promotion. Addressing this question is highly significant because (1) globally, less than half of the newborns are fully colostrum fed (2) the evidence for the importance of the microbiota for the prevention of undernutrition has only been demonstrated in juvenile or adult pre-clinical models while stunting already starts before weaning.ResultsTo address the importance of diet at birth in growth failure, we developed a unique mouse model in which neonates are breastfed by mothers at an advanced stage of lactation who no longer provide colostrum. Feeding newborn mice with mature milk instead of colostrum resulted in significant growth retardation associated with the biological features of chronic undernutrition, such as low leptin levels, dyslipidemia, systemic inflammation, and growth hormone resistance. We next investigated the role of colostrum in microbiota shaping. At the end of the lactation period, we found a major difference in gut microbiota alpha diversity, beta diversity, and taxa distribution in control and colostrum-deprived mice. To determine the causal relationship between changes in microbiota and growth trajectories, we repeated our experiment in germ-free mice. The beneficial effect of colostrum on growth remained in the absence of microbiota.ConclusionOur data suggest that colostrum may play an important role in the prevention of growth failure. They highlight that the interplay between neonatal gut microbiome assembly and diet may not be as crucial for growth control in the developing newborn as described in young adults. This opens a paradigm shift that will foster research for colostrum’s bioactives that may exert a similar effect to microbiota-derived ligands in promoting growth and lead to new avenues of translational research for newborn-tailored prevention of stunting.98mWSFedBqCALfgBr5hPfAVideo

Measuring Caste-based Inequities Impacting Indian Children: An Analysis of Minimum Nutrition Availability

The Indian enigma, the prevalence of higher chronic undernutrition among Indian children compared to poorer countries, is driven by stunted children from the so-called lower caste. Based on this background, the study measures the extent of the inequities contributed by the caste system to the availability of minimum nutrition among children aged 2 years and less in the country. We use the third and fifth rounds of the National Family Health Survey (NFHS) and employ the Human Opportunity Index (HOI) for the analysis. HOI is the technique that measures the inequality of opportunity experienced by children. The study controls for other social, family, regional and child-level circumstances. Findings reveal that the success story of the economic growth of the country has not contributed to an equal allocation of minimum nutrition availability, where the absolute difference of the HOI index between children belonging to the low caste subgroups and others is high. On the other hand, considering the account of HOI across the two NFHS rounds for each subgroup, the improvement rate depicts an optimistic future.

‘Counselling is not just providing information’: perceptions of caregivers and stakeholders on the design of nutrition and health counselling interventions for families with young children in rural Kenya

BackgroundGlobally, a fifth of the children continue to face chronic undernutrition with a majority of them situated in the Low- and Middle-Income Countries (LMIC). The rising numbers are attributed to aggravating factors like limited nutrition knowledge, poor feeding practices, seasonal food insecurity, and diseases. Interventions targeting behaviour change may reduce the devastating nutrition situation of children in the LMICs.ObjectiveFor the co-design of a Behaviour Change Communication (BCC) intervention for young children in rural Kenya, we aimed to identify the experiences, barriers, facilitators, and preferences of caregivers and stakeholders regarding nutrition and health counselling.DesignWe employed a qualitative study design and used a semi-structured interview guide. The in-depth interviews were recorded, transcribed, and analysed using content analysis, facilitated by the software NVivo.SettingHealth and Demographic Surveillance System (HDSS) area in Siaya County, rural Kenya.ParticipantsWe interviewed 30 caregivers of children between 6 and 23 months of age and 29 local stakeholders with experience in implementing nutrition projects in Kenya.ResultsNutrition and health counselling (NHC) was usually conducted in hospital settings with groups of mothers. Barriers to counselling were long queues and delays, long distances and high travel costs, the inapplicability of the counselling content, lack of spousal support, and a high domestic workload. Facilitators included the trust of caregivers in Community Health Volunteers (CHVs) and counselling services offered free of charge. Preferences comprised (1) delivering of counselling by CHVs, (2) offering individual and group counselling, (3) targeting male and female caregivers.ConclusionThere is a disconnect between the caregivers’ preferences and the services currently offered. Among these families, a successful BCC strategy that employs nutrition and health counselling should apply a community-based communication channel through trusted CHVs, addressing male and female caregivers, and comprising group and individual sessions.

Persistent Global Burden of Stunting Among Children

Introduction: Childhood stunting is a critical indicator of chronic undernutrition, reflecting global challenges in poverty, food security, and health care, with variability highlighting the multifaceted nature of nutritional well-being. Objective: This study aims to provide a comprehensive overview of the global prevalence and trends of childhood stunting, elucidating the interplay of factors influencing its dynamics. Methods: A systematic review and analysis of epidemiological studies, meta-analyses, and health reports were conducted to compile a detailed table on the worldwide prevalence and trends of childhood stunting. Results: The collected data reveal a significant global burden of stunting, with notable disparities across regions, socioeconomic statuses, and age groups. Findings show a persistent high prevalence in regions like northwest Ethiopia and varied trends, with some areas achieving reductions in stunting rates due to effective interventions, while others witness stagnation or increases. Key associations were identified between stunting and factors such as low birth weight, socioeconomic status, and maternal health. The synthesis of recent studies indicates a critical ongoing public health challenge, particularly in Asia and Africa, where a significant proportion of children under five remain stunted. Discussion: The study underscores the complex interplay of demographic, socioeconomic, and environmental factors influencing stunting, highlighting the essential role of targeted and multifaceted public health interventions in mitigating this pervasive issue. Conclusion: Addressing childhood stunting necessitates a global commitment to integrated, evidence-based strategies focusing on the nutritional, health, and socio-economic determinants to ensure the well-being and growth of children worldwide.

Assessment of Community Readiness to Address Malnutrition in Rural Southwest Guatemala

AbstractBackgroundMalnutrition is prevalent throughout southwest Guatemala, where &gt;40% of children suffer from chronic undernutrition. Evidence supports that assessing a community's awareness and readiness to address malnutrition is a critical first step in improving the success of a nutrition intervention program. The objective of this study was to apply the community readiness model (CRM) to assess community readiness to address childhood malnutrition in a rural southwest region of Guatemala.MethodsThirteen key respondents of varied social roles and demographics residing in the region were interviewed. Interview questions related to addressing malnutrition were from the following predefined dimensions: Community Efforts, Community Knowledge of Efforts, Leadership, Community Climate, Community Knowledge, and Resources for Efforts. Interview recordings and notes were analyzed and scored according to the CRM guidelines, and a standardized analysis was conducted.ResultsThe overall community readiness score was 4.26 (preplanning: awareness of the issue). Community Efforts had a total score of 5 (Preparation: preparing to take action on the issue). Community Knowledge of Efforts, Community Climate, Community Knowledge, and Resources for Efforts Dimensions each had a total score of 4 (Preplanning: awareness of the issue). The overall score for the Leadership dimension was 2 (Denial/resistance: belief that the problem does not exist within the community). These scores demonstrate clear recognition for action to address childhood malnutrition as a problem. However, efforts to combat childhood malnutrition are not yet focused nor detailed for community action.ConclusionsThis rural southwest region of Guatemala recognizes that childhood malnutrition is a problem. However, efforts to address malnutrition are not yet focused or detailed enough to have measurable impact in addressing this issue. For the region to advance the stage of community readiness, it is essential to enhance knowledge of dietary strategies aimed at improving nutrition for children and increase engagement from local leadership.

Anatomical and functional changes of the fetal adrenal gland in intrauterine growth restriction.

The aim of this study was to demonstrate the establishment of adrenal sparing in intrauterine growth restricted (IUGR) human fetuses. IUGR fetuses are a subgroup of small for gestational age (SGA) fetuses that are unable to reach their own growth potential because of chronic hypoxia and undernutrition. We hypothesized that in IUGR fetuses the adrenal gland is relatively larger and secretion of noradrenaline (NA), adrenaline (A), and cortisol is increased. This is a prospective observational study including 65 singleton pregnancies (42 IUGR and 23 controls). Using two-dimensional ultrasound, we measured fetal adrenal diameters and adrenal/abdominal circumference (AD/AC) ratio between 25 and 37 weeks. We considered only one measurement per fetus. In 21 pregnancies we also measured NA, A, and cortisol levels in arterial and venous fetal cord blood collected at the time of delivery. The AD/AC ratio was significantly higher in IUGR fetuses than in controls. Cord NA and A levels were significantly higher in IUGR fetuses than in controls. An increase in cortisol secretion in IUGR fetuses was observed but the difference was not statistically significant. Adrenal sparing correlates with a relative increase in adrenal measurements and function.

The Enterics for Global Health (EFGH) Shigella Surveillance Study in Peru.

The Enterics for Global Health (EFGH) Peru site will enroll subjects in a periurban area of the low Amazon rainforest. The political department of Loreto lags behind most of Peru in access to improved sources of water and sanitation, per capita income, children born <2.5 kg, and infant and child mortality. Chronic undernutrition as manifested by linear growth shortfalls is common, but wasting and acute malnutrition are not. The recruitment of children seeking care for acute diarrheal disease takes place at a geographic cluster of government-based primary care centers in an area where most residents are beneficiaries of free primary healthcare. Rates of diarrheal disease, dysentery, and Shigella are known to be high in the region, with some of the highest rates of disease documented in the literature and little evidence in improvement over the last 2 decades. This study will update estimates of shigellosis by measuring the prevalence of Shigella by polymerase chain reaction and culture in children seeking care and deriving population-based estimates by measuring healthcare seeking at the community level. Immunization has been offered universally against rotavirus in the region since 2009, and in a context where adequate water and sanitation are unlikely to obtain high standards in the near future, control of principal enteropathogens through immunization may be the most feasible way to decrease the high burden of disease in the area in the near future.

STUNTING PREVENTION STRATEGY BY IMPROVING THE NUTRITIONAL STATUS OF TODDLER : A SYSTEMATIC REVIEW

Background: Globally, there has been progress in lowering the rates of linear growth stunting and chronic undernutrition in children under five years old, however many areas still have high rates. Aims : This systematic review is to review stunting prevention strategy with improving status of nutrition in toddler. Methods: This study demonstrated compliance with all requirements by means of a comparison with the standards established by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020. Thus, the specialists were able to guarantee that the research was as current as feasible. Publications released between 2014 and 2024 were considered for this search strategy. This was accomplished by utilizing a number of distinct online reference sites, including Pubmed, ScienceDirect, and SagePub. It was determined that reviews, previously published works, and partially completed works would not be included. Result: In the PubMed database, the results of our search brought up 691 articles, whereas the results of our search on SAGEPUB brought up 2026 articles, our search on SCIENCE DIRECT brought up 4136 articles. The results of the search conducted for the last year of 2014 yielded a total 430 articles for PubMed, 776 articles for SAGEPUB and 2307 articles for SCIENCE DIRECT. In the end, we compiled a total of 8 papers, 6 of which came from PubMed, 1 of which came from SAGEPUB and 1 of which came from SCIENCE DIRECT. We included eight research that met the criteria. Conclusion: In summary, stunting must be managed in order to protect children from its harmful effects. To do this, a variety of linked parties must contribute to the effort. Improving the mother's responsive stimulation and health education might be the first step in improving the nutritional and cognitive state of the kid.

Chronic Undernutrition in Ovine Twin Pregnancies Abolishes Differences in Birth Weight Due to Sex: An Evaluation of the Role of Nutritional and Antioxidant Supplementation.

In twin pregnancies of discordant sex, the male fetus grows larger than the female co-twin. Our study aimed to determine the effect of the sex of co-twins on lambs' birth weight in ovine pregnancies developed under natural undernourishment. Additionally, we investigated whether the nutritional and/or antioxidant supplementation provided to ewes during pregnancy could modulate the potential effects associated with the sex of co-twins. Ninety-six birth records of twin pregnancies of sheep grazing the natural Patagonian prairies were analyzed. The animals were divided into four groups: control (no supplementation), N (concentrate supplementation, 100% NRC), A (antioxidant supplementation), and NA (concentrate + antioxidant supplementation). Supplementation occurred from day 35 of gestation onwards until lambing. There were no differences in female or male birth weight in the control undernourished group. However, in group N, females or males with sex-discordant co-twins had a higher birth weight than did those with co-twins of the same sex. Group A males with female co-twins had a higher birth weight compared to males whose co-twins were also males. In NA lambs, males had a higher birth weight compared to females, regardless of their co-twin's sex. Therefore, chronic undernutrition abolished the differences in birth weight due to fetal sex. Restoring maternal nutrition or antioxidant supplementation tends to normalize birth weight and restore the differences between females and males. This effect is enhanced with the combined supplementation of concentrated food and antioxidants.

Decreased immune response in undernourished rats after air pollution exposure

Children are highly vulnerable subpopulation to malnutrition and air pollution. We investigate, in a rat nutritional growth retardation (NGR) model, the impact of Residual Oil Fly Ash (ROFA) on the lung immune response using in vitro and ex vivo methods. In vitro: Alveolar macrophages (AM) were isolated from Control (C) and NGR animals, cultured and treated with ROFA (1–100 µg/ml) for 24 h. Ex vivo: C and NGR rats were intranasally instilled with ROFA (1 mg/kg BW) or PBS. 24 h post-exposure AM were isolated and cultured. ROFA-treatment increased superoxide anion production and TNFα secretion in C-AM in vitro, though for NGR-AM this response was lower. A similar pattern was observed for TNFα and IL-6 secretion in ex vivo experiments. Regarding the antioxidant response, although NGR-AM showed increased Nrf2, after ROFA instillation an attenuated activation was observed. To conclude, chronic undernutrition altered AM response to ROFA affecting immune responsiveness to air pollutants.

Upregulation of PD-1/PD-L1 and downregulation of immune signaling pathways lead to more severe visceral leishmaniasis in undernutrition mice

BackgroundLeishmaniasis is mainly prevalent in tropical and subtropical developing countries, where chronic undernutrition often co-exists. Undernutrition is reported to promote the progression of leishmaniasis, but its immune mechanisms have not been fully elucidated.MethodsTo simulate chronic undernutrition of patients in epidemic areas and explore the immune mechanism of undernutrition promoting leishmaniasis, BALB/c mouse models with different nutritional imbalances were established, including undernutrition 75%, undernutrition 65% and obesity mouse models. After infection with Leishmania donovani in these model mice, we focused on evaluating the progress of leishmaniasis in the spleen and liver, the expression of important immunosuppressive and immunoactivation molecules, and changes of spleen transcriptome. The immune signaling pathways enriched by differentially expressed genes and hub genes were analyzed.ResultsThe results showed that among the mouse infection models, undernutrition 75% + infection group had the highest parasite load in the spleen and liver at the 8th week post-infection, possibly due to the continuous increase of PD-1, PD-L1 and TCR. Spleen RNA-seq results suggested that some immune signaling pathways were downregulated in undernutrition 75% + infection group, including neutrophil extracellular trap formation, IL-17 signaling pathway, natural killer cell-mediated cytotoxicity, etc. Among them, neutrophil extracellular trap formation pathway had the largest number of downregulated genes. This also explained why undernutrition 75% + infection group had the highest parasite load. Through PPI network analysis, hub genes such as Lcn2, Ltf, Mpo, Dnaja1, Hspa1a, Hspa1b and Hsph1 were screened out and might play important roles in the process of undernutrition promoting leishmaniasis.ConclusionsUndernutrition upregulated PD-1 and PD-L1 expression and downregulated immune signaling pathways in mice with visceral leishmaniasis. The signaling pathways and hub genes may serve as drug targets or intervention targets for the treatment of leishmaniasis patients with undernutrition.Graphical

Nearly half of HIV-positive children attending public health facilities are suffering from chronic under-nutrition in conflict-affected zones of Southern Ethiopia.

In combination with HIV infection, malnutrition is a complicated medical condition with high morbidity and mortality rates in affected children due to a variety of socioeconomic and medical etiological variables. To combat this, information from a range of contexts is required, but there is little evidence, particularly about the nutritional status of under 15 living with HIV in impoverished communities such as conflict affected areas. Therefore, in this study the magnitude and related factors of stunting among under 15 children antiretroviral therapy at public health facilities was assessed. An institution-based cross-sectional study was conducted among under 15 children living with HIV in conflict-affected zones of Southern Ethiopia. After providing written informed consent to study participants, data were collected using an interviewer-administered questionnaire and anthropometric measurements. Bivariable and multivariable logistic regression models were used to identify factors associated with nutritional status, using SPSS Version 25. Of the 401 participants, 197 (49.1%, 95% CI: 0.44, 0.54) had height-for-age z-score ≤ -2. In the multivariable analysis, larger household size (AOR = 1.58, 95% CI: 1.04-2.40), dietary diversity (AOR = 1.78; 95% CI: 1.07-2.96) and having a history of recurrent diarrhea (AOR = 1.96; 95% CI: 1.07-3.59) were significantly associated with chronic under nutrition. The prevalence found in this study was high when compared with the stunting target set in SDG, which states to end all forms of malnutrition In order to mitigate the negative health effects of diarrhea during HIV therapy, extra attention needs to be paid to facilitate timely detection and on-going monitoring. Nutrition programs in conflict-affected areas need to consider households with larger family sizes and/or routinely having fewer food groups.

How do household living conditions and gender-related decision-making influence child stunting in Rwanda? A population-based study.

Child stunting (chronic undernutrition) is a major public health concern in low- and middle-income countries. In Rwanda, an estimated 33% of children are affected. This study investigated the household living conditions and the impact of gender-related decision-making on child stunting. The findings contribute to ongoing discussion on this critical public health issue. In December 2021, a population-based cross-sectional study was conducted in Rwanda's Northern Province; 601 women with children aged 1-36 months were included. Stunting was assessed using low height-for-age criteria. The Multidimensional Poverty Index (MPI) was used to determine household socioeconomic status. Researcher-designed questionnaires evaluated gender-related factors such as social support and household decision-making. Multivariable logistic regression analysis identified risk factor patterns. Six hundred and one children were included in the study; 27.1% (n = 163) were diagnosed as stunted; there was a higher prevalence of stunting in boys (60.1%) than girls (39.9%; p<0.001). The MPI was 0.265 with no significant difference between households with stunted children (MPI, 0.263; 95% confidence interval [CI], 0.216-0.310) and non-stunted children (MPI, 0.265; 95% CI, 0.237-0.293). Most households reported a lack of adequate housing (78.9%), electricity (63.0%), good water sources (58.7%), and proper toilets (57.1%). Male-headed households dominated (92% vs. 8.0%; p = 0.018), and women often shared decision-making with their partners. However, 26.4% of women reported forced sexual intercourse within marriage (Odds Ratio [OR] 1.81; 95% CI, 1.15-2.85). Lack of support during illness ([OR], 1.93; 95% CI, 1.13-3.28) and absence of personal guidance (OR, 2.44; 95% CI, 1.41-4.26) were significantly associated with child stunting. Poverty contributes to child stunting in the Northern Province of Rwanda. Limited social support and women's lack of decision-making power in the household increase stunting rates. Interventions should empower women and address the broader social and economic context to promote both women's and children's health.

An analysis of the dual burden of childhood stunting and wasting in Myanmar: a copula geoadditive modelling approach.

To analyze the spatial variation and risk factors of the dual burden of childhood stunting and wasting in Myanmar. Analysis was carried out on nationally representative data obtained from the Myan-mar Demographic and Health Survey conducted during 2015-2016. Childhood stunting and wasting are used as proxies of chronic and acute childhood undernutrition. A child with standardized height-for-age Z score (HAZ) below -2 is categorized as stunted while that with a weight-for-height Z score (WHZ) below -2 as wasted. A nationally representative sample of households from the 15 states and regions of Myanmar. Children under the age of five (n 4162). Overall marginal prevalence of childhood stunting and wasting were 28.9% (95% CI 27.5, 30.2) and 7.3% (95% CI 6.5, 8.0) while their concurrent prevalence was 1.6% (95% CI 1.2, 2.0). The study revealed mild positive association between stunting and wasting across Myanmar. Both stunting and wasting had significant spatial variation across the country with eastern regions having higher burden of stunting while southern regions having higher prevalence of wasting. Child age and maternal weight-for-height Z score had significant non- linear association with both stunting and wasting while child gender, ethnicity and household wealth quintile had significant association with stunting. The study provides data-driven evidence about the association between stunting and wasting and their spatial variation across Myanmar. The resulting insights can aid in the formulation and implementation of targeted, region-specific interventions towards improving the state of childhood under-nutrition in Myanmar.

The Effect of Boko Haram Insurgency on Health and Nutrition among the Residents of Bolori 2 of Maiduguri Metropolitan Council of Borno State, Nigeria.

The Effect of Boko Haram Insurgency on Health and Nutrition among the Residents of Bolori 2 of Maiduguri Metropolitan Council of Borno State, Nigeria.

The interlink between chrono-nutrition and stunting: current insights and future perspectives.

Stunting is the one factor that is responsible for the irretrievable damage to children's mental and physical health. Stunting imitates chronic undernutrition throughout the most extreme critical stages of growth and development of a child in their early life, and due to that stunted child does not completely develop and are too short for their age. Stunting is mainly linked with brain underdevelopment, along with lifelong damaging consequences, comprising weakened mental and learning capacity, deprived performance in school during childhood, and enhanced risks of nutrition linked to chronic long-lasting ailments, such as diabetes, hypertension, diabesity, and obesity in the future. In this review, the authors mainly summarize the latest studies related to chronic nutrition and how it is related to stunting. Optimal nutrition, particularly during pregnancy and the first 24 months of a child's life, is crucial in preventing stunting. Circadian rhythms play a significant role in maternal and fetal health, affecting outcomes such as premature birth and stunting. Maintaining a balanced diet, avoiding late-night carbohydrate-heavy meals during pregnancy, and promoting breastfeeding align with the body's biological clock, which can benefit newborns in various ways. Providing dedicated spaces for breastfeeding in public places is important to support infant health.