High Prevalence Of Undernutrition Research Articles

Correlation Level of Energy Consumption Level of Protein and Body Image Prevalency CED in Shafta High School Surabaya

One of the nutritional problems in adolescents is Undernutrition, which can be caused by inadequate energy and protein intake. A contributing factor to the lack of intake is body image. Undernutrition can lead to decreased learning concentration and have implications for future pregnancy. To determine the relationship between energy and protein consumption levels and body image with the prevalence of Undernutrition in Shafta Surabaya High School. This study is an analytical observational research using the SQ-FFQ 2-week form to determine energy and protein consumption levels and the BSQ form to assess body image. The percentage of female students with severe energy deficit consumption (52.9%), severe protein deficit consumption (41.2%), and positive body image (84.3%) is high. The prevalence of Undernutrition is 47.1%. The Spearman correlation test results show a significant relationship between energy and protein consumption levels and body image with Undernutrition prevalence. Most respondents have severe energy and protein deficit, positive body image, and a high prevalence of Undernutrition. There is a significant relationship between energy and protein consumption levels and body image among female adolescents Further research is needed to explore adolescents' knowledge regarding the ideal body shape.

Comparative Study on the Prevalence of Malnutrition among Public Primary School Pupils in Rural and Urban Communities in Warri South

Malnutrition among primary school-age children has continued to pose a major public health issue, especially in developing countries. Nigeria is ranked amongst the top ten countries with the highest prevalence of undernutrition in children while about 2,300 children die daily in Nigeria as a result of malnutrition. Hence, the study was conducted to determine and compare the prevalence of malnutrition among public school pupils in rural and urban communities in Warri South LGA. This school-based comparative cross-sectional study made use of a bio-data form that collected socio-demographic details and anthropometric measurements of the pupils. The nutritional status of the pupils was obtained using WHO AnthroPlus software, while the resulting data were analysed and presented accordingly. The result showed that a total of 330 pupils (165 each from urban and rural public primary schools) were recruited, out of which more of the pupils in urban areas were younger, had parents who were better educated and employed while those from rural areas had higher family sizes. However, there was no difference in the sex and type of family of the pupils. The prevalence of malnutrition was reported as 36.7% with the prevalent form of malnutrition discovered as underweight (35.0%), followed by stunting (13.9%), overweight/obese (8.5%), and wasting (7.2%). Wasting, stunting, and overweight were higher among urban pupils, while the rate of underweight was higher among rural children. This high prevalence of undernutrition among urban pupils could be attributed to poor nutrition arising from a myriad of interrelated circumstances such as poor feeding, eating practices, and recurrent infection. Hence, the need for improved sensitisation of mothers concerning correct childhood feeding and provision of balanced nutrition.

Linkages between malaria and malnutrition in co-endemic regions of India

IntroductionMalaria and malnutrition are key public health challenges in India. However, the relationship between them is poorly understood. Here, we aimed to elucidate the potential interactions between the two health...

Dietary Diversity, Nutritional Status, and Associated Factors Among Pregnant Women in Their First Trimester of Pregnancy in Ambo District, Western Ethiopia

Background: Poor dietary diversity and undernutrition is a major public health concern for pregnant mothers. Optimal dietary diversity is essential during pregnancy since nutritional deficiencies may have a significant impact on both the mother’s and the fetus’s health. Pregnant women in Ambo district had inadequate dietary diversity and were undernourished, but their status during the first trimester of pregnancy was not known. As a result, the objective of this research was to assess the dietary diversity, nutritional status, and associated factors among pregnant women in the Ambo district. Methods: A community-based cross-sectional study design and a multi-stage sampling technique were used among 750 pregnant women. Data was gathered using a semi-structured questionnaire. The Food and Nutrition Technical Assistance questionnaire was modified to collect data on dietary diversity. The nutritional status of pregnant women was assessed by measuring the mid-upper arm circumference. First, descriptive statistics like mean, Standard deviation, frequency and percentage were used, then bivariable and, finally, multivariable logistic regression analysis was used to assess the association of the predictors with the outcome variable. Result: The study revealed that 73.6% and 23.9% of pregnant women had low dietary diversity and were undernourished, respectively. Being in food secured household (AOR = 4.44, 95% CI: 2.14-9.15), having good knowledge (AOR = 3.32, 95% CI: 2.10-5.23) and favorable attitude toward nutrition and health (AOR = 1.71, 95% CI: 1.10-2.66) were significantly associated with dietary diversity, whereas household size (having 1-3 household members AOR = 6.59, 95% CI: 2.53-17.21, having 4-5 household members AOR = 5.62, 95% CI: 3.15-9.99), being in food secured household (AOR = 5.64, 95% CI: 2.79-11.38), having high dietary diversity (AOR = 8.49, 95% CI: 2.47-29.23), and having optimal practice on nutrition and health (AOR = 6.85, 95% CI: 3.23-14.55) were significantly associated with undernutrition ( P < .05). Conclusions: The current study revealed that pregnant women in the study area had inadequate dietary diversity practices and a high prevalence of undernutrition. Knowledge and attitude, and households’ food security status were the predictors of dietary diversity, while household size, household food security status, dietary diversity and nutrition and health practice were predictors of undernutrition. Hence, behavior change communication needs to be designed to improve the dietary diversity and nutritional status of pregnant women.

Double burden of malnutrition among mothers and their under five children in rural areas of Oyo State, Nigeria

Background/Objective: Double burden of malnutrition, characterized by undernutrition among poor children and overnutrition among disadvantaged adults coexisting in the same population group or household, is a serious global problem. The objective of this study was to assess double burden of malnutrition among mothers and their under-five children in rural communities of Ibadan, Nigeria.
 Methods: This cross-sectional and descriptive study adopted a two-stage random sampling to recruit 217 mother-child pairs from 18 rural communities in Ido and Akinyele Local Government Areas of Ibadan. A semi-structured, interviewer-administered questionnaire was used to obtain information on socio-demographic characteristics and personal characteristics of mothers and their under-five children respectively. Anthropometric characteristics of mothers was obtained and their Body Mass Index (BMI) was determined using WHO classification. Children anthropometry was measured and expressed as stunting (height-for-age), wasting (weight-for-height) and underweight (weight-for-age) using WHO Anthro. Data were analyzed using descriptive statistics, Chi-square test, and correlation at 0.05 level of significance.
 Results: Age of mothers and under-five children were 32.3±6.2 years and 35.3±14.1 months respectively. Household size was 6.3±1.7 and 62.2% had no formal education. Underweight, overweight and obesity among mothers were 9.2%, 15.2% and 3.2%, respectively. Among children, underweight, stunting and wasting were 30.4%, 40.6% and 7.8%, respectively. Household size was significantly associated with stunting. Mothers’ BMI was positively and significantly correlated with height-for-age (r=0.173), weight-for-height (r=0.150) and weight-for-age (r=0.250) in children.
 Conclusion: This study confirms coexistence of double burden of malnutrition at household level in this rural areas of Ibadan, Nigeria. That is the concurrence of child undernutrition and maternal under and overnutrition in the same household surveyed, which was characterized by a high prevalence of undernutrition particularly stunting early in life. Therefore, a comprehensive nutritional programme that is context-specific targeted at rural women and their children should be implemented.
 Keywords: Overnutrition, Rural women, Under-five children, Nutritional status, undernutrition

Decomposing the gap in undernutrition among under-five children between EAG and non-EAG states of India

In India, the Empowered Action Group (EAG) states (Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh, Uttarakhand, Odisha, Jharkhand, and Chhattisgarh, including Assam) have a higher prevalence of undernutrition among children under the age of five (U5) than non-EAG states. However, no research has attempted to explain the difference in U5 child undernutrition between EAG and non-EAG states. To fill this gap, this study used data from the fourth round of the National Family Health Survey (NFHS-4) and applied modified Blinder–Oaxaca decomposition (also known as Fairlie decomposition). This decomposition helps quantify the relative contribution of various factors explaining the gap between EAG and non-EAG states in U5 child undernutrition. In EAG states, nearly four out of ten U5 children suffered from being underweight and stunted, and one out of five suffered from wasting. The prevalence of undernutrition was relatively higher in the EAG states than in the non-EAG states. The decomposition results revealed that almost two-thirds of the gap in U5 undernutrition between EAG and Non-EAG states was explained by the variables used in the analysis. Household wealth explained about half the difference in stunting and wasting, while religion accounted for a quarter of the difference in underweight and wasting. Maternal education explained a fourth of the difference in stunting between EAG and Non-EAG states. The disparity in undernutrition between EAG and non-EAG states could be reduced by introducing suitable long- and short-term interventions and programs. Increasing access to the public distribution system (PDS), raising awareness among low-income mothers regarding optimal inter-birth intervals, proper health and hygiene, appropriate family planning, and the importance of maternal and child health care services by frontline workers (ASHAs, Anganwadi workers, etc.) could be some of the ways to bridge the gap in undernutrition between EAG and non-EAG states in the near future.

Dietary Diversity in Infancy Is Associated with Linear Growth in The Second Year of Life

Upon completion, participant will be able to describe how dietary diversity contributes to growth in low-and middle-income settings. Despite the high prevalence of undernutrition among young children in low- and middle-income settings, few studies have examined how dietary diversity and adequacy during the complementary feeding period impacts subsequent growth and body composition. We therefore examined associations between dietary diversity (DD, range 0-7) and minimum DD (MDD, DD >4) at 9 months of age with subsequent growth trajectories (up to 23 months of age) among a cohort of infants in Nyanza, Kenya.

Improving the Nutritional Status of Adolescent Females in Gujarat: The Case for Targeted Investment.

Introduction Undernutrition is one of the key determinants of morbidity and mortality in adolescent females worldwide and in India. Malnutrition, particularly undernutrition, is highly prevalent among adolescent females. Although undernutrition affects the health status of adolescent females leading to poor growth and developmental problemissues amongthem, still, the adolescent group remains to be neglected group. The present paper particularly focuses on challenges and ways forward for improving the nutritional status of adolescent females in Gujarat. Methods and material It's a mixed method study where the secondary data analysis was conducted comparing the National Family Health Survey-5 (NFHS-5) report with the Comprehensive National Nutritional Survey (CNNS) report for the assessment of undernutrition, overweight, and anemia status among adolescent females, and the primary assessment of the nutritional status of adolescent females across Gujarat was conducted through anthropometric measurements of height and weight. Results The NFHS-5 report findings showed total thinness among adolescent females (15-19 years) in Gujarat to be 52.5%, which increased by 3% from the NFHS-4 findings. Anemia among adolescent females has also been reported to be 69%, which also increased by 12.5% from the NFHS-4 findings. Tribal regions/populations had a higher prevalence of undernutrition. Being overweight among urban adolescent females was more prevalent than in rural regions. The key findings of the CNNS report also showed that 24% of adolescent females (10-19 years) were thin while 5% of adolescent females were overweight/obese in India, while in Gujarat, 8% of adolescent females were overweight/obese. The primary data gathered suggest a prevalence of overweight in Gujarat of 8.9% in adolescent females andtotal thinness of 50%. Conclusion The nutritional status of adolescent females is still a major concern in many parts of India. Considering the complex set of challenges to tackle malnutrition in Gujarat and with specific attention to the adolescent group, it is vital to understand district-specific challengesand plan, program, and design district-specific strategies and implement actions to improve the existing nutritional status of adolescent females.

Anthropometric deficits and the associated risk of death by age and sex in children aged 6-59 months: A meta-analysis.

Risk of death from undernutrition is thought to be higher in younger than in older children, but evidence is mixed. Research also demonstrates sex differences whereby boys have a higher prevalence of undernutrition than girls. This analysis described mortality risk associated with anthropometric deficits (wasting, underweight and stunting) in children 6-59 months by age and sex. We categorised children into younger (6-23 months) and older (24-59 months) age groups. Age and sex variations in near-term (within 6months) mortality risk, associated with individual anthropometric deficits were assessed in a secondary analysis of multi-country cohort data. A random effects meta-analysis was performed. Data from seven low-or-middle-income-countries collected between 1977 and 2013 were analysed. One thousand twenty deaths were recorded for children with anthropometric deficits. Pooled meta-analysis estimates showed no differences by age in absolute mortality risk for wasting (RR 1.08, p = 0.826 for MUAC < 125 mm; RR 1.35, p = 0.272 for WHZ < -2). For underweight and stunting, absolute risk of death was higher in younger (RR 2.57, p < 0.001) compared with older children (RR 2.83, p < 0.001). For all deficits, there were no differences in mortality risk for girls compared with boys. There were no differences in the risk of mortality between younger and older wasted children, supporting continued inclusion of all children under-five in wasting treatment programmes. The risk of mortality associated with underweight and stunting was higher among younger children, suggesting that prevention programmes might be justified in focusing on younger children where resources are limited. There were no sex differences by age in mortality risk for all deficits.

Nutritional status of school children in the South Tongu District, Ghana.

BackgroundMalnutrition is a major public health problem because of the devastating consequences it has on children, their families, and society at large. Our study, therefore, sought to determine the prevalence of undernutrition and overweight/obesity and its associated factors among children aged 6–12 in the South Tongu District, Ghana.MethodsA school-based cross-sectional study was conducted among 423 school children aged 6–12 years in the South Tongu District of Ghana. A multistage sampling method was employed to recruit the school children for the study. A semi-structured questionnaire was used to collect data from the respondents. We used a dual-purpose (height and weight) measuring scale to obtain the anthropometric data. The World Health Organization’s AnthroPlus software was used to generate the z-scores for determining the nutritional status. Percentages were used to present the results of the prevalence of undernutrition and overweight/obesity among school children. Bivariate and multivariable binary logistic regression were used to examine the factors associated with undernutrition and overweight/obesity among school children. The results were presented as crude odds ratios (CORs) and adjusted odds ratios (AORs), with their 95% confidence interval (CI). Statistical significance was set at p<0.05. Stata 16.0 was used to perform the analyses.ResultsThe overall prevalence of undernutrition and overweight/obesity were 21.5% (CI = 17.7, 25.7) and 24.8% (CI = 20.8, 29.2), respectively. Specifically, the prevalence of stunting, thinness, underweight, overweight, and obesity were 10.4%, 12.1%, 3.8%, 11.1%, and 13.7%, respectively. School children whose household used water from non-portable sources were more likely to be undernourished [AOR = 2.03, 95% CI = 1.13, 3.63]. The odds of overweight/obesity was higher among school children whose mothers had attained formal education [AOR = 2.10, 95% CI = 1.09, 4.06], those who consumed beverages between meals per day [AOR = 1.87, CI = 1.08, 3.24], and those who had adequate dietary diversity score [AOR = 1.65, 95% CI = 1.02, 2.67]. School children aged 10–12 were less likely to be overweight/obese [AOR = 0.58, 95% CI = 0.35, 0.94] compared to those aged 6–9.ConclusionThe study showed a relatively high prevalence of undernutrition and overweight/obesity among school children in the South Tongu District. The identified risk factor(s) for undernutrition was the usage of water from non-potable sources whilst those of overweight/obesity were age (10–12 years), maternal formal education, beverage consumption between meals per day, and adequate dietary diversity. The findings reaffirm that malnutrition is still prevalent among school children. Hence, there is a need for the Ministry of Health, Ghana Education Service, and other Non-Governmental Organizations to pay critical attention to these factors to achieve the Sustainable Development Goal 2, target 2.2. Nutritional behavioural change education should be carried out among parents and school children. School health service activities should be intensified with a special focus on nutritional screening.

Potential contribution of Macrotermes nigeriensis-improved fermented cassava mahewu to nutrient intake adequacy of school children in Umudike, Nigeria

The high prevalence of undernutrition among children in developing countries has necessitated the present study which was aimed at evaluating the contribution of Microtermes nigeriensis-improved cassava mahewu (TECM) to nutrient intake (RNI) of children. Cassava flour was replaced with M. nigeriensis (MN) powder at 30% and fermented to obtain cassava mahewu. Standard cassava mahewu (SCM) was used as control. The samples were analysed for proximate and micronutrients after freeze drying using standard methods. Nutrient intakes were computed and percentage contributions to RNI were calculated. Data were analyzed using descriptive statistics. Results indicate that contribution of SCM to RNI were protein (5.8, 4.6%), iron (8.6, 7.5%), Zinc (4.5, 2.9%), calcium (2.5, 1.4%) and Vitamin C (34.9, 30.5%) for 6–9 and 10–15 years old respectively, which is extremely low compared to reference RNI. However, the inclusion of MN improved (P<0.05) contribution to protein (46.4 and 36.8%), Zinc (45.4 and 29.5%), Iron (72.7 and 63.6%) and Ascorbate (87.1 and 76.3%) respectively, but did not meet the requirement for calcium (1.98 and 1.06%). This finding indicates that MN-improved cassava mahewu can be used as a food-based strategy to reduce the wide spread child's malnutrition in developing countries if adequately promoted.

Dual-Energy X-Ray Absorptiometry and Anthropometry for Assessment of Nutritional Status at Diagnosis in Children with Cancer: A Single-Center Experience from India

Background The survival of children with cancer has improved owing to advances in chemotherapy and better supportive care, and nutritional support is an important component of the latter especially in low- and middle-income countries like India. Materials and Methods A prospective observational study of 137 newly diagnosed children with cancer aged less than 18 years was planned. Nutritional assessment was done using dual-energy X-ray absorptiometry (DXA), anthropometry, and serum albumin. Patients were followed for 3 months for assessment of treatment-related morbidity. Results Lean body mass (LBM; DXA), mid-upper arm circumference (MUAC), and body mass index detected undernutrition in 44, 45, and 14% patients, respectively. Combination of arm anthropometry (MUAC and triceps skinfold thickness) with serum albumin categorized patients as adequately nourished (32%), moderately depleted (18%), and severely depleted (49%). Patients with hematological malignancy had a higher prevalence of undernutrition but there was no difference in morbidities between the undernourished and adequately nourished children by any parameter. Hypoalbuminemia observed in 25% patients was associated with significant chemotherapy delays (p, 0.01) and interval admissions (p, 0.03). Using LBM as a criterion, linear regression analysis revealed MUAC (R 2 = 0.681) as the best predictor of undernutrition with lowest standard error. Conclusion Our study reports undernutrition among two-fifths of newly diagnosed patients of childhood cancer associated with high prevalence of sarcopenia and adiposity. These findings are of utmost clinical relevance in planning interventional strategies.

Mortality after multivitamin supplementation: Nearly 35-year follow-up of the randomized Linxian Dysplasia Nutrition Intervention Trial.

The objective of this study was to update the association between multivitamin supplementation and total or cause-specific mortality in a population with a high prevalence of undernutrition in China. The Linxian Dysplasia Nutrition Intervention Trial was a randomized, double-blind, placebo-controlled trial in which 3318 persons aged 40-69 years with esophageal squamous dysplasia were assigned to receive daily multivitamin supplementation or a placebo for 6 years and were followed for 29 years. The primary outcome was esophageal/gastric cardia cancer mortality. The data were analyzed with Cox proportional hazards regression models. Subgroup analyses were performed by common characteristics such as age and gender. The cumulative total mortality was 83.5%. Multivitamin supplementation did not affect total or cause-specific mortality in the participants as a whole (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.89-1.03). Subgroup analyses showed that no association between multivitamin supplementation and all-cause mortality was observed in men (HR, 0.90; 95% CI, 0.81-1.01), women (HR, 1.01; 95% CI, 0.91-1.12), younger participants (HR, 0.97; 95% CI, 0.87-1.08), or older participants (HR, 0.94; 95% CI, 0.85-1.04). Significant reductions in heart disease mortality (HR, 0.64; 95% CI, 0.47-0.87) and cerebrovascular disease mortality (HR, 0.74; 95% CI, 0.56-1.00) were seen in older men. In a subgroup of younger men and a subgroup of moderate or severe dysplasia, subjects receiving multivitamin supplementation had a lower risk of esophageal/cardia cancer mortality (HR for younger men, 0.76; 95% CI, 0.58-0.99; HR for moderate or severe dysplasia, 0.76; 95% CI, 0.58-1.00). No association between multivitamin supplementation and any cause-specific mortality was observed in a mild dysplasia population. Multivitamin supplementation in a population with esophageal squamous dysplasia was not associated with the risk of total mortality in the 35-year follow-up of this randomized controlled trial. In light of this and previous trials, multivitamin supplements should be used thoughtfully to improve health status of populations with esophageal squamous dysplasia. Multivitamin supplementation is common, yet its effect on mortality is unclear. The aim of this study was to update the long-term effects of multivitamin supplementation on total and cause-specific mortality during nearly 35 years of follow-up in the Linxian Dysplasia Nutrition Intervention Trial in China. Multivitamin supplementation in a population with esophageal squamous dysplasia was not associated with the risk of total mortality in the 35-year follow-up of this randomized controlled trial, and this indicates that multivitamin supplements should be used thoughtfully to improve health status.

Nutricional Status of Elderly People Hospitalized in Chile

ObjectivesThe objective of this study is to characterize the nutritional condition of elderly patients recently hospitalized in the internal medicine ward of a hospital in Chile, using different nutritional assessment tools. We hypothesized that there should be a high prevalence of undernutrition in this group of patients.MethodsThis is an observational, descriptive, cross-sectional study, planned to include 300 patients who are older than 65 years and recently admitted (less than 72 hours) to the internal medicine ward at the “Hospital de Urgencia Asistencia Pública” in Chile. For those patients who agreed to participate in the study and did not meet the exclusion criteria (altered state of consciousness, and severe disease), we obtained demographic and clinical data such as weight, height, calf circumference, admission diagnostic, total length of hospitalization, and the results of applying 3 nutritional assessment tools: (i) Malnutrition Screening Tool (MST), (ii) Nutritional Risk Screening 2002 (NRS 2002), and (iii) Mini Nutritional Assessment Short Form (MNA SF).ResultsOne hundred and twenty-four patients (74,9 ± 7,4 years old, 47,6% women, and 52,4% men) have been included preliminarily in the study. Based on the Body Mass Index (BMI), 13,7% of patients were underweighted, 38,7% had normal weight, 29,8% were overweight and 17,8% presented obesity (P = 0,044). The three screening tools used (MST, NRS 2002, and MNA SF) had a good correlation with BMI, however, they were able to identify more patients at nutritional risk, than considering only BMI (MST 37,9%, NRS 2002 46,8%, and MNA 42,7%). Underweight patients had longer hospital stays when compared to normal weight, overweight, and obese patients.ConclusionsConsidering only BMI, overweight and obesity conditions were more prevalent than underweight in elderly hospitalized patients in an internal medicine unit in Chile. We hypothesized this is a post-pandemic effect (long quarantines in our country), also related to the cultural and economic changes in our developing country. Although underweight was not prevalent, about 40% of elderly patients were at nutritional risk. The lower the BMI, the higher length of stay in hospital.Funding SourcesAnnual Contest to Promote Research (CAI), from University Finis Terrae, Chile.

Dual-Energy X-Ray Absorptiometry and Anthropometry for Assessment of Nutritional Status at Diagnosis in Children with Cancer: A Single-Center Experience from India.

Gauri KapoorBackground The survival of children with cancer has improved owing to advances in chemotherapy and better supportive care, and nutritional support is an important component of the latter especially in low- and middle-income countries like India. Materials and Methods A prospective observational study of 137 newly diagnosed children with cancer aged less than 18 years was planned. Nutritional assessment was done using dual-energy X-ray absorptiometry (DXA), anthropometry, and serum albumin. Patients were followed for 3 months for assessment of treatment-related morbidity. Results Lean body mass (LBM; DXA), mid-upper arm circumference (MUAC), and body mass index detected undernutrition in 44, 45, and 14% patients, respectively. Combination of arm anthropometry (MUAC and triceps skinfold thickness) with serum albumin categorized patients as adequately nourished (32%), moderately depleted (18%), and severely depleted (49%). Patients with hematological malignancy had a higher prevalence of undernutrition but there was no difference in morbidities between the undernourished and adequately nourished children by any parameter. Hypoalbuminemia observed in 25% patients was associated with significant chemotherapy delays ( p , 0.01) and interval admissions ( p , 0.03). Using LBM as a criterion, linear regression analysis revealed MUAC ( R 2 = 0.681) as the best predictor of undernutrition with lowest standard error. Conclusion Our study reports undernutrition among two-fifths of newly diagnosed patients of childhood cancer associated with high prevalence of sarcopenia and adiposity. These findings are of utmost clinical relevance in planning interventional strategies.

Dual-Energy X-Ray Absorptiometry and Anthropometry for Assessment of Nutritional Status at Diagnosis in Children with Cancer: A Single-Center Experience from India

Background The survival of children with cancer has improved owing to advances in chemotherapy and better supportive care, and nutritional support is an important component of the latter especially in low- and middle-income countries like India. Materials and Methods A prospective observational study of 137 newly diagnosed children with cancer aged less than 18 years was planned. Nutritional assessment was done using dual-energy X-ray absorptiometry (DXA), anthropometry, and serum albumin. Patients were followed for 3 months for assessment of treatment-related morbidity. Results Lean body mass (LBM; DXA), mid-upper arm circumference (MUAC), and body mass index detected undernutrition in 44, 45, and 14% patients, respectively. Combination of arm anthropometry (MUAC and triceps skinfold thickness) with serum albumin categorized patients as adequately nourished (32%), moderately depleted (18%), and severely depleted (49%). Patients with hematological malignancy had a higher prevalence of undernutrition but there was no difference in morbidities between the undernourished and adequately nourished children by any parameter. Hypoalbuminemia observed in 25% patients was associated with significant chemotherapy delays (p, 0.01) and interval admissions (p, 0.03). Using LBM as a criterion, linear regression analysis revealed MUAC (R 2 = 0.681) as the best predictor of undernutrition with lowest standard error. Conclusion Our study reports undernutrition among two-fifths of newly diagnosed patients of childhood cancer associated with high prevalence of sarcopenia and adiposity. These findings are of utmost clinical relevance in planning interventional strategies.

Protein-Energy Supplementation in Early-Life Decreases the Odds of Mental Distress in Later Adulthood in Guatemala

BackgroundThe prevalence of mental health concerns is growing worldwide, along with lack of access to and receipt of needed treatment. Current gaps in treatment provision have led to exploring alternative methods of prevention, with research linking nutrition and mental health, of particular relevance in low- and middle-income countries, with a high prevalence of undernutrition. ObjectivesTo examine whether exposure to a protein-energy nutritional supplement during the first 1000 d of life decreased odds of mental distress in adulthood among men and women in Guatemala compared with receiving a low energy-no protein supplement or supplementation outside the 1000-d window. MethodsData from participants (n = 1249) in a longitudinal cohort protein-energy supplementation trial (early-life, supplementation data from 1969 to 1977, ages 0–7 y; life course, outcome data from 2017–2018 follow-up, ages 40–57 y) were analyzed for associations between nutrition in the first 1000 d and mental distress in adulthood (WHO Self-Reporting Questionnaire 20 [SRQ-20]), controlling for early-life variables and current life stress; life course variables (e.g. education) were examined as potential mediators of this relation. Generalized linear mixed models and zero-inflated Poisson generalized linear mixed models were utilized. ResultsBoth partial and full supplementation with Atole during the first 1000 d were associated with 63% (95% CI: 0.16, 0.87) and 56% (95% CI: 0.19, 1.03) lower odds, respectively, of experiencing mental distress in adulthood. Results did not differ by sex. These inverse relations remained relatively unchanged (partial OR = 0.34 [95% CI: 0.14, 0.83]; full OR = 0.38 [95% CI: 0.16, 0.92]) after controlling for early-life and life course variables, including life stress. ConclusionsProtein-energy supplementation during the first 1000 d of life in Guatemala, where undernutrition is prevalent, may reduce the prevalence of later mental distress in adulthood. This effect appears to occur directly, rather than indirectly, through pathways of life course variables such as education, wealth, and marital status.

Accuracy of Using Mid-Upper Arm Circumference to Detect Wasting Among Children Aged 6-59 Months in Nepal.

In countries with a high prevalence of undernutrition, timely, accurate screening at the community level is essential to identify children with wasting. The World Health Organization recommends using either weight-for-height z-scores (WHZ) and mid-upper arm circumference (MUAC) or both measures and signs of edema to be used to identify children with severe acute malnutrition for treatment. We compared WHZ and MUAC cutoffs to identify wasting among children aged 6-59 months in Nepal, using WHZ as the reference standard. We used cross-sectional anthropometric data for 3,169 children aged 6-59 months from a 2017 cross-sectional dataset, representative of 42 of Nepal's 77 districts. We used descriptive statistics, receiver operating characteristic (ROC) curves, and kappa statistics to compare the use of MUAC and WHZ to identify wasting. The Youden index was calculated to determine the optimum MUAC cutoffs. The prevalence of wasting was 3.1% and 10.5% using MUAC and WHZ, respectively. We found 13.6% sensitivity for severe acute malnutrition (SAM) (MUAC <115 mm) and 21.0% sensitivity for moderate acute malnutrition (MAM) (MUAC ≥115 to <125 mm), with specificity of 99.7% and 91.2%, respectively. The sensitivity of MUAC for children aged 6-23 months was higher than for children aged 24-59 months. The total area of the ROC curve was 0.53 for the MUAC cutoff for SAM and 0.56 for MAM. The optimum MUAC cutoffs for SAM and MAM were 125 mm and 132 mm, respectively. Although MUAC can be used as a rapid screening tool to detect wasting in children aged 6-59 months, using the recommended MUAC cutoffs captures only a small proportion of the total number of wasted children. The poor sensitivity and specificity of MUAC compared to WHZ suggests a need to refine admission and discharge criteria for acute malnutrition management programs to ensure that wasting among infants and children in Nepal is consistently and accurately diagnosed and treated.

Spatial patterns and determinants of undernutrition among late-adolescent girls in Ethiopia by using Ethiopian demographic and health surveys, 2000, 2005, 2011 and 2016: a spatial and multilevel analysis

BackgroundUndernutrition among late-adolescent girls (15–19 years) in Ethiopia is the highest among Southern and Eastern African countries. However, the spatial variation of undernutrition as a national context is not well understood in Ethiopia. This study aimed at the spatial patterns and determinants of undernutrition among late-adolescent girls in Ethiopia.MethodsSecondary data analysis was conducted from women’s data of four consecutive Ethiopian Demographic and Health Surveys (EDHS) from 2000 to 2016. A total of 12,056 late-adolescent girls were included in this study. The global spatial autocorrelation was assessed using the Global Moran’s I autocorrelation to evaluate the presence of geographical clustering and variability of undernutrition. SaTScan cluster analysis by using the Bernoulli model to detect most likely SaTScan cluster areas of significant high-rate and low-rate of undernutrition was explored. A Multilevel binary logistic regression model with cluster-level random effects was fitted to determine factors associated with undernutrition among late-adolescent girls in Ethiopia.ResultsUndernutrition was clustered nationally during each survey (Global Moran’s I = 0.009–0.045, Z-score = 5.55–27.24, p-value < 0.001). In the final model, individual and community level factors accounted for about 31.02% of the regional variations for undernutrition. The odds of undernutrition among 18–19 years of adolescent girls, was 57% (AOR = 0.43; 95% CI: (0.35–0.53) lower than those 15–17 years old. Late-adolescent girls with higher educational status were 4.40 times (AOR = 4.40; 95% CI: (1.64–11.76) more likely to be undernourished than those with no educational status. The odds of undernutrition among late-adolescent girls, with the occupation of sales, was 40% (AOR = 0.60; 95% CI: 0.43–0.84) lower than those with not working adolescents. The odds of undernutrition, among late-adolescent girls, having an unimproved latrine type, was 1.79 times (AOR = 1.79; 95% CI: 1.15–2.79) higher than those participants with improved latrine type. The odds of undernutrition among late-adolescent girls with rural residents was 2.33 times higher (AOR = 2.33; 95% CI: 1.29–4.22) than those with urban residents.ConclusionUndernutrition among late-adolescent girls was spatially clustered in Ethiopia. The local significant clusters with high prevalence of undernutrition was observed in Northern and Eastern Ethiopia. Those regions with a high prevalence of undernutrition should design interventions to combat undernutrition.

A DESCRIPTIVE STUDY ON NUTRITIONAL STATUS ASSESSMENT AND MORBIDITY PATTERN OF ADOLESCENTS (10–16 YEARS) RESIDING IN URBAN SLUMS OF AMRITSAR, PUNJAB

Objectives: To assess the nutritional status and morbidity pattern of adolescents age 10–16 years and to determine the various factors associated with under-nutrition. Methods: A descriptive cross-sectional study was conducted among 1600 households which were selected by systematic random sampling method from 64 slum areas. All adolescents aged 10–16 years were included. Required information was collected on a pretested performa. Height and weight were measured to assess their nutritional status and haemoglobin estimation was done by Sahli’s method. Descriptive statistics (frequencies and proportions) and univariate logistic regression were done to determine various factors associated with under nutrition. Results: Out of 603 study participants, 75% of adolescents were under-weight. About 82.3% had anemia. About 36% suffered from one or more infectious disease in the last 3 months. Going to school, occupation, female sex, and suffering from any infectious disease in the past 3 months were found to be associated with malnutrition. Addiction was reported in 9% of study participants. Conclusions: High prevalence of under-nutrition and anemia in our study reflects inequitable distribution of resources, low purchasing capacity of foods, and unequal food sharing patterns in families making them socially and biologically vulnerable.