Middle Upper Arm Circumference Research Articles

Prevalence of nutritional risk and malnutrition in hospitalized patients: a retrospective, cross-sectional study of single-day screening.

Hospital malnutrition remains a significant public health issue, particularly in developing countries. The Global Leadership Initiative on Malnutrition (GLIM) proposed homogenizing criteria to standardize malnutrition diagnosis. This study aimed to retrospectively determine the prevalence of nutritional risk and malnutrition diagnoses among hospitalized patients using the Nutritional Risk Screening (NRS)-2002 screening instrument and the GLIM criteria, respectively. We conducted a retrospective, cross-sectional study from nutritional records of patients hospitalized in a single centre 2021. Nutrition data from records included medical diagnosis, gender, length of stay, age, weight, height, body mass index, weight loss, calf circumference, and middle upper arm circumference. Nutritional risk and malnutrition were evaluated using NRS-2002 and GLIM criteria. Its concordance was further evaluated by using a Kappa test. The study included 616 records of patients; 52.3% (n=322) of the population were male. The prevalence of nutritional risk, according to NRS-2002, was 69.5% (n=428). Nutritional risk as well as malnutrition diagnosis according to GLIM criteria was observed in 87.8% (n=374) of patienttritional risk and malnutrition were evaluated using NRS-2002 and GLIM criteria. Its concordance was further evaluated by using a Kappa test. Ws. Tools showed a strong concordance (κ= 0.732). All anthropometric data, except for height, were found to be significantly different between patients with moderate and severe malnutrition (p<0.05). Our findings highlight a high prevalence of malnutrition in this group of hospitalized patients in Mexico. NRS-2002 demonstrated good agreement with the diagnosis of malnutrition according to GLIM criteria and could be considered part of the straightforward two-step approach for malnutrition; however, further studies are needed.

Understanding the pubertal, psychosocial, and cognitive developmental trajectories of stunted and non-stunted adolescents: protocol of a multi-site Indonesian cohort study.

The prevalence of stunting among Indonesian children aged 5-12 years decreased from 30.7% in 2013 to 23.6% in 2018 but has remained among the highest rates worldwide. Furthermore, Indonesian children were shorter than the standard reported by the World Health Organization and experienced obesity. The Indonesian government has created many programs to reduce stunting in children under the age of 5 years. An early preventive strategy is necessary because stunting can manifest within the initial 1,000 days of life, including during pregnancy. Therefore, a newer perspective, such as that achieved by addressing stunting in adolescents, has been deemed useful, given that adolescents are in their pubertal stage and are undergoing lifestyle changes. This cohort study was designed to measure these factors comprehensively in stunted and non-stunted children as they pass through adolescence. For the prospective cohort, 560 individuals will be recruited from DKI Jakarta, DI Yogyakarta, and East Java. The participants will be categorized into stunted and non-stunted groups, then undergo annual examinations in which key objectives, such as weight, height, and body mass index ,will be assessed for the growth profile; waist circumference, middle-upper arm circumference, hand-grip strength, body fat percentage, and food intake will be evaluated in a nutritional assessment; psychosocial and mental issues will be evaluated according to behavioral problems, symptoms of depression, quality of life, sleep patterns, anxiety disorders, and parenting style through the use of specific questionnaires; and pubertal stage will be assessed using a self-report questionnaire. Some cross-sectional data, such as cognitive performance, hair zinc levels, vitamin D levels, bone mineral density, and bone age, will also be included. All the outcomes will be analyzed in accordance with the variable types. This study provides a thorough dataset of Indonesian adolescents encompassing several elements, such as growth, nutrition, psychosocial wellbeing, mental health, and pubertal development, for both stunted and non-stunted individuals. The data acquired from this study can be used to formulate policies to prevent stunting through targeted interventions for adolescents. Finally, a better understanding of adolescent health could lead to improved strategies to decrease the number of stunted individuals in the next Indonesian generation.

Impact of Immunonutrition on Nutritional Status in Patients Undergoing Colorectal Cancer Surgery: A Randomized Controlled Clinical Trial

This study aimed to investigate the additional effects of perioperative immunonutrition (IMN) compared with preoperative immunonutrition (IMN) on anthropometric, nutritional, and biochemical parameters, hospital stay and postoperative complications in patients with colorectal cancer. Oral supplementation enriched with arginine, omega-3 fatty acids, and dietary nucleotides was given to 25 patients before and after the operation (Group 2); 25 patients received the same formula before surgery and standard isocaloric nutrition following the operation (Group 1). Postoperative body weight, body mass index (BMI), and middle upper arm circumference (MUAC) of Group 1 decreased more than Group 2 during follow-up (p < 0.05). The biochemical parameters, C-reactive protein (CRP), aspartate aminotransferase (AST) and fasting plasma glucose (FPG) were higher, and albumin was lower than the baseline in Group 1 compared to Group 2 (p < 0.05). There was a negative correlation between CRP and Nutrition Risk Screening (NRS) 2002 scores, and prealbumin and NRS 2002 scores had a positive correlation (p = 0.007, r = 0.384; p = 0.012, r = 0.352). There was no difference in hospital stay and postoperative complications between the groups (p > 0.05). Perioperative immunonutrition, compared to preoperative immunonutrition, can be used as a positive and effective approach in improving some anthropometric measurements and biochemical parameters in patients undergoing colorectal cancer surgery.

The relationship between the severity of intellectual and developmental disabilities (IDDs) in adults with IDDs and eating and drinking problems and nutritional status.

Adults with intellectual and developmental disabilities (IDDs) experience eating, drinking and swallowing problems, such as chewing problems, choking, gagging, coughing during eating, aspiration and rumination syndrome, which may lead to poor nutritional status. This study aimed to determine the relationship between IDD levels, eating, drinking and swallowing problems and nutritional status in adults with IDDs. The sample consisted of 71 participants (37 men and 34 women) with a mean age of 22.5±7years (range 18-60years). Professionals classified intellectual disability as mild, moderate or severe. The Screening Tool of Feeding Problems scale was applied to the caregivers of adults with IDDs to identify eating, drinking and swallowing problems. Dietary intake was assessed using a 24-h dietary recall and a food and nutrition photograph catalogue. The researchers measured body weight, height and middle upper arm circumference. Body mass index was calculated. Four body mass index categories were determined: underweight (<18.5kg/m2 ), normal weight (18.5-24.9kg/m2 ), overweight (25.0-29.9kg/m2 ) and obese (≥30kg/m2 ). Chi-squared tests were used to detect the relationship between IDD levels and eating and drinking problems, and analysis of variance tests were conducted to detect the relationship between IDD levels with anthropometric measurements and dietary intake. Participants had mild (42.3%; n=30), moderate (29.6%; n=21) or severe IDD (28.2%; n=20). They were underweight (12.7%; n=9), normal weight (59.2%; n=42) or overweight and/or obese (28.2%; n=20). Participants with severe IDD had significantly higher Screening Tool of Feeding Problems 'nutrition-related behaviour' and 'eating and drinking skill deficit problem' sub-scale scores than those with mild IDD. However, the groups had no significant difference in 'food refusal and selectivity' sub-scale scores. Participants with severe IDD also had anorexia prevalence similar to those with mild IDD. The groups did not significantly differ in anthropometric measurements, daily energy intake and macronutrient and micronutrient intake. While adults with severe IDD had more eating and drinking skill deficits (e.g. chewing problems and independent eating difficulties) and nutrition-related behaviour problems than those with mild IDD, the eating, drinking and swallowing problems, which may critically affect their food intake, were similar to adults with mild IDD. The anthropometric measurements and energy and nutrient intakes of adults with severe IDD were not significantly different from those with mild IDD consistently. Findings indicate that nutritional deficiencies and nutritional behaviour problems may be avoidable in adults with IDDs.

The Outcome of the Treatment of Malnourished Children Treated by Ready To Use Therapeutic Food and Ready to Use Supplementary Food in Wad ElBashir Heath Cente 2021

introduction: Malnutrition includes both undernutrition and overnutrition. Child undernutrition is a major global health problem that is more common in low-income countries like Sudan, it can cause childhood morbidity, mortality, and impaired intellectual development. Objective: This study was conducted to assess the outcome of malnourished children treated with ready to-Use Therapeutic Food (RUTF), and ready to-Use Supplementary Food (RUSF) in Wad Elbasheir Health Centre in Ombada Locality Methods: This is an analytical Cross-Sectional facility-based Study conducted at Wad Elbasheir Health Centre. A convenient nonprobability sampling technique was used in this study. Data were collected using a datasheet after being pretested. Data were collected from secondary data from the records of malnourished children treated by the RTUF and RUSF. Results: The majority of the participants of this study were aged between 6 to 23 months (84%) and most of the participants were females (56%). This study showed that 70 (24%) of the participants were classified as severe Acute Malnutrition (SAM), while 218 (76%) were classified as moderate Acute malnutrition (MAM). This study showed that having a smaller number of children in the family and middle Upper Arm Circumference (MUAC) between 11.5-12.5 cm were more associated with recovery. Moreover, this study showed that children who use amoxicillin or anti-worms were more likely to be recovered from malnutrition. Conclusion: RUTF was designed for the nutritional management of children with uncomplicated acute malnutrition treated as outpatients. In this study, most of the children recovered. In addition, this study found that several factors were associated with better outcomes including fewer children in the family, MUAC between 11.5-12.5 cm, having MAM (compared to having SAM), and using amoxicillin or anti-worms.

Impact of integrated preventive and curative health package on nutritional status of children under 2 years of age in the health area of Tama, Tahoua region (Niger).

Niger, relevant in light of current political coup, is one of the countries with the worst human development indicators, characterized by high fertility rates and extremely high infant mortality rates. Food insecurity in the region is alarming, leading to high malnutrition rates in children. This study aimed to evaluate an integral preventive-curative health program targeting children aged under 2 years in the health area of Tama, district of Bouza, Tahoua. Anthropometric follow-up data of 6,962 children aged under 2 years were included in this study. These children received complete vaccination and malaria chemoprevention, and those older than 6 months received nutritional supplementation with a small quantity of lipid-based nutrient supplements. Fundamental growth indicators (height-for-age, weight-for-height, weight-for-age, and middle-upper arm circumference) and the Composite Index of Anthropometric Failure were calculated at the beginning and end of the program (mean time spent in the program: 14.5 ± 6.6 months) The evolution of these indicators was compared with those of a sample from a vertical vaccination program conducted in the neighboring region of Madarounfa on similar dates. The proportion of children without anthropometric failure decreased from 59.5 to 40.2% (p < 0.001), with the categories that included stunting increasing the most. When analyzing the anthropometric indicators according to the months of compliance with the program, there was a slight improvement in the indicators of acute malnutrition, whereas those of chronic malnutrition worsened significantly. However, when compared with the Madarounfa sample, the children in the present study registered a significantly lower worsening in all three indicators: height-age (-0.46 vs. -2.44; p < 0.001), weight-height (+0.31 vs. -0.55; p < 0.001) and weight-age (-0.03 vs. -1.63; p < 0.001) difference. The comprehensive preventive-curative health program slightly slows the worsening of cumulative malnutrition in the early years of life in complex contexts, such as southern Niger.

Nutrition, stress, and healthcare use during pregnancy are associated with low birth weight: evidence from a case-control study in West Ethiopia.

Low Birth Weight (LBW) remains a major public health concern globally, especially in lower and middle-income countries. In Ethiopia in general and in the study area in particular there is limited evidence regarding maternal factors associated with low birth weight. This study aimed to identify the maternal factors associated with low birth weight among neonates born in public health facilities in the west Wollega zone, West Ethiopia. We used a case-control study design and selected participant mothers with a newborn using the delivery database from three public hospitals and five health centers, between March 2022 and April 2022. Cases were identified using a newborn birth weight of <2,500 grams. Controls were identified using a newborn birth weight of ≥2,500 grams. An interviewer-administered structured questionnaire and chart review were used for data collection. Model fitness was assessed by Hosmer and Lemenshow goodness-of-fit test, including multi-collinearity checks. Candidate predictor variables were selected (using a value of p <0.25 in bivariable logistic regression models) for multivariable logistic regression to quantify the association between independent variables and LBW, expressed using Odds Ratios (OR) with a 95% Confidence Interval (CI). Mean and Standard Deviation (SD), all such values. A total of 324 mothers with their newborns (81 cases and 243 controls) were eligible for inclusion. The mean age of participants was 27.9 years (SD 6.4) in cases and 25 years (SD 3.9) in controls. Mean birth weight was 2,128 grams (SD 1,697) in cases and 2,988 grams (SD 378) in controls. In multivariable logistic regression analysis, lack of nutritional counseling (OR = 2.4; 95%CI: 1.24-4.72), maternal middle upper arm circumference of <23 cm (OR = 3.1; 95%CI: 1.64-5.91), maternal stress during pregnancy (OR = 2.8; 95% CI:1.23-6.36), and antenatal follow up less than four visits (OR = 2.8; 95% CI: 1.12-6.82) were independently associated with LBW. In this study, lack of nutritional counseling, maternal undernutrition, maternal stress during pregnancy, and antenatal follow-up visits less than recommended were associated with LBW. Special attention should be given to promoting antenatal care and counseling mothers on nutrition and relaxation to prevent stress during pregnancy.

Nutritional integration in liver transplantation for 14 year old children in the 108 Military Central Hospital: A case report

A 14 year old girl diagnosed with primary biliary cirrhosis, gastrointestinal bleeding, and esophageal varices underwent an assessment of her nutritional status using SGA, BAZ (Body Mass Index for age), and MUAC (Middle Upper Arm Circumference). Prior to transplantation, her SGA score was categorized as C, her BAZ was -1.63 standard deviations, and her MUAC measured 18.5cm. Patients receive specialized care tailored to the different stages of their condition following transplantation. In the early post-transplant period, nutritionists employ a combination of enteral and parenteral nutrition. By the end of the first week after surgery, the patient's total energy intake reached 1582.7 kcal, with a protein intake of 1.7g/kg, and her SGA score improved to B. Starting from Day 21, protein and energy intake increased to 2.4g/kg and 30kcal/kg/24h, respectively. Upon discharge, the patient exhibited enhanced nutritional status, with an SGA score of B, a BAZ of -1.56 standard deviations, and a MUAC measurement of 20.0cm. She also experienced a weight gain of 1.5kg within one month of leaving the hospital. Consequently, the implementation of a Nutritional Management Plan, structured around the distinct stages of liver transplantation, is of paramount importance, particularly for pediatric patients.

Evaluation of malnutrition and screening tools in hospitalized children

Detecting malnutrition and its related risk factors are crucial, in hospitalized children. Anthropometric z scores are used to assess malnutrition. Screening tools also aim to detect the presence of malnutrition and the developing risk of malnutrition in hospitalized children to determine who may benefit from nutritional support. Therefore, the aims of the study are to detect malnutrition and its related demographic and clinical risk factors in hospitalized children and determining the sensitivity of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Pediatric Yorkhill Malnutrition Score (PYMS) screening tools. A total of 130 hospitalized children aged between 0 and 18 years were included in to study. A survey including demographic and clinical characteristics, STAMP and PYMS were applied to parents of the children. Patients were classified into nutritional risk groups through screening tools. Anthropometric measurements (body weight, length/height, and middle upper arm circumference (MUAC) of the children were taken. Body mass index-for-age and height-for-age z scores were calculated to assess acute and chronic malnutrition prevalence. MUAC-for-age z scores were calculated as well. To detect independent risk factors for acute and chronic malnutrition multivariable logistic regression models were constructed. A total of 14.6% of hospitalized children had acute malnutrition, 21.5% of children had chronic malnutrition and 27.7% of them had low MUAC standard deviation score (SDS) (less than-2). The independent risk factors for acute malnutrition were younger maternal age at birth and long length of stay (p<0.05). The independent risk factors for chronic malnutrition were being female, younger maternal age at birth, longer illness duration and having urological or allergy and immunological diseases (p<0.05). However, MUAC for age SDS groups were not related to any demographic and clinical factors, in children of all ages (p>0.05). Regarding the screening tools, PYMS displayed 100% sensitivity against acute malnutrition. While PYMS displayed better sensitivity to identify acute malnutrition than STAMP, STAMP was more sensitive than PYMS to detect chronic malnutrition and low MUAC SDS. Low MUAC for age SDS was not related to any demographic and clinical factors, in hospitalized children of all ages, unlike acute and chronic malnutrition, in this study. Pediatric screening tools mainly PYMS did not have high sensitivity to detect chronic malnutrition and low MUAC SDS, in hospitalized children. Therefore, the tools have to be used along with z scores of anthropometric parameters.

Association between the anthropometric measurements and dietary habits on telomere shortening in healthy older adults: A-cross-sectional study.

This study aimed to evaluate the effect of anthropometric measurements and dietary habits on telomere length in healthy older residents in rural and urban areas. This was a cross-sectional study. The study population included 81 healthy older individuals aged ≥80 years. A quantitative food frequency questionnaire was used to determine dietary habits. Anthropometric measurements were taken by researchers. The telomere length of individuals was determined from leukocytes using quantitative polymerase chain reaction. Urban women had longer telomeres than rural women (P < 0.05). Rural men had significantly higher hip circumference, middle-upper arm circumference and fat-free mass than urban men (P < 0.05). It was shown that while fresh vegetable consumption was higher in rural areas, carbonated drink consumption was higher in urban areas (P < 0.05). In women, homemade bread and sugar consumption were higher in rural areas, and honey consumption was higher in urban (P < 0.05). Red meat, milk-based dessert and pastry consumption explain telomere shortening by 22.5%, 24.8% and 17.9%, respectively. In addition, the model based on anthropometric measurements also contributes to explaining telomere shortening by 42.9%. Red meat, milk-based dessert and pastry consumption, and waist circumference, hip circumference, waist-to-hip ratio and waist-to-height ratio are associated with telomere length. Longer telomeres are associated with a healthy, balanced, adequate diet and maintaining a healthy body weight/proportion, and they are crucial for achieving healthy aging. Geriatr Gerontol Int 2023; 23: 565-572.

Diet Quality and Nutritional Risk Based on the FIGO Nutrition Checklist among Greek Pregnant Women: A Cross-Sectional Routine Antenatal Care Study

The International Federation of Gynecology and Obstetrics (FIGO) nutrition checklist is a tool for everyday antenatal clinical practice, easy to use by most healthcare professionals, aiming to initiate a conversation regarding gestational weight gain (GWG) and nutrition and identify women who might require further assessment. The present cross-sectional study aimed to apply the FIGO nutrition checklist to pregnant women attending routine antenatal care and identify nutritional risk factors. Pregnant women (n = 200) were recruited from the outpatient pregnancy clinics of two hospitals in Thessaloniki and completed the checklist. The FIGO-diet quality score and the FIGO-nutritional risk score (NRS) were calculated. The results revealed that 99% of the women exhibited at least one nutritional risk factor based on the checklist. The median FIGO diet quality score of the sample was 4.0 (3.0–5.0), with 95% of the participants responding negatively to at least one question, indicating the need for improving diet quality. Improved diet quality was noted in cases of hyperemesis gravidarum and among those receiving vitamin D supplements. A large percentage of the participants (36%) exhibited five or more nutritional risk factors, as indicated by a total FIGO-NRS below 5. Women with low middle-upper arm circumference, indicative of protein-energy malnutrition (20.6% of the sample), exhibited more nutritional risk factors compared with the rest. On the other hand, being in the third trimester of pregnancy was associated with lower nutritional risk and, subsequently, better diet quality.

Prevalence and predictors of iron deficiency anemia among pregnant women in Bolosso Bomibe district, Wolaita Zone, Southern Ethiopia Community-based cross-sectional study

: Iron-deficiency anemia is defined as anemia, a condition in which there less than the normal hemoglobin (Hb) accompanied by an indication of iron deficiency. Nearly half of all pregnant women worldwide suffer from anemia, and iron deficiency accounts for about half the world’s anemia burden. Most of the studies conducted on iron-deficiency anemia during pregnancy were conducted at the institution level and associated factors are not well studied and documented. Hence, the aim of this study is to determine the prevalence of iron-deficiency anemia and associated factors among pregnant women in Bolosso Bomibe District, Southern Ethiopia, 2019. Community-based cross-sectional quantitative study was conducted from April to June 2019. Multistage sampling was used to include 270 study participants in 6 kebeles. The structured and pretested questionnaire, middle upper arm circumference (MUAC), Hb, serum ferritin, and C-reactive protein were used as a tool to collect data. The data was compiled and entered to EpiData version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 23.00 packages for analysis. Univariate, bivariate, and multivariable logistic regression with odds ratio along with the 95% confidence intervals (CI) was computed and interpreted. p value < 0.05 was declared as statistically significant. The prevalence of iron-deficiency anemia was 11.3% (95% CI: 8.9–15.7). Factors associated with iron-deficiency anemia were ANC follow-up for the recent pregnancy (adjusted odds ratio [AOR] = 3, 95% CI: 1.15−8.9, and years b/n successive pregnancy (AOR = 4,95% CI: 1.2–12.4). Prevalence of iron-deficiency anemia was low, which is a mild public health concern among pregnant women in Bolosso Bombe District. The factors associated with iron-deficiency anemia in this study population were MUAC, ANC follow-up, birth spacing among successive pregnancy, and duration of menstrual bleeding. Thus, there should be the integration of concerned stakeholders for implementation of different interventions to solve these problems.

Status gizi pada siswi remaja di pondok pesantren modern

Nutritional status of female students in Modern Islamic boarding schoolBackground: Female students in Islamic Boarding schools whose adolescents, in the majority, need attention because of their physiological condition in the future. Similar studies in Indonesia with significant subjects of adolescent girl students still need to be expanded. Objective: We aim to find out the prevalence of the nutritional status of adolescent girl students in Islamic Boarding Schools. Methods: The study used a cross-sectional design and had 435 respondents from grades 1-6 (11-19 years old) in Darussalam Gontor Modern Islamic Boarding School for Girls 1. The study measured anthropometrics such as weight, height, and middle-upper arm circumference (MUAC). The following variable was nutritional status which is classified based on Body Mass Index-for-age (BAZ) and height-for-age (HAZ) Z-score, as well as chronic energy deficiency (CED) status. Results: Most subjects (77%) were classified as having normal nutritional status based on BMI-for-age. However, there were 47.6% of students experienced CED, and 15.2% of students were stunted based on height-for-age. Nutritional status according to BMI-for-age showed that 72.73% of students with normal nutritional status and 22.75% of students with overweight were found to be stunted. Notably, among the students with normal nutritional status based on BMI-for-age, the majority were also found to have CED (95.65%). Conclusion: The prevalence of adolescent female students with underweight and severe underweight nutritional status based on BMI-for-age was 1.84%, whereas the prevalence of overweight and obesity was 20.92%. Additionally, 47.6% of female students experience CED, and 15.2% are classified as stunting based on height-for-age.

Correlation of Middle Upper Arm Circumference With Other Anthropometric Indictors and Cardiovascular Disease Risk Factors in Young Adults of Urban Areas of Hyderabad, Pakistan

Introduction: Middle Upper Arm Circumference (MUAC) is used to assess nutritional status particularly under nutrition. Recently, the use of MUAC has been suggested as a novel anthropometric marker to assess the condition of obesity among the children, adolescents, and young adults. We, therefore, setup / study to evaluate the correlation of MUAC for the assessment of various CVD risk factors. Methodology: The study was carried out from April 2021 to March 2022. Total 366 participants were randomly selected, out of which 190 were male participants and 176 were female participants. The data was collected using interview based questionnaire; middle upper arm circumference was measures using a non stretchable measuring tape. Statistical analysis was done using SPSS ver 23. Results: The mean age of participants was 24.04±4.04, the mean values of WC, WHR, SBP, DBP, and LDL were significantly higher (P&lt; 0.05) in males, the mean values of HDL were significantly higher in females(p&lt; 0.05). Non-significant difference in the mean values of BMI, FBG, Cholesterol and Triglycerides (P&gt; 0.05) were observed between male and female participants. MUAC showed strong positive correlation with BMI, WC and WHR (P&lt;.001). Except HDL all other CVD risk factors showed significant positive correlation with MUAC (P&lt;.001), however, MUAC showed a significantly negative correlation with HDL( r = -.370, P&lt;.001) in males, no correlation of MUAC with HDL ( r = -.028, P&lt;.001) was observed in females. Conclusion: Except HDL significant correlation was observed between MUAC and various CVD risk factors.

Maternal determinants of average weekly fetal weight gain in Yogyakarta, Indonesia

Average fetal weight gain (AWG) is one of the important parameters usuallyused as an indicator to identify the fetal risk of poor outcomes of intrauterinegrowth restriction (IUGR) or macrosomia. This study aimed to investigate theassociation between AWG and maternal factors such as body weight (BW), bodymass index (BMI), middle-upper arm circumference (MUAC), and economicstatus in Yogyakarta, Indonesia. This community-based cross-sectional studywas conducted in one district in the Yogyakarta Special Province, Indonesia.The study included 50 mother-infant pairs who delivered at term (37-42 weeksof pregnancy). The mother’s BW, height, BMI, and MUAC were recorded usinga case-report form. Questionnaires were also completed to establish therespondents’ economic status. Maternal factors associated with fetal birthweight were determined using univariate and multivariate analyses. Themothers registered in our study mostly had good nutritional status (74.0% hadan optimal MUAC &gt; 23cm). The mean AWG and birth weights were 172.6 ±24.5g/wk and 3.08 ± 0.34kg, respectively. Univariable analysis models wereused to assess the associations between each variable and AWG (with a cut-offvalue of 153.8 g/wk). Our study found no associations between higher MUACand higher AWG (OR=1.03; 95% CI: 0.83-1.27; p=0.77) and energy intakes perday with AWG (OR=1.0; 95% CI: 1.00-1.001; p=0.21). Socioeconomic factors suchas the mother’s educational background also showed no association with AWG(OR=0.38; 95% CI: 0.92-1.57; p=0.18). In conclusion, this finding shows that thereis no association between variables such as MUAC, mother’s age, energy intake,and educational background with the average fetal weight gain achieved.

Differences in wasting assessment through Middle-Upper Arm Circumference (MUAC) adjusted by sex, age and geographic origin for children aged 6-59 months: New reference based on anthropometric surveys from 22 low-and-middle-income countries.

The Middle Upper Arm Circumference (MUAC) bracelet is a widely used instrument in public health assessments and humanitarian assistance projects. The WHO guidelines present a universal cut-off point of 115 mm to determine whether a child has severe acute malnutrition. The objective of this study is to analyze the existing differences in the MUAC for boys and girls aged between 6 and 59 months, from 22 countries distributed in three different continents, in contrast to the use of this single cut-off point. In addition, the creation of MUAC growth charts is presented for reference use. This study was carried out with a database developed by Action Against Hunger, composed, after the data pre-processing phase, of 97 921 individuals without anthropometric failure from African, Asian, and American continents. MUAC measurements were compared between countries, dividing by sex and age groups. A k-means method was used to create country clusters to allow comparisons and the variability was resumed using a Principal Component Analysis. For each cluster, growth curves were created and smoothed using the LOESS method. Our research has revealed the existence of differences in the MUAC between countries in both, males and females, although with different trends. The evidence was confirmed with the creation of two clusters using the k-means method, which, when graphically represented by the Principal Component Analysis, showed that the MUAC was clearly different. There were also differences between males and females within each cluster, where growth curves did not overlap in any age group. All statistical analysis indicate that there are differences in the MUAC values for children without anthropometric failure between countries, but also between sexes. With this research, a new reference is proposed that consider the existing variability between human populations to improve the precision in the determination of severe acute malnutrition in children.

Nutritional factors for anemia in pregnancy: A systematic review with meta-analysis.

BackgroundAnemia in pregnancy is a serious threat to maternal and child health and is a major public health problem. However, the risk factors associated with its incidence are unclear and controversial.MethodsPubMed, Ovid Embase, Web of Science, and Cochrane databases were systematically searched (inception to June 27, 2022). The screening of search results, extraction of relevant data, and evaluation of study quality were performed independently by two reviewers.ResultsA total of 51 studies of high quality (NOS score ≥ 7) were included, including 42 cross-sectional studies, six case-control studies, and three cohort studies. Meta-analysis showed that infected parasite, history of malarial attack, tea/coffee after meals, meal frequency ≤ 2 times per day, frequency of eating meat ≤ 1 time per week, frequency of eating vegetables ≤ 3 times per week, multiple pregnancies, multiparous, low household income, no antenatal care, rural residence, diet diversity score ≤ 3, have more than 3 children, history of menorrhagia, underweight, family size ≥ 5, middle upper arm circumference < 23, second trimester, third trimester, birth interval ≤ 2 year were all risk factors for anemia in pregnancy.ConclusionsPrevention of anemia in pregnancy is essential to promote maternal and child health. Sufficient attention should be paid to the above risk factors from the social level and pregnant women's own aspects to reduce the occurrence of anemia in pregnancy.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022344937.

Factors Related Of Anemia In Adolescence Girl

Anemia during adolescence has a negative effect on growth, cognitive abilities, performance abilities and has a serious impact throughout the reproductive years. The study aims to determine the factors associated with the incidence of anemia in adolescent girls. This type of research method is a cross-sectional study. The sample in this study were female students of class XI and XII at SMAS PGRI 2 Banjarmasin who met the inclusion criteria totaling 75 people. Sampling technique with Total Sampling. The research instrument used measurements and questionnaires consisting of Body Mass Index (BMI), Middle-Upper Arm Circumference (MUAC), menstrual patterns and eating patterns. Data analysis using a computer program. The results showed that the female adolescents in SMAS PGRI 2 Banjarmasin who did not experience anemia were (70.7%) while the female adolescents who had anemia were (29.3%). There is a relationship between BMI and the incidence of anemia in adolescent girls p-value 0.023 (&lt;0.05), there is a relationship between MUAC and the incidence of anemia in adolescent girls p-value 0.012 (&lt;0.05), there is a relationship between diet and the incidence of anemia in adolescent girls p-value 0.021 (&lt;0.05), there is a relationship between menstrual patterns with the incidence of anemia in adolescent girls p-value 0.026 (&lt;0.05). Preventive and promotive efforts need to be done by increasing the consumption of nutritious food and giving blood-supplementing tablets especially for female students.

Prognostic Value of Arm Circumference for Cardiac Damage and Major Adverse Cardiovascular Events: A Friend or a Foe? A 2-Year Follow-Up in the Northern Shanghai Study.

BackgroundThe high prevalence of cardiovascular diseases globally causes a great social burden and much individual suffering. The effective recognition of high-risk subjects is critical for primary prevention in the general population. In the elderly cohort, anthropometric measurements may have different prognostic values. Our study aimed to find convincing anthropometric measures to supplement conventional risk factors for major adverse cardiovascular events (MACEs) in the elderly cohort.Materials and MethodsA total of 1,576 elderly participants (44.5% male, aged 72.0 ± 6.0 years) recruited into the Northern Shanghai Study (2014–2015) were followed up between 2016 and 2017. Following the standard guideline for cardiovascular risk evaluation, all conventional cardiovascular risk factors were assessed. The body measures were made up of body weight, body height, hip circumference, waist circumference, and middle-upper arm circumference (MUAC). Organ damage (OD) markers for cardiac, vascular, and renal diseases will be evaluated by the standardized methods.ResultsAfter the average 571 (±135) days of follow-up, a total of 90 MACEs (5.7%) occurred, i.e., 13 non-fatal myocardial infarction, 68 non-fatal stroke, and 9 cardiovascular deaths. Univariable COX survival analysis revealed that only MUAC could validly predict MACEs among anthropometric characters [adjusted hazard ratio (HR) 0.89; 95% confidence interval (CI) 0.82–0.96]. In Kaplan-Meier analysis, the group of high MUAC showed the lowest MACE risk (log-rank p = 0.01). Based on OD analysis, MUAC was independently linked to higher risk of left ventricular hypertrophy (LVH) in women and left ventricular diastolic dysfunction (LVDD) in both men and women. In adjusted COX analysis, only MUAC indicated statistical significance, but all other anthropometric parameters such as BMI, waist circumference, and waist-to-hip ratio (WHR) did not indicate significance. The higher level of MUAC remained a protective factor in fully adjusted models (HR: 0.73; 95% CI: 0.59–0.91), with p-values markedly significant in men (HR: 0.69; 95% CI: 0.49–0.97) and marginally significant in women (HR: 0.0.77; 95% CI: 0.59–1.01). After considering all factors (i.e., cardiovascular risk factors, MUAC, BMI, and WHR), the fully adjusted COX regression analysis demonstrated that the increased MUAC level was linked to decreased MACE risk in both men (HR: 0.57; 95% CI: 0.37–0.88) and women (aHR: 0.64; 95% CI: 0.46–0.93).ConclusionDespite being associated with a higher rate of cardiac damage, higher MUAC independently and significantly conferred protection against the MACE, in the elderly cohort.

Implementation of a nutritional supplementation program in a population of Cambodian children and its impact on statural growth

BackgroundStunting is a major health problem in low-income countries. We aimed to describe the implementation of a lipid-based nutrient supplement (LNS) program in a rural neighborhood in Cambodia and to assess its impact on statural growth. MethodThis was a before–after comparative study. The program was promoted by the Pédiatres du Monde (PDM) organization between 2011 and 2019 in six villages in a rural area in Cambodia. The supplementation program consisted of daily administration of LNS during the third semester of pregnancy for the mothers and then between 6 and 24 months of age for the toddlers. Anthropometric data of the children were recorded during PDM visits before and after the program implementation, which allowed us to compare child growth in the two groups: control and intervention groups. Primary outcome was height-for-age between 24 and 35 months of age. ResultsOverall, 198 data were collected for children between 24 and 35 months of age in the control group. A total of 347 pregnant women were enrolled in the intervention phase. A total of 188 data were collected for children between 24 and 35 months of age in the intervention group. The mean height-for-age z-score in the population receiving LNS was higher than in the control group (−1.14 vs. −1.60, p < 0.001). There was no significant difference between the two groups regarding the weight-for-height z-score (WHZ; −1.11 vs. −1.26, p = 0.18) and children in the intervention group had a higher middle upper-arm circumference z-score (MUACZ; −0.75 vs.. −1.1, p < 0.001). ConclusionLNS supplementation significantly and increased the HAZ between 24 and 35 months of age. However, the fight against malnutrition is complex and needs intervention on multiple levels.