Nutritional Situation Of Children Research Articles

Mise à jour de la situation nutritionnelle dans l'est algérien

The nutritional and epidemiological transitions have affected the Algerians’ lifestyle primarily in their nutritional status, eating behavior, and health status. Overweight and obesity, being present at all ages of life, includes several factors related to the risk of developing, at an older age, non-communicable diseases such as diabetes and cardiovascular disease. The nutritional situation of children under 5 years remains a concern of low birth weight, low prevalence of exclusive breastfeeding, stunting growth, and underweight. Nutritional deficiencies, mainly in micronutrients, persist in different age groups, especially in pregnant and lactating women reflecting the consequences of a poor diet characterized by low consumption of fruits and vegetables, and higher consumption of fatty products as well as sweet with high-calorie density. The issue of food and nutritional security remains an important issue. Despite the persistent nutritional problems, the level of food security indicators shows that the country is not exposed to food insecurity, but dependency on food imports remains quite high. The living conditions in rural areas must be improved in order to strengthen the agricultural sector which must be able to meet the needs of the population. Updating and analyzing the nutritional situation using existing data will enable the strategies put in place by national and international organizations to be implemented. Keywords: Nutritional status, Non-communicable diseases, Risk factors, Eastern Algeria.

An update of the nutritional situation in eastern Algeria

The nutritional and epidemiological transitions have changed the way of life for Algerians. It is observed in their nutritional status, eating behavior, and health status. Overweight and obesity are present at all ages of life. This complex problem includes many factors related to the risk of developing, at an older age, non-communicable diseases such as diabetes and cardiovascular disease. The nutritional situation of children under 5 years remains a concern of low birth weight, low prevalence of exclusive breastfeeding, stunting growth, and underweight. Nutritional deficiencies, mainly in micronutrients, persist in different age groups especially in pregnant and lactating women reflecting the consequences of a poor diet characterized by low consumption of fruits and vegetables, and higher consumption of fatty products as well as sweet having high energy density. The issue of food and nutritional security remains an important issue. Despite the persistent nutritional problems, the level of food security indicators show that the country is not exposed to food insecurity, but dependency on food imports remains quite high. The living conditions in rural areas must be improved in order to strengthen the agricultural sector which must be able to meet the needs of the population. Updating and analyzing the nutritional situation using existing data will enable the strategies put in place by national and international organizations to be implemented.

An update of the nutritional situation in eastern Algeria

The nutritional and epidemiological transitions have affected the Algerians’ lifestyle primarily in their nutritional status, eating behavior, and health status. Overweight and obesity, being present at all ages of life, includes several factors related to the risk of developing, at an older age, non-communicable diseases such as diabetes and cardiovascular disease. The nutritional situation of children under 5 years remains a concern of low birth weight, low prevalence of exclusive breastfeeding, stunting growth, and underweight. Nutritional deficiencies, mainly in micronutrients, persist in different age groups, especially in pregnant and lactating women reflecting the consequences of a poor diet characterized by low consumption of fruits and vegetables, and higher consumption of fatty products as well as sweet with high calorie density. The issue of food and nutritional security remains an important issue. Despite the persistent nutritional problems, the level of food security indicators show that the country is not exposed to food insecurity, but dependency on food imports remains quite high. The living conditions in rural areas must be improved in order to strengthen the agricultural sector which must be able to meet the needs of the population. Updating and analyzing the nutritional situation using existing data will enable the strategies put in place by national and international organizations to be implemented. Keywords: Nutritional status, Non-communicable diseases, Risk factors, Eastern Algeria.

Avaliação do consumo alimentar e estado nutricional de crianças e adolescentes com malária no município de Anajás/PA

Justificativa e Objetivos:Na região das Américas, o Brasil é o país que mais registra casos de malária, sendo que as mais comuns são por: Plasmodiumvivax e Plasmodiumfalciparum.No estado do Pará, Anajás é o município com o maior número de casos registrados. Por isso, o objetivo deste estudo foi avaliar a situação alimentar e nutricional de crianças e adolescentes com malária por Plasmodiumvivax, no município de Anajás/PA. Métodos:Estudo transversal realizado com crianças e adolescentes, na faixa etária de 2 a 16 anos, com malária por P. vivax, atendidas de janeiro a dezembro/2014. Os dados socioeconômicos e epidemiológicos foram coletados utilizando-se protocolo de pesquisa semiestruturado. As medidas antropométricas de peso e altura foram coletadas para avaliação do estado nutricional. O consumo alimentar dos participantes foi obtido pelo questionário de frequência alimentar e para estatística foi considerado o nível de significância de p

Looking Beyond Gender Attitudes of Rural Mothers on the Nutrition and Health of their Children:A Comparative Study among Santhals and Non-Santhals in West Bengal

Child malnutrition is a chronic problem in India according to NFHS-3, Forty eight per cent of children under the age of five, are stunted due to chronic under nutrition, with 70 % being anaemic. This dismal nutrition situation of children is very much a matter of gender as women differ from men in specific nutritional needs during adolescence, pregnancy and lactation. Further, girls today are women tomorrow which leads to an intergenerational cycle of malnourishment where the under nourished mother gives birth to a malnourished child. Also, women (mothers) are mostly responsible for the up keep and care of the child in its formative years, so her gender attitudes are consequential to the nutritional and health entitlements of the child. In the above context the present study focuses on the nutritional entitlements of the 515 primary school going children of 300 women from three districts of rural West Bengal by applying Clinical Nutrition Survey Chart, 24 h recall method and Food Frequency Questionnaire, health and immunization records. Nutrient intake and consumption frequency of all the 6 food groups, like meat and protein, grains, fruits, vegetables, dairy, fats and oils, were collected for the afore-mentioned sample. SPSS-17 was used for statistical calculation. It was seen gender outlook of the tribal population was more egalitarian than the general population at 0.05% level of significance. Also factors like birth order, age at weaning and mother's age at marriage were detrimental to the malnourishment status of the child.

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Background and aims: Sepsis/severe sepsis is a common disease and the most common cause of death in PICU. The nutritional situation of children is closely related to outcomes. Early study showed critical ill children could suffer iron and zinc reduction, but their relationship with prognosis is not clear. Aims: To determine the prevalence of malnutrition and change of trace elements (copper, iron, zinc) of sepsis/severe sepsis children who are hospitalized in PICU and describe their relationship to outcomes. Methods: Prospective, observational study at PICU of Beijing Children’s Hospital from November 2012 to April 2013. Z-score evaluation was used to assess children’s nutrition status. Flame atomic absorption spectrometric method was used to determine the contents of copper, zinc and iron in children’s peripheral blood. The approval of this study by the Institutional Review Board had been gotten. Results: 78 children with median age 13 (6.9, 39) months were enrolled. Prevalence of malnutrition was 38.5% (30/78),the percentage of underlying diseases and the mortality on discharge were 66.7% vs 33.3% (P=0.006) and 10.0% vs 2.6% (P=0.429).75.6% (59/78) children had lower iron level in peripheral blood, 22 (28.2%) for zinc, but no significant differences between malnutrition and normal nutrition group. Conclusions: The prevalence of malnutritionin PICU sepsis/severe sepsis children is higher than general critical ill children. Children with malnutrition have significantly higher percentage of underlying diseases, and lower iron and zinc level in peripheral blood. There are no significant differences in iron, zinc, copper level between malnutrition group and normal nutrition group.

The nutritional situation of children in Latin America: between deficiency and excess, from nutritional gap to social debt

The nutritional situation of children in Latin America: between deficiency and excess, from nutritional gap to social debt

Situational analysis of infant and young child nutrition policies and programmatic activities in Mali

Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals. Therefore, several international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel', starting with a situational analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse and interpret available information on infant and young child feeding, and the nutrition situation of children <2 years of age in Mali, as one of the six targeted countries. Between June and September 2008, key informants responsible for conducting IYCN-related activities in Mali were interviewed, and 117 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, screening and management of acute malnutrition, prevention of mother-to-child transmission of HIV, food security, and hygienic practices. Most of the key IYCN topics were addressed in national policies, training materials, and programme documents. Information on the national coverage and impact of these programmes is generally not available. Exclusive breastfeeding (<6 months) has increased in Mali, but no studies identified the contributors to this increase. Despite improvements in breastfeeding practices, optimal infant, and young child feeding is still practiced among too few young children in Mali. Several research articles were identified, but few of these were linked to programme development. Some programme monitoring and evaluation reports were available, but few of these were rigorous enough to identify whether IYCN-specific programme components were implemented as designed or were achieving desired outcomes. Therefore, we could not confirm which programmes contributed to reported improvements. Monitoring of programmes managing malnutrition identified gaps in human and institutional capacities to fully carry out intended interventions and the government has recognized the overall lack of adequate numbers of health care providers to carry out necessary programmes in Mali, of which nutrition programmes are a part. The policy and programme framework is well established for support of optimal IYCN practices, but greater resources and capacity building are needed to: (i) conduct necessary research to adapt training materials and programme protocols to programmatic needs; (ii) implement rigorous monitoring and evaluation that identify effective programme components; and (iii) apply these findings in developing, expanding, and improving effective programmes.

Situational analysis of infant and young child nutrition policies and programmatic activities in Niger

Due to limited progress towards reducing mortality and malnutrition among children <5 years of age, an alliance of international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel,' starting with a situational analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of this analysis are to compile, analyse, and interpret available information on infant and child feeding and the nutrition situation of children <2 years of age in Niger, as one of the six targeted countries. Between August and November 2008, key informants responsible for conducting IYCN-related activities in Niger were interviewed, and 90 documents were examined on: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, prevention of mother-to-child transmission of HIV, management of acute malnutrition, food security, and hygienic practices. The results reported are limited by the availability of documents for review. Mortality rates are on track to reaching the Millennium Development Goal to reduce mortality among young children by two-thirds by 2015, but there has been no change in undernutrition, and total mortality rates are still high among young children. Nearly all of the key IYCN topics were addressed, specifically or generally, in national policy documents, training materials, and programmes. A national nutrition council meets regularly to coordinate programme activities nationally. Many of the IYCN-related programmes are intended for national coverage, but few reach this coverage. Monitoring and impact evaluations were conducted on some programmes, but few of these reported on whether the specific IYCN components of the programme were implemented as designed or compared outcomes with non-intervention sites. Human resources have been identified as inadequate to fully carry out nutrition programmes in Niger. Due to these limitations, we could not confirm whether the lack of progress in reducing malnutrition was due to ineffective or inadequately implemented programmes, though both of these were likely contributors. The policy framework is well established for the promotion of optimal IYCN practices, but greater resources and capacity building are needed to: (i) increase human capacities to carry out nutrition programmes; (ii) expand and track the implementation of evidence-based programmes nationally; (iii) improve and carry out monitoring and evaluation that identify effective and ineffective programmes; and (iv) apply these findings in developing, expanding, and improving effective programmes.

Situational analysis of infant and young child nutrition policies and programmatic activities in Senegal.

Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals (MDGs). Therefore, several international agencies joined to 'Reposition children's right to adequate nutrition in the Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse and interpret available information on infant and child feeding and the nutrition situation of children <2 years of age in Senegal, as one of the six targeted countries. These findings will be used to assist in identifying inconsistencies and filling gaps in current programming. Between August and December 2008, key informants responsible for conducting IYCN-related activities in Senegal were interviewed, and 157 documents were examined on the following themes: optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, prevention of mother-to-child transmission of HIV, management of acute malnutrition, food security and hygienic practices. Nearly all of the key IYCN topics were addressed, specifically or generally, in national policy documents. Senegal reported substantial improvements since the 1990s towards reducing infant and young child mortality and underweight, and increasing exclusive breastfeeding among infants <6 months of age (34%). Senegal is one of the few countries in the region that is nearly on track for reaching related MDGs. Notable activities that may have played a role include: (1) vitamin A supplementation was expanded to nearly semi-annual national campaigns starting in 1994; (2) the Ministry of Health partnered with several national and international agencies to scale up child survival activities under the umbrella of the Basic Support for Institutionalizing Child Survival (1994-2006); (3) a national nutrition division was developed to support a national nutrition strengthening programme; (4) the national nutrition counsel was organized to coordinate nutritional activities across various organizations and governmental sectors, involving representatives from health, agriculture and surveillance; and (5) an integrated communications programme was developed to support harmonized behaviour change communication tools for the health and nutrition sectors. Along with these activities, a number of programme evaluations were conducted to ensure that programmes obtain desired results. Although useful, these evaluations were not rigorous enough to identify effective programmes that contributed to the mentioned reductions in the prevalence of underweight and mortality, and increases in exclusive breastfeeding. The policy and programme framework is well established for support of optimal IYCN practices in Senegal. Despite the recent improvements in infant and young child nutritional status indicators, there is still much to do. Greater resources and continued capacity building are needed to: (1) conduct necessary research for adapting training materials and programme protocols to programmatic needs; (2) improve and carry out monitoring and evaluation that identify effective programme components; and (3) apply these findings in developing, expanding and improving effective programmes.

Situational analysis of infant and young child nutrition policies and programmatic activities in Chad

Progress towards reducing mortality and malnutrition among children <5 years of age has been less than needed to achieve related Millennium Development Goals (MDGs). Therefore, several international agencies joined to 'reposition children's right to adequate nutrition in the Sahel', starting with an analysis of current activities related to infant and young child nutrition (IYCN). The main objectives of the situational analysis are to compile, analyse, and interpret available information on infant and child feeding, and the nutrition situation of children <2 years of age in Chad, as one of the six targeted countries. These findings are available to assist in identifying inconsistencies and filling gaps in current programming. Between June and October of 2008, key informants responsible for IYCN-related activities in Chad were interviewed, and 53 documents were examined on the following themes: the promotion of optimal breastfeeding and complementary feeding practices, prevention of micronutrient deficiencies, management of acute malnutrition, prevention of mother-to-child transmission of human immunodeficiency virus (HIV), food security, and promotion of good hygienic practices. Chad is not on track to reaching the MDGs of reducing mortality by two-thirds and malnutrition by half among children <5 years of age between 1990 and 2015. Most of the key IYCN topics were addressed in a national policy to combat malnutrition and micronutrient deficiencies. No national nutrition policy was yet ratified in Chad, so the target of many documents reviewed was the malnourished child. Researchers have identified some barriers to optimal feeding practices. However, the majority of these surveys were small scale, so they do not necessarily provide information relevant to the general population. Expanded surveys would be needed for developing evidence-based educational messages targeted to local needs. Reviewed training materials and related programmes being implemented in Chad provide specific guidance for nearly all of the key IYCN topics, except for appropriate feeding choices for the prevention of mother-to-child transmission of HIV. Some of the programmes were intended for national coverage, but we could not confirm whether these programmes were actually implemented nationally. Monitoring and evaluation reports were available for some small-scale programmes, but few of these evaluated whether IYCN-specific programme components were implemented as designed and none evaluated whether participants adopted the promoted feeding practices. Establishment of the policy and programme framework has commenced for improving IYCN practices. Formative research is needed to guide the development of evidence-based training materials and programmes to address the nutritional needs of infants and children. Once more directed programmes are established, there is a further need for rigorous monitoring and evaluation to ensure that training is adequate, programmes are implemented as designed, and effective programmes are identified for expansion nationally. Evaluations are also needed to determine where human and institutional capacity building is needed to carry out these activities as they are implemented. National and international support will be required to complete these enhancements, and thus improve the health and nutritional status of infants and young children in Chad.

Fighting anaemia and malnutrition in Hebron (Palestine): Impact evaluation of a humanitarian project

Iron supplementation in children is recommended by WHO when prevalence of anaemia is above 40%. In Palestine, due to the emergency situation caused by the outburst of the second intifada, the nutritional situation of children is worsening and iron deficiency anaemia represent one of the most serious problem. An emergency project which included universal iron supplementation (for 12,300 children), free treatment for common diseases and food supplementation to vulnerable families (for 3,275 children found anaemic or/and malnourished) and community health education was implemented in part of Hebron governorate. To evaluate project's impact we performed two random surveys: one before and one after the project. Before the project 30.1% of children (CI 95% = 24.5–35.6%) were found anaemic (<11 g/dl), while after the prevalence was 18.8% (CI 95% = 14.8–22.8%; decrease of 38%, p = 0.001). Levels and reduction in anaemia prevalence were different according to geographical areas: where prevention activities had been implemented in previous years, prevalence of anaemia was 17.1% and remained stable at lower levels (14.7%). In other areas it sharply declined from 47.4 to 21.7% ( p < 0.0005): the declined was present only for children who received iron supplementation. Comparison of anthropometrics index before versus after the project showed that low “weight for age” declined from 10.9 to 3.8% ( p = 0.0006), low “weight for height” declined from 6.0 to 1.4% after ( p = 0.0025). With simple epidemiological tools we could demonstrate and measure the effectiveness of our interventions on the health status of the general population: a 50% reduction of anaemia and a 70% reduction of global acute malnutrition.

Veränderung des Kohlenhydratstoffwechsels und der Insulinresistenz bei Patienten mit Prader-Willi-Syndrom unter einer Wachstumshormontherapie

Life expectance and life quality have markedly changed in PWS patients within the last 10-15 years. A strict diet, improved physical activity and an additive growth hormone treatment have led to these changes. Growth hormone therapy decreases body fat and improves final height. But growth hormone also antagonizes insulin and therefore increases the diabetic potential. The purpose of our study was to investigate incidence and multiple dependencies of development of impaired carbohydrate metabolism in patients with PWS under growth hormone therapy and to determine suitable parameters for the work-up. 34 patients with genetically approved PWS have been treated with growth hormone for at least 0.5 years. The mean duration of growth hormone treatment was 2.15 years (0.5-4.51). At the start of growth hormone treatment patients were 1.33 to 16.47 years old. The clinical picture and the nutritional situation of children with PWS change age-dependent and can be divided up into three phases. The patients were duty subdivided into three age-groups at the beginning of growth hormone treatment. Group 1: 15 PWS patients, mean age 2.62 years (1.33-3.78). Group 2: 10 PWS patients, mean age 5.54 years (4.08-7.61). Group 3: 9 PWS patients, mean age 11.35 years (8.89-16.47). Data were collected within 0.3-0.38 years before start of treatment and every 6 months throughout the treatment period. Anthropometrical data, fat mass by bioelectric impedance analysis (BIA), fasting insulin, HbA1c, C-peptide, blood fats and the blood sugar profile in oral glucose tolerance tests (OGT/1.75 g glucose/kg body mass) were obtained. Growth hormone therapy was started with an average dose of 0.031 mg/kg body mass in all groups. Insulin resistance was based on Homeostasis Model Assessment-Test (HOMA). No IR or pathological OGT were detected when growth hormone therapy started before the 4th year of life. When therapy started between the 4th and 8th year, PWS patients with normal weight did not develop an IR under GH therapy. 6% developed a glucose tolerance (IGT) disorder and 4% developed an increased fasting glucose (IFG). 5 of 9 PWS patients older than 8 years at therapystart showed a transient disorder of glucose metabolism: 11% of the results obtained in these patients presented an IR with no pathological OGT, 13% showed an IR with IGT, 7% showed an IR with IFG, and 2% showed an IR with transient diabetes. For 4% the IFG persisted with no IR, for 4% the IGT persisted with no IR. These patients differed from younger ones by an increased average BMI, an increase fat body ratio and an increase fasting insulin as well as an already reached puberty. No difference was found in C-peptide, HbA1c or GH dose/kg/body mass. Transient glucose metabolism disorders with no development of manifest insulin resistance are shown by PWS patients with normal weight starting from 4th year under GH therapy. Changes in the glucose metabolism with and with no development of IR appear after start of puberty and weight increase. Changes persisted partially for 18 months. GH therapy was not interrupted for any patient, whereby physical training and dietetic measurements were increased for all patients. HOMA-index and OGT shall be used in parallel to monitor glucose metabolism as both show independently distinctive features. HbA1c and C-peptide are not suitable parameters for monitoring carbohydrate metabolism in PWS patients under GH treatment.

BeKi – an initiative for nutrition education in children in the federal state of Baden-Württemberg: description, experiences, and considerations for an evaluation framework

To present the State Initiative BeKi (from Bewusste Kinderernährung, conscious child nutrition; formerly: "program Nutrition Education with Children"), carried out statewide by the Baden-Wurttemberg Ministry for Nutrition/Food and Rural Area since 1980. The mission of BeKi is the improvement of nutritional knowledge, nutritional behaviour, and nutrition situation of children. The program description considers the most important evaluation criteria for health promotion programs, including practical experience and an evaluation concept. Currently comprehensive evaluation is carried out according to the RE-AIM Model for health promotion programs which assesses the public health impact in regard of individual and institutional reach, efficacy, adoption, implementation, and maintenance. BeKi addresses all target groups involved in the upbringing and education of children from age six months up to the end of the 6th grade and provides factual, validated, and independent information on child nutrition and nutrition education. Physiological, educational, and social aspects of food and nutrition are given equal importance. Core component of BeKi are the services of more than 250 BeKi-trained child nutrition experts. Previous experience and first evaluation results confirm that BeKi is creative, committed, cost-efficient and widely-used.

Food and Nutrition Division, Food and Agriculture Organization of the United Nations (FAO), Study on the Impact of Armed Conflicts on the Nutritional Situation of Children

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