Nutritional Status Of Young Children Research Articles

Nutrient Intakes of Children Residing in Squatter Settlements on Pavements and Along Roadsides in Jaipur City

An upsurge of migrants from within and outside the state of Rajasthan has led to the springing up of squatter settlements on pavements and vacant plots along the roadsides of cities. People are forced to reside in the open due to lack of housing facilities. Migrants enter big cities in search of employment or to sell their goods. Such people squat on any available land and gradually seek access to basic amenities in their most meager forms. They subsist on low incomes. This influences their capacity to purchase food for their families thereby compromising the nutritional status of their children. A review of literature suggests that there is a paucity of data on the nutritional status of young children of families residing on pavements and squatter settlements along roadsides in big cities. Hence an attempt was made to get an insight into the dietary pattern and nutrient intakes of children of such families. (excerpt)

Macrolevel approaches to improve the availability of complementary foods.

Large numbers of infants and young children suffer from the short- and long-term health effects of poor breastfeeding and complementary feeding practices. Strategies to improve the availability of and access to low-cost fortified complementary foods can play an important corresponding role to that of behavior change in improving nutritional status of young children. However, the nutritional quality of complementary foods used in publicly funded programs is not always optimal, and such programs are costly and reach only a tiny fraction of those who could benefit. To broadly reach the target population, such foods need to be commercially available at affordable prices and promoted in a way that generates demand for their purchase. A sensible long-term policy for the promotion of low-cost fortified complementary foods calls for attention to their nutritional formulations and cost, the economics of production, and the legislative, regulatory, and competitive framework in which marketing occurs. This paper provides information on how to improve the nutritional formulations of fortified complementary foods and outlines the necessary conditions for a market approach to their production and promotion.

Gender, family, and the nutritional status of children in three culturally contrasting states of India

This paper has three main aims: to measure the clustering of children with low weight for age z-scores within families, to establish whether significant differences exist by gender in weight for age z-scores, and to demonstrate whether the presence of a mother-in-law in the household has any significant impact on the nutritional status of young children. Regression modelling is used to examine the weight for age z-scores of children under the age of four years in Maharashtra, Tamil Nadu and Uttar Pradesh using the 1992–93 Indian National Family Health Survey data. Random effects models measure the clustering of children with low weight for age z-scores in families, controlling for a number of other family factors. Our findings do not reveal significant gender differences in weight for age z-scores. Although little variation was found between family structures in the nutritional status of children, there were significant differences between families after controlling for family type. This suggests that there are differences between families that cannot be explained by a cross-sectional demographic survey. The evidence from this work suggests that nutrition programs need to adopt community nutrition interventions that aim resources at young children from families where children with low weight for age z-scores are found to cluster. However, there is a need for further inter-disciplinary research to collect data from families on behavioural factors and resource allocation in order that we might better understand why some families are more prone to having children with low weight for age z-scores. The diversity in the significant covariates between the three states in the models has shown the need for Indian nutrition programs to adopt state-specific approaches to tackling malnutrition.

Dietary intake and nutritional status of young children in families practicing mixed home gardening in northeast Thailand.

One current initiative to assist rural Thai families to increase home food production and security is the implementation of home gardens that produce fish, small animals, and vegetables. This paper presents the results of an investigation comparing seasonal dietary intake and nutritional status among northeastern Thai children in mixed-gardening and nongardening families (n = 30 for each group). Assignment to the gardening group was based on the presence of a mixed garden, whereas nongardening subjects were randomly selected and matched for comparison. Statistical analysis (paired t-test) indicated that there was no significant difference in the observed biochemical variables (serum retinol, ferritin, hemoglobin) between groups at the p < or = .05 level. Nutritional status in regard to height-for-weight, weight-for-age, and weight-for-height Z scores was better among children of gardening families, although the differences were not significant. The small sample size and reported results indicate that the relationship between the practice of mixed home gardening and dietary intake and nutritional status needs further investigation.

Title II Food Aid and the Nutrition of Children in Latin America and the Caribbean

This article addresses the policy, programme, and food-commodity aspects of United States non-emergency food assistance programmes in the Latin American and Caribbean region since the end of the Cold War. The article contains an analysis of the cost, composition, and quality-control improvements of United States Public Law 480 (P.L.480) Title II foods, which reach over one-half million recipients each year through 16 maternal and child health programmes in 6 countries. After a description of the changes in maternal and child health programmes in the 1990s, the author concludes that further improvement in the nutritional status of young children in Latin America will take place more readily from the transformation of food distribution programmes into food and nutrition security programmes than from isolated acts of supplying complementary foods of improved quality.

Nutrition in agricultural development: Intensive dairy farming by rural smallholders

This study concerns the introduction of intensive dairy farming among rural smallholders in Kilifi District, Kenya. Household surveys were conducted among dairy farmers, dairy customers and a comparison sample from rural locations. Dairy farmers were better off than the rural sample as regards household income, food production, food consumption and nutritional status of young children. These differences resulted from the dairy activities but also from greater involvement in crop cultivation and off‐farm employment. Local milk purchases by dairy customers were mostly by wealthier households with wage employment. They had higher incomes and higher food consumption than the rural sample, and the children in these households had better nutritional status. Further analysis confirms a positive relation between milk consumption and nutritional status of children, independent of household income, energy intake and level of education. Other notable findings were the high incomes from off‐farm employment of dairy farmers; regular dairy customers are chiefly households with wage employment; milk consumption among the rural population was very low. The results cast doubt on the importance of intensive dairy production as a means of livelihood for resource‐poor households and the importance of milk as a means to improve nutritional status of children in low‐income households.

Deterioration in the nutritional status of young children and their mothers in Brazzaville, Congo, following the 1994 devaluation of the CFA franc.

The effects of the January 1994 devaluation of the African Financial Community (CFA) franc on the nutritional situation of the populations concerned has been little documented. We report in this article on two nutritional cross-sectional surveys that were conducted before and after this devaluation (1993 and 1996) in two districts of Brazzaville, Congo. The surveys involved a representative sample of 4206 households with a child aged 4-23 months. Complementary feeding practices and the anthropometric indices of the children and their mothers were compared, adjusting for changes in household socioeconomic characteristics. The results show a decline in the quality of the first complementary foods offered to the infants, i.e. less frequent use of special transitional foods and imported complementary flours (of higher nutritional quality), and preparation of less nutritious local gruels. Overall, the nutritional situation had deteriorated, with greater levels of stunting and wasting among children, mothers with lower body mass index, and infants with reduced birth weights. Increased food prices would appear to be the direct cause of the decreased quality in complementary feeding, but factors other than the devaluation have also had an impact on household welfare. The influence of these factors on nutritional-status is discussed.

Malnutrition and income: Are we being misled? (A dissenting view about a confusing literature)

This article takes issue with mainstream evidence in the literature purporting to show that increasing household income alone is not enough to do something significant towards combatting malnutrition in the world. It argues that poverty lines used as a threshold to surpass (in order to show measurable improvements in the nutritional status of vulnerable women and children in the short term) are too low. It further points out that the primary determinant of nutritional status of young children may actually not be total household income, but rather that portion of it earned and controlled by the mother. Modernization and market expansion have created consumption preferences that compete with food as a need thus leading to decreasing percentages of household income being spent on food. With competing expenditure options, the relative poverty line for a given location (based on current local food prices plus the prices of other needs) is clearly at a higher household income cut‐off point than the absolute poverty line that researchers reviewed are using as a threshold. Households that raise their income barely beyond the poverty‐line‐set‐too‐low still do not show the expected improvements in the nutritional status of vulnerable household members. The point is made that poverty alleviation of an order of magnitude significantly beyond absolute poverty is needed for lasting nutritional improvement to occur; providing for an adequate minimum nutrition of all household members year‐round is simply taking more, because the percentage of total income being spent on food is lower due to competing needs. It is concluded that poverty‐redressing interventions—as much as they may be in the economic realm only—remain central in the ultimate battle against malnutrition worldwide. The paper also explores how further income elasticity of demand assessments are key to redress the misleading perception that improvements in income alone do not lead to measurable improved nutritional status of vulnerable groups. Ultimately, the paper warns of the dangers of basing mainstream policy to revert malnutrition in the Third World on the conclusions drawn from studies using what the author thinks is misleading data interpretation.

Nutrition in agricultural development: land settlement in Coast Province, Kenya.

Coast Province is the third area of population concentration in Kenya with more than 1.8 million people at the time of the census in 1989. The region is economically underdeveloped relative to central and western Kenya. In response to a great demand for land, the government of Kenya has since 1963 parcelled out tracts of land in Coast Province among smallholder tenants. This paper reviews the settlement of land in the province during 1960-70 and the effects upon later household income, food production, and nutrition. Findings are based upon information gathered from 300 tenant households surveyed between August 1985 and September 1986 in the Ukunda, Mtwapa, and Roka-East schemes respectively established in 1962, 1968, and 1969, and 150 households in rural comparison locations visited during the same period. In all aspects studied, including living conditions, household resources and income, food self-sufficiency and consumption, and nutritional status of children, the settlement tenants were better off than the rural population. Further analysis determined that the relatively better nutritional status of tenant households is only partly due to increases in food production and agricultural income. Income from employment was also higher than that of the rural comparison population. Households with large farms generally realized larger incomes, but they also had much larger families and food consumption, and the nutritional status of young children was lower among those households.

Unicef - Cornell Colloquium on Care and Nutrition of the Young Child - Planning

The need to develop appropriate knowledge-based strategies to promote better care was the basis for the UNICEF-Cornell University Colloquium on care and nutrition of the young child. The first step was to develop a conceptual model that described the various factors that influenced the quality of care and the pathways through which care influenced the nutrition status of young children below three years of age. The direct care-related behaviours included breastfeeding, complementation, feeding during illness, health related behaviours, and psychosocial care. Several underlying factors at the household, community, and national level and the interactive process of care were also considered. The resource constraints and trends were child characteristics; caregiver factors, including time availability; psychological, health, and nutrition status; organizational resources; and modernization and urbanization. The triple-A process of assessment, analysis, and action was followed to identify, understand, and prioritize the key areas while planning for the Colloquium. Besides the focus and theme papers, case-studies from developing countries and working group sessions were also included.

Nutritional status of young children: a comparison among three anthropometric classifications

to compare the usefulness of the methods proposed by Gomez, Waterlow and W.H.O., to classify the nutritional status of children under 2 years of age. the nutritional diagnosis of 436 infants was defined at 6, 12, 18 and 24 months of age, using the three proposed methods. Predictive values, positive (PV+) and negative (PV-), and agreement coefficient (K) were calculated, comparing the nutritional classification of the children on each method with a gold standard of nutritional diagnosis, based on individual growth performance since their birth. the three methods showed a good PV-, nearby 0.9, at all tested ages whereas the PV+ and K exhibited lower values. Among the three methods of classification of nutritional status, the method proposed by Gomez achieved the best levels of PV+, PV- and K, at all considered ages, mainly at 18 and 24 months of age. the Gomez' method, as an unique criterion, is better than the others, because it has a lower risk of misdiagnosing a case of malnutrition. Nevertheless, this risk is big enough to not recommend its isolated use, mainly during the first year of life,when the risk of a false positive diagnosis of malnutrition is still higher.

Evaluation of effectiveness of good growth monitoring in south Indian villages

We conducted a community intervention trial in 12 villages in Tamil Nadu, India to evaluate the benefits of growth monitoring. The villages were divided into 6 "growth-monitoring package" of intervention villages (GMP) and 6 "non-growth-monitoring package" of intervention villages (NGM). A functioning primary health care system was in place in all 12 villages. One village nutrition worker in each of the 12 villages implemented a set of interventions including health and nutritional education. About 550 children under the age of 60 months were studied over 4 years in GMP villages and a similar number of children in NGM villages. The interventions were identical in the two sets of villages except for the use of growth charts in education in the 6 GMP villages. The nutrition worker in the NGM villages had the same contact time as in the GMP villages but advised mothers without the benefit of growth charts. The research team, independently of the nutrition worker, did anthropometric studies on children in all villages every 4 to 5 months. Comparisons were done by calculating monthly gains in stature, and weight, and the significance of differences observed was adjusted for age and sex. After 30 months of interventions, similar improvements in growth were seen in GMP and NGM children. The interventions seemed to have improved the nutritional status of young children in both groups of villages. In view of the lack of additional benefit from growth monitoring over other educational interventions, we question its use as part of child survival programmes in India.

Effect of Short-Term Essential Amino Acid-Containing Dialysate in Young Children on CAPD

In young children on CAPD, hypoproteinemia and malnutrition are often observed. We used essential amino acid-containing dialysate (EAAD) to assess short-term effectiveness on serum amino acid concentrations in young children undergoing CAPD. EAAD consisted of a 540 ml, 1.5% glucose-containing dialysate and 100 ml of 7.4% essential amino acid (EAA) solution. Aside from methionine, all serum EAA rose during the 6 hour peritoneal dialysis cycle using EAAD, peaking at about 200% of pre-treatment level one hour after start of treatment. They then returned to near pre-treatment levels at the end of the cycle. However, serum methionine increased 680% of pre-treatment level, one hour after start and 390% at the end of the cycle. In the serum non-EAA tyrosine, which showed low levels in patients with chronic renal failure, increased after EAAD treatment. Other non-EAA, most of which showed increased levels in patients with chronic renal failure, decreased after EAAD treatment. These changes in serum amino acids suggest that EAA, absorbed from EAAD, may have increased uptake of non-EAA in protein synthesis. This may improve the nutritional status of young children on CAPD.

The Imo State (Nigeria) Drinking Water Supply and Sanitation Project, 2. Impact on dracunculiasis, diarrhoea and nutritional status

Morbidity due to dracunculiasis (guinea worm disease) and diarrhoea in persons of all ages, and nutritional status of young children, were used as health impact indicators in the evaluation of the Imo State Drinking Water Supply and Sanitation Project in south-eastern Nigeria. Data were collected using repeated cross-sectional surveys and longitudinal follow-up. The study area was found to have a low level of endemicity of dracunculiasis. While no impact could be demonstrated on overall period or point prevalence rates in the cross-sectional surveys, a prospective longitudinal survey showed a significant reduction in the percentage of person-fortnights positive for dracunculiasis in areas served by the project, while the control areas showed no such change. In the cross-sectional surveys it was found that, in the project villages, those persons drinking only borehole water had significantly lower period prevalence rates one year later than others. Moreover, those living further from the nearest borehole had higher rates of dracunculiasis. An impact of the project on diarrhoea morbidity was found only in limited sub-groups of the population. A greater association with water availability rather than quality was suggested for rates in young children. The prevalence of wasting (< 80% weight-for-height) among children aged less than 3 years decreased significantly over time in all 3 intervention villages; there was no such decline in the control villages.

Styles of Infant Feeding: Parental/Caretaker Control of Food Consumption in Young Children

patterns. These studies have looked at such variables as breastfeeding and weaning practices, the age when solid foods are introduced, which foods are appropriate for children, the age at weaning, the use of infant formula, overall dietary adequacy, and socioeconomic and demographic determinants. The studies employ a variety of research techniques, types of data, and underlying theoretical models, which lead to different policy implications concerning how to improve the nutritional status of young children. Some studies identify food availability and/or poverty as the primary determinants of infant-feeding patterns and therefore nutritional status (cf. Raphael and Davis 1985). Others highlight normative beliefs that limit children's access to protein sources, leading to malnutrition (Lepowsky 1985, 1987; Pettigrew 1982) or intrafamilial patterns of food distribution that lead to higher rates of morbidity and mortality for women and children generally and for female children in particular (Daniggelis 1987; McKee 1984; Pettigrew 1982; Piwoz and Viteri 1985). Several recent studies focusing on child neglect and abuse have described feeding practices in contexts where caretakers purposefully withhold food to hasten a child's death

Ethnic group differences in nutritional status of young children from low-income areas of an urban county

A nutrition assessment survey was undertaken among 566 preschool children from randomly selected low income households located within an urban county. The purpose of the survey was to determine the prevalence of selected nutrition problems and to identify relationships among ethnic and economic variables and nutritional status. Underweight was identified in 1.8%, overweight in 15.4%, and short stature in 13.1% of children. Southeast Asian children had a higher prevalence of short stature than the other ethnic groups. Low hemoglobin values were identified in 4.3%, low hematocrit in 6.9%, and elevated erythrocyte protoporphyrin in 6.0% of children. The prevalence of elevated EP was significantly higher among Southeast Asian children than non-Southeast Asians and likely was due to iron deficiency. Results of the survey suggest that Southeast Asian children constitute the group at highest nutritional risk in the low income areas surveyed.

Selective primary health care: strategies for control of disease in the developing world. XXIII. Control of infection to reduce the prevalence of infantile and childhood malnutrition.

Malnutrition is due to many complex and interacting factors, both biologic and social. This may be why so little has been accomplished in the global efforts to reduce its prevalence and impact. The greatest burden of malnutrition falls on the youngest members of society, and in these infants and children it is closely associated with infectious diseases. Because of multiple effects on host nutrition and metabolism, infections result in nutritional deterioration that must be corrected during convalescence. When this is precluded by limitations in the adequacy and availability of food, and infections are frequent, progressive deterioration in nutritional status occurs, with high morbidity and mortality rates. Measures that reduce the prevalence and nutritional consequences of infection are the most feasible and cost-effective interventions to improve nutritional status of young children at the present time. These measures include immunization, oral rehydration programs for diarrheal disease, promotion of breast feeding, continued feeding during infection, development of adequate weaning foods from mixtures of available local commodities, specific nutrient fortification, growth monitoring, improved environmental sanitation and water supplies, and education. The first seven measures can be introduced immediately in all societies and are basic elements of effective primary health care. The last two, which promise the greatest return in benefits, are the most costly and most difficult to implement. Malnutrition and infection are inseparable and the measures to deal with the former must effect a reduction in the latter if they are to succeed.

Anthropometric assessment of young children's nutritional status as an indicator of subsequent risk of dying.

This paper examines the possibility of screening children of 6–59 months old for subsequent risk of dying by using various cut-off points of weight for age, weight for height, arm-circumference for age, and arm-circumference for height. The study was conducted in Kasongo, the main town of a rural area in Zaire. The risk of dying for Kasongo under-fives was quite uniformly distributed among groups defined by various cut-off points in the distribution of anthropometric parameters. It was not possible to demonstrate differential mortality risks or to identify a threshold level below which the risk would substantially increase. These results are in contrast with similar community-based studies from India and Bangladesh. Possible explanations for this contrast as well as the operational implications of the findings are discussed.

The Wasting-Stunting Classifying Scale: A New Device for the Rapid Assessment of Nutritional Status of Young Children

A new wasting-stunting classifying scale has been developed to allow the rapid assessment of the nutritional status of young children. Three hundred and five children were classified by this device and the results compared to classification using the NCHS-WHO tables of weight-for-height and height-for-age. The field classification with the.WSC scale showed a sensitivity of 94 per cent, and a specificity of 93 per cent in weight-for-height classification, and 99 per cent sensitivity and 90 per cent specificity in height-for-age. Ninety-three per cent of the examined children were correctly classified by the WSC scale in this preliminary evaluation.

SMOKING, HEALTH, AND SURVIVAL: PROSPECTS IN BANGLADESH

Smoking is an increasingly prevalent habit in Bangladesh, particularly among men. In the past 10-15 years cigarette consumption has more than doubled. Over 100000 acres (405 km 2) of land that could produce food are planted with tobacco, and cereal imports making up for these production losses generally do not reach the below-subsistence cultivator and landless. Cancer of the lung is already the third commonest cancer among males, and annual deaths from this cause can be expected to increase by 12000 within 15 years. At present respiratory disease is the best-recognised direct health consequence of smoking. However, a more important health risk may be the reduction in nutritional status of young children which results from expenditure on smoking in households whose income for food purchase is already marginal. Smoking of only 5 cigarettes a day in a poor household in Bangladesh might lead to a monthly dietary deficit of 8000 calories (33. 5 MJ). The existence of young children in Bangladesh is already precarious owing to poor nutrition. If, as seems likely, expenditure on smoking means that they get even less food, then the survival of a large number of children is being seriously endangered.