Undernourished Populations Research Articles

From the imperial to the empty calorie: how nutrition relations underpin food regime transitions

This article works in a recursive manner by using the tools of a food regime approach to reinterpret the nutrition transition that has been underway internationally for 100 years, and then describing the contributions of nutrition science to the 1st and 2nd Food Regimes and the passages between Food Regimes. The resulting history—from the ‘imperial calorie’ through the ‘protective’ vitamin to the ‘empty calorie’—illuminates a neglected dimension to food regime theorising: the role of socio-technical systems in shaping a set of value relations that are central to class relations. Contestation over one such system, nutritionalisation, currently involves an ungovernable array of actors. In describing the protagonists to the system of nutritionalisation, a classic confrontation emerges between technical and lifeworld rationality. Representing the former approach are actor networks responsible for the ‘trade-in-health’ sector which produces foods and nutritional values aimed at both over-nourished and under-nourished populations. Clinging to a lifeworld rationality are ‘culture eaters’ worldwide, for whom nutrition value relations are secondary to communal and ecological relations. This dynamic appears within wealthier Asian states which are emerging as central to the trade-in-nutritional health sector while acting to protect their own customary dietary practices.

Policy determinants affecting the hunger millennium development goal

The possible effect of Government Consumption (a component of Gross Domestic Product (GDP)) on attainment of the hunger Millennium Development Goal (MDG1) was analyzed by evaluating the effect of macroeconomic, social, demographic and policy variables on average undernourished population. Eighty-four developing countries with data available on undernourished population were included in an ecological study. Regression models were applied to explore possible determinants of Undernourished between 1990 and 2004 and consequent achievement of the projected 2004 MDG1. In 2004, 1.4% of the overall undernourished population in the studied countries [70.16 million people] was in excess of the projected level required to meet MDG1. The multiple linear regression showed significant associations between Undernourished and poverty levels, the Gini Index, rural population and Government Consumption. The multiple logistic regression showed significant associations between achievement of projected 2004 MDG1 levels and Government Consumption and the Gini Index. The significant associations between Undernourished and Government Consumption suggest that the effects of GDP components on social conditions call for more thorough research and that policymakers such as governments and international financial institutions need to ensure that changes in distributive and redistributive policies do not negatively affect the possibility of achieving MDG1.

Multiple micronutrient supplements will not reduce incidence of low birthweight

Multiple micronutrient supplements will not reduce incidence of low birthweight

Effect of integration of supplemental nutrition with public health programmes in pregnancy and early childhood on cardiovascular risk in rural Indian adolescents: long term follow-up of Hyderabad nutrition trial

Objective To determine whether integration of nutritional supplementation with other public health programmes in early life reduces the risk of cardiovascular disease in undernourished populations.Design Approximately 15 years’ follow-up of...

Changes in a Rural Community (Yucatan, Mexico) Associated with Improvements in Production and Productivity

The World Food Summit, Rome, in 1996 estimated the undernourished population at almost 800 million. In Mexico, the highest level of undernourishment among children (27%) is recorded in the state of Yucatan. Improvements in agricultural production were carried out in a traditional Mayan farming village in the poorest area of Yucatan. Milpa crops including maize, beans, and squash yields were improved by the use of fertilizers, mulching, and herbicides while keeping the local species as cover crops. Innovations double the yields and the benefit/cost ratios. Also, improvement in chicken production was effected via construction of chicken pens and use of vaccines, which increased the benefits/cost ratio from 0.8 to about 1.3. Other innovations included production of honeybee, as well as citrus orchards and vegetables. The health status of the youths was measured in 1996 (when the project began) and again in 2000. After 4 years, improvements in production, productivity, and access to subsidies and loans had an immediate effect on both the household level of investment and the health status of children. Children who were measured in 2000 are taller than their counterparts in 1996, but the differences were not statistically significant. However, their nutritional status improved significantly in terms of body mass index (BMI) in both sexes and in all three age groups (3, 7, and 11 years) studied. The results obtained suggest that traditional, diversified farms, if properly improved, can provide the basic food requirements for the farmers' families and increase their cash income.

Malnutrition and Energy Restriction Differentially Affect Viral Immunity

Protein-energy malnutrition is associated with a decrease in immunity and an increase in infectious disease. Both of these effects are exacerbated in aging. Conversely, energy restriction (ER) without malnutrition extends the lifespan in animals and retards the age-related decline in various parameters of immune function. Recent evidence suggests, however, that aged ER mice exhibit an increased mortality in response to primary influenza infection compared with age-matched controls. Underweight may contribute to this outcome due to an inability to meet the energy demands associated with the immune response to primary viral infection. The energetic costs of immune responsiveness must be considered in the undernourished aging population and emerging studies of ER in humans.

Effects of alfalfa protein concentrate on spatial learning and memory in weaned rats

AbstractAlfalfa has been used as animal feedstuff and nowadays as a human dietary supplement in undernourished populations. Therefore, we considered whether a 65 °C prepared unfractionated alfalfa protein concentrate (UAPC) could be capable of supporting the normal body growth of weaned rats as well as their spatial learning, memory and astroglial organization. Rats were fed isocaloric (1.8 kJ g−1) and isoproteic (100 g kg−1) diets for 28 days containing UAPC or casein as their protein source. Thereafter, animals were submitted to a Morris water maze test (MWM) followed by an evaluation of memory retention. At the end of the spatial learning tests, the cerebral cortex, hippocampus and hypothalamus astrocyte population was morphologically and immunohistochemically analyzed. UAPC had two limiting essential amino acids that seem to have retarded rates of growth and caused temporary learning and memory alterations. The UAPC diet induced a transitory memory loss as well as a recoverable memory retention delay after returning to a commercial ration. The astrocyte cell number was decreased in the parietal cortex and arcuate nucleus but not in the hippocampus; however, the latter showed a minor reduction in their cell density. UAPC did not adequately support the development of weaned rats, and decreased the number of astrocytes in the cerebral cortex and hypothalamus. Copyright © 2005 Society of Chemical Industry

An analytical framework for making long -term projections of undernourishment: A case study for agriculture in Mali

A framework is developed for projecting the effects of policy, technological and environmental change on the prevalence of undernourishment in a country. This is done by integrating the Food and Agriculture Organization (FAO) methodology for estimating the proportion of undernourished population in a country into a stochastic economic agricultural sector modeling framework. The resultant framework considers the implications of climatic fluctuations, resource limitations and degradation, demographic pressure, market dynamics, adoption of improved cultivars, and cropland expansion. Such a unified framework provides a rich accounting of the factors surrounding macro level food supply and undernourishment as well as results on the regional distribution of undernourishment in face of climatic risk and regional characteristics. The framework is applied to Mali evaluating a number of alternative options for reducing undernourishment. We find that the Malian agriculture does have a significant potential for reducing undernourishment by 2015.

Nutrition and Student Performance at School

Abstract: This article reviews research from published studies on the association between nutrition among school-aged children and their performance in school and on tests of cognitive functioning. Each reviewed article is accompanied by a brief description of its research methodology and outcomes. Articles are separated into 4 categories: food insufficiency, iron deficiency and supplementation, deficiency and supplementation of micronutrients, and the importance of breakfast. Research shows that children with iron deficiencies sufficient to cause anemia are at a disadvantage academically. Their cognitive performance seems to improve with iron therapy. A similar association and improvement with therapy is not found with either zinc or iodine deficiency, according to the reviewed articles. There is no evidence that population-wide vitamin and mineral supplementation will lead to improved academic performance. Food insufficiency is a serious problem affecting children's ability to learn, but its relevance to US populations needs to be better understood. Research indicates that school breakfast programs seem to improve attendance rates and decrease tardiness. Among severely undernourished populations, school breakfast programs seem to improve academic performance and cognitive functioning. (J Sch Health. 2005;75(6):199-213)

Nutrition and Student Performance at School

This article reviews research from published studies on the association between nutrition among school-aged children and their performance in school and on tests of cognitive functioning. Each reviewed article is accompanied by a brief description of its research methodology and outcomes. Articles are separated into 4 categories: food insufficiency, iron deficiency and supplementation, deficiency and supplementation of micronutrients, and the importance of breakfast. Research shows that children with iron deficiencies sufficient to cause anemia are at a disadvantage academically. Their cognitive performance seems to improve with iron therapy. A similar association and improvement with therapy is not found with either zinc or iodine deficiency, according to the reviewed articles. There is no evidence that population-wide vitamin and mineral supplementation will lead to improved academic performance. Food insufficiency is a serious problem affecting children's ability to learn, but its relevance to US populations needs to be better understood. Research indicates that school breakfast programs seem to improve attendance rates and decrease tardiness. Among severely undernourished populations, school breakfast programs seem to improve academic performance and cognitive functioning.

Urinary cortisol and muscle mass in Turkana men

To determine the role of cortisol in modulating the effects of energetics on muscle mass in a subsistence society, measures of cortisol and body composition were obtained from a sample of Turkana men. Subjects were 63 settled and 69 nomadic men, ages 24 and older. Urinary cortisol was determined along with measures of muscle mass. Cortisol/creatinine ratio was higher among nomadic men (57.8 +/- 56.8 vs. 34.5 +/- 44.6; P < 0.001). Controlled for age, urinary cortisol was inversely related to arm muscle plus bone area (MPBA) among the nomadic (beta = -0.28; P = 0.04), but not the settled (beta = -0.04; P = 0.78) sample. Urinary cortisol was not related to any other measures of body composition. These results suggest that even in chronically undernourished populations, cortisol may be elevated primarily under conditions of acute nutritional stress. However, the catabolic effects of cortisol on muscle in our results may be confounded by other energetic factors, including energy availability.

Comparison of Linear Growth Patterns in the First Three Years of Life Across Two Generations in Guatemala

The secular increase in height is assumed to result from long-term improvements in nutritional intakes and reductions in infectious disease burdens. Nutritional supplementation in early life reduces stunting in chronically undernourished populations. It is not known whether these improvements have an impact on the growth of subsequent generations. Our objective was to estimate the intergenerational effect on offspring length of improved nutrition in the mother's early childhood. We studied 283 mother-child pairs (mothers born 1969-1977; children born 1996-1999). The mothers had received nutritional supplementation--either atole (enhanced protein-energy) or fresco (moderate energy, no protein), with both containing vitamins and minerals--prenatally and up to age 7 y as part of a community trial conducted in 4 villages in Guatemala. Length was measured on repeated occasions to 36 months of age in both mothers and children. Growth was modeled as a fractional polynomial. Children grew faster than their mothers. Children of mothers who received atole grew faster than children of women who received fresco. In both groups, lengths of individual children were positively correlated with lengths of their own mothers at the same ages. Correlations were generally stronger when the mothers had received atole in early life. We have confirmed a secular trend in growth of children in a developing country setting. The rate of child growth reflects, in part, the growth pattern of the mother, including improvements to that pattern resulting from nutritional supplementation.

Kenyan School Children Have Multiple Micronutrient Deficiencies, but Increased Plasma Vitamin B-12 Is the Only Detectable Micronutrient Response to Meat or Milk Supplementation

Animal source foods (ASF) can provide micronutrients in greater amounts and more bioavailable forms compared to plant source foods, but their intake is low in many poor populations. However, the impact of ASF on micronutrient status of undernourished populations has not been assessed. Supplemental meat (60-85 g/d), milk (200-250 mL/d) or energy (isocaloric with the meat and milk, 240-300 kcal/d) were randomly assigned to 555 undernourished school children aged 5-14 y in a rural malaria-endemic area of Kenya, at one school meal daily for one school year. Blood and stool samples were collected at baseline and after 1 y to assess stool parasites, malaria, hemoglobin, serum or plasma C-reactive protein, ferritin, iron, zinc, copper, vitamin B-12, folate and retinol, and erythrocyte riboflavin. At baseline, there was a high prevalence of micronutrient deficiencies (iron, zinc, vitamins A and B-12 and riboflavin), yet plasma ferritin was low in few children, and none had low serum copper. At the end of the year of supplementation, plasma vitamin B-12 concentrations were significantly increased in children fed the Meat or Milk meal; prevalence of severe plus moderate deficiency fell from 80.7% at baseline to 64.1% in the Meat group and from 71.6 to 45.1% in the Milk group, respectively. No significant improvement was observed in the status of other micronutrients compared to the Energy and Control groups, although malaria and other infections may have obscured effects. Supplementation with small amounts of meat or milk reduced the high prevalence of vitamin B-12 deficiency in these children.

Prospective study of protein-energy supplementation early in life and of growth in the subsequent generation in Guatemala

The secular increase in height is assumed to result from long-term improvements in nutritional intakes and reductions in infectious disease burdens. Nutritional supplementation in early life reduces stunting in chronically undernourished populations. It is unknown whether these improvements can be transmitted to subsequent generations. Our objective was to estimate the intergenerational effect on offspring length of improved nutrition in the mother's childhood. We studied 263 children born in 1996-1999 to 231 women who had received nutritional supplementation, ie, atole (high-protein, moderate-energy drink) or fresco (nonprotein, low-energy drink), prenatally and up to age 7 y as part of a community trial in Guatemala between 1969 and 1977. Child length was measured at different times to age 36 mo. Children born to women who received the enhanced supplement were taller (age-adjusted difference: 0.80 cm; 95% CI: 0.16, 1.44 cm) than were children whose mothers received the low-energy supplement. This increment was independent of the children's birth weight or socioeconomic status but was substantially attenuated and no longer significant after adjustment for maternal height (adjusted difference: 0.43 cm; 95% CI: -0.10, 0.96 cm; P > 0.10). The effect of maternal nutritional supplementation was more pronounced in boys than in girls (P for interaction < 0.10) and in children born to women who received supplements at ages 3-7 y than in children born to women who received supplements at ages 0-3 y (P for interaction < 0.01). Nutritional supplementation in childhood has positive effects on both the supplemented persons and on the subsequent generation.

Reduced rate of fat oxidation: a metabolic pathway to obesity in the developing nations.

The purpose of this article is to document the metabolic and environmental factors associated with the increased frequency of obesity in the developing nations. While the prevalence of obesity in the developed countries is caused by the increased consumption of calorie-dense foods, in the developing nations, because obesity coexists with undernutrition, additional factors are necessary to account for it. The evidence suggests that an important contributing factor for obesity in the developing nations is a reduced fat oxidation and increased metabolism of carbohydrate that has been brought about by the chronic undernutrition experienced during prenatal and postnatal growth. This shift toward a preferential metabolic use of carbohydrate rather than of fat results in an increased deposition of body fat. This tendency, along with the general decrease of energy expenditure in physical activity associated with urbanization, and the culturally mediated acceptance of fatness leads to obesity among populations from the developing nations. A joint effect of these factors is that in the developing nations obesity is associated with short stature resulting from developmental undernutrition, while in the developed countries obesity is associated with tall stature. It is hoped that future research will address the mechanisms whereby undernutrition increases the tendency toward obesity. Understanding how to modify fat oxidation could affect our ability to prevent weight gain among undernourished populations of the developing nations. Therefore, future research on the interaction of undernutrition and the development of obesity is of prime importance for anthropology concerned with the origins of human variability.

Differences in stunting prevalences calculated from two similar growth references may be large and inconsistent in undernourished children

Background : In 2000, the US Centers for Disease Control and Prevention (CDC) released a set of growth references that address limitations of the internationally recommended 1977 National Center for Health Statistics (NCHS) references. Aim : This study compares length-for-age Z -scores (LA Z -scores), height-for-age Z -scores (HA Z -scores), and age-specific stunting prevalences of undernourished children using the 1977 NCHS versus the 2000 CDC references. Subjects and methods : Data come from > 2000 children from the Cebu Longitudinal Health and Nutrition Study in the Philippines. Anthropometric data were collected bimonthly from birth to 2 years, at 8.5 and 11.5 years, and at 15 years in girls and 16 years in boys. Z -scores and stunting prevalences are compared between references. Results : LA Z -scores were generally lower using the 1977 references, and stunting prevalences were higher from 0 to 2 years, with some crossover. Differences in HA Z -scores after 8.5 years of age were inconsistent in both direction and magnitude by reference and sex, with additional crossover. Conclusions : When applied to an undernourished population, the two references in question perform differently, with inconsistencies in direction and magnitude of Z -scores and stunting prevalences. The 2000 CDC growth references are clearly an improved tool. However, there are challenges inherent in switching to a new reference that will require the attention of researchers and field workers.

The history of folic acid.

The history of folic acid.

Double blind, cluster randomised trial of low dose supplementation with vitamin A or βcarotene on mortality related to pregnancy in Nepal

Objective: To assess the impact on mortality related to pregnancy of supplementing women of reproductive age each week with a recommended dietary allowance of vitamin A, either preformed or as...

Nutrition and education: a randomized trial of the effects of breakfast in rural primary school children

Hunger during school may prevent children in developing countries from benefiting from education. Although many countries have implemented school feeding programs, few programs have been rigorously evaluated. We conducted a randomized, controlled trial of giving breakfast to undernourished and adequately nourished children. The undernourished group comprised 407 children in grades 2–5 in 16 rural Jamaican schools (weights-for-age ≤ ―1 SD of the National Center for Health Statistics references) and the adequately nourished group comprised 407 children matched for school and class (weights-for-age > ― 1 SD). Both groups were stratified by class and school, then randomly assigned to breakfast or control groups. After the initial measurements, breakfast was provided every school day for 1 school year. Children in the control group were given one-quarter of an orange and the same amount of attention as children in the breakfast group. All children had their heights and weights measured and were given the Wide Range Achievement Test before and after the intervention. School attendance was taken from the schools’ registers. Compared with the control group, height, weight, and attendance improved significantly in the breakfast group. Both groups made poor progress in Wide Range Achievement Test scores. Younger children in the breakfast group improved in arithmetic. There was no effect of nutritional group on the response to breakfast. In conclusion, the provision of a school breakfast produced small benefits in children’s nutritional status, school attendance, and achievement. Greater improvements may occur in more undernourished populations; however, the massive problem of poor achievement levels requires integrated programs including health and educational inputs as well as school meals. Am J Clin Nutr 1998;68:873–9

The interface of nutrition and dentition.

Gross undernutrition in children retards deciduous dental eruption. High fluoride consumption adds to the delay, Exfoliation of teeth is delayed in high fluoride areas. Fluoride has adverse effects on teeth and produces mottling changes and abnormal teeth. Bailey’s formula is not accurate in assessing ages of children in undernourished populations.