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Kundu RN, Gautam RK, Chatterjee A, Bharati P, Liczbińska G, Malina RM. Nutritional status of infants and young children in India across three decades: Analysis of five national family health surveys. Eur J Clin Nutr 2024; 78:591-606. [PMID: 38467858 DOI: 10.1038/s41430-024-01427-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Three indicators of early childhood undernutrition and associated factors are evaluated among under-5 children in five National Family Health Surveys in India spanning 1992 to 2021. METHODS Data for 533,495 children under 5 years of age (U-5) were analysed in the context of three commonly used indicators of early childhood undernutrition - wasting, stunting and underweight. In addition to descriptive and inferential statistics, binary logistic regression was used to estimate the effects of specific explanatory factors on the three indicators using adjusted odds ratios. RESULTS Over the three-decade interval, stunting was reduced by 22.1% in boys and 20.9% in girls, followed by underweight, 19.3% in boys and 17.4% in girls; wasting, in contrast, was reduced to a considerably lesser extent, 2.8% in boys and 0.9% in girls. Demographic, maternal and socioeconomic factors were associated with the incidence of early childhood undernutrition, specifically among young mothers and those with less education in low-income families, and among children from Scheduled Tribes or Scheduled Castes. Stunting and underweight declined significantly over the past three decades while wasting changed negligibly. The disparity in the occurrence of early childhood undernutrition was apparent throughout socioeconomic categories and regions of India. CONCLUSIONS The results highlight the need for special programs aimed at reducing waste among children and also the need for customized initiatives focused on the improvement of maternal education and wealth in addition to other ancillary factors related to regional variation.
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Affiliation(s)
- Ramendra Nath Kundu
- Department of Anthropology, West Bengal State University, Kolkata, 700126, West Bengal, India
| | - Rajesh K Gautam
- Department of Anthropology, Dr. Harisingh Gour Vishwavidyalaya (A Central University), Sagar, Madhya Pradesh, India
| | - Arna Chatterjee
- Department of Anthropology, West Bengal State University, Kolkata, 700126, West Bengal, India
| | - Premananda Bharati
- Biological Anthropology Unit, Indian Statistical Institute, Kolkata, India
| | - Grażyna Liczbińska
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Poznań, Poland.
| | - Robert M Malina
- Professor Emeritus, Department of Kinesiology and Health Education, University of Texas, Austin, TX, 78705, USA
- Adjunct Professor, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
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Dos Reis Araujo T, Alves BL, Dos Santos LMB, Gonçalves LM, Carneiro EM. Association between protein undernutrition and diabetes: Molecular implications in the reduction of insulin secretion. Rev Endocr Metab Disord 2024; 25:259-278. [PMID: 38048021 DOI: 10.1007/s11154-023-09856-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
Undernutrition is still a recurring nutritional problem in low and middle-income countries. It is directly associated with the social and economic sphere, but it can also negatively impact the health of the population. In this sense, it is believed that undernourished individuals may be more susceptible to the development of non-communicable diseases, such as diabetes mellitus, throughout life. This hypothesis was postulated and confirmed until today by several studies that demonstrate that experimental models submitted to protein undernutrition present alterations in glycemic homeostasis linked, in part, to the reduction of insulin secretion. Therefore, understanding the changes that lead to a reduction in the secretion of this hormone is essential to prevent the development of diabetes in undernourished individuals. This narrative review aims to describe the main molecular changes already characterized in pancreatic β cells that will contribute to the reduction of insulin secretion in protein undernutrition. So, it will provide new perspectives and targets for postulation and action of therapeutic strategies to improve glycemic homeostasis during this nutritional deficiency.
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Affiliation(s)
- Thiago Dos Reis Araujo
- Obesity and Comorbidities Research Center (OCRC), Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Carl Von Linnaeus Bloco Z, Campinas, SP, Cep: 13083-864, Brazil
| | - Bruna Lourençoni Alves
- Obesity and Comorbidities Research Center (OCRC), Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Carl Von Linnaeus Bloco Z, Campinas, SP, Cep: 13083-864, Brazil
| | - Lohanna Monali Barreto Dos Santos
- Obesity and Comorbidities Research Center (OCRC), Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Carl Von Linnaeus Bloco Z, Campinas, SP, Cep: 13083-864, Brazil
| | - Luciana Mateus Gonçalves
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Everardo Magalhães Carneiro
- Obesity and Comorbidities Research Center (OCRC), Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Carl Von Linnaeus Bloco Z, Campinas, SP, Cep: 13083-864, Brazil.
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Caffarelli C, Santamaria F, Piro E, Basilicata S, Delle Cave V, Cipullo M, Bernasconi S, Corsello G. New insights in pediatrics in 2021: choices in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine. Ital J Pediatr 2022; 48:189. [PMID: 36435791 PMCID: PMC9701393 DOI: 10.1186/s13052-022-01374-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/25/2022] [Indexed: 11/28/2022] Open
Abstract
In this review, we report the developments across pediatric subspecialties that have been published in the Italian Journal of Pediatrics in 2021. We highlight advances in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, hematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine.
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Affiliation(s)
- Carlo Caffarelli
- Department of Medicine and Surgery, Clinica Pediatrica, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci 14, Parma, Italy.
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Ettore Piro
- Department of Sciences for Health Promotion and Mother and Child Care G. D'Alessandro, University of Palermo, Palermo, Italy
| | - Simona Basilicata
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Valeria Delle Cave
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Marilena Cipullo
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | | | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care G. D'Alessandro, University of Palermo, Palermo, Italy
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Lontchi-Yimagou E, Anoop S, Kurian ME, Ye K, Kehlenbrink S, Thomas N, Hawkins M. Response to Comment on Lontchi-Yimagou et al. An Atypical Form of Diabetes Among Individuals With Low BMI. Diabetes Care 2022;45:1428-1437. Diabetes Care 2022; 45:e159-e160. [PMID: 36318676 PMCID: PMC9679258 DOI: 10.2337/dci22-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | - Shajith Anoop
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Vellore, India
| | - Mathews Edatharayil Kurian
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Vellore, India
| | - Kenny Ye
- Albert Einstein College of Medicine, Bronx, NY
| | - Sylvia Kehlenbrink
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, MA
| | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Vellore, India
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Ahmed S, PrayGod G, R. Lee N, Kelly P, Trilok-Kumar G, Chisenga M, Kweka B, Faurholt-Jepsen D, Krogh-Madsen R, AM Shaw J, M. Paglinawan-Modoc D, Solon J, Frahm Olsen M, Stefanovski D, Cox S, Nitsch D, Keogh R, Filteau S. Long-term health after Severe Acute Malnutrition in children and adults- the role of the Pancreas (SAMPA): Protocol. F1000Res 2022; 11:777. [PMID: 36300035 PMCID: PMC9577280 DOI: 10.12688/f1000research.123389.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 01/13/2023] Open
Abstract
Background: Prenatal growth retardation may increase the risk of later chronic non-communicable diseases (NCDs), including diabetes; however, long-term effects of wasting malnutrition in childhood or adulthood are less studied. Pancreatic exocrine and endocrine functions, both critical for nutrition and NCD aetiology, may not fully recover following malnutrition. However, the evidence and mechanistic information is piecemeal. We hypothesise that wasting malnutrition at any age has long-term detrimental effects on endocrine and exocrine pancreatic structure and function. Methods: The SAMPA international research programme will assess pancreatic structure and function in 3700 participants from ongoing observational nutrition cohorts, two adolescent and four adult, in Zambia, Tanzania, Philippines, and India. Pancreas size, structure, and calcification will be assessed by ultrasound and computed tomography (CT) scan; exocrine function by faecal elastase and serum lipase; and endocrine function by haemoglobin A1c (HbA1c) and blood glucose, insulin and C-peptide concentrations during an oral glucose tolerance test (OGTT). In-depth hormonal analyses of incretins, glucagon, proinsulin and trypsinogen during OGTT and intravenous glucose tolerance tests will be done in subsets of adult participants. Pancreatic size and function outcomes will be compared between people with and without prior wasting malnutrition. Analyses will investigate effect modification by sex, current age, time since malnutrition, current body mass index and dietary patterns. Mathematical modelling of OGTT data will be used to estimate the relative contribution to glucose dysregulation of decreased insulin production, changes in insulin clearance and increased insulin resistance. Proinsulin/insulin ratio will be analysed in archived samples from the Tanzanian cohort using a nested case-control design to investigate whether abnormal values precede diabetes. Conclusions: SAMPA, a large-scale multi-centre research programme using data from people with or without prior wasting malnutrition to assess several aspects of pancreatic phenotype, will provide coherent evidence for future policies and programmes for malnutrition and diabetes.
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Affiliation(s)
- Sana Ahmed
- Institute of Home Economics, University of Delhi, Delhi, 110016, India,
| | - George PrayGod
- National Institute for Medical Research, Mwanza, Tanzania
| | - Nanette R. Lee
- USC-Office of Population Studies Foundation, Inc., University of San Carlos, Populations Studies Foundation, Cebu City, 6000, Philippines
| | - Paul Kelly
- University Teaching Hospital, Lusaka, Zambia,Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Geeta Trilok-Kumar
- Institute of Home Economics, University of Delhi, Delhi, 110016, India,Delhi School of Public Health, Institution of Eminence, University of Delhi, Delhi, 110007, India
| | | | - Belinda Kweka
- National Institute for Medical Research, Mwanza, Tanzania
| | | | - Rikke Krogh-Madsen
- Centre for Physical Activity Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark,Department of Infectious Diseases, Copenhagen University Hospital, Amager and Hvidovre, Hvidovre, Denmark
| | - James AM Shaw
- Translational and Clinical Research Institute, Newcastle University, The Medical School, Framlington Place, Newcastle-upon-Tyne, UK
| | | | - Juan Solon
- Nutrition Center of the Philippines, Muntinlupa City, Manila, Philippines
| | - Mette Frahm Olsen
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, 2100, Denmark,Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, 1017, Denmark
| | - Darko Stefanovski
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Philadelphia, USA
| | - Sharon Cox
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Dorothea Nitsch
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Ruth Keogh
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
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