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Pavlidou E, Papadopoulou SK, Alexatou O, Voulgaridou G, Mentzelou M, Biskanaki F, Psara E, Tsourouflis G, Lefantzis N, Dimoliani S, Apostolou T, Sampani A, Chatziprodromidou IP, Angelakou EP, Giaginis C. Childhood Mediterranean Diet Adherence Is Associated with Lower Prevalence of Childhood Obesity, Specific Sociodemographic, and Lifestyle Factors: A Cross-Sectional Study in Pre-School Children. EPIDEMIOLOGIA 2023; 5:11-28. [PMID: 38247997 PMCID: PMC10801514 DOI: 10.3390/epidemiologia5010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The Mediterranean diet (MD) has been related with a decreased probability of overweight/obesity as well as central obesity at all stages of the human life, decreasing the risk of diverse disease states and improving quality of life. Over the last few years, the prevalence of childhood overweight/obesity and especially abdominal obesity has highly increased worldwide, being associated with a higher likelihood of overweight/obesity as well as central obesity at the next stages of the life during adulthood. The purpose of the present study was to explore the relationship of MD compliance with sociodemographic, anthropometry and lifestyle features in pre-school children aged 2-5 years old. METHODS This is a cross-sectional study, which includes 5188 pre-school children from diverse regions of Greece. Relevant questionnaires were applied to evaluate the sociodemographic features of the enrolled children. Anthropometric parameters were measured by relevant techniques. Qualified questionnaires were utilized for assessing several lifestyle factors such as physical activity, quality of life, breastfeeding practices, MD adherence, as well as the prevalence of childhood asthma and diabetes mellitus type I. RESULTS Of the enrolled children, 41.7% showed low MD compliance and 36.4% of them indicated moderated compliance, while only 21.9% of them showed a high MD adherence. Overweight/obesity was noted in 24.2% of the assigned children, while abdominal obesity was noticed in 18.2% of them. Higher MD compliance was related with an elevated prevalence of sex (boys, p = 0.0005), Greek nationality (p = 0.0088), rural type of residence (p = 0.0099), childhood overweight/obesity (p < 0.0001) and abdominal obesity (p < 0.0001), lower childbirth weight (p < 0.0001), increased physical activity (p = 0.0041), improved quality of life (p = 0.0008), exclusive breastfeeding (p < 0.0001), childhood asthma (p = 0.0001) and diabetes mellitus type 1 (p = 0.0002). CONCLUSIONS A higher MD adherence is associated with specific sociodemographic, better anthropometric, and beneficial lifestyle factors in pre-school children. However, MD compliance remains low or moderate in the vast majority of children aged 2-5 years old. Thus, future public strategies and policies should be performed to inform parents of the potential beneficial effects of MD against obesity and related chronic diseases at the next stage of their children's lives.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | | | - Evmorfia Psara
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece;
| | - Nikos Lefantzis
- Department of Oral and Maxillofacial Surgery, Medical School, Attikon Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Sophia Dimoliani
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Thomas Apostolou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527 Athens, Greece;
| | | | - Exakousti-Petroula Angelakou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
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Hossain MS, Raheem E, Okely AD. 24-hour movement guidelines and weight status among preschool-aged children in Bangladesh: A community-level cross-sectional study. Brain Behav 2023; 13:e3094. [PMID: 37248817 PMCID: PMC10338773 DOI: 10.1002/brb3.3094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 04/29/2023] [Accepted: 05/15/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Increasing levels of urbanization and digitization in Bangladesh may be adversely associated with children's weight status and related movement behaviors. This study examined the prevalence of obesity, physical activity (PA), sedentary behavior, and sleep among young children from a district town in northern Bangladesh and identified factors associated with unhealthy weight status. METHODS Population-based cross-sectional study involving all kindergarten schools in Jamalpur District town. Schools and children aged 4-7 years were randomly selected and had their weight and height measured. Mothers completed a questionnaire on their child's PA, recreational screen time, and sleep and sociodemographic factors. Children's weight status was based on World Health Organization (WHO) categories. Meeting the PA recommendation was based on the WHO guidelines for children and adolescents, and meeting the sedentary behavior and sleep recommendations was based on the Canadian/Australian 24-hour movement guidelines for children and young people. RESULTS A total of 585 children and their parents were included in the study. Overall, 15% of children were overweight or obese. Three-quarters of children met the sleep guideline, and 50% met the PA guideline. Less than one third of children (31%) met the recreational screen time guideline, whereas 15% met all three guidelines. However, when adjusted for all predictors in the model, maternal education, family income, and child's age were significantly associated with overweight/obesity. Children with higher maternal education level were 2.3 times (AOR = 2.33, 95% CI: 1.19-4.78) more likely to be overweight/obese. Children in families with a higher monthly income had 1.9 times (AOR = 1.95, 95% CI: 1.14, 3.35) higher risk of being overweight/obese. CONCLUSIONS Prioritizing maternal education (mother-centric interventions) can help address the high levels of childhood obesity in Bangladesh.
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Affiliation(s)
- Mohammad Sorowar Hossain
- Department of Emerging and Neglected DiseasesBiomedical Research FoundationDhakaBangladesh
- School of Environment and Life SciencesIndependent UniversityDhakaBangladesh
| | - Enayetur Raheem
- Department of Digital HealthBiomedical Research FoundationDhakaBangladesh
| | - Anthony D Okely
- School of Health and SocietyUniversity of WollongongWollongongNew South WalesAustralia
- Illawarra Health and Medical Research InstituteWollongongAustralia
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Handayani NS, Huriyati E, Hasanbasri M. Association of Maternal Education With Nutritional Outcomes of Poor Children With Stunting in Indonesia. Asia Pac J Public Health 2023; 35:373-380. [PMID: 37415330 DOI: 10.1177/10105395231185980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
The consequences of poverty and food insecurity can indirectly contribute to obesity. Long-term effect of stunting children may be the risk factor for overweight and obesity in the poor in Indonesia. The role of parental education is also associated with overweight and obesity in children. This study aimed to observe the risk of stunted children becoming overweight and obese based on maternal education among poor people in Indonesia. This study involved three cohorts design. Cohort 1 is a 14-year cohort, and two 7-year cohorts for cohorts 2 and 3. We used secondary longitudinal data from Indonesian Family Life Survey (IFLS) 3 (2000), IFLS 4 (2007), and IFLS 5 (2014). After stratification by high maternal education and economic status of the family, there is an increased risk of stunting children becoming overweight and obese, with a risk ratio of 2 in cohort 1 and 1.69 in cohort 2. These results showed that stunted children with high-education mothers and lived in the low-income families have a 1.69 to 2 times higher risk of becoming overweight and obese. Thus, the importance of primary education and health education for women to increase children's health in the future.
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Affiliation(s)
- Nur Septia Handayani
- Department of Health, Faculty of Vocational Studies, Universitas Airlangga, Surabaya, Indonesia
| | - Emy Huriyati
- Department of Nutrition and Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mubasysyir Hasanbasri
- Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Fouad HM, Yousef A, Afifi A, Ghandour AA, Elshahawy A, Elkhawass A, Hawees H, Shaheen E, Alaaeldin M, Kamal M, Bastawy S, Rabie S, Wissa F, Shalaby S. Prevalence of malnutrition & anemia in preschool children; a single center study. Ital J Pediatr 2023; 49:75. [PMID: 37322509 DOI: 10.1186/s13052-023-01476-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Malnutrition including undernutrition, overnutrition, and micronutrient deficiencies are considerable problems worldwide, with variable burdens among different communities. Its complications include physical and cognitive impairment, with the probability of irreversible lifelong consequences. We aimed to assess the prevalence of undernutrition, overweight, obesity, and anemia in preschoolers, being a risk group for developmental adverse events. METHODS We recruited 505 healthy preschool children, with a male: female ratio of 1.05:1. Children with chronic diseases were excluded. We used anthropometry and complete blood count to screen for malnutrition and anemia. RESULTS The mean age of the study group was 3.8 ± 1.4 years (1.02-7). The screening results were average in 228 (45.1%) children, while 277 (54.9%) children had either abnormal anthropometry, anemia, or both. We observed undernutrition in 48 (9.5%) children; among them, 33 (6.6%) were underweight, 33 (6.6%) wasted, and 15 (3%) were stunted, with no significant difference between children aged below or above five. We identified overnutrition in 125 (24.8%); 43 (8.5%) were overweight, 12 (2.4%) were obese, and 70 (13.9%) had a high body mass index Z score, not qualifying the definition of overweight. Anemia was diagnosed in 141 (27.9%) children and was significantly more frequent among older children without gender discrimination. About 10% (50 children) had both anemia and abnormal anthropometry. The frequency of abnormal anthropometry was comparable between children with anemia and those with normal hemoglobin. CONCLUSION Malnutrition and anemia in preschoolers are still a heavy burden affecting about half of our study group, with an upward trend towards the overnutrition side. Anemia is still a moderate public health problem in preschoolers.
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Affiliation(s)
- Hanan Mina Fouad
- Pediatrics Department, Helwan University, Cairo, Egypt.
- National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
| | - Aly Yousef
- Pediatrics Department, Helwan University, Cairo, Egypt
| | - Ahmed Afifi
- Pediatrics Department, Helwan University, Cairo, Egypt
| | - Ahmed A Ghandour
- Community, Environmental and Occupational Medicine Department, Helwan University, Cairo, Egypt
| | - Amira Elshahawy
- Pediatric Department, the National Nutrition Institute, General Organization of Teaching Hospitals, Ministry of Health, Cairo, Egypt
| | | | - Hazem Hawees
- Intern in Helwan University Hospital, Cairo, Egypt
| | - Eman Shaheen
- Clinical and chemical Pathology Department, Helwan University, Cairo, Egypt
| | | | - Mostafa Kamal
- Clinical and chemical Pathology Department, Helwan University, Cairo, Egypt
| | - Samah Bastawy
- Clinical and chemical Pathology Department, Helwan University, Cairo, Egypt
| | - Samah Rabie
- Psychiatry Department, Helwan University, Cairo, Egypt
| | - Farah Wissa
- Intern in Helwan University Hospital, Cairo, Egypt
| | - Sherine Shalaby
- Pediatrics Department, Helwan University, Cairo, Egypt
- Pediatrics Department, Suez Canal University, Ismailia, Egypt
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Overweight and obesity in preschool children in Turkey: A multilevel analysis. J Biosoc Sci 2023; 55:344-366. [PMID: 35086578 DOI: 10.1017/s0021932022000025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Childhood obesity/overweight is a worldwide concern and its prevalence is increasing in many countries. The first aim of this study is to analyse the trends in overweight and obesity among children under the age of five in Turkey based on the new World Health Organization (WHO) standards, using data from the 'five-round of the Turkey Demographic and Health Surveys' (TDHSs). The second aim is to examine whether or not the maternal/household and individual-level factors are associated with overweight/obesity using TDHS 2003, 2008, and 2013 datasets. A total sample of 14,231 children under the age of five were extracted from the TDHS in 1993, 1998, 2003, 2008, and 2013 to determine the prevalence of the trend. Pooled data from 8,812 children were included in the analysis to examine factors associated with overweight/obesity. Taking into account the clustered data structure, multilevel logistic regression models were utilised. In 1993, 1998, 2003, 2008, and 2013 the prevalence of overweight children was 5.3%, 4.9%, 10.0%, 11% and 11.6%, respectively. The factors that were independently associated with overweight/obesity were as follows: living in single-parent households (adjusted odds ratio (aOR) = 2.27, 95%CI = 1.21-4.26), compared to living in dual-parent households; having an obese mother (aOR = 4.25, 95%CI = 1.73-10.44), overweight mother (aOR = 3.15, 95%CI = 1.29-7.69), and a normal-weight mother (aOR = 2.70, 95%CI = 1.11-6.59) compared to having an underweight mother; being aged between 13-24 months (aOR = 1.72, 95%CI = 1.30 to 2.27), compared to being aged 0-12 months; male gender (aOR = 1.30, 95%CI = 1.11 to 1.53); being stunted (aOR = 2.18, 95%CI = 1.74 to 2.73); high birth weight (aOR = 1.55, 95%CI = 1.08 to 2.23) compared to low birth weight. In addition, overweight was higher in children of mothers who had completed primary school (aOR = 1.21, 95%CI = 1.01 to 1.59) than children of mothers who had not completed primary school. These findings reveal that, over the years, there has been a substantial increase in obesity/overweight among children which demonstrates the importance of evaluating the overweight indicators at the maternal/household level.
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Mulu A, Neupane S. The Association of Maternal BMI with Overweight among Children Aged 0-59 Months in Kenya: A Nationwide Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1413. [PMID: 36674176 PMCID: PMC9859472 DOI: 10.3390/ijerph20021413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Childhood overweight is a growing global public health challenge and is prevalent in many countries. We aimed at exploring the prevalence of childhood overweight and the association of maternal body mass index (BMI), maternal demographic factors, and child-related factors with childhood overweight among Kenyan children aged 0-59 months. This study utilized Kenya's 2014 demographic and health survey, which was based on national representative cross-sectional data. A total of 8316 children and their mothers' data were analyzed. Overweight in children and maternal BMI were defined using WHO standard criteria. Multivariate logistics regression models were used to study the association of maternal BMI and childhood overweight. Nationally 5% of Kenyan children aged 0-59 months are overweight (5.5% male vs. 3.8% female). The highest prevalence in overweight among children was found in Central region (6.9%) and lowest in North Eastern (3.1%) which could be explained by the various economic disparities. Maternal BMI with underweight was associated with lower odds (OR 0.30, 95% CI 0.14-0.64) whereas, overweight and obesity were associated with higher odds of overweight (OR for overweight 1.64, 95% CI 1.28-2.11 and OR for obesity 1.74, 95% CI 1.22-2.47) among their children compared to normal weight mothers. Overweight among children is of great concern and therefore initiatives to tackle both child and maternal health are urgently needed.
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Affiliation(s)
| | - Subas Neupane
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, 33100 Tampere, Finland
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Metwally AM, Sallam SF, Mawla MAA, Alian KM, Abdel-Latif GA, Hasanin HM, Kamal AN, Hanna C, Shebini SME, Ahmed NH, Mabrok HB, Mahmoud MH, Ismail AS, Boseila SAW, El-Alameey IR, Mahfouz NN, Shaaban FA, Ibrahim NA, Hassan NE, El-Masry SA, Naga MM, Khalil A. Promoting weaning practices and growth of Egyptian infants by using communication for behavioral development approach. BMC Pediatr 2022; 22:689. [DOI: https:/doi.org/10.1186/s12887-022-03741-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/10/2022] [Indexed: 10/31/2023] Open
Abstract
AbstractBackgroundAccess to various affordable and nutritious foods is considered a challenging factor for households with limited resources affecting the proper weaning practices. In order to motivate communities to adhere to the right and proper weaning practices, the social aspect should be considered through close communication with the targeted communities. This study aimed to evaluate how impactful the use of the principles of Communication for Development (C4D) that respect parents’ beliefs and their cultural norms is in improving the weaning practices and growth of infants in an Egyptian village.MethodsAn interventional three-phase study was conducted for three years. The intervention targeted 464 mothers of infants up to 2 years of age. C4D interventions encouraged each mother to provide her baby with nutritious and varied options through age-appropriate introduction and diversification of nutrient-rich complementary foods under the slogan “ enjoy meals like a baby”. The effectiveness of the approach was measured by five essential weaning practices: Introduction of solid, semi-solid, or soft foods, Minimum dietary diversity, minimum meal frequency, Minimum acceptable diet, and consumption of iron-rich foods.ResultsThere was marked and significant improvement in the awareness and of the majority of the weaning practices’ indicators as a result of the interventions. This was noticed for the timely introduction of complementary foods which increased from 36.7% to 82.0%, the minimum meal frequency indicator (3–5) which increased from 25.3% to 67.3%, iron-rich or fortified food (68.0% to 82%) as well as a regular checkup for baby health at the health unit (71.3%). Indicators that were improved but failed to achieve the target were the “Minimum Dietary Diversity” (reached 32%) and the minimum acceptable diet (reached 22.0%). A significant effect on linear growth especially for females is evidenced by the remarkable decrease in wasting (from 31.5% to 11.1%) and obesity (from 12.0% to 0%) associated with a considerable decrease in underweight (from 40% to 16.7%).ConclusionTargeting caregivers through the C4D approach have succeeded in providing them with the support required for the provision of adequate nutrition for their infants that had significantly marked improvement in growth indices of their infants.
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Metwally AM, Sallam SF, Mawla MAA, Alian KM, Abdel-Latif GA, Hasanin HM, Kamal AN, Hanna C, Shebini SME, Ahmed NH, Mabrok HB, Mahmoud MH, Ismail AS, Boseila SAW, El-Alameey IR, Mahfouz NN, Shaaban FA, Ibrahim NA, Hassan NE, El-Masry SA, Naga MM, Khalil A. Promoting weaning practices and growth of Egyptian infants by using communication for behavioral development approach. BMC Pediatr 2022; 22:689. [PMID: 36456920 PMCID: PMC9713754 DOI: 10.1186/s12887-022-03741-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Access to various affordable and nutritious foods is considered a challenging factor for households with limited resources affecting the proper weaning practices. In order to motivate communities to adhere to the right and proper weaning practices, the social aspect should be considered through close communication with the targeted communities. This study aimed to evaluate how impactful the use of the principles of Communication for Development (C4D) that respect parents' beliefs and their cultural norms is in improving the weaning practices and growth of infants in an Egyptian village. METHODS An interventional three-phase study was conducted for three years. The intervention targeted 464 mothers of infants up to 2 years of age. C4D interventions encouraged each mother to provide her baby with nutritious and varied options through age-appropriate introduction and diversification of nutrient-rich complementary foods under the slogan " enjoy meals like a baby". The effectiveness of the approach was measured by five essential weaning practices: Introduction of solid, semi-solid, or soft foods, Minimum dietary diversity, minimum meal frequency, Minimum acceptable diet, and consumption of iron-rich foods. RESULTS There was marked and significant improvement in the awareness and of the majority of the weaning practices' indicators as a result of the interventions. This was noticed for the timely introduction of complementary foods which increased from 36.7% to 82.0%, the minimum meal frequency indicator (3-5) which increased from 25.3% to 67.3%, iron-rich or fortified food (68.0% to 82%) as well as a regular checkup for baby health at the health unit (71.3%). Indicators that were improved but failed to achieve the target were the "Minimum Dietary Diversity" (reached 32%) and the minimum acceptable diet (reached 22.0%). A significant effect on linear growth especially for females is evidenced by the remarkable decrease in wasting (from 31.5% to 11.1%) and obesity (from 12.0% to 0%) associated with a considerable decrease in underweight (from 40% to 16.7%). CONCLUSION Targeting caregivers through the C4D approach have succeeded in providing them with the support required for the provision of adequate nutrition for their infants that had significantly marked improvement in growth indices of their infants.
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Affiliation(s)
- Ammal M. Metwally
- grid.419725.c0000 0001 2151 8157Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Sara F. Sallam
- grid.419725.c0000 0001 2151 8157Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Mohamed A. Abdel Mawla
- grid.419725.c0000 0001 2151 8157Pediatrics Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Khadija M. Alian
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Ghada A. Abdel-Latif
- grid.419725.c0000 0001 2151 8157Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Hasanin M. Hasanin
- grid.419725.c0000 0001 2151 8157Pediatrics Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Ayat N. Kamal
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Carine Hanna
- grid.419725.c0000 0001 2151 8157Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Salwa M. El Shebini
- grid.419725.c0000 0001 2151 8157Nutrition and Food Science Department, Food Technology and Nutrition Research Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Nihad H. Ahmed
- grid.419725.c0000 0001 2151 8157Nutrition and Food Science Department, Food Technology and Nutrition Research Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Hoda B. Mabrok
- grid.419725.c0000 0001 2151 8157Nutrition and Food Science Department, Food Technology and Nutrition Research Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Maha H. Mahmoud
- grid.419725.c0000 0001 2151 8157Nutrition and Food Science Department, Food Technology and Nutrition Research Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Ahmed S. Ismail
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Samia A. W. Boseila
- grid.419725.c0000 0001 2151 8157Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Inas R. El-Alameey
- grid.419725.c0000 0001 2151 8157Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt ,Faculty of Applied Medical Sciences, Clinical Nutrition Department, Taibahu University, Almadina almunawara, Saudi Arabia
| | - Nermine N. Mahfouz
- grid.419725.c0000 0001 2151 8157Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Fatma A. Shaaban
- grid.419725.c0000 0001 2151 8157Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Nihad A. Ibrahim
- grid.419725.c0000 0001 2151 8157Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Nayera E. Hassan
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Sahar A. El-Masry
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Maie M. Naga
- grid.419725.c0000 0001 2151 8157Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Aya Khalil
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
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Pang M, Wang J, Jiang X, Li H, Li S, Kong F. The Effects of Living Environment, Health Status of Family Members, and Migrant Elderly following Children’s Attitude about Care on Grandchildren’s Health Status in Weifang, China. CHILDREN 2022; 9:children9091333. [PMID: 36138641 PMCID: PMC9497741 DOI: 10.3390/children9091333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/17/2022] [Accepted: 08/28/2022] [Indexed: 12/03/2022]
Abstract
As urbanization is growing quickly in China, many migrant elderly following children (MEFC) migrate to big cities to care for their grandchildren (grandchildren of MEFC=GMEFC). This study aimed to explore the effects of the living environment, health statuses of family members, and MEFC’s attitude regarding the care of their children (children of MEFC=CMEFC) for their GMEFC on GMEFC’s health statuses in Weifang, China. Multistage cluster random sampling was used to select the participants, and 613 MEFC were included in total. Descriptive analysis, univariate analysis and binary logistic regression were used to investigate the association between the related variables and GMEFC’s health statuses. It was found that 74.9% of the GMEFC had excellent health statuses. The GMEFC who had siblings, the CMEFC with excellent health statuses, and the MEFC with excellent health statuses were more likely to have excellent health statuses. Moreover, the GMEFC who were female, elevators occasionally malfunctioned, the MEFC who were dissatisfied with the CMEFC’s time spent on caring, and the MEFC who did not understand or forgive the CMEFC’s limited time on caring were less likely to have GMEFC with excellent health statuses. The results indicated that a better living environment, better health statuses of family members, and a positive attitude of the MEFC regarding the care of CMEFC for GMEFC would result in a better health status of GMEFC.
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Affiliation(s)
- Mingli Pang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Xiaoxu Jiang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Hexian Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Correspondence:
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Nutritional status of school children in the South Tongu District, Ghana. PLoS One 2022; 17:e0269718. [PMID: 36001627 PMCID: PMC9401153 DOI: 10.1371/journal.pone.0269718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 05/26/2022] [Indexed: 12/02/2022] Open
Abstract
Background Malnutrition is a major public health problem because of the devastating consequences it has on children, their families, and society at large. Our study, therefore, sought to determine the prevalence of undernutrition and overweight/obesity and its associated factors among children aged 6–12 in the South Tongu District, Ghana. Methods A school-based cross-sectional study was conducted among 423 school children aged 6–12 years in the South Tongu District of Ghana. A multistage sampling method was employed to recruit the school children for the study. A semi-structured questionnaire was used to collect data from the respondents. We used a dual-purpose (height and weight) measuring scale to obtain the anthropometric data. The World Health Organization’s AnthroPlus software was used to generate the z-scores for determining the nutritional status. Percentages were used to present the results of the prevalence of undernutrition and overweight/obesity among school children. Bivariate and multivariable binary logistic regression were used to examine the factors associated with undernutrition and overweight/obesity among school children. The results were presented as crude odds ratios (CORs) and adjusted odds ratios (AORs), with their 95% confidence interval (CI). Statistical significance was set at p<0.05. Stata 16.0 was used to perform the analyses. Results The overall prevalence of undernutrition and overweight/obesity were 21.5% (CI = 17.7, 25.7) and 24.8% (CI = 20.8, 29.2), respectively. Specifically, the prevalence of stunting, thinness, underweight, overweight, and obesity were 10.4%, 12.1%, 3.8%, 11.1%, and 13.7%, respectively. School children whose household used water from non-portable sources were more likely to be undernourished [AOR = 2.03, 95% CI = 1.13, 3.63]. The odds of overweight/obesity was higher among school children whose mothers had attained formal education [AOR = 2.10, 95% CI = 1.09, 4.06], those who consumed beverages between meals per day [AOR = 1.87, CI = 1.08, 3.24], and those who had adequate dietary diversity score [AOR = 1.65, 95% CI = 1.02, 2.67]. School children aged 10–12 were less likely to be overweight/obese [AOR = 0.58, 95% CI = 0.35, 0.94] compared to those aged 6–9. Conclusion The study showed a relatively high prevalence of undernutrition and overweight/obesity among school children in the South Tongu District. The identified risk factor(s) for undernutrition was the usage of water from non-potable sources whilst those of overweight/obesity were age (10–12 years), maternal formal education, beverage consumption between meals per day, and adequate dietary diversity. The findings reaffirm that malnutrition is still prevalent among school children. Hence, there is a need for the Ministry of Health, Ghana Education Service, and other Non-Governmental Organizations to pay critical attention to these factors to achieve the Sustainable Development Goal 2, target 2.2. Nutritional behavioural change education should be carried out among parents and school children. School health service activities should be intensified with a special focus on nutritional screening.
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11
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Kwansa AL, Akparibo R, Cecil JE, Infield Solar G, Caton SJ. Risk Factors for Overweight and Obesity within the Home Environment of Preschool Children in Sub-Saharan Africa: A Systematic Review. Nutrients 2022; 14:nu14091706. [PMID: 35565675 PMCID: PMC9100775 DOI: 10.3390/nu14091706] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are established at home during preschool years, yet the precise factors that contribute to preschool overweight and obesity have not been fully elucidated. This review aims to identify factors in the home environment associated with overweight and or obesity in preschool children in SSA. Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Africa Journals Online (AJOL) and the African Index Medicus databases were systematically searched for qualitative and quantitative studies published between 2000 and 2021. Eleven studies (ten quantitative, one qualitative) met the inclusion criteria. Overall, the results highlight the paucity of studies exploring factors in the home environment associated with overweight and obesity in preschool children in Sub-Saharan Africa. The home food environment and maternal BMI appear to be important factors associated with overweight and obesity in preschool children; however, the information for all other factors explored remains unclear due to the lack of evidence. For successful obesity prevention and treatment interventions to be developed, more research in this area is required to understand how different aspects of the home environment contribute to overweight and obesity in preschool Sub-Saharan African children.
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Affiliation(s)
- Albert L. Kwansa
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Robert Akparibo
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Joanne E. Cecil
- School of Medicine, Population and Behavioural Sciences, University of St Andrews, St Andrews KY16 9TF, UK;
| | | | - Samantha J. Caton
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
- Correspondence:
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Lackey KA, Fehrenkamp BD, Pace RM, Williams JE, Meehan CL, McGuire MA, McGuire MK. Breastfeeding Beyond 12 Months: Is There Evidence for Health Impacts? Annu Rev Nutr 2021; 41:283-308. [PMID: 34115518 DOI: 10.1146/annurev-nutr-043020-011242] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Because breastfeeding provides optimal nutrition and other benefits for infants (e.g., lower risk of infectious disease) and benefits for mothers (e.g., less postpartum bleeding), health organizations recommend that healthy infants be exclusively breastfed for 4 to 6 months in the United States and 6 months internationally. Recommendations related to how long breastfeeding should continue, however, are inconsistent. The objective of this article is to review the literature related to evidence for benefits of breastfeeding beyond 1 year for mothers and infants. In summary, human milk represents a good source of nutrients and immune components beyond 1 year. Some studies point toward lower infant mortality in undernourished children breastfed for >1 year, and prolonged breastfeeding increases interbirth intervals. Data on other outcomes (e.g., growth, diarrhea, obesity, and maternal weight loss) are inconsistent, often lacking sufficient control for confounding variables. There is a substantial need for rigorous, prospective, mixed-methods, cross-cultural research on this topic. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Kimberly A Lackey
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho 83844, USA;
| | - Bethaney D Fehrenkamp
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho 83844, USA;
| | - Ryan M Pace
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho 83844, USA;
| | - Janet E Williams
- Department of Animal, Veterinary and Food Sciences, University of Idaho, Moscow, Idaho 83844, USA
| | - Courtney L Meehan
- Department of Anthropology, Washington State University, Pullman, Washington 99164, USA
| | - Mark A McGuire
- Department of Animal, Veterinary and Food Sciences, University of Idaho, Moscow, Idaho 83844, USA
| | - Michelle K McGuire
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho 83844, USA;
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Danquah FI, Ansu-Mensah M, Bawontuo V, Yeboah M, Kuupiel D. Prevalence, incidence, and trends of childhood overweight/obesity in Sub-Saharan Africa: a systematic scoping review. ACTA ACUST UNITED AC 2020; 78:109. [PMID: 33292679 PMCID: PMC7599109 DOI: 10.1186/s13690-020-00491-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/20/2020] [Indexed: 02/08/2023]
Abstract
Background The growing burden of non-communicable diseases (NDC), particularly in low-and middle-income countries, poses a significant threat to global health. Obesity and overweight constitute major risk factors of NCDs such as heart diseases, diabetes, and kidney disease, and as a result, contribute significantly to the development of chronic morbidities, reduced quality of life, and increased risk of premature death. This study described evidence on the prevalence, incidence, and trends of childhood overweight and obesity in sub-Sahara Africa (SSA). Methods We conducted a systematic scoping review employing the Arksey and O’Malley framework, Levac et al. recommendations, and the Joanna Briggs Institute guidelines. To obtain relevant published articles for this review, we performed a comprehensive keywords search in PubMed, Google Scholar, Web of Science, and CINAHL via EBSCOhost platform for studies published between 2009 and June 2019. Guided by the eligibility criteria, title and abstracts, as well as the full-text articles were independently screened in parallel by two investigators. All relevant data were independently extracted by two investigators using a piloted form designed in Microsoft and thematic analysis conducted. Results Of the 81 included studies obtained from 250,148 potentially eligible articles, the majority (25) conducted in South Africa followed by 18 in Nigeria. Six studies were conducted in Ethiopia (6), Tanzania (5), Kenya (4), Cameroon (4), Ghana (3), Uganda (2), Mozambique (2), and Sudan (2). One study each was conducted in Botswana, Gambia, Lesotho, Mauritius, Seychelles, Togo, and Zimbabwe. The remaining three articles were multi-country studies. Most (81.5%) of the included studies were cross-sectional surveys and the majority (79) focused on both male and female participants. The majority (80/81) of the included studies reported on the prevalence of childhood overweight/obesity, 8 on the trends of childhood overweight/obesity, and one presented evidence on the incidence of childhood overweight and obesity in SSA. Conclusion This review demonstrates limited studies on childhood overweight/obesity in most SSA countries although the included studies suggest an increasing burden. Considering the consequences of childhood obesity, there is a need for more primary researches to inform policies decision and implementation to halt the rise of childhood obesity/overweight in SSA. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-020-00491-2.
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Affiliation(s)
- Frederick Inkum Danquah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Monica Ansu-Mensah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Vitalis Bawontuo
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana.,Research for Sustainable Development Consult, Sunyani, Ghana
| | - Matilda Yeboah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Desmond Kuupiel
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana. .,Research for Sustainable Development Consult, Sunyani, Ghana. .,Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4001, South Africa.
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Danquah FI, Ansu-Mensah M, Bawontuo V, Yeboah M, Udoh RH, Tahiru M, Kuupiel D. Risk factors and morbidities associated with childhood obesity in sub-Saharan Africa: a systematic scoping review. BMC Nutr 2020; 6:37. [PMID: 32884829 PMCID: PMC7460801 DOI: 10.1186/s40795-020-00364-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/24/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The rising burden of childhood obesity is a major public health concern, particularly in sub-Saharan Africa (SSA), where most health systems are weak and least prepared for complications that may arise. While the need for preventive action is increasingly recognized, policy implementation within the sub-region has often been inadequate, non-systematic, and ad hoc. This study described evidence on the risk factors and morbidities associated with childhood obesity in SSA. METHODS Guided by the Arksey and O'Malley framework incorporating the Levac et al. recommendations, and the Joanna Briggs Institute guidelines, we conducted a scoping study to address the research question. Thorough keywords systematic search was conducted for potentially eligible articles in PubMed, Google Scholar, Web of Science, and CINAHL published between 2009 and June 2019. Articles obtained were screened independently by two investigators at the abstract and full text phases using the eligibility criteria. All relevant data were extracted by two investigators in parallel and thematic analysis conducted. RESULTS A total of 337,229 articles were obtained from the database search of which 68 satisfied the inclusion criteria and were included for data extraction. These 68 included studies were conducted in 19 countries with the majority, 27.9% (19/68) from South Africa followed by Nigeria with 20.6% (14/68). Six of the included studies were conducted in Ethiopia, 5 studies in Kenya, 4 studies each in Tanzania and Cameroon, and 2 studies each in Ghana, Uganda, and Sudan. Of the 68 included studies, one each was conducted in Botswana, Gambia, Lesotho, Mauritius, Mozambique, Seychelles, Togo, and Zimbabwe. Most (80.9%) of the included studies were cross-sectional, and only one was an intervention trial. Of the 68 included studies, 53 reported on risk factors, 12 reported on morbidities, and 3 reported both risk factors and morbidities. We found no evidence in almost 60% (28/47) of countries included in the World Health Organisation Africa region. CONCLUSION This review findings suggest a paucity of literature on the risk factors of childhood obesity and morbidities in most SSA countries. Hence, there is the need to intensify research efforts, especially experimental study designs using innovative strategies to promote healthy lifestyle choices that will prevent or minimize the risks and health consequences of childhood obesity in SSA.
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Affiliation(s)
- Frederick Inkum Danquah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Monica Ansu-Mensah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Vitalis Bawontuo
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
- Research for Sustainable Development Consult, Sunyani, Ghana
| | - Matilda Yeboah
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Roseline H. Udoh
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Mohammed Tahiru
- Department of Public Health, Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Desmond Kuupiel
- Research for Sustainable Development Consult, Sunyani, Ghana
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Durban, 4001 South Africa
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Gudu E, Obonyo M, Omballa V, Oyugi E, Kiilu C, Githuku J, Gura Z, Ransom J. Factors associated with malnutrition in children < 5 years in western Kenya: a hospital-based unmatched case control study. BMC Nutr 2020; 6:33. [PMID: 32742713 PMCID: PMC7389647 DOI: 10.1186/s40795-020-00357-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 06/18/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Globally, under-nutrition accounts for > 3 million deaths annually among children < 5 years, with Kenya having ~ 35,000 deaths. This study aimed to identify factors associated with malnutrition in children aged < 5 years in western Kenya. METHODS We conducted a hospital-based unmatched case-control study between May and June 2017. Cases were defined as children aged 6-59 months with either z-score for weight-for-height ≤ -2SD or ≥ +2SD; weight-for-age ≤ -2SD or ≥ +2SD; or height-for-age ≤ -2SD. Controls were children aged 6-59 months with age-appropriate anthropometric measurements. Cases were consecutively recruited while systematic random sampling was used to select controls. Data from interviews and clinical records were collected and entered into Epi-Info, which was used to run unconditional logistic regression analyses. RESULTS A total of 94 cases and 281 controls were recruited. Of the cases, 84% (79/94) were under-nourished. Mother not having attended ante-natal clinic (OR = 7.9; 95% CI: 1.5-41.2), deworming (OR = 0.8; 95% CI: 0.4-1.2), and pre-lacteal feeding (OR = 1.8; 95% CI: 1.1-3.0) were associated with under-nutrition. Delayed developmental milestones (AOR = 13.9; 95% CI: 2.8-68.6); low birth weight (AOR = 3.3; 95% CI: 1.4-7.6), and paternal lack of formal education (AOR = 4.9; 95% CI: 1.3-18.9) were independently associated with under-nutrition. CONCLUSION Proper pre-natal care, child feeding practices and deworming programs should be enhanced to reduce pediatric malnutrition.
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Affiliation(s)
- Edwin Gudu
- Ministry of Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
- Ministry of Health, Field Epidemiology & Laboratory Training Program, Nairobi, Kenya
| | - Mark Obonyo
- Ministry of Health, Field Epidemiology & Laboratory Training Program, Nairobi, Kenya
| | - Victor Omballa
- Center for Global Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Elvis Oyugi
- Ministry of Health, Field Epidemiology & Laboratory Training Program, Nairobi, Kenya
| | - Cecilia Kiilu
- West Pokot County Health Department, Kapenguria, West Pokot Kenya
| | - Jane Githuku
- Ministry of Health, Field Epidemiology & Laboratory Training Program, Nairobi, Kenya
| | - Zeinab Gura
- Ministry of Health, Division for Human Resource for Health Development, Nairobi, Kenya
| | - James Ransom
- Piret Partners Consulting, 611 Pennsylvania Avenue SE, Unit 358, Washington, DC 20003 USA
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Choukem SP, Tochie JN, Sibetcheu AT, Nansseu JR, Hamilton-Shield JP. Overweight/obesity and associated cardiovascular risk factors in sub-Saharan African children and adolescents: a scoping review. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2020; 2020:6. [PMID: 32211050 PMCID: PMC7092532 DOI: 10.1186/s13633-020-0076-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 02/13/2020] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Recently, childhood and adolescence overweight/obesity has increased disproportionately in developing countries, with estimates predicting a parallel increase in future cardiovascular disease (CVD) burden identifiable in childhood and adolescence. Identifying cardiovascular risk factors (CVRF) associated with childhood and adolescence overweight/obesity is pivotal in tailoring preventive interventions for CVD. Whilst this has been examined extensively in high-income countries, there is scant consistent or representative data from sub-Saharan Africa (SSA). OBJECTIVE This scoping review synthesises contemporary studies on CVRF associated with overweight and obesity in SSA children and adolescents to provide evidence on the current burden of overweight/obesity and CVD in this population. METHODS We searched MEDLINE and Google Scholar up to July 31, 2019 for observational and experimental studies and systematic reviews addressing childhood and adolescence overweight/obesity and CVRF in SSA without language restriction. Four investigators working in four pairs, independently selected and extracted the relevant data. The methodological quality of all included studies was assessed. RESULTS We included 88 studies with a total of 86,637children and adolescents from 20 SSA countries. The risk of bias was low in 62 (70.5%), moderate 18 (20.5%), and high in eight (9%) studies. Overweight/obesity in SSA children and adolescents is rising at an alarming rate. Its main associations include physical inactivity, unhealthy diets, high socio-economic status, gender and high maternal body mass index. Identified CVRF in overweight/obese SSA children and adolescents are mainly metabolic syndrome, hypertension, dyslipidaemia, diabetes and glucose intolerance. There is a dearth of guidelines or consensus on the management of either childhood overweight/obesity or CVRF in overweight/obese SSA children and adolescents. CONCLUSION The current findings suggest an urgent need to review current health policies in SSA countries. Health education and transforming the current obesogenic environment of the SSA child and adolescent into one which promotes physical activity and healthy dietary habits is required.
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Affiliation(s)
- Simeon-Pierre Choukem
- Department of Clinical Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Diabetes and Endocrine Unit, Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Joel Noutakdie Tochie
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Aurelie T. Sibetcheu
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Jobert Richie Nansseu
- Health and Human Development (2HD) Research Network, Douala, Cameroon
- Disease, Epidemics and Pandemics Control, Ministry of Public Health, Yaoundé, Cameroon
| | - Julian P. Hamilton-Shield
- Bristol Biomedical Research Centre (Nutrition Theme), University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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Mařincová L, Šafaříková S, Cahlíková R. Analysis of main risk factors contributing to obesity in the region of East Africa: meta-analysis. Afr Health Sci 2020; 20:248-256. [PMID: 33402913 PMCID: PMC7750060 DOI: 10.4314/ahs.v20i1.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Over a few decades obesity has become a major global health problem. Its prevalence worldwide has more than doubled since 1980. The situation is expected to worsen in the future, especially in the developing countries that experience nutrition transition due to economic growth. It contributes to reduction in malnutrition which supports an increase in obesity prevalence. Objectives The aim of this study was to analyse the predictors of obesity in the region of East Africa. Methods Meta-analysis of existing studies was used in order to find the different risk factors and their significance in obesity development. Data extracted from 16 published academic research articles described the situation in East African countries. The significance of the effect of each variable was tested by means of an asymptotic chi-square test, or Fisher's exact (factorial) test and the risk ratios were calculated. Results Based on the chi-square test and the risk ratios of the aggregated data, three risk factors were found to be significant in the development of obesity – gender, type of residence and socio-economic status. In East African countries, women are significantly more likely to be obese. Living in an urban area and socioeconomic status are also positively associated with obesity. Because of insufficient data three other risk factors did not prove to be of any significance – alcohol consumption, smoking and education level. Conclusion Conclusions of this meta-analysis confirm world trends but we also found results that are not in line with them (e.g. education). This meta-analysis confirms the huge existing research gap concerning obesity predictors in the East African region.
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Houle B, Rochat TJ, Newell ML, Stein A, Bland RM. Breastfeeding, HIV exposure, childhood obesity, and prehypertension: A South African cohort study. PLoS Med 2019; 16:e1002889. [PMID: 31454346 PMCID: PMC6711496 DOI: 10.1371/journal.pmed.1002889] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/22/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Evidence on the association between breastfeeding and later childhood obesity and blood pressure (BP) is inconsistent, especially in HIV-prevalent areas where, until recently, HIV-infected women were discouraged from breastfeeding, but obesity is increasingly prevalent. METHODS AND FINDINGS The Siyakhula cohort (2012-2014), a population-based prospective cohort study, collected data over 3 visits on HIV-negative children ages 7 to 11 years in rural South Africa. We used weight (body mass index [BMI]), fat, and BP as outcome variables and incorporated early life (including mother's age at delivery and HIV status) and current life factors (including maternal education and current BMI). Our primary exposure was breastfeeding duration. We dichotomized 3 outcome measures using pre-established thresholds for clinical interpretability: (1) overfat: ≥85th percentile of body fat; (2) overweight: >1 SD BMI z score; and (3) prehypertension: ≥90th percentile for systolic BP (SBP) or diastolic BP (DBP). We modelled each outcome using multivariable logistic regression, including stopping breastfeeding, then early life, and finally current life factors. Of 1,536 children (mean age = 9.3 years; 872 girls; 664 boys), 7% were overfat, 13.2% overweight, and 9.1% prehypertensive. Over half (60%) of the mothers reported continued breastfeeding for 12+ months. In multivariable analyses, continued breastfeeding between 6 and 11 months was associated with approximately halved odds of both being overfat (adjusted odds ratio [aOR] = 0.43, 95% confidence interval [CI] 0.21-0.91, P = 0.027) and overweight (aOR = 0.46, CI 0.26-0.82, P = 0.0083), but the association with prehypertension did not reach statistical significance (aOR = 0.72, CI 0.38-1.37, P = 0.32). Children with a mother who was currently obese were 5 times more likely (aOR = 5.02, CI 2.47-10.20, P < 0.001) to be overfat and over 4 times more likely to be overweight (aOR = 4.33, CI 2.65-7.09, P < 0.001) than children with normal weight mothers. Differences between HIV-exposed and unexposed children on any of the outcomes were minimal and not significant. The main study limitation was that duration of breastfeeding was based on maternal recall. CONCLUSIONS To our knowledge, this is the first study examining and quantifying the association between breastfeeding and childhood obesity in an African setting with high HIV prevalence. We observed that breastfeeding was independently associated with reduced childhood obesity for both HIV-exposed and unexposed children, suggesting that promoting optimal nutrition throughout the life course, starting with continued breastfeeding, may be critical to tackling the growing obesity epidemic. In the era of widespread effective antiretroviral treatment for HIV-infected women for life, these data further support the recommendation of breastfeeding for all women.
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Affiliation(s)
- Brian Houle
- School of Demography, The Australian National University, Canberra, Australia
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- CU Population Center, Institute of Behavioral Science, University of Colorado at Boulder, Boulder, Colorado
| | - Tamsen J. Rochat
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- MRC/Developmental Pathways to Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, South Africa
| | - Marie-Louise Newell
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Alan Stein
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, United Kingdom
| | - Ruth M. Bland
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Institute of Health and Wellbeing and Royal Hospital for Children, University of Glasgow, Glasgow, United Kingdom
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Cauich-Viñas P, Azcorra H, Rodríguez L, Banik SD, Varela-Silva MI, Dickinson F. Body Mass Index in Mother and Child Dyads and its Association With Household Size and Parents' Education in 2 Urban Settings of Yucatan, Mexico. Food Nutr Bull 2019; 40:383-392. [PMID: 31195833 DOI: 10.1177/0379572119842990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Overweight/obesity (OW/OB) coexists in mother-child dyads. However, a dearth of evidence on the factors associated with this phenomenon calls for research. OBJECTIVE To analyze the association of sociodemographic factors with OW/OB in a sample of 260 Maya mother-child dyads from Yucatan, Mexico. METHODS During 2011 to 2014, we measured height and weight in children and their mothers and calculated their body mass index (BMI). The OW/OB cutoff points were defined, for mothers, as having a BMI >25 kg/m2 and, for children, as having a BMI-for-age >2 standard deviation of the World Health Organization references. Mother-child dyads were grouped according to their BMI status: (1) normal weight mother and child, (2) normal weight mother and OW/OB child, (3) OW/OB mother and normal weight child, and (4) OW/OB mother and child. A multinomial logistic regression model was used to analyze the interrelationships among BMI status in mother-child dyads, household size, and parental education. RESULTS Overweight/obesity coexisted in 40% of dyads. Compared to normal weight dyads (1), each unit increase in household size and in years of maternal education decreased the risks of the coexistence of OW/OB in mother-child dyads (odds ratio [OR] = 0.72, 95% confidence interval [CI] 0.55-0.94, P = .015; OR = 0.70, 95% CI 0.52-0.94, P = .019, respectively). Conversely, each year increase in paternal education increased the risk for OW/OB in dyads (OR = 1.47, 95% CI 1.08-1.99, P = .015). CONCLUSIONS Results suggest that household size and parental education contribute to shape BMI-based nutritional status in this sample of mother-child dyads.
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Affiliation(s)
| | - Hugo Azcorra
- Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, México
| | - Luis Rodríguez
- Universidad Autónoma de Yucatán, Mérida, Yucatán, México
| | - Sudip Datta Banik
- Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, México
| | | | - Federico Dickinson
- Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, México
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Stunting and Overweight among 12-24-Month-Old Children Receiving Vaccination in Ho Chi Minh City, Vietnam. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1547626. [PMID: 30911539 PMCID: PMC6399549 DOI: 10.1155/2019/1547626] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/01/2019] [Accepted: 01/29/2019] [Indexed: 02/06/2023]
Abstract
Introduction Malnutrition and obesity are a double burden on children in developing countries and could induce higher risks of noncommunicable diseases in the long term. In the big cities of Vietnam, both issues are present and share the issue of nutrition problems; the prevalence of malnutrition in children is gradually decreasing while the prevalence of obesity is increasing rapidly. The paper aims to identify the prevalence of stunting and overweight/obesity in apparently healthy young children in Ho Chi Minh City (HCMC). Methods A prospective cross-sectional study recruited 12-24-month-old children receiving national vaccination in community health centers in HCMC from February 2016 to July 2017. Sixteen healthcare centers were randomly selected among 8 districts of HCMC. Stunting and overweight were defined by height-for-age z-score <-2 SD and BMI z-score ≥+2 SD. Results A total of 768 children had mean age of 16.8±4.2 months old, 51.7% boys. The prevalence of stunting and overweight/obesity was 8.2% and 10.7%, respectively. Stunting was associated with older age, boys, and low birth weight of children and occupation of mothers (P <0.05). No associated risk factor was observed for overweight/ obesity status. Conclusion The prevalence of overweight/obesity was higher than the prevalence of stunting in 12-24-month-old children in HCMC. Overweight/obesity would be a public health problem for children in big cities.
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Wekesah FM, Nyanjau L, Kibachio J, Mutua MK, Mohamed SF, Grobbee DE, Klipstein-Grobusch K, Ngaruiya C, Haregu TN, Asiki G, Kyobutungi CK. Individual and household level factors associated with presence of multiple non-communicable disease risk factors in Kenyan adults. BMC Public Health 2018; 18:1220. [PMID: 30400905 PMCID: PMC6219015 DOI: 10.1186/s12889-018-6055-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs), are increasing globally, causing about 60% of disability-adjusted life years and 39.8 million deaths in 2015. Risk factors often cluster and interact multiplicatively in an individual and this is strongly associated with the development and severity of NCDs. We assessed the sociodemographic factors associated with the presence of multiple NCD risk factors among individuals aged 18 years and older in the Kenyan population. METHODS We used national representative data from 4066 individuals out of 4500 who participated in the WHO STEPs study in 2015. NCD risk factor counts were derived by summing the risk factors present in an individual and categorising into 1-3, 4-6 and 7+ risk factors in any combination of the 12 assessed NCD risk factors (hypertension, diabetes mellitus, cholesterol, insufficient physical activity, excessive alcohol use, tobacco use and obesity, excess sugar intake, insufficient fruit and vegetables intake, high salt consumption, and use of unhealthy cooking fats and oils). Ordered logistic regression was used to investigate the sociodemographic factors associated with an individual possesing multiple NCD risk factors. RESULTS Majority (75.8%) of the individuals in the study possesed 4-6 and 10% had ≥7 NCDs risk factors. Nearly everyone (99.8%) had insufficient fruits and vegetable intakes, 89.5% consumed high salt in their diet and 80.3% did not engage in sufficient physical activity. Apart from NCD risk count which increased with age among both men and women, associations with other socio-demographic factors differed between men and women. A woman of Akamba ethinicity had lower odds (0.43) while Meru women had higher odds (3.58) of higher NCD risk factor count, compared to the Kalenjin women. Among men, being a Kisii or Luo was associated with lower odds (0.48 and 0.25 respectively) of higher NCD risk factor count. Women in a marital union had higher odds (1.58) of a higher NCD risk factor count. CONCLUSION Majority of Kenyan adults possess more than four NCD risk factors; a clear indication of an emerging epidemic of NCDs in this population. Effective and multi-sectoral interventions targeting multiple risk factors in individuals are required to mitigate especially the behavioural and modifiable NCD risk factors in Kenya.
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Affiliation(s)
- Frederick M Wekesah
- African Population and Health Research Center, 2nd Floor, APHRC Campus, Manga Close, Off Kirawa Road, Kitisuru, P.O. Box 10787 00100, Nairobi, Kenya
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, Netherlands
| | - Loise Nyanjau
- Division of Non Communicable Diseases, Ministry of Health, Nairobi, Kenya
| | - Joseph Kibachio
- Division of Non Communicable Diseases, Ministry of Health, Nairobi, Kenya
- The Institute of Global Health, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Martin K Mutua
- African Population and Health Research Center, 2nd Floor, APHRC Campus, Manga Close, Off Kirawa Road, Kitisuru, P.O. Box 10787 00100, Nairobi, Kenya
| | - Shukri F Mohamed
- African Population and Health Research Center, 2nd Floor, APHRC Campus, Manga Close, Off Kirawa Road, Kitisuru, P.O. Box 10787 00100, Nairobi, Kenya
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Tilahun N Haregu
- African Population and Health Research Center, 2nd Floor, APHRC Campus, Manga Close, Off Kirawa Road, Kitisuru, P.O. Box 10787 00100, Nairobi, Kenya
| | - Gershim Asiki
- African Population and Health Research Center, 2nd Floor, APHRC Campus, Manga Close, Off Kirawa Road, Kitisuru, P.O. Box 10787 00100, Nairobi, Kenya
| | - Catherine K Kyobutungi
- African Population and Health Research Center, 2nd Floor, APHRC Campus, Manga Close, Off Kirawa Road, Kitisuru, P.O. Box 10787 00100, Nairobi, Kenya
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Santas F, Santas G. Prevalence of pre-school children for overweight/obesity in Turkey. World J Pediatr 2018; 14:77-83. [PMID: 29336003 DOI: 10.1007/s12519-017-0103-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 11/04/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Most of the studies and interventions are targeted to address undernutrition, but childhood obesity has become a silent killer among children. Developing countries, including Turkey, could recognize the importance of the issue now and have begun to discuss the necessity of studies on this subject. Therefore, this study aims to examine the prevalence of obesity among pre-school children in Turkey. METHODS The data source of this study is the Turkey Demographic and Health Survey (TDHS)-2013. The TDHS-2013 was a sample study to gather information about the fertility levels and changes in them, infant and child mortality, family planning, and maternal and infant health at the national level. RESULTS Overweight/obesity for height was 8.6% and 6.6% for age. Overweight/obesity problems are mostly observed in the West and are higher in urban areas. Overweight/obesity decreases with increasing age. There is a positive correlation between overweight/obesity and maternal educational level. As the household welfare level increases, overweight/obesity increases in pre-school children. Female children are at higher risk of overweight/obesity than males. As birth order increases, overweight/obesity decreases. Children living in other regions have overweight/obesity problems more than the pre-school children living in the East. CONCLUSIONS This study speculates that obesity appears to be a major problem among pre-school children in Turkey. Based on the findings, the current situation of overweight/obesity among pre-school children is so close to many developing and developed countries, whose obesity levels are a greater concern. This finding demonstrates that effective interventions of obesity should begin as early as infancy in Turkey, as it is a developing country.
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Affiliation(s)
- Fatih Santas
- Department of Health Administration, Faculty of Economics and Administrative Science, Bozok University, 66200, Yozgat, Turkey.
| | - Gulcan Santas
- Department of Health Administration, Faculty of Economics and Administrative Science, Hacettepe University, Ankara, Turkey
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Ngaruiya C, Hayward A, Post L, Mowafi H. Obesity as a form of malnutrition: over-nutrition on the Uganda "malnutrition" agenda. Pan Afr Med J 2017; 28:49. [PMID: 29184601 PMCID: PMC5697987 DOI: 10.11604/pamj.2017.28.49.11176] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 06/01/2017] [Indexed: 12/28/2022] Open
Abstract
The objectives were to highlight the burden of overweight and obesity as an additional area of importance for the malnutrition agenda in Uganda and to provide evidence-based considerations for stakeholders involved. Introduction: Mirroring other Low- and Middle-Income Countries (LMICs), Uganda is experiencing a “double burden” of over-nutrition related issues - both obesity and overweight, and related non-communicable diseases (NCDs) alongside the under-nutrition that has long plagued the country. Despite the commonplace assumption that under-nutrition is the predominant form of malnutrition in Uganda, we explore recent literature that in fact, challenges this notion. While food insecurity has contributed to the under-nutrition problem, a lack of dietary diversity also has a demonstrated role in increasing over-nutrition. We cannot afford to ignore over-nutrition concomitant with stunting and wasting in the country. Increase in the burden of this less acknowledged form of malnutrition in Uganda is critical to investigate, and yet poorly understood. A move towards increased regionally targeted over-nutrition research, funding, government prioritization and advocacy is needed.
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Affiliation(s)
- Christine Ngaruiya
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Alison Hayward
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Lori Post
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Hani Mowafi
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
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Chi DL, Luu M, Chu F. A scoping review of epidemiologic risk factors for pediatric obesity: Implications for future childhood obesity and dental caries prevention research. J Public Health Dent 2017; 77 Suppl 1:S8-S31. [PMID: 28600842 DOI: 10.1111/jphd.12221] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/06/2017] [Indexed: 01/31/2023]
Abstract
RESEARCH QUESTIONS What are the non-modifiable (socioeconomic, genetic) and modifiable factors (physical activity, dietary behaviors) related to childhood (under age 12) obesity? How can this knowledge be applied to oral health professionals' efforts to prevent or manage dental caries in children? OBJECTIVES Studies have identified risk factors for childhood obesity. The purpose of this scoping review was to develop a conceptual model to identify non-modifiable and modifiable risk factors for childhood obesity and to illustrate how these findings are relevant in developing interventions aimed at preventing obesity and dental caries in children. METHODS The authors searched PubMed and Embase and limited the study to English-language publications. A total of 2,572 studies were identified. After de-duplication, 2,479 studies remained and were downloaded into a citation-management tool. Two authors screened the titles and abstracts for relevance. Two hundred and sixty studies remained and were retrieved for a full-text review, and 80 studies were excluded, resulting in 180 studies included in the scoping review. An inductive content analytic methods was used to organize all statistically significant obesity risk factors into seven domains, which were classified as non-modifiable or modifiable; then a conceptual model of common risk factors associated with childhood obesity and dental caries was developed. RESULTS Non-modifiable obesity risk factors include biological and developmental (e.g., genes, developmental conditions, puberty), sociodemographic and household (e.g., race/ethnicity, socioeconomic status, parent education, unemployment), cultural (e.g., degree of acculturation), and community (e.g., neighborhood composition). Modifiable risk factors included behavioral (e.g., diet, physical activity, weight), psychosocial (e.g., maternal stress, family functioning, parenting practices, child temperament), and medical (e.g., parent smoking, maternal health, child health). CONCLUSIONS Identifying common risk factors has important implications for future oral health research aimed at preventing childhood obesity and dental caries. Epidemiologic knowledge gleaned from the literature can be used to develop rigorous interventions and programs aimed at preventing these highly prevalent diseases and improving health outcomes for children.
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Affiliation(s)
- Donald L Chi
- Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Monique Luu
- Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Frances Chu
- Oral Health Sciences, University of Washington, Seattle, WA, USA
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Choukem SP, Kamdeu-Chedeu J, Leary SD, Mboue-Djieka Y, Nebongo DN, Akazong C, Mapoure YN, Hamilton-Shield JP, Gautier JF, Mbanya JC. Overweight and obesity in children aged 3-13 years in urban Cameroon: a cross-sectional study of prevalence and association with socio-economic status. BMC OBESITY 2017; 4:7. [PMID: 28163924 PMCID: PMC5286775 DOI: 10.1186/s40608-017-0146-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 01/28/2017] [Indexed: 11/29/2022]
Abstract
Background Childhood overweight/obesity is increasing rapidly in developing countries. There is a need to provide more evidence on its burden in sub-Saharan Africa, and to identify associated factors in order to set preventive measures. We aimed to determine the prevalence of overweight/obesity and assess its association with the socioeconomic status in nursery and primary school children in urban Cameroon. Methods In this cross-sectional study, we included by multi-staged cluster random sampling 1343 children from high (HSES, n = 673) and low (LSES, n = 670) socioeconomic status schools in Douala. Parent/child demographic data were collected, and children’s anthropometric parameters were measured using validated methods. The World Health Organization body mass index-for-age reference curves were used. Results The prevalence of overweight/obesity was 12.5% (13.2% in girls, 11.8% in boys). The risk of overweight/obesity was 2.40 (95% CI 1.70, 3.40) higher in HSES children compared to LSES after adjusting for age and gender. However this association was attenuated to 1.18 (95% CI 0.59, 2.35) once adjustment had been made for a range of potential confounders. Conclusions Overweight/obesity is relatively common in sub-Saharan African children and prevalence is associated with HSES. However, this association may be mediated by sweet drink consumption, passive means of travel to school and not doing sport at school. We suggest that these potentially modifiable behaviors may be effective targets for obesity prevention. Further studies should specifically focus on unhealthy behaviors that mediate overweight/obesity as well as other non communicable diseases in children. Electronic supplementary material The online version of this article (doi:10.1186/s40608-017-0146-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Simeon-Pierre Choukem
- Health and Human Development (2HD) Research Group, Douala, Cameroon.,Department of Internal Medicine, Douala General Hospital, P.O. Box 4856, Douala, Cameroon.,Department of Internal Medicine and Pediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Josiane Kamdeu-Chedeu
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Sam D Leary
- Biomedical Research Unit in Nutrition, Diet and Lifestyle, University of Bristol, Bristol, UK
| | | | - Daniel N Nebongo
- Health and Human Development (2HD) Research Group, Douala, Cameroon
| | | | - Yacouba N Mapoure
- Department of Internal Medicine, Douala General Hospital, P.O. Box 4856, Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | - Jean-François Gautier
- Department of Diabetes, Endocrinology and Nutrition, Assistance Publique - Hôpitaux de Paris, Lariboisière Hospital, University Paris-Diderot Paris-7, 2 rue Ambroise Paré, 75010 Paris, France
| | - Jean Claude Mbanya
- National Centre of Obesity, Diabetes and Endocrinology, Yaoundé Central Hospital, Yaoundé, Cameroon.,Laboratory of molecular and metabolic medicine, Biotechnology Center, University of Yaoundé 1, Yaoundé, Cameroon.,Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
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Makoka D, Masibo PK. Is there a threshold level of maternal education sufficient to reduce child undernutrition? Evidence from Malawi, Tanzania and Zimbabwe. BMC Pediatr 2015; 15:96. [PMID: 26297004 PMCID: PMC4546212 DOI: 10.1186/s12887-015-0406-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 07/14/2015] [Indexed: 12/04/2022] Open
Abstract
Background Maternal education is strongly associated with young child nutrition outcomes. However, the threshold of the level of maternal education that reduces the level of undernutrition in children is not well established. This paper investigates the level of threshold of maternal education that influences child nutrition outcomes using Demographic and Health Survey data from Malawi (2010), Tanzania (2009–10) and Zimbabwe (2005–06). Methods The total number of children (weighted sample) was 4,563 in Malawi; 4,821 children in Tanzania; and 3,473 children in Zimbabwe Demographic and Health Surveys. Using three measures of child nutritional status: stunting, wasting and underweight, we employ a survey logistic regression to analyse the influence of various levels of maternal education on child nutrition outcomes. Results In Malawi, 45 % of the children were stunted, 42 % in Tanzania and 33 % in Zimbabwe. There were 12 % children underweight in Malawi and Zimbabwe and 16 % in Tanzania.The level of wasting was 6 % of children in Malawi, 5 % in Tanzania and 4 % in Zimbabwe. Stunting was significantly (p values < 0.0001) associated with mother’s educational level in all the three countries. Higher levels of maternal education reduced the odds of child stunting, underweight and wasting in the three countries. The maternal threshold for stunting is more than ten years of schooling. Wasting and underweight have lower threshold levels. Conclusion These results imply that the free primary education in the three African countries may not be sufficient and policies to keep girls in school beyond primary school hold more promise of addressing child undernutrition.
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Affiliation(s)
- Donald Makoka
- Centre for Agricultural Research and Development (CARD), Lilongwe University of Agriculture and Natural Resources, P.O. Box 219, Lilongwe, Malawi.
| | - Peninah Kinya Masibo
- School of Public Health, Department of Nutrition, Moi University, Nairobi campus, P.O. Box 63056 - 00200, Nairobi, Kenya. .,African Population and Health Research Center (APHRC), Research Capacity Strengthening, Training Programs, Kirawa Road, Off Peponi Road, P.O. Box 10787-00100, Nairobi, Kenya.
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Wu S, Ding Y, Wu F, Li R, Hu Y, Hou J, Mao P. Socio-economic position as an intervention against overweight and obesity in children: a systematic review and meta-analysis. Sci Rep 2015; 5:11354. [PMID: 26112253 PMCID: PMC4481703 DOI: 10.1038/srep11354] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 05/22/2015] [Indexed: 12/22/2022] Open
Abstract
Studies that investigated the association between socio-economic position (SEP) and obesity in children suggest inconsistent results. The aim of this study is to summarize and quantify the current evidence on SEP and risks of overweight and obesity in children aged 0–15 years. Relevant studies published between 1990 to Sep 4, 2014 were searched in Medline, Web of Science, Embase, and the Cochrane Database of Systematic Reviews. Risk estimates from individual studies were pooled using random-effects models, according to lowest vs the highest SEP category. A total of 62 articles were included in the meta-analysis. The odds of both overweight risk and obesity risk were higher in the children with lowest SEP than in those with highest SEP (OR, 1.10, 95% CI: 1.03–1.17, and OR, 1.41, 95% CI: 1.29–1.55, respectively). Sub-group analyses showed that the inverse relationships between SEP and childhood overweight and obesity were only found in high-income countries and in more economic developed areas. In conclusion, our study suggests that children with lower SEP had higher risks of overweight and obesity, and the increased risks were independent of the income levels of countries.
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Affiliation(s)
- Shunquan Wu
- Research and Technology Service Center, 302 Hospital of PLA, Beijing, China
| | - Yingying Ding
- Department of Medical Microbiology and Parasitology, Second Military Medical University, Shanghai, China
| | - Fuquan Wu
- International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Institute, Second Military Medical University, Shanghai, China
| | - Ruisheng Li
- Research and Technology Service Center, 302 Hospital of PLA, Beijing, China
| | - Yan Hu
- Research and Technology Service Center, 302 Hospital of PLA, Beijing, China
| | - Jun Hou
- Research and Technology Service Center, 302 Hospital of PLA, Beijing, China
| | - Panyong Mao
- Research and Technology Service Center, 302 Hospital of PLA, Beijing, China
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Kimani-Murage EW, Muthuri SK, Oti SO, Mutua MK, van de Vijver S, Kyobutungi C. Evidence of a Double Burden of Malnutrition in Urban Poor Settings in Nairobi, Kenya. PLoS One 2015; 10:e0129943. [PMID: 26098561 PMCID: PMC4476587 DOI: 10.1371/journal.pone.0129943] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 05/14/2015] [Indexed: 01/09/2023] Open
Abstract
Background Many low- and middle-income countries are undergoing a nutrition transition associated with rapid social and economic transitions. We explore the coexistence of over and under- nutrition at the neighborhood and household level, in an urban poor setting in Nairobi, Kenya. Methods Data were collected in 2010 on a cohort of children aged under five years born between 2006 and 2010. Anthropometric measurements of the children and their mothers were taken. Additionally, dietary intake, physical activity, and anthropometric measurements were collected from a stratified random sample of adults aged 18 years and older through a separate cross-sectional study conducted between 2008 and 2009 in the same setting. Proportions of stunting, underweight, wasting and overweight/obesity were dettermined in children, while proportions of underweight and overweight/obesity were determined in adults. Results Of the 3335 children included in the analyses with a total of 6750 visits, 46% (51% boys, 40% girls) were stunted, 11% (13% boys, 9% girls) were underweight, 2.5% (3% boys, 2% girls) were wasted, while 9% of boys and girls were overweight/obese respectively. Among their mothers, 7.5% were underweight while 32% were overweight/obese. A large proportion (43% and 37%%) of overweight and obese mothers respectively had stunted children. Among the 5190 adults included in the analyses, 9% (6% female, 11% male) were underweight, and 22% (35% female, 13% male) were overweight/obese. Conclusion The findings confirm an existing double burden of malnutrition in this setting, characterized by a high prevalence of undernutrition particularly stunting early in life, with high levels of overweight/obesity in adulthood, particularly among women. In the context of a rapid increase in urban population, particularly in urban poor settings, this calls for urgent action. Multisectoral action may work best given the complex nature of prevailing circumstances in urban poor settings. Further research is needed to understand the pathways to this coexistence, and to test feasibility and effectiveness of context-specific interventions to curb associated health risks.
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Affiliation(s)
| | | | - Samuel O. Oti
- African Population and Health Research Center, Nairobi, Kenya
- Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Martin K. Mutua
- African Population and Health Research Center, Nairobi, Kenya
| | - Steven van de Vijver
- African Population and Health Research Center, Nairobi, Kenya
- Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
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Keino S, Plasqui G, Ettyang G, van den Borne B. Determinants of Stunting and Overweight among Young Children and Adolescents in Sub-Saharan Africa. Food Nutr Bull 2014; 35:167-78. [DOI: 10.1177/156482651403500203] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Stunting and overweight are nutritional problems affecting most of sub-Saharan Africa. The region now has the world's highest rate of stunting among children (43%), while overweight and obesity are becoming a global epidemic, and Africa is not spared. The past two decades have seen a dramatic increase in obesity in sub-Saharan Africa. Objective The purpose of this systematic review is to explore the determinants of stunting and overweight in sub-Saharan Africa. Methods A literature search was conducted in PubMed using the key words stunting, overweight, obesity, Africa, sub-Saharan Africa, determinants, and prevalence. Limits were set to include articles published between 1990 and 2012. The systematic review resulted in 38 studies, and after selection based on title, content, and country of the study, 18 studies were eligible for this review. Data were analyzed by the chi-square test. Results The prevalence rates of stunting and over-weight were dependent on socioeconomic, demographic, and environmental factors. Many studies indicate that male children and those living in a rural setting are more likely to be stunted, whereas overweight among children depends more on age, household composition, occupation of the mother, and the mother's body mass index. Stunting occurred together with overweight among both boys and girls from 1 to 5 years of age. Stunting was more prevalent among boys than among girls. Indicators of socioeconomic status, such as mother's education, mother's occupation, and household income, were some of the determinants directly linked to stunting, whereas environmental factors, such as rural or urban setting and sanitation, influenced both stunting and overweight. Concurrent stunting and overweight is influenced by maternal and household factors, such as maternal height, age, and education, large household size, and lower socioeconomic status. Conclusions Although socioeconomic, demographic, and environmental factors were significant in determining stunting and overweight, other factors, such as nutrition and lifestyle, were important risk factors. Stunting in childhood is a risk factor that may result in overweight and obesity later in adolescence and adulthood, indicating the need to screen children below 1 year of age to identify stunting early in life. Promoting exclusive breastfeeding is reported to be important in preventing both stunting and overweight among children. More research is needed to explore the relationship between stunting and overweight and to explore policy guidelines to address the phenomenon.
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Meller FDO, Araújo CLP, Madruga2 SW. Fatores associados ao excesso de peso em crianças brasileiras menores de cinco anos. CIENCIA & SAUDE COLETIVA 2014; 19:943-55. [DOI: 10.1590/1413-81232014193.01552013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 03/15/2013] [Indexed: 11/21/2022] Open
Abstract
O objetivo do estudo foi identificar os fatores associados ao excesso de peso em crianças brasileiras menores de cinco anos. Foram utilizados dados da Pesquisa Nacional de Demografia e Saúde (PNDS) de 2006, um estudo transversal de base domiciliar. O diagnóstico do excesso de peso baseou-se no índice peso-para-altura superior a 2 escores z acima da mediana do padrão antropométrico da Organização Mundial de Saúde - 2006. A população estudada constituiu-se de 4.388 crianças. A prevalência de excesso de peso nas crianças foi descrita segundo variáveis socioeconômicas, demográficas, antropométricas e comportamentais. Foram realizadas análises bruta e ajustada através da Regressão de Poisson e todas foram estratificadas pelo sexo da criança. A prevalência de excesso de peso foi de 6,6%. Após análise ajustada, o índice de massa corporal materno e o peso ao nascer foram associados ao excesso de peso. Além disso, o excesso de peso mostrou-se associado ao tempo de amamentação exclusiva, nos meninos e ao nível socioeconômico e situação conjugal, nas meninas. Enfatiza-se a necessidade da implementação de políticas públicas que atuem, o mais precocemente possível, nos principais determinantes do excesso de peso.
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Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R, Uauy R. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013; 382:427-451. [PMID: 23746772 DOI: 10.1016/s0140-6736(13)60937-x] [Citation(s) in RCA: 4211] [Impact Index Per Article: 382.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Maternal and child malnutrition in low-income and middle-income countries encompasses both undernutrition and a growing problem with overweight and obesity. Low body-mass index, indicative of maternal undernutrition, has declined somewhat in the past two decades but continues to be prevalent in Asia and Africa. Prevalence of maternal overweight has had a steady increase since 1980 and exceeds that of underweight in all regions. Prevalence of stunting of linear growth of children younger than 5 years has decreased during the past two decades, but is higher in south Asia and sub-Saharan Africa than elsewhere and globally affected at least 165 million children in 2011; wasting affected at least 52 million children. Deficiencies of vitamin A and zinc result in deaths; deficiencies of iodine and iron, together with stunting, can contribute to children not reaching their developmental potential. Maternal undernutrition contributes to fetal growth restriction, which increases the risk of neonatal deaths and, for survivors, of stunting by 2 years of age. Suboptimum breastfeeding results in an increased risk for mortality in the first 2 years of life. We estimate that undernutrition in the aggregate--including fetal growth restriction, stunting, wasting, and deficiencies of vitamin A and zinc along with suboptimum breastfeeding--is a cause of 3·1 million child deaths annually or 45% of all child deaths in 2011. Maternal overweight and obesity result in increased maternal morbidity and infant mortality. Childhood overweight is becoming an increasingly important contributor to adult obesity, diabetes, and non-communicable diseases. The high present and future disease burden caused by malnutrition in women of reproductive age, pregnancy, and children in the first 2 years of life should lead to interventions focused on these groups.
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Affiliation(s)
- Robert E Black
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Cesar G Victora
- Universidade Federal de Pelotas, Pelotas, Rio Grande do Sol, Brazil
| | - Susan P Walker
- The University of the West Indies, Tropical Medicine Research Institute, Mona Campus, Kingston, Jamaica
| | - Zulfiqar A Bhutta
- The Aga Khan University and Medical Center, Department of Pediatrics, Karachi, Pakistan
| | - Parul Christian
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mercedes de Onis
- World Health Organization, Department of Nutrition for Health and Development, Geneva, Switzerland
| | - Majid Ezzati
- Imperial College of London, St Mary's Campus, School of Public Health, MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, London, UK
| | - Sally Grantham-McGregor
- Institute of Child Health, University College London, London, UK; The University of the West Indies, Mona, Jamaica
| | - Joanne Katz
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Ricardo Uauy
- London School of Hygiene and Tropical Medicine, London, UK
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Yu Z, Han S, Zhu J, Sun X, Ji C, Guo X. Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis. PLoS One 2013; 8:e61627. [PMID: 23613888 PMCID: PMC3628788 DOI: 10.1371/journal.pone.0061627] [Citation(s) in RCA: 533] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 03/12/2013] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Overweight/obesity in women of childbearing age is a serious public-health problem. In China, the incidence of maternal overweight/obesity has been increasing. However, there is not a meta-analysis to determine if pre-pregnancy body mass index (BMI) is related to infant birth weight (BW) and offspring overweight/obesity. METHODS Three electronic bibliographic databases (MEDLINE, EMBASE and CINAHL) were searched systematically from January 1970 to November 2012. The dichotomous data on pre-pregnancy overweight/obesity and BW or offspring overweight/obesity were extracted. Summary statistics (odds ratios, ORs) were used by Review Manager, version 5.1.7. RESULTS After screening 665 citations from three electronic databases, we included 45 studies (most of high or medium quality). Compared with normal-weight mothers, pre-pregnancy underweight increased the risk of small for gestational age (SGA) (odds ratios [OR], 1.81; 95% confidence interval [CI], 1.76-1.87); low BW (OR, 1.47; 95% CI, 1.27-1.71). Pre-pregnancy overweight/obesity increased the risk of being large for gestational age (LGA) (OR, 1.53; 95% CI, 1.44-1.63; and OR, 2.08; 95% CI; 1.95-2.23), high BW (OR, 1.53; 95% CI, 1.44-1.63; and OR, 2.00; 95% CI; 1.84-2.18), macrosomia (OR, 1.67; 95% CI, 1.42-1.97; and OR, 3.23; 95% CI, 2.39-4.37), and subsequent offspring overweight/obesity (OR, 1.95; 95% CI, 1.77-2.13; and OR, 3.06; 95% CI, 2.68-3.49), respectively. Sensitivity analyses revealed that sample size, study method, quality grade of study, source of pre-pregnancy BMI or BW had a strong impact on the association between pre-pregnancy obesity and LGA. No significant evidence of publication bias was observed. CONCLUSIONS Pre-pregnancy underweight increases the risk of SGA and LBW; pre-pregnancy overweight/obesity increases the risk of LGA, HBW, macrosomia, and subsequent offspring overweight/obesity. A potential effect modification by maternal age, ethnicity, gestational weight gain, as well as the role of gestational diseases should be addressed in future studies.
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Affiliation(s)
- Zhangbin Yu
- State Key Laboratory of Reproductive Medicine, Department of Pediatrics, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, Nanjing, China
| | - Shuping Han
- State Key Laboratory of Reproductive Medicine, Department of Pediatrics, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, Nanjing, China
| | - Jingai Zhu
- State Key Laboratory of Reproductive Medicine, Department of Pediatrics, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, Nanjing, China
| | - Xiaofan Sun
- State Key Laboratory of Reproductive Medicine, Department of Pediatrics, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, Nanjing, China
| | - Chenbo Ji
- State Key Laboratory of Reproductive Medicine, Department of Pediatrics, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, Nanjing, China
| | - Xirong Guo
- State Key Laboratory of Reproductive Medicine, Department of Pediatrics, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, Nanjing, China
- * E-mail:
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Pawloski LR, Curtin KM, Gewa C, Attaway D. Maternal-child overweight/obesity and undernutrition in Kenya: a geographic analysis. Public Health Nutr 2012; 15:2140-7. [PMID: 22414734 PMCID: PMC10271325 DOI: 10.1017/s1368980012000110] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 01/03/2012] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of the study was to examine geographic relationships of nutritional status (BMI), including underweight, overweight and obesity, among Kenyan mothers and children. DESIGN Spatial relationships were examined concerning BMI of the mothers and BMI-for-age percentiles of their children. These included spatial statistical measures of the clustering of segments of the population, in addition to inspection of co-location of significant clusters. SETTING Rural and urban areas of Kenya, including the cities of Nairobi and Mombasa, and the Kisumu region. SUBJECTS Mother-child pairs from Demographic and Health Survey data including 1541 observations in 2003 and 1592 observations in 2009. These mother-child pairs were organized into 399 locational clusters. RESULTS There is extremely strong evidence that high BMI values exhibit strong spatial clustering. There were co-locations of overweight mothers and overweight children only in the Nairobi region, while both underweight mothers and children tended to cluster in rural areas. In Mombasa clusters of overweight mothers were associated with normal-weight children, while in the Kisumu region clusters of overweight children were associated with normal-weight mothers. CONCLUSIONS These findings show there is geographic variability as well as some defined patterns concerning the distribution of malnutrition among mothers and children in Kenya, and suggest the need for further geographic analyses concerning the potential factors which influence nutritional status in this population. In addition, the methods used in this research may be easily applied to other Demographic and Health Survey data in order to begin to understand the geographic determinants of health in low-income countries.
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Affiliation(s)
- Lisa R Pawloski
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA.
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Geographic distribution and socio-economic determinants of women's nutritional status in Mali households. Public Health Nutr 2012; 16:1575-85. [PMID: 23072839 DOI: 10.1017/s136898001200451x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Mali is one of the poorest countries in Africa, with 72% of its population surviving on less than $US 1.00 per day. Health and demographic indicators are bleak. With few exceptions, studies related to the health of women in Mali have largely been under-represented. In addition, in recent years a new type of malnutrition stemming from weight gain and obesity has been observed throughout Africa. The present study aimed to (i) describe geographic and health variations of women of reproductive age, (ii) describe geographic variations of household salt iodine levels and (iii) investigate potential factors associated with women’s anthropometric status and use of adequately iodized salt among households in Mali. DESIGN Demographic and Health Survey data, multistage-stratified cluster sampling methodology. SETTING Rural and urban areas of Mali. SUBJECTS Non-pregnant women (n 6015) between the ages of 19 and 44 years. RESULTS Nineteen per cent of the women were overweight or obese while 11% were underweight. Seventy-eight per cent of the households utilized adequately iodized salt. Underweight women were more prevalent in southern Mali, while obesity was more frequent in the north-east and within the major urban areas. Households located within the southern parts of Mali were more likely to utilize adequately iodized salt. Education, age, modern contraceptive use, breast-feeding status at time of the survey and household wealth index were significantly associated with the women’s BMI or households’ use of adequately iodized salt. CONCLUSIONS The combined use of statistical and geographic system analysis contributes to improve targeting of interventions among vulnerable populations.
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Ma JQ, Zhou LL, Hu YQ, Liu JR, Liu SS, Zhang J, Sheng XY. Feeding and growth of normal birth weight infants during the first year of life in Shanghai. Early Hum Dev 2012; 88:831-6. [PMID: 22749637 DOI: 10.1016/j.earlhumdev.2012.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Revised: 06/09/2012] [Accepted: 06/11/2012] [Indexed: 11/19/2022]
Abstract
AIM This study aimed to explore the relationship between infant feeding practices and growth outcomes in the first 12 months of life. DESIGN Investigators completed 262 questionnaires, which included infant feeding patterns, feeding environment, feeding beliefs/attitudes and caregivers' feeding behaviors through on-site face-to-face interviews with the main caregivers of infants at 12 months of age. The infant's weight and length at ages 6 and 12 months were measured. SETTING The study was conducted in urban Shanghai, China. SUBJECTS This study included 262 healthy normal birth weight full-term singleton 6-month-old infants and their main caregivers. RESULTS Among 262 infants, 86 (32.82%) infants were overweight [BMI-for-age z scores (BAZ)>+1] at 12 months. Compared with normal weight infants, the overweight infants had higher birth weights (P=0.009). Furthermore, the overweight infants gained significantly more weight (P<0.001) in the first year of life. In normal weight infants, caregivers worried more about infants being "underweight" and "eating less" (P<0.001) whereas caregivers with overweight infants worried more about infants being "overweight" (P<0.001). Consequently, the total score of caregivers' over-feeding behaviors was significantly higher in normal weight infants (P=0.029). However, in overweight infants, the scores of "fed quickly within 10 min" (r=0.223, P=0.039) and "feeding was the best way to stop the infant's fussiness" (r=0.285, P=0.008) were positively correlated with BAZ. CONCLUSIONS Overweight in early life is associated with carelessness about excessive appetite and some particular infant feeding behaviors of caregivers in Shanghai.
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Affiliation(s)
- Jing-Qiu Ma
- Department of Child and Adolescent Healthcare, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Institute for Pediatric Research, MOE-Shanghai Key Laboratory of Children's Environmental Health, Yangpu District, China
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Patterns of childhood and adolescent overweight and obesity during health transition in Vanuatu. Public Health Nutr 2011; 15:158-66. [PMID: 21835097 DOI: 10.1017/s1368980011001662] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Rapid economic development and subsequent changes in lifestyle and disease burdens ('health transition') is associated with increasing prevalence of obesity among both adults and children. However, because of continued infectious diseases and undernutrition during the early stages of transition, monitoring childhood obesity has not been prioritized in many countries and the scope of the problem is unknown. Therefore we sought to characterize patterns of childhood overweight and obesity in an early transitional area, the South Pacific archipelago of Vanuatu. DESIGN We completed an anthropometric survey among children from three islands with varying levels of economic development, from rural areas (where adult obesity prevalence is low) to urban areas (where adult obesity prevalence is high). SETTING The islands of Ambae (rural), Aneityum (rural with tourism) and Efate (urban). SUBJECTS Boys and girls (n 513) aged 6-17 years. RESULTS Height-, weight- and BMI-for-age did not vary among islands, and prevalence of overweight/obesity based on BMI was low. However, girls from Aneityum - a rural island where the tourism industry increased rapidly after malaria eradication - had increased central adiposity compared with girls from the other islands. This is contrary to adult patterns, which indicate higher obesity prevalence in urban areas. Multiple factors might contribute, including stunting, biological responses after malaria control, sleeping patterns, diet and physical activity levels. CONCLUSIONS Measures of central adiposity highlight an emerging obesity risk among girls in Vanuatu. The data highlight the synergistic relationship among infectious diseases, undernutrition and obesity during the early stages of health transition.
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de Onis M, Blössner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010; 92:1257-64. [PMID: 20861173 DOI: 10.3945/ajcn.2010.29786] [Citation(s) in RCA: 1222] [Impact Index Per Article: 87.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Childhood obesity is associated with serious health problems and the risk of premature illness and death later in life. Monitoring related trends is important. OBJECTIVE The objective was to quantify the worldwide prevalence and trends of overweight and obesity among preschool children on the basis of the new World Health Organization standards. DESIGN A total of 450 nationally representative cross-sectional surveys from 144 countries were analyzed. Overweight and obesity were defined as the proportion of preschool children with values >2 SDs and >3 SDs, respectively, from the World Health Organization growth standard median. Being "at risk of overweight" was defined as the proportion with values >1 SD and ≤2 SDs, respectively. Linear mixed-effects modeling was used to estimate the rates and numbers of affected children. RESULTS In 2010, 43 million children (35 million in developing countries) were estimated to be overweight and obese; 92 million were at risk of overweight. The worldwide prevalence of childhood overweight and obesity increased from 4.2% (95% CI: 3.2%, 5.2%) in 1990 to 6.7% (95% CI: 5.6%, 7.7%) in 2010. This trend is expected to reach 9.1% (95% CI: 7.3%, 10.9%), or ≈60 million, in 2020. The estimated prevalence of childhood overweight and obesity in Africa in 2010 was 8.5% (95% CI: 7.4%, 9.5%) and is expected to reach 12.7% (95% CI: 10.6%, 14.8%) in 2020. The prevalence is lower in Asia than in Africa (4.9% in 2010), but the number of affected children (18 million) is higher in Asia. CONCLUSIONS Childhood overweight and obesity have increased dramatically since 1990. These findings confirm the need for effective interventions starting as early as infancy to reverse anticipated trends.
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Affiliation(s)
- Mercedes de Onis
- Growth Assessment and Surveillance Unit, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland.
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Childhood overweight and obesity among Kenyan pre-school children: association with maternal and early child nutritional factors—Erratum. Public Health Nutr 2010. [DOI: 10.1017/s1368980009992904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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