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Rojo-Trejo ME, Robles-Osorio ML, Rangel B, García OP, Becerra-Hernández MF, Cárdenas-Rodríguez L, Sabath E. Appendicular Muscle Mass Index as the Most Important Determinant of Bone Mineral Content and Density in Small for Gestational Age Children. Clin Pediatr (Phila) 2024:99228241242515. [PMID: 38581300 DOI: 10.1177/00099228241242515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
Preterm small for gestational age (SGA) children are at increased risk for low bone mineral content later in life; however, data on SGA children born at term are scarce. We included 44 SGA and 57 adequate for gestational age (AGA) children aged 6 to 11 years to compare bone mineral density (BMD) and bone mineral content (BMC) and to identify which anthropometric and biochemical values influence bone mineralization in these children. Fat mass, appendicular skeletal muscle mass index (ASMMI), BMC, and BMD were significantly lower in SGA children than in AGA (P ≤ .005). Appendicular muscle mass index correlated with BMC(TBLH,FN,L1-L4) and BMD(TBLH,FN,L1-L4) in both groups (r2 = 0.7, P < .05). In multivariate analysis, ASMMI was strongly associated with BMC and BMD in both groups. There were no differences in clinical biomarkers, calcium intake, and physical activity between the groups. Achieving adequate muscle mass contributes to adequate bone mineralization and a lower risk for low BMC and BMD in SGA children.
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Affiliation(s)
| | | | - Beatriz Rangel
- Nutrition School, Universidad Autónoma de Querétaro, Querétaro, México
| | - Olga P García
- Nutrition School, Universidad Autónoma de Querétaro, Querétaro, México
| | | | | | - Ernesto Sabath
- Nutrition School, Universidad Autónoma de Querétaro, Querétaro, México
- Renal Division and Metabolic Unit, Hospital General de Querétaro, Queretaro, México
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Pedrero-Tomé R, Marrodán MD, López-Ejeda N, Escruela M, Rocaspana M, Vargas A, Casademont C, Gutiérrez R, Lanusse C. Impact of integrated preventive and curative health package on nutritional status of children under 2 years of age in the health area of Tama, Tahoua region (Niger). Front Nutr 2023; 10:1259706. [PMID: 37941771 PMCID: PMC10629985 DOI: 10.3389/fnut.2023.1259706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/06/2023] [Indexed: 11/10/2023] Open
Abstract
Background Niger, relevant in light of current political coup, is one of the countries with the worst human development indicators, characterized by high fertility rates and extremely high infant mortality rates. Food insecurity in the region is alarming, leading to high malnutrition rates in children. This study aimed to evaluate an integral preventive-curative health program targeting children aged under 2 years in the health area of Tama, district of Bouza, Tahoua. Methodology Anthropometric follow-up data of 6,962 children aged under 2 years were included in this study. These children received complete vaccination and malaria chemoprevention, and those older than 6 months received nutritional supplementation with a small quantity of lipid-based nutrient supplements. Fundamental growth indicators (height-for-age, weight-for-height, weight-for-age, and middle-upper arm circumference) and the Composite Index of Anthropometric Failure were calculated at the beginning and end of the program (mean time spent in the program: 14.5 ± 6.6 months) The evolution of these indicators was compared with those of a sample from a vertical vaccination program conducted in the neighboring region of Madarounfa on similar dates. Results The proportion of children without anthropometric failure decreased from 59.5 to 40.2% (p < 0.001), with the categories that included stunting increasing the most. When analyzing the anthropometric indicators according to the months of compliance with the program, there was a slight improvement in the indicators of acute malnutrition, whereas those of chronic malnutrition worsened significantly. However, when compared with the Madarounfa sample, the children in the present study registered a significantly lower worsening in all three indicators: height-age (-0.46 vs. -2.44; p < 0.001), weight-height (+0.31 vs. -0.55; p < 0.001) and weight-age (-0.03 vs. -1.63; p < 0.001) difference. Conclusion The comprehensive preventive-curative health program slightly slows the worsening of cumulative malnutrition in the early years of life in complex contexts, such as southern Niger.
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Affiliation(s)
- Roberto Pedrero-Tomé
- Research Group in Nutritional Epidemiology (EPINUT), Unit of Physical Anthropology, Department of Biodiversity, Ecology, and Evolution, Faculty of Biological Sciences, Complutense University of Madrid, Madrid, Spain
| | - María Dolores Marrodán
- Research Group in Nutritional Epidemiology (EPINUT), Unit of Physical Anthropology, Department of Biodiversity, Ecology, and Evolution, Faculty of Biological Sciences, Complutense University of Madrid, Madrid, Spain
| | - Noemí López-Ejeda
- Research Group in Nutritional Epidemiology (EPINUT), Unit of Physical Anthropology, Department of Biodiversity, Ecology, and Evolution, Faculty of Biological Sciences, Complutense University of Madrid, Madrid, Spain
| | | | | | - Antonio Vargas
- Department of Nutrition and Health, Action Against Hunger, Madrid, Spain
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de Oliveira MH, Araújo J, Ramos E, Conde WL. MULT: New height references and their efficiency in multi-ethnic populations. Am J Hum Biol 2023; 35:e23859. [PMID: 36626316 DOI: 10.1002/ajhb.23859] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/24/2022] [Accepted: 12/11/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To develop new height references (MULT) based on longitudinal data of multi-ethnic populations and to compare them to the height references from the Dutch Growth Study, from the Centers for Disease Control and Prevention (CDC) and from the World Health Organization (WHO). METHODS The MUL height references were developed through the LMS method and the Generalized Additive Models for Location Scale and Shape. They were constructed based on 2611 subjects (15 292 measurements) from the advantaged quintile of the Young Lives (Younger Cohort), Millennium Cohort Study, Adolescent Nutritional Assessment Longitudinal Study, and Epidemiological Health Investigation of Teenagers in Porto studies. The M, S curves were described to compare the growth trajectory of the MULT, DUTCH, CDC and WHO height references. For the population comparative analysis, we used the total sample of the studies (91 063 observations, 17 641 subjects). The Lin's concordance correlation coefficient (CCC) and Cohen's kappa coefficient (K) were used to verify the agreement between MULT, WHO and CDC height references. RESULTS The MULT height references showed taller boys for the periods of 61-174 months and 196-240 months and taller girls for 61-147 and 181-240 months, when compared to CDC and WHO height references. There was an almost perfect agreement between WHO and MULT height references (CCC >0.99) for the subjects aged 2 to 5 years. CONCLUSIONS MULT height references presented a taller population and a high agreement with WHO growth charts, especially for children under 5 years, indicating that it could be useful to assess nutritional status of multi-ethnic populations.
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Affiliation(s)
| | - Joana Araújo
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.,Department of Public Health and Forensic Sciences, and Medical Education - Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Elisabete Ramos
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.,Department of Public Health and Forensic Sciences, and Medical Education - Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Wolney Lisboa Conde
- Department of Nutrition, School of Public Health - University of São Paulo, São Paulo, Brazil
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Atukunda P, Ngari M, Chen X, Westerberg AC, Iversen PO, Muhoozi G. Longitudinal assessments of child growth: A six-year follow-up of a cluster-randomized maternal education trial. Clin Nutr 2021; 40:5106-5113. [PMID: 34461584 PMCID: PMC7613314 DOI: 10.1016/j.clnu.2021.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/29/2021] [Accepted: 08/14/2021] [Indexed: 11/29/2022]
Abstract
Background & aims Child growth impairments are rampant in sub-Saharan Africa. To combat this important health problem, long-term follow-up studies are needed to examine possible benefits and sustainability of various interventions designed to correct inadequate child growth. Our aim was to perform a follow-up study of children aged 60−72 months whose mothers participated in a two-armed cluster-randomized education intervention trial lasting 6 months in rural Uganda when their children were 6−8 months old with data collection at 20−24 and at 36 months. The education focused on nutrition, hygiene, and child stimulation. Methods We measured growth using anthropometry converted to z-scores according to WHO guidelines. We also included assessments of body composition using bioimpedance. We used multilevel mixed effect linear regression models with maximum likelihood method, unstructured variance-covariance structure, and the cluster as a random effect component to compare data from the intervention (receiving the education and routine health care) with the control group (receiving only routine health care). Results Of the 511 children included in the original trial, data from 166/263 (63%) and 141/248 (57%) of the children in the intervention and control group, respectively, were available for the current follow-up study. We found no significant differences in any anthropometrical z-score between the two study groups at child age of 60−72 months, except that children in the intervention group had lower (P = 0.006) weight-for-height z-score than the controls. There were no significant differences in the trajectories of z-scores or height growth velocity (cm/year) from baseline (start of original trial) to child age of 60−72 months. Neither did we detect any significant difference between the intervention and control group regarding body composition (fat mass, fat free mass, and total body water) at child age 60−72 months. Separate gender analyses had no significant impact on any of the growth or body composition findings. Conclusion In this long-term study of children participating in a randomized maternal education trial, we found no significant impact of the intervention on anthropometrical z-scores, height growth velocity or body composition. Trial registration Clinical Trials (clinical trials.gov) ClinicalTrials.gov ID NCT 02098031.
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Affiliation(s)
| | - Moses Ngari
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya.
| | - Xi Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
| | - Ane C Westerberg
- Institute of Health Sciences, Kristiania University College, Oslo, Norway; Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.
| | - Per O Iversen
- Department of Nutrition, University of Oslo, Norway; Department of Haematology, Oslo University Hospital, Oslo, Norway; Division of Human Nutrition, Stellenbosch University, Tygerberg, South Africa.
| | - Grace Muhoozi
- Department of Human Nutrition and Home Economics, Kyambogo University, Kampala, Uganda.
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Scheffler C, Hermanussen M, Soegianto SDP, Homalessy AV, Touw SY, Angi SI, Ariyani QS, Suryanto T, Matulessy GKI, Fransiskus T, Safira AVC, Puteri MN, Rahmani R, Ndaparoka DN, Payong MKE, Indrajati YD, Purba RKH, Manubulu RM, Julia M, Pulungan AB. Stunting as a Synonym of Social Disadvantage and Poor Parental Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031350. [PMID: 33540885 PMCID: PMC7908185 DOI: 10.3390/ijerph18031350] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 12/12/2022]
Abstract
Socially, economically, politically and emotionally (SEPE) disadvantaged children are shorter than children from affluent background. In view of previous work on the lack of association between nutrition and child growth, we performed a study in urban schoolchildren. We measured 723 children (5.83 to 13.83 years); Kupang, Indonesia; three schools with different social background. We investigated anthropometric data, clinical signs of malnutrition, physical fitness, parental education, and household equipment. Subjective self-confidence was assessed by the MacArthur test. The prevalence of stunting was between 8.5% and 46.8%. Clinical signs of under- or malnutrition were absent even in the most underprivileged children. There was no delay in tooth eruption. Underprivileged children are physically fitter than the wealthy. The correlation between height and state of nutrition (BMI_SDS, skinfold_SDS, MUAC_SDS) ranged between r = 0.69 (p < 0.01) and r = 0.43 (p < 0.01) in private school children, and between r = 0.07 (ns) and r = 0.32 (p < 0.01) in the underprivileged children. Maternal education interacted with height in affluent (r = 0.20, p < 0.01) and in underprivileged children (r = 0.20, p < 0.01). The shortness of SEPE disadvantaged children was not associated with anthropometric and clinical signs of malnutrition, nor with delay in physical development. Stunting is a complex phenomenon and may be considered a synonym of social disadvantage and poor parental education.
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Affiliation(s)
- Christiane Scheffler
- Institute of Biochemistry and Biology, Human Biology, University of Potsdam, 14469 Potsdam, Germany
- Correspondence:
| | | | - Sugi Deny Pranoto Soegianto
- Indonesian Pediatric Society, East Nusa Tenggara Branch, Kupang-East Nusa Tenggara, Kupang 85351, Indonesia; (S.D.P.S.); (T.S.); (T.F.); (R.M.M.)
| | - Alexandro Valent Homalessy
- Indonesian Medical Association Branch, Kupang 85351, Indonesia; (A.V.H.); (S.Y.T.); (Q.S.A.); (G.K.I.M.); (A.V.C.S.); (M.N.P.); (R.R.); (D.N.N.); (M.K.E.P.)
| | - Samuel Yan Touw
- Indonesian Medical Association Branch, Kupang 85351, Indonesia; (A.V.H.); (S.Y.T.); (Q.S.A.); (G.K.I.M.); (A.V.C.S.); (M.N.P.); (R.R.); (D.N.N.); (M.K.E.P.)
| | - Sevany Isabella Angi
- DDS PPDGS Konservasi Gigi FKG UGM, Jl. Sekip Utara, Sumatra, Medan 20153, Indonesia; (S.I.A.); (Y.D.I.)
| | - Queen Sugih Ariyani
- Indonesian Medical Association Branch, Kupang 85351, Indonesia; (A.V.H.); (S.Y.T.); (Q.S.A.); (G.K.I.M.); (A.V.C.S.); (M.N.P.); (R.R.); (D.N.N.); (M.K.E.P.)
| | - Tjahyo Suryanto
- Indonesian Pediatric Society, East Nusa Tenggara Branch, Kupang-East Nusa Tenggara, Kupang 85351, Indonesia; (S.D.P.S.); (T.S.); (T.F.); (R.M.M.)
| | - Giovanni Kathlix Immanuel Matulessy
- Indonesian Medical Association Branch, Kupang 85351, Indonesia; (A.V.H.); (S.Y.T.); (Q.S.A.); (G.K.I.M.); (A.V.C.S.); (M.N.P.); (R.R.); (D.N.N.); (M.K.E.P.)
| | - Taolin Fransiskus
- Indonesian Pediatric Society, East Nusa Tenggara Branch, Kupang-East Nusa Tenggara, Kupang 85351, Indonesia; (S.D.P.S.); (T.S.); (T.F.); (R.M.M.)
| | - Andrea V. Ch. Safira
- Indonesian Medical Association Branch, Kupang 85351, Indonesia; (A.V.H.); (S.Y.T.); (Q.S.A.); (G.K.I.M.); (A.V.C.S.); (M.N.P.); (R.R.); (D.N.N.); (M.K.E.P.)
| | - Maria Natalia Puteri
- Indonesian Medical Association Branch, Kupang 85351, Indonesia; (A.V.H.); (S.Y.T.); (Q.S.A.); (G.K.I.M.); (A.V.C.S.); (M.N.P.); (R.R.); (D.N.N.); (M.K.E.P.)
| | - Rani Rahmani
- Indonesian Medical Association Branch, Kupang 85351, Indonesia; (A.V.H.); (S.Y.T.); (Q.S.A.); (G.K.I.M.); (A.V.C.S.); (M.N.P.); (R.R.); (D.N.N.); (M.K.E.P.)
| | - Debora Natalia Ndaparoka
- Indonesian Medical Association Branch, Kupang 85351, Indonesia; (A.V.H.); (S.Y.T.); (Q.S.A.); (G.K.I.M.); (A.V.C.S.); (M.N.P.); (R.R.); (D.N.N.); (M.K.E.P.)
| | - Maria Kurniati Ester Payong
- Indonesian Medical Association Branch, Kupang 85351, Indonesia; (A.V.H.); (S.Y.T.); (Q.S.A.); (G.K.I.M.); (A.V.C.S.); (M.N.P.); (R.R.); (D.N.N.); (M.K.E.P.)
| | - Yohannes Dian Indrajati
- DDS PPDGS Konservasi Gigi FKG UGM, Jl. Sekip Utara, Sumatra, Medan 20153, Indonesia; (S.I.A.); (Y.D.I.)
| | | | - Regina Maya Manubulu
- Indonesian Pediatric Society, East Nusa Tenggara Branch, Kupang-East Nusa Tenggara, Kupang 85351, Indonesia; (S.D.P.S.); (T.S.); (T.F.); (R.M.M.)
| | - Madarina Julia
- Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta 55281, Indonesia;
| | - Aman B. Pulungan
- Department of Child Health, Faculty of Medicine, Universitas Indonesia-Ciptomangunkusumo Hospital, Jakarta 10430, Indonesia;
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