1
|
Samodra YL, Hsu HC, Chuang KY, Chuang YC. Family economic trajectories and body mass index in Indonesia: Evidence from the Indonesian Family Life Surveys 2 to 5. Prev Med Rep 2023; 34:102262. [PMID: 37273523 PMCID: PMC10236453 DOI: 10.1016/j.pmedr.2023.102262] [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: 02/05/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 06/06/2023] Open
Abstract
Indonesia faces the double burdens of childhood obesity and malnutrition. A family's socioeconomic status has been suggested to be one of the most influential factors contributing to childhood nutritional problems. This study aimed to: 1) identify the distinct trajectories of family economics; and 2) assess whether a family's economic trajectory influences children's body mass index (BMI). We analyzed trajectory patterns of family economic levels from 1997 to 2015 among 846 children aged under 3 years in 1997 using data from Indonesian Family Life Surveys. Trajectory patterns were identified with Group-Based Trajectory Modeling using the traj plug-in in STATA software. The BMI was classified according to 2007 World Health Organization growth standards. Adjusted relative risk ratios (aRRRs) of family economic level trajectories and children's BMI were calculated using multinomial logistic regressions. We identified three distinct trajectories of family economic level: stable poorest, stable middle, and increasing richest. In the total sample, there were no significant relationships between a family's income trajectory and children's BMI in the adjusted models. A significant relationship existed for male children, but not for female children, of compared to the poorest family trajectory group, male children in the increasing richest trajectory group were more likely to be overweight/obese (aRRR 6.1, 95% confidence interval: 1.22-30.62) after adjusting for age and BMI. The present results highlight the importance of early interventions to minimize the potential adverse impacts of excessive BMI later in adulthood.
Collapse
|
2
|
Tatah L, Bain LE, Kongnyuy E, Assah F, Mbanya JC. Shared correlates of maternal and childhood overweight in Cameroon: a cross-sectional analysis of demographic and health survey data. BMC Public Health 2023; 23:1265. [PMID: 37386386 PMCID: PMC10311895 DOI: 10.1186/s12889-023-16164-y] [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] [Received: 10/03/2022] [Accepted: 06/21/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Overweight parents are likelier to bear overweight babies, who are likelier to grow into overweight adults. Understanding the shared risks of being overweight between the mother-child dyad is essential for targeted life course interventions. In this study, we aimed to identify such risk factors in Cameroon. METHODS We conducted secondary data analysis using Cameroon's 2018 Demographic and Health Surveys. We used weighted multilevel binary logistic regressions to examine individual, household, and community correlates of maternal (15-49 years) and child (under five years) overweight. RESULTS We retained 4511 complete records for childhood and 4644 for maternal analysis. We found that 37% [95%CI:36-38%] of mothers and 12% [95%CI:11-13%] of children were overweight or obese. Many environmental and sociodemographic factors were positively associated with maternal overweight, namely urban residence, wealthier households, higher education, parity and being a Christian. Childhood overweight was positively associated with a child being older and a mother being overweight, a worker, or a Christian. Therefore, only religion affected both mothers overweight (aOR: 0.71[95%CI:0.56-0.91]) and childhood overweight (aOR 0.67[95%CI: 0.5-0.91]). Most of the potentially shared factors only indirectly affected childhood overweight through maternal overweight. CONCLUSION Besides religion, which affects both mothers and childhood overweight (with the Muslim faith being protective), much of childhood overweight is not directly explained by many of the observed determinants of maternal overweight. These determinants are likely to influence childhood overweight indirectly through maternal overweight. Extending this analysis to include unobserved correlates such as physical activity, dietary, and genetic characteristics would produce a more comprehensive picture of shared mother-child overweight correlates.
Collapse
Affiliation(s)
- Lambed Tatah
- Health of Populations in Transition Research Group (HoPiT), University of Yaoundé I, 8046, Yaoundé, Cameroon
- Medical Research Council Epidemiology Unit, University of Cambridge, CB2 0QQ, Cambridge, UK
| | - Luchuo Engelbert Bain
- Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
- International Development Research Centre, IDRC, Ottawa, ON, Canada
| | | | - Felix Assah
- Health of Populations in Transition Research Group (HoPiT), University of Yaoundé I, 8046, Yaoundé, Cameroon
| | - Jean Claude Mbanya
- Health of Populations in Transition Research Group (HoPiT), University of Yaoundé I, 8046, Yaoundé, Cameroon
| |
Collapse
|
3
|
Khadilkar AV, Oza C, Mondkar SA, Khadilkar V, Kanungo A, Sethi BK, Kumar KMP, Tandon N, Rao PV, Kumar S, Bandgar TR, Raghupathy P. Nutritional Status of Underprivileged Indian Children and Youth with Type-1 Diabetes - A Multicentre Study. Indian J Endocrinol Metab 2023; 27:216-222. [PMID: 37583405 PMCID: PMC10424112 DOI: 10.4103/ijem.ijem_224_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/25/2022] [Accepted: 11/20/2022] [Indexed: 08/17/2023] Open
Abstract
Background India has the highest number of prevalent type-1 diabetes (T1D) cases in the under-20-year age population. Data on the anthropometry of underprivileged Indian children with T1D are scarce. In economically disadvantaged countries like India, poor growth in patients with T1D is a major concern due to limited accessibility and affordability. Besides, due to the double burden of malnutrition, the prevalence of obesity is increasing mirroring the global trends, which may lead to the development of insulin resistance. Objectives This study aims to assess the prevalence of malnutrition in Indian children and youth with T1D and to identify the determinants of short stature. Methods A registry-based cross-sectional analysis of data collected from various centres across India enrolled in the Changing Diabetes in Children (CDiC) programme. Results We observed that 6.4% were undernourished (3.4% severe undernutrition) and 17.7% (overweight 13.2%) had combined overweight/obesity. 21.2% of participants had short stature (adjusted for mid-parental height) with 7.4% cases of familial short stature. Longer duration of illness and insulin requirement were significant positive predictors of short stature while glycaemic control, insulin regimen and mid-parental height did not have a significant relationship with short stature. Participants on basal-bolus regimen had significantly higher insulin requirements and better glycaemic control than the ones on mixed-split regimen. Conclusion We report that around one-fifth of children and youth with T1D were overweight/obese and around a fourth were stunted, especially those with longer duration of diabetes and higher insulin requirements. Close monitoring of anthropometric parameters is necessary for all children with T1D to optimize growth and nutrition.
Collapse
Affiliation(s)
- Anuradha V. Khadilkar
- Department of Growth and Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, Odisha, India
- Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, Odisha, India
| | - Chirantap Oza
- Department of Growth and Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, Odisha, India
| | - Shruti A. Mondkar
- Department of Growth and Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, Odisha, India
| | - Vaman Khadilkar
- Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, Odisha, India
- Department of Paediatric Endocrinology, Senior Paediatric Endocrinologist, Jehangir Hospital, Pune, Maharashtra, Odisha, India
| | - Alok Kanungo
- Department of Pediatric Endocrinology, Kanungo Institute of Diabetes Specialties, 1120, Dumduma, Bhubhaneswar, Odisha, India
| | - Bipin K. Sethi
- Department of Endocrinology – Tapadia Diagnostics, Hyderabad, Telangana, India
| | - KM Prasanna Kumar
- Department of Endocrinology, Centre for Diabetes and Endocrine Care, Bengaluru, Karnataka, India
| | - Nikhil Tandon
- Department of Endocrinology, All India Institute of Medical Sciences, Delhi, India
| | - P V Rao
- Diabetes Research Society, Hyderabad, Telangana, India
| | - Surendra Kumar
- Department of Endocrinology, Patna Medical College, Patna, Bihar, India
| | - Tushar R. Bandgar
- Department of Endocrinology, Seth G S Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Palany Raghupathy
- Department of Pediatric Endocrinology, Paediatric and Adolescent Endocrinology Division, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India
| |
Collapse
|
4
|
Karlsson O, Kim R, Guerrero S, Hasman A, Subramanian S. Child wasting before and after age two years: A cross-sectional study of 94 countries. EClinicalMedicine 2022; 46:101353. [PMID: 35360149 PMCID: PMC8961190 DOI: 10.1016/j.eclinm.2022.101353] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/08/2022] [Accepted: 03/02/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Wasting reflects infections and poor nutrition and affects almost 50 million children at any given time. Wasting comes with immediate risk of mortality and increased risks for long-term negative consequences for development. Children under two are particularly sensitive to undernutrition and infections. We estimated the age patterning in wasting prevalence. METHODS We calculated wasting prevalence and used Poisson regression models to estimate prevalence ratios comparing prevalence in children under and over two years using data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 94 mostly low- and middle-income countries, including 804,172 children under five, born to a nationally representative sample of women 15-49 years old. Wasting prevalence was defined as the percentage of children with weight-for-height below -2 z-score from the median of the WHO 2006 growth standard. FINDINGS Wasting prevalence for children under two was 14% (95% CI: 13, 14) while it was 9% (95% CI: 9, 9) for children 2-4 years old-leading to a prevalence ratio of 0·66 (95% CI: 0·64, 0·67) in our pooled sample. Prevalence ratios were less than one, indicating lower prevalence in children over two, in 87 countries and statistically significantly lower than one at a 5% level (non-adjusted) in 68 countries. Wasting prevalence was generally lower in children under two for males and females and the wealthiest and poorest households. INTERPRETATION Since wasting prevalence was observed to be greater among children 0-2 years, and adverse exposure to undernutrition and infections are particularly harmful and interventions are more effective during the 1000 days from conception until age two, nutrition interventions should ensure coverage of children under two through programmatic measures to increase detection and enrollment in wasting programs. FUNDING UNICEF, Nutrition Section, Programme Division in New York.
Collapse
Affiliation(s)
- Omar Karlsson
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115, United States
- Department of Economic History, School of Economics and Management, Lund University, P.O. Box 7083, Lund 220 07, Sweden
| | - Rockli Kim
- Division of Health Policy & Management, College of Health Science, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, South Korea
- Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, United States
- Corresponding authors at: S.V. Subramanian, Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, United States. Rockli Kim, Division of Health Policy & Management, College of Health Science, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, South Korea.
| | - Saul Guerrero
- UNICEF Programme Division, 3 United Nations Plaza, New York, NY 10017, United States
| | - Andreas Hasman
- UNICEF Programme Division, 3 United Nations Plaza, New York, NY 10017, United States
| | - S.V. Subramanian
- Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, United States
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115, United States
- Corresponding authors at: S.V. Subramanian, Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, United States. Rockli Kim, Division of Health Policy & Management, College of Health Science, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, South Korea.
| |
Collapse
|