Association between admission criteria and body composition among young children with moderate acute malnutrition, a cross-sectional study from Burkina Faso

Household behavior and vulnerability to acute malnutrition in Kenya

Anticipating those most at-risk of being acutely malnourished significantly shapes decisions that pertain to resource allocation and intervention in times of food crises. Yet, the assumption that household behavior in times of crisis is homogeneous-that households share the same capacity to adapt to external shocks-ostensibly prevails. This assumption fails to explain why, in a given geographical context, some households remain more vulnerable to acute malnutrition relative to others, and why a given risk factor may have a differential effect across households? In an effort to explore how variation in household behavior influences vulnerability to malnutrition, we use a unique household dataset that spans 23 Kenyan counties from 2016 to 2020 to seed, calibrate, and validate an evidence-driven computational model. We use the model to conduct a series of counterfactual experiments on the relationship between household adaptive capacity and vulnerability to acute malnutrition. Our findings suggest that households are differently impacted by given risk factors, with the most vulnerable households typically being the least adaptive. These findings further underscore the salience of household adaptive capacity, in particular, that adaption is less effective for economic vis-à-vis climate shocks. By making explicit the link between patterns of household behavior and vulnerability in the short- to medium-term, we underscore the need for famine early warning to better account for variation in household-level behavior.

Childhood BMI and other measures of body composition as a predictor of cardiometabolic non-communicable diseases in adulthood: a systematic review

OBJECTIVE

There is growing evidence that childhood malnutrition is associated with non-communicable diseases (NCD) in adulthood and that body composition mediates some of this association. This review aims to determine if childhood body composition can be used to predict later-life cardiometabolic NCD and which measures of body composition predicts future NCD.

DESIGN

Electronic databases were searched for articles where: children aged under 5 years had body composition measured; cardiometabolic health outcomes were measured a minimum of 10 years later.

SETTING

The databases Embase, Medline and Global Health were searched through July 2020.

PARTICIPANTS

Children aged under 5 years with a follow-up of minimum 10 years.

RESULTS

Twenty-nine studies met the inclusion criteria. Though a poor proxy measure of body composition, body mass index (BMI) was commonly reported (n 28, 97 %). 25 % of these studies included an additional measure (ponderal index or skinfold thickness). Few studies adjusted for current body size (n 11, 39 %).

CONCLUSIONS

Many studies reported that low infant BMI and high childhood BMI were associated with an increased risk of NCD-related outcomes in later life but no conclusions can be made about the exact timing of child malnutrition and consequent impact on NCD. Because studies focussed on BMI rather than direct measures of body composition, nothing can be said about which measures of body composition in childhood are most useful. Future research on child nutrition and long-term outcomes is urgently needed and should include validated body composition assessments as well as standard anthropometric and BMI measurements.