Nutrition challenges for the twenty-first century

Nutritional Status of Children and Its Associated Factors in Selected Earthquake-Affected VDCs of Gorkha District, Nepal

Background

Malnutrition is a major public health problem and most enveloping cause of morbidity and mortality among children and adolescents throughout the world. This study was aimed at assessing the nutritional status and associated factors among 6-10-year-old children in selected earthquake-affected areas of Gorkha district, Nepal.

Methods

A community-based cross-sectional study among 420 mothers having children of age groups 6-10 years (with anthropometric measurement among children) was conducted using a mixed method in selected earthquake-affected areas of Gorkha district, Nepal, from October 2015 to April 2016. Gorkha was selected purposively from 14 earthquake-affected districts. Two village development committees were selected randomly among 6 having severe impact. Randomly, 5 wards were selected from each of the 2 village development committees. As the sample was 420, 42 children were selected randomly from every ward.

Result

Among the 420 children, 31.9% were underweight, 51.9% were stunted, and 2.9% were wasted after the earthquake. Children who were more prone to being underweight were the following: male children (RR = 1.34 95% CI: 1.01-1.78) and children from illiterate mothers (RR = 2.49, 95% CI: 1.85-3.36), illiterate fathers (RR = 1.73, 95% CI: 1.32-2.27), and homemaker mothers (RR = 0.28, 95% CI: 0.20-0.38); children whose families were using nonimproved sources of water (RR = 2.60, 95% CI: 1.07-6.60); and households having food insecurity (RR = 12.97, 95% CI: 3.29-51.18). Similarly, children of illiterate fathers (RR = 1.67, 95% CI: 1.41-1.97), children of illiterate mothers (RR = 2.32, 95% CI: 1.91-2.83), children of homemaker mothers (RR = 0.59, 95% CI: 0.49-0.70), children whose family were using treated water (RR = 0.32, 95% CI: 0.15-0.67), and children from food insecure households (RR = 10.52, CI: 4.05-27.33) were found to be stunted. After adjustment, children from households consuming nonimproved water were 6 times more likely (OR = 6.75; 95% CI: 1.59-28.62) to be wasted.

Conclusion

Illiterate mothers, illiterate fathers, mothers engaged in occupation other than household work, and food insecure households were found to be independent predictors of underweight and stunting. Nonimproved source of drinking water was found to be independent predictors of wasting.

Prevalence of short stature and malnutrition among Egyptian primary school children and their coexistence with Anemia

Background

Under nutrition and overweight typically occur during nutritional transition periods in developing countries including Egypt. Short stature and anemia are public health concern due to its strong link with malnutrition which is a preventable risk factor.

Objectives

to estimate the prevalence of overweight, obesity, underweight and short stature and its concurrence with anemia, also to determine the etiological profile of short stature among primary school children in Egypt.

Methods

A cross-sectional study was carried out on 33,150 Egyptian children aged 6–11 years old from January 2018 to January 2020, allocated in 59 primary schools from diverse geographical districts in Egypt. Complete anthropometric measurements were conducted and applied according to WHO growth charts. Hemoglobin level was measured. Systematic approach to detect the etiology of short stature was applied randomly to a sample of 380 stunted children.

Results

The prevalence of underweight was 8.2%, while obesity and overweight represented 21.8% (9.6 and 12.2% respectively). Overall short stature constituted 17%. The main etiologies of short stature were familial (40.8%) and constitutional (24.2%). Anemia was diagnosed in 26% of children; while concurrent anemia and stunting was reported in 9.9%. Regarding anemia and anemia with stunting were more common among girls (30.0% (OR = 1.50, CI95%: 1.43–1.58) and 11.4% (OR = 1.39, CI95%:1.29–1.49) respectively), who were living in rural areas (33.4% (OR = 1.96, CI 95%:1.87–2.06) &12.7% (OR = 1.72, CI 95%:1.60–1.85)) and those who had low socioeconomic status)34.6% (OR = 2.54, CI 95%:2.29–2.82) & 17.2% (OR = 3.32, CI 95%:2.85–3.88() respectively. Anemia with stunting was significantly higher among children aged ≥9 years old representing 12% (OR = 1.40, CI 95%:1.30–1.51).

Conclusion

Prevalence of short stature, obesity and anemia was high among primary school children in Egypt with a strong concurrence between anemia and stunting. Intensive parental health education and in-depth nutritional assessment are required.

Predictors of Stunting among School-Age Children in Northwestern Ethiopia

Background

Stunting is a major public health problem in most developing countries, and it increases the risk of illness and death throughout childhood. It is also a major public health problem in Ethiopia. Most of the few studies done in Ethiopia were done in schools. However, the prevalence of stunting of school-age children at the community level is largely unknown.

Objective

To assess prevalence and predictors of stunting among school-age children in Mecha District, Amhara Regional State, Ethiopia.

Methods

A community-based cross-sectional study was conducted from August 28, 2017, to October 10, 2017. Target population for the study was school-age children (children of age 5–15). A total of 802 children were included in the study. The multistage sampling procedure was applied. Data were collected through face-to-face interview using the structured questionnaire. Anthropometric measurement was performed and analyzed using ENA SMART software. Association was assessed using logistic regression (backward LR). Statistical significance was measured using adjusted odds ratio at 95% CI and P value less than 0.05.

Results

About 37.9%, with 95% CI (34.6, 41.3), of children were stunted. The predictors of stunting were child age with AOR (95% CI) 1.4 (1.02, 1.91), family size with AOR (95% CI) 1.83 (1.21, 2.75), mother's education with AOR (95% CI) 1.81 (1.01, 3.24), father's occupation with AOR (95% CI) 5.23 (1.55, 17.64), and child's immunization status with AOR (95% CI) 5.6 (2.90, 10.82).

Conclusion

Stunting is still an important problem among children in the age of 5–15 years. Therefore, special attention should be given to child's full immunization, limiting of family size, continued promotion of female education, and appropriate feeding practice of children depending on their age.

The proportion of dementia attributable to common modifiable lifestyle factors in Barbados

OBJECTIVE

To understand what number and proportion of dementia cases in Barbados are attributable to modifiable lifestyle factors and what effect a reduction in these risk factors would have on future dementia prevalence.

METHODS

This was an observational study using Levin's Attributable Risk formula, which assumes independence of risk factors, to calculate the population attributable risk (PAR) of dementia (all-cause) for six risk factors: midlife obesity, physical inactivity, smoking, low educational attainment, diabetes mellitus, and midlife hypertension in Barbados. A recently-published, modified formula was utilized to account for non-independence of risk factors using secondary data for Barbados. The number and proportion of dementia cases attributable to each risk factor and to all risk factors combined were computed, as was the effect that any reduction in these risk factors might have on future dementia prevalence.

RESULTS

Accounting for the fact that risk factors do not operate independently, 50.9% (1 526 cases) were attributable to the combined effect of the six risk factors under study. According to the analysis, if each risk factor were reduced by 5% - 20% per decade, dementia prevalence could be 3.3% - 31.8% lower by 2050.

CONCLUSION

Using a largely theoretical model, the six modifiable lifestyle factors were estimated to be attributable to 50.9% of dementia cases in Barbados. Since the risk factors have much in common, any intervention that targets one of them could significantly reduce future dementia prevalence.

Life expectancy with and without cognitive impairment in seven Latin American and Caribbean countries

Background

The rising prevalence of cognitive impairment is an increasing challenge with the ageing of our populations but little is known about the burden in low- and middle- income Latin American and Caribbean countries (LAC) that are aging more rapidly than their developed counterparts. We examined life expectancies with cognitive impairment (CILE) and free of cognitive impairment (CIFLE) in seven developing LAC countries.

Methods

Data from The Survey on Health, Well-being and Ageing in LAC (N = 10,597) was utilised and cognitive status was assessed by the Mini-Mental State Examination (MMSE). The Sullivan Method was applied to estimate CILE and CIFLE. Logistic regression was used to determine the effect of age, gender and education on cognitive outcome. Meta-regression models were fitted for all 7 countries together to investigate the relationship between CIFLE and education in men and women at age 60.

Results

The prevalence of CI increased with age in all countries except Uruguay and with a significant gender effect observed only in Mexico where men had lower odds of CI compared to women [OR = 0.464 95% CInt (0.268 – 0.806)]. Low education was associated with increased prevalence of CI in Brazil [OR = 4.848 (1.173–20.044)], Chile [OR = 3.107 (1.098–8.793), Cuba [OR = 2.295 (1.247–4.225)] and Mexico [OR = 3.838 (1.368–10.765). For males, total life expectancy (TLE) at age 60 was highest in Cuba (19.7 years) and lowest in Brazil and Uruguay (17.6 years). TLE for females at age 60 was highest for Chileans (22.8 years) and lowest for Brazilians (20.2 years). CIFLE for men was greatest in Cuba (19.0 years) and least in Brazil (16.7 years). These differences did not appear to be explained by educational level (Men: p = 0.408, women: p = 0.695).

Conclusion

Increasing age, female sex and low education were associated with higher CI in LAC reflecting patterns found in other countries.