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Welch C, Wong CK, Lelijveld N, Kerac M, Wrottesley SV. Adolescent pregnancy is associated with child undernutrition: Systematic review and meta-analysis. MATERNAL & CHILD NUTRITION 2024; 20:e13569. [PMID: 37781871 PMCID: PMC10749999 DOI: 10.1111/mcn.13569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/07/2023] [Accepted: 09/05/2023] [Indexed: 10/03/2023]
Abstract
Adolescent pregnancy is associated with poor fetal growth and development which, in turn, increases the risk of childhood wasting and underweight. However, evidence on how young maternal age affects childhood anthropometry beyond the neonatal period is limited. This systematic review and meta-analysis examined associations between adolescent pregnancy and child wasting and underweight and explored potential underlying social and biological factors. Peer-reviewed literature published in English since 1990 was systematically searched. Eligible studies presented data on wasting and/or underweight in children (≤59 months) born to adolescent mothers (10-19, or ≤24 years where applicable) from low- and middle-income countries. Data extraction used a predefined extraction sheet. Both meta-analysis and qualitative synthesis were performed. Of 92 identified studies, 57 were included in the meta-analysis. The meta-analysis showed that children born to adolescent versus adult mothers were at a higher risk of moderate (odds ratio [OR]: 1.12, 95% confidence interval [CI]: 1.00-1.26 p = 0.04) and severe underweight (OR: 1.21, 95% CI: 1.08-1.35 p < 0.01). Associated risk of wasting was not statistically significant: (OR: 1.05, 95% CI: 0.98-1.12 p = 0.17); severe wasting (OR: 1.16, 95% CI: 0.68-1.96 p = 0.59). These findings were supported by the qualitative synthesis. Evidence on the potential role of biological/social factors was limited, but suggested an intermediary role of maternal nutritional status which warrants further exploration. Particularly in contexts where adolescent pregnancy remains common, interventions to both delay adolescent pregnancy and improve adolescent nutritional status could help reduce the risk of undernutrition in children and contribute to breaking the intergenerational cycle of malnutrition.
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Affiliation(s)
- Caroline Welch
- Department of Population HealthLondon School of Hygiene & Tropical MedicineLondonUK
| | - Christopher K. Wong
- Department of Population HealthLondon School of Hygiene & Tropical MedicineLondonUK
| | - Natasha Lelijveld
- Department of Population HealthLondon School of Hygiene & Tropical MedicineLondonUK
- Emergency Nutrition Network (ENN)OxfordshireUK
| | - Marko Kerac
- Department of Population HealthLondon School of Hygiene & Tropical MedicineLondonUK
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Kanmiki EW, Fatima Y, Mamun AA. Multigenerational transmission of obesity: A systematic review and meta-analysis. Obes Rev 2022; 23:e13405. [PMID: 34970828 DOI: 10.1111/obr.13405] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/03/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022]
Abstract
There is a strong link between parental and offspring obesity status. However, the state of epidemiological evidence on multigenerational transmission of overweight/obesity, such as from grandparents to grandchildren, is relatively unknown. This systematic review collates and appraises existing evidence on multigenerational transmission of overweight/obesity and uses meta-analytic estimates for quantitative synthesis. Six electronic databases were searched for publications reporting the relationship between grandparents and their grandchildren overweight/obesity status. A total of 25 studies from 17 countries with a combined population of 238,771 study participants met the inclusion criteria. About 60% (15) of the reviewed studies reported a positive association between grandparent-grandchild (GP-GC) overweight/obesity, out of which 11 were statistically significant. Seven studies reported odds ratios of GP-GC overweight/obesity associations and were included in the meta-analysis. The pooled estimates showed a significant GP-GC association in overweight/obesity status (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.01-2.57). Thus, the current research evidence shows that grandchildren's overweight/obesity status is associated with their grandparents' overweight/obesity status, indicating a multigenerational transmission of obesity. However, more studies, especially from developing countries, are required to assess the robustness of these findings. Future studies should also focus on the mechanisms through which this transmission occurs.
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Affiliation(s)
- Edmund W Kanmiki
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia.,ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland, Australia.,Alliance for Social Innovations and Livelihood Improvement (ASOLI), Bolgatanga, Upper East Region, Ghana
| | - Yaqoot Fatima
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia.,ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland, Australia.,Murtupuni Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia
| | - Abdullah A Mamun
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland, Australia.,ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland, Australia.,Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, Queensland, Australia
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Endalifer ML, Andargie G, Mohammed B, Endalifer BL. Factors associated with dietary diversity among adolescents in Woldia, Northeast Ethiopia. BMC Nutr 2021; 7:27. [PMID: 33926578 PMCID: PMC8082914 DOI: 10.1186/s40795-021-00430-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Consuming diversified food during the adolescent period is essential to build a healthy and active mind for their later life. Food prices increased in the local market due to fewer production of crops. Thus, exploring the dietary diversity of adolescents in this area is crucial to estimate diet quality. So the aim of the study was to identify determinant factors of dietary diversity. Methods An institution-based cross-sectional study was conducted among adolescent students in Woldia town. A total of four hundred eleven students were included in the study. A simple random sampling technique was used to select the participants. The outcome variable was dietary diversity; it was calculated by summing of the number of food group consumed by individuals in the given reference period. Bivariable and multivariable logistic analysis was done. The odds ratio with a 95% confidence interval was computed to measure an association. A variable with a P-value less than 0.05 is considered a significant factor. Results The proportion of inadequate dietary diversity was 49.1% (95% CI 44.5–53.8). Being female (AOR =5.53, 95% CI 3.447–8.859), secondary and above mothers’ education level (AOR=0. 27, 95%CI 0.153–0.477), living in a family size five and above (AOR= 2.09, 95CI% 1.31–3.34), and poor knowledge about nutrition (AOR=4.56, 95% CI 2.727–7.639) were significantly associated with inadequate dietary diversity. Conclusions and recommendations Inadequate dietary diversity was associated with sex, knowledge of nutrition, maternal education level, and family size. It is better to design a nutrition intervention program that focus on nutrition education to scale up diversified food consumption among adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-021-00430-6.
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Affiliation(s)
- Melese Linger Endalifer
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia.
| | - Gashaw Andargie
- Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bekri Mohammed
- Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bedilu Linger Endalifer
- Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Nutritional Status from 1 to 15 Years and Adolescent Learning for Boys and Girls in Ethiopia, India, Peru, and Vietnam. POPULATION RESEARCH AND POLICY REVIEW 2019. [DOI: 10.1007/s11113-019-09557-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Abstract
There has been little examination of: (1) associations of early-life nutrition and adolescent cognitive skills, (2) if they vary by gender, (3) if they differ by diverse contexts, and (4) contributions of post-infancy growth to adolescent cognitive attainment. We use Young Lives data on 7687 children from Ethiopia, India, Peru, and Vietnam to undertake ordinary least squares estimates of associations between age-1 height-for-age z-score (HAZ) and age-15 cognitive outcomes (math, reading, vocabulary), controlling for child and household factors. Age-1 HAZ is positively associated with cognitive scores in all countries. Child gender-specific estimates for these coefficients either do not differ (math, reading) or favor girls (vocabulary). Augmenting models to include growth in HAZ between ages 1 and 15 years that was not predicted by HAZ at age 1 reveals that such improvements are associated with higher cognitive scores, but that sex-specific coefficients for this predictor favor boys in India and Peru. The results suggest that nutritional indicators at age 1 have gender-neutral associations with math and reading and favor girls for vocabulary achievement at age 15, but unpredicted improvements in HAZ by adolescence are associated with higher cognitive scores for boys than for girls. This evidence enriches our understanding of relationships between children’s nutritional trajectories during childhood and adolescent cognitive development, and how these associations vary by gender in some contexts to the possible disadvantage of girls.
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Schott W, Aurino E, Penny ME, Behrman JR. The double burden of malnutrition among youth: Trajectories and inequalities in four emerging economies. ECONOMICS AND HUMAN BIOLOGY 2019; 34:80-91. [PMID: 31248754 DOI: 10.1016/j.ehb.2019.05.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 05/31/2019] [Accepted: 05/31/2019] [Indexed: 06/09/2023]
Abstract
As part of the nutritional transition, undernutrition is globally declining while changes brought by economic development have ushered in increases in overweight and its related economic costs and health consequences around the world. We examine trajectories in stunting and overweight from age one year to mid-adolescence and from mid-childhood to early adulthood among two cohorts from Ethiopia, India, Peru and Vietnam using data from the Young Lives study. We examine descriptive data and then model trajectories in stunting and overweight status over age. Group-based trajectory analysis with five ages of overweight and stunting for each country-cohort reveals (1) trajectories of catch-up growth for a subset of study children between the ages of 12 and 19 in the older cohort in Ethiopia (20.1% of the cohort), India (20.5%), Peru (16.9%), and Vietnam (14.0%); (2) trajectories of increasing probabilities of stunting as children age from 12 to 22 in the older cohort in India (22.2%) and Peru (30.7%); (3) trajectories of early (childhood) increases in overweight probabilities (younger cohort: India, 3.4%, Peru, 19.4%, and Vietnam, 8.1%), and of later (adolescence) increases in overweight probabilities (older cohort: Ethiopia, 0.5%, India, 6.3%, Peru, 40.9%, and Vietnam, 9.4%). Multinomial logit prediction of membership in trajectory categories reveals that higher wealth quartiles and maternal schooling are protective against high stunting probability trajectory group membership, but higher wealth and urban residence predict high overweight probability trajectory group membership. This evidence suggests a window of opportunity for interventions to reduce stunting and to avert overweight development in adolescence, in addition to the often-emphasized first 1000 days after conception. A life-course approach to policies and programs to target both undernutrition and overweight should be considered.
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Affiliation(s)
- Whitney Schott
- Population Studies Center, 3718 Locust Walk, University of Pennsylvania, Philadelphia, PA, 19104, USA; A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA.
| | - Elisabetta Aurino
- Department of Management and Centre for Health Economics and Policy Innovations, Imperial College London and Young Lives, University of Oxford, UK.
| | - Mary E Penny
- Instituto de Investigación Nutricional, Av. La Molina 1885, La Molina, Lima, Peru.
| | - Jere R Behrman
- Population Studies Center, 3718 Locust Walk, University of Pennsylvania, Philadelphia, PA, 19104, USA; Economics Department, Ronald O. Perelman Center for Political Science and Economics (PCPSE), 133 South 36th Street, University of Pennsylvania, Philadelphia, PA, 19104-6297, USA.
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Reynolds SA, Fernald LCH, Deardorff J, Behrman JR. Family structure and child development in Chile: A longitudinal analysis of household transitions involving fathers and grandparents. DEMOGRAPHIC RESEARCH 2018; 38:1777-1814. [PMID: 30906204 PMCID: PMC6430138 DOI: 10.4054/demres.2018.38.58] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Adults support child development economically, socially, and emotionally. Household transitions may disrupt these support structures, impacting child development. OBJECTIVE We document the large portion of children in Chile that experience biological-father and grandparent household transitions, and test if these transitions are associated with child vocabulary and behavior and if income could be a mechanism behind our findings. METHODS We apply first-differences and lagged-dependent-variable analyses to a large, nationally representative, longitudinal survey of over 5,000 Chilean children. RESULTS We find that children whose mothers separated from their parents' homes within the two years between two survey rounds have worse age-normalized Peabody Picture Vocabulary Test scores than children in households without such transitions. Changes in income per capita do not explain these associations. When fathers enter households between the two survey rounds there is a gain in income per capita but no association between father entrance and child's vocabulary score. Similarly, there is no significant association between fathers separating from the household and child vocabulary, though father departure is associated with lower income per capita. We find no association between household transitions and Child Behavioral Checklist (CBCL) scores. CONCLUSIONS These findings provide evidence that Chilean grandparents promote language development when coresiding with their grandchildren and that Chilean fathers are an important source of household income. CONTRIBUTION Our study examines fathers and grandparents simultaneously. We are able to take the directionality (i.e., movement in or out of the home) of biological father transitions into account.
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Affiliation(s)
- Sarah A Reynolds
- School of Public Health, University of California, Berkeley, USA
| | - Lia C H Fernald
- School of Public Health, University of California, Berkeley, USA
| | | | - Jere R Behrman
- Department of Economics, University of Pennsylvania, Philadelphia, USA
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