Examining the Effect of Geographic Region of Residence on Childhood Malnutrition in Uganda

OBJECTIVES

In our study, we examine how geographic region of residence may predict childhood malnutrition, expressed as stunting, wasting and underweight, among children under the age of 5 years in Uganda.

METHODS

Using data from the 2016 Uganda Demographic and Health Survey, we performed an incremental multivariate multilevel mixed-effect modelling to examine the effect of a child, parental and household factors on the association between region of residence and each indicator of childhood malnutrition.

RESULTS

Approximately 28%, 3% and 9% of children under age 5 suffered from stunting, wasting and underweight, respectively. The bivariate result shows that the proportion of children suffering from stunting and underweight was relatively lower in the Kampala region compared with the other regions. With the exception of the Northern region (6.44%), wasting was higher (4.12%) among children in the Kampala region. Children in the other regions were more likely to experience stunting and underweight. When controlling for child, parent and household factors, children in the other regions were less likely to suffer from underweight and stunting, compared with those in Kampala region. Children in the other regions, except the Northern region, were less likely to be wasted compared with those in Kampala region.

CONCLUSION

Our finding suggests that child, parental and household characteristics have effects on the association between region of residence and childhood malnutrition. Addressing individual and household socioeconomic disparities may be vital in tackling regional differences in childhood malnutrition.

Fetal Exposure to Chinese Famine Increases Obesity Risk in Adulthood

Fetal exposure to famine may have long-term consequences in adulthood. The purpose of the present study was to explore the association between famine exposure in fetal life (Chinese famine in 1959–1961) and obesity risk in adulthood. A total of 8054 subjects (3422 male, 4632 female) were recruited from the cross-sectional 2010–2012 China National Nutrition and Health Survey (CNNHS). The subjects born in 1960 and 1961 were selected as the exposed group, while the subjects born in 1963 were selected as the unexposed group. Multiple linear or logistic regression was performed to examine the association between fetal exposure to famine and risk of obesity (body mass index (BMI), waist circumference (WC), obesity, central obesity) adjusting for gender, education level, economic status, physical exercise, sedentary time, smoking, drinking, the intake of livestock and poultry and the intake of cereal and beans. Compared with the unexposed group, WC increased by 0.52 cm after adjusting the covariates (p = 0.021) and females in the exposed group had a significantly higher prevalence of central obesity with an odds ratio (OR) of 1.15 (1.01,1.31) after adjusting the confounders (p = 0.030). WC increased by 0.71 cm, 1.21 cm after adjusting the covariates compared with the unexposed group among the total subjects and the female subjects in urban areas (p = 0.021, p = 0.001). The female subjects had a significantly higher prevalence of obesity and central obesity, with ORs of 1.34 (1.04,1.71) (p = 0.022), 1.28 (1.07,1.53) (p = 0.008) respectively. Our results suggest that fetal exposure to the Chinese famine increased obesity risk in adulthood, and the association was stronger in female and urban subjects.

Protein Malnutrition Pre- and Postnatal and Nutritional Rehabilitation Modulates the Morphology of Muscle Fibers in Wistar Rats

This study investigated the effects of pre- and postnatal conditions of protein deficiency followed to nutritional rehabilitation in the morphology of skeletal muscle. Twelve Wistar male rats were distributed in two groups: nourished (N), with normal protein diet and undernourished (U), with low protein diet. The respective diet was maintained until animals completed 21 days of life. After that, part of group U (n = 4) received normal protein diet, forming a third group, renourished group (R). Forty-two-day-old animals were euthanized and we performed histopathological and morphometric analysis of the soleus muscle. Analysis stained in hematoxylin and eosin (H&E) of the group N revealed polygonal and equidistant muscle fibers, with normal distribution in muscle fascicles. However, D group had rounded and disorganized fibers with different distances between them in muscle fascicles. R group presented muscle fibers with several formats, polygonal and rounded, and some muscle fascicles starting the reorganization process. In N group, analysis of the connective tissue showed predominance of type I collagen and a lower amount collagen type III, both well organized. Whereas U group had a predominance of disorganized type III collagen, in R group, there was return of type I collagen, but partially organized. Muscle fiber area of U (163.18 ± 52.55 μm²) and R (381.79 ± 26.62 μm²) groups was smaller than N (1229.2 μm² ± 61.12 μm²). Muscle fibers density of groups U (3369 ± 1226 fibers/mm²) and R (1979 ± 28 fibers/mm²) was larger than N (830 ± 113 fibers/mm²). The nutritional rehabilitation in the present study showed an attempt of reorganization of the muscle tissue.

Over-nutrient environment during both prenatal and postnatal development increases severity of islet injury, hyperglycemia, and metabolic disorders in the offspring

Prenatal and postnatal over-nutrition has emerged as a new health issue contributing to metabolic disorders in early development of the offspring. Accumulating evidence has suggested that adverse prenatal and postnatal environments gave rise to the predisposition to metabolic syndromes including hyperglycemia, obesity, and diabetes. However, little research has concentrated on the effects of exposures to both adverse conditions before and after birth of the offspring. In this study, we aimed to investigate whether prenatal and postnatal over-nutrition is able to cause metabolic disorders to female mice feed on high-fat/fructose diet (HFFD) as well as their offspring. Female mice were fed on either HFFD or a normal chow diet (NC), while their offspring were divided into four experimental groups as NC/NC, HFFD/NC, NC/HFFD, and HFFD/HFFD (prenatal/postnatal diet order), respectively. Both NC/HFFD and HFFD/HFFD offspring exhibited obvious body weight and fat content gain, hyperglycemia, and severe insulin resistance. Interestingly, when compared to NC/HFFD offspring, the HFFD/HFFD offspring exhibited more severe alterations in their metabolism and dysfunctions on pancreatic β-cells, suggesting a potential impact of prenatal HFFD on the programming of pancreatic β-cell deficiency in the fetus. Meanwhile, the results from HFFD/NC mice indicated that a balance diet after birth partially compensated the adverse prenatal HFFD impact. In conclusion, this study demonstrated that prenatal and postnatal over-nutrition increases severity of islet injury, hyperglycemia, and metabolic disorders in the offspring.