Effectiveness of Dietary Management for Moderate Wasting among Children > 6 Months of Age-A Systematic Review and Meta-Analysis Exploring Different Types, Quantities, and Durations

Currently, no World Health Organization guidelines exist for the management of approximately 31.8 million moderately wasted children globally. The objective of this review was to synthesise evidence on the optimal type, quantity, and duration of dietary treatment for moderate wasting. Ten electronic databases were searched until the 23rd of August 2021. Experimental studies comparing interventions for the dietary management of moderate wasting were included. Meta-analyses were conducted and results were presented as risk ratios or mean differences with 95% confidence intervals. Seventeen studies comparing specially formulated foods were included involving 23,005 participants. Findings suggest little or no difference in recovery between Fortified Blended Foods (FBFs) with improved micronutrient and/or milk content (enhanced FBFs) and lipid-based nutrient supplements (LNS), whereas children treated with non-enhanced FBFs (locally produced FBFs or standard corn-soy blend) may have lower recovery rates than those treated with LNS. There was no difference in recovery when ready-to-use therapeutic and ready-to-use supplementary food were compared. Other outcomes mostly aligned with results for recovery. In conclusion, LNSs improve recovery compared to non-enhanced FBFs, but are comparable to enhanced FBFs. Programmatic choice of supplement should consider factors such as cost, cost-effectiveness, and acceptability. Further research is required to determine optimal dosing and duration of supplementation.

Smart Management of Malnutrition Using Local Foods: A Sustainable Initiative for Developing Countries

Malnutrition is one of the major challenges the developing world is currently facing, whether it is caused by climate change, terrorism and conflict, or demographic shifts. Poverty is the main cause of malnutrition in this part of the world, and no progress is possible without the alleviation of poverty to reduce malnutrition. Reducing household vulnerability and increasing household resilience is the pathway to sustainable malnutrition management. Malnutrition has been a major threat to the health and development of children in developing countries, presenting as high levels of micronutrient deficiencies, stunting, and global acute malnutrition. The rates of malnutrition of all forms are above the thresholds accepted by the WHO in some regions. To this end, the resilience program on achieving nutrition in a developing country through at-home learning activities for nutritional rehabilitation and dietary promotion (known as FARN) reported, in this case, successful results from both statements from beneficiaries and non-beneficiaries on the reduction and management of malnutrition in their health centers. FARN activity encourages the consumption of locally available foods not only to eradicate malnutrition but also to protect the ecosystem and sustainable nutrition security. This is much like the saying, “Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime” to the vulnerable people; parents' knowledge of their child's nutritional status and the use of local-based foods diets showed improvement, which is proof of the impact of the resilience program. It can be concluded that the resilience program through its activities at the level of the selected community significantly affected the factors and degree of persistence of malnutrition and the level of resilience of the populations. Thus, the FARN program showed resounding success in its ability to promote sustainable malnutrition management.

Household food spending, parental and childhood's diet quality, in financial crisis: a cross-sectional study in Greece

BACKGROUND

Over the past decade, the financial crisis has affected harshly the household income of Greek people. This study aimed to investigate whether the effect of the financial crisis on food spending has affected the dietary habits in the family environment.

METHODS

Under a cross-sectional study conducted during 2014-2016, 1145 children and their parents completed questionnaires examining socio-economic and dietary characteristics. The MedDietScore and the KIDMED Score were used to assess parental and childhood adherence to the Mediterranean diet, respectively.

RESULTS

The parents who reported that the financial crisis has affected food spending used to consume weekly fewer fruits (3.26 ± 0.94 vs. 3.41 ± 0.90, P = 0.016), carbohydrate foods (3.16 ± 0.57 vs. 2.99 ± 0.55, P < 0.001) and legumes (3.28 ± 0.76 vs. 3.14 ± 0.67, P = 0.001) and more nutrient-poor/energy-dense foods (2.55 ± 0.98 vs. 2.20 ± 0.82, P < 0.001) compared with non-affected parents. Their children showed a decreased weekly consumption of vegetables (2.82 ± 0.90 vs. 2.97 ± 0.98, P = 0.019) and increased weekly consumption of nutrient-poor/energy-dense foods (2.38 ± 0.97 vs. 2.19 ± 0.80, P < 0.001). The affected parents had a lower MedDietScore than non-affected parents (25.76 ± 8.10 vs. 27.03 ± 8.11, P = 0.034). No difference was revealed on the KIDMED Score (P = 0.294).

CONCLUSIONS

The constrained food spending due to financial crisis has an independent and inverse impact on parent's diet quality while keeping unaffected preadolescent's diet quality. This finding highlights the role of parents as a protective 'wall' against the deterioration of their children's diet quality. The modification on the prices of healthy food and the provision of food aid particularly in economically disadvantaged households is underlined.