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Miller LC, Neupane S, Joshi N, Lohani M. A multi-sectoral community development intervention has a positive impact on diet quality and growth in school-age children in rural Nepal. MATERNAL & CHILD NUTRITION 2024; 20:e13637. [PMID: 38488300 PMCID: PMC11168361 DOI: 10.1111/mcn.13637] [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: 05/29/2023] [Revised: 12/26/2023] [Accepted: 02/18/2024] [Indexed: 06/13/2024]
Abstract
Poor diet quality (diet diversity and animal-source food [ASF] consumption) during childhood negatively affects growth, development, behaviour and physiologic function in later life. Relatively less is known about the impact of poor diet on the growth of school-age children compared to children <5 years of age, especially in low/middle-income countries. A better understanding of delivery strategies for effective interventions to improve diet and hence growth in school-age children is needed. A 36-month longitudinal controlled impact evaluation in rural Nepal assessed the nutrition and growth of children <5 years of age in families assigned via community clusters to full package intervention (community development, training in nutrition [during pregnancy and for children <5 years] and livestock husbandry), partial package (training only) or control (no inputs). Concurrent data were collected prospectively (baseline plus additional four rounds) on school-age children (5-8 years at baseline) in these households; the present study analysed findings in the cohort of school-age children seen at all five study visits (n = 341). Diet quality improved more in the full package school-age children compared to those in partial package or control households. full package children consumed more ASF (β +0.40 [CI 0.07,0.73], p < 0.05), more diverse diets (β +0.93 [CI 0.55,1.31], p < 0.001) and had better head circumference z-scores (β +0.21 [CI 0.07,0.35], p < 0.01) than control children. In conclusion, a multi-sectoral community development intervention was associated with improvements in diet and growth of school-age children in rural Nepal even though the intervention focused on the diet of children <5 years of age. The diet and growth of school-age children can be favourably influenced by community-level interventions, even indirectly.
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Affiliation(s)
- Laurie C. Miller
- Department of Pediatrics, Tufts Medical Center and Friedman School of Nutrition Science and PolicyTufts UniversityBostonMassachusettsUSA
| | - Sumanta Neupane
- Nutrition Diet and Health, Division of Poverty, Health, and NutritionInternational Food Policy Research InstituteKathmanduNepal
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Ouedraogo DS, Compaore EWR, Ouedraogo O, Dicko MH. Associated factors of dietary diversity among schoolchildren in Plateau Central region of Burkina Faso: a cross-sectional study. BMC Nutr 2024; 10:91. [PMID: 38918872 PMCID: PMC11197321 DOI: 10.1186/s40795-024-00896-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/11/2024] [Indexed: 06/27/2024] Open
Abstract
CONTEXT School-age is a dynamic period of growth and development, leading to good health and a productive adult life. Adequate dietary intake provides essential nutrients for growth, health and cognition. However, the practices of adequate nutrition is still not a matter of course for schoolchildren in many countries. The aim of this study was to identify associated factors of dietary diversity among students in public primary school in the Central Plateau Region. METHOD Multi-stage sampling was used to select schoolchildren. A semi-structured questionnaire was used to collect information's of food consumption at home and at school using a 24-h dietary recall method. Binary logistic regression was used to identify variables associated with students' dietary diversity scores (DDS) with statistical significance at p < 0.05, after performing Chi-square test of independence to identify candidates variables at p < 0.25. RESULTS The study involved 560 pupils aged 6 to 14 older, including 52.9% girls and 47.9% boys. Dietary diversity was divided into three classes: low (DDS ≤ 4), medium (DDS = 5) and high (DDS ≥ 6). Thus, 13.4% of students have a low DDS and average in 48.9%, versus 37.7% high. Students in Ganzourgou were twice as likely to have a low DDS (AOR = 2.01, 95% CI:1.00-4.04) compared to those in Oubritenga. Household drinking water source, pupil status and father's occupation were significantly associated with pupils' dietary intake. CONCLUSION Primary schoolchildren don't have good dietary practices in the Plateau Central Region. Promoting dietary diversification in households and balanced meals in school canteens would be necessary to improve the DDS of schoolchildren. TRIAL REGISTRATION Clinical Trial Number: 2022_33_/MS/MESRSI/CERS of 02/14/2022.
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Affiliation(s)
- Daniel Somwaoga Ouedraogo
- Department of Biochemistry/Microbiology, Laboratory of Biochemistry, Biotechnology, Food Technology and Nutrition (LABIOTAN), Joseph KI-ZERBO University, Ouagadougou, Burkina Faso.
- , 03 BP 7021, Ouagadougou 03, Burkina Faso.
| | - Ella W R Compaore
- Department of Biochemistry/Microbiology, Laboratory of Biochemistry, Biotechnology, Food Technology and Nutrition (LABIOTAN), Joseph KI-ZERBO University, Ouagadougou, Burkina Faso
- , 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Ousmane Ouedraogo
- Department of Biochemistry/Microbiology, Laboratory of Biochemistry, Biotechnology, Food Technology and Nutrition (LABIOTAN), Joseph KI-ZERBO University, Ouagadougou, Burkina Faso
- , 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Mamoudou H Dicko
- Department of Biochemistry/Microbiology, Laboratory of Biochemistry, Biotechnology, Food Technology and Nutrition (LABIOTAN), Joseph KI-ZERBO University, Ouagadougou, Burkina Faso
- , 03 BP 7021, Ouagadougou 03, Burkina Faso
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Ejoh AR, Nwachan BM, Noumo NT. An assessment of the nutritional status of internally displaced school children in the West and Littoral Regions of Cameroon. Food Sci Nutr 2024; 12:4086-4099. [PMID: 38873487 PMCID: PMC11167137 DOI: 10.1002/fsn3.4068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 02/16/2024] [Accepted: 02/24/2024] [Indexed: 06/15/2024] Open
Abstract
Malnutrition remains a major public health challenge among children in developing countries, especially those experiencing civil wars and political unrest. It is imperative to ascertain the level of malnutrition, particularly in displaced children, to develop and effectively implement interventions. This study was a cross-sectional survey conducted to assess the nutritional status of 657 internally displaced school-aged children (5-15 years) enrolled in primary schools in the West and Littoral Regions of Cameroon. The height, weight, and mid-upper arm circumference of the children were measured using standard measurements. Clinical examinations were also made on the children. Other parameters that affect nutritional status, such as morbidity and health-seeking practices, were assessed using pre-tested, structured interviewer questionnaires. An analysis of the data revealed that stunting was the most prevalent form of malnutrition (27.1%), followed by wasting (23%), thinness (21.6%), and underweight (20.1%). About 44.5% of the children had low serum iron, and 35.7% of them had poor protein status. The prevalence of anemia was 30.0%. The most common signs of protein, vitamin A, and iron deficiencies observed were thin, dry, or sparse hair (5.2%), pallor (7.3%), and xerosis (3.3%), respectively. About 32% of the children had been sick within the previous month of the study, and the most common illness was the common cold (19.8%). Most of them (>60%) had good health-seeking practices. The high prevalence of stunting, wasting, thinness, underweight, anemia, protein, and iron deficiency calls for interventions such as nutrition education and supplementation to prevent malnutrition and diet-related diseases among children.
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Affiliation(s)
- Aba Richard Ejoh
- Nutrition, Food and Bioresource TechnologyUniversity of BamendaBamendaCameroon
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Bello F, Koukou E, Bodjrenou S, Termote C, Azokpota P, Hounkpatin WA. Food and nutrition knowledge, attitudes and practices among children in public primary school with canteens in southern Benin: a case study. BMC Nutr 2024; 10:40. [PMID: 38438938 PMCID: PMC10910792 DOI: 10.1186/s40795-024-00857-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 02/22/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Food and nutrition notion among schoolchildren in Benin is still less documented. Few studies have examined the determinants of food and nutrition among schoolchildren while others have attempted to link knowledge, attitudes and practices to diet. The present study aims to evaluate food and nutrition knowledge, attitudes and practices among schoolchildren enrolled in public primary schools canteens in Cotonou and its surroundings. METHODS A diagnostic study was conducted in twelve public primary schools with canteens. A structured interview questionnaire was used to collect data from 861 schoolchildren aged 7 to 14 years. Three scores were used to assess the level of knowledge, attitude and practice. The overall score was the total of correct responses. The maximum score for all the three parameters was 15, 6 and 4 respectively for knowledge, attitude and practices. Data were analyzed using STATA 16. Logistic regression was performed to identify the relationship between food and nutrition practices and knowledge and attitude. Pearson goodness of fit test was performed to verify the adequacy of the model. A P-value of less than 0.05 (P < 0.05) was considered significant at 95% confidence interval. RESULTS schoolchildren's nutrition knowledge was low (mean score 2.52 ± 1.33) while attitude and practices were acceptable (mean score 4.08 ± 1.39 and 2.84 ± 0.77). Only 18.2% of schoolchildren knew the different food groups and 3.4% knew that they should eat at least five fruits and vegetables a day. Most of the schoolchildren (93.6%) were favorable to eat at least five fruits and vegetables and 86.8% were willing to eat more than 3 times a day. Among all practices, snacking between meals and eating breakfast were poorly observed by the schoolchildren. Nutrition knowledge was associated with practices observed among schoolchildren but not with attitudes. However, a significant positive association was observed (p < 0.05) between attitudes and practices. CONCLUSION Knowledge on food and nutrition among schoolchildren from public primary schools with canteen was low. This study suggests implementation of nutritional education to improve schoolchildren's knowledge and attitudes towards healthy diets and nutrition.
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Affiliation(s)
- Faïck Bello
- School of Nutrition and Food Technology and Sciences, Faculty of Agricultural Sciences, University of Abomey-Calavi, Calavi, Benin.
| | - Elie Koukou
- School of Nutrition and Food Technology and Sciences, Faculty of Agricultural Sciences, University of Abomey-Calavi, Calavi, Benin
- Alliance of Bioversity International and CIAT, Abomey-Calavi, Calavi, Benin
| | - Sam Bodjrenou
- School of Nutrition and Food Technology and Sciences, Faculty of Agricultural Sciences, University of Abomey-Calavi, Calavi, Benin
- Alliance of Bioversity International and CIAT, Abomey-Calavi, Calavi, Benin
| | - Céline Termote
- Alliance of Bioversity International and CIAT, Duduville Campus, Nairobi, Kenya
| | - Paulin Azokpota
- School of Nutrition and Food Technology and Sciences, Faculty of Agricultural Sciences, University of Abomey-Calavi, Calavi, Benin
| | - Waliou Amoussa Hounkpatin
- School of Nutrition and Food Technology and Sciences, Faculty of Agricultural Sciences, University of Abomey-Calavi, Calavi, Benin
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Rosa KD, Beatriz Limberger L, de Queiroz Fischer M, Dos Santos C, Reuter CP, Dallazem Bertol C, André Horta J, Franke SIR, Prá D. Anaemia among school children of different socioeconomical status in a city of Southern Brazil. Ann Hum Biol 2024; 51:1-7. [PMID: 38251840 DOI: 10.1080/03014460.2023.2298473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/06/2023] [Indexed: 01/23/2024]
Abstract
Background: Iron deficiency is one of the leading causes of anaemia, with those most affected being children and women of childbearing age, in Brazil there is a scarcity of studies involving the local prevalence of anaemia. Aim: To evaluate anaemia and associated factors in schoolchildren in Santa Cruz do Sul through the analysis of biochemical and haematological markers and parasitological examination of faeces. Subjects and methods: School children from 10 to 12 years of age were evaluated through complete blood count, serum ferritin, C-reactive protein and stool parasitological examination, as well as socio-demographic characteristics and prophylaxis with ferrous sulphate in childhood. Results: It was found that 13.0% of the population was anaemic, girls were very slightly overrepresented among the anaemic children. Only 5.3% had altered haematocrit levels; 26.6% had low Mean Corpuscular Volume levels; 18.4% had low ferritin levels; 2.4% had increased C-reactive protein levels, and 21.7% had altered eosinophils. As for the socioeconomic level, classes A2 and D presented lower haemoglobin levels, as well as class D presenting lower ferritin levels, although without statistical significance. Only 6.0% of the population presented iron-deficiency anaemia and 46.0% of the schoolchildren had used ferrous sulphate supplementation in childhood. Conclusion: The prevalence of anaemia in the studied municipality is low, probably due to the high municipal human development index. Epidemiological studies are essential to characterise the population in a systematic form, to prevent future problems.
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Affiliation(s)
- Karini da Rosa
- Programa de Pós Graduação em Envelhecimento Humano, Universidade de Passo Fundo, Passo Fundo, Brazil
| | - Luana Beatriz Limberger
- Programa de Pós Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Maiara de Queiroz Fischer
- Programa de Pós Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Caroline Dos Santos
- Programa de Pós Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Cézane Priscila Reuter
- Programa de Pós Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Charise Dallazem Bertol
- Programa de Pós Graduação em Envelhecimento Humano, Universidade de Passo Fundo, Passo Fundo, Brazil
| | - Jorge André Horta
- Programa de Pós Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Silvia Isabel Rech Franke
- Programa de Pós Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, Brazil
| | - Daniel Prá
- Programa de Pós Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul, Santa Cruz do Sul, Brazil
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Gharge S, Vlachopoulos D, Skinner AM, Williams CA, Iniesta RR, Unisa S. The effect of the Mid-Day Meal programme on the longitudinal physical growth from childhood to adolescence in India. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002742. [PMID: 38206897 PMCID: PMC10783765 DOI: 10.1371/journal.pgph.0002742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/30/2023] [Indexed: 01/13/2024]
Abstract
The study aims to examine the effect of the world's largest school-feeding programme, the Mid-Day Meal (MDM) programme, on the changes in the underweight prevalence among school-children in India. Data from the Indian Human Development Survey (IHDS) Rounds 1 (2004-05) and 2 (2011-12) were utilized. The sample included individual-level information of children aged 6 to 9 years in IHDS-1 who then turned 13 to 16 years in IHDS-2. The sample was categorised into four groups based on their MDM consumption history (Group 1: no MDM support in IHDS-1 and IHDS-2, Group 2: MDM support in IHDS-1, Group 3: MDM support in IHDS-2, Group 4: persistent MDM support in IHDS-1 and IHDS-2). The dependent variable was underweight status as defined by the World Health Organisation Child Growth Standards Body Mass Index for age (BMI Z-score) < -2 SD of the median. Bivariate analysis was used to examine the prevalence of underweight and establish associations between underweight status and socio-demographic characteristics. Logistic regression was performed to assess the strength of the association of socio-demographic characteristics and MDM consumption patterns with underweight across poor and non-poor asset groups. The findings suggest that early and persistent MDM support among respondents reduced the likelihood of low BMI Z-scores compared to those without MDM support. Respondents from the poor asset group who received MDM support in at least one of the two survey rounds had higher odds of being underweight in comparison with those who did not receive MDM support at all. Girls and adolescents residing in the Eastern region of India were less likely to be underweight. The study shows that the MDM programme was effective in reducing the rate of underweight among school children. However, continuous programme upscaling with a special focus on children from poor households will significantly benefit India's school-aged children.
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Affiliation(s)
- Shivani Gharge
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Dimitris Vlachopoulos
- Children’s Health and Exercise Research Centre, Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Annie M Skinner
- Children’s Health and Exercise Research Centre, Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Craig A Williams
- Children’s Health and Exercise Research Centre, Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Raquel Revuelta Iniesta
- Children’s Health and Exercise Research Centre, Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Sayeed Unisa
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Mideksa S, Getachew T, Bogale F, Woldie E, Ararso D, Samuel A, Girma M, Tessema M, Hadis M. School feeding in Ethiopia: a scoping review. BMC Public Health 2024; 24:138. [PMID: 38195498 PMCID: PMC10777510 DOI: 10.1186/s12889-023-17613-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 12/29/2023] [Indexed: 01/11/2024] Open
Abstract
INTRODUCTION Undernutrition is a major public health problem in developing countries, especially in Sub-Saharan Africa. Undernourished children are smaller and have low weight. To solve this issue, school feeding (corn-soya blend, vegetable oil) started in 1994 in Ethiopia. Thus, this scoping review aims to map the evidence relating to school feeding programs and their potential role in managing children`s nutrition in Ethiopia. METHODS This scoping review is informed by the methodological framework of Arksey & O'Malley for scoping reviews and recommendations on the framework by Levac and colleagues. The databases searched included the Education Resources Information Centre, International Initiative for Impact Evaluation, Cochrane Library, MEDLINE, and Google Scholar. To ensure its comprehensive search, grey literature sources were searched. The search was undertaken on 26 April 2023. Studies on school feeding, such as coverage, and studies that evaluate the educational and nutritional impacts of school feeding in Ethiopia, regardless of study designs, were included. Reports (publications) about school feeding without scientific methodology were excluded. RESULT Twenty-seven studies were included in this review. It includes cross-sectional, prospective cohort, laboratory-based analysis, experimental, case study, and qualitative study designs. The school feeding program results were inconclusive, while some indicate a positive effect on body mass index, height, thinness, anemia, weight, dropout rate, class attendance, and enrollment. The others showed that the school feeding program did not affect stunting, thinness, weight, hemoglobin level, enrollment, attendance, dropout rate, and academic achievement. Factors affecting school feeding programs negatively include poor quality food and financial constraints. However, no literature on school feeding program coverage was found. CONCLUSION School feeding programs improved nutritional status, and academic performance, although some studies show any effect. Poor-quality food provisions and financial constraints affect school feeding programs. There are mixed findings, and further research is required to determine the effect of school feeding programs conclusively. To ensure the program's sustainability, it should be supported by a national policy, and budget allocation is needed. In addition, more evidence should be generated to show the coverage of school feeding programs in Ethiopia.
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Affiliation(s)
- Samson Mideksa
- Knowledge Translation Directorate, Ethiopian Public Health Institute, P O Box 1242, Addis Ababa, Ethiopia.
| | - Tsegaye Getachew
- Knowledge Translation Directorate, Ethiopian Public Health Institute, P O Box 1242, Addis Ababa, Ethiopia
| | - Firmaye Bogale
- Knowledge Translation Directorate, Ethiopian Public Health Institute, P O Box 1242, Addis Ababa, Ethiopia
| | - Ermias Woldie
- Knowledge Translation Directorate, Ethiopian Public Health Institute, P O Box 1242, Addis Ababa, Ethiopia
| | - Desalegn Ararso
- Knowledge Translation Directorate, Ethiopian Public Health Institute, P O Box 1242, Addis Ababa, Ethiopia
| | - Aregash Samuel
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Meron Girma
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Masresha Tessema
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mamuye Hadis
- Knowledge Translation Directorate, Ethiopian Public Health Institute, P O Box 1242, Addis Ababa, Ethiopia
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Teshome MS, Lema TB, Abessa TG, Mingels S, Granitzer M, Rameckers E, Verbecque E. Current evidence on the effectiveness of Ready-to-Use Supplementary Foods in children with moderate acute malnutrition: a systematic review and meta-analysis. J Nutr Sci 2024; 12:e130. [PMID: 38179261 PMCID: PMC10765019 DOI: 10.1017/jns.2023.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/10/2023] [Accepted: 12/01/2023] [Indexed: 01/06/2024] Open
Abstract
Moderate acute malnutrition (MAM) is defined by a weight-for-height Z-score (WHZ) between -3 and -2 of the WHO reference or by a mid-upper arm circumference (MUAC) of ≥11⋅5 and <12⋅5 cm. This study aimed to synthesise the evidence for the effectiveness of Ready-to-Use Supplementary Food (RUSF) compared to other dietary interventions or no intervention on functioning at different levels of the International Classification of Functioning, Disability, and Health (ICF) among children with MAM between 2 and12 years old. Three databases (PubMed, Scopus, and Web of Science) were systematically searched (last update: 20 November 2022). Pooled estimates of effect were calculated using random-effects meta-analyses. The level of evidence was estimated with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method. Seven studies were included. RUSF had a significant small-sized better effect (pooled mean: 0⋅38; 95 % CI = [0⋅10, 0⋅67], P = 0⋅01, I² = 97 %) on different anthropometric measurements compared to other dietary interventions among MAM children (n 6476). Comparing RUSF with corn-soy blend Plus Plus (CSB++) showed that RUSF had a small-sized but significantly better effect on the children's anthropometric measures compared to children who received CSB++ (pooled mean: 0⋅16; 95 % CI = [0⋅05, 0⋅27], P = 0⋅01; I2 = 35 %). MAM children treated with RUSF had a better recovery rate compared to those treated with CSB++ (pooled risk difference: 0⋅11; 95 % CI = [0⋅06, 0⋅11], P < 0⋅001; I2 = 0 %). The RUSF intervention seems promising in improving MAM children's nutritional outcomes and recovery rate compared to other dietary interventions.
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Affiliation(s)
- Melese Sinaga Teshome
- Department of Nutrition and Dietetics, Faculty of Public Health, Health Institute, Jimma University, Jimma, Ethiopia
- Rehabilitation Research Centre (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, 3590Diepenbeek, Belgium
| | - Tefera Belachew Lema
- Department of Nutrition and Dietetics, Faculty of Public Health, Health Institute, Jimma University, Jimma, Ethiopia
| | - Teklu Gemechu Abessa
- Department of Special Needs and Inclusive Education, Jimma University, Jimma, Ethiopia
| | - Sarah Mingels
- Rehabilitation Research Centre (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, 3590Diepenbeek, Belgium
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven 3000, Belgium
| | - Marita Granitzer
- Rehabilitation Research Centre (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, 3590Diepenbeek, Belgium
| | - Eugene Rameckers
- Rehabilitation Research Centre (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, 3590Diepenbeek, Belgium
- Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands
- Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
| | - Evi Verbecque
- Rehabilitation Research Centre (REVAL), Faculty of Rehabilitation Sciences, Hasselt University, 3590Diepenbeek, Belgium
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Zailani H, Owolabi OA, Sallau AB. Contribution of school meals to the recommended nutrient and energy intake of children enrolled in the National Homegrown School Feeding Program in Zaria, Nigeria. Arch Pediatr 2023; 30:471-476. [PMID: 37704525 DOI: 10.1016/j.arcped.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/12/2023] [Accepted: 07/07/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND A poor nutritional status in children results in reduced physical and mental health and poor academic performance. The National Homegrown School Feeding Program (NHSFP) was introduced in Nigeria in 2016 to ameliorate short-term hunger and improve the nutritional status of school-aged children (SAC). At least 33% of the recommended nutrient intake (RNI) for the enrolled students should be met by the school meals. However, to our knowledge, the contribution of school meals served through the NHSFP to the RNI of SAC in Zaria, Nigeria, remains to be explored. METHODS We conducted a school-based cross-sectional study among 276 eligible SAC recruited from public primary schools in the Zaria Local Government Area. Portion sizes of the meals served through the NHSFP were determined using an electronic scale, meal samples were collected for nutrient analysis, and the average daily nutrient intake of the participants from the meals was calculated. The average daily intake of nutrients and energy of the participants was compared with the age- and sex-specific RNI to estimate the percentage contribution of the meals. RESULTS The portion sizes recorded were 199.3 ± 20.6 g, 263.9 ± 11.5 g, 242.1 ± 16.8 g, 311 ± 17.3 g, and 160.3 ± 1.9 mL, respectively, for moi-moi, jollof rice and beans, bean porridge, jollof rice and boiled egg, and yoghurt. In addition, the meals contained moisture (30.13-66.11%), ash (0.73-7.08%), crude fat (9-32.61%), crude protein (7.25-24.5%), crude fiber (0-2.45%), and total carbohydrate (2.19-29.74%) with an energy content ranging from 183.6 to 330.57 kcal. Similarly, the meals contained calcium (82.58-711 mg), potassium (133-797 mg), sodium (340-1720 mg), iron (0.078-8.60 mg), zinc (1.84-13.4 mg), vitamin A (2.38-100.56 RAE), and vitamin C (0.04-1.57 mg) per 100 g of the school meals. The meals contributed 18.2-19.1%, 102.8-183.7%, 13.04-13.6%, and 26.1%-35.8% of the RNI for carbohydrates, proteins, fiber, and energy, respectively. Furthermore, they contributed 137-175%, 314.3-502.2%, 87.6-142.1%, 21.5-25.1%, 279.2-348.5%, 3.3-5.9%, 24.7-48.8%, and 3.3-5.9% of the RNI for iron, zinc, calcium, potassium, sodium, vitamin A, and vitamin C, respectively. CONCLUSION The meals served through the NHSFP contributed at least 33% of the RNI for energy, protein, iron, calcium, sodium, vitamin A, and zinc. However, they could not meet the 33% of the RNI for carbohydrates, fiber, potassium, and vitamin C. Increasing the portion sizes and the diversity of the meals can address the suboptimal contribution of the meals to the RNI for carbohydrates, fiber, potassium, and vitamin C.
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Affiliation(s)
- Halliru Zailani
- Department of Biochemistry, Ahmadu Bello University, Zaria, Nigeria; Graduate Institute of Nutrition, China Medical University, Taichung 404, Taiwan.
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Ernawati F, Efriwati, Nurjanah N, Aji GK, Hapsari Tjandrarini D, Widodo Y, Retiaty F, Prihatini M, Arifin AY, Sundari D, Rachmalina R, Salimar, Julianti ED, Aidi MN, Syauqy A. Micronutrients and Nutrition Status of School-Aged Children in Indonesia. J Nutr Metab 2023; 2023:4610038. [PMID: 37705875 PMCID: PMC10497362 DOI: 10.1155/2023/4610038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 07/21/2023] [Accepted: 08/26/2023] [Indexed: 09/15/2023] Open
Abstract
Micronutrient deficiencies (MNDs) in school-aged children are still a major health problem in Indonesia. This study was designed to examine the status of micronutrients and their relationship to the nutritional status of children aged 5-12 years since an up-to-date database on the micronutrient status of children aged 5-12 years is needed. Data from the 2018 Indonesian Basic Health Research (Riskesdas) were used in this study, with 2456 subjects for analysis. Micronutrient analysis was carried out, including iron status (ferritin, C reactive protein (CRP)), levels of zinc, vitamin D, calcium, and vitamin A (retinol) in school-aged children (5-12 years). The ELISA measurement was applied to measure CRP, ferritin, and vitamin D. Zinc levels were analysed with atomic absorbance spectroscopy (AAS). Moreover, high-performance liquid chromatography (HPLC) was applied to calculate vitamin A. In addition, stunting and thinness data were also obtained from the Riskesdas study. The results showed that the prevalence of stunting and thinness in school-aged children was 11.4% and 9.2%, respectively, showing that the stunting prevalence in the city was lower than in the village (4.5% vs. 6.9%, P = 0.000, respectively). In addition, the prevalence of MNDs in Indonesian children was 13.4%, 19.7%, 4.2%, 3%, and 12.7% for ferritin, zinc, calcium, vitamin A, and vitamin D, respectively. The mean serum level of vitamin A and zinc was significantly lower in stunted children compared to normal school children (P = 0.010 and P = 0.014). The serum concentration of vitamin D was significantly lower in overweight children compared to thin and normal children (P = 0.000). Serum values of ferritin, zinc, and vitamin A were significantly higher in overweight children compared to thin and normal children (P = 0.000). A poor correlation was observed between the z-score of height-for-age (HAZ) and the levels of zinc (r = 0.089, P = 0.000), vitamin A (r = 0.105, P = 0.000), and vitamin D (-0.073, P = 0.000). In addition, very weak correlations between z-scores of body mass index-for-age (BAZ) and the serum concentrations of ferritin (0.091, P = 0.000), zinc (r = 0.115, P = 0.000), vitamin A (r = 0.137, P = 0.000), and vitamin D (r = -0.112, P = 0.000) were also seen. In conclusion, school-aged children in Indonesia experienced stunting, thinness, and micronutrient deficiency. Furthermore, stunting and thinness were also related to micronutrient deficiencies.
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Affiliation(s)
- Fitrah Ernawati
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Efriwati
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Nunung Nurjanah
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Galih Kusuma Aji
- Research Center for Agroindustry, National Research and Innovation Agency, BJ Habibie Science Center, Setu, Kota Tangerang Selatan, Banten 15314, Indonesia
| | - Dwi Hapsari Tjandrarini
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Yekti Widodo
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Fifi Retiaty
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Mutiara Prihatini
- Health Policy Agency (BKPK), Ministry of Health, Jl. Percetakan Negara, Jakarta Pusat 10560, Indonesia
| | - Aya Yuriestia Arifin
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Dian Sundari
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Rika Rachmalina
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Salimar
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Elisa Diana Julianti
- Research Center for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jl. Raya Jakarta-Bogor No. KM 46, Pakansari, Kecamatan Cibinong, Kabupaten Bogor, Jawa Barat 16911, Indonesia
| | - Muhammad Nur Aidi
- Department of Statistics, IPB University, Jalan Meranti Wing 22 Level 4, Babakan, Dramaga, Kabupaten Bogor, Jawa Barat 16680, Indonesia
| | - Ahmad Syauqy
- Department of Nutrition Science, Diponegoro University, Jl. Prof Sudarto, Tembalang, Kota Semarang 50275, Indonesia
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Vastrad P, Neelopant S, Prasad UV, Kirte R, Chandan N, Barvaliya MJ, Hatnoor S, Shashidhar SB, Roy S. Undernutrition among rural school-age children: a major public health challenge for an aspirational district in Karnataka, India. Front Nutr 2023; 10:1209949. [PMID: 37502723 PMCID: PMC10368874 DOI: 10.3389/fnut.2023.1209949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
Background For school-age children, a healthy transition from childhood to adolescence and adulthood depends on proper nutrition. Globally, most nutritional surveys focus on preschool and adolescents, neglecting school-age children. Recent studies have shown the prevalence of thinness among adolescents to be 26.5% in Karnataka. Similarly, among children aged < 5 years in the Raichur district, the prevalence of stunting, wasting, and being underweight was 39.8, 23.2, and 40.7%, respectively. The present study aimed to bridge the data gap between < 5 years of children and adolescents through a nutritional survey of school-going children in Raichur, one of the aspirational districts of India. Materials and methods A cross-sectional survey was conducted from January to March 2020 among rural school-age children (n = 2700) in 30 villages of the Raichur district of Karnataka, India. The school children were selected through a multi-stage cluster sampling technique. The WHO Anthro-plus software was used for calculating the age and sex-specific Z-scores for weight-for-age (WAZ), height-for-age (HAZ), and BMI-for-age (BAZ). Results Of the 2,700 school-age children surveyed, the mean weight and height were 22.2 kg (+5.8) and 124.9 cm (+11.6), respectively. The prevalence of children having weight-for-age Z-scores < -2 SD (Underweight) was 45.3% (95% CI: 42.7%-47.8%). The magnitude of stunting and severe stunting was 19.5% (95% CI: 18.0%-21.0%) and 7.6% (95% CI: 6.6%-8.6%), respectively. The proportion of children with BMI for age Z-scores < -2SD (thinness) was 43% (95% CI: 41.1%-44.9%), with sub-district Sindhanur having a dual burden of malnutrition. Conclusion Despite many flagship programs, the prevalence of undernutrition in school-age children remains a considerable public health problem in the aspirational district of Raichur, India. Furthermore, exploratory studies are recommended to identify the factors associated with undernutrition among school-age children and strategize evidence-based intervention.
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Affiliation(s)
- Phaniraj Vastrad
- Model Rural Health Research Unit, Department of Health Research (Government of India), Sirwar, Raichur, Karnataka, India
| | | | - U. Venkateswara Prasad
- Model Rural Health Research Unit, Department of Health Research (Government of India), Sirwar, Raichur, Karnataka, India
| | - Rahul Kirte
- Model Rural Health Research Unit, Department of Health Research (Government of India), Sirwar, Raichur, Karnataka, India
- Raichur Institute of Medical Sciences, Raichur, Karnataka, India
| | - N. Chandan
- National Institute of Traditional Medicine, Indian Council of Medical Research (ICMR), Belagavi, Karnataka, India
| | - Manish J. Barvaliya
- National Institute of Traditional Medicine, Indian Council of Medical Research (ICMR), Belagavi, Karnataka, India
| | - Shivappa Hatnoor
- Raichur Institute of Medical Sciences, Raichur, Karnataka, India
| | - S. B. Shashidhar
- Raichur Institute of Medical Sciences, Raichur, Karnataka, India
| | - Subarna Roy
- Model Rural Health Research Unit, Department of Health Research (Government of India), Sirwar, Raichur, Karnataka, India
- National Institute of Traditional Medicine, Indian Council of Medical Research (ICMR), Belagavi, Karnataka, India
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Dietary Practices and Nutrient Intake of Internally Displaced School Children in the West Region of Cameroon. INTERNATIONAL JOURNAL OF FOOD SCIENCE 2023; 2023:9954118. [PMID: 36852392 PMCID: PMC9966561 DOI: 10.1155/2023/9954118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 02/20/2023]
Abstract
Background and Aims Poor diets and subsequent malnutrition are among the greatest current societal challenges triggering immense health and economic burden especially among populations that are forcibly displaced. It is indispensable to establish the dietary patterns of any population, especially in displaced populations, in order to develop and effectively implement interventions for the specific population. Methods A cross-sectional study was conducted to assess dietary practices and nutrient adequacy of 307 internally displaced pupils aged between 5 and 15 years in the West Region of Cameroon. Pretested, structured interviewer questionnaires were used to collect data on the demographic and socioeconomic status of the children and their caregivers, the nutrition knowledge of caregivers, the dietary practices of the children, dietary diversity, their food sources, and coping strategies that were used during food shortage. SPSS version 23 was used to analyze the data. The dietary diversity of the children was assessed at the individual level using FAO method of assessing women's dietary diversity score. Results Out of the total 307 children, 148 (48.2%) were boys and 159 (51.8%) were girls. During food shortages, most of the mothers/caregivers (72%) used borrowing as the main auxiliary food source and others (28%) used food as payment for work or begging. A majority of the children (56%) usually ate only two times in a day. Most of the children were of unacceptable or low dietary diversity (66.2%). The most frequently consumed food group was cereals as it was eaten by 21% of the children, seven or more times per week; meanwhile, the least was animal products with only 3% of the children consuming it seven or more times weekly. Their diets were energy-deficient (1640.5 ± 1.64 kcal) and unbalanced with daily inadequate protein (18.45 ± 1.13 g), vitamin A (470.27 ± 1.38 μg), and iron (4.02 ± 0.08 mg) intake. The nutrition knowledge of the mothers/caregivers was poor as less than half (41%) of them had an acceptable nutrition knowledge. Conclusion The high prevalence of poor dietary patterns and poor nutrition knowledge imposes the necessity of developing nutritional interventions and education strategies aimed at promoting healthy eating habits in the children.
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Wordofa M, Abera D, Mesfin A, Desta K, Taye B, Tsegaye A. Magnitude of Anemia and Undernutrition Among Primary School Children in a Setting of Mass Deworming in Central Ethiopia. Pediatric Health Med Ther 2022; 13:385-400. [PMID: 36606002 PMCID: PMC9809382 DOI: 10.2147/phmt.s381467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/22/2022] [Indexed: 01/01/2023] Open
Abstract
Background Undernutrition and anemia in children continue to be a public health problem in developing countries. Besides, intestinal parasitic infection among school children is common in developing countries. World Health Organization (WHO) recommends periodic deworming of children who live in endemic areas. The aim of this study was to determine the magnitude of anemia and undernutrition among school children in a setting of mass deworming. Methods A cross-sectional study was conducted among 510 school children aged 5-14 years from three randomly selected governmental schools in Sululta town, central Ethiopia. Socio-demographic variables were assessed using interviewer administered structured questionnaire. Anthropometric data were obtained and analyzed using WHO Anthroplusv1.0.4. Venous blood samples were collected using EDTA vacutainers. Hemoglobin level was determined by Sysmex KX-21N automated hematology analyzer and stool samples were processed using direct wet mount, formol-ether concentration and Kato-Katz methods. Data were entered and analyzed using SPSS version 21. Logistic regression analysis was performed to determine the association of anemia and undernutrition with the independent variables. Results The overall magnitude of anemia was 3.7%. Among anemic individuals, 84.2% and 15.8% of participants had mild and moderate anemia, respectively. The magnitude of stunting and thinness was 16.9% and 10.8%, respectively. Of them, 18.6% of stunting and 14.5% of thinness were severe. Of factors related to undernutrition, children from large families (≥5) were less likely to be stunted (AOR=0.38, 95% CI=0.2-0.7, P=0.002) compared to small families. Conclusion The magnitude of anemia in the study area was considered as an insignificant public health problem and none of the socio-demographic variables of participants were significantly associated with anemia and likewise with undernutrition except for family size. Further studies are required to clearly understand the impact of mass deworming on the magnitude of anemia and undernutrition.
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Affiliation(s)
- Moges Wordofa
- Addis Ababa University, College of Health Sciences, Department of Medical Laboratory Sciences, Addis Ababa, Ethiopia,Correspondence: Moges Wordofa, Addis Ababa University, College of Health Sciences, Department of Medical Laboratory Sciences, Addis Ababa, Ethiopia, Email
| | - Dessie Abera
- Addis Ababa University, College of Health Sciences, Department of Medical Laboratory Sciences, Addis Ababa, Ethiopia
| | | | - Kassu Desta
- Addis Ababa University, College of Health Sciences, Department of Medical Laboratory Sciences, Addis Ababa, Ethiopia
| | - Bineyam Taye
- Biology Department, Colgate University, Hamilton, NY, USA
| | - Aster Tsegaye
- Addis Ababa University, College of Health Sciences, Department of Medical Laboratory Sciences, Addis Ababa, Ethiopia
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Ezzat MA, Albassam EM, Aldajani EA, Alaskar RA, Devol EB. Implementation of new indicators of pediatric malnutrition and comparison to previous indicators. Int J Pediatr Adolesc Med 2022; 9:216-224. [PMID: 36937329 PMCID: PMC10019954 DOI: 10.1016/j.ijpam.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/11/2022] [Accepted: 12/27/2022] [Indexed: 01/08/2023]
Abstract
Background Early identification of childhood malnutrition is imperative to improve overall health outcomes, and more importantly, to start early intervention to decrease the risk of future complications. This study aimed to evaluate new malnutrition Z-score growth indicators for detecting pediatric malnutrition and degrees of severity and compare their accuracy with that of growth chart centiles. Patients and Methods This retrospective study included 475 pediatric patients from several pediatric nutrition clinics for six months. The participant's weight, height, age, and growth parameters were recorded using both traditional growth charts (centiles) and updated malnutrition indicators (z-scores). The percentage and degree of malnutrition using centiles and Z-scores were compared. Results In children aged <2 years, the percentage of malnutrition was 4.7% higher when measured using new malnutrition indicators (weight-for-length Z-score) compared with (weight-for-length centiles). Our results also showed 9.6% higher number of malnourished children >2 years of age when BMI-for-age Z-score was used compared to weight-for-height centiles while there were 15.8% higher malnourished children when BMI-for-age Z-score was compared to BMI-for-age centiles for the same group. We found a significant difference (X2 = 202.548, P=<.0001) between the degree of malnutrition in children aged >2 years using BMI-for-age Z-score (normal vs. malnourished) and the degree of malnutrition using BMI centiles (normal vs. malnourished). Approximately 34% of the children classified as normal using centiles were classified as malnourished using Z-scores. Comparing the degrees of Malnutrition, approximately 23% (45 of 196) of children classified as normal based on centiles were classified as having mild malnutrition when Z-scores were used, and 42% (80 of 192) of children who were classified as having mild malnutrition based on centiles were classified as having moderate malnutrition when Z-scores were used. Conclusions In our study, a higher percentage of children showed malnutrition when assessed using the Z-score (BMI-for-age for children >2 years/weight-for-length for children <2 years of age) than the centiles growth chart.
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Affiliation(s)
- Mai Adnan Ezzat
- Department of Nutrition, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Corresponding author. Nutrition Department, King Faisal Specialist Hospital and Research Center, Saudi Arabia.
| | - Ebtsam Mohmmed Albassam
- Department of Nutrition, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Eman Abdullah Aldajani
- Department of Nutrition, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Raneem Abdulaziz Alaskar
- Department of Nutrition, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Edward Bentz Devol
- King Faisal Specialist Hospital and Research Centre, Department of Biostatistics, Riyadh, Saudi Arabia
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Saavedra JM, Prentice AM. Nutrition in school-age children: a rationale for revisiting priorities. Nutr Rev 2022:6811793. [PMID: 36346900 DOI: 10.1093/nutrit/nuac089] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Middle childhood and early adolescence have received disproportionately low levels of scientific attention relative to other life stages, especially as related to nutrition and health. This is partly due to the justified emphasis on the first 1000 days of life, and the idea that early deficits and consequences may not be fully reversible. In addition, these stages of life may superficially appear less "eventful" than infancy or late adolescence. Finally, there has been historical ambiguity and inconsistency in terminology, depending on whether viewing "childhood" through physiologic, social, legal, or other lenses. Nevertheless, this age bracket, which encompasses most of the primary education and basic schooling years for most individuals, is marked by significant changes, inflection points, and sexually driven divergence in somatic and brain growth and development trajectories. These constitute transformative changes, and thus middle childhood and early adolescence represents a major and last opportunity to influence long-term health and productivity. This review highlights the specificities of growth and development in school age, with a focus on middle childhood and early adolescence (5 years-15 years of age, for the purposes of this review), the role of nutrition, the short- and long-term consequences of inadequate nutrition, and the current global status of nutrition in this age group. Adequate attention and emphasis on nutrition in the school-age years is critical: (a) for maintaining an adequate course of somatic and cognitive development, (b) for taking advantage of this last major opportunity to correct deficits of undernutrition and "catch-up" to normal life course development, and (c) for addressing the nutritional inadequacies and mitigating the longer-term consequences of overnutrition. This review summarizes and provides a rationale for prioritizing nutrition in school-age children, and for the need to revisit priorities and focus on this part of the life cycle to maximize individuals' potential and their contribution to society.
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Affiliation(s)
- Jose M Saavedra
- with the Division of Gastroenterology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Andrew M Prentice
- is with the MRC Unit, The Gambia and MRC International Nutrition Group, London School of Hygiene & Tropical Medicine, London, UK
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Under-nutrition and its determinants among school-aged children in northwest Ethiopia. Heliyon 2022; 8:e11235. [PMID: 36339772 PMCID: PMC9626546 DOI: 10.1016/j.heliyon.2022.e11235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/28/2021] [Accepted: 10/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Malnutrition among children has lifelong implications, its outcomes not only cover the whole life but also transfer from one generation to another generation. Most studies conducted before focused on undernutrition in pregnant mothers and children less than 5 years of age, whereas school-age children are often omitted from health and nutrition surveys or surveillance. In Northwest Ethiopia, particularly in the study area, the community levels nutritional status of school-age is not well studied and documented. Therefore, this study aimed to assess the prevalence and determinants of the under-nutritional status of school-age children in Gondar Zuria District, Northwest Ethiopia. Methods A community-based cross-sectional study design was employed with 364 respondents from January to April 2020. Data entered using Epi Data software version 3.1. Standard deviation scores were obtained by the world health organization Anthro Plus software to determine the nutritional status of children, and further analysis was done by using STATA version 14 software. Adjusted odds ratio with its corresponding 95 % confidence interval was used to declare statistically significant variables. Results The prevalence of overall under-nutrition was 71.98% (95%, CI: 67%–76%) from which, 43.13% (95%, CI: 38%–48%) were stunted, 40.93% (95%, CI: 35%–46%) were under-weight, and 35.44% (95%, CI: 30%–40%) were wasted. Child age [AOR = 0.30, 95% CI (0.13–0.68)], food insecurity [AOR = 2.24, 95% CI (1.03–4.83)], good knowledge of mother/care giver [AOR = 0.40, 95% CI (0.17–0.92)], having larger family size (Tzioumis and Adair, 2014; Wolde et al., 2015; Mohammed et al., 2019) [6-8] [AOR = 2.92, 95% CI (1.29–6.58)], and unprotected drinking water sources [AOR = 2.84, 95% CI (1.00–8.06)] were the predictors of under-nutrition. Conclusion According to the world health organization cut-offs, the prevalence of overall under-nutrition in the study area was very high. Child age, food insecurity, knowledge of mother/caregiver, having a larger family size, and unprotected drinking water sources were the predictors of under-nutrition. The district offices should give attention to the improvement of the food security status of the community, and give priority to the availability and accessibility of drinking water sources, particularly pipe water sources. Special attention to older age groups of children is important to control the prevalence of under-nutrition.
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Berhanu A, Garoma S, Arero G, Mosisa G. Stunting and associated factors among school-age children (5-14 years) in Mulo district, Oromia region, Ethiopia. SAGE Open Med 2022; 10:20503121221127880. [PMID: 36212231 PMCID: PMC9536101 DOI: 10.1177/20503121221127880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 09/05/2022] [Indexed: 11/05/2022] Open
Abstract
Objective: Stunting continues to be a major public health challenge in developing countries, including Ethiopia. Studies revealed that the extent of stunting among under-5 children in Ethiopia is well studied, but there is a scarcity of data among school-age children. Therefore, this study aimed to assess the magnitude of stunting and associated factors among school-age children in the Mulo district, Ethiopia. Methods: A community-based cross-sectional study was conducted among 606 school-age children (5–14 years) in Mulo district, Central Ethiopia, from 1 to 30 July 2019. A multistage sampling technique was used to select study participants. The collected data were entered into Epi Info version 7.2.2.16 software and analyzed using SPSS version 21 and World Health Organization AnthroPlus software. Bivariate and backward stepwise multivariable statistical methods were employed to assess stunting and its associated factors. Statistical significant association was declared at a p value of <0.05. Result: In this study, prevalence of stunting among school-age children was 42.4%. Of which, 144 (23.76%) were males and 113 (18.65%) were females. Age group between 10 and 14 years old, (adjusted odds ratio = 1.896, 95% confidence interval: 1.328–2.708), male sex (adjusted odds ratio = 2.688, 95% confidence interval: 1.892–3.821), increased family size (adjusted odds ratio = 1.711, 95% confidence interval: 1.191–2.458), absence of latrine in the compound (adjusted odds ratio = 2.541, 95% confidence interval: 1.711–3.773), and consuming less than three times per day (adjusted odds ratio = 2.68, 95% confidence interval: 1.375–5.223) were factors significantly associated with stunting. Conclusion: The study revealed that the prevalence of stunting among school-age children was high. Age, sex, family size, availability of latrine, and meal frequency were factors significantly associated with stunting. Therefore, interventional educations on the importance of timely feeding, a balanced diet, family planning, environmental sanitation, and personal hygiene should be given for the parents/caregivers. In addition, analytic studies are recommended to further assess the causes of stunting among the school-age children in the area.
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Affiliation(s)
- Alemayehu Berhanu
- Oromia Special Zone Surrounding Finfine Health Office, Mulo District Health Office, Addis Ababa, Ethiopia
| | | | | | - Getu Mosisa
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia,Getu Mosisa, Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte 395, Ethiopia.
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Food Fortification of Instant Pulse Porridge Powder with Improved Iron and Zinc Bioaccessibility Using Roselle Calyx. Nutrients 2022; 14:nu14194070. [PMID: 36235722 PMCID: PMC9573692 DOI: 10.3390/nu14194070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/17/2022] Open
Abstract
Undernutrition and mineral deficiencies negatively impact both the health and academic performance of school children, while diets high in phytic acid and some phenolics inhibit the absorption of minerals such as iron and zinc. This study developed instant porridge powders rich in iron and zinc using pregelatinized chickpea flour (PCPF) and pregelatinized foxtail millet flour (PFMF) and assessed the potential of utilizing roselle calyx powder (RCP) as a source of organic acids to enhance its iron and zinc bioaccessibility. Physical properties, nutrients, mineral inhibitors and in vitro iron and zinc bioaccessibility of different proportions of PCPF, PFMF and RCP in instant porridge powders were evaluated. Three instant porridge powder formulations including instant chickpea powder (ICP) using PCPF, instant composite flour (ICF) using PCPF and PFMF and instant pulse porridge powder (IPP) using PCPF, PFMF and RCP were developed. Results show that all instant porridge powders were accepted by sensory evaluation, while different ingredients impacted color, consistency and the viscosity index. Addition of RCP improved the bioaccessibility of iron (1.3-1.6-fold) and zinc (1.3-1.9-fold). A 70 g serving of these instant porridge powders substantially contributed to daily protein, iron and zinc requirement for children aged 7-9 years. These porridge powders hold potential to serve as school meals for young children in low-to-middle income countries.
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Zerga AA, Tadesse SE, Ayele FY, Ayele SZ. Impact of malnutrition on the academic performance of school children in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2022; 10:20503121221122398. [PMID: 36161209 PMCID: PMC9500247 DOI: 10.1177/20503121221122398] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/03/2022] [Indexed: 11/15/2022] Open
Abstract
Objective This study aimed to identify the impact of malnutrition on the academic performance of children in Ethiopia. Method The protocol of this study is registered in PROSPERO with a registration number CRD42021242269. A comprehensive search of studies from HINARY, MEDLINE (via PubMed), EMBASE, Cochrane Library, SCOPUS, Google Scholar, and Google was conducted. All published and unpublished studies conducted about the effect of any forms of malnutrition on academic performance of elementary school children in Ethiopia using the English language were included. Quality of the articles was assessed using the Joanna Briggs Institute critical appraisal tool. The pooled log odds ratio with 95% confidence interval was determined to identify the effect of malnutrition on academic performance. I-square statistics was applied to check the degree of heterogeneity between studies. The presence of publication or small study bias had been assessed by Funnel plots, Egger's weighted regression test, and Begg's rank correlation test. Result A total of 10 studies were included in this study. The pooled prevalence of good academic performance among elementary school students in Ethiopia was 58% (95% confidence interval: 48%, 69%). Stunting (odds ratio = 0.48; 95% confidence interval: 0.30, 0.79), underweight (odds ratio = 0.38; 95% confidence interval: 0.27, 0.53), and iodine deficiency (odds ratio = 0.49; 95% confidence interval: 0.31, 0.78) had a significant association with the academic performance. Rural residence (odds ratio = 0.61; 95% confidence interval: 0.44, 0.83), being female (odds ratio = 0.53; 95% confidence interval: 0.37, 0.77), and uneducated parent (odds ratio = 0.51; 95% confidence interval: 0.44, 0.58) were also factors associated with good academic performance of primary school children in Ethiopia. Conclusion This study concluded that malnutrition in the form of stunting, underweight, and iodine deficiency affected the academic performance of elementary school children in Ethiopia. So, the Ministry of Health worked better to strengthen the nutrition intervention at the critical periods of brain development.
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Affiliation(s)
- Aregash Abebayehu Zerga
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Eshete Tadesse
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Fanos Yeshanew Ayele
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Segenet Zewdie Ayele
- Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Faber M. Fostering healthy eating in children. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2022. [DOI: 10.1080/16070658.2022.2082146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mieke Faber
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Department of Dietetics and Nutrition, University of the Western Cape, Bellville, South Africa
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
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Awasthi S, Kumar D, Mahdi AA, Agarwal GG, Pandey AK, Parveen H, Singh S, Awasthi R, Pande H, T. S. A, Mahanta BN, Singh CM, Mathew JL, Ahmad MK, Singh K, Bhat MA, A. R. S, Kar S, Nair S. Prevalence of specific micronutrient deficiencies in urban school going children and adolescence of India: A multicenter cross-sectional study. PLoS One 2022; 17:e0267003. [PMID: 35544476 PMCID: PMC9094555 DOI: 10.1371/journal.pone.0267003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/01/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Childhood and adolescence require adequate amount of micronutrients for normal growth and development. The primary objective of study was to assess the prevalence of deficiencies of Vitamins (Vitamin A, 25 Hydroxy Vitamin D, Vitamin B12 and Folate) and minerals (Calcium, Zinc, Selenium and Iron), among urban school going children aged 6–11 and 12–16 years in ten cities of India. Secondary objective was to find the association between micronutrient deficiencies with sociodemographic and anthropometric indicators. Methods A multi-center cross-sectional study was conducted across India. Participants in the age groups of 6 to 11 years (group 1) and 12 to 16 years (group 2) were selected from randomly chosen schools from each center. Data on socio economic status, anthropometric measures was collected. Blood samples were collected for biochemical analysis of micronutrients. Point estimates and 95% confidence intervals was used to assess the prevalence of deficiencies. Associations were observed using chi square, student t test and ANOVA test. Results From April 2019 to February 2020, 2428 participants (1235 in group 1 and 1193 group 2) were recruited from 60 schools across ten cites. The prevalence of calcium and iron deficiency was 59.9% and 49.4% respectively. 25 Hydroxy Vitamin D deficiency was seen in 39.7% and vitamin B12 in 33.4% of subjects. Folate, Selenium and Zinc were deficient in 22.2%, 10.4% and 6.8% of subjects respectively. Vitamin A deficiency least (1.6%). Anemia was prevalent in 17.6% subjects and was more common among females. Conclusion One or more micronutrient deficiencies are found in almost one half of school going children in urban area. Hence efforts must be made to combat these on priority. Trial registration number CTRI/2019/02/017783.
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Affiliation(s)
- Shally Awasthi
- Department of Pediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
- * E-mail:
| | - Divas Kumar
- Department of Pediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Abbas Ali Mahdi
- Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Girdhar G. Agarwal
- Department of Statistics, University of Lucknow, Lucknow, Uttar Pradesh, India
| | - Anuj Kumar Pandey
- Department of Pediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Hina Parveen
- Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Shweta Singh
- Department of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Rajiv Awasthi
- Prarthana Diabetic Care Centre, Lucknow, Uttar Pradesh, India
| | - Harsh Pande
- Department of Pediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Anish T. S.
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerela, India
| | - B. N. Mahanta
- Department of Medicine, Assam Medical College, Dibrugarh, Assam, India
| | - C. M. Singh
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Joseph L. Mathew
- Department of Pediatric Medicine, Post Graduate Institute of Medical Sciences, Chandigarh, India
| | - Mohammad Kaleem Ahmad
- Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Kuldeep Singh
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mushtaq A. Bhat
- Department of Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Somashekar A. R.
- Department of Pediatrics, M. S. Ramaiah Institute of Medical Sciences, Bangalore, Karnataka, India
| | - Sonali Kar
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Orissa, India
| | - Suma Nair
- Department of Community Medicine, Kasturba Medical College, Manipal, Karnataka, India
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de Oliveira ECV, Madruga FP, Retondario A, Jagher A, de Oliveira PDP, Alves RC, Almeida CCB, de Cerqueira MMO. SCHOOL FOOD IN CHILD DAYCARE CENTERS: POOR IN MACRO AND MICRONUTRIENTS. CLINICAL NUTRITION OPEN SCIENCE 2022. [DOI: 10.1016/j.nutos.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Esmail S, Rajikan R. Parasitic Infection Is Associated with Undernutrition among Primary School Children in Aden Governorate, Yemen. JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.3923/jms.2022.83.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Molla W, Argaw D, Kabthymer RH, Wudneh A. Prevalence and associated factors of wasting among school children in Ethiopia: Multi-centered cross-sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.100965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Khan DSA, Das JK, Zareen S, Lassi ZS, Salman A, Raashid M, Dero AA, Khanzada A, Bhutta ZA. Nutritional Status and Dietary Intake of School-Age Children and Early Adolescents: Systematic Review in a Developing Country and Lessons for the Global Perspective. Front Nutr 2022; 8:739447. [PMID: 35187014 PMCID: PMC8848764 DOI: 10.3389/fnut.2021.739447] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 12/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background The prevalence of double burden of malnutrition (DBM) is high in low- and middle-income countries (LMICs). Data on malnutrition trends is present for children <5 years of age, however the data for school-going children and adolescents aged 5–15 years is scarce. Objective This systematic review presents the pooled prevalence of nutritional status and dietary intake among school-going children and adolescents (5–15 years of age) in an LMIC of Pakistan and the perspective for broader global nutrition in this age group. Methods An electronic search of databases was run on Pubmed and Medline (via Ovid) along with gray literature and archives of local scientific journals till 2nd January 2021. Studies meeting the eligibility criteria were included and relevant data were extracted, and a pooled proportional analysis was performed. Results A total of 51 studies including 62,148 children of 5–15 years met the inclusion criteria, of which 30 studies reported on anthropometric indices alone, eight on dietary intake patterns while 13 reported both. All of the included studies had a cross-sectional study design. There were 20 studies from the province of Punjab, 15 from Sindh, eight from Khyber Pakhtoonkhwa, two from Balochistan, and three from multiple cities across Pakistan. The pooled proportional analysis showed that the proportion of underweight children and adolescents was 25.1% (95% CI 17.3–33.7%); stunting 23% (95% CI 11.8–36.7%); wasting 24% (95% CI 15.2–34%); thinness 12.5% (95% CI 9.4–16.1%); overweight 11.4% (95% CI 7.2–16.3%); and obesity 6.9% (95% CI 3–12%). A relatively high intake of carbohydrates, soft drinks, and sweets/chocolates; and a low intake of protein-rich foods, fruits, and vegetables, compared to the recommended daily allowance (RDA), was reported. Conclusion The limited data suggests the presence of DBM amongst children aged 5–15 years and also identified that dietary intake patterns are not meeting the recommended allowance. This review highlights the gaps and the need for larger, well-designed studies for this age group with the representation of different contexts and the need for similar studies in various LMICs, so that appropriate actions be deliberated and appropriate programs should be designed focusing on this vital population.
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Affiliation(s)
| | - Jai K. Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Shagufta Zareen
- Policy and Strategic Planning Unit, Ministry of Health, Government of Punjab, Lahore, Pakistan
| | - Zohra S. Lassi
- Faculty of Health and Medical Sciences, Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Afsah Salman
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, ON, Canada
| | - Muhammad Raashid
- Policy and Strategic Planning Unit, Ministry of Health, Government of Punjab, Lahore, Pakistan
| | | | - Aijaz Khanzada
- Ministry of Health, Government of Sindh, Karachi, Pakistan
| | - Zulfiqar A. Bhutta
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, ON, Canada
- *Correspondence: Zulfiqar A. Bhutta
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Antwi J, Quaidoo E, Ohemeng A, Bannerman B. Household food insecurity is associated with child’s dietary diversity score among primary school children in two districts in Ghana. Food Nutr Res 2022; 66:7715. [PMID: 35140560 PMCID: PMC8788658 DOI: 10.29219/fnr.v66.7715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Dietary diversity is generally considered as a good indicator of nutrient adequacy and is influenced by various factors at the national, household, and individual levels.
Objective: The present study sought to determine the relationships between household food insecurity, primary caregivers’ nutrition knowledge, and dietary diversity of school-aged children in Ghana.
Methods: This forms part of a longitudinal study conducted in the Ayawaso West Municipal district in Accra (urban setting) and the Upper Manya Krobo district (rural setting) in Ghana. Data were collected from a total of 116 caregiver-child dyads using 24-h dietary recall and a short version of the US 12-month Household Food Security Survey Module. Nutrition knowledge and sociodemographic data were obtained using a structured questionnaire. Multivariable logistic regression was used to check for factors associated with children’s dietary diversity.
Results: Majority of households reported food insecurity, with a higher percentage of insecure households located in the rural area (88.9% vs. 46.5%, P ≤ 0.0001), compared to the urban setting. Diet diversity among the study children was low, with a mean (standard deviation [SD]) of 5.8 (2.1) out of 14 food groups. Children living in food insecure households were three times more likely to have received low diverse diet compared to those from food secure households (adjusted odds ratio [OR] =3.3, 95% confidence interval [CI]: 1.4–8.0). Caregivers’ nutrition knowledge was, however, not related to children’s dietary diversity.
Discussion and conclusion: Household food insecurity was a main predictor of dietary diversity among school-age children in this study. Thus, caregiver knowledge in nutrition may not be enough, particularly in the presence of food insecurity to guarantee adequate nutrition for school-aged children.
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Affiliation(s)
- Janet Antwi
- Department of Agriculture, Nutrition and Human Ecology, Prairie View A&M University, Prairie View, TX, USA
| | - Esi Quaidoo
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Agartha Ohemeng
- Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana
- Agartha Ohemeng, Department of Nutrition and Food Science, University of Ghana, P.O. Box LG 134, Legon, Accra, Ghana.
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Gichohi-Wainaina WN, Mremi R, Chande M, Msuya JM, Kumwenda NC, Muzanila YC, Msere H, Muhimbula H, Bekunda M, Okori P. Drivers of Pigeon Pea Consumption Among School-Aged Children in Central Tanzania. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2021.726404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Protein energy malnutrition (PEM) and iron deficiencies (ID) are of major public health concern in Tanzania including among school-aged children. PEM and ID in early childhood have serious, long-term consequences because they impede motor, sensory, social and emotional development, growth retardation, poor cognitive development, learning disability of children, lowered resistance to infectious diseases, and reduced physical work capacity. The objective of this study was to elucidate the drivers of pigeon pea consumption among school-aged children in Dodoma district, Central Tanzania. Understanding these drivers would be useful in promoting pigeon pea consumption among school-aged children as one of the strategies to increase dietary protein and iron intake.Methods: This study was a cross-sectional study in which data were collected using a questionnaire based on a combination of the Theory of Planned Behavior and Health Belief Model. The data were collected from caregivers (n = 138) in four villages in Kongwa district, Dodoma region, Central Tanzania. We used correlations and multiple regressions to assess associations between constructs and identify predictive constructs. Mann–Whitney U tests were used for score comparisons with a significant p-value set at <0.10.Results: Health value was significantly correlated with health behavior identity (rs = 0.63, p < 0.001) and also significantly predicted health behavior identity (rs = 0.49, p = 0.001). The constructs cues to action and control belief were significantly associated with intention (β = −0.41, p = 0.059 and β = 0.06, p = 0.019 respectively). Finally, we observed that intention was a significant predictor of behavior (β = 1.38, p = 0.001). We also observed a significant negative interaction between perceived barriers and intention to consume pigeon pea (β = −0.04, p = 0.006), indicating that perceived barriers limit intention to consume pigeon pea.Conclusion and Implication: Our findings indicate that when the caregiver places increased importance on preventing her school-aged child from being iron or protein deficient or indeed anemic (health value), it results in a positive evaluation of the effectiveness of giving pigeon pea to address these nutrient deficiencies. Programs and efforts aimed at promoting pigeon pea consumption should focus on educating caregivers on iron and protein deficiency and the role that pigeon pea could play in addressing these. However, perceived barriers such as pest infestation during storage need to be addressed to increase pigeon pea consumption. The involvement of post-harvest management specialists is therefore crucial. Along with this, increasing productivity and crop management is also crucial to ensure year-round affordable supply of pigeon pea.
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Argaw D, Hussen Kabthymer R, Endale T, Wudneh A, Daniel Meshesha M, Tadesse Hirbu J, Bayisa Y, Abebe L, Tilahun R, Aregawi S, Lodebo Funga M, Wodaynew T, Demisse B, Cherinet Eritero A, Getachew Assefa D, Daganchew Zeleke E, Mengistu N, Temesgen Alemu K, Molla W. Stunting and associated factors among primary school children in Ethiopia: School-based cross-sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Awasthi S, Kumar D, Singh S, Dixit S, Agarwal G, Mahdi AA. Prevalence of specific micronutrient deficiencies in urban school going children of India aged between 6 and 16 years: study protocol for a multicentric cross-sectional study. BMJ Open 2021; 11:e046783. [PMID: 34907037 PMCID: PMC8671943 DOI: 10.1136/bmjopen-2020-046783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 10/28/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Childhood and adolescence are the period of rapid physical and cognitive growth and development, requiring adequate nutrition. Malnutrition in the form of undernutrition or micronutrient deficiency or overweight/obesity affects the health, cognition and educational achievement of this age group. The objective of this study is to assess the prevalence of calcium, iron, zinc, selenium, folate, vitamin A, 25 hydroxy vitamin D and vitamin B12 deficiencies in the serum and haemoglobin, ferritin and lead levels and its association with reported dietary intake and cognitive abilities, in urban school going children aged 6-16 years in 10 cities of India. METHODS AND ANALYSIS A multicentric cross-sectional study will be conducted to recruit 2400 participants (240 per site) across India. Participants will be selected using random sampling and will be categorised into age groups of 6-11 years and 12-16 years, with equal distribution. Data on socioeconomic status, anthropometric measures and 3-day dietary intake and cognitive performance will be collected. Blood samples will be collected for biochemical analysis of micronutrients. Findings will estimate the prevalence of micronutrient deficiencies and their association with dietary habits and cognitive functioning. ETHICS AND DISSEMINATION Study protocol has been reviewed and approved by institutional ethics committee of all 10 participating sites. Results will be shared and published in a peer-reviewed journal, so that the findings will be helpful for the stakeholders in planning nutritional interventions for targeted groups. TRIAL REGISTRATION NUMBER CTRI/2019/02/017783.
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Affiliation(s)
- Shally Awasthi
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Divas Kumar
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shweta Singh
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Swati Dixit
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Girdhar Agarwal
- Department of Biostatistics, University of Lucknow, Lucknow, Uttar Pradesh, India
| | - Abbas Ali Mahdi
- Department of Biochemistry, King George's Medical University, Lucknow, Uttar Pradesh, India
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Sagbo H, Barreto SM, Costa ABP, Mendes LL, Khanafer N, Giatti L. Undernutrition and associated factors in primary schoolchildren in Lokossa, Benin: a cross-sectional study. Rev Bras Enferm 2021; 75:e20210254. [PMID: 34852123 DOI: 10.1590/0034-7167-2021-0254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 09/01/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to estimate the prevalence of stunting and thinness and sociodemographic, household, family, dietary, and scholar associated factors in schoolchildren living in Lokossa-Benin. METHODS a survey conducted in a probabilistic sample (n=615) of primary schoolchildren (8-17 years), from 12/2018 to 01/2019, using structured questionnaire and 24-hour dietary recall. Thinness and stunting were defined as Height-for-age and Body Mass Index-for-age below-2 standard deviations, respectively. Associations were estimated by chi-square test and logistic regression. RESULTS thinness and stunting prevalence was 13.1% (95%CI:9.0-18.7) and 25.5% (95%CI:20.6-31.2), respectively. Odds of thinness were higher among older schoolchildren and those who experienced hunger at school. Odds of stunting increased with age, low diet diversity, experiencing hunger at school, and having school meal five days a week (OR:2.09; 95%CI:1.29-3.36). CONCLUSIONS stunting was the most common problem. Older schoolchildren and those with food deprivation or poor diet diversity were the most affected.
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Affiliation(s)
- Herbert Sagbo
- Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | | | - Luana Giatti
- Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil
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Crop diversity is associated with higher child diet diversity in Ethiopia, particularly among low-income households, but not in Vietnam. Public Health Nutr 2021; 24:5857-5868. [PMID: 34528505 DOI: 10.1017/s1368980021003281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To examine associations of household crop diversity with school-aged child dietary diversity in Vietnam and Ethiopia and mechanisms underlying these associations. DESIGN We created a child diet diversity score (DDS) using data on seven food groups consumed in the last 24 h. Generalised estimating equations were used to model associations of household-level crop diversity, measured as a count of crop species richness (CSR) and of plant crop nutritional functional richness (CNFR), with DDS. We examined effect modification by household wealth and subsistence orientation, and mediation by the farm's market orientation. SETTING Two survey years of longitudinal data from the Young Lives cohort. PARTICIPANTS Children (aged 5 years in 2006 and 8 years in 2009) from rural farming households in Ethiopia (n 1012) and Vietnam (n 1083). RESULTS There was a small, positive association between household CNFR and DDS in Ethiopia (CNFR-DDS, β = 0·13; (95 % CI 0·07, 0·19)), but not in Vietnam. Associations of crop diversity and child diet diversity were strongest among poor households in Ethiopia and among subsistence-oriented households in Vietnam. Agricultural earnings positively mediated the crop diversity-diet diversity association in Ethiopia. DISCUSSION Children from households that are poorer and those that rely more on their own agricultural production for food may benefit most from increased crop diversity.
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Rachmadewi A, Soekarjo D, Maehara M, Alwi B, Mulati E, Rah JH. School Canteens in Selected Areas in Indonesia: A Situation Analysis. Food Nutr Bull 2021; 42:225-246. [PMID: 34282661 DOI: 10.1177/03795721211008021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The school canteen has a massive impact on the dietary intake and nutritional status of school-age children and adolescents. This study aimed at assessing the current situation of school canteens in selected areas in Indonesia and relevant knowledge, attitudes, and behaviors of school-going children and adolescents. METHODS A qualitative study was implemented in a purposive sample of 18 schools in Klaten and West Lombok districts with 2 comparison schools in Jakarta and Klaten. Focus group discussions and in-depth interviews were conducted with a wide range of stakeholders to collect information on nutrition knowledge, food preferences, related policies and governance, and opinions toward school canteens. Data were analyzed using thematic synthesis and narrative analysis. RESULTS Specific government guidelines on healthy foods and beverages to be sold in canteens are not yet in place. Many canteens had inadequate infrastructure and were managed informally, with limited rules, monitoring, and supervision. Although healthy options including vegetables and fruits were available in most canteens, unhealthy foods and beverages were abundant and cheap. Lack of awareness of the importance of nutrition of school-age children and adolescents was pervasive among all stakeholders. Personal preference and availability were main drivers of the students' food choices. CONCLUSIONS Concerted multisectoral and multistakeholders' efforts are warranted to improve the quality of school canteens in Indonesia by developing a comprehensive relevant guideline, improving the capacity of related stakeholders and service providers, enhancing the implementation and monitoring, and generating demand for healthy canteens.
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Affiliation(s)
| | | | | | | | - Erna Mulati
- Directorate of Family Health, 106265Ministry of Health, Republic of Indonesia
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Khadilkar AV, Khadilkar VV, Gondhalekar KM, Kajale NA, Karkera PH, Prasad M, Trehan A, Barr RD, Ladas EJ. Reference centile curves for mid-upper arm circumference for assessment of under- and overnutrition in school-aged Indian children and adolescents. Nutrition 2021; 91-92:111401. [PMID: 34364267 DOI: 10.1016/j.nut.2021.111401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/09/2021] [Accepted: 06/17/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Malnutrition is common in developing countries and is not restricted to young children. It has been suggested that measuring mid-upper arm circumference (MUAC) is an easy, accurate, and low-cost method of identifying malnutrition in the early stages. The aims of this study were to construct age- and sex-specific MUAC reference centiles, and to define and validate cutoffs for assessment of under- and overnutrition in Indian children 5 to 17 y of age. METHODS This was a cross-sectional, multicentric, observational study conducted in seven schools in seven states from June 2018 to November 2019. The study included 6680 healthy 5- to17-y-old children. MUAC was measured using non-stretch tapes (UNICEF). Sex-specific MUAC percentiles were computed for age and height. Cutoffs for MUAC z-scores for thinness and overnutrition were defined and validated for healthy school children (n = 726) and children with cancer (n = 500). RESULTS Reference centiles for MUAC for age (and height) for boys and girls are presented. Cutoffs defined for thinness and for obesity were -0.7 and +1.5 z-score, respectively (corresponding to 25th and 95th percentiles of the MUAC for age/height). For ease of use, rounded cutoffs for thinness were 16 and 18.5 cm from 5 to 9 and 10 to 14 y of age, respectively, in both sexes, and a cutoff of 22 cm in boys and 20 cm in girl from 15 to 17 y of age. For obesity, 20 and 25.5 cm from 5 to 9 and 10 to 14 y of age, respectively, in both girls and boys and a rounded cutoff of 29 cm in boys and 27 cm in girls from 15 to17 y are proposed. CONCLUSIONS We presented MUAC percentiles and cutoffs for screening for thinness and overnutrition in Indian children from 5 to 17 y of age. These data may also be used in children with cancer and other chronic disorders with growth failure.
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Affiliation(s)
- Anuradha V Khadilkar
- Paediatric Growth and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital. Pune University, Pune, India.
| | - Vaman V Khadilkar
- Paediatric Growth and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital. Pune University, Pune, India
| | - Ketan M Gondhalekar
- Paediatric Growth and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital. Pune University, Pune, India
| | - Neha A Kajale
- Paediatric Growth and Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital. Pune University, Pune, India
| | - Priya H Karkera
- Fitterfly Health Technologies, Mumbai, India; Department of Nutrition, Surya Children's Hospital, Mumbai, India
| | - Maya Prasad
- Paediatric Oncology, Tata Memorial Hospital, Mumbai, India
| | - Amita Trehan
- Paediatric Haematology Oncology Unit, Advanced Pediatric Center, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ronald D Barr
- Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Elena J Ladas
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Irving Medical Center, New York, New York, USA
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Mantey AA, Annan RA, Lutterodt HE, Twumasi P. Iron status predicts cognitive test performance of primary school children from Kumasi, Ghana. PLoS One 2021; 16:e0251335. [PMID: 34010354 PMCID: PMC8133497 DOI: 10.1371/journal.pone.0251335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 04/25/2021] [Indexed: 01/01/2023] Open
Abstract
Background Good nutritional status of school-aged children is crucial in achieving improved cognition. The objective of this study was to assess the relationship between nutritional status and cognition of school-aged children in the Kumasi metropolis, Ghana. Methods 389 children were selected from ten government-owned schools. Socio-demographic and anthropometric data were collected. Blood samples were collected and analyzed for nutrients levels. Dietary intakes were assessed using food frequency questionnaire and previous day’s nutrients intake. Cognition test was performed using the Ravens Colored Progressive Matrix (RCPM). Results Mean age of participants was 8.9±1.4 years, mean RCPM score was 17.9±5.4. More girls scored RCPM below the 40th percentile (45.5%) than boys (33.7%), while mother’s level of education significantly associated with RCPM percentiles of the children (p = 0.037). Four dietary patterns were generated from food frequency data, and scores of the second pattern, depicting vegetables, non-fruits, bread and cereals, showed a weak negative correlation (r = -0.132, p = 0.026) with previous day’s dietary zinc intake. Cognitive status did not vary by anthropometric and dietary patterns. More anemic (54.4%) than non-anemic (33.3%) children were below the 40th RCPM percentile. Mean previous day’s intake for folate (p<0.001), vitamin B6 (p = 0.018), iron (p<0.001), and zinc (p = 0.001) differed significantly between the cognitive test score percentiles of the children. Spearman rank correlation showed weak positive associations between RCPM score and hemoglobin (r = 0.246, p = 0.003) and serum ferritin (r = 0.176, p = 0.036). Binary regression analysis showed anemic children (aOR = 0.4; 95%CI = 0.2–0.8, p = 0.014), compared with non-anemic had decreased odds, while boys, compared with girls had increased odds (aOR = 2.0 95%CI = 1.0–4.0, p = 0.035) for scoring above the 50th RCPM percentile. Conclusions Iron status, especially hemoglobin levels, correlated with the cognitive performance of school-aged children in the metropolis. Thus nutritional strategies aimed at reducing iron deficiency anemia are needed.
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Affiliation(s)
- Afua Afreh Mantey
- Department of Laboratory Technology, Kumasi Technical University, Kumasi, Ghana
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- * E-mail:
| | - Reginald Adjetey Annan
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Herman Erick Lutterodt
- Department of Food Science and Technology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Teo CH, Chin YS, Lim PY, Masrom SAH, Shariff ZM. Impacts of a School-Based Intervention That Incorporates Nutrition Education and a Supportive Healthy School Canteen Environment among Primary School Children in Malaysia. Nutrients 2021; 13:nu13051712. [PMID: 34070053 PMCID: PMC8158127 DOI: 10.3390/nu13051712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/01/2021] [Accepted: 05/10/2021] [Indexed: 12/02/2022] Open
Abstract
In this study, a school nutrition program (SNP) that incorporates nutrition education and a healthy school canteen environment was developed to improve nutrition knowledge among intervention respondents and provide a healthier environment for them to practice healthy eating. In the current study, we evaluated the impacts of the SNP on eating behaviors, physical activity, body mass index-for-age (BAZ), and cognitive performance at pre-intervention, post-intervention, and 3-month follow-up points between intervention and comparison groups. This intervention study involved 523 primary school children (7–11 years old) from six selected schools in Batu Pahat District, Malaysia. Each respondent completed anthropometric and cognitive performance assessments and a set of standardized questionnaire at pre-intervention, post-intervention, and 3-month follow-up points. Multiple linear mixed model analysis was performed to determine the impacts of that SNP after being adjusted for covariates. After the program, the intervention group increased their frequency of breakfast, lunch, and dinner consumption and morning tea snacking and showed more frequent physical activity and better cognitive performance as compared to the comparison group overtime (p < 0.05). At 3-month follow-up, the intervention group showed lower BAZ scores than their comparison counterparts (p < 0.05). The SNP showed positive effects on eating behaviors, physical activity, BAZ, and cognitive performance in school children. Hence, the SNP is highly recommended for all primary school children.
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Affiliation(s)
- Choon Huey Teo
- Department of Nutrition, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Selangor, Malaysia; (C.H.T.); (Z.M.S.)
- Department of Nutrition, Batu Pahat District Health Office, Johor State Health Department, Ministry of Health, Jalan Mohd Khalid, Batu Pahat 83000, Johor, Malaysia
| | - Yit Siew Chin
- Department of Nutrition, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Selangor, Malaysia; (C.H.T.); (Z.M.S.)
- Research Centre of Excellence, Nutrition and Non-Communicable Diseases, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Selangor, Malaysia
- Correspondence: ; Tel.: +603-9769-2680
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Selangor, Malaysia;
| | - Shahril Azian Haji Masrom
- Department of District Health Office, Batu Pahat District Health Office, Johor State Health Department, Ministry of Health, Johor Bahru 80000, Johor, Malaysia;
| | - Zalilah Mohd Shariff
- Department of Nutrition, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Selangor, Malaysia; (C.H.T.); (Z.M.S.)
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Ng CM, Kaur S, Koo HC, Mukhtar F. Involvement of children in hands-on meal preparation and the associated nutrition outcomes: A scoping review. J Hum Nutr Diet 2021; 35:350-362. [PMID: 33938062 DOI: 10.1111/jhn.12911] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Emerging research has explored hands-on meal preparation as a strategy to improve children's nutrition-related outcomes. This scoping review was conducted to describe the extent of studies on children's involvement in hands-on meal preparation and the related psychosocial outcomes, actual nutrition behaviour/food consumption and weight status. METHODS Scoping review methodology was used to select relevant studies, as well as extract and collate the data. Four databases (PubMed, Google Scholar, Science Direct and Cochrane Database of Systematic Reviews) were searched from the earliest available time up to December 2020. Observational studies, experimental studies and reviews that were conducted among children aged 5-12 years old and published from 2010 to 2020 were retrieved. Studies extracted involved children in hands-on healthy meal preparation activities and explored the associated nutrition outcomes. RESULTS In total, 28 studies (5 observational studies, 21 experimental studies, 2 reviews) were included in the final review. Studies conducted demonstrated improvement in children's psychosocial outcomes and actual nutrition behaviour/food consumption after participating in hands-on meal preparation activities, despite differences in methodology, programme content and settings (countries/cultural origins). Limited studies assessed children's nutrients intake and weight status. CONCLUSIONS The current review suggests that hands-on meal preparation comprises approach for instilling positive perceptions towards nutrition/healthy foods, potentially improving children's diet. Future studies should include the assessment of nutrient intake and weight status. The long-term sustainability of these nutrition outcomes should be explored.
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Affiliation(s)
- Choon Ming Ng
- Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Satvinder Kaur
- Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Hui Chin Koo
- Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | - Firdaus Mukhtar
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang, Malaysia
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Roothaert R, Mpogole H, Hunter D, Ochieng J, Kejo D. Policies, Multi-Stakeholder Approaches and Home-Grown School Feeding Programs for Improving Quality, Equity and Sustainability of School Meals in Northern Tanzania. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021. [DOI: 10.3389/fsufs.2021.621608] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Malnutrition among children of school-going age is a challenge of serious concern in developing countries especially Sub-Saharan Africa. Many programs focus on mothers and under-5-year-old children, leaving the school going age unattended. It has been shown that school meals can reduce school absenteeism, improve concentration in class and reduce early dropouts. In Tanzania, successful home-grown school feeding programs are localized in few areas but have not been scaled-out. The objective of this study was to analyze the policy and organizational environment which enables or promotes home-grown school feeding approaches. The study consisted of a systematic review, key informant interviews and focus group discussions in Arumeru and Babati Districts, Tanzania. In total, 21 key informant interviews with 27 participants and 27 focus group discussions with 217 participants were conducted. The results show that Tanzania lacks a clear policy on school feeding; there are no guidelines for school meal quality, participation in school feeding programs is not mandatory, leading to many students being left out and going hungry. Students in private schools tend to be better off than those in public schools in terms of provision and quality of school meals. We recommend that policies and practices are developed based on positive experiences of home-grown school feeding programs implemented in Tanzania by the World Food Programme and Project Concern International and emphasize that these policies need to be developed in a multi-sectoral manner. A conceptual framework for improving home-grown school feeding in public schools in Tanzania highlights four critical components: leadership and public awareness; operational modalities; contributions from parents; and meal diversity and nutrition. The home-grown school feeding model provides mechanisms to improve diversity of meals and their nutritional value, increase participation of communities and inclusion of students. Parents will still be responsible for the largest part of food supplies, but the model also requires participation of multiple stakeholders, and provision of natural resources such as land and water by the local government for production of nutritious food for young students. Minimum levels of social protection are recommended to ensure that no student is denied school meals.
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Hoang NTD, Orellana L, Gibson RS, Le TD, Worsley A, Sinclair AJ, Hoang NTT, Szymlek-Gay EA. Multiple micronutrient supplementation improves micronutrient status in primary school children in Hai Phong City, Vietnam: a randomised controlled trial. Sci Rep 2021; 11:3728. [PMID: 33580103 PMCID: PMC7881239 DOI: 10.1038/s41598-021-83129-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/28/2021] [Indexed: 01/21/2023] Open
Abstract
We aimed to determine the efficacy of multiple micronutrient supplementation on the biomarkers of iron, zinc, and vitamin A status across anthropometric status categories in Vietnamese school children. In this 22-week randomised controlled trial, 347 undernourished, normal weight, or overweight/obese children aged 6-9 years were allocated to receive every school day a multiple micronutrient supplement (10 mg iron, 10 mg zinc, 400 µg vitamin A) or a placebo. Haematological indices; circulating ferritin, zinc, and retinol (corrected for inflammation); and C-reactive protein were measured at baseline and 22 weeks. At week 22, linear mixed models showed that mean corpuscular volume increased by 0.3 fL, serum ferritin by 9.1 µg/L, plasma zinc by 0.9 µmol/L, and plasma retinol by 15%, and the prevalence of zinc deficiency decreased by 17.3% points in the intervention group compared to placebo. No intervention effects were found for other haematological indices, or the prevalence of anaemia. Multiple micronutrient supplementation for 22 weeks improved the biomarkers of zinc and vitamin A status and some biomarkers of iron status, and reduced the prevalence of zinc deficiency in Vietnamese school children.Trial registration: This trial was registered on 06/09/2016 at www.anzctr.org.au as ACTRN12616001245482.
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Affiliation(s)
- Ngan T D Hoang
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
| | - Rosalind S Gibson
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Tuyen D Le
- National Institute of Nutrition, Hanoi, Vietnam
| | - Anthony Worsley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | | | | | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
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Verma M, Sharma P, Khanna P, Srivastava R, Sahoo SS. Nutrition Status of School Children in Punjab, India: Findings from School Health Surveys. J Trop Pediatr 2021; 67:5948850. [PMID: 33130876 DOI: 10.1093/tropej/fmaa068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND School-going children and adolescents are rarely targeted in nutrition surveys, despite the significant impact of nutritional status on their health, cognition, educational achievements and future economic productivity. The present secondary data analysis evaluated the nutritional status of children and adolescents in the 5-18 years age group. MATERIALS AND METHODS The anthropometric measurements of children and adolescents studying in the government and government-aided schools were collected under the 'Rashtriya Bal Swasthya Karyakram' in the District Fatehgarh Sahib of Punjab, India between March and August 2018. It was analyzed using SPSS version 21. Mean and standard deviation for weight-for-age, height-for-age, body mass index (BMI) for age z-scores were calculated using World Health Organization's Anthro-plus software. RESULTS A total of 897 children's data were included in the study. Out of 352 children in 5-9 years age group, mean weight, height and BMI were 15.7 ± 3.8 kg, 110.7 ± 10.6 cm and 12.7 ± 2.1 kg/m2. About 58.8%, 37.4% and 31.8% of the children were categorized as severely underweight, stunted and thin, respectively. In the 10-18 years age group, mean weight, height and BMI were 30.5 ± 9.5 kg, 140 ± 13.4 cm and 15.2 ± 2.6 kg/m2. Severe stunting was present in 19.4% of adolescents, while 26.9% were severely thin. CONCLUSION Our study depicts a high level of undernutrition in school-going children and adolescents. There is a need to strengthen the nutrition interventions for middle childhood and adolescence period that can help in a healthy transition from childhood to adulthood and break the intergenerational cycle of malnutrition. Lay summaryNational and state-level health-priorities focus mainly on improving the nutrition status of under-5-year children, while the school-going children and adolescents are usually neglected. The present secondary data analysis estimates the burden of malnutrition in school-going children and adolescents. These data were collected under one of India's national health programs that intend to tackle childhood illnesses. Our study depicts a high level of undernutrition in school-going children and adolescents. We found that girls were affected more by malnutrition in middle childhood, i.e. during 5-9 years (both by stunting and thinness) compared to boys. But in middle and late adolescence, males were more stunted and thin compared to females. Programs to support adolescents' nutrition interventions could provide an opportunity for a healthy transition from childhood to adulthood and could be an essential step in breaking the intergenerational cycle of malnutrition.
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Affiliation(s)
| | - Priyanka Sharma
- Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India
| | - Poonam Khanna
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Rachana Srivastava
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Soumya Swaroop Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab 151001, India
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Aiga H, Abe K, Randriamampionona E, Razafinombana AR. Possible causalities between malnutrition and academic performances among primary schoolchildren: a cross-sectional study in rural Madagascar. BMJ Nutr Prev Health 2021; 4:18-29. [PMID: 34308108 PMCID: PMC8258079 DOI: 10.1136/bmjnph-2020-000192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/03/2020] [Accepted: 12/12/2020] [Indexed: 11/04/2022] Open
Abstract
Background The importance of addressing malnutrition is increasing in the context of children’s health and their academic performances. Childhood malnutrition further could reduce a country’s economic productivity. No earlier study adequately estimated the causalities between schoolchildren’s malnutrition and their academic performances. How nutritional status contributes to children’s academic performances has never been reported from Madagascar. This study aims to estimate the possible causalities between their nutritional status and academic performances in rural Madagascar. Methods A cross-sectional household survey was conducted in Antananarivo-Avaradrano district, Madagascar, from November to December 2017, by targeting 404 first and second graders 5–14 years of age enrolled in 10 public primary schools. Children’s anthropometric measurements and structured interviews with their mothers/caregivers were conducted. Children’s academic performances data (mathematical and national language proficiencies) were collected at each school. To estimate associations between their malnutrition and academic performances, bivariate and multivariate analyses were conducted. To estimate their possible causalities between them, three conditions were examined (crude covariational relationship, covariational relationship through controlling for a third variable and temporal precedence). Results Four independent variables produced significantly positive coefficients with mathematical proficiency in multivariate analysis. Of the four, ‘not being stunted’ and ‘attendance rate’ were estimated to be possible causes of higher mathematical proficiency because they satisfied all the three conditions for a causality. On the other hand, three independent variables produced significantly positive coefficients with national language proficiency in multivariate analysis. Yet, none of them were estimated to be possible causes of higher national language proficiency. Conclusions A hypothetical causal path indicates that ‘not being stunted’ is likely to have caused higher ‘attendance rate’ and thereby higher ‘mathematical proficiency’ in a two-step manner. This study is the first attempt to estimate the possible causalities between schoolchildren’s nutritional status and their academic performances in Madagascar.
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Affiliation(s)
- Hirotsugu Aiga
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | - Emmanuel Randriamampionona
- Association des consultants a la recherche au devellopement economique et social (ACREDES), Ministry of National Education, Antananarivo, Madagascar
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Singh JK, Acharya D, Rani D, Gautam S, Thapa Bajgain K, Bajgain BB, Park JH, Yoo SJ, Poder TG, Lewin A, Lee K. Underweight and Associated Factors Among Teenage Adolescent Girls in Resource-poor Settings: A Cross-sectional Study. Risk Manag Healthc Policy 2021; 14:9-19. [PMID: 33442312 PMCID: PMC7797319 DOI: 10.2147/rmhp.s280499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/17/2020] [Indexed: 11/23/2022] Open
Abstract
Background and Purpose Understanding the undernutrition status of teenage adolescent girls living in urban slums and its associated factors is meaningful to formulate customized health strategies. This study aimed to determine the prevalence of being underweight and associated factors among teenage adolescent girls in urban slums. Materials and Methods In this cross-sectional study, we enrolled a total of 418 teenage adolescent girls from five of 210 urban slums of Varanasi district, Uttar Pradesh, India employing two-stage probability sampling for the selection of households and subjects, between September 2016 and July 2017. The study of underwight subjects was assessed with BMI for age using standard criteria. Factors associated with being underweight were determined by multivariable logistic regression analysis. Results Of 418 study subjects, 49.76% (208/418) were underweight. Results revealed that sociodemographic factors such as teenage adolescent girls who were from SC/ST (schedule caste/schedule tribe) caste/ethnicity (adjusted odds ratio (AOR)=2.02, 95%CI: 1.00–4.23), subjects whose father’s education level was primary or lower (AOR=1.87, 95%CI: 1.12–3.11), and number of people in the family >4 (AOR=2.18, 95%CI: 1.18–4.03) were associated with being underweight. Likewise, dietary behavior-related factors such as vegetarian (AOR=2.21, 95%CI: 1.25–3.92), and <3 meals per day (AOR=2.36, 95%CI: 1.40–3.98) than their counterparts were associated with being underweight. In addition, teenage adolescent girls from food-insecure households (AOR=3.33, 95%CI: 2.01–5.51) were more likely to be underweight than those from food-secure households. Conclusion The higher burden of underweight among teenage adolescent girls in Indian urban slums needs to be addressed through specific public health interventions such as by improving education, providing education regarding dietary behavior, and having access to sufficient, safe, and nutritious foods.
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Affiliation(s)
- Jitendra Kumar Singh
- Department of Community Medicine and Public Health, Janaki Medical College, Tribhuvan University, Janakpur, Nepal
| | - Dilaram Acharya
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju, Republic of Korea.,Department of Community Medicine, Kathmandu University, Devdaha Medical College and Research Institute, Rupandehi, Nepal
| | - Divya Rani
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Salila Gautam
- Department of Public Health, Sanjeevani College of Medical Sciences, Purbanchal University, Rupandehi, Nepal
| | | | - Bishnu Bahadur Bajgain
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ji-Hyuk Park
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Seok-Ju Yoo
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Thomas G Poder
- School of Public Health, University of Montreal, Montreal, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, CIUSSS de l'Est-de-L'île-de-Montréal, Montreal, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Montreal, Quebec, Canada.,Faculty of Medicine and Health Science, Sherbrooke University, Sherbrooke, Quebec, Canada
| | - Kwan Lee
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju, Republic of Korea
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Ng CM, Satvinder K, Koo HC, Yap RWK, Mukhtar F. Influences of psychosocial factors and home food availability on healthy meal preparation. MATERNAL & CHILD NUTRITION 2020; 16 Suppl 3:e13054. [PMID: 33347728 PMCID: PMC7752129 DOI: 10.1111/mcn.13054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 11/28/2022]
Abstract
The involvement of children in healthy meal preparation activities has emerged as a potential strategy to promote healthy eating behaviour among children. However, there is a lack of understanding of children's internal (psychosocial factors) and external factors (home food availability) that may support the practice of preparing healthy meals. This study aimed to determine children's psychosocial factors of healthy meal preparation within themselves and their external environment of home food availability as predictors for the practice of healthy meal preparation. Public schools (n = 8) from all three zones (Bangsar-Pudu, Keramat and Sentul) in Kuala Lumpur, Malaysia, were selected through stratified random sampling. Two hundred children aged 9-11 and their parents participated. Children's psychosocial factors towards healthy meal preparation and their home food availability were assessed through children and parents, respectively, using validated questionnaires. Majority of the schoolchildren (86.5%) had poor practice of healthy meal preparation. Increased attitude (r = 0.344, P < 0.001) and self-efficacy (r = 0.501, P < 0.001) of healthy meal preparation and the availability of fruits (r = 0.304, P < 0.001), vegetables (r = 0.243, P < 0.001) and healthful ready-to-eat foods (r = 0.227, P = 0.001) at home were positively correlated with the practice of preparing healthy meals. After adjusting for age, sex and monthly household income, increased self-efficacy (P < 0.001), availability of fruits (P = 0.01) and lower availability of less healthful ready-to-eat food (P = 0.01) were associated with better healthy meal preparation practices. Outcomes revealed that positive self-efficacy of healthy meal preparation, home food availability of fruits and less healthful alternatives were associated with the practice of healthy meal preparation and thus should be targeted in future health-promotion strategy.
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Affiliation(s)
- Choon Ming Ng
- Faculty of Applied SciencesUCSI UniversityKuala LumpurMalaysia
| | - Kaur Satvinder
- Faculty of Applied SciencesUCSI UniversityKuala LumpurMalaysia
| | - Hui Chin Koo
- Faculty of Applied SciencesTunku Abdul Rahman University CollegeKuala LumpurMalaysia
| | | | - Firdaus Mukhtar
- Department of PsychiatryFaculty of Medicine and Health Sciences, Universiti Putra MalaysiaSerdangMalaysia
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Hailegebriel T. Prevalence and Determinants of Stunting and Thinness/Wasting Among Schoolchildren of Ethiopia: A Systematic Review and Meta-Analysis. Food Nutr Bull 2020; 41:474-493. [PMID: 33191793 DOI: 10.1177/0379572120968978] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Several studies have been carried out assessing the prevalence of undernutrition and possible determinants among schoolchildren in Ethiopia, but there is a lack of systematically gathered and analyzed information. OBJECTIVE This systematic review and meta-analysis aimed to summarize epidemiological data on undernutrition and possible determinants among schoolchildren in Ethiopia. METHODS We conducted a systematic review using open access articles that report the prevalence of stunting and wasting/thinness among schoolchildren from PubMed Central, Scopus, and Science direct. The pooled prevalence was determined using a random-effect model while heterogeneities between studies were evaluated by I 2 test. RESULTS A total of 24 716 schoolchildren were included in the 39 eligible articles. The prevalence of stunting and wasting/thinness among schoolchildren in Ethiopia were 23.1% (95% CI: 19.0-27.0) and 22% (95% CI: 17-26), respectively. There was a marked difference in the prevalence of stunting and wasting/thinness across regions of Ethiopia. The risk of stunting was increased with meal frequency ≤3 times a day (odds ratio [OR] = 3.02, 95% CI: 1.90-4.14), age >10 years (OR = 2.16, 95% CI: 1.47-2.85), and family size ≥5 (OR = 1.88, 95% CI: 1.40-2.35). Similarly, the risk of wasting/thinness was increased with male sex (OR = 2.06, 95% CI: 1.54-2.58), low family income (OR = 2.16, 95% CI: 1.30-3.01), and age >10 years (OR = 1.78, 95% CI: 0.74-2.82). CONCLUSION This study revealed that more than one-fifth of schoolchildren are stunted or wasted/thin in Ethiopia. Large family size, male sex, and student age were consistently associated with stunting and wasting/thinness among schoolchildren. This study highlights the importance of an integrated effort to reduce undernutrition in Ethiopia.
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Assessment of Prevalence and Risk Factors for Intestinal Parasitosis, Malnutrition, and Anemia among School Children in Ghindae Area, Eritrea. J Trop Med 2020; 2020:4230260. [PMID: 33178289 PMCID: PMC7647778 DOI: 10.1155/2020/4230260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 06/30/2020] [Indexed: 11/24/2022] Open
Abstract
Background Research studies on determination of risk factors for intestinal parasitic infections and related malnutrition and anemia in various tropical areas are necessary for appropriate preventive resource allocation and cost effective control. This study is aimed at evaluating the prevalence and risk factors of intestinal parasitosis, malnutrition, and anemia amongst elementary and junior school students in Ghindae area, Eritrea. Method A cross-sectional study was conducted in 6 schools around Ghindae from February to April 2018. 460 children were selected randomly for analysis and consent was taken from guardians. The pertinent sociodemographic data was collected using a pretested questionnaire, and anthropometric measurements were carried out to determine the proportion of students with malnutrition, stunting, and thinness. Fecal samples were examined by formal-ether concentration technique, and blood specimen was collected and analyzed for the assessment of hemoglobin using Hemocue analyzers. The association between predictors and outcome variables were measured with a stepwise logistic regression model. Result The overall prevalence of intestinal parasitosis was 45.3%. Protozoan infections (38.2%) were more prevalent than soil-transmitted helminthic infections (10.4%). The presence of different intestinal parasitic infections had statistically significant association with the residence area, hand washing habits, source of drinking water, and type of latrine used. The prevalence of malnutrition was 36.9% with 18.5% stunting and 21.2% thinness. Students of rural areas had 2.03 times more odds of having malnutrition. The current prevalence of anemia was 12.4%, out of which 7.6% had mild anemia while 4.4% of them had moderate anemia and 0.4% were severely anemic. Conclusion The prevalence of parasitic infection among school-age children in Ghindae area was high. Unsafe drinking water sources from streams and springs were among the core problems for increased prevalence along with decreased awareness on personal hygienic and sanitation practices. Undernutrition was widely prevalent among students in Ghindae area. Height for age and BMI for age scores of all participants were found to be below the WHO growth standards. Malnutrition was in higher prevalence in rural areas outside Ghindae, which is attributed to two times higher odds than their counterparts. The magnitude of anemia found in this study is considered a mild public health problem.
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AbuKishk N, Turki Y, Saleh S, Albaik S, Hababeh M, El-Khatib Z, Kassim N, Arab H, Abu-Diab K, Zeidan W, Seita A. Anaemia prevalence in children newly registered at UNRWA schools: a cross-sectional study. BMJ Open 2020; 10:e034705. [PMID: 32967866 PMCID: PMC7513562 DOI: 10.1136/bmjopen-2019-034705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 05/16/2020] [Accepted: 07/22/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Children entering first grade at the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) schools in West Bank, Gaza, Lebanon, Jordan and Syria complete a comprehensive medical examination at UNRWA health centres (HCs) as a requirement for their acceptance. Our study aimed to assess anaemia prevalence and undernutrition indicators among new entrant school children during their preschool medical examination. SETTINGS In 2017, we conducted a cross-sectional study in 59 UNRWA HCs, targeting children entering first grade at UNRWA schools in four of UNRWA's countries of operation (known as fields), namely Gaza, West Bank, Syria and Lebanon. PARTICIPANTS 2419 completed the study. Boys and girls living inside or outside Palestine refugee camps were included. Verbal consent was obtained from their parents. PRIMARY AND SECONDARY OUTCOME MEASURES Sociodemographic and anthropometric data on each child were collected. Underweight (weight-for-age z-score <-2 SD), stunting (height-for-age z-score <-2 SD), thinness (body mass index-for-age z-score <-2 SD) and obesity (body mass index-for-age z-score >+2 SD) were examined according to WHO growth indicators (5-10 years). RESULTS 2419 students (1278 girls and 1141 boys) aged 6.1±0.4 years were examined. The prevalence of anaemia (haemoglobin (Hb) <11.5 g/L) was 25.0% (Gaza: 29.3%; West Bank: 22.0%; Syria: 30.0%; Lebanon: 18.3%). The mean Hb level was 12.0±0.9 g/L. The overall prevalence of stunting, thinness and underweight was 3.2%, 3.5% and 5.6%, respectively, with the highest levels found in Syria (4.3%, 6.3% and 10.1%, respectively). The highest prevalence of overweight was in Lebanon (8.6%), and the lowest was in Gaza (2.6%). Significant differences were found among fields with regard to undernutrition indicators (p=0.001). Also, children with anaemia had significantly higher prevalence of being underweight (5.2%) in comparison with those without anaemia (p=0.001). CONCLUSIONS The prevalence of anaemia among the surveyed children increased to 25.0%, compared with the previous study conducted by UNRWA in 2005 (19.5%). Thus, it is recommended that Hb testing be included in the medical examination of new entrant school children attending UNRWA schools.
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Affiliation(s)
- Nada AbuKishk
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | - Yassir Turki
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | - Suha Saleh
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | - Shatha Albaik
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | - Majed Hababeh
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | | | | | - Hasan Arab
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | | | - Wafaa Zeidan
- Health Department, UNRWA HeadQuarters, Amman, Jordan
| | - Akihiro Seita
- Health Department, UNRWA HeadQuarters, Amman, Jordan
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Dutta M, Bhise M, Prashad L, Chaurasia H, Debnath P. Prevalence and risk factors of anemia among children 6–59 months in India: A multilevel analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Massad S, Gebre-Medhin M, Dary O, Abdalla M, Holleran S, Karmally W, Bordelois P, Khammash U, Deckelbaum RJ. Micronutrient status of Palestinian school children following salt and flour fortification: a cross-sectional study. BMC Nutr 2020; 6:38. [PMID: 32864153 PMCID: PMC7448451 DOI: 10.1186/s40795-020-00367-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 07/30/2020] [Indexed: 12/02/2022] Open
Abstract
Background In 1996 and in 2006, Palestine initiated salt iodization and multiple micronutrient fortification of wheat flour, respectively as a strategy to prevent deficiencies of these nutrients. In 2009, we assessed the impact of these interventions on the health and nutritional status of schoolchildren residing in the West Bank. Methods We surveyed a sample of 22 schools run by the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the Palestinian Government. We randomly selected students from the first (mean age 6.7 years [SD 0.5]), sixth (11.8 years [0.6]), and ninth grades (14.8 years [0.6]). Data were obtained from 1484 (99%) of 1500 students planned for enrollment. Results Our results suggest that iodine intake appears adequate and there was essentially no iodine deficiency. As to the status of other micronutrients, the main nutritional micronutrient risks for schoolchildren in the West Bank continue to be low serum levels of iron, zinc, and vitamin B-12; folate levels were seemingly high. The overall prevalence of anemia was 9.6%, but there were pockets of anemia in certain districts. Almost 42% of the anemia in our sample was explained by iron deficiency. There were significant differences in iron deficiency between girls and boys, 29.5% vs. 15.7%, respectively (p = 0.0001). There were no cases of lead toxicity in the studied sample. Conclusions Wheat flour and salt fortification has had a major influence on improving the micronutrient status of Palestinian children, for some but not all micronutrients. The recommended key blood and biochemical parameters to be incorporated in the surveillance system are iron, zinc, and vitamin B12.
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Affiliation(s)
- Salwa Massad
- Juzoor for Health and Social Development, Ramallah, 970 Palestine
| | - Mehari Gebre-Medhin
- Department of Women's and Children's Health, Pediatrics, University Hospital, SE-751 85 Uppsala, Sweden
| | - Omar Dary
- USAID Bureau of Global Health, Washington, DC USA
| | - Marwah Abdalla
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032 USA
| | - Steve Holleran
- Institute of Human Nutrition, Columbia University, New York, NY 10032 USA
| | - Wahida Karmally
- Irving Institute for Clinical and Translational Research, Columbia University Irving Medical Center, New York, NY 10032 USA
| | - Paula Bordelois
- Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032 USA
| | - Umaiyeh Khammash
- Juzoor for Health and Social Development, Ramallah, 970 Palestine
| | - Richard J Deckelbaum
- Institute of Human Nutrition, Columbia University, New York, NY 10032 USA.,Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032 USA
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Nutritional Status of Children and Its Associated Factors in Selected Earthquake-Affected VDCs of Gorkha District, Nepal. Int J Pediatr 2020; 2020:5849548. [PMID: 32695188 PMCID: PMC7362290 DOI: 10.1155/2020/5849548] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 05/15/2020] [Accepted: 06/18/2020] [Indexed: 11/18/2022] Open
Abstract
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.
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Nasr M, Pourmirzaei M, Esmaeil Motlagh M, Heshmat R, Qorbani M, Kelishadi R. Mapping the relative risk of weight disorders in children and adolescents across provinces of Iran: the CASPIAN-V study. Health Promot Perspect 2020; 10:238-243. [PMID: 32802760 PMCID: PMC7420165 DOI: 10.34172/hpp.2020.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/30/2020] [Indexed: 11/30/2022] Open
Abstract
Background: This study aimed to find possible spatial variation in children’s weight disorders and in predicting the spatial distribution. Methods: The study population of this ecological study consisted of 7-18-year-old students living in 30 provinces of Iran. We used Besag, York and Mollie (BYM) model, a Bayesian model, to study the relative risk (RR) of underweight and excess weight (overweight and obese). The model was fitted to data using OpenBUGS (3.2.1) software. Results: The highest RR of underweight was found in southeastern provinces. Whereas, the highest RR of excess weight was documented in northern, northwestern and capital provinces.Sistan-Balouchestan (RR=1.973; Bayesian confidence interval [BCI]: 1.682, 2.289), Hormozgan(RR=1.482; BCI: 1.239, 1.749), South Khorasan (RR=1.422; BCI: 1.18, 1.687) and Kerman(RR=1.413; BCI: 1.18, 1.669) had the highest RR of underweight. Mazandaran (RR=1.366; BCI:1.172,1.581), Gilan (RR=1.346; BCI: 1.15,1.562), Tehran (RR=1.271; BCI: 1.086,1.472) and Alborz (RR=1.268; BCI: 1.079,1.475) provinces are high risk regions for excess weight. Conclusion: The significant variations in geographical distribution of weight disorders are because of various sociodemographic and ethnic differences. The current findings should be considered in health policy making in different regions of the country.
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Affiliation(s)
- Marzieh Nasr
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadali Pourmirzaei
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Sociocultural and economic determinants of stunting and thinness among adolescent boys and girls in Nepal. J Biosoc Sci 2020; 53:531-556. [PMID: 32638672 DOI: 10.1017/s0021932020000358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Despite the increasing interest in the determinants of adolescent undernutrition in low- and middle-income countries, a comprehensive multi-level overview at the country level is missing. Using the nationally representative 2014 Nepal Adolescent Nutrition Survey, this study aimed to provide a comprehensive overview of the sociocultural and economic determinants of stunting and thinness of adolescent boys and girls in Nepal. Multivariate logistic regression models were used to estimate the associations between multiple individual, household and community determinants and stunting and thinness among 3773 adolescents aged 10-19 years (1888 boys and 1885 girls). The prevalence rates of stunting and thinness indicated suboptimal nutritional status and an inadequate growth environment in Nepali adolescents. The results highlighted an association of paternal occupation and education, household income, number of earning household members, geographical place of residence, caste/ethnicity and nutritional knowledge with stunting, with higher odds for males and older adolescents. Paternal occupation, education, household income, geographical region, caste/ethnicity and nutrition knowledge were associated with thinness, with higher odds for males and younger adolescents. The findings underscore the importance of involving adolescents, their parents and their communities in interventions. Such interventions should not only be aimed at improving adolescent nutrition but also at optimizing adolescents' growth environment for better health and development. Future research should focus on context-specific causal pathways and mechanisms through which sociocultural and economic determinants influence nutritional outcomes within broader societal, cultural and political settings. A longitudinal approach, including a range of dietary and nutrition indicators would allow understanding how and when the relative importance of these factors change during adolescence.
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