1
|
Garrett R, Ferreira J, Abramovay R, Brandão J, Brondizio E, Euler A, Pinedo D, Porro R, Cabrera Rocha E, Sampaio O, Schmink M, Torres B, Varese M. Transformative changes are needed to support socio-bioeconomies for people and ecosystems in the Amazon. Nat Ecol Evol 2024; 8:1815-1825. [PMID: 39107371 DOI: 10.1038/s41559-024-02467-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 06/13/2024] [Indexed: 10/10/2024]
Abstract
Current social-technical and political conditions threaten the integrity of the Amazon biome. Overcoming these lock-ins requires structural transformations away from conventional economies towards 'socio-bioeconomies' (SBEs). SBEs are economies based on the sustainable use and restoration of Amazonian ecosystems, as well as Indigenous and rural livelihood systems in the region. They include sustainable eco-tourism as well as diversified production and innovative processing of fruits, nuts, oils, medicines, fish and other products deriving from socio-biodiversity. Using a sustainability transitions perspective, we argue for multi-scalar policy changes to sustain, enhance and scale-out and scale-up SBE initiatives. To nurture niche SBE acitivities, we advocate for improvements in infrastructure, value chains and social organizations. To dismantle structural barriers, we call for an end to harmful subsidies, greater representation of marginalized communities in territorial planning, enhanced rural-urban and intersectoral linkages, international collaboration, shifts in demand, and changes in conservation and production narratives. Policies for SBEs must also use clear definitions, participatory processes and a multi-biome approach to avoid perverse outcomes.
Collapse
Affiliation(s)
- Rachael Garrett
- Department of Geography and Conservation Research Institute, University of Cambridge, Cambridge, UK.
| | | | - Ricardo Abramovay
- Josué de Castro Chair of the School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Joyce Brandão
- Department of Geography and Conservation Research Institute, University of Cambridge, Cambridge, UK
| | - Eduardo Brondizio
- Department of Anthropology, Indiana University-Bloomington, Bloomington, IN, USA
- Environment and Society Program (UNICAMP-NEPAM), University of Campinas, Campinas, Brazil
| | - Ana Euler
- Brazilian Agricultural Research Corporation (EMBRAPA), Brasília, Brazil
| | - Danny Pinedo
- Departamento Académico de Antropología, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - Emiliano Cabrera Rocha
- Department of Geography and Conservation Research Institute, University of Cambridge, Cambridge, UK
| | - Oscar Sampaio
- Department of Geography and Conservation Research Institute, University of Cambridge, Cambridge, UK
- Federal University of Mato Grosso, Cuiaba, Brazil
| | - Marianne Schmink
- Latin American Studies, University of Florida, Gainesville, FL, USA
| | - Bolier Torres
- Faculty of Life Sciences, Universidad Estatal Amazónica, Puyo, Ecuador
| | | |
Collapse
|
2
|
de Carvalho AM, Garcia LMT, Lourenço BH, Verly Junior E, Carioca AAF, Jacob MCM, Gomes SM, Sarti FM. Exploring the Nexus between Food Systems and the Global Syndemic among Children under Five Years of Age through the Complex Systems Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:893. [PMID: 39063469 PMCID: PMC11276875 DOI: 10.3390/ijerph21070893] [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: 05/20/2024] [Revised: 07/02/2024] [Accepted: 07/06/2024] [Indexed: 07/28/2024]
Abstract
The intricate relationship between food systems and health outcomes, known as the food-nutrition-health nexus, intersects with environmental concerns. However, there's still a literature gap in evaluating food systems alongside the global syndemic using the complex systems theory, especially concerning vulnerable populations like children. This research aimed to design a system dynamics model to advance a theoretical understanding of the connections between food systems and the global syndemic, particularly focusing on their impacts on children under five years of age. The framework was developed through a literature review and authors' insights into the relationships between the food, health, and environmental components of the global syndemic among children. The conceptual model presented 17 factors, with 26 connections and 6 feedback loops, categorized into the following 5 groups: environmental, economic, school-related, family-related, and child-related. It delineated and elucidated mechanisms among the components of the global syndemic encompassing being overweight, suffering from undernutrition, and climate change. The findings unveiled potential interactions within food systems and health outcomes. Furthermore, the model integrated elements of the socio-ecological model by incorporating an external layer representing the environment and its natural resources. Consequently, the development of public policies and interventions should encompass environmental considerations to effectively tackle the complex challenges posed by the global syndemic.
Collapse
Affiliation(s)
| | | | | | - Eliseu Verly Junior
- Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro 20550-013, Brazil;
| | | | | | - Sávio Marcelino Gomes
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa 58051-900, Brazil;
| | - Flávia Mori Sarti
- School of Arts, Sciences and Humanities, University of Sao Paulo, Sao Paulo 03828-000, Brazil;
| |
Collapse
|
3
|
Mosquera PS, Lourenço BH, Matijasevich A, Castro MC, Cardoso MA. Prevalence and predictors of breastfeeding in the MINA-Brazil cohort. Rev Saude Publica 2024; 57Suppl 2:2s. [PMID: 38422331 PMCID: PMC10897961 DOI: 10.11606/s1518-8787.2023057005563] [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: 05/19/2023] [Accepted: 08/29/2023] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE To describe the prevalence and factors associated with exclusive (EBF) and continued breastfeeding (BF) practices among Amazonian children. METHODS Data from 1,143 mother-child pairs recorded on the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) birth cohort were used. Information on EBF and BF was collected after childbirth (July 2015-June 2016) and during the follow-up visits at 1 and 6 months postpartum, 1, 2, and 5 years of age. For longitudinal analysis, the outcomes were EBF and BF duration. Probability of breastfeeding practices were estimated by Kaplan-Meier survival analysis. Associations between baseline predictors variables and outcomes among children born at term were assessed by extended Cox regression models. RESULTS EBF frequencies (95% confidence interval [95%CI]) at 3 and 6 months of age were 33% (95%CI: 30.2-36.0) and 10.8% (95%CI: 8.9-12.9), respectively. Adjusted hazard ratio for predictors of early EBF cessation were: being a first-time mother = 1.47 (95%CI: 1.19-1.80), feeding newborns with prelacteals = 1.70 (95%CI: 1.23-2.36), pacifier use in the first week of life = 1.79 (95%CI: 1.44-2.23) or diarrhea in the first two weeks of life = 1.70 (95%CI: 1.15-2.52). Continued BF frequency was 67.9% (95%CI: 64.9-70.8), 29.3% (95%CI: 26.4-32.4), and 1.7% (95%CI: 0.9-2.8) at 1, 2 and 5 years of age, respectively. Adjusted hazard ratio for predictors of early BF cessation were: male sex = 1.23 (95%CI: 1.01-1.49), pacifier use in the first week of life = 4.66 (95%CI: 2.99-7.26), and EBF less than 3 months = 2.76 (95%CI: 1.64-4.66). CONCLUSIONS EBF and continued BF duration among Amazonian children is considerably shorter than recommendations from the World Health Organization. Significant predictors of breastfeeding practices should be considered for evaluating local strategies to achieve optimal breastfeeding practices.
Collapse
Affiliation(s)
- Paola S. Mosquera
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de NutriçãoSão PauloBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, Brasil
| | - Bárbara H. Lourenço
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de NutriçãoSão PauloBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, Brasil
| | - Alicia Matijasevich
- Universidade de São PauloFaculdade de MedicinaDepartamento de Medicina PreventivaSão PauloBrasilUniversidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo, Brasil
| | - Marcia C. Castro
- Harvard T.H. Chan School of Public HealthDepartment of Global Health and PopulationBostonMAEstados UnidosHarvard T.H. Chan School of Public Health. Department of Global Health and Population. Boston, MA, Estados Unidos.
| | - Marly A. Cardoso
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento de NutriçãoSão PauloBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento de Nutrição. São Paulo, Brasil
| |
Collapse
|
4
|
Wake SK, Zewotir T, Mekebo GG, Fissuh YH. Rural-urban differentials in child body mass index over time. BMC Pediatr 2023; 23:412. [PMID: 37608309 PMCID: PMC10464314 DOI: 10.1186/s12887-023-04241-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 08/10/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The body mass index is a simple index based on weight and height that can be used to screen children and adults for potential weight problems. The objective of this study was to investigate urban-rural variations in child BMI and its distribution from 2006 to 2016 in four low and middle-income countries. METHODS This study used data from the Young Lives prospective cohort study conducted in Ethiopia, India, Peru, and Vietnam to assess the BMI change for children aged 5 to 15 between 2006 and 2016. We adopted a mixed-effect model to analyze the data. RESULTS The study revealed substantial changes and rises in BMI in Vietnam, Peru, India, and Ethiopia between 2006 and 2016. Peru had the highest BMI changes in both urban-rural areas. A low BMI was observed in Ethiopia and India. Urban-rural differences had a significant role in determining BMI variation. In urban Ethiopia, the mean BMI increased from 14.56 kg/m2 to 17.52 kg/m2, and in rural areas, it increased from 14.57 kg/m2 to 16.67 kg/m2. Similarly, in urban Vietnam, the BMI increased from 16 kg/m2 to 20.3 kg/m2, and in rural areas, it increased from 14.69 kg/m2 to 18.93 kg/m2. CONCLUSIONS The findings showed an increase in BMI changes in Ethiopia, India, Peru, and Vietnam from 2006 to 2016. Urban-rural differences have a significant contribution to determining BMI variation.
Collapse
Affiliation(s)
- Senahara Korsa Wake
- College of Natural and Computational Sciences, Ambo University, Ambo, Ethiopia.
| | - Temesgen Zewotir
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa
| | | | - Yemane Hailu Fissuh
- College of Natural and Computational Sciences, Aksum University, Axum, Ethiopia
| |
Collapse
|
5
|
Suryani D, Kusdalinah K, Krisnasary A, Simbolon D, Angraini W. Determinants of Feeding Patterns with Stunting in Children in the Coastal Area of Bengkulu City. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The age of 0–2 years is a golden period for human growth and development known as the “golden age,” characterized by rapid growth. This period is the First 1000 Days of Life (HPK). The proper diet greatly affects the nutritional status of children.
AIM: The purpose of the study was to determine child feeding patterns with the incidence of stunting in children in the Coastal area of Bengkulu City.
METHODS: This study was an analytical observational study with a cross-sectional design. The research sample was children under five aged 6–24 months in the coastal area of Bengkulu City as many as 75 children were selected using the accidental sampling technique. Children’s nutritional intake using the Semi Food Frequency questionnaire for energy, protein, fat, carbohydrates, calcium, iron, zinc, and phosphorus. Nutritional intake data were processed by nutrisurvey. Data analysis with Chi-square test and the level of significant 0.05.
RESULTS: The frequency of food consumed by children 6–24 months in the form of mashed food 2 times a day was 54.2%, soft food 3 times a day was 54.5%, and family food 3 times a day was 82.5%. The percentage of children with energy, protein, fat, and carbohydrate intake below the recommendation was much higher in normal children (in sequence 84.6%, 81.8%, 84.9%, and 86.3%) compare to stunted children (in sequence 15.4%, 18.2%, 15.1%, and 13.7%). Likewise, calcium, fe, zinc, and phosphor intake below the recommendation was much higher in normal children (in sequence 82%, 85.5%, 80.6%, and 82.1%) compare to stunted children (in sequence 18%, 14.5%, 19.4%, and 17.9%).
CONCLUSIONS: There was no relationship between the type of food, macronutrient and micronutrient intake with stunting. Education and counseling at Integrated Healthcare Center need to be carried out, regarding the importance of consuming the proper food and the proper frequency of eating, surveys of nutritional consumption and routine health checks for pregnant women and children under five.
Collapse
|
6
|
Kempton JW, Périssé ARS, Hofer CB, de Vasconcellos ACS, de Sousa Viana PV, de Oliveira Lima M, de Jesus IM, de Souza Hacon S, Basta PC. An Assessment of Health Outcomes and Methylmercury Exposure in Munduruku Indigenous Women of Childbearing Age and Their Children under 2 Years Old. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10091. [PMID: 34639393 PMCID: PMC8508331 DOI: 10.3390/ijerph181910091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/04/2021] [Accepted: 09/16/2021] [Indexed: 11/17/2022]
Abstract
In line with the 1000-day initiative and the Sustainable Development Goals (SDG) 2 and 3, we present a cross-sectional analysis of maternal health, infant nutrition, and methylmercury exposure within hard-to-reach indigenous communities in the state of Pará, Brazilian Amazon. We collected data from all women of childbearing age (i.e., 12-49) and their infants under two years old in three Munduruku communities (Sawré Muybu, Sawré Aboy, and Poxo Muybu) along the Tapajos River. We explored health outcomes through interviews, vaccine coverage and clinical assessment, and determined baseline hair methylmercury (H-Hg) levels. Hemoglobin, infant growth (Anthropometric Z scores) and neurodevelopment tests results were collected. We found that 62% of women of childbearing age exceeded the reference limit of 6.0 μg/g H-Hg (median = 7.115, IQR = 4.678), with the worst affected community (Sawré Aboy) registering an average H-Hg concentration of 12.67 μg/g. Half of infants aged under 24 months presented with anemia. Three of 16 (18.8%) infants presented H-Hg levels above 6.0 µg/g (median: 3.88; IQR = 3.05). Four of the 16 infants were found to be stunted and 38% of women overweight, evidencing possible nutritional transition. No infant presented with appropriate vaccination coverage for their age. These communities presented with an estimated Infant Mortality Rate (IMR) of 86.7/1000 live births. The highest H-Hg level (19.6 µg/g) was recorded in an 11-month-old girl who was found to have gross motor delay and anemia. This already vulnerable indigenous Munduruku community presents with undernutrition and a high prevalence of chronic methylmercury exposure in women of childbearing age. This dual public health crisis in the context of wider health inequalities has the potential to compromise the development, health and survival of the developing fetus and infant in the first two critical years of life. We encourage culturally sensitive intervention and further research to focus efforts.
Collapse
Affiliation(s)
| | - André Reynaldo Santos Périssé
- Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (ENSP/Fiocruz), Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro 21041-210, Brazil; (A.R.S.P.); (S.d.S.H.)
| | - Cristina Barroso Hofer
- Instituto de Pediatria e Puericultura Martagão Gesteira, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rua Bruno Lobo, 50, Cidade Universitária, Rio de Janeiro 21941-912, Brazil;
| | - Ana Claudia Santiago de Vasconcellos
- Laboratório de Educação Profissional em Vigilância em Saúde, Escola Politécnica de Saúde Joaquim Venân-cio, Fundação Oswaldo Cruz (EPSJV/Fiocruz), Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil;
| | - Paulo Victor de Sousa Viana
- Centro de Referência Professor Hélio Fraga, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (CRPHF/ENSP/Fiocruz), Estrada de Curicica, 2000, Curicica, Rio de Janeiro 22780-195, Brazil;
| | - Marcelo de Oliveira Lima
- Seção de Meio Ambiente, Instituto Evandro Chagas, Secretaria de Vigilância em Saúde, Ministério da Saúde (SEAMB/IEC/SVS/MS), Rodovia BR-316 km 7 s/n, Levilândia 67030-000, Brazil; (M.d.O.L.); (I.M.d.J.)
| | - Iracina Maura de Jesus
- Seção de Meio Ambiente, Instituto Evandro Chagas, Secretaria de Vigilância em Saúde, Ministério da Saúde (SEAMB/IEC/SVS/MS), Rodovia BR-316 km 7 s/n, Levilândia 67030-000, Brazil; (M.d.O.L.); (I.M.d.J.)
| | - Sandra de Souza Hacon
- Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (ENSP/Fiocruz), Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro 21041-210, Brazil; (A.R.S.P.); (S.d.S.H.)
| | - Paulo Cesar Basta
- Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (ENSP/Fiocruz), Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro 21041-210, Brazil; (A.R.S.P.); (S.d.S.H.)
| |
Collapse
|
7
|
Carvalho GC, de Oliveira RAP, Araujo VHS, Sábio RM, de Carvalho LR, Bauab TM, Corrêa I, Chorilli M. Prevalence of vulvovaginal candidiasis in Brazil: a systematic review. Med Mycol 2021; 59:946-957. [PMID: 34137857 DOI: 10.1093/mmy/myab034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/26/2021] [Accepted: 06/15/2021] [Indexed: 12/18/2022] Open
Abstract
Vulvovaginal candidiasis (CVV) is a condition whose signs and symptoms are related to inflammation caused by Candida spp infection. It is the second leading cause of vaginitis in the world, representing a public health problem. The present systematic review comes with the proposal of analyze and identify the available evidence on CVV prevalence in Brazil, pointing out its variability by regions. For this, a systematic literature review was carried out with meta-analysis of cross-sectional and cohort studies, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guide recommendations, and was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2020 CRD42020181695). The databases used for survey were LILACS, Scielo, Scopus, PUBMED, Web of Science and CINAHL. Fifteen studies were selected to estimate CVV prevalence in the Brazilian territory. South and Southeast regions have higher prevalences than the North and Northeast regions, no data were found for the Midwest region. The estimated prevalence for Brazil is 18%, however, it is suggested that this number is higher due to underreporting and the presence of asymptomatic cases. Therefore, new epidemiological studies are recommended throughout Brazil, to elucidate the profile of this disease in the country, in addition to assisting in the elaboration of an appropriate prevention plan by state. LAY ABSTRACT Data found in the literature regarding the epidemiological profile of VVC in Brazil are obsolete and incomplete, so the present systematic review has the proposal to analyze and identify the evidence on VVC prevalence in Brazil. The estimated prevalence is 18%, however, this number can be higher.
Collapse
Affiliation(s)
- Gabriela Corrêa Carvalho
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | | | - Victor Hugo Sousa Araujo
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | - Rafael Miguel Sábio
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | - Lídia Raquel de Carvalho
- Biostatistics department, Institute of Biosciences, São Paulo State University (UNESP), 18618687 Botucatu, Brazil
| | - Taís Maria Bauab
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| | - Ione Corrêa
- Nursing department, Medical School, São Paulo State University (UNESP), 18618687 Botucatu, Brazil
| | - Marlus Chorilli
- Department of Drugs and Pharmaceutics, School of Pharmaceutical Sciences, São Paulo State University (UNESP), 14800-903 Araraquara, Brazil
| |
Collapse
|
8
|
Boah M, Azupogo F, Amporfro DA, Abada LA. The epidemiology of undernutrition and its determinants in children under five years in Ghana. PLoS One 2019; 14:e0219665. [PMID: 31365528 PMCID: PMC6668784 DOI: 10.1371/journal.pone.0219665] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 06/28/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Understanding the burden and contextual risk factors is critical for developing appropriate interventions to control undernutrition. METHODS This study used data from the 2014 Ghana Demographic and Health Survey to estimate the prevalence of underweight, stunting, and wasting. Single multiple logistic regressions were used to identify the factors associated with underweight, wasting and stunting. The study involved 2720 children aged 0-59 months old and mother pairs. All analyses were done in STATA/IC version 15.0. Statistical significance was set at p<0.05. RESULTS The prevalence of underweight, wasting and stunting were 10.4%, 5.3%, and 18.4% respectively. The age of the child was associated with underweight, wasting and stunting, whereas the sex was associated with wasting and stunting. Normal or overweight/obese maternal body mass index category, high woman's autonomy and middle-class wealth index were associated with a lower odds of undernutrition. The factors that were associated with a higher odds of child undernutrition included: low birth weight (<2.5 kg), minimum dietary diversity score (MDDS), a higher (≥4th) birth order number of child, primary educational level of husband/partner and domicile in the northern region of Ghana. CONCLUSION There is still a high burden of child undernutrition in Ghana. The age, sex, birth weight, birth order and the MDDS of the child were the immediate factors associated with child undernutrition. The intermediate factors that were associated with child undernutrition were mainly maternal related factors and included maternal nutritional status and autonomy. Distal level factors which were associated with a higher odds of child undernutrition were the wealth index of the household, paternal educational status and region of residence. We recommend that interventions and policies for undernutrition should address socioeconomic inequalities at the community level while factoring in women empowerment programmes.
Collapse
Affiliation(s)
- Michael Boah
- Ghana Health Service, Bolgatanga, Upper East Region, Ghana
| | - Fusta Azupogo
- Department of Family and Consumer Sciences, Faculty of Agriculture, University for Development Studies, Tamale, Ghana
| | - Daniel Adjei Amporfro
- Department of Social Medicine and Health Service Management, Harbin Medical University, Harbin, China
| | | |
Collapse
|
9
|
Influence of Maternal Fish Intake on the Anthropometric Indices of Children in the Western Amazon. Nutrients 2018; 10:nu10091146. [PMID: 30142890 PMCID: PMC6164537 DOI: 10.3390/nu10091146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 08/19/2018] [Accepted: 08/20/2018] [Indexed: 12/19/2022] Open
Abstract
We studied trends in fish intake among pregnant women living in the Madeira River Basin in Rondônia State, Brazil, to investigate the influence of maternal fish intake on anthropometric indices of children followed up to 5 years. Maternal fish intake was assessed using hair mercury concentrations of mothers and children at delivery and 6, 24, and 59 months. Data analysis was performed using a linear mixed-effect model. Mothers were predominantly young, had low incomes and limited schooling, and breastfed for >6 months. Only 1.9% of children had low birth weight. Anthropometric indices in approximately 80% of the study population showed Z-score values ranging from ≥-2 to ≤1. The influence of maternal fish intake on anthropometric indices, including height-to-age (H/A), weight-to-age (W/A), and weight-to-height (W/H) were not statistically significant after model adjustments. However, higher income and larger birth weight had a positive influence on H/A and W/A, whereas W/H gain was favored by higher maternal educational status and breastfeeding duration. Other variables (hemoglobin concentration and maternal age) had a positive significant influence on anthropometric indices. Maternal fish intake (or its attendant MeHg exposure) did not affect children growth. Nevertheless, it is advisable to avoid mercury-contaminated fish during pregnancy and childhood.
Collapse
|