Stunting and Wasting Among Indian Preschoolers have Moderate but Significant Associations with the Vegetarian Status of their Mothers.
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ABSTRACT:
SUBMITTER: Headey DD
PROVIDER: S-EPMC7269725 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Child undernutrition remains high in India with far-reaching consequences for child health and development. Anthropometry reflects undernutrition. We examined the state-level trends in underweight, stunting, and wasting prevalence and inequality by living standards using four rounds of the National Family Health Surveys in 26 states in India, conducted in 1992-1993, 1998-1999, 2005-2006, and 2015-2016. The average annual reduction (AAR) for underweight ranged from 0.04 percentage points (pp) (95% CI - 0.12, 0.20) in Haryana to 1.05 pp (95% CI 0.88, 1.22) in West Bengal for underweight; 0.35 pp (95% CI 0.11, 0.59) in Manipur to 1.47 (95% CI 1.19, 1.75) in Himachal Pradesh for stunting; and - 0.65 pp (95% CI - 0.77, - 0.52) in Haryana to 0.36 pp (95% CI 0.22, 0.51) in Bihar & Jharkhand for wasting. We find that change in the pp difference between children with the poorest and richest household living standards varied by states: statistically significant decline (increase) was observed in 5 (3) states for underweight, 5 (4) states for stunting, and 2 (1) states for wasting. Prevalence of poor anthropometric outcomes as well as disparities by states and living standards remain a problem in India.
| S-EPMC8266817 | biostudies-literature
Project description:The cardiovascular and other health benefits and potential harms of protein and micronutrient deficiency of vegetarian diets continue to be debated.Study participants included urban migrants, their rural siblings and urban residents (n = 6555, mean age - 40.9 yrs) of the Indian Migration Study from Lucknow, Nagpur, Hyderabad and Bangalore. Information on diet (validated interviewer-administered semi-quantitative food frequency questionnaire), tobacco, alcohol, physical activity, medical histories, as well as blood pressure, fasting blood and anthropometric measurements were collected. Nutrient databases were used to calculate nutrient content of regional recipes. Vegetarians ate no eggs, fish, poultry and meat. Using multivariate linear regression with robust standard error model, we compared the macro- and micro-nutrient profile of vegetarian and non-vegetarian diets.Vegetarians, (32.8% of the population), consumed greater amounts of legumes, vegetables, roots and tubers, dairy and sugar, while non-vegetarians had a greater intake of cereals, fruits, spices, salt (p?<?0.01), fats and oils. Vegetarians had a higher socioeconomic status, and were less likely to smoke, drink alcohol (p?<?0.0001) and engage in less physical activity (p?=?0.04). On multivariate analysis, vegetarians consumed more carbohydrates (??=?7.0 g/day (95% CI: 9.9 to 4.0), p?<?0.0001), vitamin C (??=?8.7 mg/day (95% CI: 4.3 to13.0), p?<?0.0001) and folate (??=?8.0 mcg/day (95% CI: 3.3 to 12.7), p?=?0.001) and lower levels of fat (??=?-1.6 g/day (95% CI: -0.62 to -2.7), p?=?0.002), protein (??=?-6.4 g/day (95% CI: -5.8 to -7.0), p?<?0.0001), vitamin B12 (??=?-1.4 mcg/day (95% CI: -1.2 to -1.5), p?<?0.0001) and zinc (??=?-0.6 mg/day (95% CI: -0.4 to -0.7), p?<?0.0001).Overall, Indian vegetarian diets were found to be adequate to sustain nutritional demands according to recommended dietary allowances with less fat. Lower vitamin B12 bio-availability remains a concern and requires exploration of acceptable dietary sources for vegetarians.
| S-EPMC4055802 | biostudies-other
Project description:The longitudinal relationship between stunting and wasting in children is poorly characterized. Instances of wasting or poor weight gain may precede linear growth retardation. We analyzed longitudinal anthropometric data for 1599 children from 8 cohort studies to determine the effect of wasting [weight-for-length Z-score (WLZ) < -2] and variability in WLZ in the first 17 mo on length-for-age Z-score (LAZ) at 18-24 mo of age. In addition, we considered the effects of change in WLZ during the previous 6-mo period on length at 18 and 24 mo. Wasting at 6-11 or 12-17 mo was associated with decreased LAZ; however, children who experienced wasting only at 0-5 mo did not suffer any long-term growth deficits compared with children with no wasting during any period. Children with greater WLZ variability (?0.5 SD) in the first 17 mo of life were shorter [LAZ = -0.51 SD (95% CI: -0.67, -0.36 SD)] at 18-24 mo of age than children with WLZ variability <0.5. Change in WLZ in the previous 6-mo period was directly associated with greater attained length at 18 mo [0.33 cm (95% CI: 0.11, 0.54 cm)] and 24 mo [0.72 cm (95% CI: 0.52, 0.92 cm)]. Children with wasting, highly variable WLZ, or negative changes in WLZ are at a higher risk for linear growth retardation, although instances of wasting may not be the primary cause of stunting in developing countries.
| S-EPMC3374667 | biostudies-literature
Project description:Vegetarian diets have gained popularity in sports. However, few data exist on the status of micronutrients and related biomarkers for vegetarian and vegan athletes. The aim of this cross-sectional study was to compare the micronutrient status of omnivorous (OMN, n = 27), lacto-ovo-vegetarian (LOV, n = 26), and vegan (VEG, n = 28) recreational runners. Biomarkers of vitamin B12, folate, vitamin D, and iron were assessed. Additionally, serum levels of calcium, magnesium, and zinc were examined. Lifestyle factors and supplement intake were recorded via questionnaires. About 80% of each group showed vitamin B12 adequacy with higher levels in supplement users. Mean red blood cell folate exceeded the reference range (>340 nmol/L) in all three groups (OMN: 2213 ± 444, LOV: 2236 ± 596, and VEG: 2354 ± 639 nmol/L; not significant, n.s.). Furthermore, vitamin D levels were comparable (OMN: 90.6 ± 32.1, LOV: 76.8 ± 33.7, and VEG: 86.2 ± 39.5 nmol/L; n.s.), and we found low prevalence (<20%) of vitamin D inadequacy in all three groups. Less than 30% of each group had depleted iron stores, however, iron deficiency anemia was not found in any subject. Our findings suggest that a well-planned, health-conscious lacto-ovo-vegetarian and vegan diet, including supplements, can meet the athlete's requirements of vitamin B12, vitamin D and iron.
| S-EPMC6566694 | biostudies-literature
Project description:Introduction: Child undernutrition is a major public health problem. One third of all undernourished children globally reside in Sub-Saharan Africa (SSA). The aim of this study was to systematically review studies to determine the factors associated with stunting, wasting and underweight in SSA and contribute to the existing body of evidence needed for the formulation of effective interventions. Methods: This systematic review was conducted using the 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Five computerized bibliographic databases were searched: Scopus, PubMed, PsycINFO, CINAHL and Embase. The included studies were rated using eight quality-appraisal criteria derived from the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist: sample size, sampling methodology, response rate, outcome measures, statistical analyses, control for confounding, study limitation, and ethical consideration. Results: Of a total of 2810 articles retrieved from the five databases, 49 studies met our inclusion criteria. The most consistent factors associated with childhood stunting, wasting and underweight in SSA were: low mother's education, increasing child's age, sex of child (male), wealth index/SES (poor household), prolonged duration of breastfeeding (>12 months), low birth weight, mother's age (<20 years), source of drinking water (unimproved), low mother's BMI (<18.5), birth size (small), diarrhoeal episode, low father's education and place of residence (rural). Conclusions: The factors that predispose a child to undernutrition are multisectoral. To yield a sustainable improvement in child nutrition in SSA, a holistic multi-strategy community-based approach is needed that targets the factors associated with undernutrition, thereby setting the region on the path to achieving the WHO global nutrition target by 2025.
| S-EPMC5580567 | biostudies-literature
Project description:BACKGROUND: Nutrition is one of many factors affecting the cognitive development of children. In Cambodia, 55% of children <5 y were anemic and 40% stunted in 2010. Currently, no data exists on the nutritional status of Cambodian school-aged children, or on how malnutrition potentially affects their cognitive development. OBJECTIVE: To assess the anthropometric and micronutrient status (iron, vitamin A, zinc, iodine) of Cambodian schoolchildren and their associations with cognitive performance. METHODS: School children aged 6-16 y (n = 2443) from 20 primary schools in Cambodia were recruited. Anthropometry, hemoglobin, serum ferritin, transferrin receptors, retinol-binding protein and zinc concentrations, inflammation status, urinary iodine concentration and parasite infection were measured. Socio-economic data were collected in a sub-group of children (n = 616). Cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM) and block design and picture completion, two standardized tests from the Wechsler Intelligence Scale for Children (WISC-III). RESULTS: The prevalence of anemia, iron, zinc, iodine and vitamin A deficiency were 15.7%; 51.2%, 92.8%, 17.3% and 0.7% respectively. The prevalence of stunting was 40.0%, including 10.9% of severe stunting. Stunted children scored significantly lower than non-stunted children on all tests. In RCPM test, boys with iron-deficiency anemia had lower scores than boys with normal iron status (-1.46, p<0.05). In picture completion test, children with normal iron status tended to score higher than iron-deficient children with anemia (-0.81; p = 0.067) or without anemia (-0.49; p = 0.064). Parasite infection was associated with an increase in risk of scoring below the median value in block design test (OR = 1.62; p<0.05), and with lower scores in other tests, for girls only (both p<0.05). CONCLUSION: Poor cognitive performance of Cambodian school-children was multifactorial and significantly associated with long-term (stunting) and current nutritional status indicators (iron status), as well as parasite infection. A life-cycle approach with programs to improve nutrition in early life and at school-age could contribute to optimal cognitive performance.
| S-EPMC4236074 | biostudies-other
Project description:ObjectivesThe aim of this study was to investigate the relationship between anthropometric characteristics and both geophagy and cognitive function of children.Study designThe study prospectively followed singleton children whose mothers participated in the MiPPAD clinical trial in Allada, Benin, from birth to age 12?months. Anthropometric measurements were taken at birth and 9 and 12?months. Wasting, stunting and underweight were defined as weight-for-length, length-for-age and weight-for-age Z-scores less than -2, respectively. Cognitive and motor functions were assessed using the Mullen Scales of Early Learning. Parent-reported geophageous habits of children were collected when the children were 12?months. Multiple linear and logistic regressions were used to analyse the data.ResultsA total of 632 children (49.7% girls) were involved in the study. Stunting, wasting and underweight were observed in 14.1%, 13.6% and 17.7%, respectively, at 9?months and 17.3%, 12.7% and 17.2%, respectively, at 12?months. The prevalence of geophagy among the children was 48.2%. Impaired growth at 9 and 12?months was consistently associated with low cognitive and gross motor (GM) score. Children stunted at 9?months had lower GM scores at 12?months compared with their non-stunted peers (? = -3.48, 95% confidence interval -6.62 to -0.35).ConclusionsStunting, wasting and underweight are associated with cognitive and GM deficits in infants. In this setting, impaired growth was not associated with geophagy. Further research evaluating geophagy and growth prospectively and concurrently from birth to 36?months is needed.
| S-EPMC7532992 | biostudies-literature
Project description:Background: Sub-inflammation and insulin resistance characterize women with PCOS. Data on dietary modulation of inflammation among PCOS women is scant, particularly from Indian subcontinent. The present study aimed to assess the effect of plant based vs. animal origin diets on serum markers of inflammation (primary outcome measure). Methods: This observational case-control study compared age and BMI matched PCOS and apparently healthy women from two populations following different dietary practices. The vegetarian women from New-Delhi (n = 82 PCOS and n = 179 healthy) and non-vegetarian women from Srinagar (n = 62 PCOS and n = 141 healthy) formed the groups. Using a uniform methodology, detailed clinical, biochemical, hormonal, and inflammatory marker assessment was undertaken. Results: The mean age of the overall cohort was 26.23 ± 4.59 years with a mean BMI of 24.39 ± 3.72 kg/m2. Overall pro-inflammatory markers (TNF-α, IL-6, IL-1β, hs-CRP and serum resistin) were significantly higher (p ≤ 0.05) and anti-inflammatory markers (IL-10 and adiponectin) were lower among women with PCOS than healthy subjects. On comparing vegetarian women with non-vegetarians, higher daily calorie intake (1895.46 ± 258.19 vs. 1860.13 ± 323.96 Kcal) with a higher protein and fat and lower carbohydrate intake was recorded in the latter, although the percent energy derived from carbohydrates was higher among vegetarians. Clinical and biochemical parameters were comparable among the groups except mFG score, total serum testosterone and serum lipid levels which were higher among non-vegetarian women as compared to their vegetarian counterparts from both categories (PCOS and healthy). Interestingly, vegetarian women with PCOS and healthy women had higher serum pro-inflammatory and lower anti-inflammatory markers compared to their non-vegetarian counterparts. Conclusion: Women with PCOS consuming Indian vegetarian diet have higher pro-inflammatory and lower anti-inflammatory marker levels than their age and BMI matched healthy non-vegetarian counterparts. This interesting observation can be attributed to the dietary composition, among other factors and needs confirmation from well-designed randomized studies on a larger cohort. Clinical Trial Registration: The study was registered with CTRI database under registration number CTRI/2013/09/003996.
| S-EPMC6857098 | biostudies-literature
Project description:To assess the effect of educational dietary intervention offered in the child's first year of life, as well as teenage mothers and grandmothers in carrying out the dietary recommendations at four to seven years.Randomized clinical trial initiated in 2006, in Porto Alegre, RS, involving 323 teenage mothers and grandmothers who cohabited. The intervention consisted of six counseling sessions on breastfeeding and healthy complementary feeding. The first session occurred in the maternity ward and the other ones in the households of mothers at seven, 15, 30, 60, and 120 days of the child's life. The information about the child's diet were obtained on a monthly basis in the first six months, every two months in the second half-year, and at four to seven years, using a food frequency questionnaire. To assess the adequacy of food consumption to the recommendations from the Ministry of Health, we elaborated a score system that would reflect the compliance with the Ten Steps for Healthy Toddlers from 2 to 10 Years. The average scores of intervention and control groups were compared using the t-test.Low adherence to recommendations on child nutrition was found in the study population, with no difference in implementation the steps between the groups. The score on the compliance with the steps was similar in both groups (9.6 [SD = 1.63] and 9.3 [SD = 1.60] in the intervention and control groups, respectively) and no influence of the cohabitation with the grandmother was found.Educational dietary intervention in the first four months of the child's life for teenage mothers and grandmothers had no effect on the compliance with the recommendations at four to seven years of the child's life.Avaliar o efeito de intervenção alimentar educativa oferecida, no primeiro ano de vida da criança, a mães adolescentes e avós maternas, no cumprimento das recomendações alimentares aos quatro a sete anos.Ensaio clínico randomizado iniciado em 2006, em Porto Alegre, RS, envolvendo 323 mães adolescentes e avós maternas, quando em coabitação. A intervenção consistiu em seis sessões de aconselhamento sobre aleitamento materno e alimentação complementar saudável. A primeira sessão ocorreu na maternidade e as demais, nos domicílios das mães aos sete, 15, 30, 60 e 120 dias de vida da criança. As informações sobre alimentação da criança foram obtidas mensalmente nos primeiros seis meses de vida, a cada dois meses no segundo semestre, e aos quatro a sete anos, por meio de questionário de frequência alimentar. Para avaliar a adequação do consumo alimentar às recomendações do Ministério da Saúde, elaborou-se um sistema de escore que refletisse o cumprimento dos Dez Passos Para Uma Alimentação Saudável Para Crianças de 2 a 10 Anos. As médias dos escores dos grupos intervenção e controle foram comparadas por meio do teste t.Houve baixa adesão às recomendações sobre alimentação infantil na população estudada, sem diferença no cumprimento dos passos entre os grupos. O escore relativo ao cumprimento dos passos foi semelhante nos dois grupos (9,6 [DP = 1,63] e 9,3 [DP = 1,60] nos grupos intervenção e controle, respectivamente) e não houve influência da coabitação com a avó materna.Intervenção alimentar educativa nos primeiros quatro meses de vida da criança para mães adolescentes e avós maternas não teve efeito no cumprimento das recomendações alimentares aos quatro a sete anos de vida.
| S-EPMC5167099 | biostudies-literature
Project description:Repeated pregnancy leaves young mothers nutritionally deprived which may in turn lead to poor infant growth. We measure the occurrence and persistence of stunting among offspring of young mothers who experienced repeated pregnancies using data from the Cebu Longitudinal Health and Nutrition Survey. We selected mothers aged 14-24 years (n?=?1,033) with singleton birth. We determined the length-for-age z scores (LAZ) at 12 and 24 months of the index child using the World Health Organisation 2007 growth standard. We fitted LAZ, stunting occurrence (i.e. LAZ?<?- 2) and persistence from 12 to 24 months into regression models and tested for the mediating effect of low birthweight and feeding practices. In these models, repeated pregnancy was analysed in an ordinal approach using number of past pregnancies of young mothers at birth of the index child. Compared to infants born to young mothers aged 14-24 years who had no previous pregnancies, those born to young mothers with repeated pregnancies have at least 0.15 (95% CI - 0.23, - 0.08) LAZ lower and are at higher chance of stunting by at least 40% (95% CI 1.19, 1.67) at 12 and 24 months. Similar cohorts of infants showed an elevated risk of persistent stunting from 12 through 24 months with a relative risk ratio of 1.51 (95% CI 1.21, 1.88). Optimal feeding practices substantially mediated stunting outcomes by further reducing the effects of repeated pregnancy to stunting occurrence and persistence by 19.95% and 18.09% respectively. Mediation tests also showed low birthweight in the causal pathway between repeated pregnancy and stunting. Repeated pregnancy in young mothers is a predictor of stunting among children under 2 years. Secondary pregnancy prevention measures and addressing suboptimal feeding practices are beneficial to mitigate the negative impact of repeated adolescent pregnancy on children.
| S-EPMC7459341 | biostudies-literature