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Abstract Background Household-level food safety practices may have a long-term outcome on the nutrition and health status of under-five children. This study explores the relationships between caregivers’ self-reported food safety knowledge, behavior, perception of food safety control, and their young child’s (

Childhood malnutrition is a major global health problem with long-term sequelae, including non-communicable diseases (NCDs). Mechanisms are unknown but may involve metabolic programming, resulting from "short-term" solutions to optimise survival by compromising non-priority organs. As key players in lipid metabolism, desaturases have been shown to be predictive of NCDs. We hypothesised that the association between specific desaturase activities and NCD risk determinants (including body composition, serum glucose, insulin levels, and blood pressure) are influenced by childhood post-malnutrition weight gain. 278 Afro-Caribbean adults with well-documented clinical history of severe malnutrition in childhood were studied. Extensive metabolic analyses including body composition (DXA), fasting serum glucose and lipidomics (n = 101), and fasting serum insulin (n = 83) were performed in malnutrition survivors and matched community controls (n = 90). Established lipid ratios were used as proxies of desaturase activities: CE 16:1/CE 16:0 for stearoyl-CoA desaturase (SCD1), LysoPC 20:4/20:3 for fatty acid desaturase 1 (FADS1), and LysoPC 20:3/18:2 for FADS2. Compared to community controls, adult malnutrition survivors (mean ± SD) age 28.3 ± 7.8 and BMI 23.6 ± 5.2 had higher SCD1 and FADS1 activity, (B ± SE) 0.07 ± 0.02 and 0.7 ± 0.08, respectively, but lower FADS2 activities (B ± SE) −0.05 ± 0.01, adjusted for sex and age (p < 0.0005). SCD1 was positively associated with adult BMI and body fat percentage, and negatively associated with lean mass and height. Stratification based on weight gain during nutritional rehabilitation among malnutrition survivors might signal the potential associations between weight gain during that critical period, desaturase activities, and some of adult metabolic parameters, with the lowest tertiles (slowest catch-up weight gain) performing more similarly to controls. In adult survivors of early-life severe acute malnutrition, desaturase activity is associated with markers of NCD risk, especially adiposity. These associations seem to be strengthened by faster weight gain during nutritional rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Childhood malnutrition in India remains among the highest in the world. Adult alcohol consumption and severe malnutrition have increased among indigenous people in South India. However, the association between them is poorly understood. Objectives: We aimed to evaluate this association, which could help design better intervention strategies. Methods: This case–control observational study was conducted in the Nilgiri district in South India. Cases included children aged 1–5 years with moderate malnutrition. Controls were defined as children in the same age group with normal weight-for-age. A questionnaire was used to collect data on demographics, socioeconomic status (SES), and parental education. The WHO Alcohol Use Disorders Identification Test (AUDIT) questionnaire was used to estimate parental alcohol use. Health-care workers collected data from within the community. Results: The baseline demographics of the children in the control (n = 250) and case groups (n = 177) were similar. Paternal age and AUDIT scores were not different in the two groups. SES was lower in the malnourished group, while maternal education among cases was significantly lower. Maternal and paternal education were associated with childhood malnutrition (odds ratio [OR]: 0.728 [95% confidence interval (CI): 0.583–0.903] and OR: 0.753 [95% CI: 0.589–0.957], respectively). After adjustment for covariates, paternal alcohol use was associated with a higher risk of malnutrition (OR: 1.56 [95% CI: 1.00–2.47]), which SES partly mediated. Conclusion: Paternal alcohol consumption is associated with childhood malnutrition, partially mediated by lower SES. Furthermore, lower SES appeared to be strongly associated with paternal alcohol consumption.

Objective: There is conflicting evidence around prescription practices in the management of malnutrition; the study objective was to explore medication classifications prescribed and their relationship between time‐to‐recovery and specific demographic characteristics among children with malnutrition in Guatemala. Design: Descriptive correlational study of data obtained in a retrospective record review. Sample: Children aged 0–5 years with malnutrition treated in a Guatemalan Nutrition Rehabilitation Center between 2019 and 2020 (N = 155). Measures: Variables assessed were medication classification of prescribed medications, age, gender, time‐to‐recovery, malnutrition severity, and COVID cohort. Results: The most frequently used medication classifications were vitamins (95%), respiratory (75%), antipyretic (68%), antibiotic (61%), and gastrointestinal agents (54%). Antibiotic, respiratory, corticosteroid, antipyretic, and gastrointestinal agents were prescribed significantly more in cases with a time‐to‐recovery of 6 weeks or greater. Conclusions: Medication classifications prescribed most often were related to common comorbidities of malnutrition and illnesses affecting children in Guatemala, such as respiratory and diarrheal diseases. The medication used in cases with a time‐to‐recovery of ≥6 weeks suggest these cases may have had more comorbidities, which could explain the longer recovery times. Caution is suggested in routine prophylactic antibiotic use in public health settings, given the lack of association with improved recovery times, the potential for antibiotic drug resistance, and the negative effects on renal function among children. [ABSTRACT FROM AUTHOR]

Childhood malnutrition, which is endemic in rural areas of low‐income countries, leads to a host of deleterious outcomes such as poor cognitive development, low educational attainment and lower lifetime wages. Promoting the consumption of eggs among young children has emerged as a promising strategy to combat childhood malnutrition, though pathways to scale remain unclear. In this paper, we evaluate the impact of a social and behaviour change communication (SBCC) campaign combined with a program in which rural families purchased chickens on credit (poultry + SBCC; n = 769) relative to an arm in which families only received the poultry intervention (poultry only; n = 750), using a difference‐in‐difference estimation strategy with propensity score matching. The SBCC consisted of radio messages, in‐person training, text message reminders and posters. We found a relatively modest but statistically significant increase in the number of times per week respondents in the poultry + SBCC arm reported feeding eggs to children of 0.28 (p = 0.02) compared to the poultry‐only arm. The increase in egg feeding, however, was more pronounced for boys (0.42, p < 0.01) than for girls (0.14, p = 0.26). In addition, the campaign increased egg feeding more for those who were already feeding eggs to children (0.63, p < 0.01) than those who were not engaging in those practices at baseline (0.26, p < 0.01). However, the difference in these differences was not statistically significant. Future campaigns should ensure higher saturation of messaging and include specific messaging around the importance of feeding girls as well as boys. Campaigns seeking to scale up egg feeding quickly could potentially target the easier‐to‐reach segment of caregivers who already occasionally feed eggs to children though these might not be the neediest group. Key messages: A multi‐pronged social and behaviour change communication campaign increased egg consumption among young children in rural Rwanda.While the egg consumption gains were modest, the social behaviour change campaign was not fully implemented due to COVID‐19 and other challenges, so it is possible that a more fully implemented campaign could achieve greater impacts.Effects appeared to be most pronounced for boys and those who were already feeding eggs to children. [ABSTRACT FROM AUTHOR]

Background: Childhood malnutrition remains a significant public health problem impacting the physical and mental growth if school aged children, particularly in limited-resource countries. Objective: The study objective was to assess levels of physical activity, patterns of screen time (S.T.), the relationship between physical activity and screen time patterns, and how these factors affect growth status (adjusting for socioeconomic status). Methodology: A cross-sectional study included 3,834 children between 6–14 years attending pre-selected schools. Teachers, students, and parents were invited to fill out a standardized questionnaire, and Body Mass Index (BMI) was calculated using Center for disease control (CDC) centile charts. A Chi-square was performed to see the possible association between any height and weight abnormalities and all possible risk factors. Multivariate logistic regression was applied to see the effect of variables significantly associated with univariate analysis. Results: Approximately 2,447 (63.8%) children were between 11–14 years old and 1,387 (36.2%) were between 4–10 years old. The mean height was 143.71 ± 16.51 centimetres, the mean weight was 36.5 ± 12.9 kilogram, and the mean BMI was 17.16 ± 3.52. Multivariate logistic regression status and junk food combined affected stunting socioeconomic status was significantly associated with being underweight p = 0.001. Conclusion: Childhood obesity and stunting remain significant problems in Pakistani school-going children. These are significantly associated with poverty, a lack of physical activity opportunities, and available food quality.

Abstract Childhood malnutrition, which is endemic in rural areas of low‐income countries, leads to a host of deleterious outcomes such as poor cognitive development, low educational attainment and lower lifetime wages. Promoting the consumption of eggs among young children has emerged as a promising strategy to combat childhood malnutrition, though pathways to scale remain unclear. In this paper, we evaluate the impact of a social and behaviour change communication (SBCC) campaign combined with a program in which rural families purchased chickens on credit (poultry + SBCC; n = 769) relative to an arm in which families only received the poultry intervention (poultry only; n = 750), using a difference‐in‐difference estimation strategy with propensity score matching. The SBCC consisted of radio messages, in‐person training, text message reminders and posters. We found a relatively modest but statistically significant increase in the number of times per week respondents in the poultry + SBCC arm reported feeding eggs to children of 0.28 (p = 0.02) compared to the poultry‐only arm. The increase in egg feeding, however, was more pronounced for boys (0.42, p

Childhood malnutrition continues to be a pressing concern in sub-Saharan African countries, as it affects millions of children. Despite numerous efforts to mitigate malnutrition, this problem persists. We investigated the effects of mothers' education on the nutritional status of children aged 0-59 months in Tanzania using data from the 2020/21 National Panel Survey. Three indicators of childhood malnutrition were assessed: stunting, underweight, and wasting. Chi-square Test statistics were used to estimate the association between childhood nutritional status and the categorical variables of mothers' education. For the analysis, the study employed binary logistic regression to examine the relationship between mothers' education and childhood nutrition status. The findings revealed that higher levels of maternal and paternal education reduce the probability of child stunting, underweight, and wasting. Furthermore, occupation of the head of the household and living in urban areas is associated with a decreased probability of child stunting, wasting, and underweight. Based on these findings, the study advocates for policy interventions that enhance educational opportunities for women and girls and improve healthcare services, particularly in rural areas. The research also recommends government and stakeholder involvement in creating employment opportunities and ensuring the economic stability of families. [ABSTRACT FROM AUTHOR]

Background: Childhood malnutrition remains a significant public health problem impacting the physical and mental growth if school aged children, particularly in limited-resource countries. Objective: The study objective was to assess levels of physical activity, patterns of screen time (S.T.), the relationship between physical activity and screen time patterns, and how these factors affect growth status (adjusting for socioeconomic status). Methodology: A cross-sectional study included 3,834 children between 6-14 years attending pre-selected schools. Teachers, students, and parents were invited to fill out a standardized questionnaire, and Body Mass Index (BMI) was calculated using Center for disease control (CDC) centile charts. A Chi-square was performed to see the possible association between any height and weight abnormalities and all possible risk factors. Multivariate logistic regression was applied to see the effect of variables significantly associated with univariate analysis. Results: Approximately 2,447 (63.8%) children were between 11-14 years old and 1,387 (36.2%) were between 4-10 years old. The mean height was 143.71 ± 16.51 centimetres, the mean weight was 36.5 ± 12.9 kilogram, and the mean BMI was 17.16 ± 3.52. Multivariate logistic regression status and junk food combined affected stunting socioeconomic status was significantly associated with being underweight p = 0.001. Conclusion: Childhood obesity and stunting remain significant problems in Pakistani school-going children. These are significantly associated with poverty, a lack of physical activity opportunities, and available food quality. [ABSTRACT FROM AUTHOR]

Background: Malnutrition in school aged children can predispose to infectious diseases, noncommunicable diseases and death. Numerous risk factors of childhood malnutrition has been published with generation of instituted policies, yet the complications of childhood malnutrition is still not abated in our locality. Hence the need to explore the effect of house hold food insecurity (HHFIS) on childhood malnutrition. Objective: To determine the prevalence of malnutrition and the association between HHFIS and malnutrition among 6-12-year-old primary school pupils in Nnewi Southeast Nigeria. Methods: This cross-sectional descriptive study was carried out on 270 primary school pupils. Sociodemographic data was collected using a pretested interviewer administered questionnaire. Information on food availability in the home was collected and used to grade HHFIS into food secured household, moderate food insecurity, Household food insecurity, Severe HHFIS/child hunger. Data was analyzed using Statistical Package for Social Sciences (SPSS) software version 21.0. Level of significance for tests of association was set at 5%. Results: The result showed that 143(53%) were males and 127(47%) were females. Seventy-five (27.8%) were wasted, 21(7.8%) had severe wasting, 18(6.7%) had underweight, 17(6.3%) were overweight, while 9(3.3%) had obesity and 3(1.1%) were stunted. Low Socio-Economic Class (SEC) and HHFIS, were associated with under-nutrition. (p < 0.05) While high SEC and HHFIS were associated with overweight/obesity (p < 0.05). Conclusion: The prevalence of under nutrition was high among 6-12 year old school children in Nnewi. Prompt and adequate provision of household food security can help mitigate the impact of malnutrition in the sub region. [ABSTRACT FROM AUTHOR]

Engaging Catherine Malabou's philosophical work on biological plasticity, this article combines microbiological and geopolitical analysis of the deadliest manifestations of childhood malnutrition. At the scale of microbiology, childhood malnutrition is a devastating condition and a mystery to which it seems microbiomes – the ecosystems of microbes in the gut – hold a key. At the scale of geopolitics, childhood malnutrition is a calamity generated by racial capitalism, poverty, and underdevelopment. What should we do with the plasticity that makes us? Malabou asks. Engaging philosophically with the plastic materiality of microbiomes in childhood malnutrition, the article focuses on destructive plasticity as an ontological alternative to what science on malnutrition pursues as a problem of causality. This leads to an argument that medicine, as well as humanitarian, security, and development interventions, must reckon with the destructive plasticity of what is in essence a political disease of annihilation. The article ends by speculating on resistance via the biological act of nurturing. [ABSTRACT FROM AUTHOR]

Abstract Background Child health, especially childhood mortality, is one of the critical indicators of human development. No child mortality is desirable, but it is still high in Bangladesh. We aimed to assess the effect of the child's desired status on childhood morbidity and mortality in Bangladesh. Methods We used the data from the nationally representative cross-sectional Bangladesh Demographic and Health Survey (BDHS) 2017–18 and restricted the analyses to children born in the past five years preceding the survey. We estimated the undesired status (excess in boy, girl, both, and parity) by subtracting an ideal number of children from the total live birth. We measured childhood mortality (perinatal, early neonatal, neonatal, post-neonatal, infant, child, and under-five mortality), morbidity (fever, diarrhea, cough, and acute respiratory infectious-ARI), nutritional problems (stunting, wasting, underweight, and low birth weight), and treatments (postnatal care, treatment for fever, diarrhea/cough, and vitamin A supplementation). Finally, we utilized the chi-square test and multilevel mixed-effects logistic regression analyses. Results The prevalence of undesired children was 19.2%, 21.5%, 3.7%, and 25.4% for boys, girls, both boys and girls, and parity, respectively. Age, education, residence, division, and wealth index were significantly associated with undesired children. The prevalence of under-five mortality was 3.3% among desired children, almost double (5.4%) among undesired children. The likelihood of under-five mortality was [adjusted odds ratio (aOR): 2.05, p ≤ 0.001] higher among undesired children. Despite lower under-five mortality among higher socioeconomic status, the relative contribution of undesired children to under-fiver mortality was substantial. The undesired girl children were associated with an increased likelihood of moderately wasting (aOR: 1.28, p = 0.072), severely underweight (aOR: 1.41, p = 0.066), and low birth weight (aOR: 1.50, p ≤ 0.05). Moreover, the undesired children were 19% (p ≤ 0.05) more likely to be infected with fever. The undesired children had lower treatment for diarrhea and fever/cough and were less likely to get vitamin A supplementation (aOR: 0.71, p ≤ 0.001). Conclusions The share of childhood morbidity, mortality, and malnutrition were higher among undesired children. Every child should be wanted, and no unwanted pregnancies are desirable; thereby, the government should reemphasize the proper use of family planning methods to reduce child mortality and malnutrition.

Approximately 230 million children under 5 years old of age suffer from malnutrition and over half of the children below 5 years old deaths are due to malnutrition nowadays. To gain a better understanding of this problem, the application of spatial analysis has risen exponentially in recent years. In this review, the present state of information on the use of spatial analysis in childhood malnutrition studies was evaluated using four databases of digital scientific journals: ScienceDirect, Scopus, PubMed and CINAHL. We chose 2,278 articles from the search results and a total of 27 articles met our criteria for review. The following information was extracted from each article: objective of study, study area, types of malnutrition, subject, data sources, computer software packages, spatial analysis and factors associated with childhood malnutrition. A total of 10 spatial analysis methods were reported in the reviewed articles and the Bayesian geoadditive regression model was the most common method applied in childhood malnutrition studies. This review highlights the importance of the application of spatial analysis in determining the geographic distribution of malnutrition cases, hotspot areas and risk factors correlated with childhood malnutrition. It also provides implications for strategic initiatives to eradicate all forms of malnutrition. [ABSTRACT FROM AUTHOR]

Introduction: Protein-Energy Malnutrition (PEM) and prevalence of under-weight children in India, is an important health concern. Aim: To evaluate the effect of Oral Nutritional Supplement (ONS) on growth, overall nutrient intake and frequency of illness in nutritionally at-risk Indian children. Materials and Methods: In this prospective, randomised, gender-stratified, controlled, parallel group, open label study, 216 children (aged 4-6 years with weight-for-age z-score between -2 and -1) were randomised (1:1) to receive either 45 g of ONS {Test product+Dietary advice (T+D)} or control group {Dietary advice only (D-only)} for three months. Primary endpoints included weight-for-age z-score and weight gain in terms of g/kg/day from baseline to three months. Secondary endpoints included change in height-for-age z-scores; frequency of illness, change in dietary nutrient intake and Protein/Energy (P/E) ratio from baseline through three months. Safety endpoint included Adverse Events (AEs). PROC MIXED was used to perform Repeated Measures Analysis Of Variance (RMANOVA) based on the changes in z-scores. The z-scores changes within the group from baseline to the end of three months End-ofStudy (EOS) were compared using paired t-test. Results: At baseline, the mean (SD) weight-for-age z-scores were similar in both the groups {1.50 (0.309) and -1.49 (0.312) in T+D and D-only groups, respectively}. At the EOS, only T+D group showed significant mean (SD) change from baseline in weight-for-age z-score compared to the D-only group {0.59 (0.296), p

Abstract Background Malnutrition is a public health problem, as wasting affects 7.5% of children worldwide. The harmful effects of severe acute malnutrition (SAM) can last a lifetime, but how SAM in childhood affects later breastfeeding ability is not clear. In the present study, we assessed the human milk output and body composition among mothers with a history of childhood SAM. Methods This retrospective cohort study was carried out in Miti-Murhesa Health Zone (Democratic Republic of Congo) from January 15 to March 17, 2020. We selected lactating mothers with breastfed infants aged 2–12 months. Two categories of mothers were included: those who had been treated for SAM during their childhood (years 1988–2003; n = 39) and a community control with no history of SAM (n = 40). The weight, height, and mid-upper arm circumference were measured and body mass index (BMI) calculated as weight/height2. Body composition and human milk output were assessed using standard deuterium dilution methods. Student t and chi2 tests ware applied to compare two groups. Results The mean age ± standard deviation of the mothers was 24.4 ± 5.1 and 26.0 ± 6.1 years for the SAM and control groups, respectively (p = 0.186). The age of their infants was 5.4 ± 2.3 months in both groups (p = 0.962). In the SAM and control groups, the mean maternal BMI was 23.8 ± 2.3 and 23.6 ± 3.7 kg/m2 (p = 0.849), mean Fat Mass 27.1% ± 5.0 and 27.1% ± 5.8% (p = 0.708), and the mean Fat Free mass 72.9% ± 5.0 and 72.9% ± 5.8% (p = 0.998), respectively. Human milk output was 833.7 ± 152.1 g/d in SAM group and 827.4 ± 171.4 g/d in the control group (p = 0.864). Conclusions We found no significant difference in human milk output and body composition in mothers treated for SAM during childhood compared to community controls.

Childhood malnutrition is a global epidemic with significant public health ramifications. The alarming increase in childhood obesity rates, in conjunction with the COVID-19 pandemic, pose major challenges. The present review aims to critically discuss policies and action plans promoting healthy nutrition among infants and children, globally. Since the Convention on the Rights of the Child in 1989 and the joint consortium held by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) that led to the "Ten Steps to Successful Breastfeeding", several policymakers and scientific societies have produced relevant reports. Today, the WHO and UNICEF remain the key players on the field, elaborating the guidelines shaped by international expert teams over time, but we still have a long way to go before assuring the health of our children. [ABSTRACT FROM AUTHOR]

Background: Child health, especially childhood mortality, is one of the critical indicators of human development. No child mortality is desirable, but it is still high in Bangladesh. We aimed to assess the effect of the child's desired status on childhood morbidity and mortality in Bangladesh.Methods: We used the data from the nationally representative cross-sectional Bangladesh Demographic and Health Survey (BDHS) 2017-18 and restricted the analyses to children born in the past five years preceding the survey. We estimated the undesired status (excess in boy, girl, both, and parity) by subtracting an ideal number of children from the total live birth. We measured childhood mortality (perinatal, early neonatal, neonatal, post-neonatal, infant, child, and under-five mortality), morbidity (fever, diarrhea, cough, and acute respiratory infectious-ARI), nutritional problems (stunting, wasting, underweight, and low birth weight), and treatments (postnatal care, treatment for fever, diarrhea/cough, and vitamin A supplementation). Finally, we utilized the chi-square test and multilevel mixed-effects logistic regression analyses.Results: The prevalence of undesired children was 19.2%, 21.5%, 3.7%, and 25.4% for boys, girls, both boys and girls, and parity, respectively. Age, education, residence, division, and wealth index were significantly associated with undesired children. The prevalence of under-five mortality was 3.3% among desired children, almost double (5.4%) among undesired children. The likelihood of under-five mortality was [adjusted odds ratio (aOR): 2.05, p ≤ 0.001] higher among undesired children. Despite lower under-five mortality among higher socioeconomic status, the relative contribution of undesired children to under-fiver mortality was substantial. The undesired girl children were associated with an increased likelihood of moderately wasting (aOR: 1.28, p = 0.072), severely underweight (aOR: 1.41, p = 0.066), and low birth weight (aOR: 1.50, p ≤ 0.05). Moreover, the undesired children were 19% (p ≤ 0.05) more likely to be infected with fever. The undesired children had lower treatment for diarrhea and fever/cough and were less likely to get vitamin A supplementation (aOR: 0.71, p ≤ 0.001).Conclusions: The share of childhood morbidity, mortality, and malnutrition were higher among undesired children. Every child should be wanted, and no unwanted pregnancies are desirable; thereby, the government should reemphasize the proper use of family planning methods to reduce child mortality and malnutrition. [ABSTRACT FROM AUTHOR]

The success of Community-based Therapeutic Care (CTC) in reducing mortality from severe acute malnutrition is well documented, although the sustainability of short-term successes is unknown. Modelled on CTC principles, the Nutrition Therapeutic Program (NTP) has been well established in the Western Cape in South Africa, but outcomes of this six-month program have yet to be measured. The aim of our study is to determine outcomes of malnourished children after 6 months on the NTP, looking at weight gain, defaulting rates, and mortality, and to compare these outcomes to international sphere standards. A retrospective descriptive cohort study was conducted in a peri-urban, low-income settlement in the Western Cape. 270 patients meeting criteria for malnutrition between the age of six months and five years were recruited from three community clinics between January 2017 - December 2018. Outcomes revealed a mortality rate of 0,7%, which was below the international Sphere target of <3%. Other outcomes did not meet sphere targets, with a defaulting rate of 53% (target <15%), success rate of 27% (target >75%), and average daily weight gain at six months of 0,76 g/kg/day (target >3 g/kg/day). We concluded that sphere targets may not be appropriate success metrics in this context, as the increased length of the program may be responsible for the higher defaulting rates, whilst recourse to in-hospital treatment means lower mortality rates are achievable. We feel that clear, achievable, and tailored local targets should be set to motivate healthcare practitioners to address the problem of childhood malnutrition in South Africa. [ABSTRACT FROM AUTHOR]

Down Syndrome (DS) is a chromosomal abnormality associated with a spectrum of cognitive and physical disabilities. Children with DS are exposed to both lower and excess body weight and follow distinct growth-curve patterns that deviate significantly from those of children without chromosomal defects. Anthropometric parameters are assessed in the pediatric population with the use of growth charts. The study is based on data from 411 children and adults with DS from Poland. Detailed information concerning children and online survey results were also analyzed. Centiles and standard deviation scores (SDS) of obtained anthropometric parameters were aligned with the data using the LMS method. The study aims to identify which type of growth chart (standard vs specialized) is a leading tool for earlier detection of developmental disorders in DS. The results obtained in the two types of growth charts differed. The advantage of the specialized growth charts over the standard ones cannot be unequivocally determined. Only the combination of both tools allows to detect the development disorders early in the broadest possible way.

Asymptomatic or subclinical infection by diarrheal enteropathogens during childhood has been linked to poor health and nutritional outcomes. In this study, we aimed to assess the impact of asymptomatic Shigella infection on different forms of childhood malnutrition including the composite index of anthropometric failure (CIAF). We used data from 1715 children enrolled in the multi-country birth cohort study, MAL-ED, from November 2009 to February 2012. Monthly non-diarrheal stools were collected and assessed using TaqMan Array Cards (TAC). Poisson regression was used to calculate incidence rates of asymptomatic Shigella infection. Generalized estimating equations (GEE) were used to assess the association between asymptomatic Shigella infection and nutritional indicators after adjusting for relevant covariates. Incidence rates per 100 child-months were higher in Tanzania, Bangladesh and Peru. Overall, after adjusting for relevant covariates, asymptomatic Shigella infection was significantly associated with stunting (aOR 1.60; 95% CI: 1.50, 1.70), wasting (aOR 1.26; 95% CI: 1.09, 1.46), underweight (aOR 1.45; 95% CI: 1.35, 1.56), and CIAF (aOR 1.55; 95% CI: 1.46, 1.65) in all the study sites except for Brazil. The high incidence rates of asymptomatic Shigella infection underscore the immediate need for Shigella vaccines to avert the long-term sequelae involving childhood growth. [ABSTRACT FROM AUTHOR]

Dysregulations in the mammalian target of rapamycin (mTOR) pathway are associated with several human anomalies. We aimed to elucidate possible implications for potential aberrations in the mTOR pathway with childhood malnutrition. We analyzed the activity of phospho-mTORC1 and the expressions of several mTOR pathway genes, namely: MTOR, TSC1, LAMTOR2, RPS6K1 and RICTOR from peripheral blood mononuclear cells isolated from venous blood of children suffering from different forms of malnutrition and compared them with those from healthy children. Significant reduction in the phosphorylation of mTORC1 was noted, as well as a decrease in expression of LAMTOR2 gene and increase in TSC1 gene expression were observed between malnourished children in comparison to the healthy children. The deregulation in the activity of the TSC1 and LAMTOR2 gene was significantly associated with all forms of childhood malnutrition. Our findings provide key insights into possible down-modulation in the overall activity of the mTOR pathway in childhood malnutrition. Further studies focusing on the analysis of a multitude of components involved in the mTOR pathway both at the gene and protein expression levels are required for conclusive evidence for the aforementioned proposition. [ABSTRACT FROM AUTHOR]

Abstract Background Children with uncomplicated severe acute malnutrition are managed routinely within out-patient malnutrition treatment programs. These programs do not offer maternal mental health support services, despite maternal mental health playing a significant role in the nutritional status of children. Additionally, the burden of maternal Common Mental Disorders (CMDs) is poorly described among mothers of children attending these programs. This study thus determined the burden and risk factors for maternal CMDs among children attending out-patient malnutrition clinics in rural North-western Nigeria. Methods We conducted a cross-sectional study among 204 mothers of children with severe acute malnutrition who attending eight out-patient malnutrition clinics in Jigawa, North-western Nigeria. We used the World Health Organization Self-Reporting Questionnaire-20 (WHO SRQ-20) screening tool, a recognised and validated proxy measure for CMDs to identify mothers with CMDs. The prevalence of maternal CMDs was determined by identifying the proportion of mothers with SRQ scores of ≥8. Risk factors for CMD were determined using multivariable logistic regression. Results Maternal CMD prevalence in children attending these facilities was high at 40.7%. Non-receipt of oral polio vaccine (OPV) (AOR 6.23, 95%CI 1.85 to 20.92) increased the odds for CMD. While spousal age above 40 (AOR 0.95, 95%CI 0.90 to 0.99) and long years spent married (AOR 0.92, 95%CI 0.85 to 0.98) decreased the odds for CMD. Conclusions Our findings indicate maternal CMD burden is high in out-patient malnutrition clinics in North-western Nigeria. Maternal mental health services would need to be integrated into the community management of acute malnutrition programs to provide more holistic care, and possibly improve long-term outcomes after discharge from these programs.

Objective: Insufficient weight gain is one of the most common complaints in pediatric outpatient clinics in Turkey. This study aimed to investigate the effects of maternal psychiatric problems and familial factors on malnutrition in their children. Methods: A total of 34 mothers of malnourished children aged 0 16 years, who applied to the pediatric metabolism outpatient clinic without underlying organic disease and mothers of healthy individuals from the same age and gender group were included in the study. Sociodemographic status, Symptom Checklist-90, multidimensional scale of perceived social support (MSPSS), and scale for domestic violence against women scales evaluation results of both groups were compared. Results: An illness-dependent cause of malnutrition was not found in 34 of 127 (26.7%) patients. A statistical difference was found between the two groups in terms of educational status of parents, income level of the family, and work of the mother (p=0.008, p=0.039, p=0.009, and p=0.004, respectively). A statistical difference was found between the groups in terms of gestational week and the birth weight of the children (p=0.006 and p=0.011, respectively). The scores of cases who had planned pregnancy in the MSPSS were found to be statistically significantly higher than the cases without planned pregnancy (p=0.012). The rate of depression, somatization, obsession, sensitivity, and anxiety symptoms in cases with moderate or severe malnutrition severity was found to be statistically significantly higher than the cases with mild malnutrition (p=0.039, p=0.029, p=0.028, p=0.028, and p=0.011, respectively). Conclusion: Parental education level, mother's working status, income level, mother's environmental support, and child's birth weight were determined as factors affecting the children's nutritional status, malnutrition type, and severity by causing effects on maternal psychology. [ABSTRACT FROM AUTHOR]

Introduction: Protein-Energy Malnutrition (PEM) and prevalence of under-weight children in India, is an important health concern. Aim: To evaluate the effect of Oral Nutritional Supplement (ONS) on growth, overall nutrient intake and frequency of illness in nutritionally at-risk Indian children. Materials and Methods: In this prospective, randomised, gender-stratified, controlled, parallel group, open label study, 216 children (aged 4-6 years with weight-for-age z-score between -2 and -1) were randomised (1:1) to receive either 45 g of ONS {Test product+Dietary advice (T+D)} or control group {Dietary advice only (D-only)} for three months. Primary endpoints included weight-for-age z-score and weight gain in terms of g/kg/day from baseline to three months. Secondary endpoints included change in height-for-age z-scores; frequency of illness, change in dietary nutrient intake and Protein/Energy (P/E) ratio from baseline through three months. Safety endpoint included Adverse Events (AEs). PROC MIXED was used to perform Repeated Measures Analysis Of Variance (RMANOVA) based on the changes in z-scores. The z-scores changes within the group from baseline to the end of three months End-of-Study (EOS) were compared using paired t-test. Results: At baseline, the mean (SD) weight-for-age z-scores were similar in both the groups {1.50 (0.309) and -1.49 (0.312) in T+D and D-only groups, respectively}. At the EOS, only T+D group showed significant mean (SD) change from baseline in weight-for-age z-score compared to the D-only group {0.59 (0.296), p<0.001 vs. 0.04 (0.267), p=0.0974}. Mean rate of weight gain (g/kg/day) was significantly higher in T+D group vs. D-only group (1.12 vs. 0.26, p<0.0001). At baseline, height-for-age z-scores were similar in both the groups {-1.36 (0.668) vs -1.37 (0.638) in T+D and D-only groups, respectively}. At EOS, the mean (SD) change from baseline in height-for-age z-score was -0.02 (0.198), p=0.2389 in T+D group and -0.15 (0.171), p<0.001 in the D-only group. However, the change was not proportionate to weight-for-age z-score. Total absolute number of illness episodes was less in T+D group vs. D-only group (9 vs. 13). Improvement in dietary nutrient intake (carbohydrate, fat, protein and energy) and P/E ratio was significantly higher (p<0.001) in T+D group vs. D-only group. Overall, 8.3% children in T+D group experienced at least one treatment-emergent AE. Conclusion: The ONS helps to improve growth, nutrient intake and reduces frequency of illness in nutritionally at-risk children. [ABSTRACT FROM AUTHOR]

Despite significant investment, childhood malnutrition continues to be a significant public health problem especially in least developed countries. The aim of this study was to find association between household biomass fuel (BMF) use and childhood malnutrition in Bangladesh using data from Demographic and Health Survey 2011. We included a total 6891 children under 5 years of age in the analysis. The prevalence of wasting, underweight, and stunting from BMF using household was 16.1% (n = 997; 95%CI, 15.1–17.3), 39.0% (n = 2399; 95%CI, 37.1–40.9), and 43.3% (n = 2620; 95%CI, 41.6–45.1), respectively. Underweight and stunting were significantly higher among children from households using BMF compared with the children from CF using households (underweight, biomass vs clean fuel: 39.0% vs. 23.5%, p < 0.001; stunting, biomass vs clean fuel: 43.3 vs. 31.5%, p < 0.001). The use of BMF in the household was significantly associated with underweight (OR = 1.38; 95%CI: 1.10–1.73) and stunting (OR = 1.58; 95%CI: 1.18–1.98) among children <5 years of age after adjusting possible confounders in mixed effect logistic regression analysis. This study found a significant association between chronic childhood malnutrition and household BMF use which is indicating possible alternative risk factor for malnutrition. Further prospective research is required to explore the mechanism of how BMF use results in chronic malnutrition. [ABSTRACT FROM AUTHOR]

Background: Malnutrition is a public health problem, as wasting affects 7.5% of children worldwide. The harmful effects of severe acute malnutrition (SAM) can last a lifetime, but how SAM in childhood affects later breastfeeding ability is not clear. In the present study, we assessed the human milk output and body composition among mothers with a history of childhood SAM. Methods: This retrospective cohort study was carried out in Miti-Murhesa Health Zone (Democratic Republic of Congo) from January 15 to March 17, 2020. We selected lactating mothers with breastfed infants aged 2–12 months. Two categories of mothers were included: those who had been treated for SAM during their childhood (years 1988–2003; n = 39) and a community control with no history of SAM (n = 40). The weight, height, and mid-upper arm circumference were measured and body mass index (BMI) calculated as weight/height2. Body composition and human milk output were assessed using standard deuterium dilution methods. Student t and chi2 tests ware applied to compare two groups. Results: The mean age ± standard deviation of the mothers was 24.4 ± 5.1 and 26.0 ± 6.1 years for the SAM and control groups, respectively (p = 0.186). The age of their infants was 5.4 ± 2.3 months in both groups (p = 0.962). In the SAM and control groups, the mean maternal BMI was 23.8 ± 2.3 and 23.6 ± 3.7 kg/m2 (p = 0.849), mean Fat Mass 27.1% ± 5.0 and 27.1% ± 5.8% (p = 0.708), and the mean Fat Free mass 72.9% ± 5.0 and 72.9% ± 5.8% (p = 0.998), respectively. Human milk output was 833.7 ± 152.1 g/d in SAM group and 827.4 ± 171.4 g/d in the control group (p = 0.864). Conclusions: We found no significant difference in human milk output and body composition in mothers treated for SAM during childhood compared to community controls. [ABSTRACT FROM AUTHOR]

Abstract Background Environmental enteric dysfunction (EED) is an acquired enteropathy of the small intestine, characterized by enteric inflammation, villus blunting and decreased crypt-to-villus ratio. EED has been associated with poor outcomes, including chronic malnutrition (stunting), wasting and reduced vaccine efficacy among children living in low-resource settings. As a result, EED may be a valuable interventional target for programs aiming to reduce childhood morbidity in low and middle-income countries. Main text Several highly plausible mechanisms link the proposed pathophysiology underlying EED to adverse outcomes, but causal attribution of these pathways has proved challenging. We provide an overview of recent studies evaluating the causes and consequences of EED. These include studies of the role of subclinical enteric infection as a primary cause of EED, and efforts to understand how EED-associated systemic inflammation and malabsorption may result in long-term morbidity. Finally, we outline recently completed and upcoming clinical trials that test novel interventions to prevent or treat this highly prevalent condition. Conclusions Significant strides have been made in linking environmental exposure to enteric pathogens and toxins with EED, and in understanding the multifactorial mechanisms underlying this complex condition. Further insights may come from several ongoing and upcoming interventional studies trialing a variety of novel management strategies.

Abstract Background Rates of childhood undernutrition are persistently high in Cambodia. Existing ready-to-use supplementary and therapeutic foods (RUSFs and RUTFs) have had limited acceptance and effectiveness. Therefore, our project developed and trialled a locally-produced, multiple micronutrient fortified lipid-based nutrient supplement (LNS) with therapeutic and supplementary versions. This ready-to-use food (RUF) is innovative in that, unlike many RUFs, it contains fish instead of milk. Development began in 2013 and the RUF was finalised in 2015. From 2015 until the present, both the RUTF and the RUSF versions were trialled for acceptability and effectiveness. Methods This paper draws on project implementation records and semi-structured interviews to describe the partnership between the Cambodian Ministries of Health and Agriculture, Forestry and Fisheries, UNICEF, the French National Research Institute for Sustainable Development (IRD), universities, and Vissot factory. It discusses the project implementation and lessons learned from the development and trialling process, and insights into positioning nutrition on the health agenda in low and middle-income countries. Results The lessons learned relate to the importance of project planning, management, and documentation in order to seize opportunities in the research, policy, advocacy, and programming environment while ensuring adequate day-to-day project administration and resourcing. Conclusions We conclude that projects such as ours, that collaborate to develop and test novel, locally-produced RUTFs and RUSFs, offer an exciting opportunity to respond to both local programmatic and broader research needs.

Childhood malnutrition is a global epidemic with significant public health ramifications. The alarming increase in childhood obesity rates, in conjunction with the COVID-19 pandemic, pose major challenges. The present review aims to critically discuss policies and action plans promoting healthy nutrition among infants and children, globally. Since the Convention on the Rights of the Child in 1989 and the joint consortium held by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) that led to the “Ten Steps to Successful Breastfeeding”, several policymakers and scientific societies have produced relevant reports. Today, the WHO and UNICEF remain the key players on the field, elaborating the guidelines shaped by international expert teams over time, but we still have a long way to go before assuring the health of our children.

Dysregulations in the mammalian target of rapamycin (mTOR) pathway are associated with several human anomalies. We aimed to elucidate possible implications for potential aberrations in the mTOR pathway with childhood malnutrition. We analyzed the activity of phospho-mTORC1 and the expressions of several mTOR pathway genes, namely: MTOR, TSC1, LAMTOR2, RPS6K1 and RICTOR from peripheral blood mononuclear cells isolated from venous blood of children suffering from different forms of malnutrition and compared them with those from healthy children. Significant reduction in the phosphorylation of mTORC1 was noted, as well as a decrease in expression of LAMTOR2 gene and increase in TSC1 gene expression were observed between malnourished children in comparison to the healthy children. The deregulation in the activity of the TSC1 and LAMTOR2 gene was significantly associated with all forms of childhood malnutrition. Our findings provide key insights into possible down-modulation in the overall activity of the mTOR pathway in childhood malnutrition. Further studies focusing on the analysis of a multitude of components involved in the mTOR pathway both at the gene and protein expression levels are required for conclusive evidence for the aforementioned proposition.

Asymptomatic or subclinical infection by diarrheal enteropathogens during childhood has been linked to poor health and nutritional outcomes. In this study, we aimed to assess the impact of asymptomatic Shigella infection on different forms of childhood malnutrition including the composite index of anthropometric failure (CIAF). We used data from 1715 children enrolled in the multi-country birth cohort study, MAL-ED, from November 2009 to February 2012. Monthly non-diarrheal stools were collected and assessed using TaqMan Array Cards (TAC). Poisson regression was used to calculate incidence rates of asymptomatic Shigella infection. Generalized estimating equations (GEE) were used to assess the association between asymptomatic Shigella infection and nutritional indicators after adjusting for relevant covariates. Incidence rates per 100 child-months were higher in Tanzania, Bangladesh and Peru. Overall, after adjusting for relevant covariates, asymptomatic Shigella infection was significantly associated with stunting (aOR 1.60; 95% CI: 1.50, 1.70), wasting (aOR 1.26; 95% CI: 1.09, 1.46), underweight (aOR 1.45; 95% CI: 1.35, 1.56), and CIAF (aOR 1.55; 95% CI: 1.46, 1.65) in all the study sites except for Brazil. The high incidence rates of asymptomatic Shigella infection underscore the immediate need for Shigella vaccines to avert the long-term sequelae involving childhood growth.

Background: Children with uncomplicated severe acute malnutrition are managed routinely within out-patient malnutrition treatment programs. These programs do not offer maternal mental health support services, despite maternal mental health playing a significant role in the nutritional status of children. Additionally, the burden of maternal Common Mental Disorders (CMDs) is poorly described among mothers of children attending these programs. This study thus determined the burden and risk factors for maternal CMDs among children attending out-patient malnutrition clinics in rural North-western Nigeria.Methods: We conducted a cross-sectional study among 204 mothers of children with severe acute malnutrition who attending eight out-patient malnutrition clinics in Jigawa, North-western Nigeria. We used the World Health Organization Self-Reporting Questionnaire-20 (WHO SRQ-20) screening tool, a recognised and validated proxy measure for CMDs to identify mothers with CMDs. The prevalence of maternal CMDs was determined by identifying the proportion of mothers with SRQ scores of ≥8. Risk factors for CMD were determined using multivariable logistic regression.Results: Maternal CMD prevalence in children attending these facilities was high at 40.7%. Non-receipt of oral polio vaccine (OPV) (AOR 6.23, 95%CI 1.85 to 20.92) increased the odds for CMD. While spousal age above 40 (AOR 0.95, 95%CI 0.90 to 0.99) and long years spent married (AOR 0.92, 95%CI 0.85 to 0.98) decreased the odds for CMD.Conclusions: Our findings indicate maternal CMD burden is high in out-patient malnutrition clinics in North-western Nigeria. Maternal mental health services would need to be integrated into the community management of acute malnutrition programs to provide more holistic care, and possibly improve long-term outcomes after discharge from these programs. [ABSTRACT FROM AUTHOR]

Abstract Background Existing ready-to-use supplementary and therapeutic foods (RUSFs and RUTFs) have had limited acceptance and effectiveness in Cambodia. This has hampered the treatment and prevention of child malnutrition. An innovative, locally produced, multiple micronutrient fortified lipid-based nutrient supplement (LNS) has been developed for use as an RUSF. Unlike most RUSFs, which contain milk, this product contains fish as the animal protein. Few RUSFs have been formulated using non-milk animal-source foods and they have not been widely tested. An acceptability trial that was conducted on this novel RUSF in June 2015 demonstrated that children will eat the RUSF and that caregivers will feed it to their children. The current trial aims to evaluate the effectiveness of the RUSF in preventing growth faltering and improving micronutrient status in Cambodian children. Methods and analysis This trial is a six-month, prospective, cluster randomised, non-blinded controlled trial among infants in peri-urban Phnom Penh. The trial aims to establish the superiority of the novel RUSF, compared to three alternatives (Corn-Soy Blend Plus Plus (CSB++) and Sprinkles micronutrient powders as active comparators, and the unimproved diet as a control). The allocation ratio is 1:1. Healthy children (N = 540) aged six to eleven months will be recruited. Data will be collected at baseline, and monthly thereafter for a period of six months. Participants will be provided with a monthly supply of the food to which their village has been allocated. Discussion There is an urgent need to develop locally produced and culturally acceptable RUSFs, and to compare these with existing options in terms of their potential for preventing malnutrition, in Cambodia and elsewhere. This trial will contribute much-needed data on the effectiveness of supplementary foods with an animal-source food other than milk, by comparing a novel RUSF based on fish to one that uses milk (CSB++). Moreover, it will deepen the understanding of the impact of multiple micronutrients provided with or without macronutrients, by comparing the novel RUSF and CSB++, which combine macronutrients with multiple micronutrients, to Sprinkles, which contains no macronutrients. In addition, it will augment the body of evidence from Asia. Trial registration ClinicalTrials.gov, Identifier: LNS-CAMB-INFANTS-EFF; NCT02257762.

Over 20 million children under 5 years old in the WHO Eastern Mediterranean Region have stunted growth, as a result of chronic malnutrition, with damaging long-term consequences for individuals and societies. This review extracted and analyzed data from the UNICEF, WHO and the World Bank malnutrition estimates to present an overall picture of childhood stunting in the region. The number of children under 5 in the region who are affected by stunting has dropped from 24.5 million (40%) in 1990 to 20.6 million (24.2%) in 2019. The reduction rate since the 2012 baseline is only about two fifths of that required and much more rapid progress will be needed to reach the internationally agreed targets by 2025 and 2030. Prevalence is highest in low-income countries and those with a lower Human Development Index. The COVID-19 pandemic threatens to undermine efforts to reduce stunting, through its impact on access and affordability of safe and nutritious foods and access to important health services. Priority areas for action to tackle stunting as part of a comprehensive, multisectoral nutrition strategy are proposed. In light of the threat that COVID-19 will exacerbate the already heavy burden of malnutrition in the Eastern Mediterranean Region, implementation of such strategies is more important than ever. [ABSTRACT FROM AUTHOR]

The aim of the present study was to review the current knowledge concerning the nutritional status of children with cerebral palsy. The aim was also to summarize the key factors which are responsible for the high prevalence of malnutrition. Significant reductions in anthropometric parameters were found in children with cerebral palsy in comparison to children of normal development. This deviation from typical growth, can be attributed to several factors, such as: inadequate food intake, deficiency of important trace elements (calcium, phosphorus, magnesium, iron) and vitamins (vitamin D, folate, vitamin 12) and reduced dietary density (which depends on dietary factors and mobility). Children with cerebral palsy, manifest nutritional problems and nutritional deficiency, which mainly is due to the inherent problems these children have to acquire dietary factors and their also inherent problematic in their mobility. Thus the present work attempts to provide a short review of the nutritional issues in children with cerebral palsy and the probable nutritional therapeutic interventions. [ABSTRACT FROM AUTHOR]

Over 20 million children under 5 years old in the WHO Eastern Mediterranean Region have stunted growth, as a result of chronic malnutrition, with damaging long-term consequences for individuals and societies. This review extracted and analyzed data from the UNICEF, WHO and the World Bank malnutrition estimates to present an overall picture of childhood stunting in the region. The number of children under 5 in the region who are affected by stunting has dropped from 24.5 million (40%) in 1990 to 20.6 million (24.2%) in 2019. The reduction rate since the 2012 baseline is only about two fifths of that required and much more rapid progress will be needed to reach the internationally agreed targets by 2025 and 2030. Prevalence is highest in low-income countries and those with a lower Human Development Index. The COVID-19 pandemic threatens to undermine efforts to reduce stunting, through its impact on access and affordability of safe and nutritious foods and access to important health services. Priority areas for action to tackle stunting as part of a comprehensive, multisectoral nutrition strategy are proposed. In light of the threat that COVID-19 will exacerbate the already heavy burden of malnutrition in the Eastern Mediterranean Region, implementation of such strategies is more important than ever.