Are stunted child – overweight mother pairs a real defined entity or a statistical artifact?

In a methodological contribution, Dieffenbach & Stein (DS) (The Journal of Nutrition, 142(4), 771–773.) concluded that the double burden of malnutrition (DBM), represented by stunted child – overweight mother pairs (SCOM), is a statistical artifact, meaning that SCOM does not describe a unique phenomenon because the observed rates of SCOM across a number of countries were not strongly different from the product of observed rates of maternal overweight (OM) and child stunting (SC), which DS referred to as the expected rate of SCOM. However, a growing literature continues to use SCOM as an indicator of the DBM. This study shows that the analysis by DS is not sufficient to conclude that SCOM can be explained by the co-occurrence of OM and SC due to chance alone because the analysis by DS was conducted at the country level, but applied to SCOM, which is a household-level variable. Using Demographic and Health Surveys data from 202 country-year data sets, we do not confirm important implicit assumptions that are required for the claim by DS to be supported. We also outline that comparing the expected to the observed rate of SCOM is primarily informative when putting it in relation to factors that influence the supply and demand of food consumed by households. When considering these factors, we find further evidence that it is misleading to consider SCOM as a statistical artifact, as the difference between the observed and the expected rate of SCOM significantly differs by household wealth. Recognizing that SCOM is a distinct phenomenon is important for policymakers who develop double-duty strategies that address malnutrition, and for researchers who need useful indicators to study the determinants of malnutrition at the household level.     

Gender discrimination in undernutrition with mediating factors among Bengalee school children from Eastern India

This study was undertaken to determine age and sex variations in the prevalence of underweight and stunting, and to assess the impact of some socio-economic variables on undernutrition among 6–16 year old school children of Bengalee ethnicity in Chapra, West Bengal, India. The subjects were selected randomly from various schools and madrassas of the Chapra Block. A total of 725 children (342 boys and 383 girls) aged 6–16 years were measured and data on their socio-economic status were collected. Age and sex combined rates of underweight and stunting were 44.40% and 37.20%, respectively. Weight-for-age Z-score (WAZ) showed significant association with per-capita income (PCI) among boys (F = 5.45) and girls (F = 8.14). Height-for-age Z-score (HAZ) has also shown the association with per-capita income among boys (F = 4.43) and girls (F = 9.69). The WAZ was significantly associated with fathers’ educational status (FOS) (t = ?2.95) and the number of living rooms (NLR) (t = ?2.91) among girls. The HAZ showed significant association with number of siblings (NS) among girls (F = 4.25). Linear regression analyses revealed that NLR (t = 2.04) and NS (t = 1.95) had a significant impact on HAZ among boys. Among girls, PCI (t = 3.38), FOS (t = 2.87) and NLR (t = 2.81) had a significant impact on WAZ and also PCI (t = 3.28) and FOS (t = 2.90) had a significant impact on HAZ. NLR had significant associations with underweight (χ² = 3.59) and stunting (χ² = 4.20) among boys. Among girls, PCI had significant associations with underweight (χ² = 11.15) and stunting (χ² = 11.64). FOS also showed significant associations with underweight (χ² = 8.10) as well as stunting (χ² = 8.28) among girls. NLR showed a significant association with underweight (χ² = 7.75). Logistics regression analyses revealed that FOS (Wald = 8.00) and NLR (Wald = 4.09) were significant predictors of stunting among boys. Among girls, PCI was a significant predictor of underweight (Wald = 10.95) as well as stunting (Wald = 10.45). FOS, NLR and NS were also significant predictors of stunting (Wald = 8.16), underweight (Wald = 7.68) and stunting (Wald = 6.97) respectively. The present study revealed that the nutritional status of the children was unsatisfactory and it is of paramount importance not only to increase the amount of food supplementation given but also to promote gender equality.     

Hyperuricemia and metabolic syndrome in children with overweight and obesity

ObjectiveTo study the prevalence of hyperuricemia in children with overweight or obesity and analyze the relation with metabolic syndrome and the diseases that define it.Materials and methodsThis is a cross-sectional prevalence study in 148 children recruited from pediatric endocrinology consultation, with overweight or obesity (12 ± 3 years, 48% boys, BMI 31.8 ± 6.1). We measured BMI, waist-height, waist circumference, blood pressure with standard instrumentation and glucose (fasting and after overload with 75 g), insulin resistance, cholesterol HDL, triglycerides and uric acid.ResultsThe prevalence of hyperuricemia was 53%. Patients with hyperuricemia had greater BMI (33.9 vs 30.6, p = 0.003), plus waist circumference (101.4 vs 91.1 cm, p < 0.001), higher blood pressure: systolic (123.4 vs 111.9 mm Hg, p < 0.001), diastolic (78.2 vs 68.7 mm Hg, p < 0.001). They presented greater blood glucose after overload oral glucose (107.5 vs 100.7 mg/dl, p = 0.03), insulin was higher (29.2 vs 20.7 mg/dl, p = 0.001) as well as HOMA IR (6.5 vs 4.4, p < 0.001) and HDL levels were lower (49.5 vs 54.4 mg/dl, p = 0.02).Uric acid's level which most is the likely diagnosis of metabolic syndrome corresponds to 5.4 mg/dl in our sample (sensitivity: 64% and specificity 62%).ConclusionThe prevalence of hyperuricemia in children with overweight and obesity is high. In the group of patients with obesity and hyperuricemia, we found out that the parameters measured to diagnose with metabolic syndrome were less favorable. Uric acid's level from where there is a higher possibility to see metabolic syndrome is 5.4 mg/dl.     

Decomposing socioeconomic inequalities in childhood obesity: Evidence from Ireland

The objective of this paper is to quantify and decompose the socioeconomic gradient in childhood obesity in the Republic of Ireland. The analysis is performed using data from the first wave of the Growing Up in Ireland survey, a nationally representative survey of 8568 nine-year-old children conducted in 2007 and 2008. We estimate concentration indices to quantify the extent of the socioeconomic gradient in childhood obesity and undertake a subsequent decomposition analysis to pinpoint the key factors underpinning the observed inequalities. Overall the results confirm a strong socioeconomic gradient in childhood obesity in the Republic of Ireland. Concentration indices of obesity (CI = −0.168) and overweight/obese (CI = −0.057) show that the gradient is more pronounced in obese children, while results from the decomposition analysis suggest that the majority of the inequality in childhood obesity is explained by parental level variables. Our findings suggest that addressing childhood obesity inequalities requires coordinated policy responses at both the child and parental level.     

Delirium prevalence in a Colombian hospital,association with geriatric syndromes and complications during hospitalization

BackgroundThe aim of this paper is to describe the prevalence of Delirium and the factors associated with its presentation and complications identified in a geriatric unit in Colombia.Material and methodsThis is a retrospective observational study that included all patients admitted consecutively for two years in a geriatric unit of a hospital in Bogotá, Colombia. We assessed delirium prevalence with the Confusion Assessment Method (CAM). The independent variables were age, sex, functional impairment (Barthel < 90), malnutrition (MNA < 12), pressure ulcers at admission, state of the social support network, number of comorbidities, polypharmacy (5 or more drugs), complications such as ICU requirement, hospital stay, in-hospital functional impairment and mortality were also evaluated. As an exclusion criterion: not having CAM registered in the medical record, all the patients had this information.ResultsWe studied 1599 subjects with a mean age of 86 years (IQR 9). Delirium prevalence was 51.03%. Delirium was associated with a higher rate of: pressure ulcers on admission [OR 3.76 (CI 2.60–5.43 p < 0.001)], functional impairment [OR 2.38 (CI 1.79–3.16 p < 0.001)], malnutrition [OR 2.06 (CI 1.56–2.73 p < 0.001)], and infection [OR 1.46 (CI 1.17–1.82 p < 0.001)]. Moreover delirium has a higher association with mortality [OR 2.80 (1.03–7.54 p = 0.042)], in-hospital functional decline [OR 1.82 (1.41–2.36 p < 0.001)], and longer hospital stay [OR 1.04 (1.04–1.09 p = 0.006)]; independently of age, sex, pressure ulcers on admission, functional impairment, malnutrition, dementia, infection and limited social network.ConclusionOur study suggests that infectious diseases and geriatric syndromes such as, functional dependence, pressure ulcers, malnutrition or major cognitive impairment are independently associated with the presence of delirium on admission. Additionally, the presence of delirium is independently associated during hospitalization with complications, longer hospital stay, functional impairment and mortality.     

Absolute wealth and world region strongly predict overweight among women (ages 18–49) in 360 populations across 36 developing countries

This paper proposes a benchmark for comparing SES gradients across countries, based on gross domestic product apportioned to members of differing wealth categories within countries. Using this approach, we estimate absolute wealth in 360 populations in 36 developing countries and model its relationship with overweight (BMI ≥ 25) among non-pregnant women ages 18–49. A simple model based on absolute wealth alone strongly predicts odds of overweight (R² = 0.59), a relationship that holds both between countries and between different groups in the same country (10 populations for each of 36 countries). Moreover, world region modifies this relationship, accounting for an additional 22% of variance (R² = 0.81). This allows us to extract a basic pattern: rising rates of overweight in lower and middle income countries closely track increasing economic resources, and the shape of that gradient differs by region in systematic ways.     

Mother-child adrenocortical synchrony; Moderation by dyadic relational behavior

Mother-child adrenocortical synchrony, the coupling of cortisol (CT) secretion in mother and child, has been associated with shared parent-child experiences and maladaptive familial contexts. Yet, few studies tested adrenocortical synchrony in diurnal CT patterns. Guided by the bio-behavioral synchrony model, we examined whether mother-child relational behavior and maternal psychopathology may moderate the degree of concordance between mother and child's diurnal CT. Ninety-seven mothers and their six-year old children participated in two groups; mothers diagnosed with major depression disorder (N = 28) and non-depressed controls (N = 69). Mother-child interactions were observed and coded for dyadic reciprocity and dyadic tension and diurnal cortisol was collected from mother and child over two consecutive weekend days. Concordance between maternal and child's diurnal CT was found, significant above and beyond time of measurement. Maternal depression, while associated with attenuated child diurnal CT variability, was unrelated to adrenocortical synchrony. Higher child diurnal CT production predicted a stronger linkage between maternal and child's diurnal CT, suggesting that greater child physiological stress is associated with increased susceptibility to the influences of maternal stress physiology. Mother-child reciprocity was related to lower adrenocortical synchrony. Findings suggest that higher adrenocortical synchrony is associated with greater physiological stress and less adaptive dyadic relational patterns. Results raise the possibility that diurnal adrenocortical synchrony taps a unique aspect of HPA-axis functioning whose role in the cross-generational transfer of stress physiology requires further research.     

Low-grade inflammation markers in children and adolescents: Influence of anthropometric characteristics and CRP and IL6 polymorphisms

Overweight and obesity are associated with chronic and subclinical inflammation due to an imbalance of inflammatory mediators. However, the association with gene polymorphism has been rarely studied in children. The aim of this study was to determine if serum concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6) are related to the IL6 rs1800795, IL6 rs2069845 and CRP rs1205 polymorphisms (SNPs) according to body mass index (BMI) in a sample of children and adolescents. A cross-sectional study in 470 students between 7 and 17 years of age of anthropometric characteristics, high sensitivity-CRP (Hs-CRP) and IL-6 levels and three SNPs genotyped. The prevalence ratio of hs-CRP > 3 mg/L in obese individuals was 4.15 (CI 2.43–7.06; p = 0.01), and it was 1.91 (CI 1.03–3.55; p = 0.03) in overweight individuals and 1.74 (CI 1.05–2.88 p = 0.03) in females. Individuals with waist circumference (WC) and body fat percentage (BF%) alterations showed elevated levels of hs-CRP (p = 4.3 × 10⁻⁵ and p = 5.3 × 10⁻⁶). The combination of any two anthropometric measurement increases CRP levels, especially combinations with obesity body mass index (BMI): BMI + WC and BMI + BF%. Among the overweight/obesity group, T allele carriers of CRP rs1205 showed lower levels of hs-CRP (0.5, IQR = 0.3–1.8 mg/L) than CC homozygotes (1.5, IQR = 0.4–3.4 mg/L, p = 0.018). Additionally, considering subjects with two or three anthropometric alterations for CRP rs1205: rs1205 T allele carriers had lower levels of hs-CRP (0.7, IQR = 0.3–2.7 mg/L) than CC homozygotes (1.2, IQR = 0.5–3.5 mg/L, p = 0.02). In conclusion, carriers of the rs1205/T allele with higher BMIs had lower levels of hs-CRP. Schoolchildren who were overweight/obese had higher levels of CRP and IL-6, whereas individuals with WC and BF% alterations had higher levels of CRP.     

High intensity interval exercise decreases IL-8 and enhances the immunomodulatory cytokine interleukin-10 in lean and overweight–obese individuals

PurposeTo compare the effects of two interval exercises with different intensities on acute inflammatory response in lean and overweight–obese subjects.MethodsTen lean (BMI < 24.9 kg/m²) and 12 overweight–obese (BMI 25 to <34.9 kg/m²) males performed two conditions in randomly assigned: (1) high intensity interval exercise (HIIE) 10 × 60 s (85–90%P_Max)/75 s (50%P_Max); (2) moderate intensity interval exercise (MIIE) 10 × 60 s (70–75%P_Max)/60 s (50%P_Max), with blood collections at pre, immediately and 30 min post each exercise bouts to evaluate total and differential leukocyte counts, serum creatine kinase (CK), lactate dehydrogenase (LDH) and systemic levels of IL-1ra, IL-6, IL-8, IL-10, IL-17a and CCL2.ResultsIn lean group, HIIE induced a significant increase in total leukocytes and monocyte, while MIIE session did not change the number of leukocytes. Overweight–obese group presented similar increase in leukocytes, monocytes and lymphocytes in both HIIE and MIIE sessions. At baseline, overweight–obese group showed high levels of CK, IL-8, IL-6 and CCL2 and lower concentrations of IL-10 compared to lean group. The MIIE did not alter the cytokine concentrations in both groups, independently of the time analysis. The HIIE induced significant decrease in IL-8 levels 30 min post session in both the groups, and a progressive elevation in IL-10 levels immediately and 30 min post in lean and overweight–obese. Regarding IL-6, overweight–obese subjects presented progressive increase either immediately and 30 min after HIIE, while lean individuals presented significant increase only 30 min after exercise.ConclusionsThe acute inflammatory response to interval exercise is intensity-dependent. Although obesity influences the basal concentrations of several cytokines, only HIIE induced important alterations in IL-8 and IL-10 levels, which may have important implications in the control of chronic low-grade inflammation in obesity.     

Occurrence of cestodes and comparative efficacy of Typha angustata and sulphadimidine against cestodes in Columba livia domestica (Domestic Pigeon)

The occurrence of intestinal parasites of Columba livia domestica has been on the increase, leading to high economic and production losses with more fatal cases. This study was designed to investigate the prevalence of cestodes in pigeons and determine the efficacy of Typha angustata extract and sulphadimidine against these cestodes in the domestic pigeon. A total of 30 pigeons were examined. 18 (60%) pigeons were found infected with only one type of cestode species (Raillietina spp.). The difference in prevalence between males and females was statistically significant (χ² = 8.167, p = 0.004). The mean EPG count in group A (treated with T. angustata extract) before treatment and after treatment was 176 ± 4.33 and 155 ± 4.24, respectively. In group B (treated with sulphadimidine), the mean EPG calculated before treatment and after treatment was 184 ± 6.74 and 35 ± 3.53, respectively. The efficacy at day 28 of T. angustata and Sulphadimidine was 11.93% and 80.97%, respectively. It was concluded on the basis of the EPG and efficacy data that T. angustata extract had low efficacy against raillietiniasis, while as sulphadimidine, which is also used before to treat different intestinal parasites, had a good efficacy against raillietiniasis. Further studies are required to know the prevalence of other gastrointestinal parasites in pigeons and efficacy of different medicinal plants against such parasites.     

Towards an anthropometric history of latin America in the second half of the twentieth century

We examine the evolution of adult female heights in twelve Latin American countries during the second half of the twentieth century based on demographic health surveys and related surveys compiled from national and international organizations. Only countries with more than one survey were included, allowing us to cross-examine surveys and correct for biases. We first show that average height varies significantly according to location, from 148.3 cm in Guatemala to 158.8 cm in Haiti. The evolution of heights over these decades behaves like indicators of human development, showing a steady increase of 2.6 cm from the 1950s to the 1990s. Such gains compare favorably to other developing regions of the world, but not so much with recently developed countries. Height gains were not evenly distributed in the region, however. Countries that achieved higher levels of income, such as Brazil, Chile, Colombia and Mexico, gained on average 0.9 cm per decade, while countries with shrinking economies, such as Haiti and Guatemala, only gained 0.25 cm per decade.     

Alta prevalencia de obesidad en una población laboral en España

Background and objectivesTo report the prevalence of obesity in a Spanish working population and its changes in recent years.Material and methodsData were collected from routine medical examinations performed on workers by a national mutual insurance society for occupational accidents and diseases (Ibermutuamur). A structured questionnaire was completed and physical examinations were performed. Overweight was defined as BMI ranging from 25 and 29.9, obesity as BMI of 30-39.9, and morbid obesity as BMI ≥ 40 kg/m².ResultsData from 1,336,055 medical examinations performed from May 2004 to November 2007 were collected. Prevalence rates in the population examined in 2004 (n = 230,684; 73% males; average age, 36.4 years) were: morbid obesity, 0.5% (0.6% males, 0.5% females); obesity, 14.5% (17.0% males, 7.7% females); overweight, 38.4% (44.8% males, 21.3% females). Prevalence rates of obesity and overweight were higher in blue-collar workers (16.4% and 40.5% respectively) as compared to white-collar workers (10.9% and 34.4% respectively). There was a progressive increase in prevalence of obesity during the 4-year study (2004-2007) in both males (17.0%, 17.6%, 17.9%, 18.2%) and females (7.6%, 8.0%, 8.4%, 8.7%).ConclusionsPrevalence of obesity and overweight in the Spanish working population is high, especially in male blue-collar workers, and is increasing. There is a need to promote early prevention programs and specific treatments for obesity.     

Tasa estimada de disposición de glucosa en pacientes menores de 18 años con diabetes mellitus tipo 1 y sobrepeso-obesidad

ObjectiveTo assess the estimated glucose disposal rate (eGDR), insulin dose, and lipoprotein profile in children with type 1 diabetes mellitus (T1DM) and overweight or obesity as compared to children with T1DM and normal weight.MethodsA total of 115 patients (aged 5-16 years) with T1DM on intensive insulin therapy were recruited. The following parameters were measured: weight, height, body mass index, waist and hip circumference, insulin dose, eGDR, glycosylated hemoglobin, blood pressure, and lipoprotein profile. Results were stratified by sex and age.ResultsNo significant differences were found in eGDR between children with normal weight, overweight, and obesity. However, obese children older than 11 years had lower eGDR values (9.3 ± 1.3 vs 10.1 ± 0.8 mg kg^-1min^-1; p < 0.01). Insulin dose was higher in overweight and obese children, especially in IU/m²/day (37.7 vs 36.1 vs 29.4 respectively; p < 0.01). Obese children had higher low-density lipoprotein cholesterol levels than children with overweight and normal weight (106.5 vs 91.7 vs 91.5 mg/dL respectively; p < 0.01). No correlation was found between waist circumference and the different markers of insulin resistance.ConclusionsValues of eGDR values were lower in obese children with T1DM older than 11 years, and this may therefore be considered a marker of insulin resistance. Insulin dose was higher in diabetic patients with overweight or obesity, specially in IU/m²/day. Obese children with T1DM had a lipoprotein profile of cardiovascular risk.     

Body mass index,iron absorption and iron status in childbearing age women

BackgroundThe prevalence of obesity has increased at an alarming rate worldwide. Some studies have observed an association between iron (Fe) deficiency (ID) and obesity, however more research is needed.ObjectiveTo assess whether body mass index (BMI) is associated with both Fe absorption and Fe status.MethodsA cross sectional sample of 318 Chilean childbearing age women was studied. The women received either a single dose of 0.5 mg of Fe (n = 137, group 1) or 3 mg of Fe plus ascorbic acid (1:2 molar ratio) (n = 181, group 2), both as FeSO₄ with labeled radioisotopes. Fe absorption was assessed through radio Fe erythrocyte incorporation. Fe status was determined by hemoglobin (Hb), mean corpuscular volume, serum Fe, total iron binding capacity, transferrin saturation, erythrocyte Zn protoporphyrin and serum ferritin (SF).Results29%, 47% and 24% of the women were classified as normal, overweight or obese, respectively. Fe absorption was significantly lower in obese women (p < 0.05). In group 1, the geometric mean and range ±1 SD of the percentage of Fe absorption for normal-weight women was 32.9% vs. 19.7% in obese. For group 2, this percentage was 36% vs. 30%, respectively (2-way ANOVA: BMI classification and Fe dose p < 0.05; interaction p = 0.34). Although Fe absorption was lower in obese women, they had higher SF (p < 0.01) and Hb (p < 0.05) concentrations.ConclusionAlthough we did not observe a relationship between BMI and Fe status, obese women displayed lower Fe absorption compared with overweight and normal weight women, possibly due to subclinical inflammation associated with obesity.     

Difficulties with emotion regulation moderate the association between childhood history of maltreatment and cortisol reactivity to psychosocial challenge in postpartum women

Exposure to child maltreatment can lead to long-term emotional difficulties and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. However, no prior work has examined emotion regulation as a moderator of the association between childhood history of maltreatment and cortisol response to psychosocial challenge. Amongst a sample of 140 postpartum women, associations between childhood maltreatment, emotion regulation, and cortisol response to a computerized Emotional Stroop paradigm were examined using structural equation modeling. Three saliva samples (baseline, 20- and 40-min post-challenge) were collected and later assayed for cortisol. Stepwise regression analyses revealed that difficulties with emotion regulation significantly moderated the association between maternal history of child maltreatment and cortisol reactivity (β = − 0.17, CI_.95 = − 0.31, − 0.04, t = − 2.51, p = 0.01). Specifically, women with higher child maltreatment scores and greater difficulties with emotion regulation displayed reduced cortisol reactivity. This finding suggests that diminished emotion regulation capacity may uniquely contribute to blunted physiological reactivity in postpartum women exposed to higher levels of child maltreatment. As the postpartum period has significant implications for maternal well-being and infant development, these findings are discussed in terms of adaptive responsivity, maternal behaviour, and clinical practice.     

Analysis of the tennis racket vibrations during forehand drives: Selection of the mother wavelet

The time–frequency analysis of the tennis racket and hand vibrations is of great interest for discomfort and pathology prevention. This study aimed to (i) to assess the stationarity of the vibratory signal of the racket and hand and (ii) to identify the best mother wavelet to perform future time–frequency analysis, (iii) to determine if the stroke spin, racket characteristics and impact zone can influence the selection of the best mother wavelet. A total of 2364 topspin and flat forehand drives were performed by fourteen male competitive tennis players with six different rackets. One tri-axial and one mono-axial accelerometer were taped on the racket throat and dominant hand respectively. The signal stationarity was tested through the wavelet spectrum test. Eighty-nine mother wavelet were tested to select the best mother wavelet based on continuous and discrete transforms. On average only 25 ± 17%, 2 ± 5%, 5 ± 7% and 27 ± 27% of the signal tested respected the hypothesis of stationarity for the three axes of the racket and the hand respectively. Regarding the two methods for the detection of the best mother wavelet, the Daubechy 45 wavelet presented the highest average ranking. No effect of the stroke spin, racket characteristics and impact zone was observed for the selection of the best mother wavelet. It was concluded that alternative approach to Fast Fourier Transform should be used to interpret tennis vibration signals. In the case where wavelet transform is chosen, the Daubechy 45 mother wavelet appeared to be the most suitable.     

In urban South Africa, 16 year old adolescents experience greater health equality than children

Despite the strongly established link between socio-economic status (SES) and health across most stages of the life-course, the evidence for a socio-economic gradient in adolescent health outcomes is less consistent. This paper examines associations between household, school, and neighbourhood SES measures with body composition outcomes in 16 year old South African Black urban adolescents from the 1990 born Birth to Twenty (Bt20) cohort. Multivariable regression analyses were applied to data from a sub-sample of the Bt20 cohort (n = 346, 53% male) with measures taken at birth and 16 years of age to establish socio-economic, biological, and demographic predictors of fat mass, lean mass, and body mass index (BMI). Results were compared with earlier published evidence of health inequality at ages 9–10 years in Bt20. Consistent predictors of higher fat mass and BMI in fully adjusted models were being female, born post term, having a mother with post secondary school education, and having an obese mother. Most measures of SES were only weakly associated with body composition, with an inconsistent direction of association. This is in contrast to earlier findings with Bt20 9–10 year olds where SES inequalities in body composition were observed. Findings suggest targeting obesity interventions at females in households where a mother has a high BMI.     

Free-ranging domestic cats reduce the effective protected area of a Polish national park

Poland's Animal Protection Act, as of 2002, made it legal to shoot free-ranging cats and dogs. The act triggered substantial social debate with opponents arguing that this legislation was weakly supported by scientific evidence of the ecological impacts of free-ranging pets. Our main research goal was to examine the activity of free-ranging domestic cats within a Polish protected area by applying radio-telemetry methods to determine space use and degree of encroachment into the national park. We trapped and radio-tracked 19 animals from three sites (focal households) located in Ojcow National Park (ONP) in southern Poland from June 2003 to March 2006. Annual 100% MCP home range size varied from 0.02 km² to 1.46 km², and was significantly larger for males (mean ± SE = 0.79 ± 0.34 km²; median = 0.53 km²) than for females (mean ± SE = 0.13 ± 0.05 km²; median = 0.13 km²). The distance travelled by individual cats from focal sites did not significantly differ between males (mean ± SE = 232.00 ± 21.05 m; median = 191 m) and females (mean ± SE = 232.50 ± 12.47 m; median = 228 m), with maximum distances of 1.5 km for males and 1.1 km for females. All monitored cats were in close proximity to nature reserves and ranged into protected areas without any human control. Cats living in the households in the park and its surrounding buffer zone, roaming at 200 m and 1000 m radius distances from their households, occupied from 6% to 100% of the park area, respectively. Our results reveal that free-ranging domestic cats roam through and potentially impact the entire national park, thus reducing its effective protected area.     

The Double Burden of Obesity and Malnutrition in a Protracted Emergency Setting: A Cross-Sectional Study of Western Sahara Refugees

Background

Households from vulnerable groups experiencing epidemiological transitions are known to be affected concomitantly by under-nutrition and obesity. Yet, it is unknown to what extent this double burden affects refugee populations dependent on food assistance. We assessed the double burden of malnutrition among Western Sahara refugees living in a protracted emergency.

Methods and Findings

We implemented a stratified nutrition survey in October–November 2010 in the four Western Sahara refugee camps in Algeria. We sampled 2,005 households, collecting anthropometric measurements (weight, height, and waist circumference) in 1,608 children (6–59 mo) and 1,781 women (15–49 y). We estimated the prevalence of global acute malnutrition (GAM), stunting, underweight, and overweight in children; and stunting, underweight, overweight, and central obesity in women. To assess the burden of malnutrition within households, households were first classified according to the presence of each type of malnutrition. Households were then classified as undernourished, overweight, or affected by the double burden if they presented members with under-nutrition, overweight, or both, respectively.The prevalence of GAM in children was 9.1%, 29.1% were stunted, 18.6% were underweight, and 2.4% were overweight; among the women, 14.8% were stunted, 53.7% were overweight or obese, and 71.4% had central obesity. Central obesity (47.2%) and overweight (38.8%) in women affected a higher proportion of households than did GAM (7.0%), stunting (19.5%), or underweight (13.3%) in children. Overall, households classified as overweight (31.5%) were most common, followed by undernourished (25.8%), and then double burden–affected (24.7%).

Conclusions

The double burden of obesity and under-nutrition is highly prevalent in households among Western Sahara refugees. The results highlight the need to focus more attention on non-communicable diseases in this population and balance obesity prevention and management with interventions to tackle under-nutrition. Please see later in the article for the Editors'' Summary