Physical growth and nutritional status of Tsimane' Amerindian children of lowland Bolivia

This study examines patterns of growth and nutritional status of indigenous Tsimane' children under 9 years of age (n = 199 boys and 210 girls), based on a cross-sectional sample from 58 villages from the Beni Deparment of lowland Bolivia. Compared with US children, Tsimane' children are quite short, with linear growth tracking at or below the US 5th centile in both sexes. The prevalence of low height-for-age ("stunting;" HA Z-scores 相似文献   

The consequences of linear growth stunting: Influence on body composition among youth in the bolivian amazon

Stunting, or linear growth retardation, has been documented in up to half of all children in rural indigenous populations of South America. Stunting is well understood as a signal of adverse conditions during growth, and has been associated with developmentally induced modifications to body composition, including body fat and muscularity, that stem from early growth restriction. This article examines the relation between short stature and three anthropometric indicators of body composition during childhood and adolescence among a rural, indigenous population of forager‐horticulturalists. Anthropometric data were collected annually from 483 Tsimane' youth, ages 2–10 years, in 13 communities in the Beni region of Bolivia for 6 consecutive years (2002–2007). Baseline height‐for‐age was used to indicate stunting (HAZ < ?2.0) and compared with z‐scores of body mass index (BMI), sum of two skinfolds, and arm muscle area. Multilevel regression models indicate baseline stunting is associated with lower BMI z‐scores (B = ?0.386; P < 0.001), body fatness (ZSkinfold, B = ?0.164; P < 0.001), and arm muscularity (AMAZ, B = ?0.580; P < 0.001) in youth across a period of 6 years. When split by sex, there was a stronger relation between baseline stunting and lower skinfold body fat scores among girls (B = ?0.244; P < 0.001) than boys (B = ?0.080; P = 0.087). In contrast, baseline stunting was associated with lower arm muscularity in both girls (B = ?0.498; P < 0.001) and boys (B = ?0.646; P < 0.001). The relation between linear growth restriction and indicators of body composition persist into adolescence, providing additional insight into the influence of adverse conditions during growth. Am J Phys Anthropol 153:92–102, 2014. © 2013 Wiley Periodicals, Inc.     

Effect of undernutrition on deciduous tooth emergence among Rajput children of Shimla District of Himachal Pradesh, India

This article examines the influence of nutritional status on the emergence of deciduous dentition in a cross-sectional sample of 510 rural Rajput children from the Jubbal and Kotkhai Tehsils, Shimla District, Himachal Pradesh, India. The nutritional status of each child was evaluated using Z-scores of height/supine length-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ). The effects of sex and side on deciduous dental emergence were not statistically significant. Partial correlation indicates that the number of emerged teeth (T) was more strongly correlated with height than with other anthropometric variables. In most age groups, the stunted boys and girls (HAZ <-2) had fewer emerged teeth than nonstunted age peers (HAZ >-2). The mean T in underweight children was also less than that of the normal children, with a few exceptions. The stunted children have a significantly greater likelihood of delayed emergence of deciduous dentition. Measures of linear growth status are more closely related to dental development than measures of growth in mass. The findings indicate that even moderate undernutrition can delay deciduous tooth emergence.     

Trends in Height and BMI of 6‐Year‐Old Children during the Nutrition Transition in Chile

Objective: We analyzed trends in height and BMI and their interaction in 6‐year‐old Chilean children over the last 15 years. Research Methods and Procedures: We calculated height for age z‐score (HAZ), BMI z‐score, prevalence of obesity, underweight, and stunting from cross‐sectional national school‐based annual population surveys in 1987, 1990, 1993, 1996, 2000, and 2002. Using mixed model analysis, we determined the risk of obesity according to height over time as odds ratios (ORs) and 95% confidence interval and the potential influence of height and year of study on BMI z‐score. Results: Over the study period, height increased by 2.8 cm in boys and 2.6 cm in girls, whereas stunting declined from 5% to 2% in both. Tallness increased by ～2%, BMI z‐score increased from +0.3 to +0.65 in boys and to +0.62 in girls, and HAZ increased from ?0.47 in boys and ?0.45 in girls to 0 in 2002. Underweight declined from 4% to 3%, whereas obesity rose from 5% to ～14%. The probability of obesity among tall children was significantly greater than that for normal height children (OR, 2.3 to 3.5). The lowest obesity risk was observed between ?2 and ?1 HAZ. The OR for obesity in the stunted relative to normal height children was variable, ranging from 1.23 to 0.65, whereas it was significant and consistently positive (1.1 to 1.7) for boys and girls when it was compared with the lowest obesity risk according to height. Discussion: Tallness is significantly associated with increased obesity risk in children, while stunting is also associated, but to a lesser degree.     

Prevalence and Trends in Obesity among China’s Children and Adolescents, 1985–2010

Objectives

We examined the prevalence of and trends in obesity among children and adolescents in China (1985–2010).

Methods

We used data from the 1985, 1991, 1995, 2000, 2005, and 2010 Chinese National Surveys on Students’ Constitution and Health (CNSSCH). The CNSSCH is a national survey of physical fitness and health status in Chinese students that uses multistage stratified sampling of 31 provinces and municipalities. A subject was considered obese or overweight if weight-for-height exceeded the 20% or 10% of standard weight-for-height. The standard weight-for-height was the 80th percentile for sex- and age-specific growth charts.

Results

The age-adjusted prevalence of obesity and of overweight and obesity combined was 8.1% (95% CI, 8.0–8.3%) and 19.2% (95% CI, 19.1–19.4%) among children and adolescents 7–18 years in age. Obesity was more likely to be present among children or adolescents who were male (RR, 1.93; 95% CI, 1.90–1.97), urban (RR, 1.99; 95% CI, 1.95–2.02), or 10–12 years (RR, 1.43; 95% CI, 1.40–1.46). Trend analyses of the 25-year period revealed a significant increasing trend in males (RR, 1.59; 95% CI, 1.58–1.60) and in females (RR, 1.49; 95% CI, 1.48–1.50). The rate of increase in obese or overweight prevalence was highest in boys from rural areas (9% annual increase).

Conclusions

During 1985–2010, there was a significant and continuous increase in the prevalence of obesity in children and adolescents. Obesity is epidemic in China, but may be reduced with evidence-based interventions (e.g., school intervention programs).     

Obesity and Malnutrition in a Shantytown Population in the City of São Paulo,Brazil

To investigate the prevalence of obesity and malnutrition in the poor Brazilian population we conducted a survey on the socioeconomic and nutritional status of 535 families (comprising 2 411 individuals) living in shanty towns in the city of São Paulo. There was a 30% prevalence of malnutrition in the children, with chronic malnutrition as the most predominant problem. The prevalence of obesity was 6.4% in boys and 8.7% in girls. Overweight and obesity associated with stunting was found in 5.8% of boys and 6.8% girls. Adolescents showed a higher prevalence of malnutrition when weight-for-age distribution was used (boys 46.4%, girls 40.2%), but a right deviation in the distribution was observed with an increase in obesity and a decrease of malnutrition was observed (obesity was 21% in girls and 8.8% in boys; malnutrition was 15.5% in boys and 12.6% in girls) when the weight-for-height adjustment was made. Stunting was the most predominant type of malnutrition in both sexes. Obesity associated with stunting was more common than obesity without stunting, both in younger children and adolescents. Adults had a higher prevalence of obesity than malnutrition according to both the Metropolitan Life Insurance tables (1.7% of undernutrition, 16.7% of overweight, and 14.1% of obesity) and Body Mass Index (8.5% of undernutrition, 21.9% of overweight, and 14.6% of obesity). There was an increase in the percentage of obese children when at least one adult in the family was obese and an increased percentage of malnourished children when undernourished adults were present in the family. Obesity among the adults of the family decreased the occurrence of malnutrition among the children. In 9% of families there was a coexistence of obesity in the adults and malnutrition in the children. These results demonstrate a coexistence of malnutrition and obesity in poor urban Brazilian communities.     

裕固族4～13岁儿童身高、体重状况调查分析

了解裕固族4～13岁儿童身高、体重发育现状,分析该儿童4～7岁组及7～13岁组生长发育随年龄的变化关系, 为儿童保健工作提供参考依据和合理化建议。采用随机整群抽样的方法抽取484名儿童, 测量身高和体重。以全国身高体重值为参比值, 计算年龄别身高(HAZ)和年龄别体重(WAZ)值评价4～7岁儿童体格生长迟缓和低体重状况; 身体质量指数(BMI)评价7～13岁儿童超重和消瘦情况。结果显示, 调查对象身高均高于对比值, 4～7岁儿童超重检出率为3.45%, 偏瘦检出率2.30%; 7～13岁裕固族儿童营养不良人数占裕固族儿童总人数的36.90%, 严重消瘦的人数占13.10%, 其中女生的消瘦程度较男生差。所以, 儿童身高、体重生长发育符合一般生长规律。7～13岁裕固族男女生身体偏瘦人数较多的问题值得关注, 建议改善该人群营养膳食, 加强各项体育锻炼。     

Dietary patterns and changes in body weight in women

Objective: Our objective was to examine the association between adherence to dietary patterns and weight change in women. Research Methods and Procedures: Women (51,670, 26 to 46 years old) in the Nurses’ Health Study II were followed from 1991 to 1999. Dietary intake and body weight were ascertained in 1991, 1995, and 1999. A Western pattern, characterized by high intakes of red and processed meats, refined grains, sweets and desserts, and potatoes, and a prudent pattern, characterized by high intakes of fruits, vegetables, whole grains, fish, poultry, and salad dressing, were identified with principal component analysis, and associations between patterns and change in body weight were estimated. Results: Women who increased their Western pattern score had greater weight gain (multivariate adjusted means, 4.55 kg for 1991 to 1995 and 2.86 kg for 1995 to 1999) than women who decreased their Western pattern score (2.70 and 1.37 kg for the two time periods), adjusting for baseline lifestyle and dietary confounders and changes in confounders over time (p < 0.001 for both time periods). Furthermore, among women who increased their prudent pattern score, weight gain was smaller (multivariate‐adjusted means, 1.93 kg for 1991 to 1995 and 0.66 kg for 1995 to 1999) than among women who decreased their prudent pattern score (4.83 and 3.35 kg for the two time periods) (p < 0.001). The largest weight gain between 1991 and 1995 and between 1995 and 1999 was observed among women who decreased their prudent pattern score while increasing their Western pattern score (multivariate adjusted means, 6.80 and 4.99 kg), whereas it was smallest for the opposite change in patterns (0.87 and ?0.64 kg) (p < 0.001). Discussion: Adoption of a Western dietary pattern is associated with larger weight gain in women, whereas a prudent dietary pattern may facilitate weight maintenance.     

Desert locust swarms and child health

This study evaluates how in-utero exposure to an insect pest invasion, particularly, the outbreak of desert locust swarms, affects early childhood health in Africa and Asia over the past three decades (1990–2018). Employing the difference-in-differences model, we find that children being prenatally exposed to the outbreak have their height-for-age, weight-for-height, and weight-for-age z-scores lower by 0.159, 0.148, and 0.155 standard deviations, respectively, compared to unexposed children. Our heterogeneity analyses show that the health setbacks disproportionately fall on children of disadvantaged backgrounds, i.e., those born to lower-educated mothers, poorer mothers, and rural mothers. To the extent that poor health in early life exerts long-lasting irreversible consequences over the life cycle, the study calls for effective measures to minimize the pernicious effects of the desert locust swarm outbreak.     

High Malnutrition Rate in Venezuelan Yanomami Compared to Warao Amerindians and?Creoles: Significant Associations WITH Intestinal Parasites and Anemia

Background

Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children.

Methods

This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score) and acute (weight-for-height and Body Mass Index (BMI)-for-age Z score in respectively children under 5 years of age and children aged 5 years and above) malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism.

Results

Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18%) while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37%) and Trichuris trichiura (40% in both regions). The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%). Anemia prevalence was highest in the Amazon Region (24%). Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20).

Conclusions

In rural populations in Venezuela helminthiasis and giardiasis were associated with acute and chronic nutritional status respectively. These data highlight the need for an integrated approach to control transmission of parasites and improve the health status of rural Venezuelan children.     

Socioeconomic differentials in nutritional status of children in the states of West Bengal and Assam, India

Malnutrition among children is prevalent in almost all the states in India. This study assesses the extent and causes of malnutrition in two eastern Indian states with similar climates, namely West Bengal and Assam, using data from the National Family Health Survey 1998-99 (NFHS-2). The three indices of malnutrition taken for analysis are weight-for-height (WHZ), height-for-age (HAZ) and weight-for-age (WAZ). These are assumed to depend on birth order, preceding birth interval, parent's educational status, working status of the mother, mother's age at delivery of the children, source of drinking water, toilet facilities and standard of living of the household. Logistic regression was carried out separately for each of the three indices on the explanatory variables for both the states. It was found that not all variables are equally important in determining whether a baby is underweight, or suffering from acute or chronic malnutrition. Also, the importance of variables is not the same in the two states. It was observed that the coefficients associated with the variables in determining weight-for-height are not significant compared with those for weight-for-age and height-for-age.     

Anthropometric indicators of nutritional status, socioeconomic factors and mortality in hospitalized children in Addis Ababa

The influence of some household and maternal variables on three anthropometric nutritional status indices of hospitalized children in Addis Ababa, Ethiopia, are examined. On admission, only 30% of these children can be classified as being of a normal overall nutritional status. There are no significant differences in weight-for-age of hospitalized children between those residing in Addis Ababa and those residing in the rural areas. Income and father's occupation appear to be the major household factors influencing the level of two of the three indices (weight-for-age and weight-for-height). Length of last closed birth interval and, to a lesser degree, maternal age appear to have significant effects on all three nutritional status indices. Upon admission to hospital, children who will in the end survive their hospital stay are on average nutritionally normal or in a mild state of malnutrition, whereas children who will die during their stay arrive in a moderate or severe state of malnutrition. The degree of malnutrition is positively related to the risk of mortality in respiratory disease patients.     

What Time Periods of the Day Are Concerning for Parents of Children with Attention Deficit Hyperactivity Disorder?

Background/Aim

The questionnaire-children with difficulties (QCD) is a parent-assessed questionnaire designed to evaluate a child’s difficulties in functioning during specific time periods of the day. In this study, the QCD was applied to determine the time periods of the day that are concerning for the parents of children with attention deficit hyperactivity disorder (ADHD). The results were compared with those for a community sample.

Methods

Elementary and junior high school students with ADHD (243 boys, 55 girls) and a community sample of children (518 boys, 618 girls) were enrolled in this study. Their behaviors were assessed by the QCD, the ADHD-rating scale (ADHD-RS), and the Oppositional Defiant Behavior Inventory (ODBI). The effects of gender (boy/girl) and diagnosis (ADHD/community sample) on the total QCD score were analyzed across each school grade (elementary/junior high school). Correlation coefficients between QCD and ADHD-RS/ODBI scores were analyzed.

Results

The QCD score for the ADHD group was significantly lower than that for the community sample (P < 0.001). There were significantly strong correlations between “evening” and ADHD-RS and ODBI scores for all children with ADHD (r > 0.41, P < 0.001) and between “night” and inattention and oppositional symptoms for the girls with ADHD (r > 0.40, P < 0.001).

Conclusions

Parents reported that children with ADHD faced greater difficulties in completing basic daily activities compared with the community controls, particularly in the evening. Furthermore, these difficulties were related to the severity of ADHD symptoms. The parents’ perceptions depended on the gender, ADHD and oppositional symptoms, and the time period of the day. This study determined that children with ADHD face greater difficulties in daily functioning compared with community sample children, that these difficulties are time-dependent, and that these difficulties were particularly experienced in the evening.     

Determinants of nutritional status of pre-school children in India

The aim of this paper is to assess the spatial distribution of nutritional status of children of less than three years through Z-scores of weight-for-age, height-for-age and weight-for-height using data collected by the National Family Health Survey (NFHS-2, 1998-99), India. The nutritional status of pre-school children was regressed on different socio-demographic factors after eliminating the effect of age. The data show that there are gender differences and spatial variations in the nutritional status of children in India. Gender difference is not very pronounced and almost disappears when the effects of age and socio-demographic variables are removed. The spatial difference, especially the rural-urban difference, was found to be very large and decreased substantially when the effects of age and socioeconomic variables were removed. However, the differences were not close to zero. All the variables were found to affect significantly the nutritional status of children. However, the literacy of mothers did not affect height-for-age significantly. The weight-for-age and height-for-age scores showed a dismal picture of the health condition of children in almost all states in India. The worst affected states are Bihar, Madhya Pradesh, Orissa and Uttar Pradesh. Assam and Rajasthans are also lagging behind. Weight-for-height scores do not give a clear picture of state-wise variation. Goa, Kerala and Punjab are the three most developed states in India and also have the lowest percentages of underweight children according to the Z-scores. Along with these three states come the north-eastern states where women are well educated. Thus overall development, enhancement of level of education and low gender inequality are the key factors for improvement in the health status of Indian children.     

Cross-sectional comparisons of BMI and waist circumference in British children: mixed public health messages

Research suggests that there has been a leveling off in obesity prevalence occurring in the child population. However, a concern with the evidence base is that all of the studies have relied upon the use of BMI. The purpose of this study was to compare waist circumference (WC), BMI, and waist-to-height ratio (WHtR) data in three different sample of children (total number: 14,697) typically aged 11-12 years. Obesity prevalence defined by BMI did not change significantly between measurement years (2005 boys 20.6%, girls 18.0%; 2006 boys 19.3%, girls 17.3%; 2007 boys 19.8%, girls 16.4%). Obesity prevalence defined by WC was considerably higher especially, in girls (2005 boys 26.3%, girls 35.6%; 2006 boys 20.3%, girls 28.2%; 2007 boys 22.1%, girls 30.1%). The prevalence of children defined as "at risk" according to WHtR (2005 boys 23.3%, girls 21.1%; 2006 boys 16.7%, girls 15.6%; 2007 boys 17.6%, girls 17.2%) was found to be between obesity prevalence, estimated using BMI and WC. This data are the most up to date collection that includes BMI and WC in three large samples of children and clearly demonstrates inconsistencies between different measurements based on current classification systems. There is a need to understand the relationship between BMI and WC, with growth and health risk to establish a consistent public health message that is easily understood by the public.     

Soil-Transmitted Helminth Infections and Nutritional Status in School-age Children from Rural Communities in Honduras

Background

Soil-transmitted helminth (STH) infections are endemic in Honduras and efforts are underway to decrease their transmission. However, current evidence is lacking in regards to their prevalence, intensity and their impact on children''s health.

Objectives

To evaluate the prevalence and intensity of STH infections and their association with nutritional status in a sample of Honduran children.

Methodology

A cross-sectional study was done among school-age children residing in rural communities in Honduras, in 2011. Demographic data was obtained, hemoglobin and protein concentrations were determined in blood samples and STH infections investigated in single-stool samples by Kato-Katz. Anthropometric measurements were taken to calculate height-for-age (HAZ), BMI-for-age (BAZ) and weight-for-age (WAZ) to determine stunting, thinness and underweight, respectively.

Results

Among 320 children studied (48% girls, aged 7–14 years, mean 9.76±1.4) an overall STH prevalence of 72.5% was found. Children >10 years of age were generally more infected than 7–10 year-olds (p = 0.015). Prevalence was 30%, 67% and 16% for Ascaris, Trichuris and hookworms, respectively. Moderate-to-heavy infections as well as polyparasitism were common among the infected children (36% and 44%, respectively). Polyparasitism was four times more likely to occur in children attending schools with absent or annual deworming schedules than in pupils attending schools deworming twice a year (p<0.001). Stunting was observed in 5.6% of children and it was associated with increasing age. Also, 2.2% of studied children were thin, 1.3% underweight and 2.2% had anemia. Moderate-to-heavy infections and polyparasitism were significantly associated with decreased values in WAZ and marginally associated with decreased values in HAZ.

Conclusions

STH infections remain a public health concern in Honduras and despite current efforts were highly prevalent in the studied community. The role of multiparasite STH infections in undermining children''s nutritional status warrants more research.     

Growth and development of adolescent girls from the Segou Region of Mali (West Africa)

In Mali, adolescent girls face many physical stresses which, with a history of poor nutrition, can result in delayed growth and development. Despite the fact that adolescent girls encounter nutritional demands, most research in Mali has focused only on young children. This study examines anthropometric and reproductive data on 1,056 adolescent girls (aged 10-17 years) from the Segou Region of Mali. When compared to the reference population, the Malian girls exhibited poorer indicators of growth and development. Z-scores for height-for-age and weight-for-age were below 0 at all ages. Urban girls had better indicators of growth than rural girls. The body composition data show that the Malian girls have lower body fat than reference girls. Menarche was delayed by about 1.5 years compared to girls from the United States and Europe. Delayed growth and development may be due to many factors, including a history of undernutrition, poor socioeconomic status, and increased energy demands.     

Associations of Maternal Prenatal Smoking with Child Adiposity and Blood Pressure

Objective: To examine the extent to which maternal prenatal smoking is associated with adiposity, central adiposity, and blood pressure in 3‐year‐old children. Research Methods and Procedures: We studied 746 mother‐child pairs in Project Viva, a prospective cohort study, and categorized mothers as never, early pregnancy, or former smokers. Main outcome measures were overweight (BMI for age and sex > 85th percentile), BMI z‐score, sum of subscapular (SS) and triceps (TR) skinfolds, SS:TR skinfold ratio, and systolic blood pressure (SBP). Results: One hundred sixty‐one (22%) mothers quit smoking before pregnancy, 71 (10%) smoked in early pregnancy, and 514 (69%) never smoked. At age 3 years, 204 (27%) children were overweight. On multivariable analysis, compared with children of never smokers, children of early pregnancy smokers had an elevated risk for overweight [odds ratio (OR), 2.2; 95% confidence interval (CI), 1.2, 3.9] and higher BMI z‐score (0.30 units; 95% CI, 0.05, 0.55), SS + TR (2.0 mm; 95% CI, 0.9, 3.0), and SBP (2.4 mm Hg; 95% CI, ?0.1, 4.9). Children of former smokers were not more overweight (BMI z‐score, 0.02 units; 95% CI, ?0.15, 0.19) but had higher SBP (1.5 mm Hg; 95% CI, ?0.1, 3.2). We saw no relationship of smoking with central adiposity (SS:TR). Discussion: Former and early pregnancy smokers had children with somewhat higher SBP, but only early pregnancy smokers had children who were more overweight. Mechanisms linking smoking with child adiposity and blood pressure may differ. A long‐term impact of maternal smoking on offspring cardiovascular risk provides further reason to reduce smoking in women.     

An analysis of childhood malnutrition in Kerala and Goa

Improved child health and survival are considered universal humanitarian goals. In this respect, understanding the nutritional status of children has far-reaching implications for the better development of future generations. The present study assessed, first, the nutritional status of children below 5 years using the three anthropometric measures weight-for-age, height-for-age and weight-for-height in two states of India, Kerala and Goa. Secondly, it examined the confounding factors that influence the nutritional status of children in these states. The NFHS-I data for Kerala and Goa were used. The results showed that the relative prevalence of underweight and wasting was high in Kerala, but the prevalence of stunting was medium. In Goa, on the other hand, the relative prevalence of wasting and underweight was very high, and that of stunting was high. Both socioeconomic and family planning variables were significantly associated with malnutrition in these states, but at varied levels. The study recommends more area-specific policies for the development of nutritional intervention programmes.