Search

Objective: We describe differences in linear growth as measured by height-for-age z-score (HAZ) between children from Bengali and tribal populations in the Chittagong Hill Tracts of Bangladesh and examine factors associated with HAZ in both groups., Design: We used nutritional surveillance data collected in Bangladesh from 2003 to 2006 to analyze HAZ among 12,006 children aged 6-23 months and conducted multivariate linear regression and Blinder-Oaxaca decomposition to quantify the relative contribution of independent variables to differences in HAZ between Bengali and tribal children., Results: Mean HAZ was stable for Bengali children (-1.88 in 2003 to -1.90 in 2006) but improved for tribal children (-1.87 in 2003 to -1.68 in 2006). The difference between groups was significant across the study period (p = 0.008). Among Bengali children, HAZ was positively associated with father's schooling (β = 0.221; 95% CI: 0.079-0.363). Among tribal children, HAZ was positively associated with consumption of animal source foods (β = 0.073; 95% CI: 0.051-0.096) and goat ownership (β = 0.240; 95% CI: 0.025-0.454). Results of a likelihood ratio test indicated that distance to a health center was inversely associated with HAZ among tribal children (p < 0.001). Blinder-Oaxaca decomposition demonstrated a difference in pooled coefficients between groups (p = 0.004), explained primarily by differences in coefficients for paternal education (p = 0.001) and village-level prevalence of open defecation (p = 0.004)., Conclusions: Different responses among Bengali and tribal children to village-level open defecation are an explanatory factor for the difference in HAZ between Bengali and tribal populations. Open defecation may also act a proxy for unmeasured factors such as household environmental conditions and food hygiene., Abbreviations: Chittagong Hill Tracts (CHT); height-for-age z-scores (HAZ); Nutrition Surveillance Project (NSP); World Health Organization (WHO).

In Pakistan, 96% of the children under the age of two years do not receive an adequate diet. The main aim of this paper is to identify the sociodemographic, nutritional, and health-related factors associated with stunting, wasting, and underweight in children under the age of two years in Pakistan. Secondary data analysis was performed based on the Pakistan Demographic and Health Survey, 2012⁻2013. The analysis was limited to children under the age of two years ( n = 984). Analysis was done using bivariate and multivariable binary logistic regression. The incidence of stunting, wasting, and underweight in children was 28.3%, 12.1%, and 27.9%, respectively. The odds of stunting, wasting, and underweight increased with the child's age. The odds of stunting and underweight increased with the mother's low body mass index, low access to information, high birth order of child, consanguineous marriages, father's low education, rural settlement, poor toilet facilities, and low vitamin A consumption. The odds of wasting increased in children who were not being breastfed, but no significant relation was seen with stunting and underweight. There is a need to improve child nutritional status in Pakistan by addressing issues such as poverty, low parental education, low micronutrient intake, and targeting provinces where undernutrition was found to be higher.

The burden of malnutrition in Indigenous people is a major health priority and this study's aims are to understand health outcomes among Indigenous and non-Indigenous patients. This cohort study includes 608 medical inpatients in three regional hospitals. Participants were screened for malnutrition using the Subjective Global Assessment tool. Hospital length of stay, discharge destination, 30-day and six-month hospital readmission and survival were measured. Although no significant difference was observed between Indigenous participants who were malnourished or nourished ( p = 0.120), malnourished Indigenous participants were more likely to be readmitted back into hospital within 30 days (Relative Risk ( RR ) 1.53, 95% CI 1.19⁻1.97, p = 0.002) and six months ( RR 1.40, 95% Confidence Interval (CI) 1.05⁻1.88, p = 0.018), and less likely to be alive at six months ( RR 1.63, 95% CI 1.20⁻2.21, p = 0.015) than non-Indigenous participants. Malnutrition was associated with higher mortality (Hazards Ratio ( HR ) 3.32, 95% CI 1.87⁻5.89, p < 0.001) for all participants, and independent predictors for six-month mortality included being malnourished ( HR 2.10, 95% CI 1.16⁻3.79, p = 0.014), advanced age ( HR 1.04, 95% CI 1.02⁻1.06, p = 0.001), increased acute disease severity (Acute Physiology and Chronic Health Evaluation score, HR 1.03, 95% CI 1.01⁻1.05, p = 0.002) and higher chronic disease index (Charlson Comorbidity Index, HR 1.36, 95% CI 1.16⁻3.79, p = 0.014). Malnutrition in regional Australia is associated with increased healthcare utilization and decreased survival. New approaches to malnutrition-risk screening, increased dietetic resourcing and nutrition programs to proactively identify and address malnutrition in this context are urgently required.

The Ghanaian population suffers from a double burden of malnutrition. Cost of food is considered a barrier to achieving a health-promoting diet. Food prices were collected in major cities and in rural areas in southern Ghana. Linear programming (LP) was used to calculate nutritionally optimized diets (food baskets (FBs)) for a low-income Ghanaian family of four that fulfilled energy and nutrient recommendations in both rural and urban settings. Calculations included implementing cultural acceptability for families living in extreme and moderate poverty (food budget under USD 1.9 and 3.1 per day respectively). Energy-appropriate FBs minimized for cost, following Food Balance Sheets (FBS), lacked key micronutrients such as iodine, vitamin B12 and iron for the mothers. Nutritionally adequate FBs were achieved in all settings when optimizing for a diet cheaper than USD 3.1. However, when delimiting cost to USD 1.9 in rural areas, wild foods had to be included in order to meet nutritional adequacy. Optimization suggested to reduce roots, tubers and fruits and to increase cereals, vegetables and oil-bearing crops compared with FBS. LP is a useful tool to design culturally acceptable diets at minimum cost for low-income Ghanaian families to help advise national authorities how to overcome the double burden of malnutrition., Competing Interests: The authors declare no conflict of interest.

Objectives: We compared the IQ and academic achievement of the young adult offspring of parents malnourished in infancy and those of a healthy control group in order to test the hypothesis that the offspring of previously malnourished individuals would show IQ and academic deficits that could be related to reduced parental socioeconomic status., Methods: We conducted a group comparison study based on a community sample in Barbados (Barbados Nutrition Study). Participants were adult children ≥16 years of age whose parents had been malnourished during the first year of life (n = 64; Mean age 19.3 years; 42% male) or whose parents were healthy community controls (n = 50; Mean age 19.7 years; 48% male). The primary outcome was estimated IQ (Wechsler Abbreviated Scale of Intelligence); a secondary outcome was academic achievement (Wide Range Achievement Test - Third Edition). Data were analyzed using PROC MIXED with and without adjusting for parental socioeconomic status (Hollingshead Index of Social Position)., Results: IQ was reduced in the offspring of previously malnourished parents relative to the offspring of controls (9.8 point deficit; P < 0.01), but this difference was not explained by parental socioeconomic status or parental IQ. The magnitude of the group difference was smaller for basic academic skills and did not meet criteria for statistical significance., Discussion: The deleterious impact of infant malnutrition on cognitive function may be transmitted to the next generation; however, this intergenerational effect does not appear to be explained by the reduced socioeconomic status or IQ of the parent generation.

Proactive nutrition screening is an effective public health strategy for identifying and targeting individuals who could benefit from making dietary improvements for primary and secondary prevention of disease. The Dietary Screening Tool (DST) was developed and validated to assess nutritional risk among rural older adults. The purpose of this study was to evaluate the utility and validity of the DST to identify nutritional risk in middle-aged adults. This cross-sectional study in middle-aged adults (45-64 year olds, n = 87) who reside in Appalachia, examined nutritional status using an online health survey, biochemical measures, anthropometry, and three representative 24-h dietary recalls. The Healthy Eating Index (HEI) was calculated to describe overall diet quality. Adults identified by the DST with a nutrition risk had lower HEI scores (50 vs. 64, p < 0.001) and were much more likely to also be considered at dietary risk by the HEI (OR 11.6; 3.2-42.6) when compared to those not at risk. Those at risk had higher energy-adjusted total fat, saturated fat, and added sugar intakes and lower intakes of dietary fiber, and several micronutrients than those classified as not at risk by the DST. Similarly, the at-risk group had significantly lower serum levels of α-carotene, β-carotene, cryptoxanthin, lutein, and zeaxanthin but did not differ in retinol or methylmalonic acid compared with those not at risk. The DST is a valid tool to identify middle-aged adults with nutritional risk., Competing Interests: The authors declare no conflict of interest.

Early childhood development plays a key role in a child's future health, educational success, and economic status. However, suboptimal early development remains a global challenge. This study examines the influences of quality of the home learning environment (HOME) and child stunting in the first year of life on child development. We used data collected from a randomized controlled trial of preconceptional micronutrient supplementation in Vietnam (n = 1,458). The Bayley Scales of Infant Development-III were used to assess cognition, language, and motor development domains at 2 years. At 1 year, 14% of children were stunted, and 15%, 58%, and 28% of children lived in poor, medium, and high HOME environments, respectively. In multivariate generalized linear regression models, living in a high HOME environment was significantly associated with higher scores (0.10 to 0.13 SD) in each of the developmental domains. Stunted children scored significantly lower for cognitive, language, and motor development (-0.11 to -0.18), compared to nonstunted children. The negative associations between stunting on development were modified by HOME; the associations were strong among children living in homes with a poor learning environment whereas they were nonsignificant for those living in high-quality learning environments. In conclusion, child stunting the first year of life was negatively associated with child development at 2 years among children in Vietnam, but a high-quality HOME appeared to attenuate these associations. Early interventions aimed at improving early child growth as well as providing a stimulating home environment are critical to ensure optimal child development., (© 2017 John Wiley & Sons Ltd.)

Socioeconomic status (SES) is associated with childhood anthropometry, but little is known about how it is associated with tissue growth and body composition. To investigate this, we looked at components of SES at birth with growth in early and mid-childhood, and body composition in a longitudinal study in Nepal. The exposure variables (material assets, land ownership, and maternal education) were quantified from questionnaire data before birth. Anthropometry data at birth, 2.5 and 8.5 years, were normalized using WHO reference ranges and conditional growth calculated. Associations with child growth and body composition were explored using multiple regression analysis. Complete anthropometry data were available for 793 children. There was a positive association between SES and height-for-age and weight-for-age, and a reduction in odds of stunting and underweight for each increase in rank of SES variable. Associations tended to be significant when moving from the lower to the upper asset score, from none to secondary education, and no land to >30 dhur (~500 m 2 ). The strongest associations were for maternal secondary education, showing an increase of 0.6-0.7 z scores in height-for-age and weight-for-age at 2.5 and 8.5 years and 0.3 kg/m 2 in fat and lean mass compared to no education. There was a positive association with conditional growth in the highest asset score group and secondary maternal education, and generally no association with land ownership. Our results show that SES at birth is important for the growth of children, with a greater association with fat mass. The greatest influence was maternal secondary education., (© 2017 The Authors Maternal & Child Nutrition Published by John Wiley & Sons Ltd.)

Background: There is very limited data on malnutrition of preschool children in Kosovo. The main objective of the study is to provide a nutritional status profile of preschool children attending kindergartens in Kosovo., Methods: Cross-sectional study of children aged 12-59 months (n = 352 children) and children aged 60-83 months (n = 134) enrolled in public and private kindergartens of Kosovo. Anthropometric measurements used for this study are weight and height of the preschoolers (12-83 months). A measuring board was used for measuring the length/height of children younger than 2 years, while digital weight and height scale Seca 763 was used for measuring of preschool children taller than 110 and Seca 213 was used for measuring the height for children who were shorter than 110 cm. Statistical analyses of underweight and overweight trends across sex and age groups as well as between children from public and private kindergartens were carried out. Qualitative variables were tested with a chi-square test. The differences between groups were assessed with a Student t test for normally distributed variables and a Mann-Whitney test for abnormally distributed numerical variables., Results: The mean z-scores for weight-for-age, height-for-age, weight-for-height, and BMI-for-age largely fell within 0.0 and 1.0. The percentage of stunted children is 3%, whereas child wasting is 1.9%. The overall percentage of obese children is 2.3%; furthermore, 8.9% are overweight and 27.3% have a possible risk of being overweight., Conclusions: The incidence of children underweight is slightly decreasing. The prevalence of overweight and obese children in sample chosen is evident.

Background: This survey was focusing on health and oral hygiene status of primary school children at Lasbela district considering the comparatively less developed and socio demographically deprived part of the Country., Methods: A cross sectional survey was conducted to determine the health status of primary school children in seven tehseels of district Lasbela, Balochistan after applying proportionate sampling technique from March 2015 to July 2015. Field teams visited assigned schools to screen children and collect health related data on predesigned and pre coded proforma., Results: Out of 200 schools, 196 schools found opened, while 2% of schools (04) remained closed. A total of 6363 students were clinically screened. About 45% of the school children had normal body mass index (BMI) and rest were falling in different categories of malnutrition. More than 19% had ear, nose and throat (ENT) problems and around 19% presented with clinical anemia. Less than 50% of children had scar of BCG vaccination and 4% informed about use of gutka/supari chewing (smokeless tobacco use)., Conclusion: In conclusion, we estimated high prevalence of malnutrition, poor oral health including smokeless tobacco use, and low BCG coverage among primary school children at Lasbela. Current scenario suggests immediate and contextually focused interventions to confine existing public health risks and avoid future burden of disease.

Background: Malnutrition is common among patients with cancer, but little attention is given to its risks and consequences., Objectives: The aim of this study is to assess the nutritional status and identify the factors associated with malnutrition among newly diagnosed patients with cancer., Methods: Patients admitted with newly diagnosed cancer at a teaching hospital in Malaysia were recruited from January to April 2015. Nutritional status was assessed before treatment initiation, and patients were classified into three categories., Findings: A total of 132 pretreatment patients were recruited into the study. About half were severely malnourished. Patients with stage III cancer had the highest prevalence of severe malnourishment. Clinical parameters and disease characteristics were significantly associated with nutritional status. Demographic variables were also statistically significantly associated with severe nutritional status.

Child malnutrition is considered to be the key risk factor for illness during adolescence and is responsible for about one-third of child deaths globally. Historically tribal communities have lagged behind the general population in terms of most socioeconomic aspects, and one such aspect is the nutritional status of children. The present study analyzes regional variations in child malnutrition and its association with women's empowerment in the tribal communities of India. The investigation is based on secondary data compiled from India's third National Family Health Survey (NFHS). Both bivariate and multivariate techniques were used to analyze data. We found a conditional inverse association between child malnutrition and women's empowerment in tribal communities. It is conditional in the sense that women's empowerment is effective when other factors supposed to influence nutritional status are proactive. Policy prescriptions are discussed.

This cross-sectional study was conducted to determine household food security status and sociodemographic factors influencing it and to examine whether food insecurity of household is a risk factor for underweight, stunting, and thinness in primary school children of Sistan and Baluchestan Province in southeastern Iran. A sample of 610 students aged 7-11 years was selected by a multistage cluster random sampling method during December 2013-May 2014. Using U.S. Department of Agriculture Food Security questionnaire, 42.3% of households showed some degree of food insecurity. Food insecurity was positively associated with household size (p = .002) and number of children per household (p = .001) and negatively associated with mother's and father's education level (p = .005 and p = .042, respectively), father's occupation status, and household income (p < .0001). Children living in food insecure with severe hunger households were 10.13, 10.07, and 4.54 times as likely to be underweight, stunted, and thin, respectively, as counterparts from food secure households. The findings showed food insecurity was prevalent and associated with sociodemographic factors among households with schoolchildren in southeastern Iran. Nutritional status of children was also associated with food security status of their households.

Background: In Mexico, despite that the fact that several social programs have been implemented, chronic undernutrition is still a public health problem affecting 1.5 million children of <5 years. Chiapas ranks first in underweight and stunting at national level with a stunting prevalence of 31.4 % whereas for its rural population is 44.2 %. The purpose of this paper is to determine if the nutritional status of a cohort of children living in poor rural communities under Oportunidades has changed. We were interested in assessing the nutrition evolution of the children who were initially diagnosed as stunted and of those who were diagnosed as normal. Oportunidades is an anti-poverty program of the Mexican government consisting mainly in monetary transfers to the families living in alimentary poverty., Methods: A 9-year cohort prospective study was conducted with nutritional evaluations of 222 children. Anthropometric indices were constructed from measurements of weight, height, and age of the children whose nutritional status was classified following WHO standards., Results: The results showed that although these children were Oportunidades beneficiaries for 9 years and their families improved their living conditions, children still had a high prevalence of stunting (40.1 %) and 69.6 % had not recovered yet. Children who were initially diagnosed with normal nutritional status and became stunted 2 years later had a higher risk (relative risk (RR) 5.69, 2.95-10.96) of continuing stunted at school age and adolescence., Conclusions: Oportunidades has not impacted, as expected, the nutritional status of the study population. These findings pose the question: Why has not the nutritional status of children improved, although the living conditions of their families have significantly improved? This might be the result of an adaptation process achieved through a decrease of growth velocity. It is important to make efforts to watch the growth of the children during their first 3 years of age, to focus on improving the diet of women at fertile age and pay special attention to environmental conditions to break the vicious cycle of malnutrition.

Objective: To examine the association between nutritional markers at initiation and during follow up in two different cohorts of HIV-infected adults initiating highly active antiretroviral therapy (HAART) in West Africa., Methods: The ATARAO study was a one year prospective study carried in Mali. It consisted of a sample of consecutive patients initiating HAART in one of four participating centers during that period. Data were collected at time of treatment initiation (baseline) and every 3 months thereafter. The ANRS 1290 study followed Senegalese patients recruited in similar conditions. Bivariate analyses were used to identify nutritional and immunological covariates of malnutrition at baseline. Longitudinal trajectories of body mass index, hemoglobin and albumin, and their associated factors, were evaluated using mixed linear models., Results: In ATARAO, 250 participants were retained for analyses; of which, 36% had a BMI < 18.5 kg/m(2), nearly 60% were anemic and 47.4% hypoalbuminemic at time of treatment initiation. At baseline, low hemoglobin, hypoalbuminemia and low CD4 levels were associated with a BMI < 18.5 kg/m(2). Similarly, low BMI, low albumin and low CD4 counts were linked to anemia; while, hypoalbuminemia was associated with low hemoglobin levels and CD4 counts. In ANRS, out of the 372 participants retained for analyses, 31% had a low BMI and almost 70% were anemic. At baseline, low BMI was associated with low hemoglobin levels and CD4 counts, while anemia was associated with low CD4 counts and female sex. While treatment contributed to early gains in BMI, hemoglobin and albumin in the first 6 months of treatment, initial improvements plateaued or subsided thereafter. Despite HAART, malnutrition persisted in both cohorts after one year, especially in those who were anemic, hypoalbuminemic or had a low BMI at baseline., Conclusion: In ATARAO and ANRS, malnutrition was common across all indicators (BMI, hemoglobin, albumin) and persisted despite treatment. Low BMI, anemia and hypoalbuminemia were associated with attrition, and with a deficient nutritional and immunological status at baseline, as well as during treatment. In spite of therapy, malnutrition is associated with negative clinical and treatment outcomes which suggests that HAART may not be sufficient to address co-existing nutritional deficiencies.

Background and Objectives: Adequate nutrient intakes among women of reproductive age (WRA) are important determinants of maternal, neonatal and child health outcomes. However, data on dietary intake for WRA in Vietnam are lacking. This paper aimed to examine the adequacy and determinants of energy and macronutrient intakes among WRA enrolled in a study of preconceptual micronutrient supplementation (PRECONCEPT) being conducted in 20 rural communes in Thai Nguyen province, Vietnam., Methods: Dietary intakes were determined for 4983 WRA who participated in the baseline survey using a previously validated 107-item (semi-quantitative) food-frequency questionnaire that was administered by trained field workers. Multivariate linear and logistic regression analyses were used to examine factors associated with energy and macronutrient intakes., Results: A disproportionate number of energy came from starches, primarily rice. Carbohydrate, fat and protein constituted 65.6%, 19.5% and 14.8% of total energy, respectively. Fat intake was below recommended levels in 56.5% of respondents, but carbohydrate intakes were above recommended level in 54.6%. Only 0.1% and 5.2% of WRA achieved adequate intake of n-3 and n-6 long-chain polyunsaturated fatty acids, respectively. Multivariate linear regression revealed that low education, low socioeconomic status, and food insecurity were significant predictors of reduced total energy intake, reduced energy from protein and fat, and greater energy from carbohydrates. Logistic regression confirmed that inadequate macronutrient intake was more common among the poor, food insecure, and less educated., Conclusions: Imbalanced dietary intakes among underprivileged women reflect lack of dietary diversity. Nutrition programs should be linked with social development, poverty reduction, education programs and behavior change counseling in order to improve the nutritional status of WRA in Vietnam.

To reduce malnutrition and improve child survival, school feeding programmes have been established in many parts of Africa, although prevalence of child malnutrition and anaemia remains high, especially in urban slums. The objective of this study is to evaluate the effect of a school feeding programme in the slums of Nairobi (Kenya) on anaemia and nutritional status, together with an investigation for socioeconomic determinants that may overrule this effect. Sixty-seven children at the St. George primary school in Kibera participated in the school feeding programme for 1 year and data concerning anaemia rate, nutritional status and socioeconomic status were collected during a medical health check. Data were compared with a control group of children attending the same school, of the same age and with the same gender distribution without participation in a feeding programme. Data were analyzed with statistical software (SPSS 17.0). Children participating in the school feeding programme were less stunted (p = 0.02) and wasted (p = 0.02) than children in the control group, and levels of anaemia were lower (p = 0.01). Having no father (p = 0.01) and living in small families (p = 0.003) overruled the effect of the feeding programme. Also, the higher the mother's education, the more wasting was seen (p = 0.04) despite participation in the programme. The programme reduced anaemia and malnutrition and has improved child growth in our study group greatly, but we found that education level of the mother, family size and absence of a father overruled the effect of the school feeding programme. Because sample size of our study is small, we encourage further large-scaled research on reviewing programmatic interventions to develop optimal feeding strategies and improve nutritional status of children.

Background: The problem of micronutrient deficiency in the diet, in Mexico affects over 28 million people, mainly rural indigenous women. A solution is food supplementation. The aim of the study was to evaluate the impact of an enriched corn flour soy protein among indigenous women., Method: The study was conducted with a sample of 308 rural Mexican women, conducted in 2010, longitudinal intervention was double-blind and randomized. The experimental group (n = 155) consumed fortified maize meal (soy protein, iron and vitamin A, folic acid, zinc and niacin). The control group (n = 153) received unfortified flour. The evaluated indicators were: weight, body mass index, and waist circumference and blood hemoglobin levels. The intervention time was four months (intermediate) and six months (final). Statistical analysis was descriptive, bivariate and linear regression models., Results: Changes in hemoglobin levels in the experimental group were 13,1 to 13,3 mg / dL. The improvement of hemoglobine levels was shown by the most marginalized community (from 12,4 to 12,9 mg / dL). In both groups, the weight gain was 900 g. Though BMI of the experimental group (24,2 to 24,9 / kg/m²) with an increase of (0,7 / kg/m²) was equal in both groups, the waist circumference in women who consumed fortified flour was equal at the beginning and end of the study (83,0 cm) but the hip circumference changed (94,3 to 94,9 cm) in women who consumed enriched flour., Conclusions: enriched flour is an ideal food for marginalized women in rural areas who are underweight, are undernourished and have anemia.

Objective: Systemic inflammation, therapy with corticosteroids, and reduced physical activity may increase the predisposition to accumulate body fat in patients with systemic lupus erythematosus (SLE). The aim of this study was to assess the nutritional status and food intake of patients with SLE., Methods: One hundred seventy women with SLE were evaluated consecutively in a cross-sectional study. Nutritional status was assessed by subjective global assessment and body mass index. Food intake was assessed by a 24-h recall and a semiquantitative food frequency questionnaire. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), considering P < 0.05 as significant., Results: The mean ± SD age of the patients was 39.14 ± 9.98 y, and the duration of the disease was 9.94 ± 6.18 y. Approximately 91.8% patients were classified as being well nourished; 6.5% were classified as suspected or moderately malnourished, and 1.8% were classified as severely malnourished. In terms of body mass index, malnutrition was found in 1.2% of the patients, normal weight in 35.9%, overweight in 35.3%, and obesity in 27.7%. Most patients reported food consumption below the estimated needs for energy. Calcium was the nutrient with the most inadequate intake. Low consumption of fruits, vegetables, and dairy products and a high consumption of oils and fats were reported., Conclusion: The results showed that patients with SLE have inadequate nutritional status and food intake., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background & Aims: Malnutrition in the elderly is a multifactorial problem, more prevalent in hospitals and care homes. The absence of a gold standard in evaluating nutritional risk led us to evaluate the efficacy of six nutritional screening tools used in the elderly., Methods: Two hundred forty eight elderly patients (129 men, 119 female women, aged 75.2 ± 8.5 years) were examined. Nutritional screening was performed on admission using the following tools: Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), Subjective Global Assessment (SGA), Mini Nutritional Assessment - Screening Form (MNA-SF), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated., Results: Nutritional risk and/or malnutrition varied greatly, ranging from 47.2 to 97.6%, depending on the nutritional screening tool used. MUST was the most valid screening tool (validity coefficient = 0.766, CI 95%: 0.690-0.841), while SGA was in better agreement with the combined index (κ = 0.707, p = 0.000). NRS 2002 although was the highest in sensitivity (99.4%), it was the lowest in specificity (6.1%) and positive predictive value (68.2%)., Conclusions: MUST seem to be the most valid in the evaluation of the risk for malnutrition in the elderly upon admission to the hospital. NRS 2002 was found to overestimate nutritional risk in the elderly., (Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

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 (χ(2)=3.59) and stunting (χ(2)=4.20) among boys. Among girls, PCI had significant associations with underweight (χ(2)=11.15) and stunting (χ(2)=11.64). FOS also showed significant associations with underweight (χ(2)=8.10) as well as stunting (χ(2)=8.28) among girls. NLR showed a significant association with underweight (χ(2)=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., (Copyright © 2012 Elsevier GmbH. All rights reserved.)

Objectives: The aim of this study was to evaluate the nutritional status and body composition in Mbyá-Guaraní adolescents and adults from three communities in the Province of Misiones, in northern Argentina., Methods: Anthropometric parameters were analyzed in 45 individuals (aged 14-60). Data were transformed to z-scores using NHANES I and II., Results: Ninety-three percent of the sample showed some kind of malnutrition (undernutrition and/or excess of weight). Stunting and overweight reached the highest prevalences (85.0 and 10.0%, respectively). The most Mbyá people were found to have low arm muscle and fat areas. They also tended to have shorter than normal lower limbs. Centralized obesity was evident in both sexes and in all the age intervals., Conclusions: Extreme poverty, together with changes in life habits and diet composition, resulted in decrease of body size and changes in body proportions and composition. Although these changes could be considered as an adaptive response to the chronic exposure of these populations to adverse environmental conditions, they would favor the co-occurrence of malnutrition and overweight in a single scenario, and consequently increase the risk of infectious and nontransmissible diseases., (Copyright © 2011 Wiley-Liss, Inc.)

Background: Preschool children call for focused attention in India because India has the highest percentage of undernourished children in the world., Objective: To compare the growth and nutritional status of Indian preschool children for the periods 1998/99 and 2005/06,, Subjects and Methods: Using data on weight and length/height as well as the sociodemographic background of preschool children from the National Family Health Surveys (NFHS) from 1998/99 and 2005/06, we determined the distribution of weight and length/height and their association with sociodemographic variables., Results: The distributions of weight and length/height around the mean remained remarkably stable over age but were much greater in India than the international norms. The rates of growth of mean weight and length/ height were far lower in India than the international norms up to the age of 2 years. The temporal trend indicates declines in the percentages of undernourished (low weight-for-age) and stunted (low height-for-age) children over the 7-year period, although the degree of improvement was far better for stunting than for underweight. Mother's educational status is the only variable that has been found to influence child nutrition., Conclusion: The level of mothers' education needs urgent attention with top priority to reduce the prevalence of underweight and stunting of children. This also implies that, for future benefit, girls should be given more facilities for better education. Breastfeeding and weaning practices also need special attention.

Objective: Nutritional status is assessed by measuring BMI or percent body fat (%fat). BMI can misclassify persons who carry more weight as fat-free mass and %fat can be misleading in cases of malnutrition or in disease states characterized by wasting of lean tissue. The fat-free mass index (FFMI) is proposed to assess body composition in individuals who have a similar body composition but differ in height allowing identification of those suffering from malnutrition, wasting or those that possess a relatively high muscle mass. The purpose was to determine whether the FFMI differs in a group of racially/ethnically diverse adults., Design: Cross-sectional., Subjects: Subjects were a multi-ethnic sample (Caucasian, CA; African American, AA; Hispanic, HIS and Asian, AS) of 1339 healthy males (n = 480) and females (n = 859) ranging in age from 18-110 years. Total body fat, total fat-free mass and bone mineral density were estimated using dual energy X-ray absorptiometry., Results: FFMI differed among the four ethnic groups (P ≤ 0.05) for both genders. A curvilinear relationship was found between age and FFMI for both genders although the coefficients in the quadratic model differed between genders (P ≤ 0.001) indicating the rate of change in FFMI differed between genders. The estimated turning point where FFMI started to decline was in the mid 20s for male and mid 40s for female participants. An age × gender interaction was found such that the rate of decline was greater in male than female participants (P ≤ 0.001). For both genders, FFMI was greatest in AA and the least in AS (P ≤ 0.001). There was no significant interaction between race and age or age(2) (P = 0.06). However, male participants consistently had a greater FFMI than female participants (P ≤ 0.001)., Conclusions: These findings have clinical implications for identifying individuals who may not be recognized as being malnourished based on their BMI or %fat but whose fat-free mass corrected for height is relatively low.

Objectives: To determine the cut off score of the CNS in predicting 12 months mortality., Design: Data was collected and followed up from a previous study among elderly subjects (n = 515) living in community institutional setting. The risk of malnutrition and 12 months mortality was ranked by the CNS and compared with that by SGA. Reliability was assessed by the sensitivity and specificity of the prediction with SGA as well as BMI alone. Sensitivity and specificity was calculated to determine validity as well as using positive and negative predictive values in predicting mortality at 12 months., Results: All three tools (BMI, SGA, CNS) demonstrated significant difference of higher mortality rate (P < .001) in the malnourished group. CNS at score < or = 21 showed comparable results to SGA tool and BMI at classifying malnutrition. And using cut off score > or = 22 also show significant results with SGA in classifying patients with normal nutrition. CNS score at > or = 22 sensitivity was 60.9% and specificity was 72.9% with a Negative Predictive value of 92.3% and a Positive Predictive value of 25.8%., Conclusion: CNS tool at cut off > or = 22 is just as good as using BMI or SGA in identifying those who have a normal nutritional status. This is useful in particular, when biochemical or anthropometric data is not available. This further validates the use of > or = 22 as the best cut off point with the CNS tool and just as good at predicting of mortality when compared with SGA and BMI assessments.

This paper reports on the presence of dual burden households in Orang Asli (OA, indigenous people) communities and its associated factors. A total of 182 OA households in two districts in Selangor with the required criteria (182 non-pregnant women of child bearing age and 284 children aged 2-9 years old) participated in the study. Height and weight of both women and children were measured. Energy intake and food variety score (FVS) were determined using three 24-hour diet recalls. While 58% were underweight and 64% of the children were stunted, the prevalence of overweight and obesity in women were 31% and 20% respectively. The percentage of dual burden households (overweight mother/underweight child) was 25.8% while 14.8% households had normal weight mother/normal weight child. The mean food variety score (FVS) was similar for women (7.0+/-2.1) and children (6.9+/-1.9). Dual burden households were associated with women's employment status (OR: 3.18, 95% CI: 2.65-5.66), FVS of children (OR: 0.71, 95% CI: 0.51-0.95) and FVS of women (OR: 1.39, 95% CI: 1.02- 1.89). The FVS of children (OR: 0.49, 95% CI: 0.25-0.89) and women (OR: 1.92, 95% CI: 1.64-2.77) remained significant even when dual burden households were compared to only households with normal weight mother/normal weight child. In these OA communities, food variety may predict a healthier diet in children, but may increase the risk of overweight and obesity in adults. Efforts to address households with dual burden malnutrition should consider promotion of healthy diets and lifestyle for all members.

Incomplete chronic substrat-energetic unsufficiency, connected with protein-fat difficiency of daily rations is revealed 13-17 year old in habitants of Khabarovs region (both natives and non-natives). The unsufficiency is majority revealed in native teenagers is combination with a feebly revealed adaptive reactions on bower levels of integral index of organisms functional response.

National level data show food insecurity/insufficiency is more common in Latino families than the dominant population, however local ethnic rates aren't often available, nor have there been many studies of food insufficiency/insecurity among Latino ethnic groups. This study presents food insufficiency data from three low income immigrant Latino Chicago communities. Data were collected as part of a larger study of ethnic Latino differences in health and nutrition attitudes/behaviors and child health services use. Face to face interviews were conducted with 320 mothers of Latino children entering school for the first time (mean age 5.5 years). Food insufficiency questions from the Radimer/Cornell and NHANES III instruments were used. Participants were 70% Mexican, 22% Puerto Rican and 8% other Latino, reflecting Chicago Latino distribution. Thirty percent (n = 96) reported household food insufficiency, although most was worry about obtaining food, and was due to lack of money or Food Stamps. Some families experienced more severe food access problems, namely adults and children skipping meals, and adults or children going without food for an entire day. Puerto Rican families reported more severe food insufficiency than Mexican families, but there were few other ethnic differences. Only 30% of these low income food insufficient families were Food Stamp participants although 90% of the children received school meals. These data point to the need for better screening and program outreach for low income, immigrant Latino families.