Undernutrition

Background: Malnutrition especially undernutrition is a major health problem affecting the development of the children in many developing countries of the world. It continues to be the principal cause of ill-health and premature mortality and morbidity among children. Objectives: To assess the nutritional status of 6-14 year old school going children and the association among socioeconomic factors, living conditions and child undernutrition. Methods: The present study was conducted in village Ganota of Doda district, Jammu & Kashmir to assess the nutritional status of 100 school going children (5-14 years). Nutritional status of the children was assessed in terms of anthropometric measurement. Weight for age (WAZ), height for age (HAZ) and body mass for age (BMIZ) of the sample subjects were calculated and compared with WHO-2007 reference standard. Data were entered and analyzed using statistical software epi info 7 and Anthro Plus. Results: Results show that out of the total children screened (N=100), 36.00 percent were found stunted, 9.00 percent underweight and 2.00 percent were observed as wasted. It was further observed that female children were at higher risk of undernutrition in terms of stunting (42.86 percent of the female children), whereas underweight (11.39 percent and wasting (2.53 percent) were prevalent only in male children. Besides poverty, there are other socioeconomic factors – (mother's education, birth order in the family, joint family system, social and economic categories) and living conditions – (nature of sanitation, cooking area and fuel used) that directly or indirectly affect the nutritional status of the school-going children. Conclusion: There is a great need to focus the attention of the leaders and policy-makers for intervening in such areas, as nutritional status of children is a main indicator of development and a precondition for the society to progress.

Este documento presenta un analisis del hambre estacional en Guatemala, que se manifiesta por una variacion regular y marcadamente estacional de la desnutricion aguda infantil, alcanzando picos todos los anhos entre los meses de mayo y septiembre. Se analizan nueve factores que inciden sobre el hambre estacional, indicando las causas de su variacion y su incidencia sobre el estado nutricional de los menores de cinco anhos. Se realizan calendarios especificos de cada zona biogeografica de Guatemala y se propone un Plan de Accion para combatir el Hambre Estacional. Adicionalmente, se presenta por primera vez una propuesta para dar seguimiento a la desnutricion aguda estacional a traves de la metodologia de Corredores Endemicos de Desnutricion Aguda.

A cross-sectional study investigated age and sex variations in chronic energy deficiency (CED) among 114 individuals (2-80 years) of Gond population of Binouri village, Bilaspur, Chhattisgarh. The sample was selected randomly to study CED grades using anthropometric indicators. Nutritional status was evaluated in four groups of different age categories- pre-schoolers: 2-5 years (n=17), children: 6-12 years
(n=38), adolescents: 13-18 years (n=12) and adults: >18years (n=47) using the age-sex specific cut-off points of body mass index (BMI). Statistical analysis was performed using MS Excel and SPSS software.
The considered socio-demographic variables such as age at marriage, educational and occupational status showed significant difference with respect to sex. Majority of the adult population belongs to the lower socio-economic class with few middle classes among the studied population. No significant age sex specific difference is observed for mean values of anthropometric variables such as height, weight and
BMI. The overall frequency of CED among the studied population is 37.83 % (serious stage) with highest among children (50%). Moreover, occurrence of thinness is found to be higher among girls as compared to
the boys. The prevalence of Grade III thinness is found to be highest among pre-schooler children (18.75%) followed by children with 2.63%. Whereas Grade I undernutrition is highest among children (34.21%) followed by pre-school children (25.0%), adult (17.78%) and adolescent (16.67%). All the age groups considered in the present study are not statistically significant for the degree of malnutrition except for adults (p < 0.05). The result shows that undernutrition is more prevalent among children than their adult counterpart. Similar data from other  communities from state(s) should be collected and analyzed for better understanding and to reduce the prevalence of undernutrition in children and women as a whole.

Este documento tiene como objetivo analizar el Pacto Hambre Cero de Guatemala a la luz de las experiencias latinoamericanas, para asi proponer opciones para mejorar el disenho y la ejecucion del Pacto. Se incluye un análisis institucional, legal y financiero de cuatro programas de lucha contra el hambre en Brasil, Colombia-Antioquia, Nicaragua y Perú, que llevan bastantes anhos de operacion y que han mostrado una reducción significativa de los indicadores de desnutrición crónica y pobreza. Además, el texto presenta un análisis de las fuentes de gasto público en Guatemala y propuestas para mejorar la cantidad y calidad de ese gasto.

AbstrAct: Being a developing nation, rural India is still facing a serious health problem in form of undernutrition particularly among young children. To optimize this problem, the Central Government has been operating a nationwide nutritional intervention programme in the form of Integrated Child Development Service (ICDS) scheme. Unfortunately, it has failed to achieve the desired goal during last four decades. Therefore the present study was designed to measure the seriousness and severity of overall undernutrition using Composite Index of Anthropometric Failure (CIAF) among the rural Bengalee preschool children of Sagar Block, South 24 Parganas, West Bengal, India. This cross-sectional study was conducted among 656 preschool children (326 boys and 330 girls) aged 3 to 5 years. Height (cm) and weight (kg) measurements were taken according to standard procedure, age and sex specific 2 z-scores values of height-forage , weight-for-height and weight-forage were used to assess stunting, wasting and underweight, respectively, as per the World Health Organization Guidelines. CIAF was also computed as per standard methodology to assess the degree of undernutrition among the studied children. The overall age and sex combined prevalence of stunting, wasting, underweight and CIAF was 26.2%, 35.4%, 51.1% and 61.3%, respectively. CIAF showed a higher prevalence of undernutrition (61.28%) in comparison to other three indicators i.e., stunting, wasting and underweight. We conclude that the nutritional status of the subjects was not satisfactory. It was also established that the CIAF is a better indicator of nutritional status than traditional measures of stunting, wasting and underweight, because it determines overall (total) anthropometric failure. Assessment of nutritional status by composite index of anthropometric failure (CIAF): a study among preschool children of Sagar Block, South 24 Parganas District, West Bengal, India

AbstrAct: The prevalence of stunting (low height-forage) is a key indicator of long-term chronic under-nutrition which reflects an anthropometric failure to reach linear growth potentials due to prolonged food deprivation and/or disease or illness during the early stage of life. The present study assesses the prevalence and socioeconomic and demographic correlates of stunting among adolescents of the Northeast India. This cross-sectional study was undertaken among 1,818 (830 boys; 988 girls) adolescents (aged 10–18 years) belonging to ethnically heterogeneous populations of Karbi Anglong district of Assam, using stratified random sampling method. Anthropometric measurements of height and weight were recorded using standard procedures. Socioeconomic and demographic variables were obtained using pre-structured schedule. The age-sex specific L, M and S reference values were used to calculate height-forage Z-score (HAZ). According to WHO, HAZ found to be <−2SD was classified as stunting. The data were analysed using descriptive statistics, t-test, ANOVA, chi-square analyses, binary and step-wise multiple logistic regression analysis in SPSS (version, 17.0). The prevalence of stunting was observed to be significantly higher among boys (48.4%) than girls (37.8%) (p<0.01). Age-sex specific prevalence was found to be higher among boys than girls aged 14–18 years and contrary were observed among girls aged 10–14 years (p>0.05). The binary logistic regression analysis showed that several socioeconomic and demographic variables were significantly associated with stunting (p<0.05). The step-wise multiple logistic regression analysis showed that sex (boys), age groups (13–15 years and 16–18 years), father's occupation (cultivator) and Rupees ≤5000 household income was significantly associated with stunting (p<0.05). Appropriate nutritional intervention programmes and dissemination of knowledge at population level related to under-nutrition are necessary to ameliorate their nutritional status.

Abstract

Background: Undernutrition, particularly Chronic Energy Deficiency (CED), among tribal males is a major health problem in India. In the recent years, prevalence of Hypertension (HT) is increasing among them. Our cross sectional study assessed the nutritional status as well as prevalence of HT and compare the association of different anthropometric and blood pressure (BP) variables with age among Sabar adult males of Purulia District, West Bengal, India.

Research Methods: Measurements of height, weight, hip and waist circumferences, systolic and diastolic blood pressure, and pulse rate of 215 adults aged 18-63 years were taken following standard procedure and calibrated machines. Body Mass Index (BMI), Waist-Hip Ratio (WHR), Waist-to-Height Ratio (WHtR), Conicity Index (CI) and Mean Arterial Pressure (MAP) were calculated. The ANOVA and Chi Square tests and correlation analysis were performed to test for significant differences and association between variables. Statistical significant was set at 0.05.

Results: The coexistence of high prevalence of undernutrition based on BMI (CED = 47.0%) and HT (37.7%) among adult male Sabars was observed.

Conclusion: Paradoxically, there existed a high prevalence of CED and HT among Sabar men. Further research is required to fully understand the mechanism behind this paradox. Apparently, this population seems to suffer from a double burden of high CED and HT. Similar studies should also be undertaken among other tribal populations (both men and women) to determine whether such a paradox exists among them.

Keywords: Sabar; Body Mass Index; Chronic Energy Deficiency; Blood pressure; Hypertension.
Introduction
For the last couple of decades, the evaluation of undernutrition or Chronic Energy Deficiency (CED) has been a major concern for researchers worldwide. Previous studies suggest that CED of women during pregnancy can lead to low birth weight babies as well as result in adverse health implications such as increased risk

Nutritional status is an important index of economic growth and development. The status of nutrition of a given population has positively or negatively influenced nation’s economic growth. Our study was designed to find out the relationship between socio-demographic characteristics and nutritional status among adult Sabars. The present cross-sectional study was conducted at six villages under Ranibandh block of Bankura District, West Bengal. A total 226 adults (males = 111 and females = 115) Sabars, aged above 18 years in these village were included in the study. The mean (SD) values of age, family members, family income per month, and per-capita income were 37.32 (16.62) years, 4.63 (1.85) members, 2725.2 (1424.3) Rupees, 691.58 (545.32) Rupees, respectively. The prevalence of illiteracy was 45.0% and 82.6%, respectively among males and females. There was a statistically significant (Chi-square = 39.67, p < 0.001) difference between two sexes. Among males more than 65.8% were daily wage laborers. Among females collection of products was the main occupation (28.7%). The frequency of use of drinking water from tube well, tap and well were 79.2%, 11.1% and 4.4%, respectively. The mean (SD) height, weight, mid-upper arm circumference (MUAC) and (body mass index (BMI) of the subjects were 159.88 (5.93) cm, 49.6 (7.42) kg, 28.38 (7.83) cm and 19.4 (2.59) kg/m2, respectively, among males. The mean (SD) height, weight, MUAC and BMI among females were 1148.9 (5.04) cm, 40.1 (5.88) kg, 22.9 (2.34) cm and 18.0 (2.30) kg/m2, respectively. All mean values were higher among men. The rates of under nutrition were higher (60.0%) among the illiterate group than the literate group (37.0%) based on BMI. Likewise, based on MUAC, the rates of under nutrition were higher (41.4%) among illiterates compared to literates. The prevalence of under nutrition based on BMI and MUAC was high according to the World Health Organization (WHO) guideline, indicating critical nutritional situation. To reduce the nutritional stress among this ethnic group, immediate appropriate nutritional intervention programes should be initiated. Serious efforts are needed to increase their educational status and per-capita income.
Keywords: Sabar, BMI, MUAC, Educational Status, Nutritional Status

Aim: This study was carried out to determine the prevalence of undernutrition among Bengalee children of Purba Medinipur. Stunting, wasting and underweight were used to assess the prevalence of under-nutrition among children. However, these indices were not properly determined appropriate prevalence due to overlapping condition, but Composite Index of Anthropometric Failure (CIAF) is a single measure to assess the prevalence of under-nutrition which is better than other indices for the determination of undernutrition among children.
Methods: This cross-sectional study was conducted among school going Bengalee children of Desopran block and Haldia municipality of Purba Medinipur district, West Bengal, India. Total no. of participants were 622 aged 6 to 10 years. Among them 307 and 315 were boys and girls, respectively. Age and sex specific nutritional status of the subjects was assessed using height-for-age, weight-for-height, and weight-for-age as per NCHS guidelines and CIAF (Composite Index of Anthropometric Failure) was also computed as per standard methodology. Results: Boys were taller and heavier than girls. Significant age variations were noticed in anthropometric variables. Prevalence of wasting, stunting and underweight were 21.0%, 31.0%, and 41.9%, respectively. Moreover, prevalence of CIAF was 55.3% among the studied children. Result also revealed that rate of CIAF was much higher than the other three conventional indicators. Conclusion: It can be concluded that undernutrition among the school going children was very high and might be treated as a serious health problem. Appropriate authorities should take immediate remedial measures to reduce the rate of undernutrition. Similar studies should also be conducted from other regions of West Bengal.

Depuis la crise alimentaire de 2005 au Niger s'est rapidement déployé, dans l'ensemble du Sahel, autour de la problématique de la malnutrition, un dispositif d'aide médicale humanitaire sans précédent par ses volumes et son inscription dans le temps. En 2013, avec plus de 400 000 enfants atteints de malnutrition aigue sévère soignés, contre à peine quelques milliers moins de 10 ans auparavant, le Niger, ce pays sahélien de 17 millions d'habitants, représentait à lui seul 20 % des enfants malnutris pris en charge dans le monde (UNICEF). En quelques années, cet Etat est passé d'un pays en crise à un épicentre de la mobilisation humanitaire puis à une « success story » de la santé publique transnationale. Cette trajectoire est en grande partie celle de la mise en récit d'une situation nutritionnelle d'urgence qui trouve une réponse dans les promesses d'un modèle technique de prise en charge porté par la médecine humanitaire (Crombé et Jezequel 2007 ; Bradol et Jezequel 2010 ; Bradol et Vidal 2009).

Resumen: Se presenta evidencia que asocia la perturbación de sistemas agrícolas de subsistencia con la presencia de desnutrición infantil y sobrepeso-obesidad en adultos de zonas rurales de la península de Yucatán. Se comparan la talla para la edad (T/E), el peso para la edad (P/E) y el índice de masa corporal (IMC) de niños y adultos de tres poblaciones rurales de Yucatán y Campeche, México cuya estrategia agrícola de subsistencia fue alterada de manera distinta desde 1970. Los niños de las regiones menos perturbadas eran significativamente más altos, pero no más pesados que los niños de las otras dos regiones por lo que tenían un IMC menor. Los niños de la zona perturbada más pobre eran más bajos y menos pesados que el resto. El IMC de los adultos varones era más alto en las zonas más perturbadas solo en cohortes que crecieron después de que su régimen de subsistencia fuera alterado. Se concluyó que la perturbación de la agricultura de subsistencia promovió el desarrollo de un fen...

Objective: To explore the possibility for a statistically appropriate value of mid-upper arm circumference (MUAC) to identify the state of severe undernutrition, based on very low BMI, among adult Indian slum dwellers. Design: Cross-sectional study on adults. Height and MUAC were recorded and BMI was computed. Chronic energy deficiency (CED) was determined using the WHO international guidelines as BMI < 18·5 kg/m 2 and normal as BMI ≥ 18·5 kg/m 2. Besides calculating mean, SD and 25th, 50th and 75th percentile values, multiple linear regression analysis was undertaken to assess the associations between age, MUAC and BMI. Receiver-operating characteristic curve analysis was performed to determine the best MUAC cutoff to identify CED status. The χ 2 test was used to assess significance of the difference in CED prevalence across MUAC categories. Setting: An urban slum in Midnapore town, West Bengal State, India. Subjects: Male (n 467) and female (n 488) Indian slum dwellers. Results: MUAC of 22·7 and 21·9 cm, respectively, in males and females were the best cutoff points to differentiate CED from non-CED. Conclusions: Results supported the validity of the WHO-recommended MUAC cutoffs for adults. There is still a need to establish statistically appropriate MUAC cutoffs to predict undernutrition and morbidity.

Undernourishment is characterized by a decrease of the metabolic rate as a result of lack of nutrients important to life. Shiitake mushroom (Lentinula edodes) can be an alternative to reverse undernourishment. The aim of this study was to explore the metabolic changes and consequent elemental concentrations found in undernourished rats and undernourished rats treated with shiitake mushroom (n = 12 rats each group). To determine the elemental concentration, blood samples were analyzed by Particle Induced X-ray Emission (PIXE). For metabolomics, blood samples were tested under Fourier Transform Infrared Spectroscopy (FT-IR). The results indicated that the supplementation with shiitake mushroom in undernourished rats altered the composition of blood proteins, elements and volume. Several strong correlations were observed between the elemental concentrations and metabolic parameters.

The human population expected to reach 10 billion by 2100, the probability of conflict aggravated by scarceness over the XXI century is growing. Conflict is likely to be driven by a number of factors: changing climate, urbanization, migration, and food insecurity. According to the FAO 2018 report, global malnutrition rose from 777 million in 2015 to 815 million people in 2016. Data also highlight that the majority of these people live in countries affected by political conflicts (489 million out of
815 million). While significant food support comes from the USA and the EU, this feeds about 100 million peoples annually across 73 countries, their role is of cure and not prevention. Reducing food conflict in politically fragile countries on a sustained basis requires new investment and partnerships to develop biotechnological solutions including genetically modified crops. According to our analyses, GM Bt crops with the scope of food, feed, and processing can improve food security, and in broader way alter political conflicts in developing countries. The food supply chain, and policy decisions about safe GM crops should be the areas worth reconsidering, clear, and constructive reference to safe GM crops as an important option for a higher level of self-sufficiency has to be made.

Maternal and perinatal undernutrition affects the lung development of litters and it may produce long-lasting alterations in respiratory health. This can be demonstrated using animal models and epidemiological studies. During pregnancy, maternal diet controls lung development by direct and indirect mechanisms. For sure, food intake and caloric restriction directly influence the whole body maturation and the lung. In addition, the maternal food intake during pregnancy controls mother, placenta, and fetal endocrine systems that regulate nutrient uptake and distribution to the fetus and pulmonary tissue development. There are several hormones involved in metabolic regulations, which may play an essential role in lung development during pregnancy. This review focuses on the effect of metabolic hormones in lung development and in how undernutrition alters the hormonal environment during pregnancy to disrupt normal lung maturation. We explore the role of GLP-1, ghrelin, and leptin, and also retinoids and cholecalciferol as hormones synthetized from diet precursors. Finally, we also address how metabolic hormones altered during pregnancy may affect lung pathophysiology in the adulthood.

Executive Summary

Background. Numerous studies have shown that mid-upper arm circumference (MUAC) correlates well with body mass index (BMI) in adult populations. However, globally applicable MUAC cutoffs have not been established to classify undernutrition among adults. Increasingly, MUAC is being used to assess nutritional status and to determine eligibility for services among adults, especially in people living with HIV and/or tuberculosis. Many countries and programs have established their own MUAC cutoffs to determine eligibility for program services, but there is limited evidence supporting these cutoffs and it is not known whether the cutoffs are optimal.

Methods. Tufts University, a partner on the Food and Nutrition Technical Assistance III Project (FANTA) funded by the U.S. Agency for International Development (USAID), undertook an individual participant data meta-analysis (IPDMA) to explore the sensitivity (SENS) and specificity (SPEC) of various MUAC cutoffs for identifying undernutrition among adults (men and nonpregnant women), as defined by the primary outcome of low BMI (<18.5). Data were compiled from 17 studies of adults: 7 from Africa, 5 from South Asia (India), 2 from Southeast Asia (Vietnam), 2 from North America (USA), and 1 from South America (Argentina). For the dataset for each individual study, as well as for the combined dataset from all studies, measures of diagnostic accuracy (SENS, SPEC, positive predictive value [PPV], negative predictive value [NPV], area under the receiver operating characteristic curve [AUROCC], and the receiver operating characteristic [ROC] curve) were determined for every 0.5 cm across a range of MUAC values from 19.0 cm to 26.5 cm. The summary statistics used a bivariate random effects model to jointly estimate SENS and SPEC while accounting for the heterogeneity between studies. The models included MUAC as the only independent variable predicting low BMI. Various subgroup analyses we performed to determine how MUAC cutoffs might differ in different settings and subpopulations.

Results.1 The number of participants in each study ranged from 182 (ZAM) to 4,926 (VIE-FEM). The mean age for all studies combined was 32.4±12.0 years, with ages ranging from 18 years to 91 years. More than two-thirds of participants in the combined dataset were female (69%). Five studies included HIV-positive participants only, five studies included both HIV-positive and HIV-negative participants, and HIV status was not ascertained in seven of the studies. The mean MUAC measurement varied between studies, ranging from 19.7 cm in MAL-HWW to 32.7 cm in SAF. Slightly more than a quarter (27%) of the participants had low BMI (<18.5). Prevalence of low BMI ranged from approximately 5% or less in six studies to almost 90% in two studies.
Measures of SENS, SPEC, PPV, and NPV for all MUAC cutoffs varied between individual studies, but MUAC was highly discriminatory in its ability to distinguish nonpregnant adults with BMI <18.5 from those with BMI ≥18.5. The AUROCCs ranged from 0.61 (ZAM) to 0.98 (USA-HIV), with the majority of values being greater than 0.90. The AUROCC for all of the datasets combined was 0.92, which is considered to be in the “excellent” range based on general interpretations for the AUROCC. Results of the meta-analysis showed that MUAC cutoffs in the range of ≤23.0 cm to ≤25.5 cm could potentially serve as appropriate indicators for low BMI, with acceptable levels of SENS and SPEC at each of these cutoffs for the purposes of screening for undernutrition in communities or clinics. Based on our analysis, we propose that a MUAC ≤24.0 cm meets the criteria for optimizing SENS and SPEC across various subpopulations when assessed against low BMI.
1 See Table 1 for the full names of the individual studies.
Determining a Global Mid-Upper Arm Circumference Cutoff to Assess Underweight in Adults (Men and Nonpregnant Women)
v
Conclusions. The recommendation for a MUAC cutoff (or range of cutoffs) based on this IPDMA is only a first step toward determining a standardized and global MUAC cutoff for nonpregnant adults. Validation studies are needed to determine whether the proposed MUAC cutoff can be efficiently and effectively used as a screening tool for adult undernutrition. If found to be a valid and reliable nutrition screening tool, the use of MUAC in place of BMI in communities and clinics will reduce the amount of time and technical skill required for nutrition screening, resulting in a higher yield of individuals who would benefit from further nutrition assessment and intervention.

Background. Undernutrition among adult tribal women
is a major health problem in India.
Objectives. To compare the utility of two different anthropometric indicators of chronic energy deficiency
(CED) among tribal Kora Mudi women and to determine which of these two is a better indicator of undernutrition.
Methods. A cross-sectional study of 123 individuals was conducted. The body mass index (BMI) and mid-upper-arm circumference (MUAC) were used to evaluate CED.
Results. The prevalence of CED based on BMI less than 18.5 was 55.3%, and the prevalence of CED based on MUAC less than 22.0 cm was 51.2%. Both of these prevalence rates are classified in the very high-prevalence category (≥ 40%) and indicate a critical situation according to World Health Organization recommendations.
Mean BMI increased significantly with higher quartile of
MUAC. There was a significant difference in the prevalence
of CED between the MUAC quartiles. The risk ratio
for CED for women in the lowest quartile of MUAC was
9.33 compared with those in the highest quartile. There
was a significant positive association between MUAC
and BMI. Regression analysis demonstrated that MUAC
had a significant positive impact on BMI; the percentage
of the variation in BMI explained by MUAC was 52%.
Logistic regression analysis demonstrated that overall,
82.11% of cases of CED were correctly classified with
the use of MUAC. The use of MUAC correctly diagnosed
82.35% of cases of CED and 81.82% of women with
normal nutritional status.
Conclusions. This population was facing severe nutritional
stress. With limited resources and in the absence of skilled manpower, it may be more appropriate to use
MUAC for human population surveys, particularly
among tribal populations of developing countries.

Background: Anthropometry is an inexpensive and non-invasive method of growth and nutritional assessment. The objective of the study was to estimate the prevalence of undernutrition among school-going children belonging to urban and rural area of District Dehradun using WHO standards.

Strong leadership has been highlighted as a common element of success within countries that have made rapid progress in tackling child and maternal undernutrition. Yet little is known of what contributes to nutrition leaders’ success or lack of it in particular policy environments. This study of 89 individuals identified as influential within child and maternal undernutrition policy and programming in Bangladesh,
Ethiopia, Kenya and India sheds light on why particular individuals have been effective in contributing
towards positive changes in nutrition policy, and how they operate in the wider policy/political sphere.
We employ a framework working outwards from individual capabilities, knowledge and motivations, through to wider political economy considerations and the narratives and knowledge structuring individual capacity. We argue that only by locating individuals within this wider political economy can we begin to appreciate the range of strategies and avenues for influence (or constraints to that influence) that individual leaders employ and encounter.

ABSTRACT:
Dear Honorable Secretary-General
We are writing as an international and inter-sectoral civil society coalition, representing hundreds of organizations and networks, to present our recommendations to be acted upon at the UN High-Level Plenary on the Millennium Development Goals...

For Citation:A Letter sent to the UN General Secretary (Mr. Ban Ki Moon), Regarding the the Millennium Development Goals (MDG),  July 2010

This Topic Guide has been compiled to provide an overview of undernutrition in the context of development. It covers the nature, scale and complex range of causes of undernutrition and summarises the evidence for what works to address the problem. The Guide covers direct nutrition interventions (or nutrition specific development as it is often termed), indirect interventions (nutrition sensitive), and the global coordination structures, governance and funding which are essential for an enabling environment within which undernutrition can be successfully reduced. The focus of this Guide is on undernutrition, defined as the outcome of insufficient (quantity and quality) of food intake (hunger) and repeated infectious diseases. Undernutrition includes being underweight for one’s age, too short for one’s age (stunted), underweight for one’s height (wasted), and deficient in vitamins and minerals (micronutrient malnutrition). This review does not focus on the other component of malnutrition, which is overnutrition.

The objective of this study was to assess undernutrition prevalence among children under-two years in Indonesia and its related factors. This ecological study was conducted to 437 districts using data extracted from nationally representative surveys, which were National Socioeconomic Survey (Susenas) and National Basic Health Research (Riskesdas) year 2007. Overall, prevalence of High Stunting (HS), High Wasting (HW), and High Underweight (HU) was 46.9%, 59.5%, and 17.2%, respectively. Median prevalence of inadequate intake of energy, protein, iron, and zinc were 33.3%, 11.1%, 81.8%, and 55.6%, respectively. Median prevalence of Acute Respiratory Infection (ARI) was 15.9%, while the median prevalence of diarrhea was 13.0%. Median proportion of low education of the mother was 46.9%. Prevalence of HS was associated with household income, low education proportion of mother, and proportion of food expenditure. Prevalence of HW was associated with prevalence of inadequate energy intake a...

Malnutrition is a major concern in low- and middle-income countries (LMIC), but the full extent of nutritional deficiencies remains unknown largely due to lack of accurate assessment methods. This study seeks to develop and validate an objective, passive method of estimating food and nutrient intake in households in Ghana and Uganda. Household members (including under-5s and adolescents) are assigned a wearable camera device to capture images of their food intake during waking hours. Using custom software, images captured are then used to estimate an individual&#39;s food and nutrient (i.e., protein, fat, carbohydrate, energy, and micronutrients) intake. Passive food image capture and assessment provides an objective measure of food and nutrient intake in real time, minimizing some of the limitations associated with self-reported dietary intake methods. Its use in LMIC could potentially increase the understanding of a population&#39;s nutritional status, and the contribution of hous...

To explore the possibility for a statistically appropriate value of mid-upper arm circumference (MUAC) to identify the state of severe undernutrition, based on very low BMI, among adult Indian slum dwellers. Cross-sectional study on adults. Height and MUAC were recorded and BMI was computed. Chronic energy deficiency (CED) was determined using the WHO international guidelines as BMI&lt;18·5 kg/m2 and normal as BMI≥18·5 kg/m2. Besides calculating mean, sd and 25th, 50th and 75th percentile values, multiple linear regression analysis was undertaken to assess the associations between age, MUAC and BMI. Receiver-operating characteristic curve analysis was performed to determine the best MUAC cut-off to identify CED status. The χ 2 test was used to assess significance of the difference in CED prevalence across MUAC categories. An urban slum in Midnapore town, West Bengal State, India. Male (n 467) and female (n 488) Indian slum dwellers. MUAC of 22·7 and 21·9 cm, respectively, in males a...

Objective: To assess the prevalence of thinness among 3.0-5.5 years old preschool children of integrated child development services (ICDS) scheme of Sagar Block, South 24 Parganas, West Bengal, India. Methods: This cross-sectional study was conducted among 656 preschool children (326 boys and 330 girls). Height (cm) and weight (kg) measurements were taken according to standard procedure. The body mass index (BMI) of the subjects were categorised according to the new international cutoff point for thinness proposed by Cole et al. Low BMI for age was defined as thinness and age sex specific cut off values of mild, moderate and severe grades of thinness as proposed by Cole et al. Results: The age combined mean BMI were 13.48 (±0.92) kg/m 2 for boys and 13.30 (±1.00) kg/m 2 for girls. Sex combined mean BMI was 13.39 (±0.96) kg/m 2. The mean BMI showed a decreasing trend irrespective of sex up to age of 4.5 year. Over all (age combined) sex difference in mean BMI was observed (t=2.37; p&...

Abstract: The objective of this study was to examine child, mother, and environmental factors associated with undernutrition in children less than five years old in a Maya community in Yucatan, Mexico. This investigation was designed as a case-control study. All cases (n=42) of undernutrition were included, and a sample of 52 controls was randomly selected from the study population. The frequency of investigated exposure factors was compared between cases and controls by using logistic regression. Undernutrition was associated with child’s age (&gt; 36 months old; OR = 3.53; 95 % CI = 1.04, 18.40) and mother’s marital status (married; OR = 0.29; 95 % CI = 0.09, 0.90). The odds of undernutrition were 2.81 times higher in children infected with Giardia spp, but this association was not significant (P = 0.18) after controlling for child’s age and mother’s marital status. In conclusion, child’s age and mother’s marital status were associated with child undernutrition in study subjects. ...

Background: Ascaris lumbricoides infections are one of the commonnest intestinal nematode infections in the world, with a profound negative effect on nutritional status among underprivileged populations. In Sri Lanka, Ascaris infections and low nutritional status still persist in the plantation sector. However, research regarding the association between Ascaris infections and nutritional status is scarce. The main purpose of this study was to determine the association between Ascaris infections and physical growth among children in a plantation sector in Sri Lanka.