The obesity epidemic is a worldwide phenomenon

Obesity is not just a disease of developed nations. Obesity levels in some lower-income and transitional countries are as high as or higher than those reported for the United States and other developed countries, and those levels are increasing rapidly. Shifts in diet and activity are consistent with these changes, but little systematic work has been done to understand all the factors contributing to these high levels. The goal of this review is to provide an understanding of the patterns and trends of obesity arounnd the world and some of the major forces affecting these trends. Several nationally representative and nationwide surveys are discussed

Sex Differences Independent of Other Psycho-sociodemographic Factors as a Predictor of Body Mass Index in Black South African Adults

To better understand the sex differences in body mass index (BMI) observed in black South African adults in the Transition and Health during Urbanization of South Africans Study, the present study investigated whether these differences can be explained by the psycho-sociodemographic factors and/or health-related behaviours. A cross-sectional survey was undertaken among 1,842 black South African individuals from 37 study sites that represented five levels of urbanization. The behavioural factors that possibly could have an influence on the outcome of body-weight and that were explored included: diet, smoking, level of education, HIV infection, employment status, level of urbanization, intake of alcohol, physical activity, and neuroticism. The biological factors explored were age and sex. The prevalence of underweight, normal weight, and overweight among men and women was separately determined. The means of the variables were compared by performing Student's t-test for normally-distributed variables and Mann-Whitney U-test for non-normally-distributed variables. The means for the underweight and overweight groups were tested for significant differences upon comparison with normal-weight individuals stratified separately for sex. The differences in prevalence were tested using chi-square tests (p<0.05). All the variables with a large number of missing values were tested for potential bias. The association between sex and underweight or overweight was tested using the Mantel-Haenszel method of odds ratio (OR) and calculation of 95% confidence interval (CI), with statistical significance set at p<0.05 level. Logistic regression was used for controlling for confounders and for testing for effect modification. Females were more likely to be overweight/obese (crude OR=5.1; CI 3.8-6.8). The association was attenuated but remained strong and significant even after controlling for the psycho-sociodemographic confounders. In this survey, the risk for overweight/obesity was strongly related to sex and not to the psycho-sociodemographic external factors investigated. It is, thus, important to understand the molecular roots of sex and gender-specific variability in distribution of BMI as this is central to the future development of treatment and prevention programmes against overweight/obesity

What approaches are most effective at addressing micronutrient deficiency in children 0-5 years?:A review of systematic reviews

Introduction Even though micronutrient deficiency is still a major public health problem, it is still unclear which interventions are most effective in improving micronutrient status. This review therefore aims to summarize the evidence published in systematic reviews on intervention strategies that aim at improving micronutrient status in children under the age of five. Methods We searched the literature and included systematic reviews that reported on micronutrient status as a primary outcome for children of 0–5 years old, had a focus on low or middle income countries. Subsequently, papers were reviewed and selected by two authors. Results We included 4235 reviews in this systematic review. We found that (single or multiple) micronutrient deficiencies in pre-school children improved after providing (single or multiple) micronutrients. However home fortification did not always lead to significant increase in serum vitamin A, serum ferritin, hemoglobin or zinc. Commercial fortification did improve iron status. Cord clamping reduced the risk of anemia in infants up to 6 months and, in helminth endemic areas, anthelminthic treatment increased serum ferritin levels, hemoglobin and improved height for age z-scores. Anti-malaria treatment improved ferritin levels. Discussion Based on our results the clearest recommendations are: delayed cord clamping is an effective intervention for reducing anemia in early life. In helminth endemic areas iron status can be improved by anthelminthic treatment. Anti-malaria treatment can improve ferritin. In deficient populations, single iron, vitamin A and multimicronutrient supplementation can improve iron, vitamin A and multimicronutrient status respectively. While the impact of home-fortification on multimicronutrient status remains questionable, commercial iron fortification may improve iron status

Public Health Nutrition: 5(1A)

Abstract Objective: The goal of this paper is to explore the hypothesis that the nutrition transition is related to households having an underweight and an overweight member simultaneously (under/over households and under/over pairs). Design: The 1993 China Health and Nutrition Survey (CHNS) was used to test the association between being an under/over household and household characteristics related to the nutrition transition. Sociodemographic and diet patterns were tested for the main age combinations of the under/over pairs. Setting: In China, 8.1% of all households were found to have underweight and overweight members within the same household. Subjects: Results are from the 1993 China Health and Nutrition Survey and are based on a sample of 13 814 persons from 3340 households. Results: The under/over household was more urban, had a higher income and was more likely to have assets such as a television, a motor vehicle and a washing machine, even after controlling for sociodemographic confounders. The under/over household had a diet that was higher in fat and protein compared with the underweight and normal weight households. There were no significant differences between the under/over and overweight households, with many of the associations near unity. Comparisons of the under/over subgroups by age of the under/over pairs showed some differences by income and occupation, but not for diet. Conclusions: It is imperative, as more individuals become exposed to the diet and lifestyle patterns of the nutrition transition, to find effective public health programmes that can simultaneously promote a healthy lifestyle, improve diet quality and address both undernutrition and chronic disease. Keywords China Diet Household food distribution Under/over Underweight Overweight A number of scholars have identified the presence of households with undernutrition and overweight coexisting in the same household. This finding has been regarded as a sign of the shift to the nutrition transition stage linked to diet-related non-communicable disease (NCD). Initial observations in South Africa found low-income, overweight women coexisting in communities with a high prevalence of child undernutrition 1,2 . Subsequent research has shown that this is a common condition in a wide range of countries 3 -5 . Garrett and Ruel 6 have also found obesity and overweight among women clustering with stunting among children. We have hypothesised these findings to be the result of diet and activity changes related to the rapid shift in the stage of the nutrition transition. Here and throughout this paper, the term nutrition transition is used to refer to the shift towards the diet-related NCD phase. Furthermore, emerging and rising obesity in many developing countries 7 indicate that this might be a broader global concern. However, few studies have considered households with underweight and overweight individuals of any age, simultaneously. These households, which are the focus of this paper, will be henceforth referred to as under/over households, and the underweight and overweight individuals within these households will be referred to as under/over pairs. The study by Doak et al. 5 found urban residence to be associated with the under/over households in Brazil, China and Russia. In China, the transitions in diet and activity related to overweight and chronic disease occurred first in the urban areas and among high-income households 8 -10 . These factors, as well as other sociodemographic variables such as household assets, may contribute to the likelihood of underweight and overweight clustering within households. The 1993 China Health and Nutrition Survey is used to test the association between household characteristics. Tests were made related to the nutrition transition and being an under/over household. This survey has in-depth anthropometric, dietary and socio-economic status (SES) data from all household members. It was expected that a common set of factors leads to increased overweight status, which are also related to the q The Authors 200

The underweight/overweight household: an exploration of household sociodemographic and dietary factors in China

OBJECTIVE: The goal of this paper is to explore the hypothesis that the nutrition transition is related to households having an underweight and an overweight member simultaneously (under/over households and under/over pairs). DESIGN: The 1993 China Health and Nutrition Survey (CHNS) was used to test the association between being an under/over household and household characteristics related to the nutrition transition. Sociodemographic and diet patterns were tested for the main age combinations of the under/over pairs. SETTING: In China, 8.1% of all households were found to have underweight and overweight members within the same household. SUBJECTS: Results are from the 1993 China Health and Nutrition Survey and are based on a sample of 13814 persons from 3340 households. RESULTS: The under/over household was more urban, had a higher income and was more likely to have assets such as a television, a motor vehicle and a washing machine, even after controlling for sociodemographic confounders. The under/over household had a diet that was higher in fat and protein compared with the underweight and normal weight households. There were no significant differences between the under/over and overweight households, with many of the associations near unity. Comparisons of the under/over subgroups by age of the under/over pairs showed some differences by income and occupation, but not for diet. CONCLUSIONS: It is imperative, as more individuals become exposed to the diet and lifestyle patterns of the nutrition transition, to find effective public health programmes that can simultaneously promote a healthy lifestyle, improve diet quality and address both undernutrition and chronic disease

Ascariasis, Amebiasis and Giardiasis in Mexican children : distribution and geographical, environmental and socioeconomic risk factors

The aim of this study is to provide an overview of the geographical distribution of Ascariasis, Amebiasis and Giardiasis, and to identify specific geographical, socioeconomic and environmental factors that are associated with the incidence of these infections in Mexican children. We made use of publicly available data that was reported by federal organizations in Mexico for the year 2010. The contribution of geographical, socioeconomic and environmental factors to the incidence of infections was assessed by a multivariable regression model using a backwards selection procedure. A. lumbricoides incidence was associated with mean minimum temperature of the state, the state-wide rate of households without access to piped water and toilet, explaining 77% of the incidence of A. lumbricoides infections. Mean minimum precipitation in the state, the rate of households without access to a toilet, piped water and sewage system best explained (73%) the incidence of E. histolytica infections. G. lamblia infections were only explained by the latitude of the state (11%). In addition to the well-known socioeconomic factors contributing to the incidence of A. lumbricoides and E. histolytica we found that temperature and precipitation were associated with higher risk of infection

Sex Differences Independent of Other Psycho-sociodemographic Factors as a Predictor of Body Mass Index in Black South African Adults

To better understand the sex differences in body mass index (BMI) observed in black South African adults in the Transition and Health during Urbanization of South Africans Study, the present study investigated whether these differences can be explained by the psycho-sociodemographic factors and/or health-related behaviours. A cross-sectional survey was undertaken among 1,842 black South African individuals from 37 study sites that represented five levels of urbanization. The behavioural factors that possibly could have an influence on the outcome of body-weight and that were explored included: diet, smoking, level of education, HIV infection, employment status, level of urbanization, intake of alcohol, physical activity, and neuroticism. The biological factors explored were age and sex. The prevalence of underweight, normal weight, and overweight among men and women was separately determined. The means of the variables were compared by performing Student\u2019s t-test for normally-distributed variables and Mann-Whitney Utest for non-normally-distributed variables. The means for the underweight and overweight groups were tested for significant differences upon comparison with normal-weight individuals stratified separately for sex. The differences in prevalence were tested using chi-square tests (p&lt;0.05). All the variables with a large number of missing values were tested for potential bias. The association between sex and underweight or overweight was tested using the Mantel-Haenszel method of odds ratio (OR) and calculation of 95% confidence interval (CI), with statistical significance set at p&lt;0.05 level. Logistic regression was used for controlling for confounders and for testing for effect modification. Females were more likely to be overweight/ obese (crude OR=5.1; CI 3.8-6.8). The association was attenuated but remained strong and significant even after controlling for the psycho-sociodemographic confounders. In this survey, the risk for overweight/ obesity was strongly related to sex and not to the psycho-sociodemographic external factors investigated. It is, thus, important to understand the molecular roots of sex- and gender-specific variability in distribution of BMI as this is central to the future development of treatment and prevention programmes against overweight/obesity

Profile of Children with Undernutrition Admitted in Two Secondary-Level Hospitals in Maputo City, Mozambique

This research was undertaken as part of a Ph.D. program. This was funded by the FlemishInternational Cooperation Agency (FICA) under the Building Institutional Capacity Mozambican INS (BICMINS) project within ITM and INS (DiV-PA-20140910).Mozambique has one of the highest child undernutrition rates in Sub-Saharan Africa. The aim of this study was to characterize the profile of children from 1 to 14 years old hospitalized for undernutrition and to explore associated risk factors. Clinical, demographic, socioeconomic, and environmental data were collected. Anthropometric measurements and stool samples were collected from a child and their caretaker. The wealth index was determined using Principal Components Analysis. A total of 449 children and their caretakers were enrolled. The children had a median age of 1.0 year [IQR: 1.0-2.0], and 53.9% (242/449) were male. Most were admitted with severe undernutrition (35.7%, 159/449 kwashiorkor and 82.0%, 368/449 with -3SD Z-score indexes). The most common co-morbidities were HIV (30.0%, 120/400), diarrhea (20.0%; 80/400), and anemia (12.5%; 50/400). Among the caretakers, 9.5% (39/409) were underweight, 10.1% (40/397) were overweight, and 14.1% (56/397) were obese. Intestinal parasites were found in 24.8% (90/363) children and in 38.5% (77/200) caretakers. The majority of children (60.7%, 85/140) came from low- to middle-wealth households. Most were severely undernourished, suggesting that they seek medical care too late. The finding of overweight/obese caretakers in combination with undernourished children confirms that Mozambique is facing a double burden of malnutrition.publishersversionpublishe