The Nutritional Dual-Burden in Developing Countries – How is it Assessed and What Are the Health Implications?

This paper focuses on the phenomenon of the nutritional dual-burden in the developing world. Nutritional dual-burden is defined as the coexistence of under-and-over nutrition in the same population/group, the same household/family, or the same person. In this paper we aim: a) to describe the different types of nutritional dual-burden, b) to identify the anthropometric indicators generally used to classify the nutritional dual-burden, c) to focus our attention on a dual-burden group (the Maya from Merida, Yucatan, Mexico), d) to illustrate problems in the categorization of the dual-burden, and e) to suggest possible health implications. Our results show that, for our sample, the prevalence of individual dual- -burden among children is very low, but is very high among the mothers and for mother-child pairs (household dual-burden). Most importantly, the criteria used to assess the nutritional status of the individuals and of the families will play an important role in the estimated prevalence of nutritional dual-burden, and this will have practical impacts for health intervention programs

Logistics of using the Actiheart physical activity monitors in urban Mexico among 7- to 9-year-old children

Logistics of using new measurement devices are important to understand when developing protocols. This paper discusses the logistics of using Actiheart physical activity monitors on children in an urban, tropical environment in a developing country. Actiheart monitoring of 36 children aged 7-9 years old was undertaken for 7 days in the city of Mérida, Yucatán, Mexico. The Actiheart proved fragile for children and difficult to mend in the field. The excessive sweating due to the tropical climate caused poor adherence of the electrode pads, requiring a pad change midway through and extra pads to be provided. Also extra time was needed to be allotted for increased instructions to participants and their mothers and for individual calibration. When collecting objectively measured physical activity data under harsh conditions, the protocol must accommodate local conditions and device limitations and allow increased time with participants to obtain good quality data. © 2011 Wiley-Liss, Inc

Do maternal grandmothers influence breastfeeding duration and infant nutrition? Evidence from Merida, Mexico

Objectives: Breast-feeding is sensitive to somatic, hormonal, behavioral and psychological components of maternal capital. However, through grandmothering, older women may also influence breast-feeding by transferring informational resources to their daughters. We hypothesized that mothers with prolonged instrumental support from their own mother are more likely to have received advice and to have favorable attitudes/practices regarding breastfeeding, compared to those lacking such support, with implications for the grandchild's somatic capital. Methods: We recruited 90 mother-infant dyads (52 with grandmaternal support, 38 without) in Merida, Yucatan, Mexico. All children were first-borns, aged ~2 years. Anthropometry and body composition were assessed. Data on grandmother's breastfeeding advice and maternal breastfeeding duration were obtained by questionnaire. Maternal attitudes to breast-feeding were assessed using the Iowa Infant Feeding Attitude Scale. Results: Women with instrumental support were more likely to have received grandmaternal advice during pregnancy/infancy on exclusive breast-feeding duration (60% vs. 37%, p = 0.033) and the type of first complementary food (81% vs. 47%, p = 0.001). However, women with support had a less favorable attitude to breastfeeding than those without and breastfed their children for less time (median 5 vs. 10.5 months, p = 0.01). No group differences were found in children's length, weight, skinfolds or lean mass z-score. Discussion: Although grandmothers providing instrumental support provided advice regarding breastfeeding, their attitudes may reflect issues beyond nutritional health. Advice of maternal grandmothers did not promote extended breastfeeding, however the differences in breastfeeding attitudes were not associated with the children's nutritional status. Grandmothers should be included in public health interventions promoting breastfeeding

Czy istnieje sezonowy rytm rozwoju w warunkach tropikalnych? (Raport 1 z dwuletnich comiesięcznych badań na Jukatanie w Meksyku)

The main aim of this work concerns the answer to the question of whether the general regularity of seasonal differences in changes of height, weight, and body components during ontogeny in tropics exists. If so, whether this phenomenon depends on cyclic changes in nature or this rather is an adjustment to local conditions and mode of life.  To answer this question the studies took place in the tropical climate of Yucatan and included 49 boys and 47 girls aged 11-12 years and being of Maya, Mestizo, and Creole origin. The youths were attending two schools that were located in rather poor districts of Merida (the capital city of the Yucatan State, Mexico). The investigations started in February 2002 and ended in November 2003 and were continued monthly. The standard anthropometric methodology was applied to measure body height, weight, arm, waist, hip, and calf circumferences, and five subcutaneous fat folds (biceps and triceps brachii, subscapular, suprailiac and calf). Bioimpedance techniques were used to estimate fat mass (FM ), fat-free mass (FFM ), and total body water (TBW). The results show that general regularities in monthly or longer rates of stature increments and increments or declines of body mass do not exist. There are not similar regularities of changes even in groups of coevals of the same gender and within the youths coming from the same district. Each variable shows a quite specific rate of change

Caesarean birth and adiposity parameters in 6- to 8-year-old urban Maya children from two cities of Yucatan, Mexico

Objectives The purpose of this study was to analyze the association between birth mode and fat mass index (FMI = fat mass [kg]/height [m]2), and z‐score values of waist circumference (WCZ) and sum of triceps and subscapular skinfolds (SumSkfZ) in a sample of 256 6‐ to 8‐year‐old urban Maya children from the cities of Merida and Motul in Yucatan, Mexico. Methods From September 2011 to January 2014, we measured height, weight, waist circumference and skinfolds in children, and height and weight in their mothers. Body composition was estimated in both generations through bioelectrical impedance analysis. Data on children's birth mode and birth weight were obtained from birth certificates. A pre‐validated questionnaire for mothers was used regarding household living conditions. Multiple regression models were used to analyze the association between birth mode and adiposity parameters, adjusting for the effect of place of residence, household crowding index, children's birth weight, and maternal fat mass. Separate regression models were run for boys and girls. Results Caesarean‐born children comprised 43% of the entire sample. Caesarean section (CS) was found to be associated with higher values of body adiposity in girls, but not in boys. Specifically, our models predicted that girls born by CS had an increased value of 0.817 kg/m2 in FMI and showed higher SDs values for WCZ and SumskfZ (0.29 and 0.32 SD, respectively) than girls who were delivered vaginally. Discussion Our results support the hypothesis that CS is associated with increased levels of adiposity in childhood, but only in girls

Caesarean birth and adiposity parameters in 6‐to 8 year‐old urban Maya children from two cities of Yucatan, Mexico [Abstract]

Caesarean birth and adiposity parameters in 6‐to 8 year‐old urban Maya children from two cities of Yucatan, Mexico [Abstract

Body mass index in mother and child dyads and its association with household size and parents’ education in 2 urban settings of Yucatan, Mexico

Background: Overweight/obesity (OW/OB) coexists in mother-child dyads. However, dearth of evidence on the factors associated with this phenomenon calls for research. Objective: To analyze the association of sociodemographic factors with OW/OB in a sample of 260 Maya mother-child dyads from Yucatan, Mexico. Methods: During 2011-2014 we measured height and weight in children and their mothers and calculated their body mass index (BMI). The OW/OB cut-off points were defined, for mothers, as having a BMI >25kg/m2 and, for children, as having a BMI-for-age >2SD of the World Health Organization references. Mother-child dyads were grouped according to their BMI status: 1) normal weight mother and child, 2) normal weight mother and OW/OB child, 3) OW/OB mother and normal weight child, and 4) OW/OB mother and child. A multinomial logistic regression model was used to analyze the interrelationships among BMI status in mother-child dyads, household size and parental education. Results: OW/OB coexisted in 40% of dyads. Compared to normal weight dyads (1), each unit increase in household size and in years of maternal education decreased the risks for the coexistence of OW/OB in motherchild dyads (OR=0.72, 95% IC 0.55-0.94, P=0.015; OR=0.70, 95% IC 0.52-0.94, P=0.019, respectively). Conversely, each year increase in paternal education increased the risk for OW/OB in dyads (OR=1.47, 95% CI 1.08-1.99, P=0.015). Conclusions: Results suggest that household size and parental education contribute to shape BMI-based nutritional status in this sample of mother-child dyads. A higher level of maternal education acts as a protective factor against OW/OB in mothers and children

Fat free mass explains the relationship between stunting and energy expenditure in urban Mexican Maya children

Background: Childhood stunting has been associated with an increased risk of obesity in adulthood, but the causes are unclear. This study hypothesizes that stunting significantly reduces both resting and activity energy expenditure. Aim: To assess and describe energy expenditure of low socio-economic Maya children and to determine whether stunting is independently related to energy expenditure after controlling for lean mass. Subjects and methods: Thirty-three urban Maya children, 17 boys, aged 7–9 years, living in Merida, Mexico, were measured for height, weight and bioelectrical impedance analysis (BIA). Body composition was estimated from BIA. Energy expenditure was measured for one week using the Actiheart (combined heart rate and accelerometer). Results: Stunting (height-for-age below the 5th percentile of NHANES III based references) affected 35% of these physically active children. Using multiple linear regression analysis, greater lean body mass predicted higher resting and activity energy expenditure. Stature was not a significant predictor of resting energy expenditure. A lower height-for-age z-score, but not stunting as a categorical variable, significantly predicted lower activity energy expenditure. Conclusion: The hypothesis that stunting reduces total energy expenditure (resting + active) in children is not supported. Rather, children with shorter stature and less lean body mass have lower total energy expenditure. Complex interactions between body size, body composition, and metabolic activity appear to elevate the risk for later life obesity in these Maya children

Height, Weight and Body Mass Index by Age and Sex in Children Aged 4 to 6 Years in Merida, Mexico, as Compared to International References After Normalization with LMS

A cross-sectional study was done in 2006–2007 of 458 children (218 boys and 240 girls) aged 4 to 6 years (range 4.00 to 6.99 years) in Merida, Mexico. Height (cm) and body weight (kg) were measured to estimate growth; body mass index (BMI, kg/m2) was calculated to evaluate nutritional status. Results showed signifi cant sex difference with respect to height, weight, and BMI. Increment of height and weight with age was observed. However, age difference in BMI was not consistent. Nutritional status was evaluated using International Obesity Task Force (IOTF) classifi cation and BMI cut-off values showed notable rates of overweight (boys 14.41% and girls 17.75%) and obesity (boys 12.43% and girls 7.21%). Anthropometric data of height, weight, and BMI were normalized using LMS methodology and were compared with World Health Organization (WHO) growth reference data. Again, increment of height and weight with age was observed although those were lower in the present study for boys and girls than the corresponding WHO growth reference data. In contrast, mean BMI by age in the present results exceeded WHO reference data, especially above the 85th percentile. Assessment of nutritional status with reference to IOTF and WHO revealed similar trends

A commercially driven design approach to UK future small payload launch systems

Miniaturisation of satellite componentry, increasingly capable small sensors and substantial increases in processing capacity and transmission bandwidth are driving rapid growth in small payload development and consequential launch demand. The advent of horizontal take-off spaceports opens the door for a new generation of small payload launch systems that will fulfil this demand. However, the key to a launch system's success is its ability to provide a return on the substantial costs of development while delivering pricing levels commensurate with the needs of launch customers. Therefore, commercially led design approaches are needed to refine and optimise the design of the new small payload launch systems required. This approach was embodied in an ongoing UKSA funded NSTP2 project titled Future UK Small Payload Launcher (FSPLUK). The approach is first founded upon a bespoke and specific market assessment. This characterises, segments and quantifies the commercial opportunity and establishes principal desired system performance requirements. An assessment of available technologies at differing TRLs permits initial vehicle configuration options to be developed and technically assessed. Technically viable options are then assessed in terms of commercial viability with the best advanced into more detailed technical assessment and system optimisation. The resultant vehicles are again tested for commercial viability and, if successful, emerge as recommended development avenues. Using these methods, it has been possible to iterate design concepts from apparently simple yet economically sub-optimised stacked launcher systems through several design iterations to a resultant highly flexible and economically efficient conceptual design. The key finding relates to the inter-relationship between payload flexibility, in permitting maximised flight rates from a reasonably complex but highly reusable first stage design, and low disposable upper stage unit cost. This has driven the resultant system to feature an air launched integrated re-usable first stage vehicle, configured with a flexible internal payload bay from which one or more upper stages are deployed. This configuration maximises commercial utility and reusability. The resultant high flight rate allows development costs to be efficiently amortised with minimised direct launch costs. The configuration therefore meets low cost per kg price targets while delivering a positive return on development expenditure over life. It also provides a flight proven vehicle platform with available internal real-estate for application as a hypersonic air test platform for new propulsion systems, such as SABRE. The commercially led approach has created the foundation for viable and economically justifiable development