Changes in the nutritional status of Bolivian women 1994-1998: demographic and social predictors

Introduction: Bolivia, as one of the poorest Latin American countries, has dealt with the problems of undernutrition for the last 50 y. Little importance has been given to the increase in overweight and obesity among the population, despite the scientific evidence linking overweight and obesity with mortality and morbidity. Objective: To describe the social and demographic determinants of the nutritional status among women in Bolivia between 1989 and 1998 to gain a better understanding of the nutrition transition phenomena and to identify urgent research needs. Methodology: Secondary analysis of the raw data of the Bolivian National Demographic and Health Surveys of 1994 and 1998. Changes in the prevalence of underweight, obesity and overweight are described by sociodemographic characteristics of Bolivian women. Social and demographic determinants of nutritional status have been fitted into a logistic model. Results: The prevalence of overweight (defined as 25 less than or equal to BMI < 30 kg/m(2)) among women of reproductive age (20-44 y) increased by 9 percentage points between 1994 and 1998 (P < 0.001), while the prevalence of normal BMI decreased by 10 percentage points (P < 0.001). The decrease in the prevalence of underweight (defined as BMI <18.5 kg/m(2)) from 2.4% in 1994 to less than 1% in 1998 was statistically significant (P < 0.001). Obesity (defined as BMI &GE;30 kg/m(2)) was positively associated with geographical region (P = 0.001), educational level (P < 0.001), age (P = 0.003) and total number of children (P = 0.001) and negatively associated to rural locality (P = 0.001) and native languages(P < 0.001). Overweight was inversely associated with rural locality (P = 0.013) and with Quechua language (P = 0.04), while the total number of children (P < 0.001) and year of survey (P < 0.001) were positively associated. Underweight decreased dramatically (P < 0.001), being positively associated with the region of residence (P = 0.04) and inversely associated with the total number of children (P = 0.006). Conclusion: The present study suggests that the population of Bolivia is in a transitional stage, with overweight becoming as much of a problem as undernutrition

Feeding practices and growth among young children during two seasons in rural Ethiopia

BACKGROUND: The use of indices of infant and young child feeding practices to predict growth has generated inconsistent results, possibly through age and seasonal confounding. The aim of this study was to evaluate the association of a dietary diversity score (DDS) and infant and child feeding index (ICFI) with growth among young children in a repeated cross-sectional and a follow-up study in two distinct seasons in rural southwest Ethiopia. METHODS: We used a repeated cross-sectional design comparing child feeding practices to nutritional status in 6–12 month old children during harvest (HS; n = 320) and pre-harvest season (PHS; n = 312). In addition, 6–12 month old children from the HS were reassessed 6 months later during PHS. In addition to child anthropometry, child feeding practices were collected using 24-h and 7-day dietary recalls. RESULTS: The mean (±SD) length-for-age z-score (LAZ) of the 6–12 month old children was −0.77 (±1.4) and −1.0 (±1.3) in HS and PHS, respectively, while the mean (±SD) of the follow-up children in PHS was −1.0 (±1.3). The median DDS (IQR) was 2.0 (1.0, 3.0.), 2.0 (2.0, 3.0) and 3.0 (2.0, 4.0) for the children in HS, PHS and the follow-up children in PHS, respectively. The DDS in HS was positively associated with LAZ at follow-up (β = 0.16; 95% CI: 0.01, 0.30; P = 0.03) after controlling for confounding factors. ICFI and DDS were not associated with mean LAZ, weight-for-height z-score and weight-for-age z-score within season. However, the odds of being stunted when having a DDS ≤ 2 was 2.3 times (95% CI: 1.10, 4.78; P = 0.03) higher compared to a DDS &gt; 2 child in HS and 1.7 times (95% CI: 1.04, 2.71; P = 0.04) higher for the pooled sample of 6–12 months old children in HS and PHS. CONCLUSIONS: The DDS was found to be an indicator for child stunting during the Ethiopian harvest season. The DDS can be an appropriate tool to evaluate the association of child feeding practices with child growth irrespective of season. Inclusion of other dimensions in the construction of ICFI should be considered in future analysis as we found no association with growth

Infant and young child feeding practices and child linear growth in Nepal : regression-decomposition analysis of national survey data, 1996–2016

Suboptimal infant and young child feeding (IYCF) practices have profound implications on child survival, health, growth, and development. First, our study analysed trends in 18 IYCF indicators and height-for-age z-score (HAZ) and stunting prevalence across Nepal's Family Health Survey 1996 and four rounds of Nepal Demographic and Health Surveys from 2001-2016. Second, we constructed multivariable regression models and decomposed the contribution of optimal IYCF practices on HAZ and stunting prevalence over the 1996-2016 period. Our findings indicate that most age-appropriate IYCF practices and child linear growth outcomes improved over the past two decades. At present, according to the World Health Organization's tool for national assessment of IYCF practices, duration of breastfeeding is rated very good, early initiation of breastfeeding and exclusive breastfeeding (EBF) are rated good, whereas minimal bottle-feeding and introduction of solid, semi-solid or soft foods are rated fair. Our study also reports that a paucity of age-appropriate IYCF practices-in particular complementary feeding-are significantly associated with increased HAZ and decreased probability of stunting (p < .05). Moreover, age-appropriate IYCF practices-in isolation-made modest statistical contributions to the rapid and sustained reduction in age-specific child linear growth faltering from 1996-2016. Nevertheless, our findings indicate that comprehensive multisectoral nutrition strategies-integrating and advocating optimal IYCF-are critical to further accelerate the progress against child linear growth faltering. Furthermore, specific focus is needed to improve IYCF practices that have shown no significant development over the past two decades in Nepal: EBF, minimum acceptable diet, and minimal bottle-feeding

Anthropometry of height, weight, arm, wrist, abdominal circumference and body mass index, for Bolivian adolescents 12 to 18 years: Bolivian adolescent percentile values from the MESA study

Anthropometry is important as clinical tool for individual follow-up as well as for planning and health policy-making at population level. Recent references of Bolivian Adolescents are not available. The aim of this cross sectional study was to provide age and sex specific centile values and charts of Body Mass Index, height, weight, arm, wrist and abdominal circumference from Bolivian Adolescents. Data from the MEtabolic Syndrome in Adolescents (MESA) study was used. Thirty-two Bolivian clusters from urban and rural areas were selected randomly considering population proportions, 3445 school going adolescents, 12 to 18 y, 45% males; 55% females underwent anthropometric evaluation by trained personnel using standardized protocols for all interviews and examinations. Weight, height, wrist, arm and abdominal circumference data were collected. Body Mass Index was calculated. Smoothed age- and gender specific 3(rd), 5(th), 10(th), 25(th), 50(th) 75(th), 85(th), 90(th), 95(th) and 97(th) Bolivian adolescent percentiles(BAP) and Charts(BAC) where derived using LMS regression. Percentile-based reference data for the antropometrics of for Bolivian Adolescents are presented for the first time

Food insecurity and linear growth of adolescents in Jimma Zone, Southwest Ethiopia

Background: Although many studies showed that adolescent food insecurity is a pervasive phenomenon in Southwest Ethiopia, its effect on the linear growth of adolescents has not been documented so far. This study therefore aimed to longitudinally examine the association between food insecurity and linear growth among adolescents. Methods: Data for this study were obtained from a longitudinal survey of adolescents conducted in Jimma Zone, which followed an initial sample of 2084 randomly selected adolescents aged 13-17 years. We used linear mixed effects model for 1431 adolescents who were interviewed in three survey rounds one year apart to compare the effect of food insecurity on linear growth of adolescents. Results: Overall, 15.9% of the girls and 12.2% of the boys (P=0.018) were food insecure both at baseline and on the year 1 survey, while 5.5% of the girls and 4.4% of the boys (P=0.331) were food insecure in all the three rounds of the survey. In general, a significantly higher proportion of girls (40%) experienced food insecurity at least in one of the survey rounds compared with boys (36.6%) (P=0.045). The trend of food insecurity showed a very sharp increase over the follow period from the baseline 20.5% to 48.4% on the year 1 survey, which again came down to 27.1% during the year 2 survey. In the linear mixed effects model, after adjusting for other covariates, the mean height of food insecure girls was shorter by 0.87 cm (P<0.001) compared with food secure girls at baseline. However, during the follow up period on average, the heights of food insecure girls increased by 0.38 cm more per year compared with food secure girls (P<0.066). However, the mean height of food insecure boys was not significantly different from food secure boys both at baseline and over the follow up period. Over the follow-up period, adolescents who live in rural and semi-urban areas grew significantly more per year than those who live in the urban areas both for girls (P<0.01) and for boys (P<0.01). Conclusions: Food insecurity is negatively associated with the linear growth of adolescents, especially on girls. High rate of childhood stunting in Ethiopia compounded with lower height of food insecure adolescents compared with their food secure peers calls for the development of direct nutrition interventions targeting adolescents to promote catch-up growth and break the intergenerational cycle of malnutrition