10 research outputs found
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How age and sex affect treatment outcomes for children with severe malnutrition: A multi-country secondary data analysis
Key messages
* There are few differences in recovery outcomes for wasting treatment by age and sex.
* Though differences are small, mean daily weight gain (g/kg/day) appears to be significantly lower in boys than girls. Likewise, though differences are small, younger children (6–23 months) often have a significantly longer mean length of stay compared with older children (24–59 months).
* The strength of our evidence does not indicate the need to change current inclusion criteria for wasting treatment programmes on the basis of age and sex but does suggest the need for further research to understand the effects of different confounders on treatment outcomes.Data Availability Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.Supporting Information is available online at: https://onlinelibrary.wiley.com/doi/full/10.1111/mcn.13596#support-information-section .Age and sex influence the risk of childhood wasting. We aimed to determine if wasting treatment outcomes differ by age and sex in children under 5 years, enroled in therapeutic and supplementary feeding programmes. Utilising data from stage 1 of the ComPAS trial, we used logistic regression to assess the association between age, sex and wasting treatment outcomes (recovery, death, default, non-response, and transfer), modelling the likelihood of recovery versus all other outcomes. We used linear regression to calculate differences in mean length of stay (LOS) and mean daily weight gain by age and sex. Data from 6929 children from Kenya, Chad, Yemen and South Sudan was analysed. Girls in therapeutic feeding programmes were less likely to recover than boys (pooled odds ratio [OR]: 0.84, 95% confidence interval [CI]: 0.72–0.97, p = 0.018). This association was statistically significant in Chad (OR: 0.61, 95% CI: 0.39–0.95, p = 0.030) and Yemen (OR: 0.47, 95% CI: 0.27–0.81, p = 0.006), but not in Kenya and South Sudan. Multinomial analysis, however, showed no difference in recovery between sexes. There was no difference between sexes for LOS, but older children (24–59 months) had a shorter mean LOS than younger children (6–23 months). Mean daily weight gain was consistently lower in boys compared with girls. We found few differences in wasting treatment outcomes by sex and age. The results do not indicate a need to change current programme inclusion requirements or treatment protocols on the basis of sex or age, but future research in other settings should continue to investigate the aetiology of differences in recovery and implications for treatment protocols
South Africa's Health Promotion Levy: excise tax findings and equity potential
In 2016, the South African government proposed a 20% sugar-sweetened beverage (SSB) tax. Protracted consultations with beverage manufacturers and the sugar industry followed. This resulted in a lower sugar-based beverage tax, the Health Promotion Levy (HPL), of approximately 10% coming into effect in April 2018. We provide a synthesis of findings until April 2021. Studies show that despite the lower rate, purchases of unhealthy SSBs and sugar intake consumption from SSBs fell. There were greater reductions in SSB purchases among both lower socioeconomic groups and in subpopulations with higher SSB consumption. These subpopulations bear larger burdens from obesity and related diseases, suggesting that this policy improves health equity. The current COVID-19 pandemic has impacted food and nutritional security. Increased pandemic mortality among people with obesity, diabetes, and hypertension highlight the importance of intersectoral public health disease-prevention policies like the HPL, which should be strengthened
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Maternal traditional dietary pattern and antiretroviral treatment exposure are associated with neonatal size and adiposity in urban, black South Africans
© 2018 The Authors. This study examines the associations between maternal Traditional dietary pattern adherence and HIV/treatment with neonatal size and adiposity in urban, black South Africans, as well as how specific maternal factors-that is BMI and gestational weight gain (GWG)-may influence these associations. Multiple linear regression models were used to examine associations among maternal Traditional diet pattern adherence (pattern score), HIV/treatment status (three groups: HIV negative, HIV positive (antenatal antiretroviral treatment (ART) initiation), HIV positive (pre-pregnancy ART initiation)), BMI and GWG (kg/week), and newborn (1) weight:length ratio (WLR, kg/m) in 393 mother-neonate pairs, and (2) Peapod estimated fat mass index (FMI, kg/m3) in a 171-pair subsample. In fully adjusted models, maternal obesity and GWG were associated with 0·25 kg/m (P=0·008) and 0·48 kg/m (P=0·002) higher newborn WLR, whereas Traditional diet pattern score was associated with lower newborn WLR (-0·04 kg/m per +1 sd; P=0·033). In addition, Traditional diet pattern score was associated with 0·13 kg/m3(P=0·027) and 0·32 kg/m3(P=0·005) lower FMI in the total sample and in newborns of normal-weight women, respectively. HIV-positive (pre-pregnancy ART) v. HIV-negative (ref) status was associated with 1·11 kg/m3(P=0·002) higher newborn FMI. Promotion of a Traditional dietary pattern, alongside a healthy maternal pre-conception weight, in South African women may reduce newborn adiposity and metabolic risk profiles. In HIV-positive women, targeted monitoring and management strategies are necessary to limit treatment-associated effects on in utero fat deposition
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The relationships between socioeconomic status, dietary knowledge and patterns, and physical activity with adiposity in urban South African women
BACKGROUND: This cross-sectional study examined the relationship between socioeconomic status (SES), dietary knowledge and patterns, and physical activity level with body mass index of urban South African young women.
METHODS: Data were collected on 160 black South African women (aged 18–24 years) and included household SES, food frequency and nutritional knowledge questionnaires, self-reported physical activity and anthropometry. To assess household SES index, 1–7 assets were categorised as a lower household SES and those with 8–13 assets as a higher household SES. Structural equation modelling analysis was used to determine the direct, indirect and total effects on adiposity of household SES, age, education, nutrition knowledge score, dietary patterns and physical activity.
RESULTS: The prevalence of overweight and obesity was similar among women from high SES households compared with their low SES peers (48.4 vs. 44.8%). More than half (53%) of the women had poor dietary knowledge. Women from low SES households spent more time in moderate to vigorous intensity exercise (MVPA) compared with their high SES counterparts. Two distinct dietary patterns (Western and mixed) were identified. SEM results show that a unit increase in adherence to the ‘Mixed’ dietary pattern compared with ‘Western’ was associated with a 0.81 lower BMI kg/m2 (95% CI −1.54; −0.08), while ≥ 150 minutes’ MVPA per week was associated with a 1.94 lower BMI kg/m2 (95% CI −3.48; −0.41).
CONCLUSION: The associations of SES, diet and physical activity on BMI must be taken into account when developing and designing interventions that target improvement in young women’s health