Determinants of Stunting and Severe Stunting Among Under-Fives in Tanzania: Evidence from the 2010 Cross-Sectional Household Survey.

Stunting is one of the main public health problems in Tanzania. It is caused mainly by malnutrition among children aged less than 5 years. Identifying the determinants of stunting and severe stunting among such children would help public health planners to reshape and redesign new interventions to reduce this health hazard. This study aimed to identify factors associated with stunting and severe stunting among children aged less than five years in Tanzania. The sample is made up of 7324 children aged 0-59 months, from the Tanzania Demographic and Health Surveys 2010. Analysis in this study was restricted to children who lived with the respondent (women aged 15-49 years). Stunting and severe stunting were examined against a set of individual-, household- and community-level factors using simple and multiple logistic regression analyses. The prevalence of stunting and severe stunting were 35.5 % [95 % Confidence interval (CI): 33.3-37.7] and 14.4 % (95 % CI: 12.9-16.1) for children aged 0-23 months and 41.6 % (95 % CI: 39.8-43.3) and 16.1 % (95 % CI: 14.8-17.5) for children aged 0-59 months, respectively. Multivariable analyses showed that the most consistent significant risk factors for stunted and severely-stunted children aged 0-23 and 0-59 months were: mothers with no schooling, male children, babies perceived to be of small or average size at birth by their mothers and unsafe sources of drinking water [adjusted odds ratio (AOR) for stunted children aged 0-23 months = 1.37; 95 % CI: (1.07, 1.75)]; [AOR for severely stunted children aged 0-23 months = 1.50; 95 % CI: (1.05, 2.14)], [AOR for stunted children aged 0-59 months = 1.42; 95 % CI: (1.13, 1.79)] and [AOR for severely stunted children aged 0-59 months = 1.26; 95 % CI: (1.09, 1.46)]. Community-based interventions are needed to reduce the occurrence of stunting and severe stunting in Tanzania. These interventions should target mothers with low levels of education, male children, small- or average-size babies and households with unsafe drinking water

Taurine

Taurine occurs as one of the most abundant free amino acids in a wide variety of animal tissues; it is mostly absent from plants. In man and other mammals, the highest taurine concentrations are found in heart, retina, spleen and bone marrow. Blood cells such as platelets and leucocytes are also very rich in taurine. Traditionally taurine has been regarded as an end product of methionine metabolism. Other pathways for taurine biosynthesis exist but they have not been fully characterised and in mammals the cysteinsulfinate pathway seems to be the major pathway

L-arginine

L-Arginine is a basic, semi-essential amino acid that was discovered in 1886 in lupin seedlings and then in 1895 in mammalian protein (Boger & Bode-Boger 2001). For humans L-arginine is considered to be a semi-essential amino acid or a conditionally essential amino acid, as requirements may increase during metabolic stress or when there is insufficient endogenous L-arginine for optimal growth or tissue repair; for birds and carnivores it is an essential amino acid. It is also the most abundant nitrogen carrier in animals and humans.3rd ed

Prebiotics

Gibson & Roberfroid (1995) introduced the concept of prebiotic as 'a non-digestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon and thus improves health: This concept has been further developed to define prebiotics as 'selectively fermented ingredients that allow specific changes, both in the composition and/or activity of the gastrointestinal microflora that confers benefits upon host wellbeing and health'.3rd ed

Probiotics

There is a long history of consuming fermented foods and beverages containing microorganisms to improve health. The term 'probiotic' is derived from Greek and means 'for life: As far back as 1908, Metchnikoff, the Nobel laureate, stated that 'ingested lactobacilli can displace toxin-producing bacteria, promoting health and prolonging life' (Elmer 2001). The term 'probiotics' was first coined in 1965 and has since been applied to those live microorganisms that are able to promote health when consumed in sufficient quantities (FAO/WHO 2001). This is in contrast to the term 'prebiotics' which are dietary components. Although it has taken the most part of a century for scientists to investigate their health benefits, there are now several thousand studies published on probiotics, the majority published since 2000.3rd ed

Changes in eating behavior after laparoscopic adjustable gastric banding: a systematic review of the literature

This systematic review evaluates the current evidence base for eating behavior changes after laparoscopic adjustable gastric banding (LAGB). A literature search from 1990 to February 2010 was conducted to identify original studies that assessed eating behavior in adults who have undergone LAGB. Sixteen articles (14 separate studies) met inclusion criteria. Although strength of the evidence base was limited by observational study designs and methodological weaknesses, results suggest that positive changes in eating behavior occur after surgery, including reduced over-eating in response to emotional and situational cues. There is some evidence to suggest that uncontrolled eating behaviors persist in some individuals, and that this may be problematic for weight loss after surgery. Few studies examined the relationship between changes in eating behavior and weight loss; thus, optimal behavioral strategies for promoting positive weight outcomes remain unclear. Further interventional research addressing the inherent limitations of the current-evidence base is required to guide development of evidence-based management guidelines for LAGB in future

Insights into those who volunteer for, but quit, weight loss programs

Weight loss programs attract many volunteers, yet drop out rates can be high, reducing the quality of results and outcomes and making it difficult to assist consumers. Our current weight loss study, examining different iso-energetic meal patterns, recruited 181 adults (50 men, 131 women). Thirty-six (20%), (9 Men, 27 Women) declined follow up within the first month. The aim was to determine if there were any differences physiologically between the groups or if there were other reasons why volunteers declined to continue. Analysis revealed there were no significant differences (p > 0.05) with respect to initial weight, body composition (% body fat, lean body mass), serum lipid profile, insulin resistance, age, gender, BMI, waist, blood pressure or depression score (all assessed using standard methods) between those who continued and those who did not. We speculated that random allocation to an unwanted meal pattern may have contributed to dropping out. Results indicate that there were no significant differences (p > 0.05) for a dropout’s baseline meal pattern between each of the three meal patterns, and for each gender. Interviews and qualitative data provided only 1 case where the meal pattern allocation had been the deciding factor to drop out. The remainder cited work, time constraints and family commitments as the primary reason. We conclude that a profile to reliably predict those who will quit a weight loss study could not be developed, and that we need to develop tools to evaluate lifestyle predictors more effectively