THE DUAL BURDEN OF MALNUTRITION IN CHILDREN IN LOW- AND MIDDLE-INCOME COUNTRIES

High levels of childhood undernutrition persist in many low- and middle-income countries (LMIC). Rapid shifts in dietary and physical activity patterns brought about by the nutrition transition have led to increased childhood obesity in these same countries, leading to the co-existence of under- and overnutrition, known as the dual burden of malnutrition. The dual burden occurs at the population, household, and individual level. We used two different data sources to address the different levels of the dual burden in children: 1) Demographic and Health Surveys (DHS) from over 35 countries to assess contemporary global anthropometric trends in children <5y and to explore the role of socioeconomic status, and 2) the Cebu Longitudinal Health and Nutrition Survey (CLHNS) to assess determinants of discordant nutritional status among mother-daughter dyads during a period of rapid economic change in the Philippines. Global malnutrition prevalence in children <5y decreased, driven by stunting decreases. Overweight increased in over a third of countries. Children <2 years experienced worse stunting and overweight trends compared to children 2-5y. Countries with nearly equal prevalence of stunting and overweight increased over time. We did not detect a pronounced shift in anthropometry with respect to wealth status as has been noted in adults, however we document a widening wealth gap between the poorest and richest households in a majority of countries. Considerable between-country heterogeneity was noted, which may make drawing global conclusions difficult. We observed a U-shaped relationship between the mother-daughter dyad’s height difference and daughter’s adult central adiposity, with the tallest and shortest daughters experiencing increased central adiposity. This is the first assessment of dual burden trends in children on a global scale. Governments and policy makers must be aware of the changing dynamics and adapt nutrition programs and policies accordingly.Doctor of Philosoph

Childhood Dual Burden of Under- and Overnutrition in Low- and Middle-inCome Countries: A Critical Review

In low- and middle income countries, the distribution of childhood nutritional diseases is shifting from a predominance of undernutrition to a dual burden of under- and overnutrition. This novel and complex problem challenges governments and health organizations to tackle opposite ends of the malnutrition spectrum. The dual burden may manifest within a community, household, or individual, but these different levels have not been addressed collectively

Prevalence and trends in the childhood dual burden of malnutrition in low- and middle-income countries, 1990–2012

Abstract Objective To describe trends in country- and individual-level dual burden of malnutrition in children &lt;5 years, and age-stratified (&lt;2 years, ≥2 years) country-level trends, in thirty-six low- and middle-income countries (LMIC). Design Using repeated cross-sectional nationally representative data, we calculated the prevalence of malnutrition (stunting, wasting, overweight) at each survey wave, annualized rates of prevalence change for each country over time, and trends before and after 2000, for all children &lt;5 years and separately for those &lt;/≥2 years. We examined country- (ratio of stunting to overweight) and individual-level (coexistence of stunting and overweight) dual burden in children &lt;5 years. Setting Demographic and Health Surveys from thirty-six LMIC between 1990 and 2012. Subjects Children &lt;5 years. Results Overall malnutrition prevalence decreased in children &lt;5 years, driven by stunting decreases. Stunting rates decreased in 78 % of countries, wasting rates decreased in 58 % of countries and overweight rates increased in 36 % of countries. Rates of change differed for children &lt;/≥2 years, with children &lt;2 years experiencing decreases in stunting in fewer countries yet increases in overweight in more countries. Countries with nearly equal prevalences of stunting and overweight in children &lt;5 years increased from 2000 to the final year. Within a country, 0·3–10·9 % of children &lt;5 years were stunted and overweight, and 0·6–37·8 % of stunted children &lt;5 years were overweight. Conclusions The dual burden exists in children &lt;5 years on both country and individual levels, indicating a shift is needed in policies and programmes to address both sides of malnutrition. Children &lt;2 years should be identified as a high-risk demographic

Determinants of Successful Aging in a Cohort of Filipino Women

This study describes a multidimensional measure of successful aging (SA) and examines the relationship with chronic disease status and self-reported health. Using data from the 2015 Cebu Longitudinal Health and Nutrition Survey of 1568 Filipino women, we created a four domain measure of SA (physiological, mental health, cognitive, sociological). We explored age-stratified associations of each domain and total SA with various health behaviors, chronic disease status, and correlations with self-reported health measures. Both age groups reported aging well, but younger women had higher mean SA scores. Association patterns between domain and total SA and sociodemographic and health behaviors were similar across age groups. Physiological score was associated with hypertension for all ages, and with diabetes in younger women. Total SA was moderately correlated with self-reported health measures. Participants reported aging successfully despite chronic disease status. Future studies should use a multidimensional definition of SA which incorporates elders&rsquo; perspective

The Deep X-ray Radio Blazar Survey (DXRBS) - II. New identifications

The definitive version may be found at www.wiley.comHermine Landt, Paolo Padovani, Eric S. Perlman, Paolo Giommi, Hayley Bignall and Anastasios Tzioumi

Examples of extreme intraday variability

The original publication can be found at www.springerlink.comLucyna Kedziora-Chudczer, David L. Jauncey, Mark A. Wieringa, Anastasios K. Tzioumis and Hayley E. Bignal

Interstellar scintillation and annual cycles in the BL Lac source PKS 1519-273

The original publication can be found at www.springerlink.comWe have measured annual cycles in the time scales of the rapid, intra-day variability of the total and circularly polarized flux density, of the unusual BL Lac source PKS 1519–273 at 4.8 and 8.6 GHz. This data was collected at the ATCA over the last seven years, and establishes unequivocally interstellar scintillation as the principal mechanism responsible for this cm-wavelength intra-day variability.David L. Jauncey, Helen M. Johnston, Hayley E. Bignall, J.E.J. Lovell, Lucyna Kedziora-Chudczer, A.K. Tzioumis and Jean-Pierre Macquar

Radio intra-day variability: Answers and questions

The original publication can be found at www.springerlink.comIntra-day variability (IDV) of active galactic nuclei (AGN) has been detected from gamma-ray energies to radio wavelengths. At high energies, such variability appears to be intrinsic to the sources themselves. However, at radio wavelengths, brightness temperatures as high as1018 to 1021 K are encountered if the IDV is intrinsic to the source. We discuss here the accumulating evidence showing that, at radio wavelengths where the highest brightness temperatures are encountered, interstellar scintillation (ISS) is the principal mechanism causing IDV. While ISS reduces the implied brightness temperatures, they still remain uncomfortably high.David L. Jauncey, Lucyna Kedziora-Chudczer, James E.J. Lovell, Jean-Pierre Macquart, George D. Nicolson, Rick A. Perley, John E. Reynolds, Anastasios K. Tzioumis, Mark H. Wieringa and Hayley E. Bignal

Overweight and stunting in migrant Hispanic children in the USA

Obesity, type 2 diabetes mellitus (DM) and metabolic syndrome (MS) are common in patients with heart failure (HF). Studies investigating the association between known biomarkers and adiposity in patient populations are limited. The aim of the present study was to investigate the association between C-reactive protein (CRP) and leptin with adiposity in a sub-group of overweight/obese patients with HF, DM and/or MS. A total of 36 patients (mean age, 56.72±9.78 years; ranging between 27 and 76 years of age; 80.6% male; 52.8% Caucasian) were enrolled and their height, weight, waist circumference and body composition (e.g. percentage body fat and lean mass), as well as the levels of CRP and leptin, were assessed. The results demonstrated that there was a significant association between CRP and leptin, CRP and body mass index (BMI) and gender and percentage body fat (