Why are West African children underweight?

The incidence of underweight amongst children under five in Western Africa has been increasing over the last decade (UNICEF, 2002). In Asia, where about two thirds of the world's underweight children live, the rate of underweight declined from about 36 per cent to some 29 per cent between 1990 and 2000. In sub-Saharan Africa, the absolute number of underweight children has increased and is now about 36 per cent. Using new data from Demographic and Health Surveys, I estimate the probability of underweight or a sample of West African children, controlling for selective survival

The relationship of ethnicity, socio-economic factors and malnutrition in primary school children in North of Iran: A cross-sectional study

related factors based on three ethnic groups among primary school children in north of Iran in 2010. Methods: This cross-sectional study was carried out through multistage cluster random sampling on 5698 subjects (2505 Fars-native, 2154 Turkman, and 1039 Sistani) in 112 schools. Well-trained staffs completed the questionnaire and measured students' weight and height. Malnutrition estimated the Z-score less than -2SD for underweight, stunting and wasting were calculated using the cutoffs from WHO references. Results: Generally, malnutrition was observed in 3.20%, 4.93% and 5.13% based on underweight, stunting and wasting respectively. It was more common in girls than in boys and in Sistani than in other ethnic groups. The correlation between malnutrition based on underweight and stunting and ethnicity was statisti-cally significant (P=0.001). Results of logistic regression analyses showed that the risk of malnutrition was in rural area 1.34 times more than urban area, in girls 1.17 times more than boys, in Sistani ethnic group 1.82 times more than Fars-native ethnic group, in low economic families 2.01 times more than high economic families. Conclusion: Underweight, stunting and wasting are the health problems in primary school children in north of Iran with a higher prevalence in girls, in rural areas, and in Sistani ethnic group

New anthropometric classification scheme of preoperative nutritional status in children: A retrospective observational cohort study

Objective: WHO uses anthropometric classification scheme of childhood acute and chronic malnutrition based on low body mass index (BMI) (\u27wasting\u27) and height for age (\u27stunting\u27), respectively. The goal of this study was to describe a novel two-axis nutritional classification scheme to (1) characterise nutritional profiles in children undergoing abdominal surgery and (2) characterise relationships between preoperative nutritional status and postoperative morbidity. Design: This was a retrospective observational cohort study. Setting: The setting was 50 hospitals caring for children in North America that participated in the American College of Surgeons National Surgical Quality Improvement Program Paediatric from 2011 to 2013. Participants: Children \u3e28 days who underwent major abdominal operations were identified. Interventions/main predictor: The cohort of children was divided into five nutritional profile groups based on both BMI and height for age Z-scores: (1) underweight/short, (2) underweight/tall, (3) overweight/short, (4) overweight/tall and (5) non-outliers (controls). Main outcome measures: Multiple variable logistic regressions were used to quantify the association between 30-day morbidity and nutritional profile groups while adjusting for procedure case mix, age and American Society of Anaesthesiologists class. Results: A total of 39 520 cases distributed as follows: underweight/short (656, 2.2%); underweight/tall (252, 0.8%); overweight/short (733, 2.4%) and overweight/tall (1534, 5.1%). Regression analyses revealed increased adjusted odds of composite morbidity (35%) and reintervention events (75%) in the underweight/short group, while overweight/short patients had increased adjusted odds of composite morbidity and healthcare-associated infections (43%), and reintervention events (79%) compared with controls. Conclusion: Stratification of preoperative nutritional status using a scheme incorporating both BMI and height for age is feasible. Further research is needed to validate this nutritional risk classification scheme for other surgical procedures in children

Correlation between body mass index and waist circumference in Nigerian adults: implication as indicators of health status

Background. Anthropometric measures have been widely used for body weight classification in humans. Waist circumference has been advanced as a useful parameter for measuring adiposity. This study evaluated the correlation between body mass index (BMI) and waist circumference and examined their significance as indicators of health status in adults. Design and Methods. The subject included 489 healthy adults from Ota, Nigeria, aged between 20 and 75 years, grouped into early adulthood (20-39 years), middle adulthood (40-59 years) and advanced adulthood (60 years and above). Weight, height and abdominal circumference were measured. BMI was calculated as weight kg/height2 (m2) and World Health Organization cut-offs were used to categorize them into normal, underweight, overweight and obese. Results. Abnormal weight categories accounted for 60 % of the subjects (underweight 11 %, overweight 31%, and obese 18%). The waist circumference of overweight and obese categories were significantly (P<0.05) higher than the normal weight category. There was no significant difference between waist circumference of underweight and normal subjects. The correlation coefficient values of BMI with waist circumference (r=0.63), body weight (r=0.76) and height (r=-0.31) were significant (P<0.01) for the total subjects. Conclusions. The study indicates that waist circumference can serve as a positive indicator of overweight and obesity in the selected communities; however, it may not be used to determine underweight in adults. Regular BMI and waist circumference screening is recommended as an easy and effective means of assessing body weight and in the prevention of weight related diseases in adults

Economic Growth, Lifestyle Changes, and the Coexistence of Under and Overweight in China: A Semiparametric Approach

We investigate the relationship between changes in socioeconomic factors and the emerging coexistence of under and overweight among adults in China during 1991-2000. Our key questions are: (1) whether any socioeconomic factor explains both increasing overweight (Body Mass Index (BMI)less than or equal to 25 kg/m2) and remaining underweight (BMI greater than or equal to 18.5 kg/m2), (2) whether China's continuing economic growth leads to further increase in the prevalence of overweight, and (3) whether China's economic growth alone can lead to commensurate decrease in its remaining underweight. Based on the theoretical model in Lakdawalla and Philipson (2002), we focus on the effects of economic growth on weight through changes in income, job-related activity and food prices. We adopt a semiparametric technique and decompose changes in the BMI distribution into the effects of changes in selected socioeconomic factors. We find that changes in the pattern of job-related activity partly explain both increasing overweight and remaining underweight. Overall income growth contributes to decreasing both under and overweight. Decreasing food prices are one of main factors shifting Chinese population from underweight toward overweight. The effects of economic growth examined in this paper well-explain increasing overweight, and thus continuing economic growth is likely to lead to further increase in overweight rates. Our results also indicate that there exist unobserved factors that significantly counteract the downward effects of economic growth on underweight rates, and thus economic growth alone is unlikely to lead to commensurate decrease in remaining underweight. To reduce remaining underweight, more direct interventions (e.g., micronutrient supplementation) may be needed.Economic Growth, Underweight, Overweight, Smiparametric, China, Health Economics and Policy, International Development,

Multidimensional Nature of Undernutrition: A Statistical Approach

The statistical assessment of undernutrition is usually restricted to a pairwise analysis of anthropometric indicators. The main objective of this study was to model the associations between underweight, stunting and wasting and to check whether multidimensionality of undernutrition can be justified from a purely statistical point of view. 3742 children aged 0 to 59 months were enrolled in a cross-sectional household survey (2004 Cameroon Demographic and Health Surveys (DHS)). The saturated loglinear model and the multiple correspondence analysis (MCA) showed no interaction and a highly significant association between underweight and stunting (P=0), underweight and wasting (P=0); but not between stunting and wasting (P=0.430). Cronbach's alpha coefficient between weight-for-age, height-for-age and weight-for-height was 0.62 (95% CI 0.59, 0.64). Thus, the study of these associations is not straightforward as it would appear in a first instance. The lack of three-factor interaction and the value of the Cronbach's alpha coefficient indicate that undernutrition is indeed (statistically) multidimensional. The three indicators are not statistically redundant; thus for the case of Cameroon the choice of a particular anthropometric indicator should depend on the goal of the policy maker, as it comes out of this study that no single indicator is to be used for all situations.Stunting; Wasting; Underweight; anthropometric measures; Z-score; Loglinear models

Use of antenatal clinic surveillance to assess the effect of sexual behavior on HIV prevalence in young women in Karonga district, Malawi.

BACKGROUND: Antenatal clinic (ANC) surveillance is the primary source of HIV prevalence estimates in low-resource settings. In younger women, prevalence approximates incidence. Sexual behavior monitoring to explain HIV distribution and trends is seldom attempted in ANC surveys. We explore the use of marital history in ANC surveillance as a proxy for sexual behavior. METHODS: Five ANC clinics in a rural African district participated in surveillance from 1999 to 2004. Unlinked anonymous HIV testing and marital history interviews (including age at first sex and socioeconomic variables) were conducted. Data on women aged <25 years were analyzed. RESULTS: Inferred sexual exposure before marriage and after first marriage increased the adjusted odds of infection with HIV by more than 0.1 for each year of exposure. Increasing years within a first marriage did not increase HIV risk. After adjusting for age, women in more recent birth cohorts were less likely to be infected. CONCLUSIONS: Marital status is useful behavioral information and can be collected in ANC surveys. Exposure in an ongoing first marriage did not increase the odds of infection with HIV in this age group. HIV prevalence decreased over time in young women. ANC surveillance programs should develop proxy sexual behavior questions, particularly in younger women

BMI-For-Age Cut-Off as an Indicator of Adiposity among In-School Children (Age 4-11 Years) in Obio/Akpor LGA, Rivers State, Nigeria

Background: Childhood overweight and obesity has been an issue of great concern to developing and developed nation where as degenerative underweight has ravaged the underdeveloped and war turn countries. Aim: This present study investigated the nutritional status of in-school children in Obio/Akpor Local Government Area of Rivers State using the WHO Body Mass Index-for-Age percentiles cut-offs. Design and Methods: This study was designed as a cross-sectional analytical research. A total of 310 in-school children comprising of 149 boys and 161 girls were multi-staged randomly selected from primary schools within Obio/Akpor LGA of Rivers state, Nigeria. Anthropometric determination of weight and height of the selected children were carried out by standard methods. Stages of development (early childhood [4-7 years] and late childhood [8-11 years]) and sex-specific prevalence of adiposity were determined using WHO BMI-for-age percentile cut-offs. SPSS version 23 (IBM® Armonk, New York) was used to analyse the data. Results: The Prevalence of overweight was found to be 29%; with 44% in children age 4-7years and 15% for children age 8-11years. Chi-square (X2 ) analysis showed that more girls (33.7%) than boys (29.1%) were significantly overweight (F=2.138, P=0.032); however nutritional status was not associated with sex (χ2 =3.12, P>0.05) but with developmental stage when stratified with sex (χ2 =52.306, P<0.01). Conclusion: The prevalence of overweight was high; but higher in females than males, observed at early childhood. Greater adiposity at early childhood with gradual reduction through late childhood may be associated with high calorie-based dieting, reduced exercise and sedentary life among younger children