1
|
Choedon T, Brennan E, Joe W, Lelijveld N, Huse O, Zorbas C, Backholer K, Murira Z, Wrottesley SV, Sethi V. Nutritional status of school-age children (5-19 years) in South Asia: A scoping review. MATERNAL & CHILD NUTRITION 2024; 20:e13607. [PMID: 38095279 PMCID: PMC10981491 DOI: 10.1111/mcn.13607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 04/01/2024]
Abstract
Information on malnutrition for school-age children and adolescents (5-19 years) in South Asia is fragmented and inconsistent, which limits the prioritization of nutrition policies, programmes and research for this age group. This scoping review aimed to synthesize existing evidence on the burden of malnutrition for children and adolescents aged 5-19 years in South Asia, and on interventions to improve their nutritional status. Cochrane Library, EMBASE, Medline and Google Scholar were systematically searched for articles published between January 2016 and November 2022. Eligible studies reported the prevalence of undernutrition, overweight/obesity, micronutrient deficiencies and unhealthy dietary intakes, and interventions that aimed to address these in South Asia. In total, 296 articles met our inclusion criteria. Evidence revealed widespread, yet heterogeneous, prevalence of undernutrition among South Asian children and adolescents: thinness (1.9%-88.8%), wasting (3%-48%), underweight (9.5%-84.4%) and stunting (3.7%-71.7%). A triple burden of malnutrition was evident: the prevalence of overweight and obesity ranged from 0.2% to 73% and 0% to 38% (with rapidly rising trends), respectively, alongside persistent micronutrient deficiencies. Diets often failed to meet nutritional requirements and high levels of fast-food consumption were reported. Education, fortification, supplementation and school feeding programmes demonstrated beneficial effects on nutritional status. Comprehensive and regular monitoring of all forms of malnutrition among children and adolescents, across all countries in South Asia is required. Further, more large-scale intervention research is needed to ensure policy and programmes effectively target and address malnutrition among children and adolescents in South Asia.
Collapse
Affiliation(s)
| | | | - William Joe
- Institute of Economic Growth (IEG)DelhiIndia
| | | | - Oliver Huse
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongVictoriaAustralia
| | - Christina Zorbas
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongVictoriaAustralia
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Faculty of HealthDeakin UniversityGeelongVictoriaAustralia
| | | | | | - Vani Sethi
- UNICEF South Asia Regional OfficeKathmanduNepal
| |
Collapse
|
2
|
Ravula P, Kasala K, Pramanik S, Selvaraj A. Stunting and Underweight among Adolescent Girls of Indigenous Communities in Telangana, India: A Cross-Sectional Study. Nutrients 2024; 16:731. [PMID: 38474859 DOI: 10.3390/nu16050731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
India's indigenous groups remain vulnerable to malnutrition, despite economic progress, reflecting the reliance on traditional agriculture and the problems of poverty and inadequate education and sanitation. This mixed-methods study analyzed the incidence, causes and determinants of chronic malnutrition, measured through stunting, thinness and underweight among adolescent indigenous girls in Telangana. Using 2017 data on 695 girls aged 11-18 years from 2542 households, the analysis showed that 13% had normal nutritional status, while 87% were stunted, underweight or thin. Early adolescents (11-14 years) had higher underweight prevalence (24.4%), while late adolescents (15-18 years) showed greater stunting (30%). Regressions identified key influencing factors. Higher education levels of heads of households and the girls themselves alongside household toilet access significantly improved nutritional status and reduced stunting and underweight. The sociocultural emphasis on starchy staple-based diets and early marriage also impacted outcomes. Tackling this crisis requires mainstreaming nutrition across development agendas via comprehensive policies, education, communication and community participation. Further research can guide context-specific solutions. But, evidence-based investments in indigenous education, livelihoods, sanitation and women's empowerment are the first steps. Nutrition-sensitive development is indispensable for indigenous groups to fully participate in and benefit from India's progress.
Collapse
Affiliation(s)
- Padmaja Ravula
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Hyderabad 502324, India
| | - Kavitha Kasala
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Hyderabad 502324, India
| | - Soumitra Pramanik
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Hyderabad 502324, India
| | - Aravazhi Selvaraj
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Hyderabad 502324, India
- World Vegetable Center, International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Hyderabad 502324, India
| |
Collapse
|
3
|
Guo H, Zong S, Yong L, Jiang Y, Qin L, Zhou L, Ren Q, Gao X, Kang F, Huang W, Chen J, Zhang L. The association between perchlorate in drinking water and height and weight of children and adolescents in Southwest China: a retrospective cross-sectional study. Front Public Health 2023; 11:1260612. [PMID: 37860794 PMCID: PMC10582749 DOI: 10.3389/fpubh.2023.1260612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/20/2023] [Indexed: 10/21/2023] Open
Abstract
Objective To investigate the association between the concentration of perchlorate in drinking water and the height and weight of children and adolescents in Sichuan Province. Methods Perchlorate in the drinking water of 24 counties in Sichuan Province from 2021 to 2022 was detected and analyzed, 66 drinking water samples were collected, and the content of perchlorate in drinking water during the wet season and dry season was detected by ultra-high performance liquid chromatography in series. The linear mixed effect model was used to estimate the relationship between perchlorate in drinking water and the height and weight of 144,644 children and adolescents, and 33 pieces of local average wage data were used as confounding factors for quality control. Results After controlling the age, gender, and local economic situation, we found that the concentration of perchlorate in drinking water increased by 10 μg/L is associated with a 1.0 cm decrease in height and a 1.6 kg decrease in weight in children and adolescents (p < 0.05). Conclusion The concentration of perchlorate in drinking water may be negatively correlated with the height and weight of children.
Collapse
Affiliation(s)
- Hongyu Guo
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Shimiao Zong
- School of Public Health, Chengdu Medical College, Chengdu, China
| | - Li Yong
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Yang Jiang
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Ling Qin
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Liang Zhou
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Qiaoqiao Ren
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Xufang Gao
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Fayang Kang
- Guangyuan Center for Disease Control and Prevention, Guangyuan, China
| | - Wei Huang
- Zigong Center for Disease Control and Prevention, Zigong, China
| | - Jianyu Chen
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Li Zhang
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| |
Collapse
|
4
|
Kebede TB, Mengesha S, Lindtjorn B, Engebretsen IMS. Anaemia, anthropometric undernutrition and associated factors among mothers with children younger than 2 years of age in the rural Dale district, southern Ethiopia: A community‐based study. MATERNAL & CHILD NUTRITION 2022; 18:e13423. [PMID: 36006033 PMCID: PMC9480945 DOI: 10.1111/mcn.13423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 07/23/2022] [Accepted: 07/29/2022] [Indexed: 11/27/2022]
Abstract
Mothers in resource‐poor settings are affected by different forms of undernutrition. However, the nutritional status of mothers in rural areas, particularly after delivery, is not well documented. This study assessed haemoglobin levels and body mass index (BMI) of mothers with children below 2 years of age in a rural district of southern Ethiopia. Factors associated with low haemoglobin levels and low BMI were analysed. A community‐based cross‐sectional study was conducted among 931 mother‐child pairs. Structured and standard questionnaires were used to collect data on background information, 24 h dietary recalls, and household food insecurity. Anthropometric and haemoglobin level assessments were performed. Anaemia was defined as haemoglobin levels below 12.0 g/dl, and anthropometric undernutrition was defined as a BMI <18.5 kg/m2. Multilevel linear regression was used to determine associations. Out of 931 mothers, 12.8% were anaemic and 12.6% had a BMI <18.5 kg/m2. The prevalence of minimum dietary diversity was 37.8%. The majority (78.5%) of the households were food insecure. Weight (β 0.02; 95% CI: 0.003−0.03), dietary diversity (β 0.08; 95% CI: 0.03−0.12) and secondary school attendance (β 0.34; 95% CI: 0.08−0.59) were associated with the mothers' haemoglobin level. Dietary diversity (β 0.08; 95% CI: 0.01−0.16) and household's wealth (β 0.6; 95% CI: 0.27−0.94) were associated with the mothers' BMI. Findings suggest that education and community‐based nutrition interventions must be strengthened to ensure household food security. Implementation of the national food‐based strategies should be considered, to improve the dietary diversity and nutritional status of mothers. Anaemia and underweight were less prevalent among mothers with young children in the rural Dale district, southern Ethiopia, than the national report of the Ethiopian Demographic and Health Survey in 2016. Dietary diversity is positively associated with haemoglobin level and body mass index among mothers with children younger than 2 years of age. The existing nutrition interventions such as the Productive Safety Net Programme need strengthening, to improve the sustained food access to rural households. Planing and implementing community‐based small‐scale activities, such as school gardening, and fish and poultry farming, to ensure the availability and affordability of nutritious foods.
Collapse
Affiliation(s)
- Tsigereda B. Kebede
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Centre for International Health University of Bergen Bergen Norway
| | - Selamawit Mengesha
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Sidama Regional Health Bureau Sidama region Hawassa Ethiopia
| | - Bernt Lindtjorn
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Centre for International Health University of Bergen Bergen Norway
| | | |
Collapse
|
5
|
Sari P, Herawati DMD, Dhamayanti M, Hilmanto D. Anemia among Adolescent Girls in West Java, Indonesia: Related Factors and Consequences on the Quality of Life. Nutrients 2022; 14:3777. [PMID: 36145153 PMCID: PMC9503484 DOI: 10.3390/nu14183777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/08/2022] [Accepted: 09/11/2022] [Indexed: 12/24/2022] Open
Abstract
Anemia in adolescent girls is still a problem in Indonesia. The impact of anemia is quite significant for adolescent health. This study aims to analyze related factors of anemia among adolescent girls, and the effect of anemia on the quality of life. The study was conducted in the Soreang District, West Java, Indonesia. This cross-sectional study involved 286 female students (15−19 years). A 24-h recall questionnaire was used to collect the nutrient intake. We use the WHOQOL-BREF to analyze the quality of life. The study assessed height, weight, body mass index (BMI), mid-upper arm circumference (MUAC), and a capillary blood sample to determine hemoglobin levels. Bivariate and multiple logistic regression tests were measured to find the factors most influencing anemia. The prevalence of anemia was 14.3%. Related factors of anemia in this study were: duration of blood show per menses, iron consumption, weight, height, and MUAC. From bivariate analyses, anemia influenced the social relationships domain with p < 0.05. Multivariate logistic regression showed that the most influencing factors for anemia were MUAC and duration of blood per menses. Anemia impacted the social relationships domain. In this study, the two main factors that affected anemia were MUAC and duration of blood each menstrual cycle.
Collapse
Affiliation(s)
- Puspa Sari
- Doctoral Study Program, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
| | - Dewi Marhaeni Diah Herawati
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
| | - Meita Dhamayanti
- Department of Child Health, Hasan Sadikin Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
| | - Dany Hilmanto
- Department of Child Health, Hasan Sadikin Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
| |
Collapse
|
6
|
Ahankari AS, Tata LJ, Fogarty AW. Weight, height, and midupper arm circumference are associated with haemoglobin levels in adolescent girls living in rural India: A cross-sectional study. MATERNAL AND CHILD NUTRITION 2019; 16:e12908. [PMID: 31823478 PMCID: PMC7083455 DOI: 10.1111/mcn.12908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 08/07/2019] [Accepted: 10/08/2019] [Indexed: 11/28/2022]
Abstract
We aimed to explore the association of physical parameters with haemoglobin (Hb) levels to test the hypothesis that impaired physical development is associated with anaemia. A cross‐sectional survey study recruited adolescent girls (13 to 17 years) living in rural areas of Maharashtra state of India. Data were collected on physical parameters include height, weight, and midupper arm circumference (MUAC). Hb levels were measured using Sahli's haemometer. Linear regression was conducted to test the hypothesis. Data were collected from 1,010 girls on physical parameter and Hb levels. The majority of the adolescent girls were diagnosed with anaemia (87%). The regression analysis adjusted for age gave a significant association of Hb levels with all three variables (MUAC, weight, and height). Hb increased by 0.11 g/dl with an each centimetre of increase in MUAC (95% confidence interval, CI, [0.08, 0.15], P < .001). Each kilogram of increase in the body weight showed an increase in Hb levels (0.02 g dl, 95% CI [0.01, 0.03], P = .001). With an each centimetre of increase in height, Hb increased by 0.01 g dl (95% CI [0.00, 0.02], P = .022). There was a consistent association between three measures of somatic growth and anaemia in the study population. It is likely that life‐course exposures from conception onwards contribute to this, and the public health implications are that preventing anaemia is a challenge that requires a multifaceted interventional approach. Understanding the importance of the timing of these life exposures will help design interventions that can achieve optimal results.
Collapse
Affiliation(s)
- Anand S Ahankari
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.,HMF Research, Halo Medical Foundation, India.,Faculty of Health Sciences, University of Hull, Hull, UK
| | - Laila J Tata
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Andrew W Fogarty
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| |
Collapse
|