Head growth of undernourished children in rural Nepal: association with demographics, health and diet

Miller, Laurie C.; Joshi, Nidhi; Lohani, Mahendra; Singh, Rupa; Bhatta, Narendra; Rogers, Beatrice Lorge; Griffiths, Jeffrey K.; Ghosh, Shibani; Mahato, Shubh; Singh, Padma; Webb, Patrick

doi:10.1080/20469047.2015.1133517

Cited by 36 publications

(44 citation statements)

References 55 publications

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“…Measuring early growth monitors health and development (de Onis et al, ), and several early anthropometry measurements—weight (de Onis, Blossner, Borghi, Morris, & Frongillo, ), length (Berkman, Lescano, Gilman, Lopez, & Black, ; Prendergast & Humphrey, ), and head circumference (Ivanovic et al, ; Miller et al, )—carry particular implications for maturation (American Academy of Pediatrics, ). Children in settings of undernutrition and enteric disease are at risk for insufficient brain growth, as well as linear growth.…”

Section: Introductionmentioning

confidence: 99%

Early childhood growth and cognitive outcomes: Findings from the MAL‐ED study

Scharf

Rogawski

Murray‐Kolb

et al. 2018

Maternal & Child Nutrition

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Although many studies around the world hope to measure or improve developmental progress in children to promote community flourishing and productivity, growth is sometimes used as a surrogate because cognitive skills are more difficult to measure. Our objective was to assess how childhood measures of anthropometry correlate with measures of child development in low-income settings with high prevalence of poor nutrition and enteric disease, to inform studies considering growth outcomes in the absence of direct child developmental skill assessment. Children from the MAL-ED study were followed from birth to 24 months of age in field sites in 8 low- and middle-income countries across 3 continents. Monthly weight, length, and head circumference measurements were performed. At 24 months, the Bayley Scales of Infant and Toddler Development was administered. We correlated cognitive measures at 24 months with anthropometric measurements from birth to 2 years comparing 3 constructs: absolute attained monthly measures, summative difference in measures from the mean growth curve, and rate of change in measures. Growth faltering at multiple time periods is related to Bayley cognitive outcomes at 24 months. Birthweight, overall growth by 18-24 months, and rate of growth in the 6- to 18-month period were most associated with 24-month developmental scores. In this study, head circumference measurements, compared with length, was more closely linked to cognitive scores at 24 months. Notably, all studies between growth and cognitive outcomes exhibited low r values (0.001-0.049). Anthropometric measures, particularly head circumference, were related to cognitive development, although explaining a low percent of variance. When feasible, direct measures of child development may be more useful.

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Section: Introductionmentioning

confidence: 99%

Early childhood growth and cognitive outcomes: Findings from the MAL‐ED study

Scharf

Rogawski

Murray‐Kolb

et al. 2018

Maternal & Child Nutrition

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“…While a number of targeted nutrition-specific interventions are known to be effective in tackling undernutrition (such as iron and folate supplementation to pregnant women and promotion of exclusive breastfeeding), the international community continues to seek broader, so-called ‘nutrition sensitive’ actions that link investments in agriculture to improved child nutrition outcomes [ 2 , 3 ]. Given that optimal animal source food consumption (ASF) is increasingly acknowledged as important to child growth, the promotion of livestock production is widely thought to support enhanced diet quality and child nutrition [ 4 – 9 ]. This can be achieved directly through own-consumption of nutrient-dense food, and/or indirectly by increasing income from sales that is used to purchase a more diversified diet [ 2 , 10 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Does ownership of improved dairy cow breeds improve child nutrition? A pathway analysis for Uganda

Kabunga¹,

Ghosh

Webb

2017

PLoS ONE

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The promotion of livestock production is widely believed to support enhanced diet quality and child nutrition, but the empirical evidence for this causal linkage remains narrow and ambiguous. This study examines whether adoption of improved dairy cow breeds is linked to farm-level outcomes that translate into household-level benefits including improved child nutrition outcomes in Uganda. Using nationwide data from Uganda’s National Panel Survey, propensity score matching is used to create an unbiased counterfactual, based on observed characteristics, to assess the net impacts of improved dairy cow adoption. All estimates were tested for robustness and sensitivity to variations in observable and unobservable confounders. Results based on the matched samples showed that households adopting improved dairy cows significantly increased milk yield—by over 200% on average. This resulted in higher milk sales and milk intakes, demonstrating the potential of this agricultural technology to both integrate households into modern value chains and increase households’ access to animal source foods. Use of improved dairy cows increased household food expenditures by about 16%. Although undernutrition was widely prevalent in the study sample and in matched households, the adoption of improved dairy cows was associated with lower child stunting in adopter household. In scale terms, results also showed that holding larger farms tends to support adoption, but that this also stimulates the household’s ability to achieve gains from adoption, which can translate into enhanced nutrition.

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“…Support for this possibility comes from studies among aboriginal Australians and Nepali children in which the both communities experienced severe nutritional stress. In both cases, approximately 50% of HC Z-scores were <−2, meeting criteria for the diagnosis of microcephaly [5,73]. Finally, the absence of head sparing and high incidence of low HC values at birth among Maasai might also be due to the timing of nutritional stress in the third trimester-a critical window in which 65% of fetal brain volume is accumulated [74].…”

Section: Discussionmentioning

confidence: 91%

Lack of head sparing following third-trimester caloric restriction among Tanzanian Maasai

et al. 2020

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The reduction of food intake during pregnancy is part of many cultural and religious traditions around the world. The impact of such practices on fetal growth and development are poorly understood. Here, we examined the patterns of diet intake among Maasai pregnant women and assessed their effect on newborn morphometrics. We recruited 141 motherinfant pairs from Ngorongoro Conservation Area (NCA) in Northern Tanzania and quantified dietary intake and changes in maternal diet during pregnancy. We obtained measurements of body weight (BW) and head circumference (HC) at birth. We found that Maasai women significantly reduced their dietary intake during the third trimester, going from an average of 1601 kcal/day during the first two trimesters to 799 kcal/day in the final trimester. The greatest proportion of nutrient reduction was in carbohydrates. Overall, 40% of HC Z-scores of the NCA sample were more than 2 standard deviations below the WHO standard. Nearly a third of neonates classify as low birth weight (< 2500g). HC was smaller relative to BW in this cohort than predicted using the WHO standard. This contrasts markedly to a Tanzanian birth cohort obtained at the same time in an urban context in which only 12% of infants exhibited low weight, only two individuals had HC Z-scores < 2 and HC's relative to birth weight were larger than predicted using the WHO standards. The surprising lack of head sparing in the NCA cohort suggests that the impact of third trimester malnutrition bears further investigation in both animal models and human populations, especially as low HC is negatively associated with long term health outcomes.

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Head growth of undernourished children in rural Nepal: association with demographics, health and diet

Cited by 36 publications

References 55 publications

Early childhood growth and cognitive outcomes: Findings from the MAL‐ED study

Early childhood growth and cognitive outcomes: Findings from the MAL‐ED study

Does ownership of improved dairy cow breeds improve child nutrition? A pathway analysis for Uganda

Lack of head sparing following third-trimester caloric restriction among Tanzanian Maasai

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