Parental BMI and Childhood Undernutrition in India: An Assessment of Intrauterine Influence

Subramanian, S. V.; Ackerson, Leland K.; Smith, George Davey

doi:10.1542/peds.2010-0222

Cited by 60 publications

(65 citation statements)

References 42 publications

(47 reference statements)

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“…Rather, short stature reflects the cumulative net impact of nutrition and, therefore, the roles of disease and more distal environmental conditions, such as socioeconomic status, on height over time and across generations. That the two regions of the world with the lowest average adult heights are also the regions with the greatest prevalence of undernourishment (sub-Saharan Africa) and the greatest number of undernourished people (Southeast Asia) 219 supports this claim. Moreover, at the individual level, the relative roles of net nutrition and genetics appear to differ between the growth periods: the impact of nutrition (and other environmental factors) may be relatively stronger during the first period, while the genetic component may be relatively stronger during the second period.…”

Section: Discussionmentioning

confidence: 87%

Adult height, nutrition, and population health

et al. 2016

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Section: Discussionmentioning

confidence: 87%

Adult height, nutrition, and population health

et al. 2016

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“…Previous studies have shown that women with secondary education are better informed about optimal child care practices [8], have better practices in terms of hygiene [27,28], feeding [18] and childcare during illness [18,21,22], have a greater ability to use the health system [29], are more empowered to make decisions [28] and are more likely to have financial resources to care for and feed children [18]. There has been a slight increase in the percentage of women who have completed secondary education in Rwanda, from 1.2 % in 2005 [30] to 2.8 % in 2010 [10], and we hypothesize that further gains in women's education may translate into improved child nutrition outcomes [7,31,32].…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with underweight status in children under five: an analysis of the 2010 Rwanda Demographic Health Survey (RDHS)

et al. 2016

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Background: Under-nutrition contributes to childhood morbidity and mortality, particularly in low-income countries. While Rwanda is one of few countries on track to reduce the prevalence of underweight children under five years old by 50 % from 1990 to 2015 (a target of Millennium Development Goal1), underweight children remain a large public health problem with one out of ten children having low weight-for-age. Methods: We performed a cross-sectional study using 2010 RDHS data on 4177 children under five years of age with weight and height measurements. Children were classified as underweight if their weight-for-age Z scores (WAZs) were <2 standard deviations (SD) and severely underweight if WAZs were <3 SD from the mean of the reference population. We used multivariable logistic regression model to identify child, maternal, and household characteristics associated with being underweight. Results: Eleven percent (469) of the 4177 children sampled were underweight and 2.2 % (90) were severely underweight. After adjusting for possible confounders, we found that children were more likely to be underweight if they were male (OR = 1.42, 95 % confidence interval (CI):1.12, 1.79); had fever in the two weeks prior to survey administration (OR = 1.45, 95 % CI:1.07, 1.97) or were non-singletons compared to first-born singletons (OR = 4.04, 95 % CI:2.12, 7.71). Mothers were more likely to have underweight children if they were over 35 years of age compared to those age 17-24 years (OR = 1.67, 95 % CI:1.04, 2.70); with BMI <18.5 compared to BMI between 18.5 to 24.9 (OR = 2.62, 95 % CI:1.70, 4.04), who had no education or primary education only (OR = 3.56, 95 % CI:1.83, 6.95; OR = 3.49, 95 % CI:1. 87, 6.51, respectively) compared to secondary education or higher, and those who did not have delivery assisted by a skilled provider (OR = 1.33, 95 % CI:1.04, 1.72). Household characteristics associated with underweight children included status in the bottom two wealth quintiles compared to the highest (OR = 1.71, 95 % CI:1.27, 2.30). Conclusion: Rwanda was one of the first countries to achieve Millennium Development Goal1. However, even in light of this success, the prevalence of underweight children remains high. Our analysis of specific child, maternal and household risk factors for under-nutrition may help identify potential interventions to address this remaining burden.

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“…Contrasting the National Family Health Survey (NFHS Round 3) findings of [2005][2006] with that of an earlier survey, the study even highlighted that more children and women in India had anemia than in 1998 and more children showed wasting through malnutrition. A different team of researchers, who also used the NFHS 2005-2006 dataset, concluded that intergenerational mechanisms linking under-nutrition across subsequent generations seemed to depend particularly on continuity of adversity, rather than being determined by intrauterine biological processes [3]. Against this background, the current study was situated in the Sundarbans area of the district of south-24 Parganas in West Bengal, India.…”

Section: Introductionmentioning

confidence: 94%

Concerning public health situation of under-nutrition in children and anemia in women in Indian Sundarbans delta: a community based cross-sectional investigation

Panda

Sadhu

Pramanik³

et al. 2016

BMC Nutr

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Background: The National Family Health Survey-Round 3 in India during [2005][2006] recorded more children and women as anaemic compared to the prevailing situation eight years ago; more children also had wasting. Analysis of this dataset further linked adversity, rather than intrauterine biological processes, with under-nutrition running across generations. Against this background we conducted the present situation assessment in the Sundarbans area of India. The Sundarbans is world's largest delta with mangrove forest and prone to natural disasters. Methods: The current community based investigation was undertaken in five villages under Patharpratima block of the Sundarbans. Participants were selected randomly from the lists of eligible children (aged ≤5 year) and married women (≤49 year) prepared for each of the villages. Interviewer administered questionnaire, tools for anthropometry and hematologic auto-analyzer were used. Data from 561 children and 1145 married women (of which 55 were pregnant) were analysed. Results: Underweight and stunting were recorded in 40 and 51 % of the children respectively. Of the 561 children, 47 (8 %), had severe acute malnutrition. Weight for height z-score reflecting acute and chronic state of nutritional deprivation revealed that four of the five villages were in critical stage. One fourth of the women had low body-massindex (BMI). Hygienic practices of women were also poor; 41 % reportedly used water, mud/ash and not soap to wash hands after defecation. Anaemia prevalence in women of all the villages was >40 % underscoring a sever public health situation. Factors independently associated with anaemia in non-pregnant women (698/1090; 64 %) were residentialvillage, low (<18.5 kg/m2) BMI of women (Adjusted Odds Ratio; AOR = 1.39; 95 % CI of AOR 1.02-1.89), non-adoption of family planning method (AOR 1.86; 95 % CI of AOR 1.36-2.54; p < 0.001) and adopting contraceptive practices other than oral pills (AOR 1.84; 95 % CI of AOR 1.32-2.56; p < 0.001). Conclusions: Sundarbans poses its unique public health challenge due to geographical-vulnerability. Securing nutritional support emerges as an immediate need for the study population residing in this natural-disaster prone area of islands and estuaries. The existing situation of anaemia in women requires innovative intervention development and would require addressing health seeking practices. Behavioural intervention appears to be the key.

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Parental BMI and Childhood Undernutrition in India: An Assessment of Intrauterine Influence

Abstract: Similarity in the association between paternal/maternal BMI and childhood undernutrition suggests that intergenerational associations in nutritional status are not driven by maternal intrauterine influences.

Cited by 60 publications

References 42 publications

Adult height, nutrition, and population health

Adult height, nutrition, and population health

Risk factors associated with underweight status in children under five: an analysis of the 2010 Rwanda Demographic Health Survey (RDHS)

Concerning public health situation of under-nutrition in children and anemia in women in Indian Sundarbans delta: a community based cross-sectional investigation

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