Rethinking the Measurement of Undernutrition in a Broader Health Context: Should We Look at Possible Causes or Actual Effects

Stein, Anthony

doi:10.2139/ssrn.2373160

Cited by 29 publications

(13 citation statements)

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“…Often, Zn deficiency in humans is attributed to low dietary diversity and high levels of phytate consumption which inhibits Zn uptake in the human gut (Gibson & Hotz, 2001), in combination with consumption of food crops produced on Zn‐deficient soils (Gregory et al., 2017; Miller & Welch, 2013; Noulas et al., 2018). Dietary deficiencies of Zn and other micronutrients, especially in Low‐ and Middle‐Income Countries (LMICs), are reported to cause great economic losses and have a considerable effect on the gross national product (GNP) by decreasing productivity and increasing health care costs (Stein, 2014).…”

Section: Introductionmentioning

confidence: 99%

Increasing zinc concentration in maize grown under contrasting soil types in Malawi through agronomic biofortification: Trial protocol for a field experiment to detect small effect sizes

et al. 2020

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The prevalence of micronutrient deficiencies including zinc (Zn) is widespread in Malawi, especially among poor and marginalized rural populations. This is due to low concentrations of Zn in most staple cereal crops and limited consumption of animal source foods. The Zn concentration of cereal grain can be increased through application of Zn‐enriched fertilizers; a process termed agronomic biofortification or agro‐fortification. This trial protocol describes a field experiment which aims to assess the potential of agronomic biofortification to improve the grain Zn concentration of maize, the predominant staple crop of Malawi. The hypotheses of the study are that application of Zn‐enriched fertilizers will create a relatively small increase in the concentration of Zn in maize grains that will be sufficient to benefit dietary supplies of Zn, and that the effectiveness of agronomic biofortification will differ between soil types. The study will be conducted at three sites, Chitedze, Chitala, and Ngabu Agricultural Research Stations, in Lilongwe, Salima, and Chikwawa Districts respectively. These three sites represent locations in the Central and Southern Regions of Malawi. At each site, two different sub‐sites will be used, each corresponding to one of two agriculturally important soil types of Malawi, Lixisols, and Vertisols. Within each sub‐site, three Zn fertilizer rates (1, 30, and 90 kg/ha) will be applied to experimental plots using standard soil application methods, in a randomized complete block design. The number of replicates at plot level has been informed by a power analysis from pilot study data, assuming that a minimum 10% increase in Zn concentration of grain at 90 kg/ha relative to the concentration at 1 kg/ha is of interest. Grain mass (yield), stover mass, and both stover and grain Zn concentrations will be measured at harvest. A second year of cropping will be used to establish whether there are any residual benefits to grain Zn concentration. The potential for Zn agronomic biofortification will be communicated to relevant academic and government stakeholders through a peer review journal article and a briefing paper.

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Section: Introductionmentioning

confidence: 99%

Increasing zinc concentration in maize grown under contrasting soil types in Malawi through agronomic biofortification: Trial protocol for a field experiment to detect small effect sizes

et al. 2020

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“…Food security is essential to human wellbeing 1 2 3 4 and a central component of the Millennium Development Goals (MDGs) of the United Nations (UN) 5 . Food security exists when “all people, at all times, have physical, social and economic access to sufficient safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life” 4 and therefore includes consideration of the macro and micro-nutrient components of the diet.…”

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confidence: 99%

“…For example, >800 million people are undernourished 6 , and >2 billion people are likely to be at risk of one or more micronutrient deficiencies (MNDs), notably the minerals Ca, iodine (I), iron (Fe), selenium (Se), Zn, and vitamins (e.g. vitamin A) 1 3 7 8 9 10 . Micronutrients have pivotal roles in human health and MNDs can retard growth and cognitive development, impair immunological functioning and increase the risks of non-communicable diseases including skeletal, cardiovascular and metabolic disorders 10 11 .…”

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confidence: 99%

“…Micronutrients have pivotal roles in human health and MNDs can retard growth and cognitive development, impair immunological functioning and increase the risks of non-communicable diseases including skeletal, cardiovascular and metabolic disorders 10 11 . It has been estimated that Fe and Zn deficiency reduce the Gross Domestic Product (GDP) of developing countries by 2–5% 1 . Although the estimated prevalence of inadequate dietary energy supply decreased from 18.7% to 11.3% at global and 23.4% to 13.5% for developing countries between 1990/2 and 2011/14 6 , trends in MNDs for all essential mineral nutrients at various geospatial scales have not been quantified over this period.…”

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confidence: 99%

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Dietary calcium and zinc deficiency risks are decreasing but remain prevalent

Kumssa

Joy

Ander

et al. 2015

Sci Rep

365

289

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Globally, more than 800 million people are undernourished while >2 billion people have one or more chronic micronutrient deficiencies (MNDs). More than 6% of global mortality and morbidity burdens are associated with undernourishment and MNDs. Here we show that, in 2011, 3.5 and 1.1 billion people were at risk of calcium (Ca) and zinc (Zn) deficiency respectively due to inadequate dietary supply. The global mean dietary supply of Ca and Zn in 2011 was 684 ± 211 and 16 ± 3 mg capita−1 d−1 (±SD) respectively. Between 1992 and 2011, global risk of deficiency of Ca and Zn decreased from 76 to 51%, and 22 to 16%, respectively. Approximately 90% of those at risk of Ca and Zn deficiency in 2011 were in Africa and Asia. To our knowledge, these are the first global estimates of dietary Ca deficiency risks based on food supply. We conclude that continuing to reduce Ca and Zn deficiency risks through dietary diversification and food and agricultural interventions including fortification, crop breeding and use of micronutrient fertilisers will remain a significant challenge.

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“…A concern with all anthropometric indices used to assess the nutritional status of children, including CIAF, is that they are head-count ratios. They do not reflect the nutrition gap and hence tell little about the depth and severity of under-nutrition ( 17 ) . These indicators are therefore of little help in analysing nutritional inequality.…”

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confidence: 99%

Decomposition of body mass growth into linear and ponderal growth in children with application to India

Chaurasia¹

2017

Br J Nutr

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In this paper, we decompose the difference between the weight of a child and the weight of a reference child into the difference between the height of the child and the height of the reference child and the difference between the weight per unit height of the child and the weight per unit height of the reference child. The decomposition provides the theoretical justification to the classification of the nutritional status proposed by Svedberg and by Nandy et al. An application of the decomposition framework to the Indian data shows that the level, depth and severity of the faltering of the growth of the body mass in Indian children are primarily due to the level, depth and severity of the faltering of the ponderal growth.

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Rethinking the Measurement of Undernutrition in a Broader Health Context: Should We Look at Possible Causes or Actual Effects

Cited by 29 publications

References 0 publications

Increasing zinc concentration in maize grown under contrasting soil types in Malawi through agronomic biofortification: Trial protocol for a field experiment to detect small effect sizes

Increasing zinc concentration in maize grown under contrasting soil types in Malawi through agronomic biofortification: Trial protocol for a field experiment to detect small effect sizes

Dietary calcium and zinc deficiency risks are decreasing but remain prevalent

Decomposition of body mass growth into linear and ponderal growth in children with application to India

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