Severe linear growth retardation in rural Zambian children: the influence of biological variables

Hautvast, Jeannine L A; Tolboom, J.J.M.; Kafwembe, Emmanuel; Musonda, Rosemary; Mwanakasale, Victor; Staveren, W.A. van; Hof, M. A. Van't; Sauerwein, Robert W.; Willems, J. L.; Monnens, L. A. H.

doi:10.1093/ajcn/71.2.550

Cited by 60 publications

(47 citation statements)

References 25 publications

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“…Although other studies have reported that children residing in rural areas have a substantially higher risk of poor nutritional status compared to their urban counterparts (Hautvast et al, 2000;Fox and Heaton, 2012), our study did not show evidence of such associations. The primary reason for this finding was that the current study was conducted within a predominantly rural context.…”

Section: Discussioncontrasting

confidence: 99%

“…Similar patterns have been reported in earlier studies which have recorded a dramatic rise in the prevalence of stunting with age among African children (Stoltzfus et al, 1997;Hautvast et al, 2000;Senbanjo et al, 2011). Stoltzfus et al (1997) as well as Glewwe and Jacoby (1995) have postulated that, parents probably enrol the more healthy children in school at earlier ages.…”

Section: Discussionsupporting

confidence: 84%

“…And although children in low income settings may all suffer the effects of deprivation, those from the least wealthy households in low income settings are more likely to be malnourished (Sigman et al, 1989;Brooks-Gunn and Duncan, 1997;Bradley and Corwyn, 2002;Abubakar et al, 2008;Ndukwu et al, 2013). Rural residence (Hautvast et al, 2000;Nabag, 2011) and a reduced likelihood of attending school (Ivanovic et al, 2012) have also been related to poor nutritional status. Over childhood, these risk factors have been known to alter the profile of undernutrition (protecting against or accentuating the risk of undernutrition) in a population (Pollitt et al, 1996), as well as being recognized as adversely affecting cognitive functioning independently of nutritional status.…”

Section: Human Neurosciencementioning

confidence: 99%

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Dietary Patterns in Pregnancy and Effects on Nutrient Intake in the Mid-South: The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study

Kitsao-Wekulo¹,

Holding²,

Taylor³

et al. 2015

Prenatal and Childhood Nutrition

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Adequate nutrition is fundamental to the development of a child's full potential. However, the extent to which malnutrition affects developmental and cognitive outcomes in the midst of co-occurring risk factors remains largely understudied. We sought to establish if the effects of nutritional status varied according to diverse background characteristics as well as to compare the relative strength of the effects of poor nutritional status on language skills, motor abilities, and cognitive functioning at school age. This cross-sectional study was conducted among school-age boys and girls resident in Kilifi District in Kenya. We hypothesized that the effects of area of residence, school attendance, household wealth, age and gender on child outcomes are experienced directly and indirectly through child nutritional status. The use of structural equation modeling (SEM) allowed the disaggregation of the total effect of the explanatory variables into direct effects (effects that go directly from one variable to another) and indirect effects. Each of the models tested for the four child outcomes had a good fit. However, the effects on verbal memory apart from being weaker than for the other outcomes, were not mediated through nutritional status. School attendance was the most influential predictor of nutritional status and child outcomes. The estimated models demonstrated the continued importance of child nutritional status at school-age.Keywords: nutritional status, school-age children, structural equation modeling, direct and indirect effects, co-occurring risk factors, cognitive outcomes INTRODUCTIONWhile the literature provides evidence that the negative effects of early malnutrition persist to school-age (Pollitt et al., 1996), there are several significant knowledge gaps. First, despite evidence that the impact of nutrition varies across different neurocognitive domains, there have been few studies investigating this area, especially in middle childhood. And yet at school age, children are exposed to more differential experiences and acquire more sophisticated abilities across various cognitive domains (Fischer and Bullock, 1984). Second, there is a complex inter-related relationship between poverty, nutritional status and neurocognitive outcomes. Not only do the constraints of low income in deprived settings create practical barriers to good nutrition; additional socio-environmental factors reinforce the effects of this deprivation (Engle and Black, 2008). Poor nutritional status at this age may have long-term negative consequences and restrict development of a child's full potential. This is therefore a critical period for investigating the link between malnutrition and developmental outcomes, especially within a multiple risk context.In many developing countries, particularly in sub-Saharan Africa, linear growth retardation, or stunting, a manifestation of chronic protein-energy malnutrition (PEM), is highly prevalent, with rates as high as 38% (de Onis et al., 2012). Various individual and environmental variabl...

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 84%

Section: Human Neurosciencementioning

confidence: 99%

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Dietary Patterns in Pregnancy and Effects on Nutrient Intake in the Mid-South: The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study

Kitsao-Wekulo¹,

Holding²,

Taylor³

et al. 2015

Prenatal and Childhood Nutrition

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“…Recumbent length (children less than two years old) or standing height (children Ն2 years old) was measured to the nearest 0.1 cm using wooden measuring boards with a sliding foot or head piece. 17 The Z-scores for height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ) were calculated using reference data from the U.S.-based National Centers for Health Statistics (NCHS) and the World Health Organization 18 in EPI-Info version 6 (Centers for Disease Control and Prevention, Atlanta, GA). Children were classified as stunted, underweight, or wasted if their HAZ, WAZ, or WHZ was <−2, respectively.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Severity of Malnutrition in Pre-School Children in a Rural Area of Western Kenya

Kwena¹,

Terlouw²,

Vlas³

et al. 2003

The American Journal of Tropical Medicine and Hygiene

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Abstract. We determined the nutritional status of children less than five years of age in an area in rural western Kenya with intense malaria transmission, a high prevalence of severe anemia and human immunodeficiency virus, and high infant and under-five mortality (176/1,000 and 259/1,000). No information is available on the prevalence of malnutrition in this area. Three cross-sectional surveys were conducted between 1996 and 1998 to monitor the effect of insecticide-treated bed nets on child morbidity. Anthropometric indices are presented for 2,103 children collected prior to and during intervention (controls only). The prevalence of stunting (Z-scores for height-for-age [HAZ] <−2), wasting (Z-scores for weight-for-height [WHZ] <−2) and being underweight (Z-scores for weight-for-age [WAZ] <−2) was 30%, 4%, and 20%, respectively. This was severe (Z-score <−3) in 12% (stunting), 1% (wasting), and 5% (underweight) of the children. Few children less than three months of age were malnourished (<2%), but height-for-age and weight-forage deficits increased rapidly in children 3−18 months of age, and were greatest in children 18−23 months old (44% stunted and 34% underweight). While the mean HAZ and WAZ stabilized from 24 months of age onwards, they still remained substantially below the reference median with no evidence of catch-up growth. Malnutrition is likely to interact with infectious diseases, placing children 3−24 months of age at high risk of premature death in this area.

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“…Children of those mothers, who have poor health as expressed by low body mass index, are more likely to be nutritionally poor. Studies suggest that under-nutrition is often inter-generational in nature that affects the health of the mother and the child throughout their life cycle [49,50]. …”

Section: Discussion Of Findingsmentioning

confidence: 99%

Inter-Linkages between Spousal Violence and Nutritional Status of Children: A Comparative Study of North and South Indian States

Sinha¹,

Chattopadhyay²

2017

Social Crimonol

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In the context of higher rates of child malnutrition and widespread occurrence of spousal violence in India, the present study aimed to explore whether maternal experience of spousal violence have any association with nutritional status of their children using data on selected North and South Indian states from the National Family Health Survey (2005)(2006). Our findings from bi-variate and multivariate analysis established spousal violence, which indicates the position of women within family, as a significant factor determining child nutritional status in both regions. Children whose mothers had experienced any form of physical/sexual violence were significantly more likely to be underweight compared to non-abused women. Higher educational attainment among mothers significantly reduced the likelihood of under nutrition among their children. On the other hand, higher body mass index which reflects better health status of mothers also had a significant effect in reducing the chances of malnutrition among children. Thus, the study provided adequate evidences to establish the fact that health and social status of women are critical in determining nutritional status among children. Elevating women's power relative to men's is strongly recommended to reduce malnourishment among children. Integration of violence screening and counselling with MCH programmes could be helpful in addressing the specific needs of women and children and provide essential support.

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Severe linear growth retardation in rural Zambian children: the influence of biological variables

Abstract: Unlike other studies, we did not identify specific biological factors, such as health and micronutrient status, which contribute to the retardation of linear growth. The normal zinc and iodine statuses of the children suggest that at least these factors are not causal.

Cited by 60 publications

References 25 publications

Dietary Patterns in Pregnancy and Effects on Nutrient Intake in the Mid-South: The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study

Dietary Patterns in Pregnancy and Effects on Nutrient Intake in the Mid-South: The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study

Prevalence and Severity of Malnutrition in Pre-School Children in a Rural Area of Western Kenya

Inter-Linkages between Spousal Violence and Nutritional Status of Children: A Comparative Study of North and South Indian States

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