Tackling malnutrition: a systematic review of 15-year research evidence from INDEPTH health and demographic surveillance systems

Abstract

BackgroundNutrition is the intake of food in relation to the body's dietary needs. Malnutrition results from the intake of inadequate or excess food. This can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity.ObjectiveTo perform a systematic review to assess research conducted by the International Network for the Demographic Evaluation of Populations and their Health (INDEPTH) of health and demographic surveillance systems (HDSSs) over a 15-year period on malnutrition, its determinants, the effects of under and over nutrition, and intervention research on malnutrition in low- and middle-income countries (LMICs).MethodsRelevant publication titles were uploaded onto the Zotero research tool from different databases (60% from PubMed). Using the keywords ‘nutrition’, ‘malnutrition’, ‘over and under nutrition’, we selected publications that were based only on data generated through the longitudinal HDSS platform. All titles and abstracts were screened to determine inclusion eligibility and full articles were independently assessed according to inclusion/exclusion criteria. For inclusion in this study, papers had to cover research on at least one of the following topics: the problem of malnutrition, its determinants, its effects, and intervention research on malnutrition. One hundred and forty eight papers were identified and reviewed, and 67 were selected for this study.ResultsThe INDEPTH research identified rising levels of overweight and obesity, sometimes in the same settings as under-nutrition. Urbanisation appears to be protective against under-nutrition, but it heightens the risk of obesity. Appropriately timed breastfeeding interventions were protective against malnutrition.ConclusionsAlthough INDEPTH has expanded the global knowledge base on nutrition, many questions remain unresolved. There is a need for more investment in nutrition research in LMICs in order to generate evidence to inform policies in these settings.

Effect of vitamin A, calcium and vitamin D fortification and supplementation on nutritional status of women: an overview of systematic reviews

“…Hence, we decided to include only De-Regil et al [ 17 ] considering it being the most comprehensive and had scored high on R-AMSTAR. Arthur et al [ 18 ] included one RCT, i.e., Tchum 2006 (list of included RCTs are provided in Additional File 6 ), for assessing effect of vitamin A supplementation on the serum retinol levels among postpartum women, because it had already been included by Caminha et al [ 19 ]; therefore, Arthur et al [ 18 ] was not included for data synthesis of serum retinol levels. Similarly, one RCT (Martins et al 2010) of Neves et al [ 20 ] was included by Oliveira et al [ 21 ]; hence, Neves et al [ 20 ] was not considered for synthesis of effect of vitamin A on the serum retinol levels in women.…”

The association between household socio-economic status, maternal socio-demographic characteristics and adverse birth and infant growth outcomes in sub-Saharan Africa: a systematic review

“…A review on malnutrition over 15 years in LMICs showed that higher maternal/caregivers' level of education and greater HWI reduced the odds of stunting during infancy. 54 In a pooled analysis of five cohort studies including South Africa, 7 the results showed that low maternal education, low maternal income, low social class (measured by paternal occupation) and low paternal education were predictors of stunting at 2 years of age. However, SES factors (maternal education, maternal income, paternal occupation and paternal education) had less influence on stunting than biological factors (birth weight and maternal height), particularly in South Africa.…”

“…Various combinations of causal factors were taken into account across the articles reviewed here, including infant gender, 55,60 infant feeding practices, 54,57 maternal age, 55 maternal anthropometry, 53 maternal morbidity (urinary tract infection, hypertensive disorders, malaria, human immunodeficiency virus, infection, gestational diabetes, pre-eclampsia, pregnancy induced hypertension, antepartum haemorrhage, pre-labour rupture of membranes, placental bleeding), 46 maternal obstetrical history (parity, previous PTB, gestation number), 46,48,67 access and usage of antenatal care services, household food insecurity, 55,60 household size and level of urbanisation. 54,60 Limitations This review has some limitations. Firstly, studies were selected using English keywords, which given the linguistic diversity in the SSA region, studies written in only other languages may have been missed.…”

Mapping the effects of drought on child stunting

“…One of the consequences of poor child nutrition is stunting, which affects more than 1 in 3 children in many developing countries (2). Stunting can lead to a higher risk of mortality as a child (3), as well as reduced physical, cognitive, and educational attainments and lifelong health problems from reduced immunity and increased disease susceptibility (4). The effects of stunting on a population are long term: the children of parents who experienced early childhood stunting are in turn at higher risk for lower developmental levels (5).…”