Energy supplementation during pregnancy and postnatal growth

Kusin, J. A.; Renqvist, U. H.; Kardjati, S; Houtkooper, Joop M.

doi:10.1016/0140-6736(92)92168-f

Cited by 97 publications

(70 citation statements)

References 10 publications

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“…The relationship between BMI and mortality at both ends of the BMI distribution, however, is unknown for developing countries 16 . Cut-off points have been established to define chronic energy deficiency for the Quetelet BMI 16 and applied in studies on mortality 17 , risk of premature births 18 , prenatal supplementary feeding 19 , and worker efficiency, morbidity and mortality 20 . However, these values depart from the desired constant when 'ideal' weights from the references are used.…”

Section: Discussionmentioning

confidence: 99%

Defining nutritional status of women in developing countries

Nestel¹,

Rutstein²

2002

Public Health Nutr.

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Objective: To define a de facto reference body mass index (BMI) for women in developing countries and compare its performance with the Quetelet BMI. Design: A logarithmic equation for elite wt/ht references was developed using the weight (wt) and height (ht) of 10 524 non-pregnant elite mothers. Functional outcomes were compared using both BMIs. Setting: Forty-six national surveys from 36 developing countries. Subjects: Mothers 15 -49 years old. Results: The de facto reference standard deviation showed 2.2% of elite women were undernourished and 6.3% overnourished; lower and upper limits for 'ideal' wt/ht were 73% and 137%, respectively. Compared with the age-based and medium frame standards of the First and Second National Health and Nutrition Examination Surveys (NHANES I & II), the de facto reference defined fewer women as undernourished (5.3% vs. 10.5% and 14.4%, respectively), but more as overnourished (20.4% vs. 13.7% and 15.9%, respectively). In the de facto reference, BMI ¼ wt=ht 1:6 . Using the agebased and medium-frame-based Quetelet BMI (wt/ht 2 ), 28.5% and 31.7% had a low and 13.0% and 14.7% a high BMI, respectively. For the de facto reference, 18.4% of the elite mothers had a low BMI and 19.3% a high BMI. Applying the de facto reference to all women showed that the distribution of BMI was similar irrespective of the reference used. Functional outcomes were similar for both BMIs. Conclusions: The NHANES I & II growth curves define more women as overnourished than the de facto curve, but the opposite for defining the undernourished. Functional outcomes were similar for both BMIs, suggesting there is no great advantage to using a de facto BMI based on national-level data from these 46 national surveys.

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Section: Discussionmentioning

confidence: 99%

Defining nutritional status of women in developing countries

Nestel¹,

Rutstein²

2002

Public Health Nutr.

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“…This new measure of adult malnutrition has already been applied to several other studies, e.g. of Indian mortality data (Naidu & Rao, 1992), the risk of prematurity in pregnancy (Naidu, Neela & Rao, 1991) and the value of supplementary feeding in pregnancy (Kusin & Houtkooper, 1992). Low adult BMIs have also been shown to be associated with poor work output, lower productivity, enhanced morbidity and mortality (Shetty & James, 1994).…”

Section: Introductionmentioning

confidence: 99%

The potential use of maternal size in priority setting when combating childhood malnutrition

James¹,

Ferro-Luzzi

Sette

et al. 1999

Eur J Clin Nutr

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Objective: To devise a strategy for assessing the nutritional status of a household and specifying the major needs in combating childhood wasting, distinguishing between inadequate food availability, poor parental care andaor the need for improved public health measures. Design: An evaluation of the relationship between children's wasting, stunting, or underweight and mothers' or adult women's body mass indexes (BMIs) in the same household. A household was designated as`malnourished' on the basis of a single child's weightaheight of`À2.0 s.d. or at risk of being malnourished if the Z-score was belowÀ1.5. Adult women's BMI was taken to signify adequate household food availability. Sibling concordance of anthropometric measures was investigated. Results: A wide variety of prevalence of severe (BMI`16.0), moderate (BMI 16.0 ± 16.9) and marginal (17.0 ± 18.4) malnutrition existed in the various study areas. The worst condition was recorded in India, while 18% of the women in Zimbabwe were classi®ed as obese. Similarly wide variation in the prevalence of child wasting and stunting was observed, with the Indian children again faring worst and those in Zimbabwe the best. The withinhousehold analysis of concordance gave higher concordance for height than for weight between siblings. Mothers' BMI was highly correlated with the BMI of all other adult women in the same household and the BMI of all the women was found to be as useful as that of the mother for relating to children's anthropometry. Households with mothers of normal body weight but wasted children were designated as in need of public health measures and improved parental care rather than of enhanced food security. The distribution of households on this combined basis of maternal BMI and child nutritional status highlighted very diverse situations in the various study areas, with higher proportions of combined maternal and child malnutrition in India and in some areas of Ethiopia, while in Zimbabwe only 1 ± 2% presented this condition. On this basis, the principal problem in India was food security; in Zimbabwe household security was rarely apparent, so public health measures and maternal care were designated as problems. In three Ethiopian communities there was a mixture of needs. Conclusions: A relatively simple household-based approach is proposed to discriminate the most pressing needs in combating childhood malnutrition, and a policy-making tool is suggested for setting priorities in community action.

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“…During intra-uterine development, genetic, endocrine and maternal factors can affect prenatal growth. Maternal factors affect not only birth weight and birth length, but also growth post-natally (Dewey, 1998;Kusin et al, 1992). The second critical period for growth faltering is during the weaning period which generally coincides with the second 6 months of life.…”

Section: Introductionmentioning

confidence: 99%

Predictors of growth from 1 to 18 months among breast-fed Ghanaian infants

et al. 2000

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Objective: To examine factors associated with the physical growth of breast-fed Ghanaian infants during the ®rst 18 months of life. Design: A community-based longitudinal study. Setting: The study was carried out in Techiman, a district capital and major food trading center in the Brong Ahafo region of Ghana. Subjects: One-month old infants n 216 with birth weight ! 2X5 kg were recruited from Maternal and Child Health Centers. Method: From 6 to 12 months, infants were provided with one of four types of nutritionally enhanced complementary foods. Anthropometric assessments were completed monthly from 1 to 12 months and every other month from 12 to 18 months. Information was collected on household characteristics, morbidity from common infections and dietary intakes. Blood samples were collected at 6 and 12 months to assess iron, zinc, ribo¯avin and vitamin A status. Multiple regression analysis was used to examine factors associated with growth during the age intervals of 1 ± 6, 4 ± 6, 6 ± 12 and 12 ± 18 months as well as size attained at 12 and 18 months. Results: Prevalence of diarrhea and fever were negatively associated with growth during the ®rst year of life. No signi®cant relationship was found between respiratory illness (de®ned as cough or purulent nasal discharge) and growth. With the exception of dietary zinc intake, dietary variables were generally not signi®cantly associated with growth. Maternal education was positively associated with growth during most of the age intervals. Conclusion: These ®ndings suggest that interventions to reduce morbidity and improve the education of girls may bene®t children's growth in this population.

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Energy supplementation during pregnancy and postnatal growth

Cited by 97 publications

References 10 publications

Defining nutritional status of women in developing countries

Defining nutritional status of women in developing countries

The potential use of maternal size in priority setting when combating childhood malnutrition

Predictors of growth from 1 to 18 months among breast-fed Ghanaian infants

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