Nutrition morbidity interactions in pre-school children

Abstract

Background & objectives: Research studies in the 1970s reported that in pre-school children, undernutrition increased the risk of infections and infections aggravated undernutrition. Over decades, there has been a reduction in prevalence of undernutrition and improvement in access to healthcare for treatment of infections. A mixed longitudinal study was undertaken to assess whether over time there were any changes from the earlier reported effect of undernutrition prior to infection on the risk of morbidity and effect of morbidity on nutritional status in pre-school children. Methods: Pre-school (0-59 months of age) children from urban low- and middle-income families whose parents were willing to allow their participation in the study were enrolled. Information on sociodemographic profile of the families was collected at enrolment. Weight of all children and length in infants were recorded every month; length/height in children 12-59 months of age was recorded once in three months. Morbidity information was collected through fortnightly visits. Results: 3888 pre-school children were followed up in 74636 home visits. Among these children, underweight and wasting were associated with a small increase in risk of infections. The odds ratio for risk of infection for underweight children was 1.09 (95% CI: 1.02 to 1.16) and for wasting was 1.18 (95% CI: 1.08 to 1.29). The deterioration in Z scores for weight-for-age and body mass index-for-age in children during illness and convalescence was small but significant ( P <0.001). Interpretation & conclusions: The increased risk of infections in undernourished children living in overcrowded tenements in areas with poor environmental hygiene was not significant, perhaps because the risk of infection in normally nourished children was also high. The deterioration in nutritional status following infection was small because of the ready access to and utilization of health and nutrition care.

Intrafamily differences in nutritional status of preschool children

“…Data from the studies in the community indicate that the families are food secure. 11,13,14 Nutrition and health education and monitoring during the research studies has ensured that:…”

“…Prevalence of morbidity was high because of poor environmental hygiene and overcrowding, but because of utilization of health services for treatment of infection there was no deterioration in nutritional status of children due to infections. 13 Regular weighing of children, and plotting of growth in WHO child growth chart is not widely followed. 16 There are inadequacies in content, quality and continued coverage of children under the food supplementation component of the ICDS programme.…”

“…6,[9][10][11][12] Infections were an important factor responsible for undernutrition earlier, but recent studies show that with improved access to health services infections were not associated with persistent deterioration in the nutritional status of children. 13 Research studies in urban food-secure families showed that in families with two under-five children, prevalence of stunting, underweight and wasting were higher in children whose elder siblings were stunted, underweight or wasted. 12 This could be because the siblings from the same family shared the factors responsible for undernutrition.…”

Research in nutrition & health interactions: achievements & challenges

“…Recent research studies on nutrition-infection-interaction showed that the prevalence of undernutrition and morbidity due to infection in under-five children continued to be high 7 . The risk of infections in undernourished children was not higher either because small statured children do not have functional decompensation and increased susceptibility to infection 7 or infections in normally nourished children were also high.…”

“…Recent research studies on nutrition-infection-interaction showed that the prevalence of undernutrition and morbidity due to infection in under-five children continued to be high 7 . The risk of infections in undernourished children was not higher either because small statured children do not have functional decompensation and increased susceptibility to infection 7 or infections in normally nourished children were also high. The deterioration in nutritional status following infection was transient in children who accessed health and nutrition services care 7 .…”