Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda

Victora, César G.; Christian, Parul; Vidaletti, Luís Paulo; Gatica-Domínguez, Giovanna; Menon, Purnima; Black, Robert E.

doi:10.1016/s0140-6736(21)00394-9

Cited by 425 publications

(378 citation statements)

References 85 publications

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“…A recent analysis of ve LMICs that achieved substantive reductions in child stunting suggest a combination of direct (nutrition-speci c) and indirect (nutrition-sensitive) health and nutrition interventions (32,33). Our ndings underscore the importance of targeted monitoring of nutrition outcomes, and support of nutrition sensitive and speci c interventions, to address the high and persistent burden of child undernutrition (34,35).…”

Section: Discussionmentioning

confidence: 66%

Changes in Child Undernutrition and Overweight in India from 2006 to 2019: An Analysis of 22 States

Varghese

Gupta

Mehta

et al. 2021

Preprint

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Objectives: India has historically displayed high levels of child stunting and low levels of child overweight. Using newly released data, we evaluated changes in priority indicators of child growth from 2006 to 2019 and examined the role of human development measures in these changes. Methods: We estimated cumulative and annualized changes in state- and district-level child growth indicators using three rounds of National Family Health Surveys (2005-06, 2015-16, 2019-20) in 22 states. Outcomes included stunting, underweight, wasting, and overweight. Human development was measured using a principal components analysis of nine survey-based items. We contrasted expected versus observed changes in district-level growth indicators between 2015 and 2019 based on changes in development measures using two-way Blinder Oaxaca decomposition. Results: From 2006 to 2019, the prevalence of stunting and underweight decreased by 10.9 percentage points (pp) and 7.1 pp, respectively, while the prevalence of wasting and overweight increased by 2.8 pp and 2.2 pp, respectively. Annualized rates of change for stunting, wasting, and underweight were lower from 2015 to 2020 compared with the 2006 to 2015 period, while rates of change in overweight were higher. Simultaneously, all nine human development indicators improved between 2006 and 2020. A unit increase between 2015 and 2020 in the human development score predicted a -4.7 pp (95% CI: - 5.7, -3.6) change in stunting, yet stunting declined by just -0.3 pp. Conclusions: Population-level reductions in child undernutrition have stalled and the rise in child overweight has accelerated between 2015 and 2020 relative to the 10 years preceding this period.

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Section: Discussionmentioning

confidence: 66%

Changes in Child Undernutrition and Overweight in India from 2006 to 2019: An Analysis of 22 States

Varghese

Gupta

Mehta

et al. 2021

Preprint

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“…In Asia, a significant proportion of the population is at risk for inadequate and deficient status for vitamin D [ 60 , 119 ], vitamin E [ 120 ], vitamin B-12 [ 121 ], folate [ 122 ], vitamin C [ 123 ], calcium [ 122 ], iron [ 122 ] and omega-3 LC-PUFAs [ 124 ]. Deficiencies in vitamin A and zinc remain to be an issue in Asia [ 125 ].…”

Section: Nutritional Adequacy and Nutritional Status In Asiamentioning

confidence: 99%

The Role of Micronutrients in Ageing Asia: What Can Be Implemented with the Existing Insights

Inui¹,

Hanley

Tee

et al. 2021

Nutrients

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Life expectancy as a measure of population health does not reflect years of healthy life. The average life expectancy in the Asia-Pacific region has more than doubled since 1900 and is now above 70 years. In the Asia-Pacific region, the proportion of aged people in the population is expected to double between 2017 and 2050. Increased life expectancy leads to an increase in non-communicable diseases, which consequently affects quality of life. Suboptimal nutritional status is a contributing factor to the prevalence and severity of non-communicable diseases, including cardiovascular, cognitive, musculoskeletal, immune, metabolic and ophthalmological functions. We have reviewed the published literature on nutrition and healthy ageing as it applies to the Asia-Pacific region, focusing on vitamins, minerals/trace elements and omega-3 fatty acids. Optimal nutritional status needs to start before a senior age is reached and before the consequences of the disease process are irreversible. Based on the nutritional status and health issues in the senior age in the region, micronutrients of particular importance are vitamins A, D, E, C, B-12, zinc and omega-3 fatty acids. The present paper substantiates the creation of micronutrient guidelines and proposes actions to support the achievement of optimal nutritional status as contribution to healthy ageing for Asia-Pacific populations.

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“…Children with concurrent wasting and stunting are among the most vulnerable of all malnourished children, with a higher mortality risk than either wasting or stunting alone, and about a 12 times greater risk of mortality in the absence of treatment than those with normal anthropometry [16,17]. In low-income countries, 4.7% of children are affected simultaneously by wasting and stunting [18]. Acknowledging the coexistence of wasting and stunting and the interactive effect on mortality risk, recent research has explored existing data to understand more about this particularly vulnerable group.…”

Section: Introductionmentioning

confidence: 99%

Response to Malnutrition Treatment in Low Weight-for-Age Children: Secondary Analyses of Children 6–59 Months in the ComPAS Cluster Randomized Controlled Trial

Bailey

Lelijveld²,

Khara³

et al. 2021

Nutrients

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Weight-for-age z-score (WAZ) is not currently an admission criterion to therapeutic feeding programs, and children with low WAZ at high risk of mortality may not be admitted. We conducted a secondary analysis of RCT data to assess response to treatment according to WAZ and mid-upper arm circumference (MUAC) and type of feeding protocol given: a simplified, combined protocol for severe and moderate acute malnutrition (SAM and MAM) vs. standard care that treats SAM and MAM, separately. Children with a moderately low MUAC (11.5–12.5 cm) and a severely low WAZ (<−3) respond similarly to treatment in terms of both weight and MUAC gain on either 2092 kJ (500 kcal)/day of therapeutic or supplementary food. Children with a severely low MUAC (<11.5 cm), with/without a severely low WAZ (<−3), have similar recovery with the combined protocol or standard treatment, though WAZ gain may be slower in the combined protocol. A limitation is this analysis was not powered for these sub-groups specifically. Adding WAZ < −3 as an admission criterion for therapeutic feeding programs admitting children with MUAC and/or oedema may help programs target high-risk children who can benefit from treatment. Future work should evaluate the optimal treatment protocol for children with a MUAC < 11.5 and/or WAZ < −3.0.

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Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda

Cited by 425 publications

References 85 publications

Changes in Child Undernutrition and Overweight in India from 2006 to 2019: An Analysis of 22 States

Changes in Child Undernutrition and Overweight in India from 2006 to 2019: An Analysis of 22 States

The Role of Micronutrients in Ageing Asia: What Can Be Implemented with the Existing Insights

Response to Malnutrition Treatment in Low Weight-for-Age Children: Secondary Analyses of Children 6–59 Months in the ComPAS Cluster Randomized Controlled Trial

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