Undernutrition is a major public health problem, contributing to 33% of deaths in infants and young children globally. In Kygryzstan, Central Asia, Mercy Corps provided 6 metric tons of rice, flour and oil as well as nutrition education to kindergartens in 40 rural regions, serving 41,000 children, for one year. Anthropometric measurements were collected at the beginning and end of the program (10 months later). Children, who were stunted, wasted and underweight at baseline, recovered by follow-up, with rates of recovery of 50%, 65% and 50%, respectively. The prevalence of stunting, wasting and underweight in the population decreased from 13.8%, 3.4% and 3.2%, respectively, to 8.6%, 2.1% and 2.3%, respectively. These results are particularly significant as the dearth of research on pre-school feeding’s impact on growth and nutrition has led to this particular intervention being deemed ineffective for improvement of nutritional outcome.

Children under 5 years of age in Ethiopia experience one of the highest rates of malnourishment in the world. Though there is a growing body of literature outlining determinants of children’s nutritional status, little attention has been given to the nutritional status of the rapidly increasing urban population of children. In this study, I contribute to this gap by asking, “What is the relationship between household residential location, feeding practices of children under 5 years of age and nutritional status?” Using data from the 2000 Ethiopian Demographic and Health Survey, I find that rural children continue to have worse nutritional status outcomes than urban children. I also find that liquid foods, mother’s occupation and household characteristics all are significant externalities associated with household residential location, that impact urban-rural differences in nutritional intake among young Ethiopian children. / text

Inadequate nutrition in preschool-aged children in an urban indigenous community outside of Santo Domingo, Ecuador has a negative impact on growth and development. Nutritional assessments have shown that children are underweight and that there are some effects of stunting and wasting in the population. This study was conducted to assess the extent of food security in this indigenous community in preparation for addressing two of the Millennium Development Goals for 2015: reducing the under-five child mortality rate by two-thirds and eradicating extreme poverty and hunger. An aim was to validate on-site assessment measures in this indigenous community regarding geographic circumstances, transportation, food culture systems and other barriers to food intake. These are interrelated and impact nutritional data collected on Tsáchila families in Ecuador. Mixed methods research were conducted to examine the factors that contribute to nutritional intake. The results showed observed food intake was less than food intake reported on the FFQ. Micronutrient and macronutrient levels, weight-for-height and height-for-age measures were below the WHO standard deviations for Z-scores for this population.

ABSTRACT BACKGROUND: Child malnutrition contributes to more than 33% of child deaths and is directly related to the productivity and success of the adult population. To combat these stark figures, the United Nations Millennium Development Goals set out to halve levels of malnutrition by 2015. While recent U.N. reports indicate that many countries are on track to reach the MDGs, there may be sub-populations within these countries that do not fair as well. The purpose of this study is to provide a comparative analysis of the nutritional status of children younger than five years of age in the Dominican Republic and the Dominican Batey sub-population. This comparison will be based on stunting levels, reportedly the best indicator of child malnutrition, as it indicates sustained levels of nutritional deficiency. METHODS: Cross-sectional data from the 2007 Dominican Republic Standard and Special Demographic Health Surveys involving 11,149 Dominican children and 919 children from Dominican Bateyes, respectively, were used. Version 20 of the Statistical Package for Social Sciences (SPSS) was used to conduct descriptive statistics, analysis of variance tests, and independent samples T-test using selected socio-demographic variables. RESULTS: A significant difference in height-for-age (stunting) was identified between Bateyes (M= -83.52, SD =134.783) and the general population (M = -51.88, SD = 134.576; t (10,032) = -6.301, p = .00, two-tailed). Study findings indicate that overall, children under five years of age who reside in Dominican Bateyes are more malnourished than their Dominican counterparts (15.9% in Bateyes as opposed to 10.8% in the general population). Furthermore, Batey children are .34 times more moderately stunted, and one time more severely stunted, than children who reside in other areas of the Dominican Republic. CONCLUSION: While the Dominican Republic is on track to meet MDG Goal 1, a significant portion of the population does not fair as well. The substantial underlying differences that exist between the Dominican the Batey sub-population have led to higher rates of stunting and require further analysis. The findings of this study should guide the design of appropriate interventions aimed at reduction of malnutrition within Batey communities. KEY WORDS: stunting, malnutrition, children, Dominican Republic, Batey, Millennium Development Goals

In South Africa a remarkable weight gain is found in black adolescent girls during mid-adolescence, which is not necessarily the case among boys (Kalk, 2001:577) . Anthropometry is one of the most basic methods for determining over-nutrition and malnutrition status. A considerable amount of research is indeed done on obesity, and quite an amount on growth stunting (OS), but few interventions exist for prevention and treatment of OS. The World Health Organization (WHO) has determined that approximately 230 million children world wide are growth stunted (OS) (WHO working group, 1986). Physical activity in children is affected by average or serious malnutrition and influences adolescents' body build and body composition (BC) because they are in a period of development. Hoffman et al. (2006), Mantsena et al. (2005) and Monyeki et al. (2005) have all found that OS children/adolescents are shorter in length and lighter in mass than adolescents that grow normally. But most OS adolescents have shown a higher skin fold-fat percentage as well as a higher body mass index (BMI). Intra-abdominal fat storage is also found in OS adolescents and children, which is a health risk. Cross sectional studies show that physical activity (p A) decrease with up to 50% during adolescence, which influences body composition. Research has indicated that a P A participation peak is reached between aged 13 and 14 years, when boys are more active than girls. What is less clear is how the pattern of adolescent obesity differs in terms of race, gender and age (Popkin & Udry, 1998). Firstly, the aim of this study was to determine what the nature of research is that has been undertaken regarding body composition (BC) of OS and malnourished adolescents in Africa and South America, by means of a literature study. The second aim was to determine which body composition variables best describe changes in BC in adolescents (13-18 years) after participation in a physical activity intervention. Thirdly, the aim was to determine which BC, relations and maturation differences are found between OS and non growth stunted (NOS) adolescents between ages 13 and 18 years. Finally, the aim was to establish whether the physical activity levels and physical activity patterns of adolescents (13 to 18 years) change congruent to age increase. The study was compiled by means of an availability sample by making use of two secondary black schools in Ikageng (Potchefstroom) in the North West Province. The availability sample comprised a control group and an experimental group of black learners each. The study was of a longitudinal study design nature which stretched from March 2004 to September 2006. Adolescents (N=309) in the North West Province (Potchefstroom, South Africa (158 boys, 211 girls) between ages 13 and 18 years were used in this study. All the learners were in grade 8 at the onset of the study 2004. The experimental group participated in a physical activity intervention programme for practically one hour, two days per week after school hours for twenty-three weeks in 2004 and in 2005 they practised three times per week for nineteen weeks (July school holiday excluded). Attendance percentage of the PA programme was noted according to attendance registers with the experimental group split into three categories, namely low (0%-30% attended), average (30%-60%) and high (60% and higher). The control group (N=87) attended no intervention program. BC, middle-to-hip ratio (MHR), body mass index (BMI), percentage body fat (% LV) and skin folds were measured for baseline and again after completion of the intervention programme. Maturation phase was determined by means of two gender specific questionnaires (Tanner Questionnaires). The Previous Physical Activity Recall (PDPAR), compiled by Trost et al. (1999), was used for the study to analyse the PA levels. Statistica (Statsoft Inc 9) and SAS (SAS Institute Inc, edition 8, Cary NC) computer processing packages were used to process the data collected. Descriptive statistics were used to represent BC components and participants. A Repeated measurements co-variance analysis (ANCOVA) (corrected for attendance percentage and gender) variance analysis (ANOVA) over time, with a Bonferroni post hoc analysis to establish how the different variables differ from each other over the various test period in months. The significance of differences found was set on p<0.05. Next the Mann-Whitney U test was applied to calculate the significant differences of certain variables between the GS and non-growth stunted (NGS) adolescents. The Chi-square test was also used to determine the categorical variables, namely differences in the distribution within the five Tanner phases, as well as the differences between the GS and NGS girls and boys separately, with regard to the distribution between the groups with a body fat percentage lower or higher than the median. The technique of multilevel modelling was used for analysing the change in PA data over time. The result gained from the literature clearly indicates that GS generally occurs in adolescents and children in developing countries. It was also found that physical activity is. beneficial to the adolescents in terms of body composition, especially for the boys. According to the body mass index (BM!) values, a small percentage of children are classified as overweight, whilst with methods such as the sum of skin folds calculation of skin fold fat percentage and %BF measured by means of air transfer pletismografie (ADP), a larger percentage of children was classified as "over fat". It has also been found that significant differences occurred between the mass, length, length-for-age-z-score (LOZ) , arm span, middle circumference, hip circumference and lean body mass of the GS (28 girls and 28 boys) and NGS (113 girls and 90 boys) groups. The results also indicated a difference in PA levels of boys in the experimental and control groups after participation in the P A programme. With increase in age and over time there was a decrease in weekend physical activity patterns in both groups (experimental and control) for both genders. The experimental group ended at higher PA level than that of the control group of boys over the 30.75 months period. Opposed to this the girls (152 and 59 subjects respectively) did indeed show significant differences during the week as well as during the weekend with the baseline measurements, whereas the experimental group initially showed higher PA levels. These differences were, however, not more significant during end measurements. Both groups of girls further showed a lower curve of PA than that of the boys. The experimental group of boys and girls, as well as the control groups displayed a decrease in PA over the 30.75 months period. With increase in age and over time, a decrease was observed in PA patterns in both groups for both genders, although the last two measurements showed a slight upward inclination, especially in the experimental group of boys. The results showed a difference in PA patterns in the boys in the experimental and control groups, which can be attributed to the PA intervention. From the literature overview the conclusion can be drawn that African countries and other developing countries, where food scarcity is more common, experience a larger extent of problems with GS. The occurrence of GS in South Africa is average. Hence it can be deduced that growth and development need to be taken into consideration when BC is determined in adolescents. Fat percentage is more sensitive measure of obesity than BMI following participation in a PA intervention programme in town community adolescents. Determining BF percentage by means of skin folds and air replacement pletismografie (ADP) is more accurate than BMI in this specific group of experimental subjects. From this study the conclusion can be drawn that differences occur between GS and NGS adolescents of both genders in certain BC and body proportion components, without a difference in sexual development. With regard to the girls in terms of PA levels, it had another effect as with the boys with the intervention. The experimental group of boys, after 3 years (of which they underwent a PA intervention for 2 years) showed a higher PA level than the control group of boys that did not participate in a PA intervention. From this it can be deduced that this intervention did indeed contribute to differences in PA of boys that participate in physical activity programmes in deprived environments, while strategies different from these will need to be developed for girls from these communities. / Thesis (Ph.D. (Human Movement Science))--North-West University, Potchefstroom Campus, 2010.

In South Africa a remarkable weight gain is found in black adolescent girls during mid-adolescence, which is not necessarily the case among boys (Kalk, 2001:577) . Anthropometry is one of the most basic methods for determining over-nutrition and malnutrition status. A considerable amount of research is indeed done on obesity, and quite an amount on growth stunting (OS), but few interventions exist for prevention and treatment of OS. The World Health Organization (WHO) has determined that approximately 230 million children world wide are growth stunted (OS) (WHO working group, 1986). Physical activity in children is affected by average or serious malnutrition and influences adolescents' body build and body composition (BC) because they are in a period of development. Hoffman et al. (2006), Mantsena et al. (2005) and Monyeki et al. (2005) have all found that OS children/adolescents are shorter in length and lighter in mass than adolescents that grow normally. But most OS adolescents have shown a higher skin fold-fat percentage as well as a higher body mass index (BMI). Intra-abdominal fat storage is also found in OS adolescents and children, which is a health risk. Cross sectional studies show that physical activity (p A) decrease with up to 50% during adolescence, which influences body composition. Research has indicated that a P A participation peak is reached between aged 13 and 14 years, when boys are more active than girls. What is less clear is how the pattern of adolescent obesity differs in terms of race, gender and age (Popkin & Udry, 1998). Firstly, the aim of this study was to determine what the nature of research is that has been undertaken regarding body composition (BC) of OS and malnourished adolescents in Africa and South America, by means of a literature study. The second aim was to determine which body composition variables best describe changes in BC in adolescents (13-18 years) after participation in a physical activity intervention. Thirdly, the aim was to determine which BC, relations and maturation differences are found between OS and non growth stunted (NOS) adolescents between ages 13 and 18 years. Finally, the aim was to establish whether the physical activity levels and physical activity patterns of adolescents (13 to 18 years) change congruent to age increase. The study was compiled by means of an availability sample by making use of two secondary black schools in Ikageng (Potchefstroom) in the North West Province. The availability sample comprised a control group and an experimental group of black learners each. The study was of a longitudinal study design nature which stretched from March 2004 to September 2006. Adolescents (N=309) in the North West Province (Potchefstroom, South Africa (158 boys, 211 girls) between ages 13 and 18 years were used in this study. All the learners were in grade 8 at the onset of the study 2004. The experimental group participated in a physical activity intervention programme for practically one hour, two days per week after school hours for twenty-three weeks in 2004 and in 2005 they practised three times per week for nineteen weeks (July school holiday excluded). Attendance percentage of the PA programme was noted according to attendance registers with the experimental group split into three categories, namely low (0%-30% attended), average (30%-60%) and high (60% and higher). The control group (N=87) attended no intervention program. BC, middle-to-hip ratio (MHR), body mass index (BMI), percentage body fat (% LV) and skin folds were measured for baseline and again after completion of the intervention programme. Maturation phase was determined by means of two gender specific questionnaires (Tanner Questionnaires). The Previous Physical Activity Recall (PDPAR), compiled by Trost et al. (1999), was used for the study to analyse the PA levels. Statistica (Statsoft Inc 9) and SAS (SAS Institute Inc, edition 8, Cary NC) computer processing packages were used to process the data collected. Descriptive statistics were used to represent BC components and participants. A Repeated measurements co-variance analysis (ANCOVA) (corrected for attendance percentage and gender) variance analysis (ANOVA) over time, with a Bonferroni post hoc analysis to establish how the different variables differ from each other over the various test period in months. The significance of differences found was set on p<0.05. Next the Mann-Whitney U test was applied to calculate the significant differences of certain variables between the GS and non-growth stunted (NGS) adolescents. The Chi-square test was also used to determine the categorical variables, namely differences in the distribution within the five Tanner phases, as well as the differences between the GS and NGS girls and boys separately, with regard to the distribution between the groups with a body fat percentage lower or higher than the median. The technique of multilevel modelling was used for analysing the change in PA data over time. The result gained from the literature clearly indicates that GS generally occurs in adolescents and children in developing countries. It was also found that physical activity is. beneficial to the adolescents in terms of body composition, especially for the boys. According to the body mass index (BM!) values, a small percentage of children are classified as overweight, whilst with methods such as the sum of skin folds calculation of skin fold fat percentage and %BF measured by means of air transfer pletismografie (ADP), a larger percentage of children was classified as "over fat". It has also been found that significant differences occurred between the mass, length, length-for-age-z-score (LOZ) , arm span, middle circumference, hip circumference and lean body mass of the GS (28 girls and 28 boys) and NGS (113 girls and 90 boys) groups. The results also indicated a difference in PA levels of boys in the experimental and control groups after participation in the P A programme. With increase in age and over time there was a decrease in weekend physical activity patterns in both groups (experimental and control) for both genders. The experimental group ended at higher PA level than that of the control group of boys over the 30.75 months period. Opposed to this the girls (152 and 59 subjects respectively) did indeed show significant differences during the week as well as during the weekend with the baseline measurements, whereas the experimental group initially showed higher PA levels. These differences were, however, not more significant during end measurements. Both groups of girls further showed a lower curve of PA than that of the boys. The experimental group of boys and girls, as well as the control groups displayed a decrease in PA over the 30.75 months period. With increase in age and over time, a decrease was observed in PA patterns in both groups for both genders, although the last two measurements showed a slight upward inclination, especially in the experimental group of boys. The results showed a difference in PA patterns in the boys in the experimental and control groups, which can be attributed to the PA intervention. From the literature overview the conclusion can be drawn that African countries and other developing countries, where food scarcity is more common, experience a larger extent of problems with GS. The occurrence of GS in South Africa is average. Hence it can be deduced that growth and development need to be taken into consideration when BC is determined in adolescents. Fat percentage is more sensitive measure of obesity than BMI following participation in a PA intervention programme in town community adolescents. Determining BF percentage by means of skin folds and air replacement pletismografie (ADP) is more accurate than BMI in this specific group of experimental subjects. From this study the conclusion can be drawn that differences occur between GS and NGS adolescents of both genders in certain BC and body proportion components, without a difference in sexual development. With regard to the girls in terms of PA levels, it had another effect as with the boys with the intervention. The experimental group of boys, after 3 years (of which they underwent a PA intervention for 2 years) showed a higher PA level than the control group of boys that did not participate in a PA intervention. From this it can be deduced that this intervention did indeed contribute to differences in PA of boys that participate in physical activity programmes in deprived environments, while strategies different from these will need to be developed for girls from these communities. / Thesis (Ph.D. (Human Movement Science))--North-West University, Potchefstroom Campus, 2010.

Infants and young children in the Northwest province of Nigeria are susceptible to malnutrition. Inappropriate and inadequate breastfeeding and complementary feeding result in stunting, underweight, and wasting. The purpose of this cross-sectional study was to examine current feeding practices of infants not older than 2 years and their nutritional status in Northwest Nigeria. The theory of planned behavior was adopted in this research. With a total sample size of 3,861, multiple linear regression was adopted as a predictive analysis to delineate the correlation between two or more independent variables and one continuous dependent variable. Also, adopted was an independent t test to demonstrate the statistical difference between the mean of the dependent variable and that of the independent variable. The coefficient of determination (R2) indicated that the change in underweight associated with exclusive breastfeeding (EBF) was 8.1%. The overall regression model was significant, F(18, 879) = 4.29, p < .05, adj. R2 = .06 predicted underweight in infants under 6 months of age. The coefficient of determination (R2) indicated that the changes in underweight associated with age appropriate complementary (CP) feeding was 8.0%. The overall regression model was significant, F(18, 2,944) = 14.29, p < .05, adj. R2 = .08. The model predicted underweight in infants 624 months of age. The results from this study can be used in the reinforcement of EBF and age appropriate CP guidelines and policies by the extension of paid leave, implementing flexibility in working hours, and private space to breastfeed.

Vitamin D is known to benefit skeletal bone health and prevent rickets in children. Limited evidence exists to support a role of vitamin D in linear growth and stunting, especially in children at high risk for growth faltering, e.g. undernourished low socio-economic status children <5 years. Also, it is unclear if the immunomodulatory benefits of vitamin D impact childhood pneumonia. It is critical to determine whether vitamin D ameliorates stunting and pneumonia, as these conditions are responsible for a high burden of child mortality and morbidity. A secondary analysis of two studies in Ecuador was undertaken to determine the prevalence of vitamin D deficiency and the effect of vitamin D status on growth (height-for-age (HAZ) and weight-for-age (WAZ) z-scores) (n=516) and illness duration in children hospitalized for severe pneumonia (n=348). Serum 25-hydroxyvitamin D (25(OH)D) concentrations of children who participated in a community-based trial (ages 6-36 months) and hospital-based trial (ages 2-59 months) were determined at baseline. Overall, 18.6% of children had serum 25(OH)D levels <17 ng/ml (n=516), 62.2% were stunted (HAZ≤-2), and 65.5% were underweight (WAZ≤-1). Children with 25(OH)D concentrations <17 ng/ml had a higher risk of stunting (HAZ≤-2) than those with concentrations ≥17 ng/ml (ORadj: 2.8; 95%CI: 1.6, 4.7) in logistic regression models. Underweight (WAZ≤-1) children were twice as likely to have 25(OH)D concentrations <17 ng/ml than normal weight children (WAZ>-1) (ORadj: 2.0; 95%CI: 1.2,3.3). Vitamin D deficiency (≤20 ng/ml) did not affect pneumonia duration among hospitalized children in Cox proportional hazard models (HRadj: 1.2; 95% CI: 0.93,1.5). Younger children (2-12 months), underweight children (WAZ≤-2), and children with higher respiratory rates had a longer duration of illness (HRadj: 0.61; 95% CI: 0.43,0.86; HRadj: 0.78; 95% CI: 0.59,1.0; HRadj: 0.97; 95% CI: 0.96,0.99, respectively). Underweight Ecuadorian children are at increased risk for lower serum 25(OH)D concentrations. Low vitamin D status is associated with stunting among undernourished children but not with the duration of pneumonia illness. This indicates that vitamin D may be a modifiable risk factor for stunting, which, if validated in further research, can potentially impart beneficial effects on growth among stunted children in resource limited settings. / 2020-06-30T00:00:00Z

Children under 5 years of age in Guyana are at an increased risk for inadequate growth. According to the United Nations Development Programme, 1 out of 3 children of preschool age are undernourished globally. This is a major public health concern as undernourishment in children under 5 years can lead to lifelong health complications. The study assessed the relationship between inadequate growth and urban classification in children under 5 years in Guyana, South America, after controlling for the following variables: mother's level of education, mother's age at birth of the child, household size, wealth, and marital status. The study framework combined the social ecological theory/model with concepts of malnutrition. The study used data from the 2009 Guyana Demographic and Health Survey, a quantitative, cross-sectional study. Logistic regression was used to test for a statistically significant association between inadequate growth and urban classification. There was a statistically significant bivariate relationship between inadequate growth and urban classification, which was no longer significant after controlling for sociodemographic covariates. Age, OR = 0.98; 95% CI = 0.96, 1.00; p =.033 was marginally significant and wealth, OR = 0.54; 95% CI = 0.37, 0.80; p = .005 were statistically significant, after controlling for sociodemographic covariates. There was a significant relationship between urban classification and mother's age at birth of child, mother's level of education, wealth quintile, and marital status. This study, which identified the need for targeted interventions, such as education, job placement, adequate housing, and appropriate nutrition, based on mother's age and wealth, will lead to positive social change in Guyana.

The purpose of this study was to identify specific nutrients or nutritional biomarkers of dietary intake that are associated with stunting among children ages 2 and older in sub-Saharan Africa. This is a systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Twelve studies from sub-Saharan Africa met the eligibility criteria, including 11 observational studies and one randomized control trial. Nine of the 12 studies assessed dietary intake of macronutrients. Four studies found a significant association between proteins and stunting. Four found that children with stunting had lower dietary fat intakes or lower blood or serum levels of certain fatty acids. Five assessed dietary intake of micronutrients or looked at serum levels micronutrients. Children with stunting had lower intakes or biomarkers for, calcium, phosphorous, vitamin D, vitamin B12, and choline. Children with stunting tend to consume diets lower in nutrients of high-quality protein foods like essential amino acids, essential fatty acids, and micronutrients such as calcium, phosphorous, vitamin D, vitamin B12, and choline.