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The Geographic Distribution of Malnutrition
Published in Frank Falkner, Infant and Child Nutrition Worldwide:, 2021
For older children and adults the body mass index is utilized to describe this association (kg/m2). Fasting, acute infections, intense exercise and any other situation producing either a decrease or an increase in stores of fluids or nutrients will modify this relation. The balance could be re-established very rapidly. This association essentially describes thinness or fatness and for that reason has been called an indicator of acute malnutrition or wasting, obesity, etc. As mentioned before, prolonged or severe stress initiates other functional changes that have repercussions on the health of the individual. Frequent or prolonged episodes of weight loss induce longitudinal growth arrest. The fact that arrest lines in long bones appear during periods of active nephrotic syndrome has been well documented. Stunted growth has been called chronic malnutrition although some evidence suggests specific nutrient deficits could also be used for this expression (Waterlow, 1988).
Lipidomics in Human Cancer and Malnutrition
Published in Qiu-Xing Jiang, New Techniques for Studying Biomembranes, 2020
Iqbal Mahmud, Timothy J. Garrett
Childhood malnutrition is a serious health problem for children in developing countries.46 Undernutrition, a major form of malnutrition, leads to stunted growth of over 250 million (43%) children under 5 years of age worldwide.47,48 Stunted growth is associated with numerous child health problems including impaired cognitive and motor development, neurodevelopment, morbidity, and mortality.19,48 LC-MS-based targeted lipidomics has been conducted in childhood undernutrition studies and identified dysregulated lipids and their roles in children’s stunted growth and disease pathogenesis18,19,49 (Figure 2.5). Using LC-MS techniques, Semba et al. first identified low ω-3 and ω-6 long-chain polyunsaturated fatty acids (PUFAs), which are essential for growth and development and low carnitine, which is essential for β-oxidation of fatty acids, in stunted children from Malawi compare to normal.18 Another study identified that both sphingomyelins (SM) and phosphatidylcholines (PC) were associated with improved growth/developmental outcomes where elevated levels of PC were observed with higher neurocognitive scores.19,50 That study first demonstrated that separate metabolic pathways might relate to stunting and neurocognition. Lower levels of sulfated neurosteroids in serum samples of stunted children were observed and indicated a potential association between stunting and brain development.18 Gut microbiota dysbiosis is a common problem in developing countries with malnourished children.51 LC-MS/MS analysis identified reduced glycerolipid and glycerophospholipids production capabilities in children from two low-income countries compared with high-income countries and suggested future efforts towards further characterization of gut microbial metabolic irregularities and their contribution to malnutrition.52 Overall, LC-MS-based lipidomics appears to be emerging in understanding the roles of lipids in biology and the pathogenesis of child malnutrition. However, our understanding of lipidomics in child malnutrition is currently limited to predetermined targeted lipid molecules. Therefore, it is highly important to study the global lipid profile in an untargeted manner, which may help us better understand the dysfunction of diverse lipids and their associated metabolic networks in child malnutrition.
Gastrointestinal system
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Coeliac disease Inflammatory disorder of small bowelMost commonly affects proximal small bowelCan cause malabsorptionSymptoms: infants: – failure to thrivechildren: – stunted growthadults: – iron-deficiency anaemia– mouth ulcers– steatorrhoea– bloating– anaemia– weight loss– malaiseInvestigations: – endoscopy and biopsy of small bowel– blood tests (antibodies)Complications: – increased risk of colon cancerManagement: – gluten-free diet
Overview of field-testing of the revised, draft South African Paediatric Food-Based Dietary Guidelines amongst mothers/caregivers of children aged 0–5 years in the Western Cape and Mpumalanga, South Africa
Published in South African Journal of Clinical Nutrition, 2021
LM du Plessis, LC Daniels, HE Koornhof, S Samuels, I Möller, S Röhrs
In South Africa, according to the 2016 South African Demographic and Health Survey (SA DHS, 2016), the mortality rate of children under the age of five years, in the five years preceding the survey, stood at 42 per 1 000 live births.4 This number is higher than it should be for a middle-income country. For children under five years of age, 27% were found to have stunted growth.4 The stunting prevalence in South Africa is persistent, as very little improvement has been made in reducing stunting in the country over the past 40 years.5 In contrast, 13% of children younger than five are overweight, putting South Africa at twice the global average (6.1%) of young child overweight.2 The minimum acceptable diet indicator for children aged 6–23 months was also calculated in the DHS of 2016. A low 23% of children met the criteria for a minimum acceptable diet,4 an indication of poor dietary diversity, which point to nutrient gaps,2 including for micronutrients. With few conditions matching the scale of malnutrition in the world today, the need to address childhood malnutrition in all its forms has never been greater.2
A review of complementary feeding practices in South Africa
Published in South African Journal of Clinical Nutrition, 2020
Nazeeia Sayed, Hettie C Schönfeldt
The causes of stunting are multi-factorial and concerted efforts on all fronts are needed to combat stunting. Stewart et al.46 proposed an expanded conceptual framework for stunted growth and development with causes grouped as: household and family factors, inadequate complementary feeding, inadequate breastfeeding and infection, within a context of broader community and societal factors. The 2016 SANHANES-1 study9 showed that at a national level only 45.6% of the population were food secure, with 28.3% at risk of hunger, and 26.0% experienced hunger (classified as food insecure). The SANHANES-1 also found the national mean Dietary Diversity Score was 4.2 (the cut-off for dietary adequacy being 4). The complementary feeding diet is reflective of a lack of diversity present in the adult diet and the struggle of dealing with food insecurity.
Dyslipidaemia among HIV-infected children on antiretroviral therapy in Garankuwa, Pretoria
Published in South African Journal of Clinical Nutrition, 2020
Estelle Viljoen, Caida MacDougall, Mothusi Mathibe, Frederick Veldman, Siyazi Mda
The current study found that children who were stunted at the time of lipid testing were more likely to have dyslipidaemia. This supports the findings of Ramteke et al. (2017)3 Stunting is associated with chronic malnutrition or systemic dysfunction during child development.25 Stunting was found to be an independent predictor of HIV disease progression and viral replication in previous South African research.1 HIV-infected children tend to grow below the healthy standards set for age and gender.2,26 It seems that growth in terms of height warrants further investigation in this population. It was observed by the researchers during the current study, while investigating historical data, that height was not well documented in patient records. This indicates that stunting could be overlooked because height is not measured and plotted routinely, whereas body weight is recorded and plotted routinely. The implication of stunted children being overlooked includes a missed opportunity to rectify chronic malnutrition in terms of macro-and micronutrients. The cause of stunted growth is mostly the vicious cycle between infection and malnutrition, especially in developing countries.25 Stunted children have been shown to retain their shorter stature into adulthood and stunting can also contribute to lower lean body mass and even lower cognitive development.25 Stunting has long-term effects on health and disease, as explained by the ‘Developmental Origins of Health and Disease’ hypothesis.26 Stunted children are predisposed to developing metabolic syndrome and the related cardiovascular risks later in life.27,28