The relationship between residential altitude and stunting: evidence from >26 000 children living in highlands and lowlands of Ethiopia

AbstractLittle information is known about the influence of altitude on child growth in Ethiopia, where most people live in highlands. We investigated the relation of residential altitude with growth faltering (stunting) of infants and young children in Ethiopia. We also examined whether the altitude–growth relationship was independent of the influence of the dietary and non-dietary determinants of growth. We used the data of 26 976 under-5-year-old children included in the Ethiopian Demographic and Health Surveys, conducted from 2005 to 2016. The samples were recruited following a two-stage cluster sampling strategy. Stunting was defined by height-for-age <−2 z-scores. The relationship between residential altitude and stunting was examined by running multiple logistic regression analysis, controlling the effect of covariate dietary and non-dietary variables. The residential altitude of the study participants ranged from −116 to 4500 m above sea level (masl). There was a significant and progressive increase in the prevalence and odds of stunting with increasing altitude (P < 0·001), irrespective of the dietary and non-dietary predictors of stunting. The prevalence of stunting was lowest in lowlands (39 %) and highest in highlands (47 %). Compared with altitude <1000 masl, the odds of stunting was 1·41 times higher at altitude ≥2500 masl (OR 1·41, 95 % CI 1·16, 1·71) and 1·29 times higher at altitude 2000–2499 masl (OR 1·29, 95 % CI 1·11, 1·49). Children living in highlands might be at a higher risk of poor growth. Further studies are warranted to understand the mechanism behind the observed altitude–stunting link and identify strategies to compensate for the growth-faltering effect of living in highlands.

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The Evolution of Growth Faltering in 37 Developing Countries: A Spline-regression Approach (OR10-08-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz034.or10-08-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Derek Headey ◽

Robert Black ◽

John Hoddinott ◽

Purnima Menon ◽

Cesar Victora

Keyword(s):

South Asia ◽

Food Policy ◽

Population Level ◽

Child Growth ◽

Eastern Africa ◽

Demographic And Health Surveys ◽

Prenatal Period ◽

Growth Faltering ◽

T1 And T2 ◽

Over Time

Abstract Objectives Childhood height-for-age z-scores (HAZ) have been improving in many countries over the last few decades. Most HAZ faltering in malnourished populations takes place during the first 1000 days of life, in the prenatal period and the first two years after birth, but little is known about how growth faltering evolves over time in countries witnessing significant HAZ improvement. We aimed to quantify the evolution of population-level patterns of growth faltering using a novel analytic approach. Methods We selected 37 low and middle-income countries with at least two Demographic and Health Surveys 7 + years apart with statistically significant increases in HAZ among children 0–59 m. For the first (T1) and second (T2) round for each country we use spline-based regressions to estimate monthly HAZ loss over the prenatal period (conception to 1 m of age) and three postnatal periods (1–6 m, 6–20 m and 20 m onwards). We tested for statistically significant changes in the speed of HAZ loss between T1 and T2. We report results by T1 HAZ, country, and region. Results The fastest HAZ improvements between T1 and T2 occurred in Armenia, Ethiopia, Bangladesh, Nepal and India. South Asia had the fastest HAZ improvement of any major region. In South Asia and Eastern Africa, where baseline prenatal HAZ loss was prominent, the majority of HAZ improvement occurred in the prenatal period, suggesting progress in maternal factors. Improvements in regions with less baseline growth faltering typically stemmed from gains in postnatal HAZ, in the 1–6 m or 6–24 m period, but never the 24–59 m period. Several countries in Central and Western Africa, where overall HAZ changes were modest, showed improvement in some age ranges but deterioration in others (e.g., Nigeria). Conclusions HAZ improvements between T1 and T2 stemmed from a mix of changes in prenatal and postnatal growth faltering, with substantial variability across countries. The timing and speed of HAZ changes varied markedly by country and region, and over time. Examining the patterns of growth faltering over time can yield important insights into the biological origins of population-level HAZ improvements and point to successes and failures of policy efforts to address the drivers of child growth, and the challenges for designing new and improved approaches. Funding Sources Bill & Melinda Gates Foundation through ARENA, led by International Food Policy Research Institute, Wellcome Trust grant to Federal University of Pelotas. Supporting Tables, Images and/or Graphs

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Monosodium glutamate is not associated with overweight in Vietnamese adults

Public Health Nutrition ◽

10.1017/s1368980012003552 ◽

2012 ◽

Vol 16 (5) ◽

pp. 922-927 ◽

Cited By ~ 8

Author(s):

Vu Thi Thu Hien ◽

Nguyen Thi Lam ◽

Nguyen Cong Khan ◽

Andrea Wakita ◽

Shigeru Yamamoto

Keyword(s):

Physical Activity ◽

Urban Areas ◽

Monosodium Glutamate ◽

Multiple Logistic Regression Analysis ◽

Saturated Fat ◽

Cluster Sampling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Rural And Urban Areas ◽

The Relationship

AbstractObjectiveTo determine the prevalence of and associated factors for overweight, especially to determine the relationship between the intake of monosodium glutamate (MSG) as a seasoning and overweight in Vietnam.DesignA cross-sectional survey was conducted of Vietnamese adults aged ≥20 years in 2008. Dietary intake was assessed by the 24 h recall method for 3 d. MSG intake was evaluated by the weighing method on three consecutive days. Physical activity was assessed based on the Global Physical Activity Questionnaire recommended by the WHO. Overweight was defined as BMI ≥ 23·0 kg/m2. Other characteristics such as age and lifelong occupation were determined by a structured questionnaire.SettingSome rural and urban areas of Hanoi, Thua Thien Hue Province and Ho Chi Minh City, Vietnam.SubjectsA total of 1528 adults living in surveyed areas were randomly selected by the multistage cluster sampling method.ResultsThe prevalence of overweight was 27·9 %, and 81·0 % of participants were MSG users. Average MSG intake was 2·2 (sd 1·8) g/d. Multiple logistic regression analysis revealed that factors associated with overweight were age, region of residence, lifelong occupation, physical activity and intakes of energy, carbohydrates, saturated fat and animal protein. There was no significant association between MSG intake and overweight.ConclusionsThe study demonstrated that overweight was not associated with MSG intake in Vietnamese adults. Further longitudinal studies should be done in different populations to determine the relationship between MSG and overweight.

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Relationship between masseter muscle thickness and overbite values in a Nigerian population

Brazilian Journal of Oral Sciences ◽

10.20396/bjos.v16i0.8650499 ◽

2017 ◽

Vol 16 ◽

pp. 1-10

Author(s):

Soyoye Abigail Olabimpe ◽

Otuyemi Donald Olayinka ◽

Kolawole Kikelomo Adebanke ◽

Ayoola Oluwagbemiga Oluwole

Keyword(s):

Masseter Muscle ◽

Muscle Thickness ◽

Progressive Increase ◽

Comparison Analysis ◽

Orthodontic Appliance ◽

Nigerian Population ◽

The Difference ◽

Study Participants ◽

The Relationship ◽

Fixed Orthodontic Appliance

Objective: This study determined the relationship between masseter muscle thickness and overbite values among Nigerians. Methods: The subjects included 66 consecutive patients (21 males and 45 females) who presented for fixed orthodontic appliance treatment. Overbite values were measured from standard lateral cephalometric radiographs taken for all patients,who were thereafter divided into three groups of reduced overbite (n=22, mean -1.11+ 2.18mm), normal overbite (n=22, mean 2.59+0.50mm) and increased overbite (n=22, mean 5.21+1.39mm). The masseter muscle thickness of each patient was measured bilaterally using ultrasonography. Associations between masseter muscle thickness and different overbite values were analyzed using unpaired t-test, ANOVA and Tukey's multiple comparison analysis. Results: Mean masseter muscle thickness was 11.23 ± 2.40 mm during relaxation and 12.81 ± 2.64 mm during contraction for study participants. The masseter muscle on the habitual side of mastication of participants was generally thicker but the difference was not statistically significant (P>0.05). There was a progressive increase in masseter muscle thickness from reduced overbite through normal overbite to increased overbite groups and the differences were statistically significant (P<0.01). Tukey's multiple comparisons showed significant differences between all the three overbite groups (P<0.05). Conclusion: There was a direct relationship between the muscle thickness and overbite variations.

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Associated factors, post infection child growth, and household cost of invasive enteritis among under 5 children in Bangladesh

Scientific Reports ◽

10.1038/s41598-021-92132-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Rina Das ◽

Md. Ahshanul Haque ◽

Mohammod Jobayer Chisti ◽

A. S. G. Faruque ◽

Tahmeed Ahmed

Keyword(s):

Post Infection ◽

Maternal Education ◽

Multiple Logistic Regression Analysis ◽

Positive Association ◽

Child Growth ◽

Z Score ◽

Growth Faltering ◽

Household Costs ◽

Household Cost ◽

Weight For Age

AbstractBoth Campylobacter- and Shigella-induced invasive enteritis are common in under-5 Bangladeshi children. Our study aimed to determine the factors associated with Campylobacter and Shigella enteritis among under-5 children, the post-infection worsening growth, and the household cost of invasive enteritis. Data of children having Shigella (591/803) and Campylobacter (246/1148) isolated from the fecal specimen in Bangladesh were extracted from the Global Enteric Multicenter Study (GEMS) for the period December 2007 to March 2011. In multiple logistic regression analysis, fever was observed more frequently among shigellosis cases [adjusted OR 2.21; (95% CI 1.58, 3.09)]. Breastfeeding [aOR 0.55; (95% CI 0.37, 0.81)] was found to be protective against Shigella. The generalized estimating equations multivariable model identified a negative association between Shigella and weight-for-height z score [aOR − 0.11; (95% CI − 0.21, − 0.001)]; a positive association between symptomatic Campylobacter and weight-for-age z score [aOR 0.22; (95% CI 0.06, 0.37)] and weight-for-height z score [aOR 0.22; (95% CI 0.08, 0.37)]. Total costs incurred by households were more in shigellosis children than Campylobacter-induced enteritis ($4.27 vs. $3.49). Households with low-level maternal education tended to incur less cost in case of their shigellosis children. Our findings underscore the need for preventive strategies targeting Shigella infection, which could potentially reduce the disease burden, associated household costs, and child growth faltering.

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Bidirectional Relationship Between Subjective Age and Frailty: Findings From the NHATS

Innovation in Aging ◽

10.1093/geroni/igaa057.867 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 271-271

Author(s):

Yuxiao Li ◽

Minhui Liu ◽

Christina Miyawaki ◽

Xiaocao Sun ◽

Tianxue Hou ◽

...

Keyword(s):

Older Adults ◽

Clinical Syndrome ◽

Community Dwelling ◽

Chronological Age ◽

Subjective Age ◽

Bidirectional Relationship ◽

Study Participants ◽

Community Dwelling Older Adults ◽

The Relationship ◽

Hispanic White

Abstract Frailty is a clinical syndrome that becomes increasingly common as people age. Subjective age refers to how young or old individuals experience themselves to be. It is associated with many risk factors of frailty, such as increased depression, worse cognitive function, and poorer psychological wellbeing. In this study, we examined the relationship between subjective age and frailty using the 2011-2015 waves of the National Health and Aging Trends Study. Participants were community-dwelling older adults without frailty in the initial wave (N=1,165). Subjective age was measured by asking participants, “What age do you feel most of the time?” Based on the Fried five phenotypic criteria: exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength, frailty was categorized into robust=0, pre-frail=1 or 2; frail=3 or more criteria met. Participants were, on average, 74.1±6.5 years old, female (52%), and non-Hispanic White (81%). Eighty-five percent of the participants felt younger, and 3% felt older than their chronological age, but 41% of them were pre-frail/frail. Generalized estimating equations revealed that an “older” subjective age predicted a higher likelihood of pre-frailty and frailty (OR, 95%CI= 1.01, 1.01-1.02). In contrast, frailty predicted an “older” subjective age (OR, 95%CI= 2.97, 1.65-5.35) adjusting for demographics and health conditions. These findings suggest a bidirectional relationship between subjective age and frailty. Older people who feel younger than their chronological age are at reduced risk of becoming pre-frail/frail. Intervention programs to delay frailty progression should include strategies that may help older adults perceive a younger subjective age.

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How Is Sleep Related to Anxiety or Depression in Older Adults With Dementia?

Innovation in Aging ◽

10.1093/geroni/igaa057.2106 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 619-619

Author(s):

Yeji Hwang ◽

Nancy Hodgson

Keyword(s):

Anxiety And Depression ◽

Regression Analyses ◽

Subjective Sleep Quality ◽

Subjective Sleep ◽

Significant Relationships ◽

People With Dementia ◽

The Family ◽

Study Participants ◽

Anxiety Depression ◽

The Relationship

Abstract Anxiety and depression are one of the most distressing symptoms for the family caregivers. Little is known about the relationship between sleep impairments and anxiety/depression in this population and how objective and subjective sleep measures differ in relation to anxiety. This study was designed to examine the relationship between sleep impairments and anxiety/depression in people with dementia, using both subjective and objective sleep measures. Among the 170 study participants, 50% (n=85) reported to have anxiety/depression. In univariate logistic regression analyses on anxiety/depression, adjusting for dementia stage, people with more subjective sleep impairment had higher odds of having anxiety/depression (OR=1.111; 95% CI: 1.020-1.211, p=0.016) and people with poorer subjective sleep quality had higher odds of having anxiety/depression (OR=1.702; 95% CI: 1.046-2.769, p=0.032). Objective sleep measures from actigraphy did not show any significant relationships to anxiety/depression. The results suggest that subjective sleep measures are closely related to anxiety/depression in this population.

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Maternal Tobacco and Alcohol Use in Relation to Child Malnutrition in Gauteng, South Africa: A Retrospective Analysis

Children ◽

10.3390/children8020133 ◽

2021 ◽

Vol 8 (2) ◽

pp. 133

Author(s):

Perpetua Modjadji ◽

Mpinane Pitso

Keyword(s):

South Africa ◽

Alcohol Use ◽

Tobacco Use ◽

Child Growth ◽

Growth Patterns ◽

World Health ◽

Poor Growth ◽

Growth Standards ◽

Validated Questionnaire ◽

Current Tobacco

Tobacco and alcohol use among mothers is associated with numerous adverse consequences for affected offspring, including poor growth and development. This study determined the association between maternal tobacco and alcohol use, and malnutrition, among infants aged ≤ 12 months (n = 300), in selected health facilities situated in Gauteng, South Africa. Data on alcohol and tobacco use were collected using a validated questionnaire, in addition to mothers’ socio-demographic characteristics and obstetric history. Stunting (low height/length-for-age), underweight (low weight-for-age) and thinness (low body mass index-for-age) were calculated using z-scores based on the World Health Organization child growth standards. The association of tobacco and alcohol use with stunting, underweight and thinness was analysed using logistic regression analysis. The results showed a mean age of 29 years (24.0; 35.0) for mothers and 7.6 ± 3 months for infants, and over half of the mothers were unemployed (63%). Approximately 18.7% of mothers had used tobacco and 3% had used alcohol during pregnancy. The prevalence of current tobacco and alcohol use among mothers were estimated at 14.3% and 49.7%, respectively, and almost three-quarters (67.3%) of them were still breastfeeding during the study period. Stunting (55%) was the most prevalent malnutrition indicator among infants, while underweight was 41.7%, and thinness was 22%. Current tobacco use was associated with increased odds of being thin [OR = 2.40, 95% CI: 1.09–5.45), and after adjusting for confounders, current alcohol use was associated with the likelihood of being underweight [AOR = 1.96, 95% CI: 1.06–3.63] among infants. Future prospective cohort studies that examine growth patterns among infants who are exposed to maternal tobacco and alcohol use from the intrauterine life to infancy are necessary to inform, partly, the public health programmes, to reduce malnutrition among children.

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The Relationship Between Maxillary Growth and Speech in Children With a Unilateral Cleft Lip and Palate at 5 Years of Age

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211010620 ◽

2021 ◽

pp. 105566562110106

Author(s):

Matthew Fell ◽

Jibby Medina ◽

Kate Fitzsimons ◽

Miriam Seifert ◽

Anne Roberts ◽

...

Keyword(s):

Cleft Lip ◽

Cleft Lip And Palate ◽

Poor Growth ◽

History Of ◽

Dental Models ◽

Maxillary Growth ◽

Growth Scores ◽

Outcomes For Children ◽

The Relationship ◽

Normal Speech

Objective: This study sought to investigate the association between maxillary growth and speech outcomes for children with a repaired unilateral cleft lip and palate (UCLP) at 5 years of age. Participants: In all, 521 children (180 females and 341 males) with a nonsyndromic complete UCLP, born between 2007 and 2012 in England, Wales, and Northern Ireland were included in this study. Outcome Measures: Maxillary growth was analyzed using dental models scored by the 5-Year-Olds’ index, and perceptual speech analyses were scored by the Cleft Audit Protocol for Speech – Augmented rating. Results: Forty-one percent of the children achieved good maxillary growth (scores 1 and 2 on 5-Year-Old’ index). Fifty percent of the children achieved normal speech (achieving UK speech standard 1). Maxillary growth was not found to have an impact on speech outcome when described by the 3 UK National Cleft Lip and Palate Speech Audit Outcome Standards. Analysis according to individual speech parameters showed dentalizations to be less prevalent in children with good maxillary growth compared to fair and poor growth ( P = .001). The remaining speech parameters within resonance, nasal airflow, and articulation categories were not significantly associated with maxillary growth. Conclusion: The findings from this study suggest that children with a history of complete UCLP, who have poor maxillary growth, are not at a higher risk of having major speech errors compared to children with good or fair maxillary growth at 5 years of age.

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An Emerging Problem of Shisha Smoking among High School Students in Ethiopia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18137023 ◽

2021 ◽

Vol 18 (13) ◽

pp. 7023

Author(s):

Selamawit Hirpa ◽

Andrew Fogarty ◽

Adamu Addissie ◽

Linda Bauld ◽

Thomas Frese ◽

...

Keyword(s):

High School ◽

High School Students ◽

Smokeless Tobacco ◽

Addis Ababa ◽

Capital City ◽

School Level ◽

Cluster Sampling ◽

High Concentration ◽

School Students ◽

Study Participants

Shisha smoking is also known as hookah, water pipe, goza, and nargile. Shisha use among the young is increasing globally. Shisha smoke results in a high concentration of carbon monoxide, tar, nicotine, and heavy metals which can be toxic to humans, especially with chronic exposure. This study aims to determine the prevalence and risk factors of shisha smoking among in-school adolescents in Ethiopia. Four regional states in Ethiopia (Oromia, Amhara, Southern Nations, Nationalities, and Peoples’ Region, Tigray) and the capital city (Addis Ababa) were the study areas. A two-stage cluster sampling approach was employed to produce a representative sample. From the sampling frames in the study areas, 36 high schools were selected randomly. A multi-level logistic regression analysis was used to account for cluster-specific random effects, the effect of individuals’, and school-level variables for ever-use of shisha. A total of 3355 secondary school grade 9 and 10 students aged between 13 and 22 years took part in this study. A total of 86 (2.6%) and 20 (0.6%) of the study participants, reported that they had ever smoked or were current smokers of shisha, respectively. Of all study participants, 38.6% perceived shisha as less harmful than cigarettes and 48.5% reported that they do not know which was more harmful to health. Students were more likely to ever use shisha if they had friend/s who smoke shisha (AOR = 16.8, 95% CI: 6.4–44.3), ever smoked cigarettes (AOR = 8.2, 95% CI: 3.4–19.8), ever used khat (AOR = 4.2, 95% CI: 1.9–10.4), ever used marijuana (AOR = 3.9, 95% CI: 1.4–11.1), ever used smokeless tobacco (AOR = 3.1 95% CI: 1.1–8.4), and students had received income from their parents (AOR = 3.1 CI: 1.1–8.8). Prevalence of ever and current use of shisha among high school students is low in Ethiopia compared to many countries in Africa. The majority of adolescents perceived shisha as less harmful to health than cigarette smoking. Health education about the harmful effects of shisha should be delivered to adolescents, along with information on other substances like khat, cigarettes, marijuana, and smokeless tobacco to prevent initiation of substance use.

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Relationship between Competency to Consent to Treatment and Psychological Well-Being: Mediating Effect of Empowerment and Emotion

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158170 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8170

Author(s):

Yeun-Joo Hur ◽

Joon-Ho Park ◽

MinKyu Rhee

Keyword(s):

Well Being ◽

Treatment Evaluation ◽

Mediating Effect ◽

Mediation Effect ◽

Psychiatric Outpatients ◽

Psychological Well Being ◽

Consent To Treatment ◽

Study Participants ◽

The Relationship

This study was conducted to evaluate the competency to consent to the treatment of psychiatric outpatients and to confirm the role of empowerment and emotional variables in the relationship between competency to consent to treatment and psychological well-being. The study participants consisted of 191 psychiatric outpatients who voluntarily consented to the study among psychiatric outpatients. As a result of competency to consent to treatment evaluation, the score of the psychiatric outpatient’s consent to treatment was higher than the cut-off point for both the overall and sub-factors, confirming that they were overall good. In addition, the effect of the ability of application on psychological well-being among competency to consent to treatment was verified using PROCESS Macro, and the double mediation effect using empowerment and emotional variables was verified to provide an expanded understanding of this. As a result of the analysis, empowerment completely mediated the relation between the ability of application and psychological well-being, and the relation between the ability of application and psychological well-being was sequentially mediated by empowerment and emotion-related variables. Based on these findings, the implications and limitations of this study were discussed.

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