scholarly journals Nurturing Environments and Nutrient-Rich Diets May Improve Cognitive Development: Analysis of Cognitive Trajectories from Six to Sixty Months from the MAL-ED Study (OR10-01-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Benjamin McCormick ◽  
Laura Caulfield ◽  
Stephanie Richard ◽  
Laura Pendergast ◽  
Laura Murray-Kolb ◽  
...  
Keyword(s):  
Discriminant Analysis ◽  
Cognitive Development ◽  
Nutrition Education ◽  
Child Nutrition ◽  
Infant Development ◽  
Latent Class ◽  
Mixed Model ◽  
Developmental Trajectories ◽  
Analysis Model ◽  
Middle Income

Abstract Objectives To identify clusters of cognitive developmental trajectories and associated differentiating factors of children aged 6 to 60 months old in 5 low to middle-income sites. Methods We followed 835 children and assessed anthropometry at enrolment (≤ 17 d old); bi-weekly illness data (0–24 and 60 mo); non-diarrheal and diarrheal stools (0–24 mo) analyzed for a panel of enteropathogens; quantitative complementary food intakes (9–24 and 60 mo); micronutrient status (Fe, Zn, Vit A; 7, 15, and 24 mo); quality of the child's home environment (6, 24, and 60 mo) and maternal reasoning ability and depressive symptoms via questionnaire. Child cognitive development was assessed by the Bayley Scales of Infant Development III (6, 15 and 24 mo) and Wechsler Preschool and Primary Scale of Intelligence (60 mo). Clusters of trajectories were identified using a latent class mixed model. Differences between clusters were described using discriminant analysis to rank the contribution of each variable using correlation-adjusted t-scores (CAT). Results Five clusters were identified. From 51 discriminatory factors, 10 had greatest descriptive power: HOME score at 60 mo (mean CAT2 ± SD: 34.6 ± 0.35), proportion of days ill from 0–24 mo (23.9 ± 0.18), years of maternal schooling (13.8 ± 0.23), mean nutrient densities of zinc (12.3 ± 0.07), protein (8.95 ± 0.09), vitamin B6 (8.2 ± 0.10), phytate (7.91 ± 0.05) and mean energy (7.82 ± 0.04) from complementary foods (9–24 mo), % days of exclusive breastfeeding (0–6 mo; 6.42 ± 0.10) and weight-for-age at enrolment (6.14 ± 0.17). The discriminant analysis model fit was statistically significant (Wilk's λ 0.54, P < 0.01). Conclusions Early life factors associated with higher scoring trajectories included stimulation and support for the child in their home, complementary feeding that typified greater diversity and animal-source foods, and maternal years of schooling. Influences associated with lower scoring trajectories included lower weight at enrolment and higher prevalence of illness. Policies promoting maternal and child nutrition, education and fostering a nurturing environment are likely to have greatest impact on child development. Funding Sources The MAL-ED study was supported by the Bill & Melinda Gates Foundation, with grants to the Foundation for the NIH and NIH/FIC.

scholarly journals Effects of a participatory agriculture and nutrition education project on child growth in northern Malawi

2010 ◽  
Vol 14 (8) ◽  
pp. 1466-1472 ◽  
Author(s):  
Rachel Bezner Kerr ◽  
Peter R Berti ◽  
Lizzie Shumba
Keyword(s):  
Nutrition Education ◽  
Child Nutrition ◽  
Mixed Model ◽  
Initial Conditions ◽  
Smallholder Farmers ◽  
Child Growth ◽  
Nutrition Intervention ◽  
Household Food Security ◽  
Quasi Experimental ◽  
Growth Scores

AbstractObjectiveTo investigate whether children in households involved in a participatory agriculture and nutrition intervention had improved growth compared to children in matched comparable households and whether the level of involvement and length of time in the project had an effect on child growth.DesignA prospective quasi-experimental study comparing baseline and follow-up data in ‘intervention’ villages with matched subjects in ‘comparison’ villages. Mixed model analyses were conducted on standardized child growth scores (weight- and height-for-age Z-scores), controlling for child age and testing for effects of length of time and intensity of village involvement in the intervention.SettingA participatory agriculture and nutrition project (the Soils, Food and Healthy Communities (SFHC) project) was initiated by Ekwendeni Hospital aimed at improving child nutritional status with smallholder farmers in a rural area in northern Malawi. Agricultural interventions involved intercropping legumes and visits from farmer researchers, while nutrition education involved home visits and group meetings.SubjectsParticipants in intervention villages were self-selected, and control participants were matched by age and household food security status of the child. Over a 6-year period, nine surveys were conducted, taking 3838 height and weight measures of children under the age of 3 years.ResultsThere was an improvement over initial conditions of up to 0·6 in weight-for-age Z-score (WAZ; from −0·4 (sd 0·5) to 0·3 (sd 0·4)) for children in the longest involved villages, and an improvement over initial conditions of 0·8 in WAZ for children in the most intensely involved villages (from −0·6 (sd 0·4) to 0·2 (sd 0·4)).ConclusionsLong-term efforts to improve child nutrition through participatory agricultural interventions had a significant effect on child growth.

scholarly journals Trajectories of child cognitive development during ages 0–3 in rural Western China: prevalence, risk factors and links to preschool-age cognition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei Wang ◽  
Yifei Chen ◽  
Sean Sylvia ◽  
Sarah-Eve Dill ◽  
Scott Rozelle
Keyword(s):  
Cognitive Development ◽  
Cognitive Skills ◽  
Infant Development ◽  
Developmental Trajectories ◽  
Rural China ◽  
Preschool Age ◽  
Western China ◽  
Rural Children ◽  
Cognitive Delay ◽  
Child Cognitive Development

Abstract Background Cognitive development after age three tends to be stable and can therefore predict cognitive skills in later childhood. However, there is evidence that cognitive development is less stable before age three. In rural China, research has found large shares of children under age three are developmentally delayed, yet little is known about the trajectories of cognitive development between 0 and 3 years of age or how developmental trajectories predict later cognitive skills. This study seeks to describe the trajectories of child cognitive development between the ages of 0–3 years and examine how different trajectories predict cognitive development at preschool age. Methods We collected three waves of longitudinal panel data from 1245 children in rural Western China. Child cognitive development was measured by the Bayley Scales of Infant Development when the child was 6–12 months and 22–30 months, and by the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition when the child was 49–65 months. We used the two measures of cognitive development before age three to determine the trajectories of child cognitive development. Results Of the children, 39% were never cognitively delayed; 13% were persistently delayed; 7% experienced improving cognitive development; and 41% experienced deteriorating development before age 3. Compared to children who had never experienced cognitive delay, children with persistent cognitive delay and those with deteriorating development before age 3 had significantly lower cognitive scores at preschool age. Children with improving development before age 3 showed similar levels of cognition at preschool age as children who had never experienced cognitive delay. Conclusions Large shares of children under age 3 in rural Western China show deteriorating cognitive development from infancy to toddlerhood, which predict lower levels of cognition at preschool age. Policymakers should invest in improving cognitive development before age 3 to prevent long-term poor cognition among China’s rural children.

scholarly journals Ride-hailing and (dis)Advantage: Perspectives from Users and Non-users

2021 ◽  
Author(s):  
Daniel Oviedo ◽  
Yisseth Scorcia ◽  
Lynn Scholl
Keyword(s):  
Latent Class ◽  
Social Groups ◽  
User Preferences ◽  
Primary Data ◽  
Regional Research ◽  
Local Policy ◽  
Analysis Model ◽  
Policy And Practice ◽  
Middle Income ◽  
The Caribbean

The introduction of ride-hailing in cities of Latin America and the Caribbean (LAC) remains a relatively new topic in regional research and a contentious issue in local policy and practice. Evidence regarding users and how do they differ from non-users is scarce, and there is little documented evidence about how user preferences and perceptions may influence the uptake of ride-hailing. This paper uses primary data from a survey collected from users and non-users of ride-hailing in Bogotá during 2019 to develop a Latent Class Analysis Model (LCA) to identify clusters of users and non-users of ride-hailing. The paper builds on results from the LCA to reflect on conditions of advantage and disadvantage that may make ride-hailing attractive and beneficial for particular social groups. The paper identifies four unique clusters: Carless middle-income ride-hailing users, Disadvantaged non-users, Young middle-class non-users, and Advantaged ride-hailing users. The research uses data on such perceptions to draw insights that may inform commercial and policy decisions. Findings suggest that issues such as the perception of legality in ride-hailing and aversion to crime play a significant role in the choice of such a mode in the context of Bogotá, particularly among socially and transport advantaged users.

scholarly journals Trajectories of mid-life to elderly adulthood BMI and incident hypertension: the China Health and Nutrition Survey

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e047920
Author(s):  
Qi Zeng ◽  
Lin Sun ◽  
Qing Zeng
Keyword(s):  
Latent Class ◽  
Mixed Model ◽  
Longitudinal Design ◽  
Nutrition Survey ◽  
Incident Hypertension ◽  
Health And Nutrition ◽  
Stable Class ◽  
Bmi Trajectories ◽  
Distinct Individual ◽  
Prevention Of Hypertension

ObjectivesThis study is designed to identify different body mass index (BMI) trajectories of individuals aged 40–70 years and test the effect of distinct BMI trajectories on incident hypertension.DesignThe accelerated longitudinal design was used for this study.MethodsThe study drew data from the third to ninth China Health and Nutrition Surveys (CHNS), and 4697 participants were included between 1991 and 2015. As analysed, three distinct individual BMI trajectories were identified by the latent class growth mixed model (LCGMM). Then, BMI values and BMI slopes were worked out through calculation with LCGMM trajectory parameters and their primary derivatives, respectively. Later, Cox proportional hazard models were applied to examine BMI values and slopes, and find out the relationship between the said predicted data and incident hypertension for different classes.ResultsThree different trajectory classes were identified, that is, low-stable class (n=3711), sharp-increasing class (n=282) and high-stable class (n=704). Compared with the low-stable class, the adjusted HRs (95% CI) were 1.321 (1.119 to 1.559) and 1.504 (1.322 to 1.711) for the sharp-increasing class and the high-stable class, respectively. The HR (95% CI) for BMI values rose from 1.081 (1.030 to 1.135) to 1.221 (1.171 to 1.273) while the HR (95% CI) for BMI slopes dropped from 1.154 (1.100 to 1.211) to 0.983 (0.943 to 1.025). That is, the HR for BMI slopes were higher than that for BMI values for the class aged 40–47 years.ConclusionThese findings suggest that the calibrated BMI trajectories for the period from mid-life to elderly adulthood have a significant effect on the risk of incident hypertension. The period from age 40 to 47 years is critical and has positive implications for the early prevention of hypertension.

scholarly journals A six-week healthy eating intervention with family engagement improves food knowledge and preferences but not dietary diversity among urban preschool children in Sri Lanka

2021 ◽  
pp. 1-22
Author(s):  
Fathima Sirasa ◽  
Lana Mitchell ◽  
Aslan Azhar ◽  
Anoma Chandrasekara ◽  
Neil Harris
Keyword(s):  
Sri Lanka ◽  
Nutrition Education ◽  
Healthy Eating ◽  
Child Nutrition ◽  
Dietary Diversity ◽  
Family Engagement ◽  
Food Preferences ◽  
Healthy Food ◽  
Food Knowledge ◽  
The Impact

Abstract Objective: To evaluate the effectiveness of a multicomponent intervention (MCI) on children’s dietary diversity and its impact pathway components of children’s food knowledge and healthy food preferences. Design: A six-week cluster randomised controlled trial with a MCI consisting of child nutrition education plus family engagement, through parental nutrition education, meal preparation and tasting was compared with two groups: single component intervention (SCI) of child nutrition education, and control, conducted during February to July 2018. Preschool centres were randomly assigned to one of the three arms. Children’s food knowledge, healthy food preferences and dietary diversity scores were collected. Intervention effects were analysed using a pre-post analysis and a difference-in-difference model. Setting: Fourteen preschool centres in an urban area of Kurunegala, Sri Lanka Participants: Child-parent dyads of children aged 4-6 years. Final analyses included 306 (for food knowledge and preferences) and 258 (for dietary diversity) dyads. Results: MCI significantly influenced the impact pathways to children’s dietary diversity by increasing children’s food knowledge and healthy food preferences scores by 3.76 and 2.79 (P<0.001) respectively, but not the dietary diversity score (P=0.603), compared to control arm. Relative to SCI, MCI significantly improved children’s food knowledge score by 1.10 (P<0.001), but no significant effects were noted for other outcome variables. Conclusion: Improved food knowledge and preferences require a positive food environment and time to develop into healthy eating behaviours. Research into dietary diversity should broaden to incorporate the contextual roles of the home and general food environments to more completely understand food choices of children.

Association Between Longitudinal Blood Pressure Trajectory and the Progression of Chronic Kidney Disease: Results From the KNOW-CKD

Hypertension ◽  
2021 ◽  
Author(s):  
Young Su Joo ◽  
Hyung Woo Kim ◽  
Ki Heon Nam ◽  
Jee Young Lee ◽  
Tae Ik Chang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Primary Outcome ◽  
Latent Class ◽  
Mixed Model ◽  
Hazards Model ◽  
Trajectory Group ◽  
End Stage

Studies on the longitudinal temporal trend of blood pressure (BP) and its impact on kidney function are scarce. Here, we evaluated the association of dynamic changes in systolic blood pressure (SBP) over time with adverse kidney outcomes. We analyzed 1837 participants from the KNOW-CKD (Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease). The main exposure was 3 distinct SBP trajectories determined by the latent class mixed model (decreasing, stable, and increasing) using 3 SBP measurements at 0, 6, and 12 months. The primary outcome was CKD progression, defined as a composite of halving estimated glomerular filtration rate from baseline value or onset of end-stage kidney disease. SBP declined from 144 to 120 mm Hg in the decreasing SBP trajectory group and rose from 114 to 136 mm Hg in the increasing trajectory group within 1 year. During 6576 person-years of follow-up (median, 3.7 years), the composite outcome occurred in 521 (28.4%) participants. There were fewer primary outcome events in the decreasing (30.6%) and stable (26.5%) SBP trajectory groups than in the increasing trajectory group (33.0%). In the multivariable-adjusted cause-specific hazards model, increasing SBP trajectory was associated with a 1.28-fold higher risk for adverse kidney outcome compared with stable SBP trajectory. However, the risk for the primary outcome did not differ between the decreasing and stable SBP trajectory groups. In this longitudinal CKD cohort study, compared with stable SBP trajectory, increasing SBP trajectory was associated with higher risk for adverse kidney outcome, whereas decreasing SBP trajectory showed similar risk.

Identifying subclasses based on developmental trajectories: comparing three latent class techniques

2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
JJ Sijbrandij ◽  
T Hoekstra ◽  
J Almansa ◽  
SA Reijneveld ◽  
U Bültmann
Keyword(s):  
Latent Class ◽  
Developmental Trajectories

scholarly journals Public health nutrition in Afghanistan: policies, strategies and capacity-building: current scenario and initiatives

2021 ◽  
Author(s):  
Jyoti Sharma ◽  
Homayoun Ludin ◽  
Monika Chauhan ◽  
Sanjay Zodpey
Keyword(s):  
Public Health ◽  
Nutrition Education ◽  
Child Nutrition ◽  
Institutional Environment ◽  
Scale Up ◽  
Critical Issue ◽  
Noncommunicable Diseases ◽  
Public Health Nutrition ◽  
Weak Institutions ◽  
Training Programmes

Background: Afghanistan is grappling with high burden of malnutrition in women and children and a rising burden of noncommunicable diseases. Aims: A narrative review was conducted with the aim of mapping current nutrition policies and capacity development initiatives to assess policy and the institutional environment and identify gaps and opportunities. Methods: A comprehensive, broad based search was conducted, including databases and websites and policy and programme documents. Results: The policy focuses on multisectoral efforts to address nutrition challenges; however; implementation of nutrition-specific and nutrition-sensitive interventions is not delivered uniformly at the community level due to continued conflict situations and geographic inaccessibility, lack of availability of trained human resources and weak institutions. There is limited evidence on the effectiveness of nutrition programmes in Afghanistan. Limited policy provisions are available to address nutrition issues due to the rising burden of noncommunicable diseases, urbanization and changing dietary patterns. The shortage of skilled nutritional professionals is a critical issue. Lack of institutional capacity, educational standards and accreditation mechanism poses major challenges. Ongoing training programmes are fragmented and fail to meet the requirements of a professional nutrition workforce. Conclusion: The findings highlight that well-structured policies and strategies focusing on maternal and child nutrition provide an enabling policy environment to scale up nutrition interventions.Evidence on the implementation of programmes is needed to aid policy recommendations. The lack of an institutional mechanism for professional nutrition education highlights the great need for action in Afghanistan for public health nutrition and education.

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