scholarly journals Infant nutrition and growth: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

2019 ◽  
Vol 48 (Supplement_1) ◽  
pp. i80-i88 ◽  
Author(s):  
Helen Gonçalves ◽  
Fernando C Barros ◽  
Romina Buffarini ◽  
Bernardo L Horta ◽  
Ana M B Menezes ◽  
...  

Abstract Background Levels of child undernutrition have declined in many middle-income countries, whereas overweight and obesity have increased. We describe time trends in nutritional indicators at age 1 year in the 1982, 1993, 2004 and 2015 Pelotas (Brazil) Birth Cohorts. Methods Each study included all children born in the urban area of the city, with over 4 200 births in each cohort. Children were measured at approximately 12 months of age. Anthropometric indicators were calculated according to World Health Organization Growth Standards. Stunting and wasting were defined as <-2 Z scores for length for age and weight for length, and overweight as >2 Z scores for weight for length. Prevalence was stratified by sex, maternal skin colour and family income. Results The prevalence of stunting declined by 53% (from 8.3% to 3.9%) from 1982 to 2015. Wasting prevalence remained stable at low levels (1.8% in 1982 and 1.7% in 2015), whereas overweight increased by 88% (6.5% to 12.2%). Undernutrition was more common among boys, those born to mothers with brown or black skin colour and in the poorest quintile of families. Socioeconomic inequalities in undernutrition decreased markedly over time. Overweight was markedly more common among the rich in 1982, but fast increase among the poor eliminated socioeconomic differences by 2015, when all groups showed similar prevalence. Conclusions Our results confirm the rapid nutrition transition in Brazil, with marked reduction in levels and inequalities in undernutrition in parallel with a rapid increase in overweight, which became the main nutritional problem for children.

2008 ◽  
Vol 24 (suppl 3) ◽  
pp. s417-s426 ◽  
Author(s):  
Aluísio J. D. Barros ◽  
Cesar G. Victora ◽  
Iná S. Santos ◽  
Alicia Matijasevich ◽  
Cora L. Araújo ◽  
...  

The aim of this study was to compare the evolution of nutritional deficits and overweight in one-year-old children from three birth cohorts started in 1982, 1993 and 2004 in Pelotas, Southern Brazil. Samples from the 1982 and 1993 cohorts and all children from 2004 were weighed and measured, and their mothers interviewed. Anthropometric deficits and overweight were assessed using both NCHS and WHO growth standards. A comparison of the existence of nutritional deficits showed that, after a decline between 1982 and 1993, its prevalence stabilized between 1993 and 2004. Across the whole period, a decrease in all deficits was observed. Obesity, on the other hand, increased. A deficit in the ratio of body length to age was found to be strongly associated with family income. The group with income below one minimum wage was the only to present a significant reduction of stunting during the study period. The most significant improvements in the reduction of nutritional deficits occurred in the first half of the study period, while social differentials remained. Fighting malnutrition is still necessary among the 40% of the population considered poor, and must be accompanied by efforts to combat overweight which is being observed in all social strata.


2018 ◽  
Vol 48 (Supplement_1) ◽  
pp. i46-i53 ◽  
Author(s):  
Mariangela F Silveira ◽  
Cesar G Victora ◽  
Bernardo L Horta ◽  
Bruna G C da Silva ◽  
Alicia Matijasevich ◽  
...  

Abstract Background Despite positive changes in most maternal risk factors in Brazil, previous studies did not show reductions in preterm birth and low birthweight. We analysed trends and inequalities in these outcomes over a 33-year period in a Brazilian city. Methods Four population-based birth cohort studies were carried out in the city of Pelotas in 1982, 1993, 2004 and 2015, with samples ranging from 4231 to 5914 liveborn children. Low birthweight (LBW) was defined as <2500 g, and preterm birth as less than 37 weeks of gestation. Information was collected on family income, maternal skin colour and other risk factors for low birthweight. Multivariable linear regression was used to estimate the contribution of risk factors to time trends in birthweight. Results Preterm births increased from 5.8% (1982) to 13.8% (2015), and LBW prevalence increased from 9.0% to 10.1%, being higher for boys and for children born to mothers with low income and brown or black skin colour. Mean birthweight remained stable, around 3200 g, but increased from 3058 to 3146 g in the poorest quintile and decreased from 3307 to 3227 g in the richest quintile. After adjustment for risk factors for LBW, mean birthweight was estimated to have declined by 160 g over 1982–2015 (reductions of 103 g in the poorest and 213 g in the richest quintiles). Conclusions Data from four birth cohorts show that preterm births increased markedly. Mean birthweights remained stable over a 33-year period. Increased prevalence of preterm and early term births, associated with high levels of obstetric interventions, has offset the expected improvements due to reduction in risk factors for low birthweight.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Angela KC ◽  
Andrew Thorne-Lyman ◽  
Binod Shrestha ◽  
Swetha Manohar ◽  
Patrick Webb ◽  
...  

Abstract Objectives Estimate the national and agro-ecological zonal prevalence of preschool child undernutrition and review temporal trends in the prevalence of undernutrition. Methods In 2016, we conducted the last in a series of 3 (also 2013 and 2014) nationally representative, annual, same-season, mixed-longitudinal nutrition surveys – PoSHAN Community Studies – in the same 21 Village Development Committees sampled across the Mountains, Hills and Tarai of Nepal. Height/length and weight measurements of 5479 children < 5 years were converted to z-scores of height-for-age (HAZ) and weight-for-height (WHZ) based on World Health Organization growth standards. Cut-offs of < -2 z-scores of HAZ and WHZ were applied to define stunting and wasting, respectively. Rates of stunting and wasting were compared to four Demographic and Health Surveys of Nepal (NDHS) from 2001–2016. Annual rates of decline in stunting and wasting were calculated. Results Preschool stunting and wasting rates from PoSHAN in 2016 were 34% [95% CI: 29.5 to 38.9%] and 13.7% [11.0 to 16.9%], similar to those observed in the 2016 NDHS: 35.8% [33.5 to 38.3%] and 9.7% [8.4 to 11.1%], respectively. Stunting was highest in the Mountains (40.6%), and wasting in the Tarai (18.9%). PoSHAN surveys revealed an annual decrease in the prevalence of stunting of 1.5% from 2013–2016 and 2.3% from 2011–2016, representing a lesser decline than in the earlier period of 2001–2011 (3.3%) (Figure 1 a). In contrast, neither series of surveys has revealed a marked decline in the national prevalence of wasting over the past 15 years (Figure 1 b). Conclusions The rates of stunting and wasting seen in the PoSHAN survey were comparable to other contemporary surveys in 2016 and suggest that the current rate of decline is inadequate to meet Nepal's 2025 World Health Assembly (WHA) target of reducing stunting to 26.5%. However, wasting has changed very little, threatening the potential to reach Nepal's national WHA target of 5%. Funding Sources Funded by USAID Feed the Future Nutrition Innovation Lab, with assistance from Sight and Life and The Gates Foundation. Supporting Tables, Images and/or Graphs


Author(s):  
Qianling Tian ◽  
Xiao Gao ◽  
Tingting Sha ◽  
Qiong He ◽  
Gang Cheng ◽  
...  

Background: At present, whether to use the World Health Organization’s (WHO) growth standards or native growth standards to assess the nutritional status in a given population is unclear. This study aimed to compare the differences between the WHO’s growth standards and China’s growth standards in assessing the nutritional status of children aged 0~36 months. Methods: We used z-scores to evaluate the nutritional status of children. The weight-for-age z-scores (WAZs), length/height-for-age z-scores (LAZ/HAZs), and weight-for-length/height z-scores (WLZ/WHZs) were calculated using the WHO’s growth standards and China’s growth standards. MeNemar’s test was used to compare the nutritional status of children. Results: The results in this study showed that there were differences between the WHO’s standards and China’s standards in assessing children’s nutritional status except for stunting and obesity. The prevalence of underweight assessed using China’s standards was higher than when using the WHO’s standards (except when 3 and 36 months old). The prevalence of wasting was significantly higher when assessed using China’s standards than when using the WHO’s standards from 12 to 36 months. The prevalence of overweight was higher when assessed using the WHO’s standards from 3 to 8 months. Conclusions: Both the WHO’s and China’s growth standards are useful measures in assessing children’s nutritional status but with key significant differences. Therefore, caution should be taken in selecting appropriate measures in a given population.


2019 ◽  
Vol 48 (Supplement_1) ◽  
pp. i16-i25 ◽  
Author(s):  
Alicia Matijasevich ◽  
Cesar G Victora ◽  
Mariangela F Silveira ◽  
Fernando C Wehrmeister ◽  
Bernardo L Horta ◽  
...  

Abstract Background Brazil experienced important progress in maternal and child health in recent decades. We aimed at describing secular trends as well as socioeconomic and ethnic inequalities in reproductive history indicators (birth spacing, previous adverse perinatal outcome, parity and multiple births) over a 33-year span. Methods Four population-based birth cohort studies included all hospital births in 1982, 1993, 2004 and 2015 in Pelotas, Southern Brazil. Information on reproductive history was collected through interviews. Indicators were stratified by family income quintiles and skin colour. Absolute and relative measures of inequality were calculated. Results From 1982 to 2015, the proportion of primiparae increased from 39.2% to 49.6%, and median birth interval increased by 23.2 months. Poor women were more likely to report short intervals and higher parity, although reductions were observed in all income and ethnic groups. History of previous low birthweight was inversely related to income and increased by 7.7% points (pp) over time—more rapidly in the richest (12.1 pp) than in the poorest quintile (0.4 pp). Multiple births increased from 1.7% to 2.7%, with the highest increase observed among the richest quintile and for white women (220% and 70% increase, respectively). Absolute and relative income and ethnic-related inequalities for short birth intervals increased, whereas inequalities for previous low birthweight decreased over time. Conclusions In this 33-year period there were increases in birth intervals, multiple births and reports of previous low-birthweight infants. These trends may be explained by increased family planning coverage, assisted reproduction and a rise in preterm births, respectively. Our results show that socioeconomic and ethnic inequalities in health are dynamic and vary over time, within the same location.


Author(s):  
Pin-Zhir Chao ◽  
Shih-Wei Huang ◽  
Reuben Escorpizo ◽  
Wen-Chou Chi ◽  
Chia-Feng Yen ◽  
...  

The aim of this study was to explore the association between employment status and World Health Organization Disability Assessment Schedule, Second Edition (WHODAS 2.0) scores of working-age subjects with hearing impairment. The data of 18,573 working-age subjects (age ≥ 18 and <65 years) with disabling hearing impairment were obtained from the Taiwan Data Bank of Persons with Disability (TDPD) for the period from 11 July 2012 to 31 October 2018. Demographic data and WHODAS 2.0 scores for each domain were analyzed to identify their relationship with employment status. Unemployed subjects with disabling hearing impairment had higher WHODAS 2.0 scores in all domains compared with the employed subjects. Binary logistic regression revealed that older age, female sex, lower educational level, institutional residence, rural residence, lower family income, and moderate to severe impairment were more strongly associated with unemployment status. The data in this large population-based study offer comprehensive information on important factors associated with the employment status of people with disabling hearing impairment. Early identification of risks of unemployment of patients with hearing impairment can raise awareness for aggressive community and government campaigns regarding public health to improve the self-confidence, social participation, and related psycho-social wellbeing of people.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kilee Kimmel ◽  
Teresia Mbogori ◽  
Mengxi Zhang ◽  
Jayanthi Kandiah ◽  
Youfa Wang

Abstract Objectives Disease and lifestyle patterns have been changing rapidly worldwide including Africa due to recent changes in economic growth and urbanization. However, research related to the effects of these changes on nutrition status in Africa is limited. This study investigated the shifts in nutritional status (undernutrition, overweight, obesity) in children and adults in 4 carefully selected low-, middle- and high income countries in Africa, identified factors associated with the shifts, and provided recommendations for future work. Methods Malawi, Kenya, Ghana, and South Africa were selected based on their economic status, population size, urbanization, etc. Nationally representative data was obtained from sources such as 2017 Global Nutrition Report, Demographic Health Surveys (DHSs), Food and Agriculture Organization Corporate Statistical Database (FAOSTAT), and World Health Organization (WHO). The prevalence of underweight, overweight and obesity (ov/ob), and some ratios were assessed and compared across the countries between 1998 and 2016. Results Varied nutrition status and shifts were observed among the countries during 1998–2016. Countries with the higher economic status also had higher prevalence and faster increasing trends of ov/ob. South Africa had the highest GDP and highest ov/ob rates in children <5, children 5-18, and adults >18 (13.3%, 24.7%, and 51.9% respectively). Malawi, with the lowest GDP, had the highest stunting rate (37%). In each country, but most notably in South Africa, trends indicated the increasing ov/ob rate (11.8%) was much greater than the declining underweight rate (2.4%). Slight declines in overweight in children under 5 years were observed in Malawi, Kenya, and Ghana, which might be due to reduced stunting rates. Sex differences existed in older children and adults, with higher rates of ov/ob in females and undernutrition among males. Conclusions Nutrition shifts, heavily influenced by economic development, are rapidly occurring in sub-Saharan Africa. The double-burden of malnutrition posts prioritization challenges for policymakers. Because undernutrition is now a declining issue, the focus should be shifted towards prevention of obesity, at least in higher income countries in Africa. Funding Sources The study is funded in part by a center grant from the US National Institutes of Health (NIH, U54HD070725).


Pathogens ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 263
Author(s):  
Brito ◽  
Barbosa ◽  
Coelho de Andrade ◽  
Sá de Oliveira ◽  
Montarroyos ◽  
...  

This study analyzed the association between individual and household factors and the incidence of trachoma among a population aged between 1 and 9 years in the state of Pernambuco. This was a population-based household study conducted using a population-based sample of residents from 96 census sectors of the 1778 sectors considered to be at social risk in the state. The estimated odds ratio of the univariate analysis presented a confidence interval of 95%. Weights and clusters were adjusted through the Generalized Linear and Latent Mixed Model (GLLAM) method. Trachoma cases were the dependent variable in the multivariate analysis. The independent variables were selected through the stepwise forward method, with an input criterion of 20% (p < 0.20) and an output criterion of 10% (p < 0.10). The prevalence was 6.65%. Trachoma was associated with a female sex, age of 5–9 years, either the absence of use or infrequent use of soap to wash the hands and face, the presence of nasal secretion, a lack of piped water from a public supply system, a greater number of rooms used for sleeping, a greater number of people living in the same household, and a family income of up to one minimum monthly wage. The prevalence of follicular trachoma in Pernambuco was higher than what is recommended by the World Health Organization (WHO).


Sign in / Sign up

Export Citation Format

Share Document