Adolescent Health and Nutrition in the US and Canada: An Overview of Issues and Determinants

BackgroundSignificant global gains in sexual, reproductive, maternal, newborn, child and adolescent health and nutrition (SRMNCAH&N) will be difficult unless conflict settings are adequately addressed. We aimed to determine the amount, scope and quality of publically available guidance documents, to characterise the process by which agencies develop their guidance and to identify gaps in guidance on SRMNCAH&N promotion in conflicts.MethodsWe identified guidance documents published between 2008 and 2018 through English-language Internet sites of humanitarian response organisations, reviewed them for their scope and assessed their quality with the AGREE II (Appraisal of Guidelines for REsearch and Evaluation II) tool. Additionally, we interviewed 22 key informants on guidance development, dissemination processes, perceived guidance gaps and applicability.FindingsWe identified 105 conflict-relevant guidance documents from 75 organisations. Of these, nine were specific to conflicts, others were applicable also to other humanitarian settings. Fifteen documents were technical normative guidelines, others were operational guides (67), descriptive documents (21) or advice on legal, human rights or ethics questions (2). Nutrition was the most addressed health topic, followed by communicable diseases and violence. The documents rated high quality in their ‘scope and purpose’ and ‘clarity of presentation’ and low for ‘rigour of development’ and ‘editorial independence’. Key informants reported end user need as the primary driver for guideline development and WHO technical guidelines as their main evidence base. Insufficient local contextualisation, lack of inter-agency coordination and lack of systematic implementation were considered problems in guideline development. Several guidance gaps were noted, including abortion care, newborn care, early child development, mental health, adolescent health beyond sexual and reproductive health and non-communicable diseases.InterpretationOrganisations are motivated and actively producing guidance for SRMNCAH&N promotion in humanitarian settings, but few documents address conflicts specifically and there are important guidance gaps. Improved inter-organisation collaboration for guidance on SRMNCAH&N promotion in conflicts and other humanitarian settings is needed.

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Low HbA1c levels and all-cause or cardiovascular mortality among people without diabetes: the US National Health and Nutrition Examination Survey 1999–2015

International Journal of Epidemiology ◽

10.1093/ije/dyaa263 ◽

2020 ◽

Author(s):

Kosuke Inoue ◽

Roch Nianogo ◽

Donatello Telesca ◽

Atsushi Goto ◽

Vahe Khachadourian ◽

...

Keyword(s):

Cardiovascular Mortality ◽

Regression Models ◽

Machine Learning Algorithms ◽

Logistic Regression Models ◽

Health And Nutrition ◽

Increased Risk ◽

The Us ◽

All Cause Mortality ◽

Hba1c Levels

Abstract Objective It is unclear whether relatively low glycated haemoglobin (HbA1c) levels are beneficial or harmful for the long-term health outcomes among people without diabetes. We aimed to investigate the association between low HbA1c levels and mortality among the US general population. Methods This study includes a nationally representative sample of 39 453 US adults from the National Health and Nutrition Examination Surveys 1999–2014, linked to mortality data through 2015. We employed the parametric g-formula with pooled logistic regression models and the ensemble machine learning algorithms to estimate the time-varying risk of all-cause and cardiovascular mortality by HbA1c categories (low, 4.0 to <5.0%; mid-level, 5.0 to <5.7%; prediabetes, 5.7 to <6.5%; and diabetes, ≥6.5% or taking antidiabetic medication), adjusting for 72 potential confounders including demographic characteristics, lifestyle, biomarkers, comorbidities and medications. Results Over a median follow-up of 7.5 years, 5118 (13%) all-cause deaths, and 1116 (3%) cardiovascular deaths were observed. Logistic regression models and machine learning algorithms showed nearly identical predictive performance of death and risk estimates. Compared with mid-level HbA1c, low HbA1c was associated with a 30% (95% CI, 16 to 48) and a 12% (95% CI, 3 to 22) increased risk of all-cause mortality at 5 years and 10 years of follow-up, respectively. We found no evidence that low HbA1c levels were associated with cardiovascular mortality risk. The diabetes group, but not the prediabetes group, also showed an increased risk of all-cause mortality. Conclusions Using the US national database and adjusting for an extensive set of potential confounders with flexible modelling, we found that adults with low HbA1c were at increased risk of all-cause mortality. Further evaluation and careful monitoring of low HbA1c levels need to be considered.

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Countdown to 2030 for reproductive, maternal, newborn, child, and adolescent health and nutrition

The Lancet Global Health ◽

10.1016/s2214-109x(16)30204-2 ◽

2016 ◽

Vol 4 (11) ◽

pp. e775-e776 ◽

Cited By ~ 20

Author(s):

Cesar Victora ◽

Jennifer Requejo ◽

Ties Boerma ◽

Agbessi Amouzou ◽

Zulfiqar A Bhutta ◽

...

Keyword(s):

Adolescent Health ◽

Child And Adolescent ◽

Child And Adolescent Health ◽

Health And Nutrition ◽

Newborn Child

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Does Ethnicity Matter for Access to Childhood and Adolescent Health Capital in China? Evidence from the Wage-Height Relationship in the 2006 China Health and Nutrition Survey

The Review of Black Political Economy ◽

10.1007/s12114-013-9158-6 ◽

2013 ◽

Vol 40 (3) ◽

pp. 315-339 ◽

Cited By ~ 3

Author(s):

Juliet U. Elu ◽

Gregory N. Price

Keyword(s):

Adolescent Health ◽

Health Capital ◽

Nutrition Survey ◽

Health And Nutrition

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Association between selenium intake, diabetes, and mortality in adults: findings from National Health and Nutrition Examination Survey (NHANES) 2003-2014

British Journal Of Nutrition ◽

10.1017/s000711452100177x ◽

2021 ◽

pp. 1-24

Author(s):

Bushra Hoque ◽

Zumin Shi

Keyword(s):

National Health ◽

Cox Regression ◽

Inverse Association ◽

Nutrition Examination Survey ◽

Health And Nutrition ◽

Hazard Ratios ◽

The Us ◽

All Cause Mortality ◽

Cvd Mortality

Abstract Selenium (Se) is a trace mineral that has antioxidant and anti-inflammatory properties. This study aimed to investigate the association between Se intake, diabetes, all-cause and cause-specific mortality in a representative sample of US adults. Data from 18,932 adults who attended the 2003-2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Information on mortality was obtained from the US mortality registry updated to 2015. Multivariable logistic regression and Cox regression were used. Cross-sectionally, Se intake was positively associated with diabetes. Comparing extreme quartiles of Se intake, the odds ratio (OR) for diabetes was 1.44 (95% CI: 1.09–1.89). During a mean of 6.6 years follow-up, there were 1627 death (312 CVD, 386 cancer). High intake of Se was associated with a lower risk of all-cause mortality. When comparing the highest with the lowest quartiles of Se intake, the hazard ratios (HRs) for all-cause, CVD mortality, cancer mortality and other mortality were: 0.77 (95% CI 0.59-1.01), 0.62 (95% CI, 0.35-1.13), 1.42 (95% CI, 0.78-2.58) and 0.60 (95% CI,0.40-0.80), respectively. The inverse association between Se intake and all-cause mortality was only found among white participants. In conclusion, Se intake was positively associated with diabetes but inversely associated with all-cause mortality. There was no interaction between Se intake and diabetes in relation to all-cause mortality.

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Prevalence and Trends of Adult Obesity in the US, 1999–2012

ISRN Obesity ◽

10.1155/2014/185132 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 13

Author(s):

Ruopeng An

Keyword(s):

Overweight And Obesity ◽

Close Monitoring ◽

Health And Nutrition ◽

Measured Weight ◽

Significant Difference ◽

The Us ◽

Before And After ◽

Prevalence Of Obesity ◽

Grade 3 ◽

Socioeconomic Consequences

Aim. To provide national estimates of obesity among US adults aged 20 years and older in 2011-2012 and track its trends from 1999 to 2012. Methods. Measured weight/height from National Health and Nutrition Examination Survey 1999–2012 waves was used to calculate body mass index (BMI) and prevalence measures. Piecewise logistic regressions were conducted to test the differential trends before and after 2010. Results. In 2011-2012, the age-adjusted prevalence of overweight and obesity combined (BMI≥25) was 71.1% (95% CI: 68.0%–74.2%) among men and 65.5% (61.8%–69.3%) among women, and the prevalence of obesity (BMI≥30) was 33.3% (30.5%–36.2%) among men and 35.8% (32.3%–39.4%) among women. From 1990–2000 to 2009-2010, the prevalence of overweight and obesity combined, obesity, grades 2 and 3 obesity combined (BMI≥35), and grade 3 obesity (BMI≥40) increased by 7.2%, 17.8%, 17.6%, and 33.0%, respectively. Compared to 2009-2010, most gender- and race/ethnicity-specific prevalence measures remained unchanged or slightly decreased in 2011-2012. No significant difference in trends among prevalence measures was found before and after 2010. Conclusions. Concurrent evidence on the leveling off of obesity in the US is thin. Given its high prevalence and profound socioeconomic consequences, close monitoring of the trend is warranted.

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Authors’ response: Mushroom intake and depression: A population-based study using data from the US National Health and Nutrition Examination Survey (NHANES), 2005–2016

Journal of Affective Disorders ◽

10.1016/j.jad.2021.09.047 ◽

2021 ◽

Author(s):

Djibril M. Ba ◽

Xiang Gao ◽

Laila Al-Shaar ◽

Joshua Muscat ◽

Vernon Chinchilli ◽

...

Keyword(s):

National Health ◽

Population Based ◽

Nutrition Examination Survey ◽

Population Based Study ◽

Health And Nutrition ◽

The Us ◽

Using Data

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The National Health and Nutrition Examination Survey (NHANES), 2021–2022: Adapting Data Collection in a COVID-19 Environment

American Journal of Public Health ◽

10.2105/ajph.2021.306517 ◽

2021 ◽

Vol 111 (12) ◽

pp. 2149-2156

Author(s):

Ryne Paulose-Ram ◽

Jessica E. Graber ◽

David Woodwell ◽

Namanjeet Ahluwalia

Keyword(s):

Data Collection ◽

Nutritional Status ◽

National Health ◽

Nutrition Examination Survey ◽

National Data ◽

Participant Recruitment ◽

Biospecimen Collection ◽

Health And Nutrition ◽

The Us ◽

Unique Source

The National Health and Nutrition Examination Survey (NHANES) is a unique source of national data on the health and nutritional status of the US population, collecting data through interviews, standard exams, and biospecimen collection. Because of the COVID-19 pandemic, NHANES data collection was suspended, with more than a year gap in data collection. NHANES resumed operations in 2021 with the NHANES 2021–2022 survey, which will monitor the health and nutritional status of the nation while adding to the knowledge of COVID-19 in the US population. This article describes the reshaping of the NHANES program and, specifically, the planning of NHANES 2021–2022 for data collection during the COVID-19 pandemic. Details are provided on how NHANES transformed its participant recruitment and data collection plans at home and at the mobile examination center to safely collect data in a COVID-19 environment. The potential implications for data users are also discussed. (Am J Public Health. 2021;111(12):2149–2156. https://doi.org/10.2105/AJPH.2021.306517 )

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