1,720,967 research outputs found
Test-retest reliability and construct validity of Toddler NutriSTEP (registered trademark)
Get PDFThis research represents phase C in the development of Toddler NutriSTEP® (Nutrition Screening Tool for Every Preschooler). NutriSTEP® is a valid and reliable screening tool designed to assess nutritional risk in preschoolers (3-5 years). A draft toddler (18-35 months) version of NutriSTEP® has recently been developed because of an expressed need. Convenience samples of caregivers were recruited across Ontario to assess the test-retest reliability and construct validity of the tool. Test-retest reliability was assessed based on total score and attribute scores using paired sample t-tests and intraclass correlation coefficients; individual questions were assessed using Wilcoxcon signed rank tests and kappa statistics. Construct validity was assessed through comparison of high-risk groups to Toddler NutriSTEP® scores, as well as through exploratory and confirmatory factor analyses. Toddler NutriSTEP® was found to be test-retest reliable and construct valid, and therefore may be used to assess nutritional risk in Canadian toddlers.Canadian Institutes of Health Researc
Prevalence, trends and predictors of anaemia and growth faltering in Malawi: A prospective case study of the micronutrient and health programme (1996-2005)
Get PDFThis thesis presents results of studies aimed at assessing the impact of an integrated, community-based micronutrient and health (MICAH) programme on linear growth retardation (stunting) and anaemia in rural Malawian children (6.0-59.9 months), and anaemia in women (15-49 years). The programme was implemented by World Vision in collaboration with its local partners in selected rural communities. Using data collected at the baseline (1996), and during evaluation of the programme (2000 and 2004), the results were compared between MICAH and Comparison areas, which only participated in the programme until 1999. Programme interventions included weekly iron supplementation, provision of potable water and sanitation, dietary diversification, promotion of appropriate child feeding practices, and prevention and treatment of parasitic infections. In children, the prevalence of stunting and anaemia was very high in 1996. Although stunting significantly declined in MICAH and Comparison areas in subsequent surveys, the difference between MICAH and Comparison areas was only significant in 2000. As for anaemia, there was a significantly lower prevalence in MICAH than Comparison areas in 2000 and 2004. Factors that were associated with a reduction in the probability of stunting at the baseline or in MICAH/Comparison areas were: increasing household socioeconomic status; children aged >=24 months; household access to protected water; exclusive breastfeeding for 6 months; and, households that raised livestock. For anaemia, factors that were associated with a reduction in childhood anaemia were: children aged >=24 months; children without malaria parasitemia; and, children from households that grew fruit trees. Among women, data were available only for the 2000 and 2004 surveys. There was no significant difference in the prevalence of anaemia in 2000, but significantly fewer women were anaemic in MICAH than Comparison areas in 2004. Women from households that reported using bed nets to prevent malaria; households with increasing socioeconomic status; and surprisingly, women who were diagnosed with malaria parasitemia were less likely to be anaemic. Growing of fruit trees had mixed results. Taken together, the studies showed that the Malawi MICAH programme is a potential model for combating stunting and anaemia in rural areas, particularly if programme interventions are integrated and community-based
The Growing Babies Project: growth and dietary intake of Old Order Amish infants and toddlers aged 6 to 18 months
No full textIn a study evaluating the growth and dietary intake of twenty-eight Old Order Amish infants and toddlers, all mothers and children were prospectively followed from either 6 to 12 months or 12 to 18 months. When plotted against the CDC growth charts, mean growth measurements for weight and height were below the median. Failure to thrive, stunting and wasting were classified in 10, 6 and 6 infants, respectively. Protein intake had a positive association with weight; height of fathers had a positive association with weight and length particularly. Both protein and energy intake had the greatest effect on weight between the ages of 9 and 15 months. Although protein intake was not limiting, energy intake was inadequate in some infants. Other nutrients found to be inadequate included vitamin D, zinc, iron and folate. Nutrient inadequacies in mothers were found for energy and folate
The Development of Nutri-eSTEP
Get PDFThis thesis presents the methods and results of a multiphase project that was conducted to develop online adaptations of the NutriSTEP® questionnaires for parents of young children (18 – 35 months and 3-5 years of age). The development of Nutri-eSTEP used an iterative process involving parents and an advisory committee of registered dietitians and health professionals. The phases guiding the development process included: 1) key intercept interviews; 2) review of feedback messages; 3) usability testing; 4) a survey to determine importance of changes; 5) satisfaction survey; and, 6) finalization and translation. Results from each phase were used to create and revise the pilot platform. Nutri-eSTEP serves as a knowledge translation vehicle to raise parental awareness of their children’s nutritional needs while providing resources to support self-management
Determining What Constitutes Nutritional Risk in Toddlers (18-35 months): First Steps in the Development of Toddler NutriSTEP (Registered Trademark)
No full textThis research is part of an ongoing program, Nutrition Screening Tool for Every Preschooler (NutriSTEP®). NutriSTEP® is a valid and reliable 17-item, parent-administered, questionnaire for nutritional risk in preschoolers (3-5 years of age). Due to an expressed need across Canada, the specific objective of this research was to create a draft toddler (18-35 month) NutriSTEP®. Based on results from a comprehensive literature review, focus groups (n=6) with 48 parents of toddlers, and input from 13 pediatric nutrition experts, many questions from the original preschooler NutriSTEP® questionnaire were refined or removed, and novel questions were added. Basic changes included combining separate fruit and vegetable intake questions, and adding breast milk and formula as examples of dairy products. In conclusion, a 19 item Toddler NutriSTEP® was created to reflect the differences in nutritional risk between preschoolers and toddlers. Next steps in the development process include refinement, test-retest reliability and criterion validation.Canadian Institutes of Health Researc
Prevalences and predictors of anemia, iron deficiency and iron deficiency anemia among children in Kampong Thom, Cambodia
Get PDFObjective: To assess predictors of anemia, iron deficiency, and iron deficiency anemia among children 6 - 59 months living in Kampong Thom province, Cambodia. Methods: A cross-sectional study was completed by the National Nutrition Program and World Vision Cambodia conducted in 2008. Children (6 - 59 months) were randomly selected ('n'=767). Weight and height were measured; demographics and illness were assessed by questionnaire, biochemical and biological measures were also collected assessing iron deficiency and presence of parasites. Multiple linear regression and binary regression was used to determine relationships among variables. Results: The prevalence of anemia was very high (57.0%). Factors that reduced the likelihood of being anemic were: female gender, age greater than 24 months, and absence of iron or vitamin A deficiency, illness (CRP >10 mg/L), and wasting. Eighty-four percent of anemic children were iron deficient, demonstrating that iron deficiency is indeed a large component in the etiology of anemia. In addition, 38.9% of all children were iron deficient and 27.1% had iron deficiency concurrent with anemia. Factors that reduced the risk of being iron deficient included age greater than 24 months with female gender, and for iron deficiency anemia the strongest predictor was age. Conclusion: Our study reinforces the importance of age, gender, illness, wasting and vitamin A deficiency in the etiology of anemia, iron deficiency, and iron deficiency anemia. Results should be used to guide future programs and interventions combating anemia and iron deficiency among this population
Nutrition counselling for at-risk infants and toddlers in an Old Order Amish community in southwestern Ontario
No full textIn the Growing Babies Project 1 (GBP1), high rates of failure to thrive (FTT) (34%), stunting (21%), and wasting (21%) were documented in Old Order Amish infants and toddlers based on the Center for Disease Control (CDC) growth references. A follow-up study (GBP2) provided mothers with personal nutrition counselling and dietary intervention for their children every 3 months from 6 to 18 months of age. Compared to GBP1, FTT increased to 48%, stunting and wasting decreased to 16% and 19%, respectively. However, comparison of growth measurements to 2006 World Health Organization growth standards indicated that FTT decreased to just 6%. This suggests that the CDC growth charts were not appropriate for assessing growth status in these children. High prevalence of inadequate dietary intakes were noted for vitamins D and E, folate and zinc. Overall, the mothers found the GBP2 project useful in understanding their children's growth and development
Dietary intakes of zinc and folate in preschoolers from Ontario: the role of food fortification
No full textThis descriptive study, the first to describe the role of food fortification in zinc and folate intakes of Canadian children, used three-day food records from 254 preschoolers (3-5 years) participating in the NutriSTEP validation project. Compared with Dietary Reference Intakes, the prevalence of inadequate (UL) zinc intakes. Zinc-fortified foods had minimal impact upon total zinc intake; higher protein and energy intakes were the most likely explanation for the excessive zinc intakes for some children. In contrast, folic acid-fortified foods made a significant contribution to total folate intake, playing an important role in preventing inadequacy. Multiple linear regression modeling using dietary, demographic, anthropometric and feeding behaviours data yielded models with low to moderate predictive capacity for zinc and folate intakes and fortified food use. Changes to food fortification regulations proposed by Health Canada (2005) appear appropriate for these children
Parenting Stress: Associations with Childhood Obesity Risk and Related Risk Behaviours
No full textThe purpose of this study was to explore the association between parenting stress and child body mass index (BMI). Behaviours known to increase childhood obesity risk were also examined in relation to parent stress: poor eating habits, increased television viewing, decreased physical activity and poor sleep habits. Cross-sectional, baseline data were collected from 110 parent-child dyads participating in a family-based obesity prevention intervention. The majority of participants identified as Hispanic/Latino and belonged to low-income households. Parents scored an average of 28.4 +/- 10.7 on the PSI-3-SF, classifying 20% as high stress. Using the World Health Organization (WHO) growth charts, 48% of children were categorized as overweight or obese. Parenting stress was not found to be associated with child weight status in this study. Parenting stress was, however, significantly associated with unhealthful behaviours that are associated with increased obesity risk. In comparison to children with unstressed parents, the children of highly stressed parents were less likely to meet the recommendation of 60 minutes spent in active play per day on weekdays. Highly stressed parents also were less likely to limit the amount of television their child viewed. While it is important to target activity and television behaviours among young children, our results suggest that interventions may also need to address parental stress as a possible underlying factor associated with unhealthful behaviours among young children
Bone mineral density of young, healthy Canadian women
No full textBackground: Bone mineral density (BMD) of healthy young women is not commonly measured. Descriptive research on factors that influence BMD could be useful in osteoporosis prevention, and could lead to the development of Canadian BMD reference standards. Methods: We recruited a convenience sample of 52 undergraduate students. BMD was measured at three clinically relevant sites using a Discovery Wi (Hologic Inc.) dual energy X-ray absorptiometer. Participants also completed a demographic questionnaire. Results: Mean BMDs measured at the femoral neck, lumbar spine, and whole body were, (respectively), 0.863±0.11; 1.019±0.09 and 1.085±0.07 g/cm2. Television watching, lactose intolerance, alcoholic drinks per week, and age were used in a linear regression model to predict whole body BMD ('r'2=0.727, p<0.001). Conclusions: Based on criteria established by the World Health Organization, young women in this group present with lower than expected BMD. Factors which influence bone health in older women also affect BMD in young women
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