127 research outputs found
Disadvantages of having an adolescent mother
No full textWe recently reported associations between maternal age at childbirth and outcomes in the off spring, using data from fi ve birth cohorts (COHORTS collaboration) in low-income and middle-income countries (LMICs), in The Lancet Global Health. Young maternal age (<19 years) was associated with lower offspring birthweight, gestational age, childhood nutritional status (weight-for-age and height-for-age at 2 years), and attained schooling, and higher adult glucose concentration, compared with off spring of mothers aged 20–24 years. These associations were independent of maternal socioeconomic status, height, and parity
Maternal and child undernutrition: consequences for adult health and human capital
No full textIn this paper we review the associations between maternal and child undernutrition with human capital and risk of adult diseases in low-income and middle-income countries. We analysed data from five long-standing prospective cohort studies from Brazil, Guatemala, India, the Philippines, and South Africa and noted that indices of maternal and child undernutrition (maternal height, birthweight, intrauterine growth restriction, and weight, height, and body-mass index at 2 years according to the new WHO growth standards) were related to adult outcomes (height, schooling, income or assets, offspring birthweight, body-mass index, glucose concentrations, blood pressure). We undertook systematic reviews of studies from low-income and middle-income countries for these outcomes and for indicators related to blood lipids, cardiovascular disease, lung and immune function, cancers, osteoporosis, and mental illness. Undernutrition was strongly associated, both in the review of published work and in new analyses, with shorter adult height, less schooling, reduced economic productivity, and--for women--lower offspring birthweight. Associations with adult disease indicators were not so clear-cut. Increased size at birth and in childhood were positively associated with adult body-mass index and to a lesser extent with blood pressure values, but not with blood glucose concentrations. In our new analyses and in published work, lower birthweight and undernutrition in childhood were risk factors for high glucose concentrations, blood pressure, and harmful lipid profiles once adult body-mass index and height were adjusted for, suggesting that rapid postnatal weight gain--especially after infancy--is linked to these conditions. The review of published works indicates that there is insufficient information about long-term changes in immune function, blood lipids, or osteoporosis indicators. Birthweight is positively associated with lung function and with the incidence of some cancers, and undernutrition could be associated with mental illness. We noted that height-for-age at 2 years was the best predictor of human capital and that undernutrition is associated with lower human capital. We conclude that damage suffered in early life leads to permanent impairment, and might also affect future generations. Its prevention will probably bring about important health, educational, and economic benefits. Chronic diseases are especially common in undernourished children who experience rapid weight gain after infancy
Anthropometric indicators of body composition in young adults: relation to size at birth and serial measurements of body mass index in childhood in the New Delhi birth cohort
No full textBackground: South Asians have a muscle-thin but adipose body phenotype and high rates of obesity-related disease. Adult body composition may be predictable in early life.Objective: Anthropometric indexes of adult body composition were examined in relation to birth size and body mass index (BMI) during childhood.Design: A population-based cohort of 1526 men and women aged 26–32 y in Delhi, India, who were measured sequentially from birth until 21 y of age were followed up. Adult weight, height, skinfold thicknesses, and waist and hip circumferences were measured. BMI and indexes of adiposity (sum of skinfold thicknesses), central adiposity (waist-hip ratio), and lean mass (residual values after adjustment of BMI for skinfold thicknesses and height) were derived.Results: Mean birth weight was 2851 g. As children, many subjects were underweight-for-age (>2 SDs below the National Center for Health Statistics mean; 53% at 2 y), but as adults, 47% were overweight, 11% were obese, and 51% were centrally obese (according to World Health Organization criteria). Birth weight was positively related to adult lean mass (P < 0.001) and, in women only, to adiposity (P = 0.006) but was unrelated to central adiposity. BMI from birth to age 21 y was increasingly strongly positively correlated with all outcomes. BMI and BMI gain in infancy and early childhood were correlated more strongly with adult lean mass than with adiposity or central adiposity. Higher BMI and greater BMI gain in late childhood and adolescence were associated with increased adult adiposity and central adiposity.Conclusions: Birth weight and BMI gain during infancy and early childhood predict adult lean mass more strongly than adult adiposity. Greater BMI gain in late childhood and adolescence predicts increased adult adiposity
Measurement of Human Recognition: A Methodology with Empirical Applications in India and Kenya
No full textThis paper develops and applies a methodology for measuring human recognition, which is defined as the acknowledgement provided to an individual by other individuals, groups, or organizations that he is of inherent value with intrinsic qualities in common with the recognizer. A framework is developed that organizes the sources of human recognition into various domains of an individual's life. The framework is used to develop an index of indicators that measures human recognition received in each of the domains and combines these domain-specific measures into a single overall measure of human recognition received. Two empirical applications of the index are presented with cross-sectional survey data from India and Kenya. Exploratory factor analysis is used to generate measures of human recognition with the index, and the resulting measures are used in multivariate regression models of nutritional status. Results from both datasets provide evidence that human recognition is a significant, independent, positive determinant of nutritional status, controlling for socio-economic characteristics. The method and applications demonstrate how latent, intangible aspects of development such as human recognition can be measured and indicate that further empirical work on the determinants and effects of human recognition is both feasible and needed.human recognition, nutrition, health, dehumanization, dignity, respect, domestic violence, measurement, India, Kenya, economic development, poverty
Zinc supplements for preventing otitis media
No full textBACKGROUND: Otitis media is inflammation of the middle ear and is usually caused by infection. It affects people of all ages but is particularly common in young children. Around 164 million people worldwide have long‐term hearing loss caused by this condition, 90% of them in low‐income countries. As zinc supplements prevent pneumonia in disadvantaged children, we wanted to investigate whether zinc supplements could also prevent otitis media. OBJECTIVES: To evaluate whether zinc supplements prevent otitis media in adults and children of different ages. SEARCH METHODS: We searched CENTRAL (2014, Issue 1), MEDLINE (1950 to February week 4, 2014) and EMBASE (1974 to March 2014). SELECTION CRITERIA: Randomised, placebo‐controlled trials of zinc supplements given at least once a week for at least a month for preventing otitis media. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the eligibility and methodological quality of the included trials and extracted and analysed data. We summarised results using risk ratios (RRs) or rate ratios for dichotomous data and mean differences (MDs) for continuous data. We combined trial results where appropriate. MAIN RESULTS: No new trials were identified for inclusion in this update. We identified 12 trials for inclusion, 10 of which contributed outcomes data. There were a total of 6820 participants. In trials of healthy children living in low‐income communities, two trials did not demonstrate a significant difference between the zinc‐supplemented and placebo groups in the numbers of participants experiencing an episode of definite otitis media during follow‐up (3191 participants); another trial showed a significantly lower incidence rate of otitis media in the zinc group (rate ratio 0.69, 95% confidence interval (CI) 0.61 to 0.79, n = 1621). A small trial of 39 infants undergoing treatment for severe malnutrition suggested a benefit of zinc for the mean number of episodes of otitis media (mean difference (MD) ‐1.12 episodes, 95% CI ‐2.21 to ‐0.03). Zinc supplements did not seem to cause any serious adverse events but a small minority of children were reported to have vomited shortly after ingestion of the supplements. The trial evidence included is generally of good quality, with a low risk of bias. AUTHORS' CONCLUSIONS: Evidence on whether zinc supplementation can reduce the incidence of otitis media in healthy children under the age of five years living in low‐ and middle‐income countries is mixed. There is some evidence of benefit in children being treated for marasmus (severe malnutrition), but this is based on one small trial and should therefore be treated with caution
Maternal postpartum vitamin A supplementation for the prevention of mortality and morbidity in infancy: a systematic review of randomized controlled trials
No full textSize at birth, weight gain in infancy and childhood, and adult blood pressure in 5 low- and middle-income-country cohorts: when does weight gain matter?
No full textBackground: Promoting catch-up growth in malnourished children has health benefits, but recent evidence suggests that accelerated child weight gain increases adult chronic disease risk. Objective: We aimed to determine how birth weight (BW) and weight gain to midchildhood relate to blood pressure (BP) in young adults. Design: We pooled data from birth cohorts in Brazil, Guatemala, India, the Philippines, and South Africa. We used conditional weight (CW), a residual of current weight regressed on prior weights, to represent deviations from expected weight gain from 0 to 12, 12 to 24, 24 to 48 mo, and 48 mo to adulthood. Adult BP and risk of prehypertension or hypertension (P/HTN) were modeled before and after adjustment for adult body mass index (BMI) and height. Interactions of CWs with small size-for-gestational age (SGA) at birth were tested. Results: Higher CWs were associated with increased BP and odds of P/HTN, with coefficients proportional to the contribution of each CW to adult BMI. Adjusted for adult height and BMI, no child CW was associated with adult BP, but 1 SD of BW was related to a 0.5-mm Hg lower systolic BP and a 9% lower odds of P/HTN. BW and CW associations with systolic BP and P/HTN were not different between adults born SGA and those with normal BW, but higher CW at 48 mo was associated with higher diastolic BP in those born SGA. Conclusions: Greater weight gain at any age relates to elevated adult BP, but faster weight gains in infancy and young childhood do not pose a higher risk than do gains at other ages
Childhood body mass index and adult pro-inflammatory and pro-thrombotic risk factors: data from the New Dehli birth cohort
No full textObjective: Weight gain and growth in early life may influence adult pro-inflammatory and pro-thrombotic cardiovascular risk factors. Methods: Follow-up of a birth cohort in New Delhi, India, whose weight and height were measured every 6 months until age 21 years. Body mass index (BMI) at birth, during infancy (2 years), childhood (11 years) and adulthood (26–32 years) and BMI gain between these ages were analysed in 886 men and 640 women with respect to adult fibrinogen, high-sensitivity C-reactive protein (hsCRP) and plasminogen activator inhibitor-1 (PAI-1) concentrations. Results: All the pro-inflammatory/pro-thrombotic risk factors were higher in participants with higher adiposity. In women, BMI at birth and age 2 years was inversely related to fibrinogen (P?=?0.002 and 0.05) and, after adjusting for adult adiposity, to hsCRP (P?=?0.02 and 0.009). After adjusting for adult adiposity, BMI at 2 years was inversely related to hsCRP and PAI-1 concentrations (P?<?0.001 and 0.02) in men. BMI gain between 2 and 11 years and/or 11 years to adulthood was positively associated with fibrinogen and hsCRP in women and with hsCRP and PAI-1 in men. Conclusions: Thinness at birth or during infancy, and accelerated BMI gain during childhood/adolescence are associated with a pro-inflammatory/pro-thrombotic state in adult life. An altered inflammatory state could be one link between small newborn/infant size and adult cardiovascular disease. Associations between pro-inflammatory markers and childhood/adolescent BMI gain are probably mediated through adult adiposity. <br/
- …
