scholarly journals Impact of Treatment with RUTF on Plasma Lipid Profiles of Severely Malnourished Pakistani Children

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2163
Author(s):  
Engy Shokry ◽  
Kamran Sadiq ◽  
Sajid Soofi ◽  
Atif Habib ◽  
Naveed Bhutto ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Severe Acute Malnutrition ◽  
Plasma Lipid ◽  
Biologically Active ◽  
Acute Malnutrition ◽  
Great Decrease ◽  
Mead Acid ◽  
Multivariate Tests ◽  
The Impact ◽  
Child Age

(1) Background: Little is known on impacts of ready-to-use therapeutic food (RUTF) treatment on lipid metabolism in children with severe acute malnutrition (SAM). (2) Methods: We analyzed glycerophospholipid fatty acids (FA) and polar lipids in plasma of 41 Pakistani children with SAM before and after 3 months of RUTF treatment using gas chromatography and flow-injection analysis tandem mass spectrometry, respectively. Statistical analysis was performed using univariate, multivariate tests and evaluated for the impact of age, sex, breastfeeding status, hemoglobin, and anthropometry. (3) Results: Essential fatty acid (EFA) depletion at baseline was corrected by RUTF treatment which increased EFA. In addition, long-chain polyunsaturated fatty acids (LC-PUFA) and the ratio of arachidonic acid (AA)/linoleic acid increased reflecting greater EFA conversion to LC-PUFA, whereas Mead acid/AA decreased. Among phospholipids, lysophosphatidylcholines (lyso.PC) were most impacted by treatment; in particular, saturated lyso.PC decreased. Higher child age and breastfeeding were associated with great decrease in total saturated FA (ΣSFA) and lesser decrease in monounsaturated FA and total phosphatidylcholines (ΣPC). Conclusions: RUTF treatment improves EFA deficiency in SAM, appears to enhance EFA conversion to biologically active LC-PUFA, and reduces lipolysis reflected in decreased ΣSFA and saturated lyso.PC. Child age and breastfeeding modify treatment-induced changes in ΣSFA and ΣPC.

scholarly journals Optimal design for a psychosocial intervention on severely acute malnourished children in humanitarian settings: results of an expert survey

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1073
Author(s):  
Dieynaba S N'DIAYE ◽  
Cécile Salpéteur ◽  
Cécile Bizouerne ◽  
Karine Le Roch
Keyword(s):  
Optimal Design ◽  
Online Survey ◽  
Psychosocial Support ◽  
Severe Acute Malnutrition ◽  
Psychosocial Interventions ◽  
Acute Malnutrition ◽  
Design Stage ◽  
Humanitarian Settings ◽  
The Impact ◽  
Combined Intervention

Background: Common psychosocial interventions focus on feeding, stimulation, emotional responsiveness and childcare and parenting. Inclusion of such a component in the outpatient management of severe acute malnutrition (SAM) children is recommended. However, clinical assessment of such interventions is tedious in humanitarian settings and modalities evidence on the impact of psychosocial interventions alongside nutrition protocol for SAM is scarce.  This survey aimed to gather expert opinions on the optimal design of a combined psychosocial and nutrition intervention feasible in humanitarian settings. Methods: From March to May 2018, an online survey was emailed to international experts in nutrition and mental health and psychosocial support, mainly from academia and international non-governmental organisations (INGOs). It included multiple choices questions on the key components of an optimal combined intervention. Results: Of the 76 experts targeted, 20 responded. 11 (55%) belonged to INGOs, 2 (10%) to academia, and 4 (20%) to international organizations and donors. For most respondents, a combined intervention should be provided in weekly 45-minuites counselling sessions, provided individually (rather than in a group) and at home (rather than at a health center). None of the proposed ideal duration (two, four or six months) gained the majority of votes. Experts thought that 35% staff training should be in “Active listening for psychosocial support”, and 30% in “Early child development”, 25% in “Maternal depression” and 9% in “Anthropometric measurements”. They estimated that a combined intervention could improve SAM recovery rate by 10% (min-max: 0-19%) vs. the nutritional protocol alone. Qualitative results highlighted the importance of tailoring the intervention to the individual, the population and the settings; as well as considering feasibility and scalability at the design stage. Conclusion: These findings could guide further research on the impact of psychosocial interventions on SAM children’s health and development, and help designing innovative approaches to treat undernutrition.

Current and Potential Role of Specially Formulated Foods and Food Supplements for Preventing Malnutrition among 6- to 23-Month-Old Children and for Treating Moderate Malnutrition among 6- to 59-Month-Old Children

2009 ◽  
Vol 30 (3_suppl3) ◽  
pp. S434-S463 ◽  
Author(s):  
Saskia de Pee ◽  
Martin W. Bloem
Keyword(s):  
Severe Acute Malnutrition ◽  
Essential Fatty Acids ◽  
Food Supplements ◽  
Complementary Food ◽  
Acute Malnutrition ◽  
Child Malnutrition ◽  
Malnourished Children ◽  
Nutrient Density ◽  
Animal Source ◽  
The Impact

Reducing child malnutrition requires nutritious food, breastfeeding, improved hygiene, health services, and (prenatal) care. Poverty and food insecurity seriously constrain the accessibility of nutritious diets that have high protein quality, adequate micronutrient content and bioavailability, macrominerals and essential fatty acids, low antinutrient content, and high nutrient density. Diets based largely on plant sources with few animal-source and fortified foods do not meet these requirements and need to be improved by processing (dehulling, germinating, fermenting), fortification, and adding animal-source foods, e.g., milk, or other specific nutrients. Options include using specially formulated foods (fortified blended foods, commercial infant cereals, or ready-to-use foods [RUFs; pastes, compressed bars, or biscuits]) or complementary food supplements (micronutrient powders or powdered complementary food supplements containing micronutrients, protein, amino acids, and/or enzymes or lipid-based nutrient supplements (120 to 250 kcal/day), typically containing milk powder, high-quality vegetable oil, peanut paste, sugar, and micronutrients. Most supplementary feeding programs for moderately malnourished children supply fortified blended foods, such as corn–soy blend, with oil and sugar, which have shortcomings, including too many antinutrients, no milk (important for growth), suboptimal micronutrient content, high bulk, and high viscosity. Thus, for feeding young or malnourished children, fortified blended foods need to be improved or replaced. Based on success with ready-to-use therapeutic foods (RUTFs) for treating severe acute malnutrition, modifying these recipes is also considered. Commodities for reducing child malnutrition should be chosen on the basis of nutritional needs, program circumstances, availability of commodities, and likelihood of impact. Data are urgently required to compare the impact of new or modified commodities with that of current fortified blended foods and of RUTF developed for treating severe acute malnutrition.

scholarly journals Association between severe acute malnutrition during childhood and blood pressure during adulthood in the eastern Democratic Republic of the Congo: the Lwiro cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pacifique Mwene-Batu ◽  
Daniel Lemogoum ◽  
Laurène de le Hoye ◽  
Ghislain Bisimwa ◽  
Michel P. Hermans ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Severe Acute Malnutrition ◽  
Nutrition Transition ◽  
Acute Malnutrition ◽  
Logistic Regression Models ◽  
Republic Of The Congo ◽  
History Of ◽  
Dichotomous Variables ◽  
Lowering Drug ◽  
The Impact

Abstract Introduction Little is known about the long-term outcomes of Severe Acute Malnutrition (SAM) during childhood. As such, this study aims to explore the association between childhood SAM and blood pressure (BP) in adulthood in a context without nutrition transition. Methodology We identified 524 adults (Median age: 22 years) who were treated for SAM during childhood in Eastern DRC between 1988 and 2007. They were compared with 407 age-and-sex matched subjects with no history of SAM in the community. The variables examined for this study were the systolic (SBP), diastolic (DBP), mean (MBP) blood pressure (BP) and pulse pressure (PP), as well as high blood pressure (HBP) defined as BP ≥ 140/90 mmHg and/or use of BP-lowering drug(s) in adulthood. For comparison, linear and logistic regression models were used for analysing continuous and dichotomous variables, respectively. Results Of the 524 exposed located, 145 were selected according to age. A total of 97 unexposed were recruited. Compared to unexposed, exposed had slightly higher SBP and PP after adjusting for occupation, body mass index (BMI) and food consumption [SBP = 1.4 mmHg (− 2.2, 4.8) and PP = 2.6 mmHg (− 0.3, 6.0)]. However, their DBP was lower than that of the unexposed [− 1.6 mmHg (− 4.6, 1.5)]. MBP and creatinine levels were similar between the two groups. The prevalence of HBP adjusted for age was higher among exposed than unexposed (9.7% vs 5.3%). In addition, the odds of having HBP was higher among exposed than unexposed, however the observed difference was not statistically significant [Odds Ratio (OR) 1.9 (0.7, 5.6)]. Finally, using multiple regression analysis, although the effect was not significant, SAM was a major contributor to HBP [adjusted OR 3.1 (0.9,10.9), p = 0.064], while only male gender and higher BMI (overweight/obesity) emerged as independent predictors of HBP among this young study population. Conclusions This study suggests that an episode of SAM in childhood has a weak impact on BP variability in young Congolese adults (from DRC) living in an environment without nutrition transition. However, people who experienced a period of SAM tended to have a higher prevalence of HBP and a much higher risk of developing HBP than unexposed. Additional multicentre studies involving a larger cohort would provide greater understanding of the impact of SAM on the overall risk of BP disorders during adulthood.

scholarly journals Analysis of risk and prognostic factors in a population of pediatric patients hospitalized for acute malnutrition at the Chiulo hospital, Angola

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Federica Maria Tripoli ◽  
Salvatore Accomando ◽  
Simona La Placa ◽  
Andrea Pietravalle ◽  
Giovanni Putoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Nutrition Education ◽  
Potential Risk ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Clinical Evolution ◽  
Malnourished Children ◽  
Potential Risk Factors ◽  
The Impact

Abstract Background Malnutrition is a multifactorial pathology in which genetic, epigenetic, cultural, environmental, socio-economic factors interact with each other. The impact that this disease has on the health of children worldwide is dramatic. Severe acute malnutrition in particular is a disease affecting nearly 20 million preschool children worldwide, most of them in Africa and South East Asia. Objectives This work aims to investigate potential prognostic factors in the clinical evolution of acute malnutrition and potential risk factors for the development of the disease. Methods Our study was carried out at the “Hospital da Missão Catolica do Chiulo”, in Angola, where the NGO Doctors with Africa CUAMM has been operating since 2000. In the first part of the study we analyzed the characteristics and clinical evolution of 163 patients hospitalized for acute malnutrition at the UEN (Unidade Especial de Nutrição) of the Chiulo Hospital over a period of 6 months, in order to identify potential prognostic factors of the disease. The second part of our study was carried out by administering a questionnaire to a group of caregivers of malnourished children and to a group of caregivers of non-malnourished children admitted to Pediatrics for other causes, with the aim of identifying potential risk factors for the development of malnutrition. Results and conclusions The analysis of prognostic factors revealed that the most relevant are the WHZ (weight for height z-score) at the time of admission, the presence of Stunting and the presence of other pathologies or clinical conditions associated with severe acute malnutrition. The analysis of risk factors has shown that not only food shortages, but also errors in the timing of the suspension of breastfeeding and the timing of the introduction of complementary foods play an important role. Equally important were some family risk factors, including the size of the family unit and the presence of deceased children. It also emerged that the lack of knowledge of what a child needs to grow up healthy often affects the development of malnutrition. It follows that a useful and low-cost tool for preventing child malnutrition would be large-scale nutrition education campaigns.

scholarly journals The impact of rickets on growth and morbidity during recovery among children with complicated severe acute malnutrition in Kenya: A cohort study

2017 ◽  
Vol 14 (2) ◽  
Author(s):  
Moses M. Ngari ◽  
Johnstone Thitiri ◽  
Laura Mwalekwa ◽  
Molline Timbwa ◽  
Per Ole Iversen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
The Impact

scholarly journals Quality of care of treatment for uncomplicated severe acute malnutrition provided by lady health workers in Pakistan

2017 ◽  
Vol 21 (2) ◽  
pp. 385-390 ◽  
Author(s):  
Eleanor Rogers ◽  
Muhammad Ali ◽  
Shahid Fazal ◽  
Deepak Kumar ◽  
Saul Guerrero ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Workers ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Cross Sectional ◽  
Supervision And Training ◽  
Mid Upper Arm Circumference ◽  
The Impact ◽  
Care Study

AbstractObjectiveTo assess the quality of care provided by lady health workers (LHW) managing cases of uncomplicated severe acute malnutrition (SAM) in the community.DesignCross-sectional quality-of-care study.SettingThe feasibility of the implementation of screening and treatment for uncomplicated SAM in the community by LHW was tested in Sindh Province, Pakistan. An observational, clinical prospective multicentre cohort study compared the LHW-delivered care with the existing outpatient health facility model.SubjectsLHW implementing treatment for uncomplicated SAM in the community.ResultsOedema was diagnosed conducted correctly for 87·5 % of children; weight and mid upper-arm circumference were measured correctly for 60·0 % and 57·4 % of children, respectively. The appetite test was conducted correctly for 42·0 % of cases. Of all cases of SAM without complications assessed during the study, 68·0 % received the correct medical and nutrition treatment. The proportion of cases that received the correct medical and nutrition treatment and key counselling messages was 4·0 %.ConclusionsThis quality-of-care study supports existing evidence that LHW are able to identify uncomplicated SAM, and a majority can provide appropriate nutrition and medical treatment in the community. However, the findings also show that their ability to provide the complete package with an acceptable level of care is not assured. Additional evidence on the impact of supervision and training on the quality of SAM treatment and counselling provided by LHW to children with SAM is required. The study has also shown that, as in other sectors, it is essential that operational challenges are addressed in a timely manner and that implementers receive appropriate levels of support, if SAM is to be treated successfully in the community.

scholarly journals The Impact of Glucose-Based or Lipid-Based Total Parenteral Nutrition on the Free Fatty Acids Profile in Critically Ill Patients

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1373
Author(s):  
Pavel Skorepa ◽  
Ondrej Sobotka ◽  
Jan Vanek ◽  
Alena Ticha ◽  
Joao Fortunato ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Parenteral Nutrition ◽  
Free Fatty Acids ◽  
Total Parenteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lipid Emulsions ◽  
Plasminogen Activator Inhibitor 1 ◽  
Mead Acid ◽  
The Impact

Introduction: Our study aim was to assess how the macronutrient intake during total parenteral nutrition (TPN) modulates plasma total free fatty acids (FFAs) levels and individual fatty acids in critically ill patients. Method: Adult patients aged 18–80, admitted to the intensive care unit (ICU), who were indicated for TPN, with an expected duration of more than three days, were included in the study. Isoenergetic and isonitrogenous TPN solutions were given with a major non-protein energy source, which was glucose (group G) or glucose and lipid emulsions (Smof lipid; group L). Blood samples were collected on days 0, 1, 3, 6, 9, 14, and 28. Results: A significant decrease (p < 0.001) in total FFAs occurred in both groups with a bigger decrease in group G (p < 0.001) from day 0 (0.41 ± 0.19 mmol∙L−1) to day 28 (0.10 ± 0.07 mmol∙L−1). Increased palmitooleic acid and decreased linoleic and docosahexaenoic acids, with a trend of increased mead acid to arachidonic acid ratio, on day 28 were observed in group G in comparison with group L. Group G had an insignificant increase in leptin with no differences in the concentrations of vitamin E, triacylglycerides, and plasminogen activator inhibitor-1. Conclusion: Decreased plasma FFA in critically ill patients who receive TPN may result from increased insulin sensitivity with a better effect in group G, owing to higher insulin and glucose dosing and no lipid emulsions. It is advisable to include a lipid emulsion at the latest from three weeks of TPN to prevent essential fatty acid deficiency.

scholarly journals Omitting edema measurement: how much acute malnutrition are we missing?

2015 ◽  
Vol 102 (5) ◽  
pp. 1176-1181 ◽  
Author(s):  
Severine Frison ◽  
Francesco Checchi ◽  
Marko Kerac
Keyword(s):  
Low Income ◽  
Large Scale ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Low Income Countries ◽  
Public Health Issue ◽  
Data Sets ◽  
Cross Sectional Survey ◽  
Prevalence Estimates ◽  
The Impact

ABSTRACT Background: Acute malnutrition is a major public health issue in low-income countries. It includes both wasting and edematous malnutrition, but the terms wasting and acute malnutrition are often used interchangeably. Little is known about the burden of edematous malnutrition, and few large-scale surveys measure it. Objective: Most acute malnutrition might be captured by the measurement of wasting alone, but this is unknown. This article aims to fill this gap. Design: This article presents a secondary data analysis of 852 nutrition cross-sectional survey data sets of children aged 6–59 mo. The data sets assembled included surveys from East, West, South, and Central Africa; the Caribbean; and Asia. The overlap between edematous malnutrition and wasting was assessed, and the impact of including/excluding edema on acute malnutrition prevalence estimates was evaluated. Results: The prevalence of edematous malnutrition varied from 0% to 32.9%, and children were more likely to have bilateral edema in Central and South Africa (OR: 4; 95% CI: 2.8, 5.6). A large proportion of children with edematous malnutrition were not wasted [62% and 66% based on midupper arm circumference (MUAC) and weight-for-height (WFH), respectively], and most were not severely wasted (83% and 86% based on MUAC and WFH, respectively). When wasting and global acute malnutrition prevalence estimates as well as severe wasting and severe acute malnutrition prevalence estimates overall were compared, the differences between estimates were small (median of 0.0% and mean of 0.3% based on WFH and MUAC for global estimates and slightly higher median of 0.1% and mean of 0.4% based on MUAC and WFH, respectively, for the severe forms), but the picture was different at the regional level. Conclusions: The terms acute malnutrition and wasting should not be used interchangeably. The omission of the measurement of edema can have important repercussions, especially at the nutrition program level.

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