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Measurements of length at birth, or in the neonatal period, are challenging to obtain and often discounted for lack of validity. Hence, classical ‘under-5’ stunting rates have been derived from surveys on children from 6 to 59 months of age. Guatemala has a high prevalence of stunting (49·8 %), but the age of onset of growth failure is not clearly defined. The objective of the study was to assess length-for-age within the first 1·5 months of life among Guatemalan infants.
Design
As part of a cross-sectional observational study, supine length was measured in young infants. Mothers’ height was measured. Length-for-age Z-scores (HAZ) were generated and stunting was defined as HAZ <−2 using WHO growth standards.
Setting
Eight rural, indigenous Mam-Mayan villages (n 200, 100 % of Mayan indigenous origin) and an urban clinic of Quetzaltenango (n 106, 27 % of Mayan indigenous origin), Guatemala.
Subjects
Three hundred and six newborns with a median age of 19 d.
Results
The median rural HAZ was −1·56 and prevalence of stunting was 38 %; the respective urban values were −1·41 and 25 %. Linear regression revealed no relationship between infant age and HAZ (r=0·101, r2=0·010, P=0·077). Maternal height explained 3 % of the variability in HAZ (r=0·171, r2=0·029, P=0·003).
Conclusions
Stunting must be carried over from in utero growth retardation in short-stature Guatemalan mothers. As linear growth failure in this setting begins in utero, its prevention must be linked to maternal care strategies during gestation, or even before. A focus on maternal nutrition and health in an intergenerational dimension is needed to reduce its prevalence.
To explore if and how female adolescents engage in shared eating and joint food choices with best friends within the context of living in urban Soweto, South Africa.
Design
A qualitative, exploratory, multiple case study was conducted using semi-structured duo interviews of best friend pairs to ascertain their eating patterns, friendship and social interactions around dietary habits.
Setting
Participants were recruited from three high schools in the urban township of Soweto, South Africa.
Subjects
Fifty-eight female adolescents (twenty-nine friend pairs) still in high school (mean age of 18 years) were enrolled.
Results
Although overweight rates were high, no association between friends was found; neither did friends share dieting behaviours. Both at school and during visits to the shopping mall, foods were commonly shared and money pooled together by friends to make joint purchases. Some friends carefully planned expenditures together. Foods often bought at school were mostly unhealthy. Availability, price and quality were reported to affect choice of foods purchased at school. Preference shaped joint choices within the shopping mall environment.
Conclusions
Food sharing practices should be investigated in other settings so as to identify specific behaviours and contexts for targeted and tailored obesity prevention interventions. School-based interventions focusing on price and portion size should be considered. In the Sowetan context, larger portions of healthy food may improve dietary intake of fruit and vegetables where friends are likely to share portions.
To explore associations between household food security and home gardening, use of soya and pressure cooker ownership in low-income households affected by HIV/AIDS in Aurangabad, India.
Design
Cross-sectional pilot study which assessed household food security using the validated US Department of Agriculture's food security core-module questionnaire. Questions were added to explore household environment, education, occupation, home gardening, use of soya and pressure cooker ownership. Households with very low v. low food security were compared using logistic regression analysis, controlling for confounding by socio-economic status.
Setting
Aurangabad is an urban setting situated in a primarily agricultural dependent area. The study was carried out in 2008, at the peak of the global food crisis.
Subjects
Adult caregivers of children affiliated with the Network of People Living with HIV/AIDS in Aurangabad.
Results
All except for one of 133 households were identified as food insecure (99·2 %). Of these households, 35·6 % had to cut size or skip a meal in the past 30 d. Households that cut meal size due to cooking fuel shortages were more likely to have very low food security (OR = 4·67; 95 % CI 1·62, 13·44) compared with households having no cooking fuel shortages. Owning a pressure cooker was shown to be protective against very low food security after controlling for confounding by socio-economic status (OR = 0·27; 95 % CI 0·11, 0·64).
Conclusions
Only pressure cooker ownership showed a protective association with low household food security. Pressure cookers save household fuel costs. Therefore, future interventions should explore pressure cookers as a sustainable means of improving household food security.
Our objective was to assess the distribution of energy, macro- and micronutrient intakes by meal (breakfast, lunch, dinner and combined snacks) in a cross-sectional sample of schoolchildren.
Design
Cross-sectional dietary survey in schoolchildren.
Setting
Twelve private and public schools in the urban setting of Quetzaltenango, Guatemala.
Subjects
A total of 449 schoolchildren (from higher and lower socio-economic strata) were enrolled in the study.
Methods
Each child completed a single, pictorial 24 h prospective diary and a face-to-face interview to check completeness and estimate portion sizes. Estimated daily intakes were examined by mealtime as: (i) absolute intakes; (ii) relative nutrient distribution; and (iii) critical micronutrient density (i.e. nutrient density in relation to the WHO Recommended Nutrient Intakes/median age-specific Guatemalan energy requirements).
Results
The daily distribution of energy intake was 24 % at breakfast, 30 % at lunch, 23 % at dinner and 23 % among snacks. Lunch was also the leading meal for macronutrients, providing 35 % of proteins, 27 % of fat and 30 % of carbohydrate. The distribution of selected micronutrients did not follow the pattern of energy, insofar as lunch provided relatively more vitamin C and Zn, whereas breakfast led in terms of vitamins A and D, thiamin, riboflavin, folate, Ca and Fe.
Conclusions
Meal-specific distribution of energy, macro- and micronutrients provides a unique and little used perspective for evaluation of children’s habitual intake, and may provide guidance to strategies to improve dietary balance in an era of coexisting energy overnutrition and micronutrient inadequacy.
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