Malnutrition remains one of the most common causes of morbidity and mortality among children, particularly in Ethiopia. The present study aimed to assess determinants of severe acute malnutrition among children aged 6–59 months in the pastoral community of Liban District, Southeastern Ethiopia. A case–control study design was conducted on 89 cases and 177 controls from 1–30 December 2020. A simple random sampling technique was used to select study participants. Data collected using interviewer-administered structured questionnaire were used, and anthropometric measurements were done by standardised calibrated instruments to collect data. Data were entered into EPI data version 3.1 and then exported to SPSS version 25.0 software for analysis. All candidate variables with P < 0⋅25 in bivariate analysis were then entered into multivariable logistic regression. Associated factors were identified at P < 0⋅05 and 95 % CI. A total of 266 (89 cases and 177 controls) having a response rate of 96⋅6 % being underweight [adjusted odds ratio (AOR) = 11⋅8, 95 % CI 3⋅17, 43⋅89], illness previous 2 weeks (AOR = 3⋅47, 95 % confidence interval (CI) 1⋅34, 8⋅99), family member with malnutrition (AOR = 4⋅52, 95 % CI 1⋅45, 14⋅01), greater than five family size, (AOR = 5⋅33, 95 % CI 2⋅08, 13⋅66), mothers unable to read and write (AOR = 3⋅66, 95 % CI 1⋅27, 10⋅56), mothers with low decision autonomy (AOR = 5⋅67, 95 % CI 2⋅26, 14⋅27), not handwashing at all critical time (AOR = 7⋅23, 95 % CI 2⋅74, 19⋅07), not feeding child animal source (AOR = 7⋅13, 95 % CI 1⋅98, 25⋅59), bottle feeding (AOR = 7⋅06, 95 % CI 2⋅34, 21⋅28) and being married (AOR = 0⋅05, 95 % CI 0⋅02, 0⋅19) were significantly associated with acute malnutrition. The present study has confirmed the association of acute malnutrition with maternal education, underweight, family size and inappropriate infant caring practices.

Meeting the recommended daily protein intake can be a challenge for community-dwelling older adults (CDOA). In order to understand why, we studied attitudes towards protein-rich products and healthy eating in general; identified needs and preferences, barriers and promotors and knowledge regarding dietary behaviour and implementation of high protein products. Attitudes towards protein-rich products and healthy eating were evaluated in focus groups (study 1, n 17). To gain insights in the needs and preferences of older adults with regard to meals and meal products (study 2, n 30), visual information on eating behaviour was assessed using photovoicing and verified in post-photovoice interviews. In studies 3 and 4, semi-structured interviews were conducted to identify protein consumption-related barriers, opportunities (n 20) and knowledge and communication channels (n 40), respectively. Risk of low protein intake was assessed using ProteinScreener55+ (Pro55+) in studies 2–4 (n 90). Focus groups showed that participants were unaware of potential inadequate dietary protein. Photovoicing showed that sixteen of thirty participants mainly consumed traditional Dutch products. In post-photovoice interviews, participants indicated that they were satisfied with their current eating behaviour. Barriers for adequate use of protein-rich products were ‘lack of knowledge’, ‘resistance to change habits’ and ‘no urge to receive dietary advice’. Promotors were ‘trust in professionals’ and ‘product offers’. Sixty-two percent had a low risk of low protein intake. CDOA feel low urgency to increase protein intake, possibly linked to low knowledge levels. A challenge for professionals would be to motivate older adults to change their eating pattern, to optimise protein intake.

Malnutrition among adolescents is often associated with inadequate dietary diversity (DD). We aimed to explore the prevalence of inadequate DD and its socio-economic determinants among adolescent girls and boys in Bangladesh. A cross-sectional survey was conducted during the 2018–19 round of national nutrition surveillance in Bangladesh. Univariate and multivariable logistic regression was performed to identify the determinants of inadequate DD among adolescent girls and boys separately. This population-based survey covered eighty-two rural, non-slum urban and slum clusters from all divisions of Bangladesh. A total of 4865 adolescent girls and 4907 adolescent boys were interviewed. The overall prevalence of inadequate DD was higher among girls (55⋅4 %) than the boys (50⋅6 %). Moreover, compared to boys, the prevalence of inadequate DD was higher among the girls for almost all socio-economic categories. Poor educational attainment, poor maternal education, female-headed household, household food insecurity and poor household wealth were associated with increased chances of having inadequate DD in both sexes. In conclusion, more than half of the Bangladeshi adolescent girls and boys consumed an inadequately diversified diet. The socio-economic determinants of inadequate DD should be addressed through context-specific multisectoral interventions.

Relapse/repeated episodes are defined as the admission of a child with a diagnosis of severe acute malnutrition (SAM) after being discharged with a status of recovery. However, there is a lack of study that documented the time to relapse of SAM and its risk factors. The present study aimed to identify the time of relapse and its risk factor among under-five children discharged after undergoing treatment for SAM in health facilities of Hadiya Zone, South Ethiopia. An institution-based retrospective cohort study was carried out in the Hadiya Zone of Southern Ethiopia among under-five children. Data were collected from 760 cards of severe acute malnourished children over the past 5 years spanning from 2014/15 to 2019/20. Both first admission and relapse data were abstracted from the records of the SAM children from 1 August to 30 August 2020 and cards of children that were admitted to program by transferee with complete records were included. After checking all the assumptions, multivariable Cox Proportional Hazards model was fitted to isolate independent determinants of time to cure. All tests were two-sided and statistical significance at P-values < 0⋅05. The mean(±sd) time for relapse of SAM among under-five children was 22(±9⋅9) weeks from discharge to relapse time. On multivariable Cox Proportional Hazards model, the hazard of relapse for SAM was significantly higher for children who had oedema (AHR 2⋅02, 95 % CI 1⋅17, 3⋅50), age of 6–11 months (AHR 5⋅2, 95 % CI 1⋅95, 13⋅87) had discharge MUAC not cured (AHR12, 95% CI 7⋅90, 19⋅52). The finding showed that children discharged from SAM are likely to have relapse in 3 weeks time.

The recommended daily dose of vitamin D is 2000 IU was found to be insufficient in many patients. The objective of the present study is to find whether the daily dose of vitamin D should be based on BMI. Two hundred and thirty patients with an established vitamin D deficiency (serum level of 25 Hydroxy vitamin D3 (25OHD3) of ≤20 ng/ml) and patients with BMI ≥30 kg/m2 were included in the study. Demographic data, comorbidities and BMI were recorded. Pre-treatment and post-treatment serum 25OHD3, calcium, phosphorus and parathyroid hormone (PTH) were tested at 0-, 3- and 6-month periods. Patients were treated with a standard dose of 50 000 IU of vitamin D weekly and 600/1200 mg of calcium a day. Once their level of 25OHD3 reached ≥30 ng/ml, patients were randomised into two groups. Group A received a standard recommended maintenance dose of 2000 IU daily and Group B patients received 125 IU/kg/m2 of vitamin D3. The data were entered in the database and analysed. The mean age of Group A was 50⋅74 ± 7⋅64 years compared to 52⋅32 ± 7⋅21 years in Group B. In both groups, pre-treatment vitamin D level was ≤15 ng/ml and increased to 34⋅6 ± 2⋅6 and 33⋅7 ± 2⋅4 ng/ml at the end of 3 months treatment with a dose 50 000 IU of vitamin D3 and calcium 600/1200 mg once a day for group A and group B, respectively. At 6 months, patients in Group A 25OHD3 level was 22⋅8 ± 3⋅80 and in Group B was 34⋅0 ± 1⋅85 ng/ml (P < 0⋅001). This preliminary study suggests that obese patients need higher dosage of vitamin D than the recommended dose. It is prudent that the dosage should be based on the BMI to maintain normal levels for a healthy musculoskeletal system.

Children with cerebral palsy (CP) typically suffer from congenital deformities, such as scoliosis and contractures, therefore, it is a challenge to measure the stature of CP children. Studies have suggested that predictive equations based on tibia length (TL) may be used as an alternative method in measuring the actual height or stature. The present study aimed to develop and validate predictive equations based on TL for CP children in Malaysia across all five levels of gross motor functions (GMFCS I to V) through a cross-sectional study. All subjects were recruited from Hospitals and Community-Based Rehabilitation (CBR) in the central and southern regions of Malaysia. Two predictive equation models were developed using multiple linear regression. For Model 1, the predictive equation was developed based on TL. On the other hand, Model 2 was developed based on TL with age was included. A flexible Seca measuring tape was used to measure the stature and TL. CP children aged 2–18 years were classified into the equation development group (EDG), n 177 and the validation group (VG), n 139. Model 1, Height = 32⋅3 + 3⋅14 (TL), demonstrated a strong correlation with the actual height (R2 0⋅834), small SEE (1⋅42), and high intra correlation coefficient (0⋅929). The findings suggested that Model 1 was more accurate in estimating the height of CP children aged 2–18 years. This model was shown to suit the Malaysian population and applicable across all GMFCS levels.

The causes of undernutrition are often linked to inappropriate complementary feeding practices and poor households’ access to water, sanitation and hygiene (WASH), but limited evidence exists on the combined effect of poor WASH and inappropriate complementary feeding practices on stunted child growth. We assessed the independent and joint contribution of inappropriate complementary feeding and poor WASH practices to stunted growth among children aged 6–23 months in the Jirapa Municipality of Ghana. A community-based cross-sectional analytical study design was used with a sample of 301 mothers/caregivers having children aged 6–23 months. The results indicate that in a multivariable logistic regression model that adjusted for confounders, children receiving both unimproved water and inappropriate complementary feeding had a higher and significant odd of becoming stunted (adjusted odds ratio = 33. 92; 95 % confidence interval 3⋅04, 37⋅17; P = 0⋅004) compared to households having both improved water sources and appropriate complementary feeding practices. Except for unimproved drinking water sources, poor sanitation and hygiene, which comprised the use of unimproved household toilet facilities, washing hands without soap and improper disposal of child faeces were not associated with the risks of stunting among children aged 6–23 months. The combined effect of unimproved water and inappropriate complementary feeding on stunting was greater than either unimproved water only or inappropriate complementary feeding only.

India is coming to grips with a stage of nutrition transition. According to the Food Safety and Standards Authority of India (FSSAI), preventable micronutrient deficiency is arising public health precedence in India. However, the foremost public health concern is the lack of national prevalence data. The present study was carried out to estimate the pooled age-wise prevalence of six preventable micronutrient deficiencies (vitamin A, vitamin B12, vitamin D, iron, iodine and folic acid) in India. A systematic review was carried out on PubMed and Global Index Medicus databases using the Boolean search strategy. Statistical analyses were done using R software, version 3.6. 2. PRISMA guidelines were strictly adhered to during the review. A preliminary literature search yielded 4302 articles; however, 270 original research articles were found eligible to be included in quantitative synthesis. The estimated overall prevalence was 17 % [95 % confidence interval (CI) 0⋅07, 0⋅26] for iodine deficiency, 37 % (95 % CI 0⋅27, 0⋅46) for folic acid deficiency, 54 % (95 % CI 0⋅49, 0⋅59) for iron deficiency, 53 % (95 % CI 0⋅41, 0⋅64) for vitamin B12 deficiency, 19 % (95 % CI 0⋅09, 0⋅29) for vitamin A deficiency and 61 % (95 % CI 0⋅07, 0⋅26) for vitamin D with high heterogeneity. We classified the population into infants (0–5 years), adolescents (<18 years), adults (>18 years) and pregnant women. Iron deficiency was most prevalent (61 %) in pregnant women. The results of the present study reinforce the data on micronutrient deficiency in India and warrant the immediate need for further active public health interventions to address these deficiencies. The study is registered with PROSPERO (CRD42020205043).