Dataset Information

Age-Based Anthropometric Cutoffs Provide Inconsistent Estimates of Undernutrition: Findings from a Cross-Sectional Assessment of Late-Adolescent and Young Women in Rural Pakistan.

ABSTRACT: Ambiguity around age ranges for adolescence and adulthood can make the application of age-based nutrition cutoffs confusing. We examined how estimates generated using the age-based anthropometric cutoffs for adolescent girls (10 to <19 y) and women of reproductive age (15-49 y) compared between late-adolescent and young women, and determined how application of both cutoffs affected late-adolescents' estimates. Using cross-sectional data from participants aged 15-23 y in the Pakistan-based Matiari emPowerment and Preconception Supplementation (MaPPS) Trial (n = 25,447), notably large differences in estimates were observed for stunting (30.5% and 7.9% for late-adolescent and young women, respectively; P < 0.001) and thinness (9.3% and 30.8%, respectively; P < 0.001). When both cutoffs were applied to adolescents' data, estimate differences were maintained. With each year of age, the difference for stunting increased and thinness decreased. Given the discrepancies observed both between and within groups, clarity around application of anthropometric cutoffs for youth (aged 15-24 y) is needed. This trial was registered at clinicaltrials.gov as NCT03287882.

SUBMITTER: Baxter JB

PROVIDER: S-EPMC8656149 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Age-Based Anthropometric Cutoffs Provide Inconsistent Estimates of Undernutrition: Findings from a Cross-Sectional Assessment of Late-Adolescent and Young Women in Rural Pakistan.

Baxter Jo-Anna B JB Kortenaar Jean-Luc JL Wasan Yaqub Y Hussain Amjad A Soofi Sajid B SB Ahmed Imran I Bhutta Zulfiqar A ZA

Current developments in nutrition 20211110 11

Ambiguity around age ranges for adolescence and adulthood can make the application of age-based nutrition cutoffs confusing. We examined how estimates generated using the age-based anthropometric cutoffs for adolescent girls (10 to <19 y) and women of reproductive age (15-49 y) compared between late-adolescent and young women, and determined how application of both cutoffs affected late-adolescents' estimates. Using cross-sectional data from participants aged 15-23 y in the Pakistan-based Matiar ...[more]

PMID: 34901693

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Project description:ObjectiveThis study aimed to characterise the burden of malnutrition and assess how underlying determinants at the structural and intermediary levels contributed to malnutrition among late adolescent and young women in rural Pakistan.DesignCross-sectional enrolment data assessment.Setting and participantsThis study was conducted using data from adolescent and young women (n=25 447) enrolled in the Matiari emPowerment and Preconception Supplementation Trial, collected from June 2017 to July 2018 in Matiari District, Pakistan. The WHO-based cut-offs were applied to anthropometric measures to estimate body mass index (BMI) categories (underweight, overweight, obese) and stunting. Hierarchical models were generated to evaluate the association between the determinants with BMI categories and stunting among late adolescent girls and young women, respectively.Primary and secondary outcome measuresThe main outcomes of interest were BMI categories and stunting. Explanatory variables included measures of socioeconomic status, education, occupation, health, well-being, food security, empowerment and food practices.ResultsRegardless of age group, the prevalence of underweight was high (36.9%; 95% CI 36.3% to 37.5%). More late adolescent girls were underweight, while more young women were overweight/obese (p<0.001). Stunting affected 9.2% (95% CI 8.9% to 9.6%) of participants, of which 35.7% were additionally underweight and 7.3% overweight/obese. Compared with those in the normal weight category, those underweight were more likely to be impoverished and less empowered. Those overweight/obese were more likely to be from a higher wealth quintile and food secure. Increased education level and food security were associated with reductions stunting risk.ConclusionsThis study informs the data gap and need for comprehensive research on adolescent nutritional status. Findings suggest factors related to poverty played an important, underlying role in undernutrition among participants. Commitment to improving the nutritional status of all adolescent and young women in Pakistan will be critical given the observed burden of malnutrition.Trial registration numberNCT03287882.

Project description:Background/objectivesTo examine associations of different anthropometric measurements of central adiposity to visceral adipose tissue (measured via multi-axial magnetic resonance imaging; MRI) and cardiometabolic disease risk factors in men with spinal cord injury (SCI). Additionally, to determine population-specific seated/supine waist and abdominal circumference cutoffs, which may identify men at increased risk of cardiometabolic disease.Participants/methodsTwenty-two men with chronic SCI underwent MRI scans, anthropometric measurements along with assessments of various cardiometabolic risk biomarkers. Pearson/part (accounting for age as a covariate) correlation coefficients were calculated to determine the associations between study variables. Abdominal and waist circumference cutoffs were extrapolated using the slope of linear regression equations.ResultsSeated/supine abdominal and waist circumferences were (P < 0.01) associated with MRI visceral fat cross-sectional area (VATCSA), VAT volume and CSA:TotalCSA. Low density lipoprotein, non-high-density lipoprotein and total cholesterol were positively associated with seated/supine abdominal and waist circumferences after controlling for age; r = 0.50-0.61, r = 0.46-0.58, r = 0.52-0.58, P < 0.05, respectively. Tumor necrosis factor alpha was associated with seated/supine abdominal and waist circumferences after accounting for age; r = 0.49-0.51 and r = 0.48-0.56, P < 0.05 respectively. The population-specific cutoffs were 86.5cm and 88.3cm for supine waist and abdominal circumferences, respectively, as well as 89cm and 101cm for seated waist and abdominal circumferences, respectively. After dichotomizing VATCSA (< or ≥ 100cm2), peak oxygen uptake, triglycerides, insulin sensitivity and glycated hemoglobin were different (P < 0.05) between groups. After dichotomizing (< or ≥ 86.5cm) supine waist circumference, VATCSA, triglycerides and insulin sensitivity were different (P < 0.05) between groups.ConclusionsSeated/supine circumferences are associated with both central adiposity and biomarkers of cardiometabolic disease risk in persons with SCI. Population-specific cutoffs are proposed herein to identify central adiposity and potential cardiometabolic disease risk after SCI.

Project description:IntroductionSevere undernutrition among under-5 children is usually assessed using single or conventional indicators (i.e., severe stunting, severe wasting, and/or severe underweight). But these conventional indicators partly overlap, thus not providing a comprehensive estimate of the proportion of malnourished children in the population. Incorporating all these conventional nutritional indicators, the Composite Index of Severe Anthropometric Failure (CSIAF) provides six different undernutrition measurements and estimates the overall burden of severe undernutrition with a more comprehensive view. This study applied the CISAF indicators to investigate the prevalence of severe under-5 child undernutrition in Bangladesh and its associated socioeconomic factors in the rural-urban context.MethodsThis study extracted the children dataset from the 2017-18 Bangladesh Demographic Health Survey (BDHS), and the data of 7661 children aged under-5 were used for further analyses. CISAF was used to define severe undernutrition by aggregating conventional nutritional indicators. Bivariate analysis was applied to examine the proportional differences of variables between non-severe undernutrition and severe undernutrition group. The potential associated socioeconomic factors for severe undernutrition were identified using the adjusted model of logistic regression analysis.ResultsThe overall prevalence of severe undernutrition measured by CISAF among the children under-5 was 11.0% in Bangladesh (rural 11.5% vs urban 9.6%). The significant associated socioeconomic factors of severe undernutrition in rural areas were children born with small birth weight (AOR: 2.84), children from poorest households (AOR: 2.44), and children aged < 36 months, and children of uneducated mothers (AOR: 2.15). Similarly, in urban areas, factors like- children with small birth weight (AOR: 3.99), children of uneducated parents (AOR: 2.34), poorest households (APR: 2.40), underweight mothers (AOR: 1.58), mothers without postnatal care (AOR: 2.13), and children's birth order ≥4 (AOR: 1.75), showed positive and significant association with severe under-5 undernutrition.ConclusionSevere undernutrition among the under-5 children dominates in Bangladesh, especially in rural areas and the poorest urban families. More research should be conducted using such composite indices (like- CISAF) to depict the comprehensive scenario of severe undernutrition among the under-5 children and to address multi-sectoral intervening programs for eradicating severe child undernutrition.

Project description:ImportanceThe United Nations' Sustainable Development Goal Target 2.2 seeks to end all forms of malnutrition by 2030 by meeting targets, including the elimination of stunting and wasting in all children younger than 5 years. Such indicators are used to monitor childhood undernutrition but may not provide a complete picture at a population level.ObjectiveTo compare global estimates of the prevalence of undernutrition using conventional indicators of anthropometric failure (AF; stunting, underweight, and wasting); the Composite Index of Anthropometric Failure (CIAF); and a proposed classification system called Categories of Anthropometric Failure (CAF) as well as to investigate the association of the conventional indicators, CIAF, and CAF with diarrheal disease as an assessment of the validity of each measure.Design, setting, and participantsCross-sectional study of the prevalence of undernutrition among children in 56 low- and middle-income countries using data from the nationally representative Demographic and Health Surveys. The study included 530 906 children younger than 5 years. Data were collected from June 2005 to December 2018 and analyzed from September 27, 2020, to February 4, 2021.Main outcomes and measuresUndernutrition identified according to conventional indicators (stunting, underweight, and wasting), the CIAF, and the proposed CAF classification system was estimated and compared. Six logistic regression models were used to examine the association between different classifications of anthropometric failure (AF) and morbidity.ResultsA total of 530 906 children (mean [SD] age, 29.0 [17.2] months; 272 355 [51.3%] boys and 258 551 [48.7%] girls) from 56 low- and middle-income countries were included in the analysis. Estimates of undernutrition generated using the conventional indicators of stunting, underweight, and wasting were lower than estimates generated using the CIAF in all countries. The CAF classification system pointed to considerable variation across countries in children with multiple AFs, which does not correspond to the overall prevalence of undernutrition. For example, 7.5% of children in Niger and 7.1% of children in Timor-Leste were stunted, underweight, and wasted, while 56.0% of children in Niger and 71.1% of children in Timor-Leste were undernourished according to the CIAF. In addition, children who had stunting, underweight, and wasting had 1.52 (95% CI, 1.45-1.61) times the odds of diarrhea compared with children who exhibited no AFs.Conclusions and relevanceThe results of this study highlight the importance of using different approaches to aid understanding of the entire spectrum of AF with regard to research and development of policies and programs to address AF. The use of the CIAF and the CAF classification system may be useful for treatment to prevent AFs and could accelerate progress in meeting targets for the Sustainable Development Goal.

Dataset Information

Age-Based Anthropometric Cutoffs Provide Inconsistent Estimates of Undernutrition: Findings from a Cross-Sectional Assessment of Late-Adolescent and Young Women in Rural Pakistan.

Publications

Age-Based Anthropometric Cutoffs Provide Inconsistent Estimates of Undernutrition: Findings from a Cross-Sectional Assessment of Late-Adolescent and Young Women in Rural Pakistan.

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