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Fulltext Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: an individual participant data meta-analysis of randomized controlled trials

Wessells KR, Arnold CD, Stewart CP, Prado EL, Abbeddou S, Adu-Afarwuah S, et al.

Am J Clin Nutr, 2021 11 02;114(Suppl 1):68S-94S.
PMID: 34590114 DOI: 10.1093/ajcn/nqab276

BACKGROUND: Small-quantity lipid-based nutrient supplements (SQ-LNSs) have been shown to reduce the prevalence of child anemia and iron deficiency, but effects on other micronutrients are less well known. Identifying subgroups who benefit most from SQ-LNSs could support improved program design.
OBJECTIVES: We aimed to identify study-level and individual-level modifiers of the effect of SQ-LNSs on child hemoglobin (Hb), anemia, and inflammation-adjusted micronutrient status outcomes.
METHODS: We conducted a 2-stage meta-analysis of individual participant data from 13 randomized controlled trials of SQ-LNSs provided to children 6-24 mo of age (n = 15,946). We generated study-specific and subgroup estimates of SQ-LNSs compared with control, and pooled the estimates using fixed-effects models. We used random-effects meta-regression to examine potential study-level effect modifiers.
RESULTS: SQ-LNS provision decreased the prevalence of anemia (Hb < 110 g/L) by 16% (relative reduction), iron deficiency (plasma ferritin < 12 µg/L) by 56%, and iron deficiency anemia (IDA; Hb < 110 g/L and plasma ferritin <12 µg/L) by 64%. We observed positive effects of SQ-LNSs on hematological and iron status outcomes within all subgroups of the study- and individual-level effect modifiers, but effects were larger in certain subgroups. For example, effects of SQ-LNSs on anemia and iron status were greater in trials that provided SQ-LNSs for >12 mo and provided 9 (as opposed to <9) mg Fe/d, and among later-born (than among first-born) children. There was no effect of SQ-LNSs on plasma zinc or retinol, but there was a 7% increase in plasma retinol-binding protein (RBP) and a 56% reduction in vitamin A deficiency (RBP

Matched MeSH terms: Infant Nutritional Physiological Phenomena*
Nutritional status of Kadazan children in a rural district in Sabah, Malaysia

Gan CY, Chin B, Teoh ST, Chan MK

Southeast Asian J. Trop. Med. Public Health, 1993 Jun;24(2):293-301.
PMID: 8266232

The nutritional status of 896 Kadazan children below 6 years of age from 23 villages of Tambunan District were studied. When stunting and wasting were defined as those who were below two standard deviations of height-for-age and weight-for-height (Waterlow et al, 1977) and based on the National Center for Health Statistics reference population, 67.6% of boys and 66.8% of girls were stunted while 12.3% of boys and 8.3% of girls were wasted. Weaning foods and toddler feeding practices were unsatisfactory. The role of health education on child care and feeding practices is emphasized.

Matched MeSH terms: Infant Nutritional Physiological Phenomena
Infant mortality decline in Malaysia, 1946-1975: the roles of changes in variables and changes in the structure of relationships

DaVanzo J, Habicht JP

Demography, 1986 May;23(2):143-60.
PMID: 3709892

This analysis has identified several factors contributing to the dramatic decline in infant mortality since World War II in Malaysia, as well as one factor that prevented the infant mortality rate from declining even more rapidly. Our main findings are the following: On average, mothers' education more than doubled over the study period, contributing to the decline in their infants' mortality. In addition, the beneficial effect of mothers' education on infant survival appears to have become stronger over the study period. Hence, further advances in education should lead to further improvements in infants' survival prospects. Another analysis of these data (Peterson et al. 1985) found that education is somewhat more influential in affecting child mortality in low-mortality, high-income areas than in the opposite type of areas. Therefore, socioeconomic development may have complemented, instead of substituted for, the the beneficial effect of mothers' education in promoting infant and child survival in Malaysia. Improvements in water and sanitation also contributed to the infant mortality decline, especially for babies who did not breastfeed. However, unlike education, these influences have become less important over time, especially for babies who are not breastfed. Hence, further improvements in water and sanitation, a goal of Malaysia's Rural Environmental Sanitation Programme, may have smaller relative effects on infant mortality than did previous improvements. Targeting such improvements on areas where women breastfeed little or not at all, however, will increase their effectiveness in promoting infant survival. The substantial reductions in breastfeeding that have taken place since World War II have kept the infant mortality rate in Malaysia from declining as rapidly as it would have otherwise. We estimate that, in our sample, the detrimental effects on infant survival of the decline in breastfeeding have more than offset the beneficial effects of improvements in water and sanitation. Unlike some other researchers (e.g., Palloni 1981), we find that changes in fertility levels and in the timing and spacing of births have had negligible effect in explaining the decline in infant mortality within the samples we have considered. We have excluded births to older women from our analysis, however; this exclusion may have led to an understatement of the influence of changes in the age pattern of childbearing.(ABSTRACT TRUNCATED AT 400 WORDS)

Matched MeSH terms: Infant Nutritional Physiological Phenomena
A survey of infant mortality rates in Sarawak

Goto S, Sado M, Yano K, Takeuchi M, Ichikawa Y

Southeast Asian J. Trop. Med. Public Health, 1974 Sep;5(3):424-9.
PMID: 4432100
Matched MeSH terms: Infant Nutritional Physiological Phenomena
Protein calorie malnutrition: a major health problem of multiple causation in Malaysia

Chen ST

Southeast Asian J. Trop. Med. Public Health, 1974 Mar;5(1):85-9.
PMID: 4209141
Matched MeSH terms: Infant Nutritional Physiological Phenomena
Fulltext Association of early life factors with dyslipidemia in children and adolescents: The CASPIAN-V study

Vard B, Adham A, Riahi R, Karimi G, Esmail Motlagh M, Heshmat R, et al.

Health Promot Perspect, 2020;10(4):349-358.
PMID: 33312930 DOI: 10.34172/hpp.2020.53

Background: This study aimed to investigate the association between prenatal/infancy factors and lipid profile in children and adolescents. Methods: This multicentric national study was conducted in 30 provinces in Iran. It comprised 4200 participants, aged 7-18 years, from the fifth survey of a national surveillance program. History regarding birth weight, as well as the type of consumed milk and food during infancy was obtained from parents. In addition to physical examinations, fasting blood samples were obtained to assess the lipid profile of these students. Results: Data from 3844 participants were available (91.5% participation rate), 52.4 % of students were boys. Mean (SD) age of participants was 12.3(3.2) years. Consuming cow milk in the first two years significantly increased the risk of high triglycerides (TG) (odds ratio [OR]:2.77, 95% CI: 1.32-5.85, P: 0.01), elevated low-density lipoprotein (LDL) (P<0.05) and low high-density lipoprotein (HDL) (P <0.05). Students who had consumed commercially made food as complementary feeding were 93% more likely to have high LDL (OR: 1.93, 95% CI=1.19-3.13, P: 0.01) and 90% more likely to have high TG than students who had consumed homemade food (OR: 1.90, 95% CI: 1.15-3.12, P: 0.01). The aforementioned figures were not significantly associated with an elevated total cholesterol (TC) level. Conclusion: Our findings revealed that the history of using human milk and home-made food as complementary feeding was associated with better lipid profile in childhood and early adolescence. Increasing public knowledge in this regard might be useful for encouragement of healthier life prevention of chronic diseases.

Matched MeSH terms: Infant Nutritional Physiological Phenomena
Preventive paediatrics: an account of health work in Trengganu, Malaya by J. W. Scharff and Cicely D. Williams from The Indian Medical Gazette 77:554, 1942

Nutr Rev, 1973 Nov;31:356-7.
PMID: 4587984
Matched MeSH terms: Infant Nutritional Physiological Phenomena
Fulltext Nutritional status and complementary feeding among Penan infants and young children in rural Sarawak, Malaysia

Bong, M.W., Norimah A. Karim, Ismail Mohd Noor

Malays J Nutr, 2018;24(4):539-550.
MyJurnal

Introduction: The Penan people are largely settled in rural and remote areas of
Sarawak with high rates of undernutrition among the children. The study aimed to
determine the nutritional status and infant and young child feeding (IYCF) practices
of Penan children. Methods: Subjects consisted of 121 children, aged between 0-23
months, from 15 Penan longhouses in Belaga district. Malnutrition was assessed
using anthropometric measurements of children and categorised according to the
World Health Organization (WHO) Growth Standards (2006). Feeding practices were
assessed using questionnaires based on WHO IYCF Indicators (2008). Results:
The prevalence of underweight was 29.8%; stunting 43.0% and wasting 5.8%.
Prevalence of exclusive breastfeeding under 6 months was 44.4%. About 86% of
infants aged 6-8 months were already given solid, semi-solid and soft foods. The
proportion of children aged 6-23 months achieving minimum dietary diversity
(MDD) was 76.6%, while minimum meal frequency (MMF) was 83.0% (breastfed and
non-breastfed). Among the children who achieved MDD, 64.9% of their meals were
derived from 4-5 food groups. More than half (55.3%) of all subjects (breastfed and
non-breastfed) received minimum acceptable diet (MAD). Achievement of iron-rich
foods (IRF) indicator was 77.7%. There was no significant association between the
IYCF indicators of MDD, MMF and MAD and underweight, stunting and wasting.
Conclusion: A high prevalence of poor nutritional status was recorded among
the Penan children. While the IYCF indicators apparently showed satisfactory
complementary feeding practices, future studies should assess quantitatively the
intake of complementary food among Penan infants and young children.

Matched MeSH terms: Infant Nutritional Physiological Phenomena
Fulltext The prevalence and risk factors of malnutrition among primary one school children in Tumpat and Bachok, Kelantan

Che Asiah, T., Zulkifli, A., Mohd Hashim, M.H., Halim, S.

Malaysian Journal of Public Health Medicine, 2004;4(1):66-71.
MyJurnal

A cross-sectional study to determine the prevalence of malnutrition and some associated factors among primary one schoolchildren, aged 7 years from rural areas of Tumpat and Bachok in Kelantan was carried out. A total of 922 chiMren from 18 primary schools were examined. The parents completed self-administered questionnaires eliciting demographic and socio-economic information. The weight and height of each child was taken. The nutritional status was assessed by the z-scores of weight-for-age (WAZ) , height- or-age (HAZ) and weight-for-height (WHZ). The prevalence of underweight was 25 .2% , stunting was 21 .1% and wasting was 6 .2%. Less than 1 .0% ofthe children were overweight. Risk factors of underweight were lueinga male (OR=l .4),
having an unemployed father (OR=2 .6) and a monthly family income of RM 251 -500 (OR=2 .0) . Being a male (OR=1 .6) was the only risk factor for stunning and working mother (OR=2 .0) was the only risk factor of wasting. In conclusion, there is still a high prevalence of undemutrition among primary one schoolchildren in rural areas of Tumpat and Bachok. This may be due to the poor socioeconomic status of the rural community and the lack of emphasis ofthe supplementary feeding program on the late preschool children. A comprehensive nutrition support program is essential, especially targeting the preschool children in these rural communities

Matched MeSH terms: Infant Nutritional Physiological Phenomena
Fulltext Infant feeding concerns in times of natural disaster: lessons learned from the 2014 flood in Kelantan, Malaysia

Sulaiman Z, Mohamad N, Ismail TA, Johari N, Hussain NH

Asia Pac J Clin Nutr, 2016;25(3):625-30.
PMID: 27440698 DOI: 10.6133/apjcn.092015.08

The flood that hit Kelantan in December 2014 was the worst in Malaysian history. Women and their infants accounted for a large proportion of the people at risk who were badly affected, as almost half of the population in Kelantan was in the reproductive age group. This report serves to raise awareness that breastfeeding mothers and infants are a special population with unique needs during a disaster. Four of their concerns were identified during this massive flood: first, the negative impact of flood on infant nutritional status and their health; second, open space and lack of privacy for the mothers to breastfeed their babies comfortably at temporary shelters for flood victims; third, uncontrolled donations of infant formula, teats, and feeding bottles that are often received from many sources to promote formula feeding; and lastly, misconceptions related to breastfeeding production and quality that may be affected by the disaster. The susceptibility of women and their infant in a natural disaster enhances the benefits of promoting the breastfeeding rights of women. Women have the right to be supported which enables them to breastfeed. These can be achieved through monitoring the distribution of formula feeding, providing water, electricity and medical care for breastfeeding mothers and their infants. A multifaceted rescue mission team involving various agencies comprising of local government, including the health and nutrition departments, private or non-governmental organizations and individual volunteers have the potential to improve a satisfactory condition of women and infants affected by floods and other potential natural disasters.

Matched MeSH terms: Infant Nutritional Physiological Phenomena
Fulltext A randomised controlled trial of glutamine-enriched neonatal parenteral nutrition in Malaysia

Mohamad Ikram I, Quah BS, Noraida R, Djokomuljanto S, Faris Irfan CY, Van Rostenberghe H

Singapore Med J, 2011 May;52(5):356-60.
PMID: 21633770

The addition of glutamine to parenteral nutrition (PN) in neonates has not shown significant benefits as compared to adults thus far. This study aimed to determine the potential benefits of the addition of glutamine to neonatal PN in a tertiary hospital in a middle-income country.

Matched MeSH terms: Infant Nutritional Physiological Phenomena
Fulltext Knowledge and beliefs about breastfeeding are not determinants for successful breastfeeding

Ishak S, Adzan NA, Quan LK, Shafie MH, Rani NA, Ramli KG

Breastfeed Med, 2014;9(6):308-12.
PMID: 24893127 DOI: 10.1089/bfm.2013.0124

A cross-sectional prospective study was performed to assess knowledge and attitude toward breastfeeding among mothers in a tertiary hospital in Malaysia and its influence on their breastfeeding practices. Two hundred thirteen women who had delivered healthy babies at term were enrolled. A structured questionnaire containing demographic data and the Iowa Infant Feeding Attitude Score were used, followed by a telephone interview after 8 weeks to determine the feeding outcome. Women of Malay ethnicity with higher education level who had received breastfeeding counseling had a significantly more favorable attitude toward breastfeeding. Ethnicity was found to be a significant determinant in the success of breastfeeding, whereas returning to work was a major reason for discontinuing breastfeeding. In ensuring a successful breastfeeding practice, apart from knowledge and attitude, issues surrounding culture and traditions as well as improving deliverance of readily available support should be addressed.

Matched MeSH terms: Infant Nutritional Physiological Phenomena
Early breast-feeding patterns in a Malaysian maternity hospital, 1980-1983

Kader HA

Malays J Reprod Health, 1984 Dec;2(2):105-10.
PMID: 12280340
Matched MeSH terms: Infant Nutritional Physiological Phenomena*
Seminar on young child nutrition: improving nutrition and health status of young children in indonesia

Isabelle M, Chan P

Asia Pac J Clin Nutr, 2011;20(1):141-7.
PMID: 21393122

The Seminar on Young Child Nutrition: Improving Nutrition and Health Status of Young Children in Indonesia held in Jakarta on November 2009 reviewed the current nutritional and health status of young children in Indonesia and identified key nutrient deficiencies affecting their optimal growth. The continuation of child growth from fetal stage is of paramount importance; and maternal and child health should be a central consideration in policy and strategy development. Clinical management of nutrient deficiency and malnutrition, as well as strategies and education to improve feeding practices of young Indonesian children were discussed in the seminar. Relevant experiences, approaches and strategies from France, New Zealand and Malaysia were also shared and followed with discussion on how regulatory systems can support the development of health policy for young children. This report highlights important information presented at the seminar.

Matched MeSH terms: Infant Nutritional Physiological Phenomena
Child health, breast-feeding, and survival in Malaysia: a random-effects logit approach

Montgomery MR, Richards T, Braun HI

J Am Stat Assoc, 1986 Jun;81(394):297-309.
PMID: 12155406

This study examines the possibility that estimation of the effect of breast-feeding on infant survival is affected by selection bias, in that children who are healthier at birth may be more likely to be breast-fed. Data are from the 1976 Malaysian Family Life Survey. "Ordinary logit models for breast-feeding and survival are estimated, and the results suggest that selection is indeed present. For example, children of higher birth weight appear to be more likely to be breast-fed and likely to survive. In addition, weight at birth and the duration of breast-feeding appear to be linked." Using birth weight as an indicator for the child's health, the authors conclude that "the direct influence of breast-feeding on survival remains of overwhelming importance even after corrections for selection bias are made."

Matched MeSH terms: Infant Nutritional Physiological Phenomena
Breast-feeding in some developing countries

Ahmad M

Egypt Popul Fam Plann Rev, 1979;13(1-2):168-86.
PMID: 12312263

PIP: Responses to questions relating to breastfeeding in the World Fertility Surveys of South Korea, Indonesia, Nepal, Sri Lanka, Malaysia, and Bangladesh are analyzed. Of these countries, the percentage of ever-married women who had breastfed in the last closed interval was between 94-99%, except for Malaysia (81%) and average number of months breastfeeding took place was from 16.5-19.2, except for Malaysia (7.3). The infant mortality rate in these countries was 33/1000 live births for South Korea, 45/1000 for Malaysia, 51/1000 for Sri Lanka, 137/1000 for Indonesia, 150/1000 for Bangladesh, and 152/1000 for Nepal. Responses, however, might vary according to different interview situations. Assuming that the reporting errors are of similar magnitude and direction, the relationship between duration of breastfeeding and the birth interval can be studied. But it is possible that breastfeeding was prolonged due to other reasons for which conception was delayed; thus the regression of breastfeeding duration on the birth interval is not as logical as the regression of the birth interval on the breastfeeding is, especially when habitual breastfeeding can be avoided. The negative relationship between breastfeeding and infant mortality does exist, assuming that a woman breastfeeds all her children for similar durations. Some breastfeeding differentials are place of residence (less for rural areas), education (reduces duration), and religion (Christians have shorter duration than Muslims, Hindus, or Buddhists). In South Korea the mean length of breastfeeding of women aged 25-34 and 35-44 are 17.5 and 20.5, and women using contraceptives are 26% for 25-34 and 20% for 35-44. South Korea also has the highest level of breastfeeding, highest incidence of ever use of contraceptives, and a very low level of fertility. Nepal and Bangladesh have a high level of breastfeeding but since their contraceptive incidence is low, their fertility level remains high. Some areas of further research include influence of breastfeeding on infant and child mortality.

Matched MeSH terms: Infant Nutritional Physiological Phenomena
To breast feed or not?

Nutr Rev, 1972 May;30(5):112-4.
PMID: 4554312
Matched MeSH terms: Infant Nutritional Physiological Phenomena
Pneumonia and diarrhoeas: killers of toddlers in developing countries

Chen ST

Trop Geogr Med, 1975 Mar;27(1):103-8.
PMID: 806152

Pneumonia and diarrhoeas are an important cause of toddler mortality and morbidity in developing countries. Of the 147 children admitted to the University Hospital at Kuala Lumpur in 1971 for pneumonia and diarrhoeas 50 (34%) were found to be suffering from protein-calorie malnutrition of varying degrees of severity. The malnourished children tended to come from poorer homes, and to have a larger number of siblings born in rapid succession when compared with normal weight children. Anemia was more common among the malnourished children. The interaction of infection and malnutrition and the social implications of these diseases are important. It is vital that hospitals in developing countries promote health in addition to their traditional curative role.

Matched MeSH terms: Infant Nutritional Physiological Phenomena
Metabolic acidosis and renal solute load in relation to the protein intake of low birth weight Malaysian neonates

Johnson RO, Johnson BH, Raman A, Lee EL, Lam KL

Aust Paediatr J, 1979 Jun;15(2):101-6.
PMID: 485988
Matched MeSH terms: Infant Nutritional Physiological Phenomena
Fulltext The Third National Health and Morbidity Survey 2006 (NHMS III)

ISBN: 978-983-3887-27-9

Citation: National Health Morbidity Survey 2006. Kuala Lumpur: Ministry of Health, Malaysia, 2008
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Infant Nutritional Physiological Phenomena

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