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The circadian clock system, an evolutionarily conserved mechanism, orchestrates diurnal rhythms in biological activities such as behavior and metabolism, aligning them with the earth's 24-hour light/dark cycle. This synchronization enables organisms to anticipate and adapt to predictable environmental changes, including nutrient availability. However, modern lifestyles characterized by irregular eating and sleeping habits disrupt this synchrony, leading to metabolic disorders such as obesity and metabolic syndrome, evidenced by higher obesity rates among shift workers. Conversely, circadian disturbances are also associated with reduced nutrient absorption and an increased risk of malnutrition in populations such as the critically ill or the elderly. The precise mechanisms of these disturbances in leading to either over-nutrition or under-nutrition is complex and not yet fully understood. Glucose, a crucial energy source, is closely linked to obesity when consumed excessively and to weight loss when intake is reduced, which suggests that circadian regulation of glucose metabolism is a key factor connecting circadian disturbances with nutritional outcomes. In this review, we describe how the biological clock in various tissues regulates glucose metabolism, with a primary focus on studies utilizing animal models. Additionally, we highlight current clinical evidence supporting the association between circadian disturbance and glucose metabolism, arguing that such disruption could predominantly contribute to under-nutrition due to impaired efficient utilization of nutrients.

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BACKGROUNDS & OBJECTIVES: The privileging of boys in immunization coverage, breastfeeding, and other child care practices in Indian patriarchal society raises questions about whether there are sex differences in the prevalence of undernutrition among children. This study evaluates the sex gap in the prevalence of Composite Index of Anthropometric Failure (CIAF) among Indian children from 2015-16 to 2019-21. Additionally, it seeks to identify the sex-specific determinants and persistent sex gap at national and subnational levels (social, economic, religious, and geopolitical regions) in anthropometric failure among the children from 2015-16 to 2019-21. MATERIALS AND METHODS: The study utilizes the 4th (2015-16) and 5th (2019-21) rounds of the National Family Health Survey data. Logistic regression models and the Fairlie decomposition technique were employed to explore the persistent and significant sex gap in the prevalence of CIAF, as well as the sex-specific determinants of CIAF among children in 2015-16 and 2019-21. RESULTS: The study reveals a significant sex gap (approximately 4%-points), with boy's disadvantage in the prevalence of CIAF from 2015-16 to 2019-21 at both the national and subnational levels (social, religious, socioeconomic groups, and geopolitical regions). The gap is more pronounced in the first year of life and decreases in later stages. A comparatively faster CIAF decline among girls from 2016 to 2021 has widened the sex gap in final year than the previous. Child, mother, household, community, and geographic backgrounds explains about 5%-6% of the sex gap in the prevalence of CIAF from 2015-16 to 2019-21. The remaining 94%-95% of the unexplained sex gap may be attributed to biological factors or other factors. Currently, a heightened boy's disadvantage in CIAF risk is observed in ST community, wealthiest families, and the northern India. CONCLUSION: The findings suggest a special attention for boys under 3 years to offset biological disadvantages like greater disease sensitivity and fragility compared to girls early on.

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INTRODUCTION: Despite documentation on injection drug use (IDU) in Kenya, the nutritional status of people who inject drugs (PWIDs) is under-explored. Elsewhere studies report under-nutrition among PWIDs which is attributed to food insecurity; competing priorities between drugs and food supply; chaotic lifestyle; reduced food intake; substance use induced malnutrition due to inflammation and comorbidities. METHODS: This was a cross-sectional study that sought to assess the nutritional status of PWIDs in Coastal Kenya. We recruited 752 participants of whom 371(49%) were on IDUs and 75 non-IDUs and 306 non-drug users using respondent driven sampling, traditional snowball, makeshift outreach and purposive sampling methods. RESULTS: More than one half of the participants (56%) had BMI classified as normal while 35% had BMI < 18.5. The proportion with BMI < 18.5 was higher among IDUs (46%) compared to the non-IDUs (33%) and non-drug users (23%) at P < 0.001. Using the mid upper arm circumference (MUAC), 17% were classified as underweight and the proportion was lowest (11%) among non- drugs users compared to 22% among IDUs (P < 0.001). However, the IDUs had lower proportion of overweight (8.1%) compared to 55% among the non- drug users. The proportion with low waist-for-hip ratio was highest among the IDUs (74%) while high waist-for-hip ratio was lowest in the same group of IDUs (11%) at P < 0.001. One half (50%), of the participants had no signs of anaemia, (47%) had mild/moderate anaemia while 21 (2.8%) had severe anaemia. However, IDUs were more likely to be overweight based on waist circumference as a parameter. The IDUs had the highest proportion (54%) of mild to moderate anaemia compared to non-IDUs (37%) and 40% non- drug users (P < 0.001). In the multivariable models, IDUs (aRRR 2.83 (95%CI 1.84‒4.35)) and non-IDUs (aRRR 1.42 (95%CI 1.07‒1.88)) compared to non- drug users were positively associated with BMI < 18.5. Being an IDU was positively associated with mild or moderate anaemia (aRRR 1.65 (95%CI 1.13‒2.41)) while non-IDUs were positively associated with severe anaemia (aRRR 1.69 (95%CI 1.16‒2.48)). CONCLUSION: A significant proportion of the participants were under-nourished with those injecting drugs bearing the heaviest brunt. Being an IDU was positively associated with the low BMI, MUAC, waist for hip ratio and mild or moderate anaemia but high waist circumference. People who inject drugs have high risk for under-nutrition and should be targeted with appropriate interventions.

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BACKGROUND: Poor appetite is common in older age, with estimated prevalence figures ranging between 15-30% in community-dwelling populations. Despite known links between poor appetite and adverse health outcomes, appetite is not routinely assessed and the causes and impact of appetite loss in older age are not well understood. This study aimed to improve understanding of the influences on, and experiences of, appetite loss among older people who have poor appetite and to consider the implications for prevention and treatment strategies. METHODS: Thirteen older adults aged 60-93 years (9 women) identified as having poor appetite (Simplified Nutritional Appetite Questionnaire (SNAQ) scores < 14; ranging from 8-11) took part in semi-structured interviews. Open-ended questions focused on influences on and experiences of appetite and appetite loss in older age. Interviews were transcribed; reflective thematic analysis was conducted using an inductive approach. RESULTS: The analysis generated three themes: 1) a complex web of influences on appetite loss, that include biological, psychological, and social factors; 2) living with poor appetite-variation in perceptions of poor appetite and attitudes to appetite loss; 3) living with poor appetite-the role and importance of the eating environment and social interactions. The themes highlight marked differences in individual 'journeys' to poor appetite, with variation in the balance and role of specific causal influences, that impact on the experience of appetite loss and on coping strategies. CONCLUSIONS: A broad range of influences (including biological, psychological and social factors) and experiences of appetite loss in older age were described. Future research should consider person-centred approaches, that take account of individual narratives of appetite loss, in the design of effective strategies to support older adults.

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BACKGROUND: Leprosy, a chronic mycobacterial disease, is frequently accompanied by malnutrition. However, it is important to regularly assess the nutritional state of leprosy patients in a resource-poor nation like India, where undernutrition is widespread. OBJECTIVES: This study aimed to compare the nutritional status of leprosy patients to that of normal individuals using the body mass index. METHODS: The electronic databases PubMed, Google Scholar, and Embase were used to conduct an open literature search. From 1st January 2000 to 31st January 2023, all articles were screened using the following MeSH terms: (nutrition OR body mass index OR body weight) AND (leprosy OR lepra) to find possibly relevant articles. RESULTS: This meta-analysis includes five research studies with a total of 1173 individuals (363 patients in the leprosy group and 810 patients in the non-leprosy group). The weighted mean difference (WMD) for BMI studies was -17.88 (95% CI -27.65 to -8.12), showing that there was a significant difference in BMI < 18.5 between leprosy patients and non-leprosy patients. There was a significant difference in DDS score and HFIAS score between patients with leprosy and non-leprosy. In a total of 342 leprosy patients, 206 developed deformities. CONCLUSION: This research increases our understanding of nutrition and leprosy. The results found that people with leprosy are nutritionally at a distinct disadvantage when compared to non-leprosy patients. It emphasises the several ways in which diet may generate circumstances that increase the risk of leprosy.

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Objective: Under nutrition especially among under-fives is a major public health challenge in Tanzania. However, the contribution of cultural practices to child under nutrition is often overlooked. This study aimed to explore the perceived socio-cultural factors contributing to the persisting under nutrition among under-fives in Tanzania. Methods: The study applied focus group discussion (FDGs) with forty practitioners to examine the sociocultural factors contributing to under nutrition during early childhood. The study participants were purposively selected and thematic analysis was used to identify themes within the data. Results: This study revealed that, under nutrition for under-fives is caused by a number of socio-cultural factors including existence of gender inequality related to dietary practices and qualities, women's excessive workload, patriarchy social-norm, excessive alcohol use and cultural taboos prohibiting women and girls from eating certain types of nutrient dense foods. Conclusion: The study highlights the multiplicity of factors including socio-cultural perspectives contributing to under nutrition among under-fives, and calls for a concerted efforts in developing and implementing issue-specific and culturally sensitive strategies towards elimination of child under nutrition.

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In common with many nations undergoing a nutrition transition, micronutrient deficiencies, undernutrition and overnutrition coexist in The Gambia. Addressing these challenges simultaneously would require transformational changes in the country's food system. However, the evidence base that would enable informed decision-making in the Gambian food system has been scant, despite several sources of routinely-collected data being available. This descriptive study brings together data from four open-access global databases on food supply, political, economic, and demographic variables, and nutrition and health between 1990 and 2017 to study potential leverage points for improvement in the food system. It compares trends in food supply and nutritional outcomes in The Gambia against regional and global averages, and identifies potential drivers taken from a food systems framework. The data show that, over the past three decades, total energy supply has increased, and obesity is rising quickly, but iron deficiency persists in a proportion of the population. Overall diet composition is poor, with lower availability of fruit and vegetables and higher supply of sugar and oils compared to regional and global averages. Domestic production is low for most food groups and so a high dependence on imports from other countries bridges the gap in terms of energy supply. Measures of economic development, particularly GDP, were positively related with supply of cereals and animal source foods over time, but no such relationship was observed with fruit and vegetable supply. Food system policy to improve nutrition and health outcomes in The Gambia needs to focus on improving the diversity of food supply - especially fruit and vegetables - and maximizing national domestic production to reduce reliance on food imports. The use of open-source global datasets can be feasible in exploring food system characteristics and trends at the national level and could be applied in other contexts.

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Background: Under nutrition among pregnant women is common public health problem in developing countries including Ethiopia. It leads to poor maternal and neonatal outcomes. Despite its consequences there is shortage of research evidence to support intervention in this regard in the southern part of the country. Therefore, the aim of the study was to assess the determinates of under nutrition among pregnant women visiting antenatal care clinics at selected health facilities in Hawassa town. Methods: Health facility based cross-sectional study was employed among 454 systematically selected study participants. Data were collected by using structured and pre-tested questionnaires with face to face interview. Data were entered into Epi info and then exported to SPSS version 26 statistical software for analysis. Data were analyzed with descriptive statistics; bivariate and multivariate binary logistic regression. Result: The over all of prevalence of under nutrition among pregnant women was 27.6% [95% CI (22.6, 30.8)]. In multivariate logistic regression model, lowest wealth quintile [AOR = 3.3, 95% CI (1.7, 7.0)], women with dietary diversity [AOR = 2.0, 95% CI (1.3, 4.0)], presence of anemia [AOR = 10.7, 95% CI (5.8,19.8)], lower pregnant women education level [AOR = 3.3, 95% CI (1.4, 7.9)], lower partner education level [AOR = 3.1, 95% CI (1.1, 8.5)], not ate flush/meat food [AOR = 2.8, 95% CI (1.7, 4.8)], and not ate other fruits [AOR = 1.8, 95% CI (1.1, 2.8)] had significant association with under nutrition. Conclusion: In this health facility based study, the burden of under nutrition was high. Lowest wealth quintiles, low dietary diversity scores, being anemic and low education of the pregnant women and her partner were associated with under nutrition. Therefore, counseling for dietary diversity during antenatal care, health promotion and education for pregnant women and empowering women on income generation activities are a key intervention to tackle under nutrition.

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BACKGROUND: Child under-nutrition remains a widespread problem around the globe. Improving child nutrition and empowering women are two important and closely connected development goals. These two interconnected goals will affect one another through different mechanisms, and the net effect may not necessarily be positive. Yet, the impact of maternal employment, one method of empowering mothers, on children's nutritional is not well studied in Ethiopia. Hence, this study is to compare the prevalence of under-nutrition and its associated factors among 6-23 months old children of employed and unemployed mothers in town kebeles of Dera district, Northwest Ethiopia, 2022. METHODS: A community-based comparative cross-sectional study design was conducted among 356 employed and 356 unemployed mothers having 6-23 months old children. A systematic random sampling technique was used to select study participants. Epi-data version 3.1 and SPSS version 25.0 statistical software were used for data entry and analysis, respectively. Both bi-variable and multivariable binary logistic regression was done to assess the association between independent and dependent variables. A p-value of less than 0.05 in a multivariable binary logistic regression was declared as the level of statistical significance. RESULT: The prevalence of under-nutrition was 69.8% (95% CI: 65.0, 74.7) among children of unemployed mothers, compared to 27.4% (95% CI: 22.7, 32.2) among children of employed mothers. Under-nutrition among children of unemployed mothers was significantly associated with being a male child, age increase by one month, household food insecurity, lack of ANC follow-up, and not exclusively breastfed. Whereas, among children of employed mothers, being a male child, age increase by one month, being sick during the last two weeks prior to data collection, not immunized to their age, and low meal frequency were significantly associated with their under-nutrition. CONCLUSION: The prevalence of under-nutrition among children of unemployed women is significantly higher than those children of employed women which consolidate the evidence that women's employment status have a positive association with child nutrition. Different factors were also identified as significant predictors of child under-nutrition among these two groups (employed and unemployed women). Thus, multi-sectoral intervention approach together with agriculture and education offices should be strengthened.

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Background: HIV-induced malnutrition is highly prevalent in different parts of the world particularly in sub-Saharan Africa. The food intervention package is one of the strategies that targets malnutrition among HIV-infected people through nutritional evaluation, counseling and care. However, little is known concerning the outcomes of intervention in such patients in treatment program. Therefore, this study aimed to assess nutritional treatment outcomes and its predictors among adult HIV-positive undernourished individuals in Ethiopia. Methods: Facility based retrospective cohort study was deployed in Adult Antiretroviral therapy clinic of Hawassa University Comprehensive Specialized Hospital. Data of 419 patients were extracted from the food by prescription registration book and patient cards using structured questionnaires. Statistical significance was assessed using Cox-proportional Hazard model by determining hazard ratios and 95% confidence interval. Results: The proportion of adult HIV patients who recovered from malnutrition after they were enrolled in the food by prescription therapy was 53.0%. The variables found to have an association with good nutritional treatment outcomes of food by prescription in the final model are being female (Adjusted Hazard Ratio (AHR) = 3.38, 95% CI: 2.15, 5.32), secondary education (AHR = 2.16, 95% CI: 1.11, 4.18), tertiary education (AHR = 3.75, 95% CI: 1.66, 8.48), SAM (AHR = 0.20; 95% CI: 0.12, 0.35), and HAART (AHR = 2.70, 95% CI: 1.50, 4.86). Having Severe Acute Malnutrition (SAM) at baseline nutritional assessment (AHR = 3.42, 95% CI; 2.81, 5.15), taking ART for more than 12 months (AHR = 0.26, 95% CI: 0.13, 0.84) and starting HAART immediately after testing positive (AHR = 0.26, 95% CI: 0.13, 0.84) are significantly associated with nutritional treatment failure. Conclusion: Fifty-three percent of HIV patients recovered from malnutrition after they were enrolled in the food by prescription therapy.

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PURPOSE: To assess the prevalence and factors associated with stunting and thinness among school-age children in rural primary schools in the East Dembia District, Northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted using a systematic random sampling procedure to select 840 school-aged children. A structured interviewer-administered questionnaire was used to collect the data. Height and weight measurements were taken, and a combined wet mount and concentration technique was used. Epi Data 3.1 was used to enter data, which was then exported to SPSS version 20 for analysis. Bi-variable and multivariable logistic regression analyses were done. Variables with a p-value of less than 0.05 were considered significantly associated with stunting and thinness. RESULTS: The prevalence of stunting and thinness was 25.5 and 13.0%, respectively. Being infected with an intestinal parasite (AOR =4.34; 95% CI: 2.52, 12.27), being in the age group 11-14 years (AOR =3.73; 95% CI: 2.19, 6.34), having the lowest dietary diversity practice (AOR =4.61; 95% CI: 1.73, 12.27), unimproved water sources (AOR =1.76; 95% CI: 1.07, 2.91), not practicing good hygiene practice (AOR =1.71; 95% CI: 1.04, 2.804) and having an unimproved latrine type (AOR =1.72; 95% CI: 1.03, 2.89) were significantly associated with stunting. On the other hand, unsecured food (AOR =1.74; 95% CI: 1.08, 2.81), eating less than 3 meals per day (AOR = 2.67; 95% CI: 1.11, 6.46), and untreated water (AOR =1.72; 95% CI: 1.08, 2.75) were factors associated significantly with thinness. CONCLUSION: Stunting and thinness are predominant public health problems in the study area, provided that the prevalence of stunting is slightly higher than that of a national survey on health and nutrition in schoolchildren, whereas the prevalence of thinness is lower when compared to the same national survey. In this study, the primary factor that was significantly associated with stunting was dietary diversity; the primary factor that was associated with thinness was eating fewer than 3 meals per day. So, an integrated strategy is important to alleviate undernutrition among school-aged children in the current study area.

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Haiti is one of the most food-insecure (FIS) nations in the world, with increasing rates of overweight and obesity. This study aimed to characterize FIS among households in urban Haiti and assess the relationship between FIS and body mass index (BMI) using enrollment data from the Haiti Cardiovascular Disease Cohort Study. FIS was characterized as no/low, moderate/high, and extreme based on the Household Food Security Scale. Multinomial logistic generalized estimating equations were used to evaluate the association between FIS categories and BMI, with obesity defined as BMI ≥ 30 kg/m2. Among 2972 participants, the prevalence of moderate/high FIS was 40.1% and extreme FIS was 43.7%. Those with extreme FIS had higher median age (41 vs. 38 years) and were less educated (secondary education: 11.6% vs. 20.3%) compared to those with no/low FIS. Although all FIS categories had high obesity prevalence, those with extreme FIS compared to no/low FIS (15.3% vs. 21.6%) had the lowest prevalence. Multivariable models showed an inverse relationship between FIS and obesity: moderate/high FIS (OR: 0.77, 95% CI: 0.56, 1.08) and extreme FIS (OR: 0.58, 95% CI: 0.42, 0.81) versus no/low FIS were associated with lower adjusted odds of obesity. We found high prevalence of extreme FIS in urban Haiti in a transitioning nutrition setting. The inverse relationship between extreme FIS and obesity needs to be further studied to reduce both FIS and obesity in this population.

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Background: Malnutrition among children has lifelong implications, its outcomes not only cover the whole life but also transfer from one generation to another generation. Most studies conducted before focused on undernutrition in pregnant mothers and children less than 5 years of age, whereas school-age children are often omitted from health and nutrition surveys or surveillance. In Northwest Ethiopia, particularly in the study area, the community levels nutritional status of school-age is not well studied and documented. Therefore, this study aimed to assess the prevalence and determinants of the under-nutritional status of school-age children in Gondar Zuria District, Northwest Ethiopia. Methods: A community-based cross-sectional study design was employed with 364 respondents from January to April 2020. Data entered using Epi Data software version 3.1. Standard deviation scores were obtained by the world health organization Anthro Plus software to determine the nutritional status of children, and further analysis was done by using STATA version 14 software. Adjusted odds ratio with its corresponding 95 % confidence interval was used to declare statistically significant variables. Results: The prevalence of overall under-nutrition was 71.98% (95%, CI: 67%-76%) from which, 43.13% (95%, CI: 38%-48%) were stunted, 40.93% (95%, CI: 35%-46%) were under-weight, and 35.44% (95%, CI: 30%-40%) were wasted. Child age [AOR = 0.30, 95% CI (0.13-0.68)], food insecurity [AOR = 2.24, 95% CI (1.03-4.83)], good knowledge of mother/care giver [AOR = 0.40, 95% CI (0.17-0.92)], having larger family size (Tzioumis and Adair, 2014; Wolde et al., 2015; Mohammed et al., 2019) [6-8] [AOR = 2.92, 95% CI (1.29-6.58)], and unprotected drinking water sources [AOR = 2.84, 95% CI (1.00-8.06)] were the predictors of under-nutrition. Conclusion: According to the world health organization cut-offs, the prevalence of overall under-nutrition in the study area was very high. Child age, food insecurity, knowledge of mother/caregiver, having a larger family size, and unprotected drinking water sources were the predictors of under-nutrition. The district offices should give attention to the improvement of the food security status of the community, and give priority to the availability and accessibility of drinking water sources, particularly pipe water sources. Special attention to older age groups of children is important to control the prevalence of under-nutrition.

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Background: Moringa stenopetala is used for medicinal and nutritional purposes. This study was, therefore, conducted to assess the contribution of Moringa stenopetala based diet in reducing under nutrition in under-five children in four districts of Southern Ethiopia. Method: A community-based comparative cross-sectional study design was employed from August to September 2016 in randomly selected comparative sites among 732 under five children. Anthropometric measurements of weight and height of children were measured based on the standard measurement protocol. Regarding moringa stenopetala diet, the consumption habit was collected by using a seven days food frequency questionnaire. Amount of moringa stenopetala leaf biomass portion size consumption was measured with local measurement and converted to kilograms. Anthropometric data were analyzed using WHO Anthro software to determine the nutritional status of the child. An independent t-test was conducted to compare the mean difference of WHO-Z score of child nutritional index. Statistical mean significance difference was measured based on p-value less than 0.05 with 95% confidence level. In addition chi-square test with a p-value, less than 0.05 with a 95% confidence level was used to compare the prevalence of stunting, wasting, and underweight in moringa stenopetala based diet and non-moringa stenopetala based diet consuming area. Result: The prevalence of stunting was 19% vs. 28.8%, wasting 4.7% vs. 9.6%, and underweight 12.19% vs 13.71% in moringa stenopetala based diet consuming and non-consuming participants respectively. There was a significant difference in stunting and wasting (p < 0.05) among moringa stenopetala based diet-consuming and non-consuming participants. Conclusion: The present study showed that moringa stenopetala based diet consumption had a significant contribution in reducing under-nutrition in under-five children.

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Context: Skinfold thickness (SFT) and body-fat (BF%) are infrequently used for childhood undernutrition. Aims: (a) Estimation of SFT at peripheral and truncal sites (b) Estimation of BF% from SFTs (c) Correlate SFT estimates with MUAC, BMI and Waist. (d) Compare rural/tribal SFTs with urban schoolchildren. Settings and Design: Ashram schools in rural/tribal settings and one urban school. Methods and Material: Using three stage sampling, four tribal schools were randomly selected and an urban school was added for comparison. A sub sample of 405 students in the age group of 7 to 15 years were included. Height, weight, MUAC and SFTs were measured BF% was estimated with Slaughter equation. Statistical Analysis: Using Excel, Epi Info 7.1 and R software, appropriate t tests were applied for comparisons, and correlation was estimated between the quantitative variables. Results: Average SFT among schoolchildren (405) was 6.64 mm. Girls (n = 215) had a BF% of 13.1%, while boys (n = 190) had BF at 11.5%. Average SFT for boys (6.69) and girls (6.48) had no statistically significant difference (t = 1.3, P = 0.1929). Boys had higher average peripheral SFT than truncal SFT while girls had higher truncal SFTs. In girls subscapular SFT was higher than triceps SFT. Median BF% in rural was lower than urban schoolchildren. BF% correlated strongly with BMI (0.56), Waist (0.63), Hip (0.61) and MUAC (0.59). Conclusion: SFT and BF % can be effectively used to detect undernutrition. Geographical and Gender differences are observed. SFT and BF% correlated well with BMI and MUAC.

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Aim: To analyse the trends and patterns of stunted only and stunted-underweight children in Malawi between the 2000 and 2015. Methods: The study used the 2000 and 2015 Malawi Demographic and Health Survey data and employed bivariate and multivariate statistical analysis techniques to explore the difference in the levels of stunted only and stunted-underweight children and key socio-economic factors between 2000 and 2015 and identify key attributes of being stunted only and being stunted-underweight. Results: The percentage of stunted only was 37.2% in 2000 and 26.8% in 2015 and the stunted-underweight percentage was 14.5% in 2000 and 8.8% in 2015. Out of the 6.9% children classified as wasted, 2.4% were also underweight and stunted, 2.4% were underweight and 2.1% did not have any other forms of undernutrition. The analysis did not identify any children that were both stunted and wasted. Only 0.7% in 2000 and 0.4% in 2015 were underweight and free of any other forms of undernutrition. There were improvements in mother education level and mother weight during this time-period which may explain the improvements in child nutritional status. Conclusion: The most common form of undernutrition is stunting and nearly all children that are underweight are also stunted. Child nutrition practitioners and health professionals should consider focusing on tackling child stunting.

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INTRODUCTION: Under-nutrition (body mass index < 18.5 kg/m2) is a global problem with an increasing trend in recent years. The burden is high in low and middle-income countries, especially in Africa. Lactating mothers are among the most vulnerable groups for under nutrition; particularly in sub-Saharan Africa. In Ethiopia, the prevalence of under-nutrition among this group is inconsistent and inconclusive. Therefore, we aimed to assess the pooled prevalence of under-nutrition and its associated factors among lactating mothers in Ethiopia. METHODS: To write this review and meta-analysis, we followed the preferred reporting items for systematic review and meta-analysis guidelines. Primary articles were searched from PubMed, Hinari, Cochrane Library, science direct databases, Google, and Google scholar. STATA version 16 software and a standardized Microsoft excel format were used for analysis and data extraction, respectively. Heterogeneity between studies was checked. To determine the pooled prevalence of under-nutrition, we used a random-effect model. Begg's and Egger's tests were done to detect publication bias. Subgroup analysis was also steered and association was uttered by a pooled odds ratio with 95% CI. RESULTS: The pooled prevalence of under-nutrition among lactating mothers was 23.84% [95% CI (19.40, 28.27)]. Educational status (no formal education) {Pooled OR 2.30 [95% CI (1.34, 3.96)]} was significantly associated with under-nutrition. CONCLUSION: The pooled prevalence of under-nutrition was high. Maternal educational status was significantly associated with under-nutrition. Therefore, the federal ministry of health and the concerned stakeholders should give attention to these most vulnerable groups and strengthen the implementation of the previously designed strategies.

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BACKGROUND: Despite of the global efforts undertaken to improve nutrition, malnutrition still continues to be a serious public health concern. Malnutrition in its various forms has been closely associated to major causes of illness, disability and death. Malnutrition in the form of childhood stunting has therefore been identified as a significant hindrance to human development. The aim of this study was to assess the nutritional status of children aged 6-59 months and determine factors associated with a high prevalence of stunting (48%) among children in Kabale district. METHODOLOGY: A cross sectional study was conducted among 640 children, aged 6-59 months selected using both simple random and systematic random sampling techniques. Interview administered questionnaires were used to collect household data whereas anthropometric data was collected using height boards, digital weighing scales and Mid Upper Arm Circumference (MUAC) Tapes. Nutrition status data was analyzed using ENA for SMART, 2011 and then exported to STATA version 12.0 for further analysis. RESULTS: The overall prevalence of stunting among children 6-59 months was 41.1%. Factors independently associated with stunting included; age of the child (children in the age category of 36-47 months APOR = 0.38; 95% CI 0.18-0.79 and those in the age category of 24-35 months APOR = 0.42; 95% CI 0.19-0.88), major source of food for the household that is children from households in which mothers indicated market as the major source of food (APOR = 0.67; 95% CI 0.48-0.94) and disposal of child stool that is children whose stool was put/ rinsed in a latrine (APOR = 0.41; 95% CI: 0.23-0.74) as well as those that whose stool was thrown in garbage (APOR = 0.29; 95% CI: 0.12-0.72). CONCLUSION: The prevalence of stunting among children aged 6-59 months in Kabale district was high. Practices/ factors independently associated with stunting among children aged 6-59 months included; age of the child, major source of food for the household and disposal of child stool. Addressing these factors requires a proper mix of both community and health based interventions. There is also need to strengthen on strategies for reducing stunting like; sanitation and hygiene as well as food and nutrition security within rural households.

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Background: Adolescent girls are vulnerable to undernutrition owing to their increased nutrition demand for growth and development, including sexual development and maturation. Despite its public health importance, undernutrition among late adolescent girls has received little attention in health and nutrition policies. Although undernutrition in adolescent girls has been investigated, most of the previous study reports were based on small sample sizes and limited geographic settings. Therefore, we aimed to estimate the prevalence and determinants of undernutrition among late adolescent girls in East Africa. Methods: Secondary data analysis was conducted among 10 East African countries using the most recent Demographic and Health Survey (DHS) reports. A total of 21,779 adolescent girls aged 15-19 years were included in this study. Descriptive statistics were conducted to describe the study population. The binary logistic regression model was fitted to identify the determinants of undernutrition among late adolescent girls. Variables with a p-value of <0.05 in the multivariate analysis were identified as statistically significant determinants of undernutrition. Results: The overall magnitude of undernutrition among late adolescent girls in East Africa was 16.50% (95% CI: 16.00-17.00), whereas the overall magnitude of obesity among late adolescent girls in East Africa was 2.41% (95% CI: 2.21-2.62). In the final model of the multivariate analysis, adolescent girls aged 18-19 years [adjusted odds ratio (AOR) = 0.55; 95% CI: 0.51-0.60], having secondary education (AOR = 0.79; 95% CI: 0.68-0.93), being from a rich wealth index family (AOR = 0.63; 95% CI: 0.56-0.69), and being from a medium wealth index family (AOR = 0.80; 95% CI: 0.72-0.89) were negatively and statistically associated with undernutrition. Likewise, having more than seven household members (AOR = 1.36; 95% CI: 1.10-1.67), walking more than 30 min to a water source (AOR = 1.10; 95% CI: 1.01-1.20), and living in Ethiopia (AOR = 1.75; 95% CI: 1.51-2.03) were positive determinants of undernutrition among late adolescent girls. Conclusion: In this study, undernutrition in late adolescent girls remains a considerable public health problem in East Africa. Age group, educational status, marital status, family wealth index, family size, time taken to reach a water source, media exposure, and country of resident were significant determinants of undernutrition. Therefore, devising strategies that improve the socioeconomic status of households and/or adolescents would help to reduce the risks of undernutrition in late adolescents.

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BACKGROUND: Little evidence exists on the relationship between diet-related factors and child/adolescent malnutrition in Nigeria. This study aimed to assess the associations between household food insecurity (HFI), dietary diversity (DD), and dietary patterns (DP) with the double burden of malnutrition (DBM) among 6-19-year-olds in two Nigerian States. METHODS: This community-based cross-sectional study was carried out among 1200 respondents (6-19 years in age) in the Gombe and Osun States of Nigeria. HFI was assessed using the HFI access scale. DD was assessed using a 24-h dietary recall. DP were determined by principal component analysis using a 30-day food frequency questionnaire. DP scores were categorized into quartiles (Q) for statistical analysis. Diet-related predictors of DBM were assessed using logistic regression. RESULTS: HFI was experienced by 568 (47.3%) respondents. The median DD score was 7.0 (maximum of 14). Two DPs were identified, diversified DP (DDP) and traditional DP (TDP). TDP was significantly associated with both thinness (Q4:OR: 2.91; 95% CI: 1.52-5.55; Ptrend: 0.002) and overweight/obesity (Q4:OR: 2.50; 95% CI: 1.43-4.35; Ptrend: 0.007), while DDP was inversely related with thinness (Q4:OR: 0.36; 95% CI: 0.21-0.61; Ptrend: 0.008) as compared to Q1. CONCLUSIONS: TDP increased the odds for DBM, while the DDP reduced the odds.

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