International Journal of Child Health and Nutrition

281-295

Authors: M Mazharul Islam, Khalid Al-Thihli, Mohamed Abdellatif

Background: Preterm births (PTB) and low birth weight (LBW) - the two distinct adverse pregnancy outcomes - are the major determinants of perinatal survival and development. The purpose of this study was to determine the incidence of LBW and PTB and identify the maternal and neonatal risk factors influencing them. Methods: Data for the study come from a cross-sectional retrospective study conducted at the maternity ward of Sultan Qaboos University Hospital (SQUH) in Oman during the period between November 2011 and February 2012. Data on 534 singleton live births that occurred during the study period were extracted from hospital record. Descriptive statistics, bivariate analysis and multivariate logistic regression model were used for data analysis. Results: The incidence of PTB and LBW were observed to be 9.7% and 13.7% respectively. Half (51.8%) of the LBW babies were PTB and 48.2% of the LBW babies were of term births. Differences and similarities were noted for the risk profile for PTB and LBW. Risk factors specific to PTB were maternal age, previous pregnancy loss, and infant’s length, while birth interval, maternal weight and BMI during pregnancy, and gestational age were the risk factors unique to LBW. ANC visit, infant’s gender, Apgar score, and head circumference of infants were the common significant risk factors influencing both LBW and PTB. Conclusions: The incidence of PTB and LBW are moderately high in Oman. They are associated with different risk factors. A greater understanding and modification of identified risk factors would help reduce the incidence of PTB and LBW in Oman.

309-315

Authors: Ross Grant, Jade Guest, Ayse Bilgin, Margaret J. Morris, Manohar Garg, Robyn Pearce

Objective:To quantitate the omega-3 status in a cohort of Australian adolescents. Design, Setting and Participants: A cross-sectional descriptive study of 251 apparently healthy adolescents (192 female, 59 male) aged 15-17 years, in year 11, from 10 schools within the Northern Sydney and Central Coast areas of New South Wales. Participants provided a morning non-fasting blood sample via finger-prick and written answers to specific demographic and lifestyle questions. Omega-3 index was calculated by adding %EPA and %DHA values in the whole blood. Equivalent erythrocyte omega-3 index values were obtained by using conversion factors (1.33 for EPA and 2.22 for DHA) from published erythrocyte/whole blood values. Main Outcome Measures: Quantitation of the individual, and estimation of the group average, blood omega-3 Index. Results: The blood omega-3 Index for this adolescent cohort ranged from 2.1-22.3 with a mean of 8.3±3.2, and median of 7.8. On average males had a higher omega-3 Index compared to females (10.5±3.7 vs 7.7±2.6, p<0.001). Fifty three percent of adolescents tested had an omega-3 Index below the optimum of >8. Three percent had an Index of <4, placing them in the high risk category for disease. On average, adolescents from low or medium socioeconomic communities had a significantly lower omega-3 Index compared to those from higher socioeconomic neighbourhoods (mean difference=1.4, p=0.018). Overall 20% of boys and 17% of girls reported regularly taking omega-3 supplements. Regular use of omega-3 supplements was associated with a higher average omega-3 Index (9.8±3.7, n=44 compared to 8.0±3.0, n=203, p=0.001 in those not taking supplements). Conclusion:This study indicates that Australian adolescents, even when from advantaged homes, have a high probability of below optimum omega-3 levels. As reduced omega-3 levels are linked to conditions of public health concern such as diabetes, asthma and depression, targeted strategies to improve the omega-3 status in the childhood population may be warranted

326-334

Authors: Giacomo Lazzeri, Valentina Pilato, Andrea Pammolli, Rita Simi, Daniela Galeone, Emanuela Balocchini, Mariano Vincenzo Giacchi

Background: The ...e vai con la frutta (let’s go with fruit) project was designed to respond to the worrying low consumption of fruits and vegetable in the large portion of population, especially in youth. The main objective was to increase fruit and vegetable consumptions at school level. Methods: In 2010/11, we randomly selected subjects from middle and high schools in five Italian regions. The subjects were randomly divided into two groups: intervention (I) and control (C). A questionnaire on fruits and vegetables consumption was administered, at the baseline as well as at end of the period. The sample size was evaluated on the expected frequency of 0.5 for a binomial random variable, of ± 1.54% with IC of 95%. Results: These results confirmed that adolescent students at baseline survey eat less than the amount of fruits and vegetables consumption recommended by the International guidelines. After the intervention time, we observed an increment in fruits and vegetables consumptions both in middle and high school students. Regarding the impact of the intervention on the factors like knowledge, attitudes and behaviour, there was a positive change in the behaviour only in the intervention group, in coherence with the consumption variations examined. Conclusions: This study is the first time that fruits and vegetables were offered at such a large scale through vending machines at schools in five regions. Several vending companies under this project agreed to revise the list of healthy snacks offered to eliminate those clearly classified as junk foods

353-358

Authors: Jesmin Akter, Kazi Rumana Ahmed, Hasina Akhter Chowdhury, Sharmin Hossain, Begum Rowshan Ara

Background: Childhood diarrheal diseases have a major impact on morbidity and mortality and these deaths are due to dehydration and mismanagement or delayed management of the disease. The mothers’ knowledge in management of diarrhea is likely related to its mortality and morbidity. The study aimed to determine the association between socio demographic attributes and mother’s knowledge on childhood diarrhea. Materials and Methods:In this cross sectional analytic study, 170 mothers who had at least one child aged below five years old were selected purposively from the out-patient department of ICDDR,B, Dhaka. Data were collected using a structured questionnaire by face to face interview. The level of knowledge was categorized as poor, average and good. Univariate and bivariate analysis were done with level of significance P<0.05. Results:The mean age of the respondents was 27 (SD=±5.6) years. Among them 46.5% were educated up to primary level and 47% had average monthly income between 5001 and 10000 taka. In the case of accessibility to mass media, 20% were found who never watch TV, 75.9% participants were found who never listen to radio, and 87.6% were found who never read newspaper. Despite the level of average knowledge was 59.5% but the proportion of the level of good knowledge was 17% among the respondents. Socio-demographic characteristics such as age, education and income (p<0.001) were significantly associated with mothers knowledge. Conclusion:The mothers had inadequate knowledge about diarrhea and their socio-demographic parameters are strongly associated with mother’s knowledge regarding diarrhea

367-376

Authors: Vered Kaufman-Shriqui, Anna Entin-Kreizman, Drora Fraser, Yelena Novack, Natalya Bilenko, Hillel Vardi, Naama Elhadad, Danit R. Shahar

Background: The ability to determine the relationship between diet and health outcomes in children requires reproducible and validated long-term dietary assessment tools such as food frequency questionnaire (FFQ). Objective: To test the reproducibility and relative validity of a FFQ for young children using 24-hour food recalls (24HRs), anthropometric measurements, and a comprehensive feeding practices questionnaire (CFPQ). Methods: Children (aged 5-6) and their mothers were recruited during one school-year (2008) from preschools. Children's anthropometric measurements were obtained. Mothers provided during a personal interview on three occasions a 110-item semiquantitative FFQ, 24HRs and CFPQ. Pearson-correlation coefficients were calculated between the results of the FFQ and 3*24HR. Validity coefficients between the FFQ and the different measurements were calculated. Scores of the 12 factors of the CFPQ were calculated and related to dietary intake. Results: Sixty-six healthy children (47% boys) were recruited. Pearson's correlations between the average of the FFQs and 3*24HRs ranged from 0.3-0.6 (P<0.05). The highest correlation coefficients were 0.59 for total fat intake and 0.56 for energy. Dietary intake of energy and carbohydrates differed significantly (P=0.05, 0.001 respectively) across the three BMI z-score levels (normal-weight, overweight, obese) and the three waist circumference tertiles (0.019, 0.006 respectively). Obesogenic factors from the CFPQ correlated with consumption of empty calories like sweets, snacks, junk foods and sweet drinks. Conclusions: The modified FFQ is a relatively valid instrument to estimate mean energy intake in preschool children. The questionnaire performs reasonably well to rank children with respect to macronutrients intake as well as obesogenic food groups.