ABSTRACT DIGEST ON MATERNAL AND CHILD NUTRITION RESEARCH – ISSUE 28

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In this issue of Abstract Digest, we present to you a collection of articles on various outcomes, determinants and interventions related to maternal and child nutrition, from around the world, with relevance to India. In addition, this issue features articles on multiple micronutrient supplementation in pregnancy from a special issue of Annals of the New York Academy of Sciences and a systematic scoping review of food environment research in low- and middle-income countries. Here are some of the highlights:

• Through a systematic analysis, Liu and colleagues (2019) estimated national and subnational all-cause and cause-specific mortality among children younger than 5 years annually in 2000–15 in India to understand progress made and to consider implications for achieving the Sustainable Development Goal (SDG) child survival targets.
  • In a comment to this study, Awasthi and colleagues (2019) analysed if regional differences in under-5 mortality in India reflect the burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease.
• Blencowe and colleagues (2019) report national-level estimates of low birthweight (LBW) for 148 countries in 2015 using population-based national or nationally representative datasets and examined trends (200-16), and found that there was some progress in reducing LBW. However, to meet the global nutrition target, progress has to be accelerated and should involve both improved measurement and programme investments to address the causes of LBW throughout the lifecycle.
• Analysing the stunting trajectories of children from post‐infancy to adolescence, in Ethiopia, India, Peru, and Vietnam, Gausman and colleagues (2019) showed catch‐up growth and recurrent stunting occur throughout childhood and there may be opportunities later into childhood and adolescence to improve child growth.
• Richard and colleagues (2019) used data from the MAL-ED cohort study to identify factors in the first 2 years of life that are associated with height-for-age, weight-for-age, and body mass index z-scores at 5 years of age and concluded that environmental enteric dysfunction (EED) markers, bacterial density, and iron markers are associated with growth at 5 y of age.
• Using the 2014 State of Food Security and Nutrition in Bangladesh report as an example, Tumilowicz and colleagues (2019) demonstrate that determining the true prevalence of undernutrition, overweight, and obesity among adolescents is complicated by racial/ethnic variation across populations in timing of the adolescent growth spurt, growth potential, and body build. The authors encourage researchers to critically examine interpretation of HAZ and BMIZ indicators and distributions by age when using the 2007 WHO Growth Reference.
• Through cross-sectional assessment, in high-burden pockets of four Indian states, Kumar and colleagues (2019) showed that mid-upper arm circumference (MUAC) is a strong predictor of maternal body mass index (BMI) among non-pregnant women with children <5 years. Hence, in a resource-constrained setting where measuring BMI may not be feasible, the MUAC cut-offs could reliably be used to screen wasting and severe wasting in non-pregnant women for providing appropriate care.
• Using data from the fourth National Family Health Survey 2016, Swaminathan and colleagues (2019) developed and applied two geographic information systems methodologies to provide estimates of four child malnutrition indicators (stunting, underweight, wasting, and anemia) for the 543 parliamentary constituencies in India.
  • Discussing this article, Goli (2019) questioned the reliability of methodologies used. In their response, Blossom and colleagues (2019) reiterated the reliability and usability of the methodologies proposed by Swaminathan et al., emphasising that these can provide broad assessments at the parliamentary constituency level.
• Using data from India’s fourth round of National Family Health Survey, Nguyen and colleagues (2019) concluded that children born to adolescent mothers are at a higher risk of being undernourished.
  • In a commentary on this article, Bhan (2019) talked about identifying interventions policies to end child and early marriage in India and adding robust measures of gender empowerment to adolescent health programmes.
• Ogbo and colleagues (2019) used a sample from the 2015–16 India National Family Health Survey to estimate the exclusive breastfeeding (EBF) prevalence and other breastfeeding patterns by region and investigate the association between the study factors (child, maternal, household, health service and community factors) and EBF by regional areas.
• In a special issue on multiple micronutrient supplementation in pregnancy:
  • Black and colleagues (2019) investigated the benefits of supplementation with multiple micronutrients in pregnancy.
  • Bourassa and colleagues (2019) reviewed evidence regarding the use of antenatal multiple micronutrient supplementation in low‐ and middle‐income countries.
  • Gernand (2019) examined the risk of excess micronutrient intake in pregnancy from antenatal supplements.
• Using data from two national surveys, Swaminathan and colleagues (2019) demonstrated that relation between iron intake and the odds of anemia was weak. Hence providing fortified iron alone may not result in substantial anemia reduction among women of reproductive age in India.
• Nguyen and colleagues (2019) examined the multi‐factorial determinants (personal, family, community, and health services) associated with maternal nutrition practices in Uttar Pradesh, India.
• Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, the GBD 2017 Diet Collaborators (2019), evaluated 15 dietary risks for their effects on mortality and disability from cancers, cardiovascular diseases, and diabetes.
  • In a comment to this study, Forouhi and Unwin (2019) raised questions about optimal diet, suboptimal diet, and significant dietary components.
• In a systematic scoping review, Turner and colleagues (2019) did a food environment research in low- and middle-income countries (LMICs) and concluded that food availability was associated with dietary outcomes at the community and school scales across multiple LMICs, although associations varied by vendor type. However, evidence regarding associations between the food environment and nutrition and health outcomes was inconclusive.
• Minocha and colleagues (2019) demonstrated that promoting appropriate levels of production and consumption of high-quality foods rich in protein is critical in India's attempts to enhance diet quality and resolve levels of undernutrition.

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