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Background WHO and the Lancet reported that malaria and malnutrition form a double health burden in low and middle-income countries. Despite the massive implementation of malaria control interventions, there is scarce evidence on the impact of intermittent preventive therapy (IPTsc) for malaria on the nutritional status of school-age children. In this study, we aimed to determine malnutrition risk factors and evaluate the impact of IPTsc for malaria on the nutritional status of school-age children in Muheza, Tanga, Tanzania. Methods We analysed secondary data from a cross-sectional baseline survey and a randomized controlled open-label trial conducted in Muheza, Tanga, Tanzania. Participants of our study were children of age 5–15 years. Baseline data collection was carried out between February-April 2019. The study continued through December 2020, during which participants were randomly assigned to one of the three groups: dihydroartemisinin-piperaquine (DP), artesunate-amodiaquine (ASAQ), or a control group, using a 3-arms balanced block design with a 1:1:1 allocation ratio. Intervention treatments were administered at recruitment, 4 months, and 8 months of the trial. Data were analysed using logistic regression and a linear mixed model. Findings At baseline, the prevalence of malaria was 27%. The prevalence of being underweight among children of ≤ 10 years was 23%. Among all children surveyed at baseline, 21% were stunted and 28% were either thin or severely thin. The odds of stunting were 78% higher (AOR = 1.78, 95%CI = [1.36, 2.33], P  < 0.001) among children who had malaria compared with those who did not have malaria. Children from low socioeconomic status (SES) had higher odds of being underweight (AOR = 1.50, 95%CI = [1.13,2.01], P  = 0.006) compared with their high SES counterparts. During the intervention, change in mean weight, height, and BMI over time as estimated from age-treatment interaction was not significantly different in the dihydroartemisinin-piperaquine (DP) and Artesunate amodiaquine (ASAQ) treatment groups compared with the control group. Conclusion Although substantial efforts to control malaria are ongoing in the study setting, the dual burden of malaria and malnutrition remains significant. Anti-malaria use for preventive purpose may not be sufficient to improve nutritional status, reinforcing that integrated interventions are required to address both malaria and malnutrition. Public health efforts should combine malaria control with nutrition programs, including community-driven strategies to enhance sustainable nutrition education and access to adequate food at home and school. Protocol for the parent study that generated these data was registered with ClinicalTrials.gov (NCT03640403) on Aug 21, 2018.

Prevalence ranges to classify levels of wasting and stunting have been used since the 1990s for global monitoring of malnutrition. Recent developments prompted a re-examination of existing ranges and development of new ones for childhood overweight. The present paper reports from the WHO-UNICEF Technical Expert Advisory Group on Nutrition Monitoring. Thresholds were developed in relation to sd of the normative WHO Child Growth Standards. The international definition of 'normal' (2 sd below/above the WHO standards median) defines the first threshold, which includes 2·3 % of the area under the normalized distribution. Multipliers of this 'very low' level (rounded to 2·5 %) set the basis to establish subsequent thresholds. Country groupings using the thresholds were produced using the most recent set of national surveys. One hundred and thirty-four countries. Children under 5 years. For wasting and overweight, thresholds are: 'very low' (≈6 times 2·5 %). For stunting, thresholds are: 'very low' (≈12 times 2·5 %). The proposed thresholds minimize changes and keep coherence across anthropometric indicators. They can be used for descriptive purposes to map countries according to severity levels; by donors and global actors to identify priority countries for action; and by governments to trigger action and target programmes aimed at achieving 'low' or 'very low' levels. Harmonized terminology will help avoid confusion and promote appropriate interventions.

Caregivers require tangible (e.g. food and financial) and intangible resources to provide care to ensure child health, nutrition and development. Intangible resources include beliefs and knowledge, education, self-efficacy, perceived physical health, mental health, healthy stress levels, social support, empowerment, equitable gender attitudes, safety and security and time sufficiency. These intangible caregiver resources are included as intermediate outcomes in nutrition conceptual frameworks yet are rarely measured as part of maternal and child nutrition research or evaluations. To facilitate their measurement, this scoping review focused on understudied caregiver resources that have been measured during the complementary feeding period in low- and lower-middle-income countries. We screened 9,232 abstracts, reviewed 277 full-text articles and included 163 articles that measured caregiver resources related to complementary feeding or the nutritional status of children 6 months to 2 years of age. We identified measures of each caregiver resource, though the number of measures and quality of descriptions varied widely. Most articles (77 %) measured only one caregiver resource, mental health ( 83) and social support ( 54) most frequently. Psychometric properties were often reported for mental health measures, but less commonly for other constructs. Few studies reported adapting measures for specific contexts. Existing measures for mental health, equitable gender attitudes, safety and security and time sufficiency were commonly used; other constructs lacked standardised measures. Measurement of caregiver resources during the complementary feeding period is limited. Measuring caregiver resources is essential for prioritising caregivers and understanding how resources influence child care, feeding and nutrition.

To study infant and young child feeding (IYCF) practices and their association with nutritional status among young children. A community-based, cross-sectional study was carried out in ten states of India, using a multistage random sampling method. Anthropometric measurements such as length/height and weight were conducted and nutritional assessment was done using the WHO child growth standards. National Nutrition Monitoring Bureau survey, 2011-2012.ParticipantsChildren aged <3 years and their mothers. Only 36 % of infants received breast-feeding within an hour of birth and 50 % were exclusively breast-fed up to 6 months. Prevalence of underweight, stunting and wasting was 38, 41 and 22 %, respectively. The chance of undernutrition among <3-year-old children was significantly higher among those from scheduled caste/scheduled tribe communities, the lowest-income group, with illiterate mothers and lack of sanitary latrine. Among infants, the chance of undernutrition was significantly higher among low-birth-weight babies, and among children whose mother had not consumed iron-folic acid tablets during pregnancy. Immunization practices and minimum dietary diversity were observed to be associated with undernutrition among 12-23-month-old children. Undernutrition is still an important public health problem in India and observed to be associated with low socio-economic status, illiteracy of mother, low birth weight and dietary diversity. Improving socio-economic and literacy status of mothers can help in improving maternal nutrition during pregnancy and thus low birth weight. Also, improving knowledge of mothers about IYCF practices will help in improving children's nutritional status.

The present study aimed to evaluate the association of frequency of consuming takeaway meals and meals out with diet quality of UK adolescents. The Diet Quality Index for Adolescents (DQI-A) tool was used to assess diet quality, where adolescents' food intake was based on 4d diary records obtained from the UK cross-sectional National Diet and Nutrition Survey (NDNS) rolling programme Years 1-6. Models included confounders. The DQI-A relies on three components, specifically diet quality, diversity and equilibrium, which reflect the degree of adherence of an adolescent's diet with food-based dietary guidelines.ParticipantsBritish (n 2045) adolescents aged 11-18 years. Mean diet quality score for all adolescents was 20·4 % (overall DQI-A score range: -33 to 100 %). After adjusting for age, gender and equivalised household income, DQI-A% score was higher for low and moderate takeaway consumers by 7·4 % (95 % CI 5·5, 9·2; P<0·01) and 3·5 % (95 % CI 1·9, 5·1; P<0·01), respectively, v. frequent consumers. Significant differences were also observed between low, moderate and frequent takeaway consumers among all DQI-A components and sub-components (P<0·05), except for the diet adequacy sub-component (DAx). Results for frequent consumption of meals out were similar but attenuated and not statistically significant for individual components before or after adjusting for confounders. Frequent consumption of takeaway meals may have a negative impact on adolescents' diet quality and therefore policies to reduce the intake of takeaways should be considered in this age group.

The present study aimed to take stock of nutrition interventions that warrant consideration as a minimum package of interventions in Indonesia to improve four key nutrition indicators for adolescents: stunting, thinness, overweight and anaemia. We conducted a review of the peer-reviewed literature published between 1995 and 2017 on nutrition-specific and nutrition-sensitive interventions that target adolescents in Indonesia. The search to identify studies was conducted in PubMed, Google Scholar and EMBASE, using key search terms. We also explored programmatic and policy documents from the grey literature as they related to adolescents and/or Indonesia. Our search yielded thirty-five peer-reviewed articles and programmatic documents. Indonesia. Adolescent girls and boys. There is very limited evidence on the impact of interventions specifically among adolescents in Indonesia. Nevertheless, findings from our review suggest the minimum package of interventions in Indonesia could include the following nutrition-specifc interventions: (i) iron-folic acid supplements, paired with antihelminths delivered at scale via school-based platforms and through health centres; and (ii) diet counselling and nutrition education provided through school-based platforms, adolescent youth centres/peer education and technology-based platforms. The minimum package could also include the following nutrition-sensitive interventions: (i) improving access to reproductive health services; and (ii) increasing the coverage of interventions designed to increase school attendance. Programmes and policies targeting adolescent nutrition are relatively new and coverage is low. To improve the nutritional status of this vulnerable population, additional evaluations of adolescent programming and surveillance data on adolescents are needed.

The main objective of the present study was to develop and evaluate a nutrition education curriculum to enhance young children's dietary behaviours and nutrition and health knowledge. A randomized controlled design was utilized. The intervention was designed to improve children's nutrition and health knowledge and preferences for fruits and vegetables through classroom lessons and activities, including direct instruction and tastings (implemented twice per week for 6 weeks). The study took place in elementary schools in a Midwestern US state. One hundred and thirty-one 2nd grade children from ten classrooms (n 82 intervention, n 49 control) participated. Multiple regression analyses that adjusted se for clustering by classroom were used to test hypotheses. Children in the intervention condition demonstrated significantly higher scores on the nutrition and health survey (β=0·47, P=0·001) and showed greater preferences for fruits and vegetables at post-test than the control group (β=0·19, P=0·003). Findings suggest that a short, 6-week intervention that aligns with educational standards has the ability to significantly enhance children's outcomes and thus may be a more feasible option for teachers to incorporate into their classrooms than what is currently available.

(13) review the literature on nutrition interventions for adolescents in Indonesia and, although there was limited information, recommended iron–folic acid supplements, anti-helminths and nutrition education delivered through schools, along with further work on this topic. (2019) Infant and young child feeding practices, sociodemographic 2 factors and their association with nutritional status of children aged <3 years in India: findings of the National Nutrition Monitoring Bureau survey, 2011–2012. (2019) High-risk environments for eating foods surplus to requirements: a multilevel analysis of adolescents’ non-core food intake in the National Diet and Nutrition Survey (NDNS).

Interventions to reduce adolescents' non-core food intake (i.e. foods high in fat and sugar) could target specific people or specific environments, but the relative importance of environmental contexts v. individual characteristics is unknown. Cross-sectional. Data from 4d food diaries in the UK National Diet and Nutrition Survey (NDNS) 2008-2012 were analysed. NDNS food items were classified as 'non-core' based on fat and sugar cut-off points per 100g of food. Linear multilevel models investigated associations between 'where' (home, school, etc.) and 'with whom' (parents, friends, etc.) eating contexts and non-core food energy (kcal) per eating occasion (EO), adjusting for variables at the EO (e.g. time of day) and adolescent level (e.g. gender).ParticipantsAdolescents (n 884) aged 11-18 years. Only 11 % of variation in non-core energy intake was attributed to differences between adolescents. In adjusted models, non-core food intake was 151 % higher (ratio; 95 % CI) in EO at 'Eateries' (2·51; 2·14, 2·95) and 88 % higher at 'School' (1·88; 1·65, 2·13) compared with 'Home'. EO with 'Friends' (1·16; CI 1·03, 1·31) and 'Family & friends' (1·21; 1·07, 1·37) contained 16-21 % more non-core food compared with eating 'Alone'. At the individual level, total energy intake and BMI, but not social class, gender or age, were weakly associated with more non-core energy intake. Regardless of individual characteristics, adolescents' non-core food consumption was higher outside the home, especially at eateries. Targeting specific eating contexts, not individuals, may contribute to more effective public health interventions.

Rates of migration have increased substantially in recent years and so has the number of left-behind children (LBC). We investigated the impact of parental migration on nutritional disorders of LBC in Bangladesh. We analysed data from the nationally representative cross-sectional Multiple Indicator Cluster Survey 2012-2013. Child stunting, wasting and underweight were used as measures of nutritional disorders. Descriptive statistics were used to describe characteristics of the respondents and to compare nutritional outcomes based on status of parental migration. Multivariate logistic regression models were used to examine the associations between parental migration and child nutritional disorders. Bangladesh.ParticipantsData of 23 402 children (aged <5 years), their parents and households. In the unadjusted models, parental migration was found significantly protective for stunting, wasting and underweight - both separately and jointly. After potential confounders were controlled for, no difference was found between LBC and non-LBC in any of these three nutritional outcome measures. Household wealth status and maternal educational status were found to significantly influence the nutritional development of the children. At the population level there is no negative impact of parental migration on stunting, wasting and underweight of LBC in Bangladesh. Remittance from parental migration might enhance affordability of better foods, health care and supplies for a cleaner environment. This affordability is crucial for the poorest section of the society.