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1.
A Narrative Review of Nutritional Malpractices, Motivational Drivers, and Consequences in Pregnant Women: Evidence from Recent Literature and Program Implications in Ethiopia.
Kibr, G
TheScientificWorldJournal. 2021;:5580039
Abstract
Maternal nutrition is very important for the wellbeing of pregnant women, childbirth, and lactating women, which are crucial and meant for the wellbeing of a mother and newborn baby. This narrative review discusses nutritional malpractices, motivational drivers, and their consequences typically from Ethiopian pregnant women's context. Different studies (regarding less of study design and type) done among pregnant women (aged 15-49 years) by considering pregnancy-related outcomes and timing of nutritional malpractices were included mostly. Accordingly, taboos of healthy diets, craving for unhealthy foods (sweet, fat, raw, and salty/spicy foods), and nonfood items (soil, coffee residue, stone, and ash) were practiced majorly by the women. The birth difficulty, fetal head plastering, fetus discoloration, fetus burns, abortion, and abdominal cramp are the primary drivers of taboos of healthy diets. Hormonal change and social and nutrient-seeking behavior are the most prevalent drivers to the consumption of unhealthy foods. Additionally, personal interest, flavor, and color of items are important motivators to practice pica. Such pica practice hurts nutrient intake, absorption of iron/zinc, abdominal health, and diarrhea occurrence. Food taboos are high predictors of health disorders, such as intrauterine growth restriction, infection, bleeding, preeclampsia, stillbirth, early birth, low birth weight, retarded development of cognitive, and anemia. Craving and eating unhealthy foods were interconnected with chronic disease development (hypertension, diabetes, heart disease, and cancer), discomforts, preterm labor, preeclampsia, and intrauterine growth restriction in women. Additionally, it is also associated with stillbirth, low birth weight, obesity, birth defect/deficit, hypertension, cancer, diabetes, metabolic syndrome, renal disease, decreased fetal growth, behavioral change, heart failure, and poor cognitive development in the infant. Overall, these nutritional malpractices are significantly associated with many argumentative pregnancies as well as developmental consequences leading to the direction of infant and maternal mortality and morbidity. Therefore, urgent implementation of health and nutrition education programs considering food misconceptions and beliefs regarding pregnancy and use of ground-breaking ways to play down the negative and maximize potential positive dietary effects designed by the government of Ethiopia could also serve as a long-term solution to the problem.
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2.
Stunting, wasting and underweight as indicators of under-nutrition in under five children from developing Countries: A systematic review.
Verma, P, Prasad, JB
Diabetes & metabolic syndrome. 2021;(5):102243
Abstract
BACKGROUND AND AIMS To compute reliable estimates of stunting, wasting and underweight along with their determinants in under 5 children from Developing Countries. METHODS Out of 190 studies on under-nutrition, accessed from PubMed and Google database, 24 studies meeting the selection criteria were considered for meta-analysis. RESULTS Overall estimate of prevalence of stunting, wasting and underweight were 43.4%, 17.8% and 35.5% respectively. Mother's education, BMI, height, wealth index, child birth-weight and sex were factors significantly associated with stunting, wasting and underweight. CONCLUSIONS Prevalence of stunting, wasting and underweight in Developing Countries were quite high. To carry-out differentials of under-nutrition between countries and ways of its reduction, more such studies are required.
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3.
Interplay between early-life malnutrition, epigenetic modulation of the immune function and liver diseases.
Campisano, S, La Colla, A, Echarte, SM, Chisari, AN
Nutrition research reviews. 2019;(1):128-145
Abstract
Early-life nutrition plays a critical role in fetal growth and development. Food intake absence and excess are the two main types of energy malnutrition that predispose to the appearance of diseases in adulthood, according to the hypothesis of 'developmental origins of health and disease'. Epidemiological data have shown an association between early-life malnutrition and the metabolic syndrome in later life. Evidence has also demonstrated that nutrition during this period of life can affect the development of the immune system through epigenetic mechanisms. Thus, epigenetics has an essential role in the complex interplay between environmental factors and genetics. Altogether, this leads to the inflammatory response that is commonly seen in non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of the metabolic syndrome. In conjunction, DNA methylation, covalent modification of histones and the expression of non-coding RNA are the epigenetic phenomena that affect inflammatory processes in the context of NAFLD. Here, we highlight current understanding of the mechanisms underlying developmental programming of NAFLD linked to epigenetic modulation of the immune system and environmental factors, such as malnutrition.
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4.
Angiopoietin-like protein 3 and 4 in obesity, type 2 diabetes mellitus, and malnutrition: the effect of weight reduction and realimentation.
Cinkajzlová, A, Mráz, M, Lacinová, Z, Kloučková, J, Kaválková, P, Kratochvílová, H, Trachta, P, Křížová, J, Haluzíková, D, Škrha, J, et al
Nutrition & diabetes. 2018;(1):21
Abstract
BACKGROUND Angiopoietin-like proteins (ANGPTLs) 3 and 4 are circulating factors that participate in the regulation of lipid and glucose metabolism. SUBJECTS AND METHODS We measured serum ANGPTL3 and 4 levels in 23 patients with obesity, 40 patients with obesity and type 2 diabetes mellitus (T2DM), 22 patients with anorexia nervosa (AN), 15 subjects undergoing 72-h fasting, and 12 patients with short bowel syndrome (SBS), and their changes after very-low-calorie diet (VLCD), bariatric surgery, partial realimentation, acute fasting, and parenteral nutrition in order to assess their possible role in metabolic regulations. RESULTS Serum ANGPTL4 levels were higher in obese subjects without/with T2DM (94.50 ± 9.51 and 134.19 ± 7.69 vs. 50.34 ± 4.22 ng/ml, p < 0.001) and lower in subjects with AN relative to healthy control subjects (38.22 ± 4.48 vs. 65.80 ± 7.98 ng/ml, p = 0.002), while serum ANGPTL3 levels demonstrated inverse tendency. Nutritional status had no effect on ANGPTL3 and 4 mRNA expression in adipose tissue. Fasting decreased ANGPTL3 and increased ANGPTL4 levels, while VLCD reduced only ANGPTL3. Bariatric surgery and realimentation of AN or SBS patients had no effect on either ANGPTL. Multiple regression analysis identified BMI as an independent predictor of ANGPTL3; and BMI and HbA1c as independent predictors of ANGPTL4, respectively. CONCLUSIONS Taken together, our data suggest that serum ANGPTL3 and 4 levels are influenced by nutritional status and fasting and could be involved in the metabolic disturbances present in obesity and AN.
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5.
Rising trend of diabetes mellitus amongst the undernourished: State -of- the -art review.
Francis, NK, Pawar, HS, Mitra, A, Mitra, A
Diabetes & metabolic syndrome. 2017;:S169-S174
Abstract
Diabetes mellitus is prevailing in the malnourished populations congruently in well-nourished ones with an escalating trend in the former group regardless of the absence of obesity as an etiologic determining factor as per the studies in underprivileged sectors of the population. Chronic undernutrition across a lifetime may be an imperative stimulator of diabetes in an individual either by progressively reducing beta cell function alongside islet cell volume and increasing the individual predisposition to other genetic or environmental diabetogenic influences with modifying influence on the course of clinical syndrome. Ketosis resistant insulinopenia is irreversible to the sustained vigorous nutritional convalescence in a substantial fraction of malnourished subjects. It also debunks a latent diabetic stage with insulin resistance reflected by greater insulin requirement in comparison to the patients with type I diabetes with the same beta cell failure fraction and obese type II diabetic patients with equivalent glycemic control gauged by HbA1c levels. Current tendency warrants the replacement of conventional therapy by community oriented theranostic approaches and health programs to curb the epidemic.
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6.
Fetal programming of the metabolic syndrome.
Marciniak, A, Patro-Małysza, J, Kimber-Trojnar, Ż, Marciniak, B, Oleszczuk, J, Leszczyńska-Gorzelak, B
Taiwanese journal of obstetrics & gynecology. 2017;(2):133-138
Abstract
Prenatal development is currently recognized as a critical period in the etiology of human diseases. This is particularly so when an unfavorable environment interacts with a genetic predisposition. The fetal programming concept suggests that maternal nutritional imbalance and metabolic disturbances may have a persistent and intergenerational effect on the health of offspring and on the risk of diseases such as obesity, diabetes, and cardiovascular diseases.
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7.
Hematological disorders following gastric bypass surgery: emerging concepts of the interplay between nutritional deficiency and inflammation.
Chen, M, Krishnamurthy, A, Mohamed, AR, Green, R
BioMed research international. 2013;:205467
Abstract
Obesity and the associated metabolic syndrome are among the most common and detrimental metabolic diseases of the modern era, affecting over 50% of the adult population in the United States. Surgeries designed to promote weight loss, known as bariatric surgery, typically involve a gastric bypass procedure and have shown high success rates for treating morbid obesity. However, following gastric bypass surgery, many patients develop chronic anemia, most commonly due to iron deficiency. Deficiencies of vitamins B1, B12, folate, A, K, D, and E and copper have also been reported after surgery. Copper deficiency can cause hematological abnormalities with or without neurological complications. Despite oral supplementation and normal serum concentrations of iron, copper, folate, and vitamin B12, some patients present with persistent anemia after surgery. The evaluation of hematologic disorders after gastric bypass surgery must take into account issues unique to the postsurgery setting that influence the development of anemia and other cytopenias. In this paper, the clinical characteristics and differential diagnosis of the hematological disorders associated with gastric bypass surgery are reviewed, and the underlying molecular mechanisms are discussed.
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8.
Postoperative metabolic and nutritional complications of bariatric surgery.
Koch, TR, Finelli, FC
Gastroenterology clinics of North America. 2010;(1):109-24
Abstract
Bariatric surgery has become an increasingly important method for management of medically complicated obesity. In patients who have undergone bariatric surgery, up to 87% with type 2 diabetes mellitus develop improvement or resolution of their disease postoperatively. Bariatric surgery can reduce the number of absorbed calories through performance of either a restrictive or a malabsorptive procedure. Patients who have undergone bariatric surgery require indefinite, regular follow-up care by physicians who need to follow laboratory parameters of macronutrient as well as micronutrient malnutrition. Physicians who care for patients after bariatric surgery need to be familiar with common postoperative syndromes that result from specific nutrient deficiencies.
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9.
Metabolic and nutritional changes after bariatric surgery.
Salameh, BS, Khoukaz, MT, Bell, RL
Expert review of gastroenterology & hepatology. 2010;(2):217-23
Abstract
Bariatric surgery is the most durable intervention for severe obesity. Appropriate candidates for surgery include those with a body mass index over 40 kg/m(2), or those with a BMI over 35 kg/m(2) who also have weight-related comorbidities. Bariatric procedures are categorized as restrictive, where food intake is limited by a small gastric 'pouch'; malabsorptive, where the length of intestine available for nutrient absorption is decreased; or a combination of both. Although pure malabsorptive procedures, such as the now-historical jejunoileal bypass, achieve greater weight loss than restrictive procedures, they are generally associated with more postoperative metabolic problems. The Roux-en-Y gastric bypass is currently considered the gold standard bariatric procedure for most patients. It results in excellent weight loss with minimal complications, but does require life-long vitamin supplementation. Compliance with vitamins and supplements is also mandatory after malabsorptive procedures. With these procedures, decreased oral intake, as well as altered absorption of nutrients from the GI tract, results in potentially low blood levels of a variety of micronutrients, especially iron, vitamin B12 and folate. Bariatric surgery also improves the comorbid conditions that are associated with obesity, such as diabetes, hypertension, dyslipidemia, obstructive sleep apnea, obesity hypoventilation, gastroesophageal reflux disease, asthma, venous stasis, polycystic ovary syndrome and pseudotumor cerebri. The resolution of diabetes is secondary to weight loss and may also be due to alteration of the enteroinsular axis.
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10.
Undernutrition and growth restriction in pregnancy.
Bergmann, RL, Bergmann, KE, Dudenhausen, JW
Nestle Nutrition workshop series. Paediatric programme. 2008;:103-21
Abstract
Newborn size is the result of intrauterine growth. Premature, low birthweight of <2,500 g, small for gestational age (SGA, <10th percentile), or intrauterine growth-restricted (IUGR) newborns may have similar weights. Serial fetal biometry (ultrasound), required for the diagnosis, timing and severity of intrauterine growth restriction in the individual infant, is still not common in epidemiological studies. SGA newborns have less lean body mass, but they particularly lack fat mass. The most important etiological determinants of intrauterine growth restriction in developed countries is cigarette smoking, while in developing countries it is usually longstanding food deprivation. Follow-up studies of SGA newborns consistently showed a positive association between birthweight and later lean body mass, whereas associations with adiposity were more variable. Most SGA infants had catch-up in length/height. Signs of the metabolic syndrome accompanied the catch-up in bodyweight and central adiposity. So far, no overarching model is available to explain how the epigenetic and hormonal tunings, which accompany intrauterine malnutrition from preconception through pregnancy, can program the regulatory systems of fundamental life processes. The theoretical concepts of a thrifty phenotype (Hales and Barker) and of a predictive adaptive response (Gluckman and Hanson) offer a comprehensive approach to understanding the empirical and experimental findings.