Malnutrition In Young Women Can Leave Communities Stuck In A Poverty Trap

Main Category: Nutrition / Diet
Also Included In: Women's Health / Gynecology
Article Date: 28 Jan 2008 - 4:00 PDT

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Maternal and child under-nutrition have a life-long impact on the health and prospects of the child, potentially affecting future generations. An international collaboration of scientists using five long-standing population studies looking at nutrition, health and human capital in developing and middle-income countries has found that the impact of malnourishment in young mothers and their babies has consequences well beyond infant health and mortality.

Conducting a review of published work combined with new data analyses on communities in Brazil, Guatemala, India, the Philippines and South Africa, the team was able to show that undernutrition was strongly associated with shorter adult height, less schooling, and reduced economic productivity. These poorer life outcomes were also often passed on from one generation to the next with the offspring of undernourished mothers also displaying low birth weight.

The team also found that lower birth weight and under-nutrition in early childhood were risk factors for high glucose concentrations, blood pressure and coronary heart disease in later life, once adult BMI and height were taken into account. This would suggest that the malnutrition suffered in the womb and as an infant could not be reversed simply by access to more food at a later stage in life.

Professor Caroline Fall, of the MRC Epidemiology Resource Centre in Southampton one of the authors who predominantly looks at nutrition in India said: "Children who are undernourished in the first 2 years of life and who put on weight rapidly later in childhood and in adolescence are at high risk of chronic diseases related to nutrition. It would appear their metabolism, which is largely set during early development, is particularly ill-equipped for coping with times of plenty they may experience later in life. Having said that, rapid height gain in the first 2 years of life is not associated with adverse health consequences in later life."

Professor Fall is spearheading a large-scale intervention trial in Mumbai looking at the impact of better diet on mother and offspring by recruiting young women before they become pregnant and providing them with a daily dietary supplement (in the form of a samosa) high in micronutritients. The trial is still in early stages, but it is hoped it will provide evidence for what intervention may work to address the problem of poor maternal and child nutrition in India.

"The damage suffered as a result of mother and child under-nutrition leads to permanent physical and mental impairment, and also harms future generations. Populations who are severely affected by stunting and the negative health and life impacts of under-nutrition in early life will be less able to grasp opportunities to climb out of poverty. We simply must find ways of addressing these problems," concluded Professor Fall.

Notes

1. Maternal and child undernutrition: consequences for adult health and human capital, Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, Singh Sachdev H, is published in the Lancet, 25 January 2008.

2. Professor Caroline Fall is a member of consultative group on Maternal and Child Health commissioned by the Lancet and of the COHORTS group (Cohort Studies of Health Outcomes Research in Transitional Societies), a collaboration of epidemiologists working with birth cohorts in Brazil, the Philipines, South Africa and India.

3. The MMNP (Mumbai Maternal Nutrition Project) is a randomised controlled trial of two combinations of vegetables. The primary hypothesis being tested is that maternal pre-pregnancy micronutrient status is limiting for foetal growth. Analysis will be by intention to treat so once randomised it is intended that ALL subjects will be followed IRRESPECTIVE of compliance with the intervention/supplement. The trial is nested within a larger project designed to empower women to independently improve their own nutrition and that of their children. The study area is Bandra East and Khar. The WIN (Women of India Network) run by the Centre for the Study of Social Change, is the focal point for data collection, registration and pregnancy follow through.

4. Research Councils UK has this week opened a new office in India, which will encourage further collaboration between researchers in both countries.

Medical Research Council