Review of the nutrition situation in the Eastern Mediterranean Region (original) (raw)
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Nutritional status and its determinants in the Eastern Mediterranean region. A review
Saudi Medical Journal
Objectives: To review relevant literature on the determinants of the nutritional status of the children below 5 years of age in the Eastern Mediterranean Regional (EMR) countries and investigate the updates related to risk factors associated with malnutrition. Methods: A search of pertinent literature and databases was conducted using the PubMed and Google Scholar databases by applying some keywords. Results: From the available literature reviewed, the mean prevalence of underweight, wasting, and stunting of the children below 5 years of age in the EMR were 12.8% (6.4%-22.6%), 7.5% (5.9%-9.4%), and 24.2% (15.6%-35.5%) respectively. The EMR countries like Sudan, Yemen, Libya, Afghanistan and Pakistan showed the highest rate of stunting amongst the children (>30%). Furthermore, on average, 5.7% of the children were seen to be overweight. Countries such as Lebanon, Egypt, Syria, Libya, and Tunisia reported the maximal prevalence of overweight children. The study also identified a positive and negative relationship between demographic and socioeconomic and health determinants with nutritional status of these children under 5 years old. Conclusion: In this review, the researchers have highlighted the prevalence of malnutrition in EMR countries. Thereafter, the review findings recommend for prioritization of different policies which aimed to improve the nutritional status of the people.
Eastern Mediterranean Health Journal, 2004
Different nutritional disorders prevail at different stages in the life cycle, e. g. growth retardation in the fetus, protein energy deficiency in children, noncommunicable conditions in adults. The scope of nutrition assessment has changed over the past 2 decades. The focus shifted from pregnant and lactating mothers and children, through functional consequences of malnutrition to deficiency disorders. Now the focus is on obesity. Clinical methods of assessment [usually indicators of late-stage malnutrition] have become less important recently although clinical indicators of iodine deficiency and vitamin A deficiency are still useful. The key method now is anthropomorphic measurement, such as weight-for-age or body mass index. All the countries of the Region have nutrition education programmes for dissemination of information and most have drawn up national dietary guidelines applying the strategies that were developed after the 1992 International Conference on Nutrition
Nutrients
Background: With increasing global rates of overweight, obesity and non-communicable diseases (NCDs) along with undernutrition and micronutrient deficiencies, the Eastern Mediterranean Region (EMR) is no exception. This review focuses on specific nutrition parameters among under five years children, namely ever breastfed, exclusive breastfeeding, mixed milk feeding, continued breastfeeding, bottle feeding, introduction of solid, semi-solid, or soft foods and malnutrition. Methodology: PubMed, Google Scholar, United Nations International Children’s Emergency Fund (UNICEF) databases, World Health Organization (WHO) databases, the World Bank databases and the Global Nutrition Report databases were explored between 10 January and 6 June 2022, to review the nutrition situation among under five years children in the EMR. Results: The regional average prevalence of ever breastfed, exclusive breastfeeding, mixed milk feeding, continued breastfeeding, bottle feeding, introduction of solid, s...
Nutrition Research, 2018
The Eastern Mediterranean Region (EMR) is undergoing social and economic changes that may impact the nutritional status of children living in its countries. The objective of this review is to evaluate the nutritional status and dietary intakes of children (0-12 years) in selected EMR countries, namely, Jordan, Lebanon, Kingdom of Saudi Arabia (KSA), and the United Arab Emirates. MedLine, PubMed, Scopus, and Google Scholar were searched for relevant articles published between 1990 and 2016; international organizations and governmental websites were also searched. Stunting in the region was estimated at 7.3% to 9.3%, wasting at 1.1% to 11.8%, and underweight at 1.6% to 5.3%. In contrast, overweight and obesity affected 19% to 21% of school-aged children from Lebanon and KSA. Available biochemical data showed that pediatric anemia, vitamin A, and vitamin D deficiencies remain a challenge in the region. Dietary intake studies have identified inadequate intakes of iron, calcium, zinc, folic acid, vitamin A, and vitamin D, concurrently with high intakes of fat, saturated fat, and sugar. This review provides valuable insight into the nutrition situation of children in 2 major areas of the EMR, the Levant and the Gulf, and identified several gaps and challenges in existing nutritional assessment studies. Key issues include the triple burden of malnutrition in this age group (underweight, nutrient inadequacies, and overweight/obesity), while calling for integrated action to improve the nutritional status of children in countries of the region. Opportunities for future research include nationwide nutritional and dietary surveys in countries where the largest data gaps remain such as the United Arab Emirates and KSA.
Children
The World Health Organization’s (WHO) Eastern Mediterranean Region (EMR) is suffering from a double burden of malnutrition in which undernutrition coexists with rising rates of overweight and obesity. Although the countries of the EMR vary greatly in terms of income level, living conditions and health challenges, the nutrition status is often discussed only by using either regional or country-specific estimates. This analytical review studies the nutrition situation of the EMR during the past 20 years by dividing the region into four groups based on their income level—the low-income group (Afghanistan, Somalia, Sudan, Syria, and Yemen), the lower-middle-income group (Djibouti, Egypt, Iran, Morocco, Pakistan, Palestine, and Tunisia), the upper-middle-income group (Iraq, Jordan, Lebanon, and Libya) and the high-income group (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates)—and by comparing and describing the estimates of the most important nutrition indicators, in...
2020
Background: Indicators for Breastfeeding are often used to assess the Ten steps to successful breastfeeding. Exclusive breastfeeding in the first six months and continued breastfeeding rates are the main indicators. Aim: To examine the trends of the global infant feeding indicators from 1995 to 2020 in the countries of the Eastern Mediterranean region. Methods: The Global database of infant feeding indicators of UNICEF/WHO/World Bank was used as the source of the data. The data was recruited from household surveys of country demographic health surveys multiple indicator cluster surveys or Family Health population surveys with comparable methodologies. The indicators included exclusive breastfeeding (EBF) (0-6 months), early initiation of breastfeeding (EIBF), continued breastfeeding for 12-23 months, 12 to 15 months and 20-23 months of age. A trend was established for surveys clustered
Journal of Pediatric Care, 2018
Background: Countries in the Eastern Mediterranean region (EMR) are facing many challenges that hinder progress in reduction of mortality rates (MRs) and nutritional status of children under-five years of age (CU5). Hence there is a need to identify breastfeeding practices that can influence malnutrition and MRs in the region. Aim: To analyze regional data of malnutrition, mortality and breastfeeding practices in mothers and CU5 in the EMR countries. Methods: Data from regional surveys of WHO and UNICEF for nutritional status and MRs in the EMR countries were analyzed in total and by income group and correlated to breastfeeding practices including timely first suckle (TFS), exclusive breastfeeding (EBF), breastfeeding rates at 12 (BR12) and 24 months (BR24) and percent designated Baby-friendly hospitals (DBFH). MRs included neonatal mortality rates (NMR), infant mortality rates (IMR), under-five mortality rates (U5MR), maternal mortality ratio (MMR). Selected indicators for development included illiteracy rates and total fertility rates (TFR). Results: Practices of early initiation (TFS), EBF, and continuity of breastfeeding are low in the region. MRs correlated with percent DBFH, TFS, EBF. Also BF12 and BF24 months correlated with stunting, wasting in the CU5, U5MR and overweight and obesity in adults. MRs correlated highly with stunting and wasting and poorly with overweight or obesity in CU5. Other variables as illiteracy, TFR, obesity and overweight in adults correlated significantly with MRs and with breastfeeding duration. At country level the low trends of shortened breastfeeding duration were associated with the high MRs and malnutrition rates. Conclusion: Suboptimal early feeding practices, low EBF and declines in breastfeeding duration impact child growth and survival and are associated with high stunting, wasting, overweight and mortality in CU5. Indices of development as improving literacy, birth spacing and can also help improve survival of children and mothers in the region.
Journal of Nutrition & Weight Loss, 2018
Background: The Eastern Mediterranean region (EMR) countries are facing many challenges that influence the nutritional status of children under-five years of age (CU5) and increase early mortality rates (MRs). Few studies have considered using global data to analyze the protective effect of breastfeeding on reducing MRs in the EMR. Aim: To analyze regional mortality rates in relation to socio-demographic, nutritional indices and early feeding practices in CU5 in the EMR countries. Methods: Data from the WHO global data bank for nutritional status and MRs in the 22 countries in EMR were analyzed MRs included neonatal mortality rates (NMR), infant mortality rates (IMR), under-five mortality rates (U5MR), maternal mortality ratio (MMR). Data was analyzed by income group and correlated to obesity and underweight, early feeding practices including early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), breastfeeding rates at 12 (BR12) and 24 months (BR24) and selected indicators for development included illiteracy rates and total fertility rates (TFR). Results: MRs correlated with global data for country rates EIBF, EBF. Also BF12 and BF24 months correlated with stunting, wasting in the CU5, U5MR and overweight and obesity in adults. MRs correlated highly with stunting and wasting and poorly with overweight or obesity in CU5. Other variables as illiteracy, TFR, obesity and overweight in adults correlated significantly with MRs and with breastfeeding duration. At country level the low trends of shortened breastfeeding duration were associated with the high MRs and rate for obesity and stunting. Conclusions: Suboptimal early feeding practices leading to the double burden of malnutrition influence MR in the under-five mortality rates in children. Improving early initiation rates and prolonging the duration of intense breastfeeding can reduce early mortality. This cannot be attained without improving social indicators of literacy and birth spacing i.e. a comprehensive developmental approach to child survival.
A Snapshot of Infant Feeding Patterns in the Eastern Mediterranean Region
2019
These indicators belong to a set of indicators whose purpose is to measure infant and young child feeding practices, policies and programmes. Infant and young child feeding practices directly affect the nutritional status and survival of children. Exclusive breastfeeding is the single most effective intervention to improve the survival of children. Improving infant and young child feeding practices is therefore critical to improved nutrition, health and development of children.