Food alone is not enough to stop/prevent or reverse stunting (most aggressive nutrition/food based intervention achieved 0.7 Z-score reduction in stunting or one third only). Many other factors play an important role in how the body receive, react, benefit from and respond to food. Enviromental enteropathy, gut microbiota, food toxins such as mycotoxin to mention a few all play a role. Does anyone have any thoughts or ideas on how to tackle this problem?
It is our conclusion from a cross-sectional study at rural Nepal.
Nearly two-thirds children were found malnourished in
Kapilvastu district of Nepal. By considering weight, height,
age, BMI and MUCA measurements of malnourished children
nearly half of them were found below the -2SD (Z score) and
one-fourths below -3SD (Z score) which is regarded as serious
condition and children need immediate intervention. Better
socio-economic status, mother’s age between 20-35 years, birth
order up to second, birth spacing more than two years between
two pregnancies, recommended exclusive breast feeding, early
recommended supplementary foods, complete immunization
and timely care seeking behaviors had positive effect on children
nutrition status and also these variables were found statistically
significant.
In the morden world peoples use numours kinds of synthetic chemicals, these chemical containing things are not properly disposed, synthetic compounds are continously leach out from that materials and enter in to food chain and atmosphere. Certain environmental chemicals are affect endocrine systems, maternal exposure of these toxic chemicals affect fetus development. suitable example is Phthalates, Bisphenol-A and some compounds used for food preservation (Rapered chips, finger chips etc...). these compounds also affect nutrient metabolism.
The food security approach addresses the problems of malnutrition levels, first ensure food diversity, then the economic access to food the third element is the proper use of food, ie the body is prepared to take advantage of the food to the fullest. In the case of mycotoxins, a problem arises that a safe food is not guaranteed
I think that the first step should be to establish an analytic model by which situations can be understood. Armed with that the problem and the appropriate solution can be determined.
There are two situations to consider:
1. The development of the condition of stunting
2. Recovery from stunting
I would suggest that the resource capture models could be a good starting point.
Consider this approach
Growth rate = n × e
Where n is the balance of nutrients and e is the efficiency of uptake/utilization.
Each of these parameters can be considered the sum of individual nutrients, with factors such as enteropathy and mycotoxins changing the efficiency. For instance Aflatoxin can interfere in protein synthesis, so exposure would result in a low protein efficiency, while the same toxin can result in decreased zinc status and prolong diarrhea impacting all nutrients.
Applied to a diagnostic tool the diet can be evaluated and the known deficiencies identified first, and the risk of others predicted. For instance an infant being fed enough corn, beans and veg but with a deficient growth rate will be at risk of aflatoxicosis,if the diet does not have gave the beans then the resource for growth is limiting.
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