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Current Nutrition Reports

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01-12-2018 | Maternal and Childhood Nutrition (AC Wood, Section Editor)

An Intergenerational Approach to Break the Cycle of Malnutrition

Authors: Katherine R. Arlinghaus, Chelsea Truong, Craig A. Johnston, Daphne C. Hernandez

Published in: Current Nutrition Reports | Issue 4/2018

Abstract

Purpose of Review

This article examines how nutritional status is treated throughout the lifecycle. In doing so, the review identifies promising life stages during which intervention may improve nutritional status of future generations.

Recent Findings

A life course perspective suggests that nutritional changes are most likely to be sustained when they occur during times of developmental transition, such as pregnancy or adolescence. Adolescence is a unique period in which malnutrition in future generations may be addressed because it is the first life stage at which pregnancy becomes feasible and individuals seek independence from parents.

Summary

A need exists to begin investigating not just how nutrition changes are sustained throughout the lifespan, but how nutritional intervention in one generation impacts the next. This intergenerational approach should be undertaken with cross-discipline collaboration to have the best chance at impacting underlying determinants of malnutrition like poverty and women’s education.

United Nations International Children’s Emergency Fund (UNICEF). Malnutrition. In: UNICEF data: monitoring the situation of children and women. 2018. https://data.unicef.org/topic/nutrition/malnutrition/. Accessed 7 Aug 2018.

Becker PJ, Nieman Carney L, Corkins MR, Monczka J, Smith E, Smith SE, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition). J Acad Nutr Diet. 2014;114(12):1988–2000. https://doi.org/10.1016/j.jand.2014.08.026.CrossRefPubMed

Tette EM, Sifah EK, Nartey ET. Factors affecting malnutrition in children and the uptake of interventions to prevent the condition. BMC Pediatr. 2015;15:189. https://doi.org/10.1186/s12887-015-0496-3.CrossRefPubMedPubMedCentral

Rodriguez L, Cervantes E, Ortiz R. Malnutrition and gastrointestinal and respiratory infections in children: a public health problem. Int J Environ Res Public Health. 2011;8(4):1174–205. https://doi.org/10.3390/ijerph8041174.CrossRefPubMedPubMedCentral

Fatima S, Ali Khan S, Fatima F. Nutritional supplements and their use in the treatment of malnutrition in developing countries. J Ayub Med Coll Abbottabad. 2015;27(4):911–22.PubMed

Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51. https://doi.org/10.1016/s0140-6736(13)60937-x.CrossRefPubMed

International Food Policy Research Institute. Global Nutrition Report 2016: From promise to impact: ending malnutrition by 2030. Washington, D.C.: 2016.

Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet. 2013;382(9890):452–77. https://doi.org/10.1016/s0140-6736(13)60996-4.CrossRefPubMed

• Abdullah A. The double burden of undernutrition and overnutrition in developing countries: an update. Curr Obes Rep. 2015;4(3):337–49. https://doi.org/10.1007/s13679-015-0170-y A health disparity continues to persist based on income level. Nutritional interventions are challenged by having to accommodate for both over- and undernutrition.CrossRefPubMed

10.

Min J, Zhao Y, Slivka L, Wang Y. Double burden of diseases worldwide: coexistence of undernutrition and overnutrition-related non-communicable chronic diseases. Obes Rev. 2018;19(1):49–61. https://doi.org/10.1111/obr.12605.CrossRefPubMed

11.

Tzioumis E, Adair LS. Childhood dual burden of under- and overnutrition in low- and middle-income countries: a critical review. Food Nutr Bull. 2014;35(2):230–43. https://doi.org/10.1177/156482651403500210.CrossRefPubMedPubMedCentral

12.

Barker DJ. The origins of the developmental origins theory. J Intern Med. 2007;261(5):412–7. https://doi.org/10.1111/j.1365-2796.2007.01809.x.CrossRefPubMed

13.

Wallack L, Thornburg K. Developmental origins, epigenetics, and equity: moving upstream. Matern Child Health J. 2016;20(5):935–40. https://doi.org/10.1007/s10995-016-1970-8.CrossRefPubMed

14.

Aizer A, Currie J. The intergenerational transmission of inequality: maternal disadvantage and health at birth. Science. 2014;344(6186):856–61. https://doi.org/10.1126/science.1251872.CrossRefPubMedPubMedCentral

15.

Hoffman DJ. Early nutrition and adult health: perspectives for international and community nutrition programs and policies. Nutr Res Pract. 2010;4(6):449–54. https://doi.org/10.4162/nrp.2010.4.6.449.CrossRefPubMedPubMedCentral

16.

Martorell R, Zongrone A. Intergenerational influences on child growth and undernutrition. Paediatr Perinat Epidemiol. 2012;26(Suppl 1):302–14. https://doi.org/10.1111/j.1365-3016.2012.01298.x.CrossRefPubMed

17.

Drake AJ, Liu L. Intergenerational transmission of programmed effects: public health consequences. Trends Endocrinol Metab. 2010;21(4):206–13. https://doi.org/10.1016/j.tem.2009.11.006.CrossRefPubMed

18.

Bowen M. Family therapy in clinical practice. Lanham: Jason Aronson; 1985.

19.

De-Regil LM, Harding KB, Roche ML. Preconceptional nutrition interventions for adolescent girls and adult women: global guidelines and gaps in evidence and policy with emphasis on micronutrients. J Nutr. 2016;146(7):1461s–70s. https://doi.org/10.3945/jn.115.223487.CrossRefPubMed

20.

Freizinger M, Franko DL, Dacey M, Okun B, Domar AD. The prevalence of eating disorders in infertile women. Fertil Steril. 2010;93(1):72–8. https://doi.org/10.1016/j.fertnstert.2008.09.055.CrossRefPubMed

21.

Dag ZO, Dilbaz B. Impact of obesity on infertility in women. J Turk Ger Gynecol Assoc. 2015;16(2):111–7. https://doi.org/10.5152/jtgga.2015.15232.CrossRefPubMedPubMedCentral

22.

Rooney KL, Domar AD. The impact of lifestyle behaviors on infertility treatment outcome. Curr Opin Obstet Gynecol. 2014;26(3):181–5. https://doi.org/10.1097/gco.0000000000000069.CrossRefPubMed

23.

McLean M, Wellons MF. Optimizing natural fertility: the role of lifestyle modification. Obstet Gynecol Clin N Am. 2012;39(4):465–77. https://doi.org/10.1016/j.ogc.2012.09.004.CrossRef

24.

Bailey MJ. Fifty years of family planning: new evidence on the long-run effects of increasing access to contraception. Brookings Pap Econ Act. 2013;2013:341–409. https://doi.org/10.1353/eca.2013.0001.CrossRefPubMedPubMedCentral

25.

• Gaskins AJ, Chavarro JE. Diet and fertility: a review. Am J Obstet Gynecol. 2018:379–89. https://doi.org/10.1016/j.ajog.2017.08.010. Current research does not support some popular hypotheses regarding specific dietary components and its effects on fertility. Links between folic acid, omega 3, and an adherence to a general healthy diet in relation to improved birth outcomes, fertility status, and conception factors are outlined in this review. A critical gap exists in distinguishing male and female dietary impacts on fertility.CrossRefPubMed

26.

Grieger JA, Grzeskowiak LE, Clifton VL. Preconception dietary patterns in human pregnancies are associated with preterm delivery. J Nutr. 2014;144(7):1075–80. https://doi.org/10.3945/jn.114.190686.CrossRefPubMed

27.

Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, Garcia FA, et al. Folic acid supplementation for the prevention of neural tube defects: US Preventive Services Task Force recommendation statement. JAMA. 2017;317(2):183–9. https://doi.org/10.1001/jama.2016.19438.CrossRefPubMed

28.

• Salas-Huetos A, Bullo M, Salas-Salvado J. Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies. Hum Reprod Update. 2017;23(4):371–89. https://doi.org/10.1093/humupd/dmx006 Male factors in fertility are less commonly explored despite its contribution to the global health issue of infertility. Adhering to a healthy diet was correlated with benefits in semen quality and fecundability rates. The reviewed literature indicates a need to further explore dietary intakes of males in relation to successful conception.CrossRefPubMed

29.

Giahi L, Mohammadmoradi S, Javidan A, Sadeghi MR. Nutritional modifications in male infertility: a systematic review covering 2 decades. Nutr Rev. 2016;74(2):118–30. https://doi.org/10.1093/nutrit/nuv059.CrossRefPubMed

30.

Toivonen KI, Oinonen KA, Duchene KM. Preconception health behaviours: a scoping review. Prev Med. 2017;96:1–15. https://doi.org/10.1016/j.ypmed.2016.11.022.CrossRefPubMed

31.

Homan G, Litt J, Norman RJ. The FAST study: fertility ASsessment and advice targeting lifestyle choices and behaviours: a pilot study. Hum Reprod. 2012;27(8):2396–404. https://doi.org/10.1093/humrep/des176.CrossRefPubMed

32.

Green-Raleigh K, Lawrence JM, Chen H, Devine O, Prue C. Pregnancy planning status and health behaviors among nonpregnant women in a California managed health care organization. Perspect Sex Reprod Health. 2005;37(4):179–83. https://doi.org/10.1363/psrh.37.179.05.CrossRefPubMed

33.

Gresham E, Bisquera A, Byles JE, Hure AJ. Effects of dietary interventions on pregnancy outcomes: a systematic review and meta-analysis. Matern Child Nutr. 2016;12(1):5–23. https://doi.org/10.1111/mcn.12142.CrossRefPubMed

34.

• Stang J, Huffman LG. Position of the Academy of Nutrition and Dietetics: obesity, reproduction, and pregnancy outcomes. J Acad Nutr Diet. 2016;116(4):677–91. https://doi.org/10.1016/j.jand.2016.01.008 Nutritional intervention is needed during both preconception and pregnancy to support healthy fetal growth and development. Recommended modifications to lifestyle vary based on mother’s pre-pregnancy weight. More research is needed regarding the association between maternal weight gain and birth outcomes. CrossRefPubMed

35.

Kominiarek MA, Rajan P. Nutrition recommendations in pregnancy and lactation. Med Clin North Am. 2016;100(6):1199–215. https://doi.org/10.1016/j.mcna.2016.06.004.CrossRefPubMedPubMedCentral

36.

Institute of Medicine, National Research Council Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy: reexamining the guidelines. Washington (DC): National Academies Press (US); 2009.

37.

Margerison Zilko CE, Rehkopf D, Abrams B. Association of maternal gestational weight gain with short- and long-term maternal and child health outcomes. Am J Obstet Gynecol. 2010;202(6):574.e1–8. https://doi.org/10.1016/j.ajog.2009.12.007.CrossRef

38.

Kapadia MZ, Park CK, Beyene J, Giglia L, Maxwell C, McDonald SD. Can we safely recommend gestational weight gain below the 2009 guidelines in obese women? A systematic review and meta-analysis. Obes Rev. 2015;16(3):189–206. https://doi.org/10.1111/obr.12238.CrossRefPubMed

39.

Jeric M, Roje D, Medic N, Strinic T, Mestrovic Z, Vulic M. Maternal pre-pregnancy underweight and fetal growth in relation to institute of medicine recommendations for gestational weight gain. Early Hum Dev. 2013;89(5):277–81. https://doi.org/10.1016/j.earlhumdev.2012.10.004.CrossRefPubMed

40.

Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. JAMA. 2017;317(21):2207–25. https://doi.org/10.1001/jama.2017.3635.CrossRefPubMedPubMedCentral

41.

Pongcharoen T, Gowachirapant S, Wecharak P, Sangket N, Winichagoon P. Pre-pregnancy body mass index and gestational weight gain in Thai pregnant women as risks for low birth weight and macrosomia. Asia Pac J Clin Nutr. 2016;25(4):810–7. https://doi.org/10.6133/apjcn.092015.41.CrossRefPubMed

42.

Ruhstaller KE, Bastek JA, Thomas A, McElrath TF, Parry SI, Durnwald CP. The effect of early excessive weight gain on the development of hypertension in pregnancy. Am J Perinatol. 2016;33(12):1205–10. https://doi.org/10.1055/s-0036-1585581.CrossRefPubMed

43.

Rong K, Yu K, Han X, Szeto IM, Qin X, Wang J, et al. Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies. Public Health Nutr. 2015;18(12):2172–82. https://doi.org/10.1017/s1368980014002523.CrossRefPubMed

44.

Johnson J, Clifton RG, Roberts JM, Myatt L, Hauth JC, Spong CY, et al. Pregnancy outcomes with weight gain above or below the 2009 Institute of Medicine guidelines. Obstet Gynecol. 2013;121(5):969–75. https://doi.org/10.1097/AOG.0b013e31828aea03.CrossRefPubMedPubMedCentral

45.

Brunner S, Stecher L, Ziebarth S, Nehring I, Rifas-Shiman SL, Sommer C, et al. Excessive gestational weight gain prior to glucose screening and the risk of gestational diabetes: a meta-analysis. Diabetologia. 2015;58(10):2229–37. https://doi.org/10.1007/s00125-015-3686-5.CrossRefPubMed

46.

Rogozinska E, Marlin N, Jackson L, Rayanagoudar G, Ruifrok AE, Dodds J, et al. Effects of antenatal diet and physical activity on maternal and fetal outcomes: individual patient data meta-analysis and health economic evaluation. Health Technol Assess. 2017;21(41):1–158. https://doi.org/10.3310/hta21410.CrossRefPubMedPubMedCentral

47.

• Vaivada T, Gaffey MF, Das JK, Bhutta ZA. Evidence-based interventions for improvement of maternal and child nutrition in low-income settings: what’s new? Curr Opin Clin Nutr Metab Care. 2017;20(3):204–10. https://doi.org/10.1097/mco.0000000000000365 This article provides a review of what has been learned about malnutrition interventions throughout the lifespan since the 2013 Lancet series on undernutrition. Making supplementation sources available to vulnerable communities is important to support the fetal growth and nutritional status of newborns.CrossRefPubMed

48.

Phelan S. Pregnancy: A “teachable moment” for weight control and obesity prevention. Am J Obstet Gynecol. 2010;202(2):135.e1–8. https://doi.org/10.1016/j.ajog.2009.06.008.CrossRef

49.

Ota E, Hori H, Mori R, Tobe-Gai R, Farrar D. Antenatal dietary education and supplementation to increase energy and protein intake. Cochrane Database Syst Rev. 2015(6):Cd000032. https://doi.org/10.1002/14651858.CD000032.pub3.

50.

American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827–e41. https://doi.org/10.1542/peds.2011-3552.CrossRef

51.

World Health Organization. Infant and young child nutrition: global strategy on infant and young child feeding: World Health Assembly 55/15,2002.

52.

United States Department of Agriculture (USDA). Women Infants and Children (WIC). 2018. https://www.fns.usda.gov/wic/breastfeeding-priority-wic-program. Accessed 10 Aug 2018.

53.

Darfour-Oduro SA, Kim J. WIC mothers’ social environment and postpartum health on breastfeeding initiation and duration. Breastfeed Med. 2014;9(10):524–9. https://doi.org/10.1089/bfm.2014.0067.CrossRefPubMedPubMedCentral

54.

Lovelady CA, Stephenson KG, Kuppler KM, Williams JP. The effects of dieting on food and nutrient intake of lactating women. J Am Diet Assoc. 2006;106(6):908–12. https://doi.org/10.1016/j.jada.2006.03.007.CrossRefPubMed

55.

Doran L, Evers S. Energy and nutrient inadequacies in the diets of low-income women who breast-feed. J Am Diet Assoc. 1997;97(11):1283–7. https://doi.org/10.1016/s0002-8223(97)00306-4.CrossRefPubMed

56.

Devine CM, Bove CF, Olson CM. Continuity and change in women’s weight orientations and lifestyle practices through pregnancy and the postpartum period: the influence of life course trajectories and transitional events. Soc Sci Med. 2000;50(4):567–82.CrossRefPubMed

57.

Savage JS, Fisher JO, Birch LL. Parental influence on eating behavior: conception to adolescence. J Law Med Ethics. 2007;35(1):22–34. https://doi.org/10.1111/j.1748-720X.2007.00111.x.CrossRefPubMedPubMedCentral

58.

Raiten DJ, Steiber AL, Carlson SE, Griffin I, Anderson D, Hay WW Jr, et al. Working group reports: evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project. Am J Clin Nutr. 2016;103(2):648s–78s. https://doi.org/10.3945/ajcn.115.117309.CrossRefPubMedPubMedCentral

59.

Singhal A, Cole TJ, Fewtrell M, Deanfield J, Lucas A. Is slower early growth beneficial for long-term cardiovascular health? Circulation. 2004;109(9):1108–13. https://doi.org/10.1161/01.Cir.0000118500.23649.Df.CrossRefPubMed

60.

• Moloney L, Rozga M, Fenton TR. Nutrition assessment, exposures, and interventions for very-low-birth-weight preterm infants: a scoping review. J Acad Nutr Diet. 2018. https://doi.org/10.1016/j.jand.2018.03.018. This scoping review is the result of a collaboration between the National Institutes of Health and the Academy of Nutrition and Dietetics to review the evidence to provide evidence-based nutrition practice guidelines for preterm infants.

61.

Gunderson GW. The National School Lunch Program: background and development. New York: Nova Science Publishers; 1971.

62.

Yaktine AL, Murphy SP. Aligning nutrition assistance programs with the Dietary Guidelines for Americans. Nutr Rev. 2013;71(9):622–30. https://doi.org/10.1111/nure.12046.CrossRefPubMed

63.

Shloim N, Edelson LR, Martin N, Hetherington MM. Parenting styles, feeding styles, feeding practices, and weight status in 4-12 year-old children: a systematic review of the literature. Front Psychol. 2015;6:1849. https://doi.org/10.3389/fpsyg.2015.01849.CrossRefPubMedPubMedCentral

64.

Yavuz HM, van Ijzendoorn MH, Mesman J, van der Veek S. Interventions aimed at reducing obesity in early childhood: a meta-analysis of programs that involve parents. J Child Psychol Psychiatry. 2015;56(6):677–92. https://doi.org/10.1111/jcpp.12330.CrossRefPubMed

65.

Lassi ZS, Moin A, Das JK, Salam RA, Bhutta ZA. Systematic review on evidence-based adolescent nutrition interventions. Ann N Y Acad Sci. 2017;1393(1):34–50. https://doi.org/10.1111/nyas.13335.CrossRefPubMed

66.

Das JK, Salam RA, Thornburg KL, Prentice AM, Campisi S, Lassi ZS, et al. Nutrition in adolescents: physiology, metabolism, and nutritional needs. Ann N Y Acad Sci. 2017;1393(1):21–33. https://doi.org/10.1111/nyas.13330.CrossRefPubMed

67.

Mesias M, Seiquer I, Navarro MP. Iron nutrition in adolescence. Crit Rev Food Sci Nutr. 2013;53(11):1226–37. https://doi.org/10.1080/10408398.2011.564333.CrossRefPubMed

68.

Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron,chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc: a report of the panel on micronutrients. Washington, D.C.: National Academy Press; 2001.

69.

Salam RA, Hooda M, Das JK, Arshad A, Lassi ZS, Middleton P, et al. Interventions to improve adolescent nutrition: a systematic review and meta-analysis. J Adolesc Health. 2016;59(4s):S29–s39. https://doi.org/10.1016/j.jadohealth.2016.06.022.CrossRefPubMedPubMedCentral

70.

United Nations International Children’s Emergency Fund (UNICEF). Adolescence: an age of opportunity: State of the World’s Children; 2011.

71.

• Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, et al. Our future: a Lancet commission on adolescent health and wellbeing. Lancet. 2016;387(10036):2423–78. https://doi.org/10.1016/s0140-6736(16)00579-1 Inadequate attention exists for researching adolescent nutrition because this life stage is commonly believed to be a child’s healthiest time of their life. However, environmental factors can dramatically contribute to nutritional decline of adolescents. Malnutrition can be addressed by targeting unhealthy social and environmental influences.CrossRefPubMedPubMedCentral

72.

Neumark-Sztainer D, Wall M, Larson NI, Eisenberg ME, Loth K. Dieting and disordered eating behaviors from adolescence to young adulthood: findings from a 10-year longitudinal study. J Am Diet Assoc. 2011;111(7):1004–11. https://doi.org/10.1016/j.jada.2011.04.012.CrossRefPubMedPubMedCentral

73.

Movassagh EZ, Baxter-Jones ADG, Kontulainen S, Whiting SJ, Vatanparast H. Tracking dietary patterns over 20 years from childhood through adolescence into young adulthood: the Saskatchewan pediatric bone mineral accrual study. Nutrients. 2017;9(9):E990. https://doi.org/10.3390/nu9090990.CrossRefPubMed

74.

Cusick SE, Kuch AE. Determinants of undernutrition and overnutrition among adolescents in developing countries. Adolesc Med State Art Rev. 2012;23(3):440–56.PubMedPubMedCentral

75.

Steinberg L, Monahan KC. Age differences in resistance to peer influence. Dev Psychol. 2007;43(6):1531–43. https://doi.org/10.1037/0012-1649.43.6.1531.CrossRefPubMedPubMedCentral

76.

Resnick MD, Catalano RF, Sawyer SM, Viner R, Patton GC. Seizing the opportunities of adolescent health. Lancet. 2012;379(9826):1564–7. https://doi.org/10.1016/s0140-6736(12)60472-3.CrossRefPubMed

77.

Morin-Major JK, Marin MF, Durand N, Wan N, Juster RP, Lupien SJ. Facebook behaviors associated with diurnal cortisol in adolescents: is befriending stressful? Psychoneuroendocrinology. 2016;63:238–46. https://doi.org/10.1016/j.psyneuen.2015.10.005.CrossRefPubMed

78.

Gerbasi ME, Richards LK, Thomas JJ, Agnew-Blais JC, Thompson-Brenner H, Gilman SE, et al. Globalization and eating disorder risk: peer influence, perceived social norms, and adolescent disordered eating in Fiji. Int J Eat Disord. 2014;47(7):727–37. https://doi.org/10.1002/eat.22349.CrossRefPubMedPubMedCentral

79.

Rauof M, Ebrahimi H, Asghari Jafarabadi M, Malek A, Babapour Kheiroddin J. Prevalence of eating disorders among adolescents in the northwest of Iran. Iran Red Crescent Med J. 2015;17(10):e19331. https://doi.org/10.5812/ircmj.19331.CrossRefPubMedPubMedCentral

80.

Bucchianeri MM, Fernandes N, Loth K, Hannan PJ, Eisenberg ME, Neumark-Sztainer D. Body dissatisfaction: do associations with disordered eating and psychological well-being differ across race/ethnicity in adolescent girls and boys? Cultur Divers Ethnic Minor Psychol. 2016;22(1):137–46. https://doi.org/10.1037/cdp0000036.CrossRefPubMed

81.

Buckingham-Howes S, Armstrong B, Pejsa-Reitz MC, Wang Y, Witherspoon DO, Hager ER, et al. BMI and disordered eating in urban, African American, adolescent girls: the mediating role of body dissatisfaction. Eat Behav. 2018;29:59–63. https://doi.org/10.1016/j.eatbeh.2018.02.006.CrossRefPubMedPubMedCentral

82.

Rodgers RF, Watts AW, Austin SB, Haines J, Neumark-Sztainer D. Disordered eating in ethnic minority adolescents with overweight. Int J Eat Disord. 2017;50(6):665–71. https://doi.org/10.1002/eat.22652.CrossRefPubMed

83.

Craven KL, Hawks SR. Cultural and western influences on the nutrition transition in Thailand. Promot Educ. 2006;13(1):14–20.CrossRefPubMed

84.

Anderson-Fye EP, Brewis A. Fat planet: obesity, culture, and symbolic body capital. School for Advanced Research Advanced Seminar Series. University of New Mexico Press; 2017.

85.

Blum RW, Gates WH. Girlhood, not motherhood: preventing adolescent pregnancy. New York: United Nations Population Fund; 2015.

86.

Azevedo WF, Diniz MB, Fonseca ES, Azevedo LM, Evangelista CB. Complications in adolescent pregnancy: systematic review of the literature. Einstein. 2015;13(4):618–26. https://doi.org/10.1590/s1679-45082015rw3127.CrossRefPubMedPubMedCentral

87.

World Health Organization (WHO). Adolescent pregnancy. Geneva: WHO; 2012.

88.

World Health Organization (WHO). Global health estimates 2015: deaths by cause, age, sex, by country and by region, 2000–2015. Geneva: WHO; 2016.

89.

Low LK, Martin K, Sampselle C, Guthrie B, Oakley D. Adolescents’ experiences of childbirth: contrasts with adults. J Midwifery Womens Health. 2003;48(3):192–8.CrossRefPubMed

90.

Lawson EJ. The role of smoking in the lives of low-income pregnant adolescents: a field study. Adolescence. 1994;29(113):61–79.PubMed

91.

Salam RA, Faqqah A, Sajjad N, Lassi ZS, Das JK, Kaufman M, et al. Improving adolescent sexual and reproductive health: a systematic review of potential interventions. J Adolesc Health. 2016;59(4s):S11–s28. https://doi.org/10.1016/j.jadohealth.2016.05.022.CrossRefPubMedPubMedCentral

92.

World Health Organization/London School of Hygiene and Tropical Medicine. Preventing intimate partner and sexual violence against women: taking action and generating evidence. Geneva: World Health Organization; 2010.

93.

Dhar D, McDougal L, Hay K, Atmavilas Y, Silverman J, Triplett D, et al. Associations between intimate partner violence and reproductive and maternal health outcomes in Bihar, India: a cross-sectional study. Reprod Health. 2018;15(1):109. https://doi.org/10.1186/s12978-018-0551-2.CrossRefPubMedPubMedCentral

94.

Lundgren R, Amin A. Addressing intimate partner violence and sexual violence among adolescents: emerging evidence of effectiveness. J Adolesc Health. 2015;56(1 Suppl):S42–50. https://doi.org/10.1016/j.jadohealth.2014.08.012.CrossRefPubMed

95.

Bourey C, Williams W, Bernstein EE, Stephenson R. Systematic review of structural interventions for intimate partner violence in low- and middle-income countries: organizing evidence for prevention. BMC Public Health. 2015;15:1165. https://doi.org/10.1186/s12889-015-2460-4.CrossRefPubMedPubMedCentral

96.

Dutton MA, James L, Langhorne A, Kelley M. Coordinated public health initiatives to address violence against women and adolescents. J Women’s Health. 2015;24(1):80–5. https://doi.org/10.1089/jwh.2014.4884.CrossRef

97.

Gore DM, Kothari AR. Getting to the root of the problem: health promotion strategies to address the social determinants of health. Can J Public Health. 2013;104(1):e52–4.PubMedPubMedCentral

98.

Monyeki MA, Awotidebe A, Strydom GL, de Ridder JH, Mamabolo RL, Kemper HC. The challenges of underweight and overweight in South African children: are we winning or losing the battle? A systematic review. Int J Environ Res Public Health. 2015;12(2):1156–73. https://doi.org/10.3390/ijerph120201156.CrossRefPubMedPubMedCentral

99.

Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. Lancet. 2014;383(9921):999–1008. https://doi.org/10.1016/s0140-6736(13)61752-3.CrossRefPubMed

100.

Berenson GS. Bogalusa Heart Study: a long-term community study of a rural biracial (black/white) population. Am J Med Sci. 2001;322(5):267–74.CrossRefPubMed

Title: An Intergenerational Approach to Break the Cycle of Malnutrition
Authors: Katherine R. Arlinghaus
Chelsea Truong
Craig A. Johnston
Daphne C. Hernandez
Publication date: 01-12-2018
Publisher: Springer US
Published in: Current Nutrition Reports / Issue 4/2018
Electronic ISSN: 2161-3311
DOI: https://doi.org/10.1007/s13668-018-0251-0

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

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Year in Review: Pediatric cardiology

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Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

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Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

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Image Credits

STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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Other articles of this Issue 4/2018

Weight Regain After Bariatric Surgery: Prevalence, Etiology, and Treatment

Trimethylamine N-Oxide and Risk of Cardiovascular Disease and Mortality

Child, Caregiver, Family, and Social-Contextual Factors to Consider when Implementing Parent-Focused Child Feeding Interventions

Dairy Consumption and Cardiometabolic Diseases: Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies

Intergenerational Effects of Health Issues Among Women of Childbearing Age: a Review of the Recent Literature

Fad Diets: Hype or Hope?

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