Childhood Malnutrition

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Global and Public Health".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 46183

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Guest Editor
Department of Public Health Policy, School of Public Health, University of West Attica, 11521 Athens, Greece
Interests: nutritional knowledge and behavior of children and adolescents; childhood obesity; lifestyle medicine; diet; exercise; sleep; dietary supplements; smoking cessation; medical nutrition therapy; diabetes; epilepsy
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Special Issue Information

Dear Colleagues,

This Special Issue, “Childhood Malnutrition”, will focus on malnutrition, including undernutrition, overweight, and obesity, in infants, children, and adolescents. Malnutrition among children and adolescents is a major public health problem. In 2019, globally, 144 million children under the age of 5 years were stunted, 47 million were wasted, and 38 million were overweight. Poor availability or access to food of adequate nutritional quality has led large population sections to be undernourished, have a poor nutritional status, or become overweight and obese. These conditions often present simultaneously and are interconnected. A healthy diet beginning in the early stages of life results in adequate energy and nutrient intake and healthy weight and is crucial for the physical, mental, and cognitive development of children and adolescents, as well as for their long-term health. This Special Issue will explore the genetic and environmental (e.g., lifestyle, psycho-social factors, etc.) determinants of malnutrition in children, focusing on relevant methodological considerations, dietary recommendations, health interventions, and public health policy actions. Various types of articles, such as original research, methodology, and review articles will be considered for publication.

Prof. Dr. Tonia Vassilakou
Guest Editor

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Keywords

  • malnutrition
  • undernutrition
  • overweight
  • obesity
  • food availability
  • healthy diet

Published Papers (10 papers)

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Editorial

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3 pages, 201 KiB  
Editorial
Childhood Malnutrition: Time for Action
by Tonia Vassilakou
Children 2021, 8(2), 103; https://doi.org/10.3390/children8020103 - 03 Feb 2021
Cited by 20 | Viewed by 5445
Abstract
Childhood malnutrition of every form, including undernutrition (wasting, stunting and underweight), micronutrient deficiencies, as well as overweight and obesity, consists a triple burden of disease, especially for low- and middle-income countries, and is one of the leading causes of poor health and a [...] Read more.
Childhood malnutrition of every form, including undernutrition (wasting, stunting and underweight), micronutrient deficiencies, as well as overweight and obesity, consists a triple burden of disease, especially for low- and middle-income countries, and is one of the leading causes of poor health and a major impediment to personal development and achievement of full human potential worldwide [...] Full article
(This article belongs to the Special Issue Childhood Malnutrition)

Research

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22 pages, 857 KiB  
Article
Effects of Nutrition, and Physical Activity Habits and Perceptions on Body Mass Index (BMI) in Children Aged 12–15 Years: A Cross-Sectional Study Comparing Boys and Girls
by Vilelmine Carayanni, Elpis Vlachopapadopoulou, Dimitra Koutsouki, Gregory C. Bogdanis, Theodora Psaltopoulou, Yannis Manios, Feneli Karachaliou, Angelos Hatzakis and Stefanos Michalacos
Children 2021, 8(4), 277; https://doi.org/10.3390/children8040277 - 03 Apr 2021
Cited by 8 | Viewed by 2469
Abstract
Background: The aim of the present study was to examine the effects of socioeconomic status, nutrition and physical activity lifestyle habits and perceptions on Body Mass Index (BMI) in children aged 12–15 years in Greece. Furthermore, to compare the difference between the [...] Read more.
Background: The aim of the present study was to examine the effects of socioeconomic status, nutrition and physical activity lifestyle habits and perceptions on Body Mass Index (BMI) in children aged 12–15 years in Greece. Furthermore, to compare the difference between the two sexes. Methods: This is a cross-sectional study conducted on a representative secondary school cohort that included 5144 subjects, aged 12 to 15 years. Students and their parents filled in validated questionnaires evaluating socioeconomic status, nutrition and physical activity. International Obesity Task Force cut offs were used to classify the children. Factor analysis of mixed data and partial proportional ordered logistic models were used to analyze ΒMΙ distributions. All analyses were stratified by gender. Results: Boys were 2.9 (95%CI: 2.592–3.328) times more likely to be overweight/obese than girls. Partial proportional ordinal models indicate significant associations between nutritional and physical habits and perceptions variables but also significant gender differences in socio-demographic, nutritional risk factors as well as physical activity habits and perceptions. Conclusions: A clear understanding of the factors that contribute to the sex differences in nutrition and physical activity habits and perceptions may guide intervention efforts. Full article
(This article belongs to the Special Issue Childhood Malnutrition)
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10 pages, 263 KiB  
Article
Triage for Malnutrition Risk among Pediatric and Adolescent Outpatients with Cystic Fibrosis, Using a Disease-Specific Tool
by Dimitrios Poulimeneas, Maria G. Grammatikopoulou, Argyri Petrocheilou, Athanasios G. Kaditis and Tonia Vassilakou
Children 2020, 7(12), 269; https://doi.org/10.3390/children7120269 - 04 Dec 2020
Cited by 10 | Viewed by 2643
Abstract
Malnutrition prevails in considerable proportions of children with Cystic Fibrosis (CF), and is often associated with adverse outcomes. For this, routine screening for malnutrition is pivotal. In the present cross-sectional study, we aimed to assess the risk for malnutrition in pediatric outpatients with [...] Read more.
Malnutrition prevails in considerable proportions of children with Cystic Fibrosis (CF), and is often associated with adverse outcomes. For this, routine screening for malnutrition is pivotal. In the present cross-sectional study, we aimed to assess the risk for malnutrition in pediatric outpatients with CF. A total of 76 outpatients (44 girls, 11.9 ± 3.9 years old, 39.5% adolescents) were recruited and anthropometric, clinical, dietary and respiratory measures were collected. All outpatients were screened for malnutrition risk with a validated disease-specific instrument. Most children exhibited a low risk for malnutrition (78.9%), whereas none of the participants were characterized as having a high malnutrition risk. In the total sample, malnutrition risk was positively associated with age (r = 0.369, p = 0.001), and inversely related to the body mass index (r = −0.684, p < 0.001), height z-score (r = −0.264, p = 0.021), and forced expiratory volume (FEV1%, r = −0.616, p < 0.001). Those classified as having a low malnutrition risk were younger (p = 0.004), heavier (p < 0.001) and taller (p = 0.009) than their counterparts with a moderate risk. On the other hand, patients in the moderate risk group were more likely pubertal (p = 0.034), with a reduced mid-upper arm fat area (p = 0.011), and worse pulmonary function (p < 0.001). Interestingly, none of the children attaining ideal body weight were classified as having a moderate malnutrition. risk, whereas 37.5% of the patients allocated at the moderate risk group exhibited physiological lung function. In this cohort of outpatients with CF that were predominantly well-nourished and attained physiological lung function, malnutrition risk was identified only in small proportions of the sample. Our data support that patients that are older, pubertal, or have diminished fat mass are at greater risk for malnutrition. Full article
(This article belongs to the Special Issue Childhood Malnutrition)
18 pages, 387 KiB  
Article
Assessment of the Nutritional Status, Diet and Intestinal Parasites in Hosted Saharawi Children
by Mónica Gozalbo, Marisa Guillen, Silvia Taroncher-Ferrer, Susana Cifre, David Carmena, José M Soriano and María Trelis
Children 2020, 7(12), 264; https://doi.org/10.3390/children7120264 - 29 Nov 2020
Cited by 4 | Viewed by 2691
Abstract
Since the early 1990s, Spanish humanitarian associations have welcomed Saharawi children from the refugee camps in Tindouf (Argelia). These children are the most affected by the lack of food, water, hygienic measures and health care. The main objective of this study was to [...] Read more.
Since the early 1990s, Spanish humanitarian associations have welcomed Saharawi children from the refugee camps in Tindouf (Argelia). These children are the most affected by the lack of food, water, hygienic measures and health care. The main objective of this study was to analyze the anthropometric, nutritional and parasitological data of 38 Saharawi boys and girls (from 10 to 13 years old) under a holiday host program in the city of Valencia. Our results confirm that malnutrition and multiparasitism are highly frequent, so it is understood that living conditions in refugee camps continue to be precarious with a lack of proper hygiene and nutrition. Furthermore, biochemical alterations, lactose malabsorption and the risk of celiac disease, also detected in our study as a secondary objective, will complicate nutritional management and restoration of health. For this reason, sustainable feeding alternatives and interventions from a hygienic and nutritional point of view are proposed, emphasizing in an improvement in the education of parents and children. Full article
(This article belongs to the Special Issue Childhood Malnutrition)
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7 pages, 231 KiB  
Article
Anthropometric Assessment of Nepali Children Institutionalized in Orphanages
by Lucía Fernández, Ana Rubini, Jose M. Soriano, Joaquín Aldás-Manzano and Jesús Blesa
Children 2020, 7(11), 217; https://doi.org/10.3390/children7110217 - 07 Nov 2020
Cited by 2 | Viewed by 2565
Abstract
Nepal is among the world’s poorest countries, and it is the third-poorest country in the South Asian region. Asia has the largest number of orphans in the world; in Nepal there are around 13,281 orphan children. The objective of this study is to [...] Read more.
Nepal is among the world’s poorest countries, and it is the third-poorest country in the South Asian region. Asia has the largest number of orphans in the world; in Nepal there are around 13,281 orphan children. The objective of this study is to evaluate the growth status of institutionalized children in Nepal through the analyses of anthropometric measures. The sample was Nepalese children aged 4 to 17, obtained from two different orphanages: in the first one, children with physical and mental disabilities coexist with children without any conditions. In the second one, there were no subjects with disabilities. Significant evidence of an association between mental and physical disability in institutionalized children and undernutrition (wasting and stunting) was found in this study. There is also weak but significant evidence of a relationship between underweight and being male. The study could help reaching a better understanding of growth status of institutionalized children in Nepal. Full article
(This article belongs to the Special Issue Childhood Malnutrition)
12 pages, 750 KiB  
Article
Sociodemographic Correlates of Obesity among Spanish Schoolchildren: A Cross-Sectional Study
by José Francisco López-Gil, Alba López-Benavente, Pedro Juan Tárraga López and Juan Luis Yuste Lucas
Children 2020, 7(11), 201; https://doi.org/10.3390/children7110201 - 28 Oct 2020
Cited by 5 | Viewed by 2538
Abstract
Some studies have been conducted in order to assess the association between weight status (assessed by body mass index) and socio-demographic factors. Nevertheless, only a few of them have indicated these associations by other anthropometric parameters (e.g., skinfolds). The aim of this study [...] Read more.
Some studies have been conducted in order to assess the association between weight status (assessed by body mass index) and socio-demographic factors. Nevertheless, only a few of them have indicated these associations by other anthropometric parameters (e.g., skinfolds). The aim of this study was to determine, compare, and examine the influence of age, sex, type of the schooling, per capita income, area of residence, and immigrant status on obesity parameters in schoolchildren aged 6–13 from the Region of Murcia. A cross-sectional study was carried out in six different Primary schools of the Region of Murcia (Spain). A total sample of 370 children (166 girls) aged 6–13 (8.7 ± 1.8) were selected. In order to determine participants’ body composition, body mass index, waist circumference, waist-to-height ratio, and skinfold measurements were calculated. Higher associations of excess of weight (OR = 1.96; 95%CI = 1.19–3.20) and abdominal obesity (OR = 3.12; 95CI% = 1.49–6.94) were shown in the case of children from public schools. A greater association of high trunk fat mass was found in children from municipalities with high per capita income (OR = 3.20; 95%CI = 1.05–9.77). Therefore, lower association of having an inadequate %BF was found in the participants aged 6–9 (OR = 0.38; 95%CI = 0.24–0.54), and immigrant students (OR = 2.63; 95%CI = 1.69–4.10). Our study suggested that overweight/obesity among schoolchildren in the Region of Murcia is higher than the overall prevalence of Spain. The results of the adjusted analyses showed that age, type of schooling, per capita income, and immigrant status were associated with obesity parameters. Full article
(This article belongs to the Special Issue Childhood Malnutrition)
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Review

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16 pages, 346 KiB  
Review
Nutritional Risks among Adolescent Athletes with Disordered Eating
by Ioanna Kontele and Tonia Vassilakou
Children 2021, 8(8), 715; https://doi.org/10.3390/children8080715 - 21 Aug 2021
Cited by 17 | Viewed by 8842
Abstract
In their attempt to achieve the optimum weight or body shape for their activity, athletes frequently use harmful weight-control practices that may lead to the development of disordered eating or eating disorders. These practices are linked to several medical and mental consequences that [...] Read more.
In their attempt to achieve the optimum weight or body shape for their activity, athletes frequently use harmful weight-control practices that may lead to the development of disordered eating or eating disorders. These practices are linked to several medical and mental consequences that may be more serious in adolescent athletes, as their bodies must meet both intensive growth demands and training requirements at the same time. Among other consequences, adolescent athletes may be at nutritional risk, due to their high nutrient needs and unhealthy eating behaviors. A literature review was conducted to examine the main nutritional risks and malnutrition issues faced by adolescent athletes that present disordered eating attitudes or eating disorders. Most studies refer to adult elite athletes, however research on adolescent athletes also indicates that the most common nutritional risks that may arise due to disordered eating include energy, macronutrient and micronutrient deficiencies, dehydration and electrolyte imbalances and changes in body composition that may lead to menstrual abnormalities, and decreased bone mass density. Educational programs and early detection of disordered eating and eating disorders are crucial to avoid the emergence and ensure timely management of nutrition-related problems in the vulnerable group of adolescent athletes. Full article
(This article belongs to the Special Issue Childhood Malnutrition)
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34 pages, 615 KiB  
Review
Neuroimaging Findings in Adolescents and Young Adults with Anorexia Nervosa: A Systematic Review
by Kalliopi Kappou, Myrto Ntougia, Aikaterini Kourtesi, Eleni Panagouli, Elpis Vlachopapadopoulou, Stefanos Michalacos, Fragiskos Gonidakis, Georgios Mastorakos, Theodora Psaltopoulou, Maria Tsolia, Flora Bacopoulou, Theodoros N. Sergentanis and Artemis Tsitsika
Children 2021, 8(2), 137; https://doi.org/10.3390/children8020137 - 12 Feb 2021
Cited by 13 | Viewed by 3988
Abstract
Background: Anorexia nervosa (AN) is a serious, multifactorial mental disorder affecting predominantly young females. This systematic review examines neuroimaging findings in adolescents and young adults up to 24 years old, in order to explore alterations associated with disease pathophysiology. Methods: Eligible studies on [...] Read more.
Background: Anorexia nervosa (AN) is a serious, multifactorial mental disorder affecting predominantly young females. This systematic review examines neuroimaging findings in adolescents and young adults up to 24 years old, in order to explore alterations associated with disease pathophysiology. Methods: Eligible studies on structural and functional brain neuroimaging were sought systematically in PubMed, CENTRAL and EMBASE databases up to 5 October 2020. Results: Thirty-three studies were included, investigating a total of 587 patients with a current diagnosis of AN and 663 healthy controls (HC). Global and regional grey matter (GM) volume reduction as well as white matter (WM) microstructure alterations were detected. The mainly affected regions were the prefrontal, parietal and temporal cortex, hippocampus, amygdala, insula, thalamus and cerebellum as well as various WM tracts such as corona radiata and superior longitudinal fasciculus (SLF). Regarding functional imaging, alterations were pointed out in large-scale brain networks, such as default mode network (DMN), executive control network (ECN) and salience network (SN). Most findings appear to reverse after weight restoration. Specific limitations of neuroimaging studies in still developing individuals are also discussed. Conclusions: Structural and functional alterations are present in the early course of the disease, most of them being partially or totally reversible. Nonetheless, neuroimaging findings have been open to many biological interpretations. Thus, more studies are needed to clarify their clinical significance. Full article
(This article belongs to the Special Issue Childhood Malnutrition)
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13 pages, 371 KiB  
Review
Vegetarian Diets and Eating Disorders in Adolescents and Young Adults: A Systematic Review
by Theodoros N. Sergentanis, Maria-Eleni Chelmi, Andreas Liampas, Chrysanthi-Maria Yfanti, Eleni Panagouli, Elpis Vlachopapadopoulou, Stefanos Michalacos, Flora Bacopoulou, Theodora Psaltopoulou and Artemis Tsitsika
Children 2021, 8(1), 12; https://doi.org/10.3390/children8010012 - 28 Dec 2020
Cited by 18 | Viewed by 8401
Abstract
Background: Eating disorders are more common among adolescents and young adults. An increase in the rates of these disorders has been reported during the last years. Meanwhile, vegetarianism is becoming more popular in these age groups. The purpose of the present paper is [...] Read more.
Background: Eating disorders are more common among adolescents and young adults. An increase in the rates of these disorders has been reported during the last years. Meanwhile, vegetarianism is becoming more popular in these age groups. The purpose of the present paper is to evaluate the association between eating disorders and vegetarian diets in adolescents and young adults. Methods: Systematic review of related articles published in PubMed, PsycInfo and Google Scholar up to 30 May 2019. Results: A total of 20 studies (14,391 subjects) were deemed eligible for this systematic review. The majority of the studies reported significant correlations between vegetarianism and eating disorders. However, due to the cross-sectional design, a causal link between eating disorders and vegetarian status cannot be established. Conclusions: Vegetarianism seems to be associated with eating disorders. Longitudinal studies are needed to establish temporal patterns between vegetarianism and the emergence of disordered eating. Full article
(This article belongs to the Special Issue Childhood Malnutrition)
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25 pages, 311 KiB  
Review
Nutritional Status of Pediatric Cancer Patients at Diagnosis and Correlations with Treatment, Clinical Outcome and the Long-Term Growth and Health of Survivors
by Vassiliki Diakatou and Tonia Vassilakou
Children 2020, 7(11), 218; https://doi.org/10.3390/children7110218 - 07 Nov 2020
Cited by 22 | Viewed by 4381
Abstract
Malnutrition is caused either by cancer itself or by its treatment, and affects the clinical outcome, the quality of life (QOL), and the overall survival (OS) of the patient. However, malnutrition in children with cancer should not be accepted or tolerated as an [...] Read more.
Malnutrition is caused either by cancer itself or by its treatment, and affects the clinical outcome, the quality of life (QOL), and the overall survival (OS) of the patient. However, malnutrition in children with cancer should not be accepted or tolerated as an inevitable procedure at any stage of the disease. A review of the international literature from 2014 to 2019 was performed. Despite the difficulty of accurately assessing the prevalence of malnutrition, poor nutritional status has adverse effects from diagnosis to subsequent survival. Nutritional status (NS) at diagnosis relates to undernutrition, while correlations with clinical outcome are still unclear. Malnutrition adversely affects health-related quality of life (HRQOL) in children with cancer and collective evidence constantly shows poor nutritional quality in childhood cancer survivors (CCSs). Nutritional assessment and early intervention in pediatric cancer patients could minimize the side effects of treatment, improve their survival, and reduce the risk of nutritional morbidity with a positive impact on QOL, in view of the potentially manageable nature of this risk factor. Full article
(This article belongs to the Special Issue Childhood Malnutrition)
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