Maternal & Child Malnutrition I and II

The word “malnutrition” includes the following: (choose all that apply)

Undernutrition, Overweight, Obesity, Micronutrient deficiencies

The following are commonly measured using standardized growth charts: (choose all that apply)

Stunting, Wasting, Underweight, Obesity

The “first 1000 days” refers to:

…early pregnancy (before birth) until the child’s 2nd birthday).

In areas with a high prevalence of anemia, micronutrient supplementation is recommended for all non-pregnant, menstruating women and girls (among other groups)..

True

The 2021 Lancet series of papers referred to in this unit on “Maternal and Child Malnutrition I & II” categorized nutrition interventions as follows: (choose all that apply)

Being from the healthcare sector or from outside of the healthcare sector, Being "direct" or "indirect"

“Stunting” refers to: (choose the single best response)

low height for age

“Wasting” refers to: (choose the single best response)

low weight for height

Stunting tends to occur most at the following time: (choose the single best answer)

In the first 3 months after birth

Wasting at birth and wasting in the first 3 months of life: (choose the single best answer)

…are still considered a challenge in LMICs, according to the 2021 series of Lancet papers.

Between 2000 and 2015, stunting has _________________ in LMICs. (choose the single best response)

improved slightly

Stunting is generally more prevalent in LICs than in MICs

True

Zinc supplements should be given when a child has diarrhea

True

Evidence strongly shows that adequate birth spacing can help improve the nutrition status of children.

True

Low iron intake and low intake of Vitamin B-12 can both causes forms of anemia.

True

Foods that contain high amounts of essential micronutrients such as iron, Vitamin B-12, Vitamin A, and iodine are often expensive, perishable (they spoil easily and quickly), and require refrigeration.

True

Iodized salt has been an enormously beneficial program, as well as being very cost-effective.

True

Stunting can prevent people from achieving their full mental and physical potential.

True

Geographically, ______________ is the global region most heavily impacted by stunting and wasting, as of approximately 2015.

South Asia

In comparison with other low-income and lower-middle income countries, India has a much higher prevalence of wasting.

True

As of 2021, only high-income countries are expected to fully meet the 10 nutrition targets set by the 2012 World Health Assembly.

False

There is currently strong evidence to suggest that promotion of breastfeeding is a positive way to improve child nutrition.

True

One general trend we’ve seen with global data on malnutrition is that we don’t yet have enough information about the nutrition of school-aged children (kids over 5 years) and adolescents.

True

We have good evidence to recommend the following strategies to improve maternal and/or child nutrition: (select all that apply)

Family planning and birth spacing, Small-quantity lipid-based nutrient supplements for kids, Therapeutic zinc supplementation for diarrhea, Large-scale food fortification, ITNs, Ready-to-use supplementary food for acute malnutrition

Iron-deficiency anemia can be caused by the following: (choose all that apply)

Loss/removal of more RBCs than are replaced by the body, Inability to absorb dietary iron, Food sources don’t have enough iron, Pregnancy and menstruation, which come with increased demand for iron, Breastfeeding, which comes with increased demand for iron

What are “complementary foods”?

Foods given from ages 6 months to about 2 years to complement breastfeeding (or possibly formula feeding)

“MMN” stands for

multiple micronutrients

In areas with a high prevalence of stunting, stunting has been partially addressed with interventions such as: (choose all that apply)

Fertility reduction strategies, WASH, Health and nutrition investments, Poverty reduction strategies, Agricultural improvements

Heidkamp et al. (2021) argue for a single global strategy for all countries to follow that will address the remaining challenges in undernutrition for maternal and child health.

False

The previous Lancet series on this topic of maternal and child malnutrition was published in 2013

according to Heidkamp et al. (2021), the evidence base has grown substantially since that time.

According to Heidkamp et al. (2021), the following are true of large-scale food fortification: (choose all that apply)

This is a cost-effective strategy, This is already a common practice in many LMICs, This strategy very effectively addresses some micronutrient deficiencies

Based on the "Stories of Change" and "Exemplars in Global Health" case studies in the reading, what proportion of national stunting reductions were driven by indirect actions targeting underlying social determinants (like poverty, WASH, and agriculture)?

Approximately half (50%) According to Heidkamp et al. (2021), what major global event has crippled health systems, exacerbated food insecurity, and reversed economic growth, threatening to set back undernutrition improvements?

The Keats et al. (2021) review replaces the confusing older terms "nutrition-specific" and "nutrition-sensitive" with what two new classification pairs?

Direct vs. Indirect interventions, and Healthcare sector vs. Non-healthcare sector interventions.

What does SQ-LNS stand for, and what specific age demographic is it tailored to help?

Small-Quantity Lipid-Based Nutrient Supplementation, tailored for infants and young children aged 6 to 24 months.

While delayed umbilical cord clamping is a strongly recommended direct intervention, the evidence specifically supports its use for which demographic?

Preterm babies (there is no strong evidence that it helps term babies).

How specifically does a Plasmodium falciparum (malaria) infection contribute to iron-deficiency anemia?

It destroys hemoglobin, releases hemozoin (which reduces RBC production in bone marrow), and stimulates hepcidin (which reduces dietary iron absorption).

Which specific type of anemia can cause severe, chronic nerve damage—such as confusion, dementia, depression, and loss of balance—if left untreated?

Vitamin B-12 Deficiency Anemia Because Vitamin B-12 is found almost exclusively in animal products (meat, eggs, dairy), people following which type of diet are at a particularly high risk for B-12 deficiency anemia?

What common food preparation mistake is a specific risk factor for folate-deficiency anemia?

Eating overcooked food (which destroys the folate), as well as diets lacking fresh fruits and vegetables.

What severe cognitive and developmental symptoms in infants are associated with severe iodine deficiency during pregnancy?

Impaired intellect, deafness, mutism, and congenital anomalies.

A deficiency in which micronutrient is specifically associated with increased morbidity and mortality from infectious diseases like diarrheal disease, pneumonia, and malaria?

Zinc

Since less than 1% of the body's calcium is used for cellular metabolism, where is over 99% of the body's calcium stored to act as a continuous reservoir?

In the bones and teeth

According to the slide notes on BMI and pediatric growth charts, how might clinicians approach plotting BMI for transgender youth?

It may be appropriate to plot transgender youth on both the male and female growth charts.

In terms of calcium deficiency risk factors, why are female athletes, women in the military, and post-menopausal women at particular risk?

Because calcium deficiency is closely linked to estrogen levels, amenorrhea (loss of menstruation), and osteoporosis.