Open AccessEnvironmental Enteropathy, Micronutrient Adequacy, and Length Velocity in Nepalese Children
Author(s) -
Morseth Marianne S.,
Henjum Sigrun,
Schwinger Catherine,
Strand Tor A.,
Shrestha Sanjaya K.,
Shrestha Binob,
Chandyo Ram K.,
Ulak Manjeswori,
Torheim Liv Elin
Publication year - 2018
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000001990
Subject(s) - medicine , micronutrient , enteropathy , micronutrient deficiency , environmental health , pathology , disease
ABSTRACT Objectives: Environmental enteropathy (EE) is likely associated with growth retardation in children, but the association between EE and length velocity z score (LVZ) has not been investigated. The objective of the study was to assess associations between fecal markers for intestinal inflammation and LVZ and whether these associations were influenced by micronutrient adequacy among 9 to 24 months old children in Bhaktapur, Nepal. Methods: Data were divided into 5 time slots (9–12, 12–15, 15–18, 18–21, and 21–24 months). Anthropometric measurement and dietary assessment (by 24 hour recall) were performed monthly. Mean nutrient density adequacy was calculated based on nutrient density adequacy of 10 micronutrients (thiamin, riboflavin, niacin, vitamin B 6 , folate, vitamin C, vitamin A, calcium, iron, and zinc). Anti‐1‐antitrypsin (AAT), myeloperoxidase (MPO), and neopterin (NEO) were measured in stool samples collected at the beginning of each time slot. An EE score was calculated based on all 3 fecal markers. Associations between AAT, MPO, NEO and EE score and LVZ were assessed by multiple linear regression analyses and Generalized Estimating Equations models. Results: Associations between fecal markers and EE score and LVZ were generally weak. EE score and MPO for 3‐month and MPO for 6‐month growth periods were significantly associated with LVZ from 9 to 24 months. These associations were slightly modified by mean nutrient density adequacy. Conclusions: EE score and MPO were significantly associated with LVZ in 9 to 24 months old Nepali children. Further studies to establish the usefulness of AAT, MPO, and NEO in assessing EE and growth retardation are warranted.