Whole Blood Omega 3 Fatty Acid Levels of HIV Exposed and HIV Unexposed 7 - 10 Years Old Children from a Low Income Country with High Burden of Under-Nutrition

Long chain polyunsaturated fatty acids are essential macronutrients that have several benefits which have been described for children’s health. Omega 3 LCPUFA metabolism has been reported to be altered in under-nourished and in HIV infected children. Therefore, we describe Eicosapentaenoic acid, Docosapentaenoic acid and Docosahexaenoic acid levels of HIV infected, HIV exposed uninfected and HIV unexposed uninfected school aged children from a low income country with a high burden of HIV infection and under-nutrition. This cross-sectional study recruited children 7 to 10 years old. Capillary blood was collected on filter paper and whole blood fatty acid analysis done using automated gas liquid chromatography. Kruskal Wallis and Median tests were used to compare the distribution and medians of the Omega 3 LCPUFA among the children according to HIV status, gender, age and nutritional status. A total of 318 children were recruited with 21 (7%) being HIV infected and 116 (37%) being HIV exposed uninfected. Chronic malnutrition was present in 12% of the children. The omega 3 fatty acids were expressed as percent weight of total fatty acids. The medians (interquartile range) for EPA, DPA and DHA for all the children were 0.19 (0.09), 0.79 (0.19) and 2.14 (0.54) %wt/wt respectively. EPA, DPA and DHA levels were not associated with the HIV status of the children. EPA levels were much lower in the 7-year-age group compared with the 8 and 9 - 10-year-age groups. Further studies assessing LCPUFA levels that include larger sample size, children from both urban and rural areas are recommended as this may assist in clearly defining the association of LCPUFA with HIV status in children from low income countries with high burden of under-nutrition.

Poverty Reduction and Pattern of Chronic Childhood Under-Nutrition in India: How Far Does the Link Exist?

In spite of an established link between poverty and under-nutrition in India, fall in under-nutrition is sluggish with fall in poverty. This research paper aims to seek answer on the effect of poverty decline on child under-nutrition in India over a period of one and a half decades. After examining the extent of association between poverty reduction and reciprocal changes in child under-nutrition, the paper found that although there was a definite influence of poverty levels on child under-nutrition at the state-level, the strength of the impact was not very high. This possibly explains why improvements in nutritional status among children have failed to keep up pace with steady reduction in mass poverty across the states in the last couple of decades. The results also strongly reiterate the magnificent role of child’s healthcare utilization and higher public spending which can help to capitalize on the increase in economic capabilities at the household level, resulting from robust economic growth and alleviation of endemic poverty.

Gestational nutrition and the development of obesity during adulthood

Recent epidemiological studies indicate a strong linkbetween intrauterine under-nutrition and propensityof such off spring for developing obesity and meta-bolic syndrome in later life. Garg et al investigated the mechanistic basis of this phenomenon and its potential reversibility in rats. The authors found that rats experiencing gestational under-nutrition but fed normally after birth (IUGR) gained body mass with excessive subcutaneous and visceral fat. The IUGR rats were alsome tabolically inflexible since they showed similar rates of energy expenditure and O2consumption in the fedand fasted states. However, if such pups were food-restricted during lactation (PNGR), their metabolic profiles resembled those of control and IPGR (subject tofood restriction during pre- and postnatal periods) rats.Thus, postnatal caloric restriction superimposed on intrauterine under nutrition significantly improved insulinsensitivity and adiposity of rats that would otherwise develop metabolic inflexibility and visceral obesity. The observations of Garg et al , have serious implications interm of the design of the future experimental studiesas well as their clinical translation in humans.

Growth and Development of the HIV Exposed Uninfected Children below 5 Years in Developing Countries: Focus on Nutritional Challenges, Mortality and Neurocognitive Function

The future of any population is children. Resource limited settings with a high prevalence of HIV infection notably also have an excessive burden of malnutrition. The advances in prevention of mother to child HIV transmission programmes have led to very effective combination antiretroviral regimens resulting in growing numbers of HIV exposed but uninfected children. The mortality of HIV exposed but uninfected children below 5 years is high in resource limited settings. It is also important to pay particular attention to their longitudinal growth and neurodevelopmental outcomes. In these settings, the contribution of feeding practices, choice of complementary foods and micronutrient deficiencies, to health outcomes of HIV exposed uninfected children are not clearly defined. This review highlights some gaps in research that need to be addressed in areas with increasing numbers of HIV exposed but uninfected children. Interventions to reduce mortality, improve growth and neurodevelopmental outcomes in HIV exposed uninfected children from resource limited areas should be prioritized.