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Maternal micronutrient status and decreased growth of Zambian infants born during and after the maize price increases resulting from the southern African drought of 2001–2002

Published online by Cambridge University Press:  02 January 2007

R Gitau
Affiliation:
Institute of Child Health, London, UK
M Makasa
Affiliation:
Lusaka District Health Management Team, Lusaka, Zambia
L Kasonka
Affiliation:
University Teaching Hospital, Lusaka, Zambia
M Sinkala
Affiliation:
Lusaka District Health Management Team, Lusaka, Zambia
C Chintu
Affiliation:
University Teaching Hospital, Lusaka, Zambia
A Tomkins
Affiliation:
Institute of Child Health, London, UK
S Filteau*
Affiliation:
Institute of Child Health, London, UK Nutrition and Public Health Interventions Research Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
*
*Corresponding author: Email Suzanne.Filteau@lshtm.ac.uk
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Abstract

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Objective

To investigate the effects on maternal micronutrient status and infant growth of the increased maize prices that resulted from the southern African drought of 2001–2002.

Design

Longitudinal cohort study.

Setting

A maternal and child health clinic in Lusaka, Zambia.

Subjects

Maternal and infant health and nutrition data and maternal plasma were being collected for a study of breast-feeding and postpartum health. Samples and data were analysed according to whether they were collected before (June to December 2001), during (January 2002 to April 2003) or after (May 2003 to January 2004) the period of increased maize price. Season and maternal HIV status were controlled for in analyses.

Results

Maize price increases were associated with decreased maternal plasma vitamin A during pregnancy (P = 0.028) and vitamin E postpartum (P = 0.042), with the lowest values among samples collected after May 2003 (vitamin A: 0.96 μmol l−1, 95% confidence interval (CI) 0.84–1.09, n = 38; vitamin E: 30.8 μmol mmol−1 triglycerides, 95% CI 27.2–34.8, n = 64) compared with before January 2002 (vitamin A: 1.03 μmol l−1, 95% CI 0.93–1.12, n = 104; vitamin E: 38.9 μmol mmol−1 triglycerides, 95% CI 34.5–43.8, n = 47). There were no significant effects of sampling date on maternal weight, haemoglobin or acute-phase proteins and only marginal effects on infant weight. Infant length at 6 and 16 weeks of age decreased progressively throughout the study (P-values for time of data collection were 0.51 at birth, 0.051 at 6 weeks and 0.026 at 16 weeks).

Conclusions

The results show modest effects of the maize price increases on maternal micronutrient status. The most serious consequence of the price increases is likely to be the increased stunting among infants whose mothers experienced high maize prices while pregnant. During periods of food shortages it might be advisable to provide micronutrient supplements even to those who are less food-insecure.

Type
Research Article
Copyright
Copyright © The Authors 2005

References

1Underwood, BA. Perspectives from micronutrient malnutrition elimination/eradication programmes [online], 2004. Available at http://www.emro.who.int/nfs/Nutrition-MicronutrientMalnutrition-Perspectives.htm. Accessed December 2004.Google Scholar
2 Famine Early Warning Systems Network. Available at http://www.fews.net/centers/current/monthlies/report 2004. Accessed December 2004.Google Scholar
3Foster, P, Leathers, HD. Purchasing power: income and the price of food. In: The World Food Problem: Tackling the Causes of Undernutrition in the Third World. Boulder, CO and London: Lynne Rienner, 1999;117–40.CrossRefGoogle Scholar
4Tiffin, R, Dawson, PJ. The demand for calories: some further estimates from Zimbabwe. Journal of Agricultural Economics 2002; 53: 221–32.CrossRefGoogle Scholar
5Block, SA, Kiess, L, Webb, P, Kosen, S, Moench-Pfanner, R, Bloem, M. Macro shocks and micro outcomes: child nutrition during Indonesia's crisis. Economics and Human Biology 2004; 2: 2144.CrossRefGoogle ScholarPubMed
6Serlemitsos, A, Fusco, H. Vitamin A fortification of sugar in Zambia [online], 2001. Available at http://www.mostproject. org/PDF/zambiasugar. Accessed October 2003.Google Scholar
7Fylkesnes, K, Musonda, RM, Sichone, M, Ndhlovu, Z, Tembo, F, Monze, M, Declining, HIV. prevalence and risk behaviours in Zambia: evidence from surveillance and population-based surveys. AIDS 2001; 15: 907–16.CrossRefGoogle ScholarPubMed
8Chisenga, M, Kasonka, L, Makasa, M, Sinkala, M, Chintu, C, Kaseba, C, et al. Factors affecting the duration of exclusive breastfeeding among HIV-infected and -uninfected women in Lusaka, Zambia. Journal of Human Lactation 2005; 21: 266–75.CrossRefGoogle ScholarPubMed
9Erhardt, JG, Mack, H, Sobeck, U, Biesalski, HK. β-Carotene and α-tocopherol concentration and antioxidant status in buccal mucosal cells and plasma after oral supplementation. British Journal of Nutrition 2002; 87: 471–5.CrossRefGoogle ScholarPubMed
10Gibson, RS. Principles of Nutritional Assessment. Oxford: Oxford University Press, 1990.Google Scholar
11Horwitt, MK, Harvey, CC, Dahm, CH Jr, Searcy, MT. Relationship between tocopherol and serum lipid levels for determination of nutritional adequacy. Annals of the New York Academy of Sciences 1972; 203: 223–36.CrossRefGoogle ScholarPubMed
12Filteau, SM, Morris, SS, Abbott, RA, Tomkins, AM, Kirkwood, BR, Arthur, P, et al. Influence of morbidity on serum retinol of children in a community-based study in northern Ghana. American Journal of Clinical Nutrition 1993; 58: 192–7.CrossRefGoogle Scholar
13Friis, H, Gomo, E, Nyazema, N, Ndhlovu, P, Krarup, H, Kaestel, P, et al. Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe. British Journal of Nutrition 2004; 92: 833–40.CrossRefGoogle ScholarPubMed
14Cole, TJ, Freeman, JV, Preece, MA. British 1990 growth reference centiles for weight, height, body mass index and head circumference fitted by maximum penalized likelihood. Statistics in Medicine 1998;17: 407–29.Google Scholar
15Tietz, NW. Clinical Guide to Laboratory Tests, 3rd ed. Philadelphia, PA and London: Saunders, 1995.Google Scholar
16Sapin, V, Alexandre, MC, Chaib, S, Bournazeau, JA, Sauvant, P, Borel, P, et al. Effect of vitamin A status at the end of pregnancy on the saturation of retinol binding protein with retinol. American Journal of Clinical Nutrition 2000; 71: 537–43.CrossRefGoogle ScholarPubMed
17Thurnham, DI, McCabe, GP, Northrop-Clewes, CA, Nestel, P. Effects of subclinical infection on plasma retinol concentrations and assessment of prevalence of vitamin A deficiency: meta-analysis. Lancet 2003; 362: 2052–8.CrossRefGoogle ScholarPubMed
18Shrimpton, R, Victora, CG, de Onis, M, Lima, RC, Blossner, M, Clugston, G. Worldwide timing of growth faltering: implications for nutritional interventions. Pediatrics 2001; 107: E75.CrossRefGoogle ScholarPubMed
19Venu, L, Harishankar, N, Krishna, TP, Raghunath, M. Maternal dietary vitamin restriction increases body fat content but not insulin resistance in WNIN rat offspring up to 6 months of age. Diabetologia 2004; 47: 1493–501.CrossRefGoogle ScholarPubMed