TABLE OF CONTENTS
FOREWORD
EXECUTIVE SUMMARY
AUTHORS
ACKNOWLEDGEMENTS
LIST OF ABBREVIATIONS
GLOSSARY
INTRODUCTION
Undernutrition Throughout the Life Cycle
Research on Interventions to Combat Undernutrition
Conceptual Framework
PREVENTING LOW BIRTHWEIGHT
Definitions and Indicators
Wasting or Stunting in utero
Prevalence of Intrauterine Growth Retardation (IUGR)
Consequences of Low Birthweight
Increased Mortality and Morbidity
Greater Risk of Stunting
Poor Neurodevelopmental Outcomes
Reduced Strength and Work Capacity
Increased Risk of Chronic Disease
Causes of Intrauterine Growth Retardation
Prenatal Food Supplementation
Beneficial Nutrition Interventions
Nonbeneficial Nutrition Interventions
Optimizing Interventions
Targeting Supplements to Undernourished Women
Best Predictors for Women at Greatest Risk of IUGR
Prepregnancy Weight
Attained Maternal Weight at 20, 28 or 36 Weeks of Gestation
Additional, Less Useful Predictors of Women at Greatest Risk of IUGR
Low Maternal Body Mass Index (BMI)
Pregnancy Weight Gain
Maternal Height
Timing of Supplementation
Duration of Supplementation
Micronutrient Supplementation During Pregnancy
Supplementation with Single Micronutrients
Iron
Folic Acid
Zinc
Vitamin A
Calcium
Iodine
Supplementation with Multiple Micronutrients
Non-Nutritional Interventions During Pregnancy
Adolescent Nutrition
Adolescent Growth
Adolescent Pregnancy
Adolescent Nutritional Status
Can Adolescents Catch-Up Incomplete Childhood Growth?
Intervening in Adolescence
Improving Dietary Intake
Improving Iron and Folate Status
Delaying First Pregnancy
Summary and Conclusions
IMPROVING CHILD GROWTH
Growth Patterns of Infants and Children
Stunting
Underweight
Wasting
Causes of Poor Growth
Interactions Between Undernutrition and Diseases
Consequences of Poor Growth
The Fundamental Importance of Care
Exclusive Breastfeeding
Complementary Feeding
Recommendations for Complementary Feeding
Estimating the Amount of Nutrients Needed in Complementary Foods
Improving the Nutrient Content of Complementary Foods
Increasing Energy Intake
Increasing Protein Intake
Improving the Micronutrient Content (Quality) of Complementary Foods
Increasing the Consumption of Animal Products
Improving the Content and Bioavailability of Nutrients in Plant-Based Complementary...
Fortification of Complementary Foods with Micronutrients
Efficacy Trials of Complementary Foods
Micronutrient Supplementation to Improve Growth
Iron
Zinc
Vitamin A
Calcium
Iodine
Multiple Micronutrients
Summary and Conclusions
PREVENTING AND TREATING ANAEMIA
The Prevalence of Anaemia and of Iron Deficiency
Causes of Anaemia
Consequences of Anaemia
Efficacy Trials of Iron Supplementation
Supplementation in Pregnancy
Iron Supplementation of Infants and Preschool Children
Iron Supplementation of School Children and Adolescents
Frequency, Duration and Prioritization of Iron Supplementation
The Role of Other Micronutrients in Anaemia
Dietary Interventions to Reduce and Prevent Iron Deficiency
Iron Fortification of Foods
Efficacy Trials
Effectiveness Trials
Maize and Wheat Flour Fortification
Condiment Fortification
Fortification of Foods for Infants and Children
Safety of Iron Fortification Programmes
Complementary Parasite Control Strategies for Prevention of Anaemia
Summary and Conclusions
PREVENTING AND TREATING IODINE DEFICIENCY
Prevalence of Iodine Deficiency
Causes of Iodine Deficiency
Consequences of Iodine Deficiency Disorders
Cretinism
Goitre
Impaired Cognitive Function
Increased Perinatal Morbidity and Mortality
Iodine Efficacy Trials
Effects on Goitre Reduction
Effects on Pregnancy Outcome
Effects on Infant Mortality
Effect on Child Growth
Potential for Iodine Toxicity
Summary and Conclusions
PREVENTING AND TREATING VITAMIN A DEFICIENCY (VAD)
Prevalence of Vitamin A Deficiency
Consequences of Vitamin A Deficiency
Efficacy Trials to Improve Vitamin A Status
Effect on Pregnancy Outcome
Impact on Morbidity and Mortality of Infants and Children
Prevention of Childhood Illness
Benefits of Providing Vitamin A to Infants in the Expanded Programme in...
Improved Growth
Impact on HIV Infection
The Efficacy of Food-Based Strategies to Improve Vitamin A Status
Summary and Conclusions
EFFECTIVENESS OF LARGE SCALE NUTRITION INTERVENTIONS
Growth Monitoring and Promotion
Integrated Care and Nutrition Interventions
Communications for Behavioural Change
Specific Nutrition-Related Recommendations
Supplementary Feeding of Young Children and Women
School Feeding
Health-Related Services
Complementarities Between Health Service Delivery and Community Nutrition
Effectiveness of Supplementation for the Control of Iron and Vitamin A...
Iron
Vitamin A
Food-Based Strategies for Control of Iron and Vitamin A Deficiency
Control of Iodine Deficiency Disorders
PRIORITIZING OPTIONS
Benefit-Cost and Cost-Effectiveness Analyses
Determining Unit Costs of Interventions
Cost-Effectiveness
Key Minimum Packages
Programme Management Principles
Contextual Success Factors
Programme Success Factors
Role of Programmes in National Nutrition Improvement
REFERENCES
APPENDIX 1. PROFILES OF SOME COMMUNITY-BASED NUTRITION INTERVENTIONS IN...
Bangladesh
Cambodia
People's Republic of China
India
Pakistan
Sri Lanka
Viet Nam
ACC/SCN NUTRITION POLICY PAPERS
ASIAN DEVELOPMENT BANK NUTRITION AND DEVELOPMENT SERIES
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