OBJECTIVE
To identify factors in childhood which might influence the development of obesity in adulthood.


BACKGROUND
The prevalence of obesity is increasing in the UK and other developed countries, in adults and children. The adverse health consequences of adult obesity are well documented, but are less certain for childhood obesity. An association between fatness in adolescence and undesirable socio-economic consequences, such as lower educational attainment and income, has been observed, particularly for women. Childhood factors implicated in the development of adult obesity therefore have far-reaching implications for costs to the health-services and economy.


SEARCH STRATEGY
In order to identify relevant studies, electronic databases--Medline, Embase, CAB abstracts, Psyclit and Sport Discus-were searched from the start date of the database to Spring 1998. The general search structure for electronic databases was (childhood or synonyms) AND (fatness or synonyms) AND (longitudinal or synonyms). Further studies were identified by citations in retrieved papers and by consultation with experts.


INCLUSION CRITERIA
Longitudinal observational studies of healthy children which included measurement of a risk factor in childhood (<18 y), and outcome measure at least 1 y later. Any measure of fatness, leanness or change in fatness or leanness was accepted. Measures of fat distribution were not included. Only studies with participants from an industrialized country were considered, and those concerning minority or special groups, e.g. Pima Indians or children born preterm, were excluded.


FINDINGS
Risk factors for obesity included parental fatness, social factors, birth weight, timing or rate of maturation, physical activity, dietary factors and other behavioural or psychological factors. Offspring of obese parent(s) were consistently seen to be at increased risk of fatness, although few studies have looked at this relationship over longer periods of childhood and into adulthood. The relative contributions of genes and inherited lifestyle factors to the parent-child fatness association remain largely unknown. No clear relationship is reported between socio-economic status (SES) in early life and childhood fatness. However, a strong consistent relationship is observed between low SES in early life and increased fatness in adulthood. Studies investigating SES were generally large but very few considered confounding by parental fatness. Women who change social class (social mobility) show the prevalence of obesity of the class they join, an association which is not present in men. The influence of other social factors such as family size, number of parents at home and childcare have been little researched. There is good evidence from large and reasonably long-term studies for an apparently clear relationship for increased fatness with higher birth weight, but in studies which attempted to address potential confounding by gestational age, parental fatness, or social group, the relationship was less consistent. The relationship between earlier maturation and greater subsequent fatness was investigated in predominantly smaller, but also a few large studies. Again, this relationship appeared to be consistent, but in general, the studies had not investigated whether there was confounding by other factors, including parental fatness, SES, earlier fatness in childhood, or dietary or activity behaviours. Studies investigating the role of diet or activity were generally small, and included diverse methods of risk factor measurement. There was almost no evidence for an influence of activity in infancy on later fatness, and inconsistent but suggestive evidence for a protective effect of activity in childhood on later fatness. No clear evidence for an effect of infant feeding on later fatness emerged, but follow-up to adulthood was rare, with only one study measuring fatness after 7y. Studies investigating diet in childhood were limited and inconc

Childhood predictors of adult obesity: a systematic review.

Sufficient quantities of water for household use, including for drinking, food preparation and hygiene, are needed to protect public health and for well-being and prosperity.



This second edition reviews the evidence about the relationships between water quantity, water accessibility and health. The effects of water reliability, continuity and price on water use, are also covered. Updated guidance, including recommended targets, is provided on domestic water supply to ensure beneficial health outcomes.

/pdf/domestic-water-quantity-service-level-and-health-57uzgl6aqs.pdf

Domestic water quantity, service level and health

Background Ever since John Snow’s intervention on the Broad St pump, the effect of water quality, hygiene and sanitation in preventing diarrhoea deaths has always been debated. The evidence identified in previous reviews is of variable quality, and mostly relates to morbidity rather than mortality.

Methods We drew on three systematic reviews, two of them for the Cochrane Collaboration, focussed on the effect of handwashing with soap on diarrhoea, of water quality improvement and of excreta disposal, respectively. The estimated effect on diarrhoea mortality was determined by applying the rules adopted for this supplement, where appropriate.

Results The striking effect of handwashing with soap is consistent across various study designs and pathogens, though it depends on access to water. The effect of water treatment appears similarly large, but is not found in few blinded studies, suggesting that it may be partly due to the placebo effect. There is very little rigorous evidence for the health benefit of sanitation; four intervention studies were eventually identified, though they were all quasi-randomized, had morbidity as the outcome, and were in Chinese.

Conclusion We propose diarrhoea risk reductions of 48, 17 and 36%, associated respectively, with handwashing with soap, improved water quality and excreta disposal as the estimates of effect for the LiST model. Most of the evidence is of poor quality. More trials are needed, but the evidence is nonetheless strong enough to support the provision of water supply, sanitation and hygiene for all.

/pdf/water-sanitation-and-hygiene-for-the-prevention-of-diarrhoea-3v616xqhcg.pdf

Water, sanitation and hygiene for the prevention of diarrhoea.

OBJECTIVE: To determine the effect of handwashing on the risk of respiratory infection. METHODS: We searched PubMed, CAB Abstracts, Embase, Web of Science, and the Cochrane library for articles published before June 2004 in all languages. We had searched reference lists of all primary and review articles. Studies were included in the review if they reported the impact of an intervention to promote hand cleansing on respiratory infections. Studies relating to hospital-acquired infections, long-term care facilities, immuno-compromised and elderly people were excluded. We independently evaluated all studies, and inclusion decisions were reached by consensus. From a primary list of 410 articles, eight interventional studies met the eligibility criteria. RESULTS: All eight eligible studies reported that handwashing lowered risks of respiratory infection, with risk reductions ranging from 6% to 44% [pooled value 24% (95% CI 6-40%)]. Pooling the results of only the seven homogenous studies gave a relative risk of 1.19 (95% CI 1.12%-1.26%), implying that hand cleansing can cut the risk of respiratory infection by 16% (95% CI 11-21%). CONCLUSIONS: Handwashing is associated with lowered respiratory infection. However, studies were of poor quality, none related to developing countries, and only one to severe disease. Rigorous trials of the impact of handwashing on acute respiratory tract infection morbidity and mortality are urgently needed, especially in developing countries.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-3156.2006.01568.x

Handwashing and risk of respiratory infections: a quantitative systematic review

Background: access to safe drinking-water is a fundamental requirement for good health and is also a human right. Global access to safe drinking-water is monitored by WHO and UNICEF using as an indicator “use of an improved source,” which does not account for water quality measurements. Our objectives were to determine whether water from “improved” sources is less likely to contain fecal contamination than “unimproved” sources and to assess the extent to which contamination varies by source type and setting. Methods and findings: studies in Chinese, English, French, Portuguese, and Spanish were identified from online databases, including PubMed and Web of Science, and grey literature. Studies in low- and middle-income countries published between 1990 and August 2013 that assessed drinking-water for the presence of Escherichia coli or thermotolerant coliforms (TTC) were included provided they associated results with a particular source type. In total 319 studies were included, reporting on 96,737 water samples. The odds of contamination within a given study were considerably lower for “improved” sources than “unimproved” sources (odds ratio [OR] = 0.15 [0.10–0.21], I2 = 80.3% [72.9–85.6]). However over a quarter of samples from improved sources contained fecal contamination in 38% of 191 studies. Water sources in low-income countries (OR = 2.37 [1.52–3.71]; p Conclusion: access to an “improved source” provides a measure of sanitary protection but does not ensure water is free of fecal contamination nor is it consistent between source types or settings. International estimates therefore greatly overstate use of safe drinking-water and do not fully reflect disparities in access. An enhanced monitoring strategy would combine indicators of sanitary protection with measures of water quality

/pdf/fecal-contamination-of-drinking-water-in-low-and-middle-oy48u11l6t.pdf

Fecal Contamination of Drinking-Water in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Post-defecation handwashing in bangladesh: Practiceand efficiency perspectives

This article was published in the PLoS ONE [© 2016 Biswas et al.] and the definitive version is available at: http://doi.org/10.1371/journal.pone.0167140 The Journal's website is at: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0167140

https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0167140&type=printable

Socio-Economic Inequality of Chronic Non-Communicable Diseases in Bangladesh.

Overweight and obesity among children and adolescents in Bangladesh: a systematic review and meta-analysis.

Aims: To evaluate the water quality of recently flooded tube wells in Bangladesh and the effect of spot chlorination on improving bacteriological quality.



Methods and Results:  The study team identified and tested water samples from 127 tube wells that were flooded within the preceding 4 weeks. Twenty-six of the tube wells with the highest concentration of thermotolerant coliform bacteria were randomly assigned to spot chlorination vs control. On initial screening, water samples from 56 recently inundated tube wells (44%) were contaminated with thermotolerant coliforms. Among the 13 wells randomized to chlorination, there was no change in the proportion of water samples that had no detectable thermotolerant coliform bacteria immediately before chlorine treatment (n = 4, 23%) and 60 min following chlorine treatment (n = 4, 23%). Similarly, there was no difference in the proportion of water samples that had no detectable thermotolerant coliforms between chlorine spot treated and control tube wells 7–18 days later (31 vs 23%P = 0·66).



Conclusions:  Spot chlorine treatment of inundated tube wells in Bangladesh three to 6 weeks after the flooding did not improve drinking water quality.



Significance and Impact of the Study:  Unless modified methods improve effectiveness, resources should not be spent promoting spot chlorination of flooded tube wells.

https://sfamjournals.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2672.2006.02940.x

Chlorine spot treatment of flooded tube wells, an efficacy trial

The prevalence of stunting, wasting, and underweight are reported separately. However, the data of the multiple anthropometric failures combinations of these conventional indicators are scant. This study attempted to estimate the overall burden of undernutrition among children under 5 years old, using the composite index of anthropometric failure (CIAF), and to explore the correlates. The study used secondary data from the Bangladesh demographic and health surveys (BDHS), undertaken in 2014. CIAF provides an overall prevalence of undernutrition, which gives six mutually exclusive anthropometric measurements of height-for- age, height-for-weight, and weight-for-age. Multivariable logistic regression was used to explore the correlates of CIAF. The overall prevalence of undernutrition using the CIAF was 48.3% (95% CI [47.1%, 49.5%]) among the children under 5 years old. The prevalence of anthropometric failure due to a combination of both stunting and underweight was 18.2%, wasting and underweight was 5.5%, and wasting, underweight, and stunting was 5.7%. The odds of CIAF were higher among young maternal age, having the poorest socio-economic status, living in rural areas, higher order of birth, and received no vaccination compared with other counterparts. In Bangladesh, one out of two children has undernutrition, which is preventing the potential of the millions of children. Mothers who gave birth before age 20 living in the rural areas with belonging to lower socio-economic status and whose children had a higher order of birth and receive no vaccination were observed as the main determinants of undernutrition. Nutrition sensitive interventions along with social protection programmes are crucial to deal the underlying causes of undernutrition.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.12930

Md. Saimul Islam

Papers

Post-defecation handwashing in bangladesh: Practiceand efficiency perspectives

Socio-Economic Inequality of Chronic Non-Communicable Diseases in Bangladesh.

Overweight and obesity among children and adolescents in Bangladesh: a systematic review and meta-analysis.

Chlorine spot treatment of flooded tube wells, an efficacy trial

Prevalence and correlates of the composite index of anthropometric failure among children under 5 years old in Bangladesh.