| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Book Reviews |
Department of Pediatrics University of Maryland School of Medicine 700 West Lombard Street Baltimore, MD 21201 E-mail: mblack{at}umaryland.edu
Nutrition, Health, and Child Development: Research Advances and Policy Recommendation, edited by Sally M Grantham-McGregor, 1998, 257 pages, softcover. Pan American Health Organization Publications Program, Washington, DC.
This publication is an excellent collection of 17 articles on children's health, nutrition, and development that emerged from a workshop held in Ocho Rios, Jamaica, in 1995. Research over the past 2 decades has documented the deleterious effects of deficits in nutrition, stimulation, and caregiving on children's health and development, particularly when they co-occur. This volume provides a major step linking research and policy in the development of effective programs that protect children against the negative effects of nutritional and environmental deprivation.
The list of authors is broad, interdisciplinary, and impressive, reflecting the importance of integrating pediatric, nutritional, psychologic, educational, and public health perspectives into programs to promote the health and development of children growing up in vulnerable circumstances, often with limited access to adequate nutrients. The book begins with an overview of literature pertaining to animals by James Smart, illustrating that animal research is plagued by some of the same methodologic challenges as is human research. Smart proposes 3 mechanisms linking undernutrition with behavior: a direct effect on the developing nervous system, a moderated effect whereby maternal caregiving buffers the effect of undernutrition on behavior, and an indirect effect whereby undernourished animals (or children) are functionally isolated from their environment and therefore do not experience stimulation to promote healthy behavior.
In their chapter on the role of the environment in human nutritional research, Ted Wachs and George McCabe present a theoretical framework that incorporates the frequent co-occurrence of nutritional deprivation and poverty. They encourage investigators to use nutrition-environment covariance as a unit of analysis and to examine indirect effects. For example, the quality of stimulation in the household may moderate the effects of nutrition on children's development.
Six of the chapters include work that was conducted in Jamaica. Julie Meeks Gardner and Sally Grantham-McGregor examine activity levels among several groups of children, finding no evidence that children's activity links undernutrition and development. Susan Walker, Christine Powell, and Sally Grantham-McGregor review the long-term effects of early childhood supplementation, stimulation, or both on the cognitive development of malnourished children and conclude that both interventions are beneficial, probably because supplementation enables the children to take advantage of the stimulation. The same group also examines the effect of early childhood stimulation programs in Jamaica and demonstrates their effectiveness in improving cognitive performance, regardless of the children's initial nutritional status. Two chapters examine school performance. One reports that anemia is associated with poor school performance in children in grades 5 and 8 and the other reports the beneficial effects of a school breakfast program on children's school performance and behavior. The final chapter investigates the link between parasitic infection and mental development.
Other chapters examine the link between cognitive performance and breast-feeding, dietary quantity and quality, iodine deficiency, parasitic infection, and iron deficiency. In addition, Ernesto Pollitt, Enrique Jacoby, and Santiago Cueto describe the negative effect of fasting (not eating breakfast) on cognitive performance among school-age children in Peru and the benefits of a school breakfast program on nutrient intake and attendance.
In summary, this book illustrates the conceptual and programmatic advances that have been made in understanding how nutritional and environmental factors influence children's development, and highlights the need for additional intervention research. Some of the chapters include policy implications, and Mary Ewing Young and Michael Latham each present chapters on policy and child development. The book provides compelling evidence that the next step in the process of promoting development among children at risk of nutritional deprivation is for investigators and policymakers to work together to develop and evaluate integrated programs linking nutrition, health, education, and the community.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
