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Food and Nutrition Bulletin - Volume 20, Number 1, March 1999

Table of Contents

United Nations University Press

Published by the United Nations University Press,
Tokyo, Japan.
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Food and Nutrition Bulletin

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International Nutrition Foundation, Inc.
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The Food and Nutrition Bulletin incorporates and continues the PAG Bulletin of the former Protein-Calorie Advisory Group of the United Nations system and is published quarterly by the United Nations University Press in collaboration with the United Nations ACC Sub-committee on Nutrition.

All correspondence concerning the content of the Bulletin, comments, news, and notices should be sent to the editor at the Boston editorial office address given above.

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Editorial policy

The Food and Nutrition Bulletin is intended to make available policy analyses, state-of-the-art summaries, and original scientific articles relating to multidisciplinary efforts to alleviate the problems of hunger and malnutrition in the developing world. It is not intended for the publication of scientific articles of principal interest only to individuals in a single discipline or within a single country or region. Notices of relevant books and other publications will be published if they are received for review. The Bulletin is also a vehicle for notices of forthcoming international meetings that satisfy the above criteria and for summaries of such meetings.

The Food and Nutrition Bulletin also serves as the principal outlet for the publication of reports of working groups and other activities of the UN ACC Sub-committee on Nutrition (SCN) and its Advisory Group on Nutrition. The SCN itself is a focal point for coordinating activities of FAO, WHO, UNICEF, the UNU, UNESCO, the World Bank, the World Food Programme, the World Food Council, the United Nations Environment Programme, and other bodies of the United Nations system that have an interest in food and nutrition.

Submissions. Unsolicited manuscripts of articles of the type published in this and previous issues may he sent to the editor at the Boston office address given above. They must be typed, double-spaced, with complete references and must include original copy for any figures used (see the “Note for contributors” in the hack of this issue).

Any disciplinary or conceptual approach relevant to problems of world hunger and malnutrition is welcome, and controversy over some of the articles is anticipated. Letters to the editor are encouraged and will be printed if judged to have an adequate basis and to be of sufficient general interest.

Peer review. The Bulletin is a peer-reviewed journal. Every article submitted first receives editorial review. If it is consistent with the editorial policy and is not obviously deficient in some way, it is sent to two or sometimes three experienced and knowledgeable reviewers. Occasionally a paper may be returned to the authors by the editor with suggestions for improvement before it is submitted to the reviewers.

If two reviewers agree that the paper should be published in the Bulletin, it is accepted and either sent immediately for copy-editing or returned to the authors for consideration of suggestions from the reviewers and the editor. If both reviewers agree that the paper should not be accepted, the editor writes a personal letter to the authors explaining the reason and enclosing the comments of the reviewers anonymously- if the reviewers do not agree with each other, either the paper is sent to a third reviewer or a decision is taken by the editor. In these cases, the authors are usually given a chance to respond to the reviewers’ comments.

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The United Nations University (UNU) is an organ of the United Nations established by the General Assembly in 1972 to be an international community of scholars engaged in research, advanced training, and the dissemination of knowledge related to the pressing global problems of human survival, development, and welfare. Its activities focus mainly on peace and conflict resolution, development in a changing world, and science and technology in relation to human welfare. The University operates through a worldwide network of research and postgraduate training centres, with its planning and coordinating headquarters in Tokyo.

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Food and Nutrition Bulletin

Editor: Dr. Nevin S. Scrimshaw
Assistant Editor: Ms. Edwina B. Murray
Manuscripts Editor: Mr. Jonathan Harrington
Senior Associate Editor - Clinical and Human Nutrition;
Dr. Cutberto Garza, Director and Professor. Division of Nutritional Sciences, Cornell University, Ithaca, N.Y., USA
Senior Associate Editor - Food Science and Technology:
Dr. Ricardo Bressani, Institute de Investigaciones, Universidad del Valle de Guatemala, Guatemala City, Guatemala Associate Editors:
Dr. Abraham Besrat, Senior Academic Officer, United Nations University, Tokyo, Japan
Dr. Hernán Delgado, Director, Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
Dr. Joseph Hautvast, Secretary General, IUNS, Department of Human Nutrition, Agricultural University, Wageningen, Netherlands
Dr. Peter Pellett, Professor, Department of Food Science and Nutrition, University of Massachusetts, Amherst, Mass., USA
Dr. Zewdie Wolde-Gabreil, Director, Ethiopian Nutrition Institute, Addis Ababa, Ethiopia
Dr. Aree Valyasevi, Professor and Institute Consultant, Mahidol University, Bangkok, Thailand

Food and Nutrition Bulletin, vol. 20, no. 1

© The United Nations University, 1999

United Nations University Press
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Table of Contents

Introductory statement


Summary of the scientific evidence on the nature and determinants of child development and their implications for programmatic interventions with young children

The size of the problem
The nature of early childhood development
Determinants of child development
Programmatic actions

Programme characteristics and content
Evaluation and assessment

The nature and nurture of child development

Processes that promote or hinder developmental competence

Development is multidetermined
Covariance among developmental influences
Temporal moderation

Implications for intervention
What not to do
Principles for effective and cost-effective interventions

Across time


Assessing intellectual and affective development before age three: a perspective on changing practices

Myths concerning intelligence testing in early childhood
Principles of assessment
Interdependence of development
Multiple sources and multiple components
Assessment sequence
Child-caregiver relationships
Framework of typical development
Emphasis on organizing and functional capabilities of the child
Identify current and emerging competencies and strengths
Collaborative process
Assessment as the beginning of intervention
Reassessment as an ongoing process

Epidemiology of child developmental problems: The extent of the problems of poor development in children from deprived backgrounds

Scope of the problem
Minorities in poverty
Effects of poverty on development
Epidemiological evidence
Epidemiological measures of effect
Single-component models

Short-term interventions
Long-term interventions

Multicomponent models

Model programmes

Developing countries
Practical applications

Head start

Integrative services model

Linda ray intervention program
Cognition and language
Home environment


Developmental epidemiology
Implications for public policy


Stability, predictive validity, and sensitivity of mental and motor development scales and pre-school cognitive tests among low-income children in developing countries

Data source

Infant development scales: mental
Infant development scales: motor
Test administered during pre-school period
Tests administered during school period


Infant development scales: mental
Infant development scales: motor
Pre-school assessments (36 to 84 months)
Prediction of performance at school age

Discussion and conclusions

Effects of health and nutrition on cognitive and behavioural development in children in the first three years of life. Part 1: Low birthweight, breastfeeding, and protein-energy malnutrition

Low birthweight
Studies of children in the first two years
Studies of children two to seven years of age
Studies of children 7 to 17 years of age
Other outcomes
Interactions with the environment
Conclusions about the effects of IUGR on development
Study design
Short-term effects of breastfeeding
Long-term effects of breastfeeding

Fatty acids
Immune response
Maternal-child interaction

Conclusions and policy implications
Protein-energy malnutrition
Severe malnutrition
Moderate stunting and wasting

Cross-sectional associations between height and development
Other functional associations

Longitudinal associations
Supplementation studies

Preventive supplementation studies
Intervention with stunted or wasted children

Vulnerable age
Conclusions about mild-to-moderate stunting
Policy implications and recommendations

Effects of health and nutrition on cognitive and behavioural development in children in the first three years of life. part 2: infections and micronutrient deficiencies: iodine, iron, and zinc

Parasitic infections
Diarrhoea and respiratory infections
Iodine deficiency

Observational studies
Intervention studies
Conclusions about iodine deficiency and development
Policy implications

Iron deficiency

Iron-deficiency anaemia and concurrent development
Longitudinal studies of development of children who had iron-deficiency anaemia in infancy
Conclusions from longitudinal studies
Treatment trials in children under two years of age
Conclusions from preventive trials
Iron-supplementation studies of anaemic school-aged children
Summary of findings and conclusions on iron deficiency and child development
Policy implications

Zinc deficiency
Other nutritional deficiencies

Vitamin A deficiency

General conclusions and policy implications

A developmental function of motor activity among nutritionally at-risk children


Research design
Communities and day-care centres
Variables and measurements


Developmental function of motor activity (12 to 30 months)
Energy intake and anthropometry
Processes involved in the regulation of motor actions


Overview of early child-care and education programmes and Jamaican case studies

Intervention programmes in the United States

Programmes for children under two years of age: predominantly centre based
Programmes for children under two years of age: predominantly home based

Programmes for children over two years of age: Centre based, home based, or both
Long-term follow-up after intervention
Intervention programmes in developing countries

Studies in various countries
Jamaican studies

Summary and conclusions

Developed countries
Developing countries


The role of care in programmatic actions for nutrition: Designing programmes involving care

Defining care
Care during complementary feeding

Adaptation to psychomotor abilities for self-feeding
Feeding responsively
The feeding situation

Psychosocial care

Responsiveness to developmental milestones and cues
Attention, affection, and involvement
Encouragement of autonomy, exploration, and learning

The research and development process for care

Evidence for the effectiveness of care in interventions
Effects of care on child growth and development: correlational studies
Effects of care on child development: experimental studies or efficacy studies
Effects of care on child growth: experimental studies or efficacy studies

Incorporating care in the design of programmes

Examples of programmes that involve care

Current work on care
Conclusions and recommendations

World bank support for early childhood development: Case studies from Kenya, India, and the Philippines

Situation analysis of the development status of children


Situation analysis of existing programmes


Project objectives


Project components, coverage, and costs


Monitoring and evaluation
Cross-cutting issues and implications for future programmes

Building on home-grown early childhood development models
Targeting the poorest
Delivery of an integrated package of services
Monitoring and evaluation

Key challenges

Economic considerations for analysis of early childhood development programmes

Analytical frameworks for considering the determinants of and the impact of human resources investments in childhood development

Direct production function impact of childhood development
Household demands for human resource investments such as in child development

Estimation issues in ascertaining the determinants of and the impact of investments in childhood development

Estimated relations related to childhood development
Estimation problems in attempting to ascertain the determinants and impact of childhood development
Possible resolutions for estimation problems

Framework for policy choices related to childhood development

Brief definitions of basic motives for policy changes
Specific examples of possible inefficiencies in childhood development


Books received

News and notes

UNU food and nutrition programme

Note for contributors

Note à l’intention des auteurs

Nota para los posibles autores

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