Introduction. The survey was conducted to establish the midterm evaluation of the National Program on NCD Prevention and Control, and to establish baseline data for a health project funded by the Millennium Challenge Account (MCA).Goal The goal of the survey was to determine the prevalence alcohol consumption pattern among Mongolian adults using WHO-approved methods, and to inform on NCD and injury control activities.Objectives:To compare the current prevalence of alcohol consumption to that identified in the previous STEPS survey. Alcohol consumption patterns, frequency of drinking and risks associated with alcohol consumption will be studied according to gender, age and place of residence of the survey respondents.Materials and MethodsThe cross-sectional survey used WHO STEPS survey methodology adapted to the countries specifics. A total of 5638 randomly selected 15-64 year-old Mongolian residents of both sexes from 36 soums of 20 aimags and 6 districts of Ulaanbaatar city participated in the survey. The survey data was fully collected using small handheld computers (PDAs). Because the data was comprised of only a sample of the large population, it was necessary to weight the data, Thus sample weighting and adjustments to correct the differences in the age-sex distribution of the sample compared to the largest population were performed. Data analysis was conducted using EPI INFO version 3.5.1 using appropriate methods for the complex sample design of the survey. Outcome measures (prevalence and mean variance) and differences between groups (age, gender and urban\ rural groups) were calculated with 95% confidence intervals (95%).Results:34.2% of Mongolian adults did not use alcohol in their life-time and 65.8% of them used alcohol to some extent. The prevalence of binge drinking was 39.7% in men and 15.1% in women, and binge drinking was 2.5 times more common in males compared to females.

IntroductionClimate change has already been started in Mongolia. The frequency of natural disaster such as drought, zud disaster, snow storm, hot and cold extreme weather, and earthquake has increased every year. As per daily information of meteorological stations, annual air temperature has been increased since 1960. Children is more sensitive in varies environmental impacts compared with adults and adverse effects caused by climate changes can be remained in all lives and it can be irreversible. Relation between climate change and children’s health is one of the issues which have not been studied yet. The purpose of this study was to investigate relationship between respiratory diseases of children and climate change as well as some air pollution parameters.Materials and MethodsStudy was carried out by cross-sectional study design. According to the regional climate classification of Mongolia, Zavkhan, Selenge, Dornod and Umnugovi provinces was selected as a target area of the study. The relationship between respiratory disease of children and climate change as well as some air pollution parameters were analyzed based on statistical data of Health Departments and Family doctors’ documentation of those provinces for prevalence and incidence of respiratory disease among the children aged 0-16 and daily information of climate parameters such as air temperature, air pressure, relative humidity and precipitation status taken from selected provinces Meteorological Departments and data for air quality basic parameters (SO2, NO2, CO2, PM 10) taken from Air Quality Department of Ulaanbaatar city.ResultsRespiratory diseases among the target ages were registered highly (70.7%) in age of 0-5 years. According to the comparison results in incidence rate of respiratory diseases by region, upper respiratory tract diseases (J09-J18) and lower respiratory tract diseases (J20-J22) were registered in Umnugovi aimag (254.75 and 50.42cases per 10000 children)which belong to very dry and warm regions and Dornod aimag (121.62 and 26.11 cases per 10000 children) which belong to dryish cold regions in 2010. Respiratory tract diseases (J09-J18, J20-J22) were correlated weak indirectly with average air temperature and minimum average air temperature. It was correlated weak directly with wind speed and air pressure. Respiratory tract diseases (J09- J18, J20-J22) were correlated directly with SO2 concentration in air (r=0.269, p>0.001) and NO2 (r=0.286, p>0.001).ConclusionClimate change and air pollution could be influenced on the increase of morbidity of respiratory tract infections. Some air pollution parameters such as SO2, NO2 and PM2.5 and air temperature, air pressure, relative humidity and wind speed are the causes of respiratory tract infections among the children aged 0-16.

Background: Weight at birth is a good indicator of the mother’s health and nutrition status during gestation and a child’s chances for survival, growth, long-term health, and psychosocial development. Low birth weight (defined as less than 2500 grams) poses a range of serious health risks for children. Objective: To assess the prevalence of low birth weights (LBW). Materials and Methods: The NNS V was implemented in 21 provinces (aimags) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. A total of 2250 children aged 0-59 months. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design. For the selection of households in urban areas, the process involved first selecting 30 khoroos (clusters), then khesegs, and then households with a child 0-59 months of age. Ethical considerations : The survey methodology was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted the PHI Directors Order on 28th June, 2016. Ethics approval for conducting the NNS V, was obtained from the Medical Ethics Committee under the Mongolian Ministry of Health. Results: Almost all (99.5%) children in the sample were weighed at birth with 5.0% weighing less than 2500 grams at birth and 12.6% weighing over 4000 grams at birth. The prevalence of low birth weight was slightly higher among girls than boys, however high birth weight was much more common in boys (15.9%) compared to girls (9.5%). Prevalence of low birth weight was highest in Western region (9.6%) and the poorest households (7.8%) while the prevalence of high birth weight was highest in Ulaanbaatar (13.8%) and wealthiest households1 (16.4%). High birth weight was more than double among children of overweight (17.5%) and obese (17.3%) mothers compared to children of normal weight (8.4%) or underweight (7.0%) mothers. Among singleton births, women <29 years of age had higher LBW rates than did those 30-39 years of age in both years, irrespective of birth order. LBW rate was more than double among mothers in kazak ethnic groups (13.8%). Conclusions The younger age of the mother was more likely to develop low birth weight, and it was twice as high among mothers in Kazak ethnic groups. Therefore, adolescents and women of reproductive age needed to improve the health education and to identify the causes and risk factors of low birth weight among mothers in Kazak ethnic groups.

Background: Breastfeeding is the ideal food source for all newborns globally. Proper feeding of infants and young children promotes optimal growth and development, especially in the critical window from birth to 2 years of age. Exclusive breastfeeding for 6 months and continued breastfeeding for the first 2 years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. Objective: To assess the indicators of infant feeding practices among 0- 23 months old children. Materials and Methods: The NNS V was implemented in 21 aimags (provinces) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design [1]. The infant and young child feeding indicators assessed in the NNS V were based on the mother’s or caretaker’s report of breastfeeding and consumption of foods and fluids by the child during the day or night prior to being interviewed. Results: 83.7% of children under 2 years started breastfeeding within 1 hour of birth and though almost all children were ever breastfed (97.9%), a slightly higher percentage of girls were ever breastfed overall and within 1 hour of birth. Children 0-5 months were categorized according to whether they were exclusively breastfed or predominantly breastfed, with the former only allowing vitamins, mineral supplements, and medicine and the latter also including plain water and non-milk liquids. Among children 0-5 months of age, 58.3% were exclusively breastfed and 65.3% were predominantly breastfed, having received other liquids or foods in addition to breast milk. The prevalence of exclusive breastfeeding was lowest in the 4th wealth index quintile (46.5%) and wealthiest quintile (54.0%) households. Conclusions Exclusive breastfeeding and early initiation of breastfeeding practices are unacceptably low in Mongolia; 20% of newborns are not breastfed within 1 hour of birth and more than 40% of infants under 6 months of age are not exclusively breastfed and therefore, not receiving optimum nutritional and immunity benefits from breast milk. Strengthening IYCF counselling in all regions and wealth quintiles to support women to practice optimal breastfeeding, along with counselling and awareness of timely and adequate complementary feeding for children under 2 years of age, should be a top priority for public health and as it is a key strategy to reduce malnutrition in children.

Background : Overweight and obesity are conditions of over nutrition resulting from consumption of more calories than the body requires leading to excess body fat accumulation. The prevalence of both overweight and obesity is increasing globally in all age groups in high, middle, and low-income countries and is largely attributed to the “nutrition transition” with a shift from traditional diets to readily available and inexpensive, low-nutrient unhealthy foods high in energy [1].
The move away from traditional to “junk” foods often occurs at the same time as the move of populations away from daily physical activity and increase in sedentary activities such as time spent in front of a phone, computer, or television, furthering increasing the risk of becoming overweight. People who are overweight or obese are at higher risk for serious health problems including hypertension, heart disease, stroke, diabetes, some cancers, and osteoarthritis. The increase in overweight and obesity is accompanied by a dramatic increase in prevalence of above mentioned chronic conditions in the worldwide. While the long-term repercussions of overweight and obesity are severe, they are largely preventable and treatable through healthy diets and healthy lifestyle behaviors [2]. Materials and Methods: The fifth National nutrition survey (NNSV) was implemented in 21 provinces (aimags) in 4 socio-economic regions (Central, Eastern, Khangai, and Western) and the capital city of Ulaanbaatar. Given the regional differences in dietary patterns and nutrition status, target populations were stratified into 5 strata based on 4 regions and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design. In total, 1750 school children data on demographic and dietary information collected by interview methods and anthropometric measurement results were used in this study. Ethical considerations: The survey protocol was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted by order of director of Scientific committee of PHI on 28th June, 2016. Ethical approval for conducting the NNS V was obtained from the Medical Ethics Committee under the Ministry of Health of Mongolia on July 7, 2016. Participation in the survey was voluntary, oral and written informed consent were obtained from adult caregivers of each children. Results: Consumption of unhealthy or junk (high-calorie, low-nutrient) foods in the past week was nearly universal (99.0%) among school children 6-11 years of age. Over half of children (51.4%) consumed junk foods at least once per week and 45.7% consumed junk foods a few times a week. Consumption of sugar-sweetened beverages was high with 80.9% of children consuming these at least once in the past week. Overall consumption of fried foods was lower than consumption of junk foods or sugar-sweetened beverages with 22.7% of children not consuming any fried foods in the past week and only 8.5% of children consuming fried foods a few times per week. Consumption of sweet foods was high with nearly all children having consumed sweet foods in the past week, 45.9% of children 6-11 years having consumed sweet foods a few times per week.
The prevalence of overweight (BMI > +1 SD) was 22.2% and prevalence of obesity (BMI > +2 SD) was 6.4%. Overweight prevalence was higher in boys (26.6%) compared to girls (17.8%) and in urban (23.9%) compared to rural (17.6%) areas with the highest prevalence in Ulaanbaatar (25.6%) compared to other regions. Children 6 years old (26.1%) and 7 years old (25.6%) had a higher prevalence of overweight than older children. Conclusion
1. Consumption of unhealthy foods and drinks is common to 6-11 year olds group, with almost all children (99.2%) consuming any type of unhealthy foods and drinks at least once per week, in particular, 8 out of 10 children were found consuming sugary drinks and/or deep fried food.
2. The consumption of unhealthy foods was not differing by child’s sex, there were revealed significant differences between living area and regions. Proportion of the school children 6-11 years of age was relatively higher in Ulaanbaatar city and urban settings.
3. The prevalence of overweight and obesity in school children aged 6-11years sharply increased from 2010 NNS IV level and reached 22.2% and 6.4%, respectively. Among children with obesity consumption of any unhealthy foods and sugary drinks were 1.4–1.9 times higher than nonobese children, respectively.

Background: Overweight and obesity are conditions of over nutrition resulting from consumption of more calories than the body requires leading to excess body fat accumulation. The prevalence of both overweight and obesity is increasing globally in all age groups in high, middle, and low-income countries and is largely attributed to the “nutrition transition” with a shift from traditional diets to readily available and inexpensive high-energy and low-nutrient foods [1].
The move away from traditional to “Junk” foods often occurs at the same time as the move of populations away from daily physical activity and increase in sedentary activities such as time spent in front of a phone, computer, or television, furthering increasing the risk of becoming overweight. People who are overweight or obese are at higher risk for serious health problems including hypertension, heart disease, stroke, diabetes, some cancers, and osteoarthritis. The increase in overweight and obesity is accompanied by a dramatic increase in prevalence of these chronic diseases at the global level. While the long-term repercussions of overweight and obesity are severe, they are largely preventable and treatable through healthy diets and healthy lifestyle behaviors [2]. Materials and Methods: The NNS V was implemented in 21 provinces (aimags) in 4 economic regions (Central, Eastern, Khangai, and Western) and the capital city of Ulaanbaatar. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design [3]. Total participated 1944 mothers’ years of age who had a child aged 0-59 months. Ethical considerations : The survey methodology was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted the PHI Directors Order on 28th June, 2016. Ethics approval for conducting the NNS V, including obtaining biological (blood and urine) samples, was obtained from the Medical Ethics Committee under Ministry of Health, Mongolia on 7th July, 2016 with granted approval to conduct the survey and send blood serum samples to the VitMin laboratory in Germany. Participation in the survey was voluntary and oral and written informed consent was obtained from all individuals selected for the survey. Participant confidentiality was maintained during data collection, data entry, data analysis, and in the dissemination of survey findings. Results: Nearly half of mothers (46.2%) were overweight with 16.5% of mothers obese and 4.1% underweight. The prevalence of overweight in mothers was highest in rural areas (50.1%), married status (49.3%), and lowest in Ulaanbaatar (42.3%) compared to other regions (48.6% to 52.6%). The overall prevalence of anaemia among mothers was 16.2% with highest prevalence amongst Kazakh (31.9%) and other ethnic minority mothers (25.1%), mothers with secondary education (20.3%) and unemployed mothers (19.9%). Minimum dietary diversity is a proxy indicator for the nutrient content of a diet based on consumption of at least 5 of 10 food groups.¹ People who consume food items from at least 5 food groups are likely to consume at least 1 animal-source food and items from 2 or more of the fruit and vegetable food groups. In the NNS V, 70.2% of mothers met the minimum dietary diversity requirement with a higher prevalence in urban areas (74.8%) and Ulaanbaatar (77.5%). Conclusion: The prevalence of overweight and obesity in mothers of reproductive age is 46.2%, with the highest percentage of mothers with overweight and obesity being in rural areas (50.1%), which is 5.8 percentage points higher than that of urban mothers. 16.2% of mothers are anemic. Prevalence of Minimum dietary diversity among mothers is 70.2%. Food consumption is inadequate in mothers with the primary and secondary education, and in mothers in rural areas, and in poorest mothers or in mothers with the second and third wealth index. ¹FAO and FHI 360. 2016. Minimum Dietary Diversity for Women: A Guide for Measurement. Rome: FAO.