bluuebunny/crossref_metadata_2025 huggingface dataset:
Iris Iii: Proposal of a Multicenter Efficacy Study Using a High-Energy, Micronutrient-Dense Spread
Authors: de Romaña Guillermo López , Gross Rainer
Published: November 2015

There is an urgent need for the development of a high-energy, micronutrient-dense food, such as a spread, for clinical and emergency nutrition. The spread to be used in the International Research on Infant Supplementation (IRIS) III trial will contain carotene-rich palm oil as a source of vitamin A and energy, and heme iron from slaughterhouse blood as an iron source. All other micronutrients shall come from a pre-mix. The product shall be designed for young children, in particular, but can be consumed by adults, as well. An efficacy study will be conducted for six months in children 6 to 12 months old.
International Workshop on Multi-Micronutrient Deficiency Control in the Life Cycle, Lima, Peru, May 30–June 1, 2001
Authors: Gross Rainer , Dwivedi Archana , Scrimshaw Nevin
Published: November 2015

Thirty-one representatives from international organizations, nongovernmental organizations, government agencies, universities, and the private sector participated in a three-day workshop in Lima, Peru, organized by the Universidad Nacional Agraria La Molina and supported by the Ministry of Health Peru, UNICEF, and the World Health Organization. The objective of the workshop was to develop a protocol for a comprehensive micronutrient supplementation program for populations in developing countries that suffer from deficiencies of several micronutrients. The workshop consisted of two components: presentation of preliminary results of the multicenter study on infant supplementation and recommendations on the policy and community, monitoring and impact evaluation, and research aspects of supplementation programs. This paper provides the summary reports of the second component.
Lysine Fortification of Wheat Flour Improves Selected Indices of the Nutritional Status of Predominantly Cereal-Eating Families in Pakistan
Authors: Hussain Tajammal , Abbas Shaid , Khan Mushtaq A. , Scrimshaw Nevin S.
Published: November 2015

Wheat provides more than 50% of the protein and calorie intake of the population of Pakistan. Legumes and animal protein that could complement the amino acid pattern of wheat, in which lysine is the first limiting amino acid for utilization of protein, are not affordable by members of lower socioeconomic groups in developing countries. The purpose of the study was to determine whether lysine fortification of wheat flour would have a positive impact on populations consuming a predominantly wheat-based diet. A double-blind study was carried out for three months on the outskirts of Peshawar, Pakistan. Forty families received wheat flour fortified with lysine, and 40 families received wheat flour without lysine. Wheat provided 59% of the protein for men, 65% for women, and 58% for children. The weight and height of the children in both groups increased during the study, but the increase was significantly greater in the lysine group. Hemoglobin increased significantly in the women receiving lysine-fortified flour. Transferrin levels increased significantly in men, women, and children in the lysine group as compared with those in the control group. Prealbumin increased significantly in adults receiving additional lysine but decreased in children. Men, women, and children in the lysine-supplemented families had significant increases in CD4, CD8, and complement C3 as compared with controls. These results indicate that lysine fortification of wheat flour can significantly improve sensitive indicators of nutritional status in a population consuming a diet in which 58% to 65% of the protein, depending on age and sex, is supplied by wheat.
Prevalence of Overweight and Obesity among High-School Girls in Tabriz, Iran, in 2001
Authors: Gargari Bahram Pourghassem , Behzad Mahdiyeh Hamed , Ghassabpour Saeideh , Ayat Arezoo
Published: November 2015

Overweight and obesity are among the most prevalent nutritional problems in developed and developing countries. In this descriptive study, we attempted to determine the prevalence of overweight and obesity in Iranian adolescent girls attending high school in Tabriz. A sample of 1,650 (final study group, 1,518) high-school girls aged 14 to 20 years was selected by stepwise random sampling from five districts of Tabriz. Overweight and obesity were defined according to body mass index (BMI) percentiles from the First National Health and Nutrition Examination Survey (NHANES I) and the International Obesity Task Force (IOTF) BMI cutoffs. According to the NHANES I criteria, 14.6% of the study subjects were overweight or obese. Overweight and obesity was seen in 11.1% and 3.6% of the students, respectively. By the IOTF cutoffs, 14% of the subjects were overweight or obese. Overweight and obesity were seen in 10.1% and 3.9% of the students, respectively. Of the study subjects, 8% had a BMI below the 15th percentile of NHANES I, an indicator of underweight. The prevalence of overweight and obesity in Tabriz high-school girls is higher than in many, but not all, parts of Iran, but lower than in some neighboring countries such as Saudi Arabia. In this age group, in addition to overweight and obesity, underweight (BMI ≤ 15th percentile) is also present.
Prevalence of Aflatoxins in Blood and Urine of Egyptian Infants with Protein–Energy Malnutrition
Authors: Hatem Nadia L. , Hassab Hoda M. A. , Al-Rahman Ehsan M. Abd , El-Deeb Sami A. , Ahmed Rania L. El-Sayed
Published: November 2015

The aim of the present work was to study the presence of aflatoxins in blood and urine of infants with protein–energy malnutrition (PEM). The study was conducted on 60 infants, 30 with kwashiorkor and 30 with marasmus, with 10 age-matched healthy infants studied as a control group. Complete blood count, liver function tests, and determination of the level of aflatoxins (B1, B2, G1, G2, M1, M2, G2a, B3, GM1, P, and aflatoxicol R0) in blood and urine were carried out in all studied infants. Serum aflatoxins were detected in more infants with kwashiorkor (80%) than in those with marasmus (46.7%). The mean serum levels of total aflatoxins, AFB1, AFG1, and AFB2a, were significantly higher in infants with kwashiorkor (p <.001). Aflatoxin B1 (AFB1) was the most commonly detected type. The prevalence of aflatoxin excretion in the urine of infants with kwashiorkor was 80%, a higher value than that in infants with marasmus (46.7%). The mean urinary concentration of total aflatoxins followed the same pattern of distribution (p < .052). There were no significant differences between groups in the mean urinary concentrations of AFB1, AFG1, AFB2a, AFM1, and AFG2a. Aflatoxins were not detected in any of the serum or urine samples of the control group. Aflatoxins are highly prevalent in this study population and show a high degree of correlation with severe PEM.
Community Assessment of Availability, Consumption, and Cultural Acceptability of Food Sources of (PRO)Vitamin A: Toward the Development of a Dietary Intervention among Preschool Children in Rural Burkina Faso
Authors: Nana Constance P. , Brouwer Inge D. , Zagré Noel-Marie , Kok Frans J. , Traoré Alfred S.
Published: November 2015

Background

Vitamin A deficiency remains a public health problem in Burkina Faso and elsewhere in the developing world. Dietary diversification is a promising strategy that needs to be explored to strengthen the country's ongoing supplementation program.

Objective

The purpose of this study was to identify locally available and acceptable (pro)vitamin A–rich foods to be included in a dietary intervention addressing vitamin A deficiency in children aged six months to three years.

Methods

A food ethnographic study combining recall methods, observation, and focused group discussion was conducted in the dry and rainy seasons. Thirty-five mother–child pairs were randomly selected and included in the study.

Results

The dietary pattern of children was characterized by low diversity with extremely low energy and vitamin A intake in both seasons. The study identified the availability of numerous (pro)vitamin A–rich foods, but these foods are either not consumed or consumed by few in low amounts and/or in low frequencies. The main constraining factors identified are related to financial accessibility (for liver), seasonal availability (for egg, milk, mango, papaya, and green leafy vegetables), and beliefs related to consumption and preparation (for green leafy vegetables). However, the study also revealed that the study population associated all identified (pro)vitamin A–rich foods with positive attributes such as health, strength, and vitamin richness, which might offer an entry point for designing and implementing dietary interventions.

Conclusions

Based on the findings of this formative research, intervention strategies with mango and liver are proposed to improve the vitamin A intake and status of children in the rural areas of Burkina Faso.
Social and Economic Development and Change in four Guatemalan Villages: Demographics, Schooling, Occupation, and Assets
Authors: Maluccio John A. , Melgar Paúl , Méndez Humberto , Murphy Alexis , Yount Kathryn M.
Published: November 2015

This article uses census data and village histories to examine changes over the last 35 years in the four villages where the Institute of Nutrition of Central America and Panama (INCAP) Longitudinal Study (1969–77) was conducted and offers a rare picture of development and change in rural localities over a long period of time. In addition, by characterizing the environment in which the subjects of this study were raised, we provide context for and inputs into quantitative analyses of data collected at various points in time on these subjects. The villages have undergone massive demographic, social, and economic change. Initial differences have conditioned many of these changes, especially differences associated with agricultural potential and location. Originally these villages were rather isolated, but road and transportation access has improved substantially. The populations in the villages have more than doubled and also have aged. While marriage patterns have held steady, religious practice has changed a great deal. After many years of steady out-migration, three of the four villages are more recently experiencing net in-migration, a pattern associated with ease of access. Schooling access and outcomes also have improved, with average grades of schooling nearly tripling and literacy doubling to levels currently above national averages. Although agriculture remains an important component of individual livelihood strategies, non-agricultural sources of employment have become more important. Much of this change is associated with declining agricultural markets and increased access to non-agricultural jobs near the villages and in the capital. Accompanying these changes has been an improvement in living standards as measured by a number of indicators of household living conditions and consumer durable goods.
Levels, Correlates, and Differences in Human, Physical, and Financial Assets Brought into Marriages by Young Guatemalan Adults
Authors: Quisumbing Agnes R. , Behrman Jere R. , Maluccio John A. , Murphy Alexis , Yount Kathryn M.
Published: November 2015

This article examines marriage patterns among individuals who participated as children in a nutrition supplementation trial in Guatemala and were followed up in 2002–04, at ages 25–42 years. Of all 1,062 known and alive couples, 735, or 69%, responded fully to the marriage assets questionnaire. Focus of the analysis is on the birth cohorts born prior to 1974, a total of 1,058 intervention participants, among whom four-fifths of men (82%) and of women (78%) were married at the time of the 2002–04 survey. Basic patterns are examined in current marital status, age at first marriage and related milestones, human capital assets brought to marriage (e.g., schooling attainment, cognitive ability, literacy, and pre-marital work experience), and physical assets and savings accounts brought to marriage. Measures of husbands' human capital at marriage are positively correlated with wives' human capital, but are consistently higher. Husbands also bring substantially more physical and financial assets than wives. A number of interesting patterns emerge, including (1) changes in the composition of assets that women bring to marriage from physical to human assets, (2) declining gaps in age and premarital work experience between husbands and wives, and (3) increasing gaps in schooling attainment and cognitive ability between husbands and wives. Given conflicting directions of change in spousal gaps in human, physical and financial assets, their net effect on changes over time in the bargaining power of husbands and wives is uncertain and deserves further investigation.
Physical Activity Level, Dietary Habits, and Alcohol and Tobacco Use among Young Guatemalan Adults
Authors: Stein Aryeh D. , Gregory Cria O. , Hoddinott John , Martorell Reynaldo , Ramakrishnan Usha , Ramírez-Zea Manuel
Published: November 2015

Physical activity, diet, and alcohol and tobacco use are all related to the development of obesity, diabetes, coronary heart disease, osteoporosis, and cancer. We examined the distribution of measures of these behaviors in a cohort of individuals born in four villages in Guatemala between 1962 and 1977 and who were 26–41 years old in 2003. Response rates to the instruments averaged 80% of cohort members known to be living in Guatemala. Physical activity levels were moderate, and were lowest among migrants to Guatemala City. Dietary habits reflect early phases of the nutrition transition, with high carbohydrate and moderate fat intakes. Migrants to Guatemala City reported higher intakes of meat and of dairy products, while those remaining in or near the original study villages reported higher consumption of tortillas and of vegetables and fruits. One-third of men reported consuming alcohol and 42% were current smokers. Very few women reported alcohol or tobacco use.
Children's Healthful Eating: From Research to Practice
Authors: Worsley Anthony
Published: November 2015

This paper provides a brief overview of some of the challenges facing the world community in promoting the nutrition status of schoolchildren. It begins by describing the main objectives and aims of children's nutrition promotion and then moves to consider the needs and environments of schoolchildren, the purposes of education and food and nutrition promotion, and the domains of schools and teachers. In the second part of the paper the evidence bases for food and nutrition promotion are considered, especially the gaps in current knowledge. This leads to a discussion of useful practice models as well as a case study of a school health promotion program in Australia. The final part of the paper examines some proposals for schoolchildren's food and nutrition policies, which might be implemented in local schools as well as nationally and internationally. The main theme underlying these proposals is that policies must be created and their effectiveness monitored regularly and reported back to schoolteachers, health workers, school communities, and governments.
Linking Nutrition and Education: A Cross-Generation Model
Authors: Wachs Theodore D.
Published: November 2015

Psychosocial influences, such as the family or the school, and biologic influences, such as nutrition or the presence of environmental toxins, can be viewed as elements of a child's overall environment. Family and school influences define dimensions of the child's psychosocial environment whereas nutrition and exposure to toxins define dimensions of the child's bioecologic environment. This paper presents a cross-generation model specifying both the nature and consequences of linkages between the psychosocial and bioecologic environments, with specific reference to schooling, nutrition, and development. Data from two studies done in Egypt and Peru are used to illustrate this model, showing how duration of breastfeeding and quality of the young child's diet are positively associated with higher levels of maternal education and intelligence.
The Impact of Child Health and Nutrition on Education in Developing Countries: Theory, Econometric Issues, and Recent Empirical Evidence
Authors: Glewwe Paul
Published: November 2015

Analysis of the impact of child health and nutrition on subsequent school performance is hampered by many difficulties. Research using retrospective data is complicated by the possibility that unobserved factors may determine both nutrition and education outcomes, which will generate correlation between these two outcomes that is not necessarily causal. Randomized trials offer a clearer method for identifying causal relationships, but they are relatively rare and encounter several difficulties in practice. This paper examines theory, estimation strategies, and recent empirical evidence to assess the current state of knowledge on the impact of child health and nutrition on education outcomes in developing countries.
Urinary Iodine Concentration of Pregnant Women and Female Adolescents as an Indicator of Excessive Iodine Intake in Sri Lanka
Authors: Silva K. D. Renuka R. , Lalani D. , Munasinghe L.
Published: November 2015

Background

Mild deficiencies and excesses of iodine have deleterious effects in both females and males. The iodine status of the population after implementation of the universal salt iodization program in Sri Lanka is not known.

Objective

This cross-sectional study was carried out to assess the iodine status of pregnant women and female adolescents, with urinary iodine concentration used as the measure of outcome.

Methods

The participants were 100 women in the first trimester of pregnancy and 99 female adolescents in Kuliyapitiya, Kurunegala District, North-Western Province, Sri Lanka. The urinary iodine concentration was measured in a casual urine sample from each subject. The iodate contents of salt samples collected from households of the adolescents participating in the study were also measured.

Results

The median urinary iodine concentration of 185.0 μg/L and the prevalence of values under 50 μg/L of only 1% among the pregnant women indicate adequate iodine intake and optimal iodine nutrition. The median urinary iodine concentration (213.1 μg/L) among female adolescents indicates a more than adequate iodine intake and a risk of iodine-induced hyperthyroidism. Approximately 8% and 4% of the adolescents and pregnant women, respectively, had urinary iodine concentrations in the range of mild iodine deficiency (51 to 100 μg/L). More than half of the adolescents (56%) and 39% of the pregnant women had urinary iodine concentrations higher than optimal. The median iodine content in salt samples was 12.7 ppm. Only 20.2% of the samples were adequately iodized, and 10.1% of the samples had very high iodine levels.

Conclusions

Female adolescents and pregnant women had no iodine deficiency, but a considerable proportion of them, especially female adolescents, were at risk for iodine-induced hyperthyroidism. There is thus a need for proper monitoring of the salt iodization program to achieve acceptable iodine status.
Agricultural Biodiversity, Nutrition, and Health: Making a Difference to Hunger and Nutrition in the Developing World
Authors: Frison Emile A. , Smith Ifeyironwa Francisca , Johns Timothy , Cherfas Jeremy , Eyzaguirre Pablo B.
Published: November 2015

Background

In spite of the strides made globally in reducing hunger, the problems of micronutrient deficiencies and coexisting obesity and related cardiovascular and degenerative diseases constitute a formidable challenge for the future. Attempts to reverse this trend with single-nutrient intervention strategies have met with limited success, resulting in renewed calls for food-based approaches. The deployment of agricultural biodiversity is an approach that entails greater use of local biodiversity to ensure dietary diversity.

Objective

To outline a new strategy proposed by the International Plant Genetic Resources Institute (IPGRI) that employs agricultural biodiversity as the primary resource for food security and health.

Methods

The authors carried out a meta-analysis to review and assemble existing information on the nutritional and healthful properties of traditional foods based on a diverse set of case studies and food composition and nutritional analysis studies. The methods highlight particular examples of foods where analysis of nutrient and non-nutrient composition reveals important traits to address the growing problems of malnutrition associated with the rise of chronic diseases. Finally, the authors analyze social, economic, and cultural changes that undermine the healthful components of traditional diets.

Results

Based on this multidisciplinary and comparative approach, the authors suggest a holistic food-based approach that combines research to assess and document nutritional and healthful properties of traditional foods, investigating options in which nutritionally valuable traditional foods can contribute to better livelihoods, and ways that awareness and promotional campaigns can identify healthful components of traditional diets that fit the needs of urban and market-oriented consumers.

Conclusions

There is an urgent need for agricultural research centers, national agricultural research systems, universities, and community-based organizations to work together under a shared policy framework with the aim of developing a strong evidence base linking biodiversity, nutrition, and health. Although these initiatives are still ongoing, the gains realized in small-scale and local pilot efforts have encouraged IPGRI to work with local partners toward the implementation of scale-up efforts in various regions.
Maternal Nutritional Status in Pastoral versus Farming Communities of West Pokot, Kenya: Differences in Iron and Vitamin A Status and Body Composition
Authors: Keverenge-Ettyang Grace Adisa , van Marken Lichtenbelt Wauter , Esamai Fabian , Saris Wim
Published: November 2015

Background

Underweight and micronutrient deficiencies are sequelae of the prevailing harsh living and economic conditions of women in sub-Saharan Africa. There are few data describing maternal nutritional status in these resource-poor settings. Provision of more effective modes of intervention requires that public health and nutrition policy at both the national and the multisectoral levels be based on community-specific nutritional and behavioral practices.

Objective

This longitudinal study investigated maternal micronutrient status in two remote, semiarid, rural communities that are ethnically similar but have distinctly different pastoral and farming lifestyles. We looked at differences in iron stores, vitamin A levels, and body composition of women in the third trimester of pregnancy and again at 4 months postpartum.

Methods

Complete data were collected from 113 pastoral and 110 farming Pokot women. Anthropometric measurements were taken, and serum ferritin and retinol levels were measured. Infants were weighed within 7 days of birth.

Results

Women from the farming community had significantly ( p < .05) lower hemoglobin concentrations than women from the pastoral community during the third trimester of pregnancy. Pastoral women had significantly higher serum ferritin concentrations than farming women during the third trimester of pregnancy ( p < .05) and at 4 months postpartum. There were no significant differences between pastoral and farming women in the percentage of women with serum retinol levels < 0.70 μmol/L during the third trimester of pregnancy (27.9% [34/113] and 24.2% [31/110], respectively) and at 4 months postpartum (29.2% [33/113] and 30.9% [34/110]) In the farming community, mean infant birthweight was significantly lower ( p < .01) than in the pastoral community and a significantly higher ( p < .05) proportion of newborns weighed less than 2.5 kg. At 4 months postpartum, the percentage of body fat was significantly lower in pastoral women than in farming women.

Conclusions

Women from the farming community in West Pokot, Kenya, have lower iron stores during the third trimester of pregnancy than women in the pastoral community. In addition, the mean weight of their newborn infants is lower than that of infants in the pastoral community. These findings may be associated with differences in living conditions, which are usually harsher in farming than in pastoral communities.
Vitamin A Stability in Salt Triple Fortified with Iodine, Iron, and Vitamin A
Authors: Raileanu Ildiko , Diosady Levente L.
Published: November 2015

Background

Dietary micronutrient deficiencies, which lead to diseases such as iodine deficiency disorders, iron-deficiency anemia, and vitamin A deficiency, are serious public health problems in the developing world. Fortifying salt with iodine, iron, and vitamin A is an attractive approach to simultaneously reduce the deficiencies of these three micronutrients in the diet.

Objective

To explore the technical feasibility of producing triple-fortified salt fortified with iodine, iron, and vitamin A that would be stable under the climatic conditions of developing countries (i.e., high temperature and high humidity).

Methods

Triple-fortified salt was obtained by granulation and encapsulation of commercially produced vitamin A products, iodine, and iron compounds. Vitamin A retention was determined in the presence of five iron and two iodine compounds, in different combinations, under three different storage conditions. The influence of commercial stabilization techniques for the vitamin A palmitate source used (spray-dried or dissolved in oil), and the type of binder used for granulation on vitamin A retention in triple-fortified salt was studied. The influence of temperature, humidity, and chemical interactions on vitamin A stability in triple-fortified salt was also investigated.

Results

The most stable formulation retained 77.73% of vitamin A after 2 months of storage at 40°C, 60% relative humidity, and 95% under ambient conditions.

Conclusions

The results indicate that the production of a stable triple-fortified salt is technically feasible.
Nutrition Education Alone Improves Dietary Practices but Not Hematologic Indices of Adolescent Girls in Iran
Authors: Amani Reza , Soflaei Maryam
Published: November 2015

Background

Iron-deficiency anemia is the most prevalent nutritional deficiency worldwide. Iron-deficiency anemia has particular negative consequences on women in their childbearing years, and its prevention is a high priority in most health systems.

Objective

This interventional study assessed the effect of nutrition education on hematologic indices, iron status, nutritional knowledge, and nutritional practices of high school girls in Iran.

Methods

Sixty healthy 16- to 18-year-old girls were randomly selected from two high schools in the city of Ahvaz and divided into two equally matched groups, one that received nutrition education, and one that did not. The education group received instruction in face-to-face sessions, group discussions, and pamphlets for 2 months. The control group did not receive any information during the study. Hematologic tests, corpuscular indices, and serum ferritin levels were measured at baseline and after 2 months. Food-frequency questionnaires were administered and histories taken, clinical signs of nutritional deficiencies observed, anthropometric measurements taken, nutritional knowledge tested, practices determined, and lifestyle questionnaires administered to all subjects.

Results

There were no statistically significant differences in any baseline characteristics between the two groups. Scores for nutritional knowledge and practices of the education group were significantly higher after two months compared with the baseline (31.4 ± 6 vs. 24.3 ± 5.9 points, p < .001, and 31.2 ± 5 vs. 28.4 ± 5.7 points, p < .05, respectively). The scores in the control group showed no significant changes from baseline to 2 months. Mean corpuscular volume values were elevated in the education group ( p < .001) but not in the control group. However, in the control group, serum ferritin concentrations showed about a 17% drop at the end of the study ( p < .004). There were no changes in other hematologic, lifestyle, clinical, or anthropometric data compared with baseline after completion of the study in both groups.

Conclusion

These findings indicate that nutritional education can improve knowledge of healthy nutrition and lifestyle choices. Focused nutritional education using available resources and correcting current dietary habits in a vulnerable group of young women may result in dietary changes that can ultimately improve iron intake.
Traditional Cooked Vegetable Dishes as Important Sources of Ascorbic Acid and β-Carotene in the Diets of Indian Urban and Rural Families
Authors: Gupta Shruti , Bains Kiran
Published: November 2015

Background

Fresh vegetable produce is abundant during the winter season in Punjab. It is an important source of vitamins and minerals in the Punjabi diet, but the availability of ascorbic acid and β-carotene from the vegetables is altered to varying degrees when they are subjected to traditional household processing methods.

Objective

To determine the importance of traditional cooked vegetable dishes as sources of ascorbic acid and β-carotene among urban and rural families during the winter.

Methods

Information about vegetable consumption, storage, and cooking practices was collected from 60 families, 30 each from urban and rural areas of Ludhiana District, Punjab, India. Samples of the common cooked vegetable dishes were prepared in the laboratory by methods ascertained from the survey and analyzed for ascorbic acid and β-carotene.

Results

The average total daily per capita consumption of vegetables by urban and rural families was 411.7 and 365.9 g, respectively. Cooked vegetable dishes provided 68.7% of the total vegetable intake for urban families and 85.0% for rural families. On average, the edible portion constituted 78.9% of the weight of the vegetables. Ten cooked vegetable dishes that were most frequently consumed by the families (mustard saag, potato—spinach, potato—fenugreek, potato—brinjal, potato—cauliflower, potato—capsicum, potato—carrots, potato—beans, potato—peas, and cabbage—peas) were selected for preparation in the laboratory and nutritional analysis. The average concentrations of ascorbic acid and β-carotene in the cooked vegetable dishes were 46.0 mg/100 g and 794.2 μg/100g fresh weight, respectively. The percentage losses of ascorbic acid and β-carotene during preparation and cooking were 26.1% and 25.9%, respectively.

Conclusions

For adult Indian men and women, the recommended dietary allowance of ascorbic acid is 40 mg, and that of β-carotene is 2,400 μg. Cooked vegetable dishes provided 269.9% and 77.5% of the recommended dietary allowances of ascorbic acid and β-carotene, respectively, indicating that these dishes are good sources of these nutrients in the diets of both urban and rural families during the winter season.
Limitations of the Current World Health Organization Growth References for Children and Adolescents
Authors: Wang Youfa , Moreno Luis A. , Caballero Benjamin , Cole Tim J.
Published: November 2015

Since the 1970s, the World Health Organization (WHO) has recommended the use of the growth references developed by the United States National Center for Health Statistics (NCHS) based on national survey data collected in the 1960s and 1970s. These references are known as the WHO or NCHS/WHO growth references. Over the past three decades, the WHO or NCHS/WHO growth references have played an important role internationally in the assessment of child and adolescent growth and nutritional status. However, the references have a number of weaknesses. The limitations of the infant portion of the references were thoroughly assessed in WHO's effort to develop a new international growth reference for infants and preschool children. The present report discusses the limitations of the NCHS/WHO references for school-aged children and adolescents, including a number of conceptual, methodological, and practical problems. The global obesity epidemic poses another challenge that the NCHS/WHO reference cannot appropriately meet. There is a need for a single international reference to assess the nutritional status and growth of school-aged children and adolescents across different countries.
Acceptability and Safety of Novel Infant Porridges Containing Lyophilized Meat Powder and Iron-Fortified Wheat Flour
Authors: Pachón Helena , Domínguez María Reyna Liria , Creed-Kanashiro Hilary , Stoltzfus Rebecca J.
Published: November 2015

Background

Lyophilized meat powder with iron-fortified wheat flour can be used to produce an infant porridge with bioavailable iron, but its acceptability and safety are unknown.

Objective

To evaluate the acceptability and safety of porridges containing lyophilized meat powder and iron-fortified wheat flour.

Methods

Peruvian mothers' input was used to develop porridges without (no meat) and with meat powder (low or high chicken liver, low or high chicken thigh). Acceptability was determined by maternal hedonic scoring, 9-day infant intake, and videotape analysis of how well infants liked each porridge. Dry and cooked porridges and meat ingredients were tested for microorganisms; meats were tested for pesticides.

Results

Mothers gave higher acceptability scores to the no-meat porridge, followed in order by low and high quantities of meat powder (e. g., mean ± SD “taste” scores were 4.5 ± 0.9 for the no-meat, 3.7 ± 1.1 for the low-liver, and 3.3 ± 1.1 for the high-liver porridges, p = .0001). Infants' porridge intake did not differ: 61.4 ± 47.1 g of no-meat, 62.1 ± 44.9 g of low-thigh, and 67.5 ± 42.0 g of low-liver (p = .7), as supported by the video analysis. Microbiologic safety was acceptable except for marginally acceptable molds and yeasts in dry ingredients. No pesticide residues were detected.

Conclusions

Despite mothers' clear preference for no-meat porridges, infants consumed equal amounts of porridges with and without meat. Thus, if mothers can be convinced to feed the meat-containing porridges to the infants despite their own preferences, the infants will consume these porridges. The mold and yeast content of the porridge ingredients must be reduced.
Effect of Daily versus Once-Weekly Home Fortification with Micronutrient Sprinkles on Hemoglobin and Iron Status among Young Children in Rural Bangladesh
Authors: Hyder S.M. Ziauddin , Haseen Farhana , Rahman Mizanur , Tondeur Mélody C. , Zlotkin Stanley H.
Published: November 2015

Background

The effectiveness of commonly suggested public health interventions to control childhood iron- deficiency anemia has been low.

Objective

To determine whether iron provided in Sprinkles daily or in a higher dose once weekly affected hemoglobin, serum ferritin levels, and serum transferrin receptor levels, and to determine whether there were dif- ferences in the effects of the two regimens.

Methods

In this cluster-randomized, community- based trial conducted in rural areas of Bangladesh, 136 children aged 12 to 24 months with mild to moderate anemia (hemoglobin 70–109 g/L) were randomly allo- cated to receive Sprinkles daily (12.5 mg of elemental iron, n = 79) or once weekly (30 mg of elemental iron, n = 73) for 8 weeks. Hemoglobin, serum ferritin, and serum transferrin receptor were assessed at the start and end of the intervention.

Results

In both groups, there were significant increases in hemoglobin and serum ferritin and a significant decrease in serum transferrin receptor ( p < .01). There were no significant differences between the groups in the increases in hemoglobin (16.1 ± 13.2 g/L for the group receiving Sprinkles daily and 12.3 ± 13.3 g/L for the group receiving Sprinkles once weekly) and serum ferritin (10.6 and 5.7 μg/L, respectively). The decrease in serum transferrin receptor also did not significantly differ between the groups (median, −2.5 and −1. 8 mg/L, respectively). The prevalence rates of iron-deficiency anemia, depleted iron stores, and tissue iron deficiency decreased significantly within each group ( p < .01), with no significant differences between the groups.

Conclusions

Home fortification of complementary foods with Sprinkles given either daily or once weekly improved iron-deficiency anemia and iron status among young children.
Assessment of the Nutritional Status of Preschool-Age Children during the Second Intifada in Palestine
Authors: Abdeen Ziad , Greenough P. Gregg , Chandran Aruna , Qasrawi Radwan
Published: November 2015

Background

The Palestinian economy has dramatically deteriorated at all levels since the Al-Aqsa Intifada (uprising) began in 2000, resulting in an unprecedented catastrophe to the livelihoods of the Palestinians residing in the West Bank and Gaza. It was also marked by lack of household physical and financial access to food and health care, which placed children at increased risk of malnutrition and poor health. This prompted a significant increase in food aid from 2002 until the summer of 2003.

Objectives

To assess the nutritional status of children 6 to 59 months of age after 1 year of food assistance.

Methods

In the West Bank and Gaza, a nationally representative sample of children 6 to 59 months of age was randomly selected with a validated multistage clustered design, with the Health Survey 1999 sample used as the sampling frame. The sample was stratified according to governorate, place of residence (urban, nonurban, or refugee camp), locality, and size of locality (number of households). A cross-sectional survey of nutritional status was carried out. Data were collected by interviews with the primary caregivers of the children. Measurements were made of children's weight and height or length. Food-intake data were collected by the 24-hour food-recall method with the use of a booklet of photographs of foods commonly eaten in Palestine.

Results

A total of 3,089 children were assessed, of whom 3.1% in the West Bank and 3.9% in the Gaza Strip were suffering from acute malnutrition; the prevalence of chronic malnutrition was 9.2% in the West Bank and 12.7% in the Gaza Strip ( p = .02). Sex, refugee status, locality, and maternal education were not significantly associated with acute malnutrition by logistic regression analysis, whereas infants 6 to 23 months of age were significantly at risk. Calorie and protein intakes were generally lower than recommended dietary allowances.

Conclusions

The prevalence rates of both acute and chronic malnutrition among children in the West Bank and Gaza are significantly higher than the national Palestinian averages. There is a need to establish nutritional surveillance systems to monitor the nutritional status of children in conflict areas.
Ferritin Concentration and Pregnancy Outcome: Linear Models for Predicting Birthweight and Birth Length
Authors: Vazirinejad Reza , Esmaeili Abbas , Vazirinejad Hassan , Hassanshahi Gholamhossien
Published: November 2015

Background

Iron-deficiency anemia can have negative consequences for pregnant women. Previous investigations conducted to explore the association between iron-related components of mothers' serum and the outcome of pregnancy have had diverse results.

Objective

This study aimed to investigate the correlation between ferritin concentration (as the index of stored iron) of mothers' serum during the last 24 hours of pregnancy and birth outcome.

Methods

Respondents were chosen from the list of all women who had given birth between January 1 and March 30, 2006, in a Rafsanjan county maternal hospital in southeast Iran. The study checklist was completed for 600 to 900 mothers (over a period of 30 days), and about 600 were eligible to participate. Blood samples were taken from 120 eligible women who were randomly selected after they had given their second consent. Data, including birthweight and birth length, were analyzed with SPSS; parametric ( t-test, correlation, logistic regression) and nonparametric (chi-square, Mann-Whitney U) tests were used where appropriate.

Results

No significant differences between different groups of respondents were found in birthweight, birth length, or the ferritin concentration of mothers' serum, indicating that the effect of confounder variables (e.g., baby's sex, mother's educational status, mother's age, gestational age, etc.) was controlled successfully. Significant positive correlations were found between the mother's ferritin concentration and the baby's birthweight ( r = 0.434, N = 120, p < .001) and birth length ( r = 0.396, N = 120, p < .001). Linear models revealed that the ferritin concentration of mothers' serum during the last 24 hours of pregnancy could be suitable to predict both birthweight and birth length.

Conclusions

This study confirms that provision of sufficient amounts of iron-related components to pregnant women is necessary to improve pregnancy outcome.
Using Criteria to Establish Nutrient Intake Values (NIVs)
Authors: Yates Allison A.
Published: November 2015

One of the most important of the nutrient intake values (NIVs) is the average nutrient requirement (ANR). The ANR is defined as an intake value that will be adequate for half of the individuals in a group of people with similar characteristics. It is used to estimate the prevalence of adequacy, and it serves as the basis for the individual nutrient level (INLx). The determination of adequacy is a complex process, with the resulting value of the ANR dependent on the criterion or functional outcome chosen to define nutrient adequacy. Because nutrients have multiple sites of action in human metabolism, it is possible to demonstrate abnormal function in one parameter measured or observed as a result of inadequate intake of a nutrient, while other parameters requiring the same nutrient appear normal or within normal ranges. Thus, depending on the criterion of adequacy selected, the requirement for a given nutrient may be at a lower or a higher intake amount. In harmonizing development of NIVs, it is important to clearly identify the criterion of adequacy selected and the rationale for its selection. Rarely are available data sufficient to provide dose—response information from which to select a level of intake at which half of the individuals demonstrate adequacy and half appear to demonstrate inadequacy. Three levels of intake, of which at least one level of intake is below the requirement for most of the individuals in the sample, and one level of intake is above their requirement, are useful for establishing a level at which half of the group might be considered to demonstrate adequacy. Types of human nutrient studies that may be used to obtain data are discussed, as well as characteristics of the sample size needed to demonstrate adequacy. The variation in requirements is also an important aspect in predicting levels of intake that will have defined probabilities of adequacy for groups (to develop the INLx, where x is the defined probability chosen). An analysis of the origins of different types of variability is presented. When estimating energy requirements, a special case of NIVs, important issues must be considered. Additionally, an example of evaluating data used to establish an ANR for vitamin A, and the effect of variability in requirements for vitamin A, is provided.
Methods for Using Nutrient Intake Values (NIVs) to Assess or Plan Nutrient Intakes
Authors: Murphy Suzanne P. , Vorster Hester H.
Published: November 2015

This article describes the methods for using nutrient intake values (NIVs) to plan and assess intakes of both individuals and population groups. The advantages of the more recent standards, which use an average nutrient requirement (ANR) and its standard deviation to describe the distribution of nutrient requirements, are highlighted. The goal of assessing the intake of an individual is to determine the probability that the person's usual diet is meeting his or her nutrient needs and whether the person is at risk for adverse effects from excessive intakes, whereas the goal of planning an individual's intake is to ensure that the probability of inadequate intake and the likelihood of excessive intake are both small. The goal of assessing intakes of groups is to determine the prevalence of inadequate intakes and the prevalence of potentially excessive intakes, whereas the goal of planning nutrient intakes for groups is to minimize the prevalence of inadequate intakes and also to minimize the prevalence of potentially excessive intakes. For all of these goals, it is important to utilize appropriate food-composition tables and accurate dietary assessment methods. To fully utilize the new paradigm, it will be necessary for the professional nutrition community to identify ways to implement these new procedures in nutrition research and nutrition programs, to describe the strengths and weaknesses of the results, and to contribute to the evolution of both the theory and the application of the NIVs when planning and assessing diets.
Relationships among Production Systems, Preschool Nutritional Status, and Pesticide-Related Toxicity in Seven Ecuadorian Communities: A Multi-Case Study Approach
Authors: Orozco Fadya , Cole Donald C. , Muñoz Verónica , Altamirano Ana , Wanigaratne Susitha , Espinosa Patricio , Muñoz Fabian
Published: November 2015

Background

Among small Andean potato farmers, greater pesticide use and better linkage to markets are promoted as ways to improve farm outputs and incomes. The health of household members is assumed to improve with higher incomes, although evidence to support such an assumption remains scarce.

Objective

Using a multidisciplinary approach, we sought to characterize agricultural systems producing potatoes and to assess relationships between these characteristics and farm household health indicators.

Methods

We included seven communities linked to a regional agricultural potato production platform (socio-organizational “space” for potato commercialization) in Chimborazo, Ecuador. The unit of analysis was the community, each of which was classified according to its level of intensity of potato production as more intensive, intermediate, or less intensive. Data on crop management, household food intake, child anthropometry, and impacts of pesticide use on adult health were collected by survey.

Results

The net income from potato production was similar in communities with more intensive and intermediate production systems and lower in those with less intensive systems. However, deficits in protein intake were more common among children in communities with more intensive systems (63%) than among those in communities with intermediate (53%) and less intensive (37%) systems. Deficits in thiamin and riboflavin intake were more prevalent in communities with more and less intensive systems than in those with intermediate systems. In contrast, the prevalence of moderate chronic malnutrition, as measured by height-for-age, was greater among children in communities with less intensive systems (27%) than among those in communities with intermediate (5%) and more intensive (7%) systems. Across all intensities, frequent use of highly hazardous pesticides was associated with adverse health effects.

Conclusions

Agricultural development programs need to work more cross-sectorally to realize the potential health benefits associated with intensification of production.