bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutrition Education: It has Never been an Easy Case for Indonesia
Authors: Februhartanty Judhiastuty
Published: November 2015

The root of Indonesian education can be traced back to the Dutch colonial period. The country adopts the 6–3–3–4 system of education, which consists of public schooling, Islamic schooling, and out-of-school education. In addition, the country has also been exposed to distance education. The call for this type of education was due to the geographic condition of Indonesia where face-to-face instruction has become limited. Studies on nutrition education in Indonesia covered various topics and teaching methods that were delivered mostly in after-class sessions. Effects on improved knowledge and attitudes were more marked than that of practices in relation to each nutrition topic. Nutrition and its related topics are delivered separately in different school subjects, such as biology, sport, health science, and home economics. Moreover, as the country keeps developing malnutrition problems, the Indonesian government through the Ministry of Health has run a feeding program that covers only children in elementary school aged 6–12 years old both in urban and rural areas. Efforts from private sectors and NGOs on the feeding program for schoolchildren seem to give complementary effects to the existing program. Human resources development of nutrition professionals was started in the early 1950s when a school for food scientists was first established. However, the professionals responsible for delivering nutrition-related topics in the school are the schoolteachers who mostly have never received relevant training for delivering such topics. For achieving effective children's nutrition education through schools, a solid partnership among stakeholders must be encouraged.
Prevalence of Obesity, Overweight, and Underweight in Qatari Adolescents
Authors: Bener Abdulbari
Published: November 2015

Background

Overweight and obesity have reached epidemic proportions in Arabian oil-rich countries and are threatening to become a global epidemic. Excess weight has a great impact on the health and quality of life of individuals. However, prevalence of underweight in the developing world has shown a decline during the last decade.

Objective

The aim of this cross-sectional study was to determine the prevalence of underweight, overweight, and obesity, as measured by body-mass index, in a representative sample of adolescents aged 12 to 17 years in the State of Qatar.

Methods

Qatari schoolchildren ( n = 3,923) from 30 schools in urban and semiurban districts responded to a sociodemographic questionnaire. Body-mass index was calculated and the prevalence of overweight and obesity was determined on the basis of cutoff points of the International Obesity Task Force (IOTF) values (above the 85th and 95th percentiles, respectively, for overweight and obesity). Underweight was defined on the basis of CDC (Centers for Disease Control and Prevention) less than 5th percentile of BMI for age.

Results

The final sample consisted of 1,968 boys and 1,955 girls. The prevalence of underweight, overweight, and obesity was 8.6%, 28.6%, and 7.9%, respectively, among adolescent boys and 5.8%, 18.9%, and 4.7% among girls. The prevalence of underweight was highest at 16 years of age among boys (10.5%) and at 17 years among girls (8.9%). The prevalence of obesity was highest at 12 years of age among boys (11.7%) and at 13 years among girls (6.4%). The 95th percentile curve for boys was above the IOTF standard curve; the 95th percentile curve for girls was below the IOTF curve.

Conclusions

Adolescents living in the State of Qatar are at high risk for overweight and obesity. There is a need to establish a national program for the prevention and treatment of obesity and related complications.
Child's Gender and Household Food Insecurity are Associated with Stunting among Young Pakistani Children Residing in Urban Squatter Settlements
Authors: Baig-Ansari Naila , Rahbar Mohammad Hossain , Bhutta Zulfiqar Ahmed , Badruddin Salma Halai
Published: November 2015

Background

The nutritional status of children is a good indicator of the overall well-being of a society and reflects food security as well as existing health-care and environmental conditions. In Pakistan, it is estimated that nearly 40% to 50% of children under the age of five are stunted. Due to greater economic opportunities available to the urban population as compared to the rural, it was believed that economic resources existed in poor urban Pakistani households but that the households lacked the skills and knowledge to translate their resources into good care and feeding practices.

Objective

This study aimed 1) to assess the prevalent care and feeding practices among children aged 6 to 18 months residing in the squatter settlements of Karachi and 2) to identify care and feeding practices, as well as any other underlying factors, associated with stunting.

Methods

A cross-sectional survey was conducted in eight settlements between October and December 2000. A total of 433 mothers of eligible children were interviewed with the use of structured questionnaires. Final analysis using multiple logistic regression was conducted on 399 mother—child pairs.

Results

Female children were nearly three times more likely to be stunted than male children. Households that were food insecure with hunger were also three times more likely than other households to have a stunted child. Lack of maternal formal schooling (adjusted prevalence odds ratio, 2.9; 95% confidence interval, 1.4 to 3.8) and large household size (adjusted prevalence odds ratio, 1.7; 95% confidence interval, 1.0 to 3.8) were also associated with stunting. Even though certain care and feeding practices were significant at the univariate level, they were not significant in the final multivariate analysis and so were excluded from the final model.

Conclusions

In households where food insecurity exists, knowledge of care practices may not be sufficient, and interventions such as food subsidies must precede or accompany educational efforts. Further follow-up is required to explore the effect of gender differences on child care.
Assessment of Nutritional Status of Children under Five Years of Age, Pregnant Women, and Lactating Women Living in Relief Camps after the Tsunami in Sri Lanka
Authors: Jayatissa Renuka , Bekele Aberra , Piyasena C. L. , Mahamithawa S.
Published: November 2015

Background

A strong earthquake that hit Aceh on December 26, 2004, triggered a powerful tsunami, resulting in an unprecedented catastrophe in Sri Lanka. The initial phase of the disaster was marked by limited access to food coupled with an inadequate supply of safe water and poor environmental hygiene and sanitation, all of which placed children at increased risk for undernutrition.

Objective

To assess the nutritional status of children under five years of age, pregnant women, and lactating women residing in 40 relief camps after the tsunami.

Methods

A cross-sectional, 30-cluster study was performed. Thirty children under five from each cluster (camp) and all pregnant and lactating women in selected camps were studied. Data were collected by interviews with the primary caregivers of the children, interviews with key informants in the camps, direct observation, and focus group discussions with mothers. Weight, height, or length was measured on children and pregnant women. Mid-upper-arm circumference of lactating women was measured.

Results

A total of 878 children were assessed, of whom 16.1%, 20.2%, and 34.7% were wasted, stunted, and underweight, respectively. The prevalence of each indicator was higher in boys than in girls. During the 2 weeks before the survey, 69.5% of the children had acute respiratory tract infections and 17.9% had diarrhea. Although the general food distribution was well in place, the food supply lacked diversity, and 70.9% of the children did not get appropriate supplementary food. The prevalence of undernutrition among pregnant women ( n = 168) was 37%. Thirty-one percent of lactating women ( n = 97) were underweight, and 20% were overweight.

Conclusions

The prevalence of both acute and chronic undernutrition among children in the camps is significantly higher than the national Sri Lankan average. There is a need to establish nutritional surveillance systems to monitor the nutritional status of displaced and nondisplaced children and mothers.
The Association between Stunting and Overweight in Latin American and Caribbean Preschool Children
Authors: Duran Pablo , Caballero Benjamin , de Onis Mercedes
Published: November 2015

Background

Although some segments of the population continue to suffer from undernutrition, other groups exhibit excess weight gain, resulting in the coexistence of undernutrition and obesity and leading to a dual nutritional burden.

Objective

To explore the association between stunting and overweight in preschool children from Latin American and Caribbean countries.

Methods

We analyzed cross-sectional data from children 0 to 5 years of age from 79 nationally representative surveys, compiled by the World Health Organization (WHO) Global Database on Child Growth and Malnutrition. This database defines stunting as low height-for-age and overweight as high weight-for-height. These variables were explored with the use of simple and multiple regression models.

Results

There were significant differences between subregions in the prevalence of stunting: the prevalence was 7.4% in the Caribbean, 11.3% in South America, and 20.4% in Central America ( p < .001). In contrast, the estimated prevalence of overweight was similar between subregions. The overall prevalence rates of stunting and overweight in Latin America and the Caribbean in the year 2000 were 13.7% and 4.3%, respectively. We found an inverse relationship ( r = −0.3) between the prevalence rates of overweight and stunting, overall and within subregions. South America exhibited the highest slope and intercept on the regression of overweight on stunting.

Conclusions

Different subregions of Latin America and the Caribbean have different prevalence rates of childhood stunting but similar prevalence rates of over-weight. There is an inverse relationship between stunting and overweight. The South American subregion had the highest increase and prevalence of overweight of the Latin American region.
Characteristics Attributed to Complementary Foods by Caregivers in Four Countries of Latin America and the Caribbean
Authors: Dutta Tanushree , Sywulka Sara M. , Frongillo Edward A. , Lutter Chessa K.
Published: November 2015

Background

Attributes that caregivers assign to complementary foods have been primarily described in the context of illness, but attributes assigned to foods in everyday circumstances must be understood to effectively promote good complementary feeding.

Objective

This study aimed to understand how mothers judge complementary foods to be appropriate by cross-cultural examination of food perceptions in four different Latin American and Caribbean countries.

Methods

We used semistructured interviews to assess attributes that mothers ascribed to a list of key foods, both home-made and manufactured, and reasons for feeding or not feeding them. We elicited attributes from 79 caregivers with children 6 to 24 months of age from two urban and periurban sites each in Brazil, Jamaica, Mexico, and Panama.

Results

Textual analysis based on six home foods common to the four countries and manufactured foods resulted in six attribute categories, five of which could be positive or negative (Nutrient Content, Effects on Child, Child's Response, Availability and Accessibility, and Other Food Attributes); one (Food Quality and Safety) was only negative. Analysis of attributes of home foods (chicken, eggs, beans, carrots, bananas or plantains, and oranges) revealed many beliefs that were common within and across countries, whereas analysis of the attributes of manufactured foods revealed that these foods were less known.

Conclusions

The consistency of the attribute categories across countries and across home and manufactured foods suggests their relevance to planning programs to improve complementary feeding in Latin America and the Caribbean and possibly other developing countries. These results can be used programmatically to assess the need for and the focus of food education programs, and to indicate which countries will be more receptive to certain foods as a means of improving complementary feeding.
Key Issues in the Success of Community-Based Management of Severe Malnutrition
Authors: Collins Steve , Sadler Kate , Dent Nicky , Khara Tanya , Guerrero Saul , Myatt Mark , Saboya Montse , Walsh Anne
Published: November 2015

Background

Acute malnutrition is an underlying factor in almost 50% of the 10 to 11 million children under 5 years of age who die each year of preventable causes. Inpatient treatment for severe acute malnutrition is associated with high opportunity and economic costs for affected families and health service providers. Community-based therapeutic care attempts to address these problems and to maximize population-level impact through improving coverage, access, and cost-effectiveness of treatment.

The community-based therapeutic care model

Community-based therapeutic care programs provide effective care to the majority of acutely malnourished people as outpatients, using techniques of community mobilization to engage the affected population and maximize coverage and compliance. People with severe acute malnutrition without medical complications are treated in an outpatient therapeutic program with ready-to-use therapeutic food and routine medication. Those suffering from severe acute malnutrition with medical complications are treated in an inpatient stabilization center according to standard World Health Organization protocols until they are well enough to be transferred to the outpatient therapeutic program.

Impact of community-based therapeutic care programs

Twenty-one (21) community-based therapeutic care programs were implemented in Malawi, Ethiopia, and North and South Sudan between 2000 and 2005. These programs, which treated 23,511 cases of severe acute malnutrition, achieved recovery rates of 79.4% and mortality rates of 4.1%. Coverage rates were approximately 73%. Of the severely malnourished children who presented, 76% were treated solely as outpatients. Initial data indicate that these programs are affordable, with the cost-effectiveness of emergency community-based therapeutic programs varying from US$12 to US$132 per year of life gained.
Costs of the Multimicronutrient Supplementation Program in Chiclayo, Peru
Authors: Lechtig Aarón , Gross Rainer , Paulini Javier , de Romaña Daniel López
Published: November 2015

Background

There is little information on the cost parameters of weekly multimicronutrient supplementation programs.

Objective

To assess the cost parameters and cost-effectiveness of a weekly multimicronutrient supplementation program in an urban population of Peru.

Methods

Data from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]), which distributed capsules and foodlets to women and adolescent girls and to children under five, were extrapolated to a population of 100,000 inhabitants.

Results

The annual cost per community member was US$1.51. The cost-effectiveness ratio was US$0.12 per 1% of prevented anemia per community member.

Conclusions

These costs are in the upper margin of iron supplementation alone. They will decrease notably when weekly multimicronutrient supplementation programs are integrated into health packages and participation by women increases. Focusing on micronutrient deficiencies would prevent these problems, and fooddistribution programs would be effectively targeted to food-deficient populations.
Evaluation of the Feasibility of International Growth Standards for School-Aged Children and Adolescents
Authors: Butte Nancy F. , Garza Cutberto , de Onis Mercedes
Published: November 2015

Development of an international growth standard for the screening, surveillance, and monitoring of school-aged children and adolescents has been motivated by two contemporaneous events: the global surge in childhood obesity and the release of a new international growth standard for infants and preschool children by the World Health Organization (WHO). If a prescriptive approach analogous to that taken by WHO for younger children is to be adopted for school-aged children and adolescents, several issues would have to be addressed regarding the universality of growth potential across populations and how to define optimal growth in children and adolescents. A working group concluded that subpopulations exhibit similar patterns of growth when exposed to similar external conditioners of growth. However, on the basis of available data, it cannot be ruled out that some of the observed differences in linear growth across ethnic groups reflect true differences in genetic potential rather than environmental influences. Therefore, the sampling frame for the development of an international growth standard for children and adolescents would have to include multiethnic sampling strategies designed to capture the variation in human growth patterns. A single international growth standard for school-aged children and adolescents could be developed with careful consideration of the population and individual selection criteria, study design, sample size, measurements, and statistical modeling of primary growth and secondary ancillary data. The working group agreed that existing growth references for school-aged children and adolescents have shortcomings, particularly for assessing obesity, and that appropriate growth standards for these age groups should be developed for clinical and public health applications.
Genetic Determinants of Prepubertal and Pubertal Growth and Development
Authors: Thomis Martine A. , Towne Bradford
Published: November 2015

This article surveys the current general understanding of genetic influences on within- and between-population variation in growth and development in the context of establishing an International Growth Standard for Preadolescent and Adolescent Children. Traditional genetic epidemiologic analysis methods are reviewed, and evidence from family studies for genetic effects on different measures of growth and development is then presented. Findings from linkage and association studies seeking to identify specific genomic locations and allelic variants of genes influencing variation in growth and maturation are then summarized. Special mention is made of the need to study the interactions between genes and environments. At present, specific genes and polymorphisms contributing to variation in growth and maturation are only beginning to be identified. Larger genetic epidemiologic studies are needed in different parts of the world to better explore population differences in gene frequencies and gene—environment interactions. As advances continue to be made in molecular and statistical genetic methods, the genetic architecture of complex processes, including those of growth and development, will become better elucidated. For now, it can only be concluded that although the fundamental genetic underpinnings of the growth and development of children worldwide are likely to be essentially the same, there are also likely to be differences between populations in the frequencies of allelic gene variants that influence growth and maturation and in the nature of gene–environment interactions. This does not necessarily preclude an international growth reference, but it does have important implications for the form that such a reference might ultimately take.
Body Composition Assessment for Development of an International Growth Standard for Preadolescent and Adolescent Children
Authors: Lohman Timothy G. , Going Scott B.
Published: November 2015

General considerations in assessing body composition in children and youths are described. Various methods are explored and recommendations are made for methods to be used in the International Growth Standard for Preadolescent and Adolescent Children Project. Exclusion of under- and overweight participants is recommended, and a method is proposed to assess both underweight and overweight. In addition to height and weight, we recommend waist circumference, selected skinfolds, and dual-energy x-ray absorptiometry (DXA) as a measure of fat, lean, and bone mineral density. We also propose using both fat mass index and fat-free mass index as an improvement over body-mass index.
Sensitivity and Specificity of a Short Questionnaire for Food Insecurity Surveillance in Iran
Authors: Dastgiri Saeed , Tutunchi Helda , Ostadrahimi Alireza , Mahboob Soltanali
Published: November 2015

Background

Food insecurity is frequent in both developed and developing countries, affecting from 5% to 25% of the general population. It has considerable health impacts on the physical, social, and psychological status of individuals in communities suffering from food insecurity.

Objective

The aim of this study was to document the epidemiologic features of food insecurity in the northwest region of Iran and to evaluate the sensitivity and specificity of a short-form (six items) questionnaire for screening of food insecurity in the region.

Methods

This cross-sectional study was conducted on 300 subjects (132 male and 168 female) selected randomly in the Asadabadi area of the northwest of Iran. Information on food consumption was obtained by a 24-hour food-recall questionnaire for 3 days in a week. This information was compared with the data from the Household Food Security Scale (six-item short questionnaire) to assess the applicability of this short scale for the surveillance of food insecurity. Hunger was defined as inadequate intake of energy. Hidden hunger was defined as adequate intake of energy and inadequate intake of one (or more) of four key nutrients (protein, calcium, vitamin A, and vitamin B2).

Results

The prevalence of hunger and hidden hunger in the area according to the 24-hour food-recall questionnaire was 26% and 42%, respectively. Only 32% of the study population was secure in terms of having access to all key nutrients. The sensitivity, specificity, and accuracy of the short questionnaire for screening for hunger in the population were 98.7%, 85.5%, and 89%, respectively; and the corresponding values for hidden hunger were 23.5%, 96.9%, and 56.3%.

Conclusions

Our findings indicate that food insecurity is prevalent in the northwest of Iran. The short questionnaire (six items) may be used as a simple, low-cost, rapid, and useful tool for the screening of food insecurity and energy intake in similar areas.
Food-Poverty Status and Food Insecurity in Rural West Lombok Based on Mothers' Food Expenditure Equivalency
Authors: Rosalina Tina , Wibowo Lindawati , Kielmann Arnfried A. , Usfar Avita Aliza
Published: November 2015

Background

When the Central Bureau for Statistics (CBS) developed a national food-poverty line for Indo- nesia, some aspects, such as food availability, food beliefs, and food habits, were not considered. In addition, the reference population was determined on the basis of their nonfood expenditures.

Objective

To develop and use a method applicable in any given sociocultural setting, as well as to determine food-poverty status in rural West Lombok, Indonesia, using mothers' food expenditure equivalency (FEE).

Method

Mothers' actual food intake determined by a modified 24-hour recall served to establish FEE. The results were verified with household food-security meas- ures based on the US Household Food Security/Hunger Measurement (US HFSSM), and the mothers' nutritional status was assessed by the body-mass index (BMI).

Results

Most mothers (72%) were food-poor and 79% were also food-insecure. Food poverty has a positive correlation with household food insecurity. The severely food poor also had the highest risk of household food insecurity. The nutritional status of mothers showed no correlation with food-poverty status and therefore was not found to be an appropriate indicator of food poverty in this cultural setting.

Conclusions

Because most food consumed by moth- ers was purchased, financial security plays a key role in determining family food sufficiency, in terms of both quantity and variety. Mothers' BMI status differed between the food-poor and non–food-poor groups, but the difference was not statistically significant, suggesting that in our setting the food-poverty line cannot be used to identify physiological need but is rather more of a social and economic indicator. We suggest the use of US HFSSM questionnaires as a simple alternative means to assess both food-poverty and food-security status, mainly because the method is simple to apply and corroborates our findings using area-specific FEEs. Finally, our study results suggest a number of follow-up investigations.
Variation in the Diets of Filipino Women over 9 Months of Continuous Observation
Authors: Beard John L. , Murray-Kolb Laura E. , Lawrence Frank , Felix Angelina , del Mundo Angelita , Haas Jere D.
Published: November 2015

Background

The variability in habitual intakes of most components in the Philippine diet is unknown.

Objective

To perform a quantitative evaluation of the traditional Philippine diet using data collected over an extended period of time. We sought to identify seasonal variations and within-subject components of variation in nutrient intake.

Methods

A quantitative evaluation of the Philippine diet was conducted in convents in metropolitan Manila as part of an efficacy trial to examine biofortified rice as an approach to improve iron nutritional status. Weighed food intakes were conducted on 54 days in each of more than 300 religious sisters over 9 months in 10 convents. The sisters consumed their habitual diets except for the substitution of one variety of rice for another.

Results

More than 40% of calories were derived from rice, with protein from meat and fish comprising 18% of calories. There were significant variations in macronutri- ent and micronutrient intakes across seasons of the year, with more rice consumed in the wet season and more fruits, eggs, milk, and beverages consumed in the dry season. The day-to-day within-subject variation (CV) in median intake was 23% for energy, 31% for protein, 42% for iron, and 138% for vitamin A.

Conclusions

These novel data show that traditional Filipino dietary patterns have substantial individual variation and are inadequate in certain micronutrients. This quantitative evaluation of diet can provide a reference point for dietary adequacy.
Constraints on the Delivery of Animal-Source Foods to Infants and Young Children: Case Studies from Five Countries
Authors: Pachón Helena , Simondon Kirsten B. , Fall Safiètou T. , Menon Purnima , Ruel Marie T. , Hotz Christine , Creed-Kanashiro Hilary , Arce Blanca , Domínguez María Reyna Liria , Frongillo Edward A. , Brown Dan L.
Published: November 2015

Background

Optimal feeding of infants and young children in developing countries includes daily feeding of animal-source foods.

Objective

To evaluate constraints on the availability of animal-source foods at the community level, access to animal-source foods at the household level, and intake of animal-source foods at the individual level among children under 3 years of age in case studies in five developing countries: Mexico, Peru, Haiti, Senegal, and Ethiopia.

Methods

Data were obtained from published and unpublished research and from program experiences of health and agriculture specialists.

Results

In Ethiopia, 27% to 51% of case-study chil- dren had consumed an animal-source food on the previous day; from 56% to 87% of children in the other case-study sites had consumed an animal-source food on the previous day. Data on intake of animal-source foods in grams were only available for the Latin American case-study sites, where daily milk intake was high in Mexico and Peru (195 and 180 g/day, respectively) and the intakes of meat, fish, and poultry (MFP) (29.0 and 13.6 g/day) and of egg (18.4 and 4.9 g/day) were low. The conceptual model guiding this work identified more constraining factors at the community and household levels than at the individual level. The most common constraints on feeding animal-source foods to young children were poverty, animal health, and land degradation at the community level; cost of animal-source foods and limited livestock holdings at the household level; and caregivers' perceptions of giving animal-source foods to children at the individual level.

Conclusions

For program planning, it is useful to simultaneously consider factors that affect community availability of, household access to, and children's intake of animal-source foods. Efforts to overcome individual- level constraints on intake of animal-source foods should be coupled with activities to address community and household constraints.
Suitability of Instant Noodles for Iron Fortification to Combat Iron-Deficiency Anemia among Primary Schoolchildren in Rural Vietnam
Authors: Le Huong Thi , Brouwer Inge D. , de Wolf Corine A. , van der Heijden Lidwien , Nguyen Khan Cong , Kok Frans J.
Published: November 2015

Background

Anemia is a significant public health problem among schoolchildren in Vietnam. Food fortification is considered one of the most sustainable long-term strategies to control iron-deficiency anemia in Vietnam. The success of a food-fortification program depends on the choice of the food vehicle.

Objectives

The aim of the present study was to identify an appropriate vehicle for iron fortification to be used in a school-feeding program aimed at improving the iron and anemia status of schoolchildren in rural Vietnam.

Methods

Children 6 to 8 years of age in two primary schools in Tam Nong District, Phu Tho Province, and their parents were included in this study. The study consisted of three substudies: a food-consumption study with 24-hour recalls of two nonconsecutive days; a food-beliefs study, with focus group discussions, a pile-sorting test, and a food attributes and differences exercise; and a food-acceptance study using noodles and biscuits fortified with sodium iron ethylenediaminetetraacetic acid (NaFeEDTA).

Results

The average number of meals consumed daily was 3.2 ± 0.4, and the average intakes of energy and iron were 1,218 ± 406 kcal and 7.5 ± 4.0 mg, respectively. Compared with biscuits and instant rice soup, instant noodles were consumed more frequently and in larger portion sizes and are more acceptable as children's food in the culture of the local people. The iron level of the fortified product did not affect the mean consumption of noodles, but a higher level of iron was associated with a lower mean consumption of biscuits ( p < .05). The production process did not affect the NaFeEDTA level in noodles; however, during preparation at least 70% of the iron is leaked into the soup.

Conclusions

Instant noodles are a suitable vehicle for iron fortification for use in school-based intervention to improve iron-deficiency anemia among primary schoolchildren in rural Vietnam.
Beyond Recommendations: Implementing Food-Based Dietary Guidelines for Healthier Populations
Authors: Smitasiri Suttilak , Uauy Ricardo
Published: November 2015

To reduce the increased burden of diet-related disease and promote human potential through food and nutrition globally, harmonization of efforts is urgently needed. This article examines the concept of food-based dietary guidelines (FBDGs) and discusses the possibilities and challenges of harmonizing the process of developing and implementing dietary guidelines. The authors argue that while the development of FBDGs has contributed to the understanding of the role of nutrients and foods in achieving optimal health, the impact of these guidelines on human health has been limited.

Science or evidence must be used in FBDG development; nevertheless, there are limitations in current nutrition science. FBDGs should address the health consequences of dietary insufficiency, excess, or imbalance with a broader perspective, considering the totality of the effects of a given dietary pattern, rather than focusing on single nutrients alone. Moreover, the food selection guideline should be seen as complementary to a strategic, comprehensive, and culturally appropriate dietary and health promoting intervention, and not only as a tool for providing nutrition policy and information.

Technically, a single unified global set of FBDGs may be desirable and even achievable. This concept, however, presents novel challenges on how to address cultural diversity and the complex social, economic, and political interactions between humans and the food supply, not to mention the complexity of its communication and implementation. Therefore, global harmonized efforts in support of strategic dietary interventions, together with strong global scientific support and facilitation for the development and communication of FBDGs at national or regional levels, are proposed to implement FBDGs for healthier populations.
Research Approaches for Improved Pro-Poor Control of Zoonoses
Authors: Schelling Esther , Grace Delia , Willingham A. Lee , Randolph Tom
Published: November 2015

Background

Developing countries face difficulties in sustainably utilizing tools to effectively implement control measures for zoonoses. This is mainly due to dispersed and heterogeneous smallholder livestock systems, predominance of informal markets, poor infrastructure and lack of resources to deliver information, interventions, and regulations. In addition, developing countries lack an evidence base for planning and targeting control efforts. Zoonotic infections are receiving more and more international attention as diseases of neglected and impoverished communities, at the intersection between livestock production, human health, and poverty.

Objective

To review research innovations and trends that can help identify and test targeted control strategies for zoonoses tailored to poor communities, focusing particularly on Africa.

Methods

Review of recommendations of relevant working groups and scientific literature.

Results

New and innovative research approaches promise to better capture the impact of zoonoses from a societal perspective and the perspective of poor livestock owners through more comprehensive frameworks that consider benefits of the control of zoonoses to the public health, livestock, and private sectors. It is challenging to better assure food safety in informal markets. Risk-based approaches with participatory elements provide a framework in which stakeholders can decide an appropriate level of protection to balance the needs for safe food, cheap food, and pro-poor economic growth. Appropriate information for all stakeholders and capacity-building of national and regional authorities is an important element of this process. New diagnostic tools that are accurate and easily used in developing-country health centers and markets can assist in reporting of cases, detection of patients, and testing of control strategies.

Conclusions

A research agenda on zoonoses of the livestock sector should be interdisciplinary and participatory and include intersectoral collaborations, notably between the livestock and public health sectors.
Health and Child Labor in Agriculture
Authors: Hurst Peter
Published: November 2015

Background

Seventy percent of child laborers—more than 150 million girls and boys under 18—are agricultural workers. They are harshly exploited, toiling in poor to appalling conditions, performing dangerous jobs with little or no pay, and are deprived of an education. Because children's bodies and minds are still growing and developing, exposure to workplace hazards and risks can be more devastating and long-lasting for them. The line between what is acceptable work and what is not is easily crossed. However, not all work that children undertake in agriculture is bad for them. Age-appropriate, lower-risk tasks that do not interfere with schooling and leisure time are not at issue here.

Objectives

The goal of this paper is to examine the links between health and child labor in agriculture. It aims to explain why the International Labour Organization's goal of eliminating all of the worst forms of child labor by 2016 will only be possible if more work is done in agriculture.

Methods

Review of the relevant literature and data on the hazards of child labor and the reasons why agricultural child labor is particularly difficult to tackle.

Results

Children who work in agriculture are exposed to a large number of health hazards, and yet the problem is particularly difficult to tackle because of the large numbers involved, the young age at which children start to work, the hazardous nature of the work, lack of regulation, invisibility of child laborers, denial of education, the effects of poverty, and ingrained attitudes and perceptions about the roles of children in rural areas.

Conclusions

Policies for preventing and reducing agricultural child labor should mainstream and integrate child labor issues at the national and international levels with increasing emphasis on poverty alleviation and expanding and improving institutional mechanisms for education, law enforcement, health, and so forth. Cooperation between the International Labour Organization and international agricultural organizations is needed to ensure that child labor in agriculture is a thing of the past.
Pesticide Practices and Suicide among Farmers of the Sundarban Region in India
Authors: Chowdhury Arabinda N. , Banerjee Sohini , Brahma Arabinda , Weiss M. G.
Published: November 2015

Background

Deliberate self-poisoning by ingesting pesticides is a serious health problem among farmers, especially in low- and middle-income countries. Preventing these suicides is a priority for a public mental health agenda.

Objective

To examine the role of pesticide poisoning in suicide and nonfatal deliberate self-harm, and clarify awareness of risks, safe practices concerning storage and use of pesticides, and associated self-injury, both unintentional and intentional, within farmer households of the Sundarban region, India.

Methods

Retrospective record review of adult cases of deliberate self-poisoning at the Block Primary Health Centres of 13 Sundarban Blocks was performed to analyze the relative roles of various methods of self-harm and their lethality. Focus group discussions, questionnaires, and in-depth interviews were undertaken in a community study of farmer households to examine pesticide-related views and practices, with particular attention to storage, use, and health impact.

Results

Pesticide poisoning was the most common method of deliberate self-harm in both men and women. Pesticide storage in most households was unsafe and knowledge was inadequate concerning adverse effects of pesticides on health, crops, and the environment.

Conclusions

An intersectoral approach linking the interests of public health, mental health, and agriculture is well suited to serve the collective interests of all three agendas better than each in isolation. Such an approach is needed to reduce morbidity and mortality from unintentional and intentional self-injury in low-income agricultural communities like those of the Sundarban region.
Conclusions of the Joint WHO/UNICEF/IAEA/IZiNCG Interagency Meeting on Zinc Status Indicators
Authors: de Benoist Bruno , Darnton-Hill Ian , Davidsson Lena , Fontaine Olivier , Hotz Christine
Published: November 2015

Zinc deficiency is an important cause of morbidity in developing countries, particularly among young children, yet little information is available on the global prevalence of zinc deficiency. A working group meeting was convened by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the International Atomic Energy Agency (IAEA), and the International Zinc Nutrition Consultative Group (IZiNCG) to review methods of assessing population zinc status and provide standard recommendations for the use of specific biochemical, dietary, and functional indicators of zinc status in populations. The recommended biochemical indicator is the prevalence of serum zinc concentration less than the age/sex/time of day-specific cutoffs; when the prevalence is greater than 20%, intervention to improve zinc status is recommended. For dietary indicators, the prevalence (or probability) of zinc intakes below the appropriate estimated average requirement (EAR) should be used, as determined from quantitative dietary intake assessments. Where the prevalence of inadequate intakes of zinc is greater than 25%, the risk of zinc deficiency is considered to be elevated. Previous studies indicate that stunted children respond to zinc supplementation with increased growth. When the prevalence of low height-for-age is 20% or more, the prevalence of zinc deficiency may also be elevated. Ideally, all three types of indicators would be used together to obtain the best estimate of the risk of zinc deficiency in a population and to identify specific subgroups with elevated risk. These recommended indicators should be applied for national assessment of zinc status and to indicate the need for zinc interventions. The prevalence of low serum zinc and inadequate zinc intakes may be used to evaluate their impact on the target population's zinc status.
Iron Metabolism and Infection
Authors: Ratledge Colin
Published: November 2015

The review highlights the intrinsic problems in the acquisition of ferric iron (FeIII) by pathogenic microorganisms, and bacteria in particular, during their infection of animals. Acquisition of iron from host sources, such as ferritin, transferrin, and heme compounds, is discussed. Acquisition can be by direct contact, via a surface receptor protein of the bacterium, with one of the iron-containing compounds, but more frequently iron is acquired by the production of a siderophore. Over 500 different siderophores are now known; they work by having a superior binding power to that of the host iron-containing materials. They literally strip the iron out of these molecules. They are low-molecular-weight (< 1,000 Da) compounds that are produced in response to iron deprivation, which is a primary host defense mechanism against infections. The iron–siderophore complex is small enough to be taken up into the bacterial cells, usually via an active transport process; the iron is removed from the siderophore, normally by a reductive process, and is then incorporated into the various apoproteins of the bacterial cell or is stored within the bacteria in the form of bacterioferritin. To combat the effectiveness of the siderophores, animals may synthesize specific proteins to bind and nullify their action. The role of one such protein, siderocalin (= lipocalin 2), is discussed. However, these countermeasures have, in turn, been thwarted by at least one bacterium, Salmonella, glycosylating its siderophore (enterobactin/enterochelin) so that binding of the modified siderophore (now termed salmochelin) with lipocalin can no longer occur.
Nutritional Status and its Correlates in Equatorial Guinean Preschool Children: Results from a Nationally Representative Survey
Authors: Custodio Estefanía , Descalzo Miguel Ángel , Roche Jesús , Sánchez Ignacio , Molina Laura , Lwanga Magdalena , Bernis Cristina , Villamor Eduardo , Baylin Ana
Published: November 2015

Background

In Equatorial Guinea, as a result of the recent growth of the oil industry, there is an opportunity to address important public health problems through public and private initiatives. To propose effective nutrition and public health strategies, it is important first to have reliable information on the nutritional status of the population and the underlying factors affecting it.

Objective

To assess the nutritional status and the prevalence of anemia among Equatoguinean children in a nationally representative sample and to identify the risk factors associated with the nutritional problems detected.

Methods

The study was a cross-sectional survey using a multistaged, stratified, cluster-selected sample. The survey included a sociodemographic, health, and dietary questionnaire and measurement of hematocrit and anthropometric features, from which nutritional indicators based on the National Center for Health Statistics (NCHS) reference and the World Health Organization (WHO) standards were calculated. Logistic regression models were used for the multivariate analysis. A total of 552 children aged 0 to 60 months were surveyed.

Results

The overall prevalence of stunting (< −2 height-for-age z-scores [HAZ]) was 29.7% based on the NCHS reference and 35.2% based on WHO standards; the risk factors associated with stunting were age ( p < .0001), low socioeconomic status ( p = .01), and fishing by a member of the household ( p = .003) The prevalence of mild anemia (hemoglobin < 110 g/L) was 69.3%, and that of moderate or severe anemia (hemoglobin < 80 g/L) was 8.3%. The only significant risk factor associated with moderate to severe anemia was low household socioeducational level ( p = .01).

Conclusions

Stunting and anemia are public health problems in Equatorial Guinea. Integrated strategies, including fighting poverty and improving maternal education, should be undertaken.
The Potential Contribution of Bread Buns Fortified with β-Carotene–Rich Sweet Potato in Central Mozambique
Authors: Low Jan W. , van Jaarsveld Paul J.
Published: November 2015

Background

Orange-fleshed sweet potato is an efficacious source of vitamin A. Substituting wheat flour with orange-fleshed sweet potato in processed products could reduce foreign exchange outlays, create new markets for producers, and result in increased vitamin A consumption among consumers provided there is adequate retention of β-carotene during processing.

Objective

To explore whether substituting 38% of wheat flour (by weight) in bread buns (“golden bread”) with boiled and mashed orange-fleshed sweet potato from fresh roots or rehydrated chips would produce economically viable β-carotene–rich products acceptable to Mozambican rural consumers.

Methods

Modified local recipes maximized sweet potato content within the limits of consumer acceptability. Sensitivity analysis determined parameters underlying economic viability. Two samples each of buns from five varieties of orange-fleshed sweet potato were analyzed for β-carotene content. Processed products with at least 15 μg/g product of trans-β-carotene were considered good sources of vitamin A.

Results

Golden bread made from fresh roots of medium-intensity orange-fleshed sweet potato varieties met the good source criterion, but bread from lighter-intensity sweet potato varieties did not. Bread from rehydrated dried chips was not economically viable. Consumers strongly preferred golden bread over pure wheat flour bread because of its heavier texture and attractive appearance. The ratio of the price of wheat flour to that of raw sweet potato root varied from 3.1 to 3.5 among the bakers, whose increase in profit margins ranged from 54% to 92%.

Conclusions

Golden bread is a good source of β-carotene and is economically viable when the price ratio of wheat flour to raw orange-fleshed sweet potato root is at least 1.5. Widespread adoption during sweet potato harvesting periods is feasible; year-round availability requires storage.