bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Providing a Small Income on Women's Nutritional Status and Household Food Expenditures in Rural Nepal
Authors: Katz Joanne , West Keith P. , Pradhan Elizabeth Kimbrough , LeClerq Steven C. , Shakya T. R. , Khatry Subarna K. , Shrestha Sharada Ram
Published: November 2015

This study evaluated the impact of providing a small income on the household food expenditures and nutritional status of women employed part-time in a health project. A prospective, nonrandomized, unmasked, controlled trial was conducted in Sarlahi District in rural southeastern Nepal. The study subjects were 870 women who applied for a job with a project distributing nutritional supplements in their villages. Of these women, 736 (85%) completed the two-year follow-up; 341 were hired for the job and 395 were not hired. The intervention consisted of part-time employment that provided a small income, and the outcome was the two-year change in mid-upper-arm circumference (MUAC) and household food expenditures after adjustment for baseline demographic and socioeconomic differences. The women who were hired were younger and better educated than those who were not hired, but in other respects the two groups of women were similar. After adjustment for these baseline differences, the change in MUAC was not significantly different between the two groups of women. The two groups of women also had similar two-year changes in total household food expenditures and in expenditures on meat, clarified butter, fish, eggs, milk, and vegetables. There was a decline in the proportion of households buying milk and ghee, and the decline was significantly smaller in the households of women who were hired. Although employment by the project did not appear to affect the nutritional status of the women or change their overall expenditure on food, households of women who were hired were more likely to be able to continue to buy certain higher-status foods that could have a nutritional benefit for other household members.
Dietary Sources of Zinc and Factors Affecting its Bioavailability
Authors: Solomons Noel W.
Published: November 2015

Zinc is one of the more ubiquitous of nutrients, being found in modest amounts in a large number of foods. Human evolution has undoubtedly shaped the needs for zinc to be absorbed from our beverages and foods of both animal and plant origin in the diet. Different environmental and ecological circumstances modify the amount of zinc that needs to become available to individuals of different regions. We use an acronym approach to review and understand the bioavailability of zinc. The biological availability of zinc can be limited by many factors intrinsic and extrinsic to the host, and it can be enhanced by few. Challenges remain in assessing the bioavailability of zinc compounds as fortificants and in developing strategies to improve the uptake of the metal by reducing phytate and tannin content of diets, either through food technology or plant genetics.
Supplementation of Infants and/Or Their Mothers with Vitamin A during the First Six Months of Life
Authors: Kirkwood Betty
Published: November 2015

It has been clearly demonstrated that in endemic areas, improving the vitamin A status of children aged six months to five years can substantially reduce their risk of mortality and severe morbidity. This paper reviews the potential benefits of improving vitamin A status during the first six months of life by either supplementing the infant or indirectly by supplementing the mother, in order to increase the vitamin A content of her breastmilk. This focus is important, since a large proportion of childhood deaths occur before six months of age. Also, whether or not supplementation has a direct benefit during the first six months of life, it could have an indirect benefit later in life if it ensures that the infant enters the second six months of life with improved vitamin A status. It might thus lead to a reduced risk of mortality in later childhood. in particular, this review evaluates the evidence concerning the health benefits.
Food Sources of Vitamin A and Provitamin a Specific to Africa: An FAO Perspective
Authors: Codjia Georges
Published: November 2015

Vitamin A deficiency is a major public health problem in Africa, especially in the Sahelian countries. It occurs mainly in young children and women of childbearing age. Inadequate intake of vitamin A is the main cause of the deficiency. The main animal sources of vitamin A are liver, eggs, milk, and milk products. They contain 25 to 8,235 retinol equivalents (RE)/100 g of edible portion. Even though these sources are rich in highly bioavailable vitamin A, their consumption among the population is still low. Plant foods rich in provitamin A represent more than 80% of the total food intake of vitamin A because of their low cost, high availability, and diversity. Fruits, roots, tubers, and leafy vegetables are the main providers of provitamin A carotenoids. Because of their availability and affordability, green leafy vegetables are consumed largely by the poor populations, but their provitamin A activity has been proven to be less than previously assumed. Among fruits, mangoes constitute an important seasonal source of vitamin A. Yellow or orange sweet potatoes are rich in provitamin A. Red palm oil has a high concentration of provitamin A carotenoids (500–700 ppm/100 g). Extension of new varieties with a high content of bioavailable provitamin A and locally adapted education and counseling on the handling and storage of provitamin A sources can significantly increase the vitamin A intake of vulnerable people. The Food and Agriculture Organization has implemented projects in several African countries to increase production and promote consumption of locally produced or available vitamin A–rich foods. The focus has been on women as the principal food producers and behavioral change agents. Adoption of food- and agriculture-based strategies as the best, appropriate, efficient, and long-term solution should be the focus of African efforts to improve nutrition. Food sources of vitamin A and provitamin A are plentiful in Africa. Food-consumption practices, food habits, and cultural aspects represent essential factors to be taken into account for successful implementation of these approaches.
Enhancing Vitamin A Intake in Young Children in Western Kenya: Orange-Fleshed Sweet Potatoes and Women Farmers Can Serve as Key Entry Points
Authors: Hagenimana Vital , Low Jan , Anyango Mary , Kurz Kathleen , Gichuki Simon T. , Kabira Jackson
Published: November 2015

In western Kenya, where vitamin A deficiency is common and the white sweet potato is an important secondary staple, orange-fleshed sweet potatoes were introduced and their consumption was promoted, along with other vitamin A–rich foods. Ten women's groups grew a number of varieties of sweet potato on group plots in on-farm trials. Five of the groups also received an intervention consisting of nutritional education, individual counseling, and participatory rapid appraisal techniques to promote vitamin A consumption, while the other five formed the control group that received no additional promotion. Changes in consumption of children under five years of age were assessed before and after a one-year intervention period using the Helen Keller International food-frequency method. Varieties were tested for yield, agronomic performance, taste and appearance, and dry matter content. They were also assessed for β-carotene content in the forms of boiled and mashed puree, sweet potato flour, and processed products. Children in the intervention group consumed vitamin A–rich foods almost twice as frequently as control children (93% more), especially orange-fleshed sweet potatoes, mangoes, dark-green leafy vegetables, butter, and eggs. The yields of orange-fleshed sweet potatoes were at least twice those of white sweet potatoes, as were the taste and appearance ratings. The dry matter content of the varieties exceeded 25%, except for one that was preferred as a weaning food. β-Carotene values were high enough that one cup of boiled and mashed sweet potato fed daily to children of weaning age would alone meet their requirement of vitamin A, even using the higher 12:1 β-carotene:retinol conversion. Orange-fleshed sweet potatoes produced and prepared by women farmers can serve as a key food-based entry point for reducing vitamin A deficiency.
Reducing Subclinical Vitamin A Deficiency through Women's Adoption of Appropriate Technologies in Tanzania
Authors: Mulokozi Generose , Mselle Laurent , Mugyabuso Joseph , Johnson-Welch Charlotte
Published: November 2015

Many at-risk populations in developing countries are vitamin A deficient. Improvement in the vitamin A status of preschool children would increase their chances of survival and improve their health. Progress has been made in combating severe forms of vitamin A deficiency, yet the extent of subclinical vitamin A deficiency is worrisome. Strategies such as supplementation, food fortification, and dietary diversification have had some impact, but efforts must be made to enhance their effectiveness. One promising strategy is to increase women's access to food-processing technologies that extend the availability of vitamin A and provitamin vitamin A–rich foods, reduce nutrient losses due to traditional processing methods, and improve the hygienic and nutritional quality of the dried food products. Because women are key to household nutrition, improving their access to such technologies would increase women's productivity and enhance the effectiveness of their nutrition-promoting behaviors. The Tanzania Food and Nutrition Centre (TFNC) within the Ministry of Health, and working with the Ministries of Agriculture and Livestock Development and Community Development, Children and Women's Affairs, implemented an intervention research study in rural Tanzania to promote women's adoption of improved solar-drying technologies for preserving vegetables and fruits and to improve children's dietary intake of provitamin A–containing foods. Children whose mothers adopted the improved solar dryers consumed significantly more foods rich in vitamin A and provitamin A (p < .001). The β-carotene content of green leafy vegetables dried in the improved enclosed dryers was better than that of vegetables dried using traditional methods. These results suggest opportunities to reduce seasonal subclinical deficiencies among children in this semiarid rural area of Tanzania.
Palm Oil: A Healthful and Cost-Effective Dietary Component
Authors: Ong A. S. H. , Goh S. H.
Published: November 2015

Palm oil is an excellent choice for food manufacturers because of its nutritional benefits and versatility. the oil is highly structured to contain predominantly oleic acid at the sn2-position in the major triacylglycerols to account for the beneficial effects described in numerous nutritional studies. Oil quality and nutritional benefits have been assured for the variety of foods that can be manufactured from the oil directly or from blends with other oils while remaining trans-free. the oxidative stability coupled with the cost-effectiveness is unparalleled among cholesterol-free oils, and these values can be extended to blends of polyunsaturated oils to provide long shelf-life. Presently the supply of genetic-modification-free palm oil is assured at economic prices, since the oil palm is a perennial crop with unparalleled productivity. Numerous studies have confirmed the nutritional value of palm oil as a result of the high monounsaturation at the crucial 2-position of the oil's triacylglycerols, making the oil as healthful as olive oil. It is now recognized that the contribution of dietary fats to blood lipids and cholesterol modulation is a consequence of the digestion, absorption, and metabolism of the fats. Lipolytic hydrolysis of palm oil glycerides containing predominantly oleic acid at the 2 position and palmitic and stearic acids at the 1 and 3 positions allows for the ready absorption of the 2-monoacylglycerols while the saturated free fatty acids remain poorly absorbed. Dietary palm oil in balanced diets generally reduce blood cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides while raising the high-density lipoprotein (HDL) cholesterol. Improved lipoprotein(a) and apo-A1 levels were also demonstrated from palm oil diets; an important benefit also comes from the lowering of blood triglycerides (or reduced fat storage) as compared with those from polyunsaturated fat diets. Virgin palm oil also provides carotenes apart from tocotrienols and tocopherols that have been shown to be powerful antioxidants and potential mediators of cellular functions. These compounds can be antithrombotic, cause an increase of the prostacyclin/thromboxane ratio, reduce restenosis, and inhibit HMG-CoA-reductase (thus reducing) cholesterol biosynthesis). Red palm oil is a rich source of β-carotene as well as of α-tocopherol and tocotrienols.
Do Street Food Vendors Sell a Sufficient Variety of Foods for a Healthful Diet? the Case of Nairobi
Authors: Mwangi Alice Mboganie , den Hartog Adel P. , Mwadime Robert K.N. , van Staveren Wija A. , Foeken Dick W.J.
Published: November 2015

This study examined whether street food vendors sell a sufficient variety of foods for a healthful diet. It was hypothesized that vendors sold only low-cost food groups to enable the buyer to afford the food while the vendor also made a profit. A structured questionnaire was administered to 580 vendors in three selected locations. Data included product names, ingredients, methods of preparation, and the sex of the vendor. A little more than half of the vendors (53%) sold food of only one group; 44% sold cereals. Overall, 36% of vendors, mostly men, sold only carbohydrate products. the percentage of vendors selling foods of more than one group was higher in the working area (53%) than in the slum area (43%, p < .05), and it was higher in both of these areas taken together than in the lower-middle income area (21%, p < .001). Micronutrient and mixed-nutrient products were associated with female vendors. Although a slight majority of all street vendors sell foods of only one group, women vendors are capable of supplying a sufficient variety of food groups that consumers can afford. It appears that consumer purchasing power dictates the food groups provided by vendors, especially cereal-based-foods. A policy on micronutrient fortification of cereal flours and fats used in popular street food preparation needs to be considered. This could be coupled with consumer and vendor education programs focusing on the importance of healthful diets.
Development and Validation of a Short Food-Frequency Questionnaire for Screening Women of Childbearing Age for Vitamin A Status in Northwestern Iran
Authors: Omidvar Nasrin , Ghazi-Tabatabie Mahmood , Harrison Gail G. , Eghtesadi Shahriar , Mahboob Soltan-Ali , Pourbakht Mahdi
Published: November 2015

A high percentage of women in their childbearing years suffer from subclinical vitamin A deficiency; 10% to 20% of pregnant women worldwide are vitamin A deficient. This study aimed to design and validate a short food-frequency questionnaire to serve as a simple screening tool for vitamin A status in women of childbearing age. the sample consisted of 187 healthy, nonpregnant, nonlactating women 15 to 49 years of age, from urban and rural areas of Marand district in East Azerbaijan. Dietary intake was evaluated by a face-to-face interview using a 24-hour dietary recall for two consecutive days and a 41-item qualitative food frequency questionnaire. Height, weight, and serum retinol were measured. Serum retinol values were less than 20 μg/dl for three subjects, while an additional 34 subjects (18%) had values between 21 and 30 μg/dl. Principal-component analysis performed on the food-frequency questionnaire identified five components that together defined 34.4% of the variance in estimated vitamin A intake and were used to derive a 20-item short food-frequency questionnaire. Internal consistency of the short instrument was acceptable (Cronbach's alpha = .59). Serum retinol was significantly correlated with total vitamin A intake and with intake of vitamin A from plant sources, as estimated by the short food-frequency questionnaire. Important sources of provitamin A in these women's diets included some not typical of other populations: nuts and green leaves of types used elsewhere in small quantities as herbs, but important in Iran because the amount and frequency of consumption are relatively high. We conclude that the questionnaire is relatively valid and potentially useful in identifying women at risk for vitamin A deficiency in this population.
Effect of Maternal Dietary Vitamin C Intake on the Level of Vitamin C in Breastmilk among Nursing Mothers in Baghdad, Iraq
Authors: Tawfeek Haifa I. , Muhyaddin Omer M. , Al-Sanwi Hana I. , Al-Baety Najat
Published: November 2015

The vitamin C content of breastmilk was investigated in a group of nursing mothers attending maternal and child health centers in Baghdad during 1998–2000. Two hundred healthy, nonsmoking, 28- to 38-year-old lactating women were studied. Individual samples of breastmilk were obtained for estimation of vitamin C. Dietary data were collected by using 24-hour food recalls. The mean intake of vitamin C was far below the Food and Agriculture Organization/World Health Organization requirement of 26 ± 2.13 (SD) mg/day). The vitamin C content of breastmilk was significantly correlated with the maternal intake of vitamin C (r = 0.61, p < .01). The vitamin C content of breastmilk varied with the season. The level was much higher in summer (3.9 ± 1.05 mg/100 ml) than in winter (3.02 ± 2.01 mg/100 ml; p < .05). This fluctuation indicates the dependence of breastmilk vitamin C on dietary intake. The results show the need to increase the consumption of vegetables and fruits and to monitor maternal ascorbic acid intake.
Recommendations for the use of Body Mass Index for the Classification of Overweight and Obese Children and Adolescents
Authors: Abrantes Marcelo Militão , Lamounier Joel Alves , Colosimo Enrico Antônio
Published: November 2015

Brazilian national data were used to compare body mass index (BMI) cutoff values proposed by Cole et al. (2000), which are based on statistical criteria of continuity to adult cutoff values, and those proposed by Must et al. (1991), which are recommended by the World Health Organization (WHO). According to the cutoff points proposed by each author, 5,736 children and adolescents were classified as of normal weight, overweight, or obese. These classifications were compared by 3 × 3 tables, and a kappa index and a confidence interval were calculated. The good concordance (kappa = 0.82) between the two cutoff values supports the hypothesis that studies on the prevalence of childhood obesity and overweight based on these two different methods can be compared. However, some differences in classification can arise when these methods are used to classify individuals. Further studies to evaluate morbidity and mortality and the classification of obesity in children and adolescents are necessary.
Multiple Micronutrient Deficiencies: Future Research Needs
Authors: Gross Rainer , Solomons Noel W.
Published: November 2015

There has been a rising current of calls for a moratorium on international nutritional research in favor of an investment in intervention programs, per se. The topic of multiple-micronutrient supplementation reviewed at the International Workshop on Multi-Micronutrient Deficiency Control in the Life Cycle (May 30–June 1, 2001) has confirmed once again, however, the intimate interaction between program development and a supporting agenda of applied research. The areas of research required to produce successful intervention programs include biologic availability, safety and efficacy, communications and behavior, effectiveness, cost-effectiveness (efficiency), and food and pharmaceutical technology. Attention to safety and surveillance for unintended adverse effects has acquired new relevance as we analyze the multi-center International Research on Infant Supplementation (IRIS) I studies. All professionals involved in research projects in this area must assure both the quality and reliability of investigations and adhere to the highest principles of ethical conduct of research in human studies. The fundamental principles of research design and hypothesis development, quality assurance, reliability of measurements, and sound and unbiased interpretation of findings apply to all experimental science, and must be guaranteed for this mission. Agencies, academic institutions, and industry alike must work to create a system in which researchers can uphold these standards, and realize at the same time that the area of multi-micronutrient supplementation in developing countries can be a fertile area for training future researchers.
Effect of a Multiple-Micronutrient-Fortified Fruit Powder Beverage on the Nutrition Status, Physical Fitness, and Cognitive Performance of Schoolchildren in the Philippines
Authors: Solon Florentino S. , Sarol Jesus N. , Bernardo Allan B. I. , Solon Juan Antonio A. , Mehansho Haile , Sanchez-Fermin Liza E. , Wambangco Lorena S. , Juhlin Kenton D.
Published: November 2015

This study aimed to determine the effect of a multiple-micronutrient-fortified beverage on the micronutrient status, physical fitness, and cognitive performance of schoolchildren. The study was a randomized, double-blind, placebo-controlled trial of schoolchildren assigned to receive either the fortified or nonfortified beverage with or without anthelmintic therapy. Data on hemoglobin level, urinary iodine excretion (UIE) level, physical fitness, and cognitive performance were collected at baseline and at 16 weeks post-intervention. The fortified beverage significantly improved iron status among the subjects that had hemoglobin levels < 11 g/dl at baseline. The proportion of children who remained moderately to severely anemic was significantly lower among those given the fortified beverage. In the groups that received the fortified product, the median UIE level increased, whereas among those who received the placebo beverage, the median UIE level was reduced significantly. Iron- and/or iodine-deficient subjects who received the fortified beverage showed significant improvements in fitness (post-exercise reduction of heart rate) and cognitive performance (nonverbal mental ability score). The study showed that consumption of a multiple-micronutrient-fortified beverage for 16 weeks had significant effects on iron status, iodine status, physical fitness, and cognitive performance among iron- and/or iodine-deficient Filipino schoolchildren. Anthelmintic therapy improved iron status of anemic children and iodine status of the iron-adequate children at baseline but it had no effect on physical fitness and cognitive performance. The results from the clinical study showed that a multiple-micronutrient-fortified beverage could play an important role in preventing and controlling micronutrient deficiencies.
Role of Public-Private Partnership in Micronutrient Food Fortification
Authors: Mannar M. G. Venkatesh , van Ameringen Marc
Published: November 2015

Iron, iodine, and vitamin A deficiencies prevent 30% of the world's population from reaching full physical and mental potential. Fortification of commonly eaten foods with micronutrients offers a cost-effective solution that can reach large populations. Effective and sustainable fortification will be possible only if the public sector (which has the mandate and responsibility to improve the health of the population), the private sector (which has experience and expertise in food production and marketing), and the social sector (which has grass-roots contact with the consumer) collaborate to develop, produce, and promote micronutrient-fortified foods. Food fortification efforts must be integrated within the context of a country's public health and nutrition situation as part of an overall micronutrient strategy that utilizes other interventions as well. Identifying a set of priority actions and initiating a continuous dialogue between the various sectors to catalyze the implementation of schemes that will permanently eliminate micronutrient malnutrition are urgently needed. The partners of such a national alliance must collaborate closely on specific issues relating to the production, promotion, distribution, and consumption of fortified foods. Such collaboration could benefit all sectors: National governments could reap national health, economic, and political benefits; food companies could gain a competitive advantage in an expanding consumer marketplace; the scientific, development, and donor communities could make an impact by achieving global goals for eliminating micronutrient malnutrition; and by demanding fortified foods, consumers empower themselves to achieve their full social and economic potential.
Food and Agriculture Policy: Issues Related to Prevention of Noncommunicable Diseases
Authors: Nugent Rachel
Published: November 2015

Good nutrition depends on access to a healthful food supply. Although a great deal of attention has been paid to food intake as a determinant of nutrition and overall health, little attention has been paid to the food supply system, health risks embedded in it, and its effect on people's choices. Most national governments intervene in their agricultural sectors in order to provide benefits to producers and consumers; however, these interventions are not designed with public health in mind. Governments should consider population nutrition and chronic disease risk when devising and implementing agricultural and food policies. They should seek opportunities to adjust agricultural and trade policies to be consistent with national health and nutritional priorities and guidelines. Although the paper gives several examples, country-specific policy changes can be determined only through analysis of individual country policies and nutrition conditions.
Ecuadorian Andean Women's Nutrition Varies with Age and Socioeconomic Status
Authors: Macdonald Barbara , Johns Timothy , Gray-Donald Katherine , Receveur Olivier
Published: November 2015

An agricultural project in Highland Ecuador provided a model context to better understand the nutrition of rural women. The adequacy of women's nutrition and the strength of associations with age and socioeconomic status were studied in 104 rural households over four rounds (two seasons) during the 1995–1996 agricultural year using a cross-sectional with repeated-measures design. Women were at high risk for micronutrient deficiencies (calcium, iron, riboflavin, and vitamin B12) due to low intakes of animal products. Two distinct constructs representing socioeconomic status were identified: modern lifestyle and farming wealth. In multivariate models, farming wealth was associated with quality of women's diet (animal protein adjusted for energy, p = 0.01). Diet quality, in turn, was positively associated with anthropometric status (p = 0.02). Women over the age of 50 weighed approximately 3.7 kg less than younger women and consumed less energy (300 kcal) and micronutrients (p < 0.05). Age was positively associated with respiratory morbidity (p = 0.01). These findings, while directly relevant to a specific context, suggest the need for cross-cultural studies to identify the extent of, and factors contributing to, the risk of nutritional inadequacy in postreproductive women in developing countries.
Fatty Acids in Chinese Edible Oils: Value of Direct Analysis as a Basis for Labeling
Authors: Wallingford John C. , Yuhas Rebecca , Du Shufa , Zhai Fengying , Popkin Barry M.
Published: November 2015

Edible oil is an important element in the diet of most transitional countries; nevertheless, little is known about the fatty acid composition of these oils. We examined the consumption of edible oils and the fatty acid composition of these oils obtained from a market survey conducted in seven Chinese provinces and in Beijing. Three days of measured household food intake from the 1997 China Health and Nutrition Survey households provided data on the consumption of edible oils. Edible oils sold in the capital cities of eight provinces were purchased. One hundred twenty-six samples, representing 14 different oils according to their labels, were assayed for their fatty acid content in 2001. Fatty acids were analyzed by standard gas chromatographic methods. More than 76% of households in China consume edible oil, providing an average of 29.6 g of edible oil per day to persons aged two years or older. Rapeseed was consumed by one-quarter of individuals. Rapeseed is rich in C22:1n9 cis (erucic acid). About 33% of edible oils differed from their labeled identification. Rapeseed oil, identified by the presence of C22:1n9 (erucic acid), was most frequently not labeled as such. In another 28% of the samples, trans isomers of linolenic acid were detected. Deviations from the label identification were more common in southern than in northern provinces. Regulations requiring complete labeling of mixed edible oils in China might help prevent unintentional consumption of fatty acids associated with adverse health outcomes. In particular, consumption of erucic acid and trans fatty acids might be reduced. The results suggest the need for closer control of food oil labeling in China, especially in the South.
Assessment of Gross Motor Development in the who Multicentre Growth Reference Study
Authors: Wijnhoven Trudy M.A. , de Onis Mercedes , Onyango Adelheid W. , Wang Tracey , Bjoerneboe Gunn-Elin A. , Bhandari Nita , Lartey Anna , Rashidi Badriya Al
Published: November 2015

The objective of the Motor Development Study was to describe the acquisition of selected gross motor milestones among affluent children growing up in different cultural settings. This study was conducted in Ghana, India, Norway, Oman, and the United States as part of the longitudinal component of the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS). Infants were followed from the age of four months until they could walk independently. Six milestones that are fundamental to acquiring self-sufficient erect locomotion and are simple to evaluate were assessed: sitting without support, hands-and-knees crawling, standing with assistance, walking with assistance, standing alone, and walking alone. The information was collected by both the children's caregivers and trained MGRS fieldworkers. The caregivers assessed and recorded the dates when the milestones were achieved for the first time according to established criteria. Using standardized procedures, the fieldworkers independently assessed the motor performance of the children and checked parental recording at home visits. To ensure standardized data collection, the sites conducted regular standardization sessions. Data collection and data quality control took place simultaneously. Data verification and cleaning were performed until all queries had been satisfactorily resolved.
Biochemical Indicators of Nutritional Status and Dietary Intake in Costa Rican Cabécar Indian Adolescents
Authors: Monge-Rojas Rafael , Barrantes Mauro , Holst Ileana , Nuñez-Rivas Hilda , Alfaro Thelma , Rodríguez Sara , Cunningham Lowella , Cambronero Priscilla , Salazar Lisbeth , Herrmann F.H. , Scrimshaw Nevin S.
Published: November 2015

The purpose of this study was to determine the blood levels of selected nutritional status indicators and the dietary intake of Costa Rican Cabécar Indians aged 10 to 16 years. The results showed that 65% of the adolescents had an adequate body mass index (BMI) for their age, and 32% had a BMI < 5th percentile. Likewise, the study revealed a high prevalence of anemia (57%), deficient serum folate levels (54%), deficient vitamin B12 levels (31%), and subclinical vitamin A deficiency (10%). Additionally, the youngsters had elevated prevalences of high triglyceride levels (77%), borderline high-density lipoprotein (HDL) cholesterol levels (46%), homocysteine levels > 10 μmol/L (29%), and homozygous mutation of methylenetetrahydrofolate reductase (MTHFR) (49%). The diet was poor, being high in saturated fat and low in polyunsaturated fat, fiber, and several micronutrients. The dietary intakes of more than 55% of the adolescents did not meet 50% of the estimated average requirements (EAR) for zinc, vitamin A, vitamin C, vitamin B12, vitamin B2, and folate. Furthermore, a high prevalence of parasitosis was found (68%). Our results show an adolescent Cabécar population with a mosaic of nutritional deficiencies and cardiovascular risk factors.
Cultural and Environmental Barriers to Adequate Iron Intake among Northern Kenyan Schoolchildren
Authors: Shell-Duncan Bettina , McDade Thomas
Published: November 2015

The purpose of this study was to examine the context of iron deficiency and feeding patterns of iron-rich foods among northern Kenyan school-aged children. A nutrition survey was conducted among 300 subjects in two Rendille communities, Korr and Karare. The objectives were to determine the prevalence of iron deficiency as it relates to parasitic infection, dietary intake, and sociodemographic factors, as well as cultural food proscriptions influencing child feeding. Sociodemographic and qualitative data on food beliefs and child-feeding practices were obtained from the primary caretaker of each subject. From pediatric subjects, 24-hour dietary recall data were obtained with the help of the primary caretaker, and capillary blood from a fingerstick was used to detect iron deficiency based on measures of hemoglobin, the zinc protoporphyrin-to-heme ratio, C-reactive protein, and transferrin receptor. With an overall prevalence of 31.2%, iron deficiency was found to be associated with dietary iron intakes constrained by diverse economic, cultural, and environmental factors among Rendille children. In Karare, where children's iron intake approached recommended levels, iron deficiency was found to be attributable to low bioavailability of iron (only 4.3% of total iron intake), rather than low dietary intake per se. By contrast, in Korr the average daily iron intake was estimated at only 65% of recommended allowances, indicating that iron deficiency was the outcome not merely of low bioavailability, but rather of overall inadequate iron intake. Sociodemographic analysis showed a significant interaction between sex and economic status, revealing that girls in economically sufficient households were 2.4 times as likely to have iron deficiency as boys. This difference in risk parallels culturally defined gender-based proscriptions for child feeding: girls are believed to benefit from “soft foods,” including rice, maize porridge, and tea, whereas boys benefit from “hard foods,” including meat, blood, and beans. Consequently, in households economically able to purchase iron-rich foods, these foods are being preferentially fed to boys. Economic development may result in improved iron status for boys, but it will be unlikely to benefit girls in the absence of a dietary modification intervention. A modification of culturally acceptable “soft foods” to include iron-rich foods may provide a sustainable approach to controlling and preventing iron deficiency in this population.
Stunted Child–Overweight Mother Pairs: Prevalence and Association with Economic Development and Urbanization
Authors: Garrett James L. , Ruel Marie T.
Published: November 2015

This paper explores the prevalence of the coexistence of a stunted child and an overweight mother in the same household (SCOWT), a somewhat paradoxical phenomenon when found in the developing world. It tests whether this phenomenon is associated with a country's level of economic development and urbanization and, by implication, the nutrition transition. It then highlights policy directions for public nutrition. Data from 42 Demographic and Health Surveys in Africa, Asia, and Latin America were used. Stunting was defined as height-for-age < −2 SD of the reference population, and maternal overweight as a body-mass index > 25 kg/m2. World Bank and United Nations figures were used for gross domestic product (GDP) per capita (an indicator of economic development) and for level of urbanization. Descriptive statistics were derived, and regression analysis was used to model the association between economic development, urbanization, and the prevalence of pairs of stunted children and overweight mothers. The prevalence of this phenomenon is generally below 10%, except in four countries, three of them in Latin America. The phenomenon is generally more prevalent in Latin America than in Africa, though not necessarily more prevalent in urban than in rural areas. The analysis finds that the phenomenon is associated with economic development, but not urbanization, and that it does differ between urban and rural areas and regions. The association with GDP per capita supports the hypothesis that SCOWT increases with economic development, up to a point. SCOWT appears to be most prevalent, as expected, in those countries in the midst of the nutrition transition. Recognizing this phenomenon is important for delineating strategies that respond to the differential needs of individuals within the household and do not just affect the household as a whole. This may become especially important with future economic development and, potentially, urbanization.
Effect of Fortification of Drinking Water with Iron plus Ascorbic Acid or with Ascorbic Acid Alone on Hemoglobin Values and Anthropometric Indicators in Preschool Children in Day-Care Centers in Southeast Brazil
Authors: de Almeida Carlos Alberto Nogueira , Dutra-de-Oliveira José Eduardo , Crott Gerson Claudio , Cantolini Alessandro , Ricco Rubens Garcia , Del Ciampo Luiz Antonio , Baptista Marina Elisa Costa
Published: November 2015

Background

Iron-deficiency anemia currently is the most frequently occurring nutritional disorder worldwide. Previous Brazilian studies have demonstrated that drinking water fortified with iron and ascorbic acid is an adequate vehicle for improving the iron supply for children frequenting day-care centers.

Objective

The objective of this study was to clarify the role of ascorbic acid as a vehicle for improving iron intake in children in day-care centers in Brazil.

Methods

A six-month study was conducted on 150 children frequenting six day-care centers divided into two groups of three day-care centers by drawing lots: the iron-C group (3 day-care centers, n = 74), which used water fortified with 10 mg elemental iron and 100 mg ascorbic acid per liter, and the comparison group (3 day-care centers, n = 76), which used water containing only 100 mg ascorbic acid per liter. Anthropometric measurements and determinations of capillary hemoglobin were performed at the beginning of the study and after six months of intervention. The food offered at the day-care centers was also analyzed.

Results

The food offered at the day-care center was found to be deficient in ascorbic acid, poor in heme iron, and adequate in non-heme iron. Supplementation with fortified drinking water resulted in a decrease in the prevalence of anemia and an increase in mean hemoglobin levels associated with height gain in both groups.

Conclusions

Fortification of drinking water with iron has previously demonstrated effectiveness in increasing iron supplies. This simple strategy was confirmed in the present study. The present study also demonstrated that for populations receiving an abundant supply of nonheme iron, it is possible to control anemia in a simple, safe, and inexpensive manner by adding ascorbic acid to drinking water.
Increased Food Intake after the Addition of Amylase-Rich Flour to Supplementary Food for Malnourished Children in Rural Communities of Bangladesh
Authors: Hossain M. Iqbal , Wahed M. A. , Ahmed Shaheen
Published: November 2015

Background

In Bangladesh, as in other developing countries, protein–energy malnutrition is most prevalent among children during weaning. After weaning, children are often fed cereal-based diluted low-calorie porridge, resulting in growth-faltering.

Objective

To assess the effect on food intake of adding amylase-rich flour (ARF) from germinated wheat to supplementary food among children in nine rural Community Nutrition Centers under the Bangladesh Integrated Nutrition Project (BINP).

Methods

A total of 166 malnourished children of either sex, aged 6 to 24 months, received one of three diets randomly allocated to the Community Nutrition Centers. The composition of the diets was the same; however, the consistency and calorie density were altered by adding either ARF or water. Thirty-five children received the standard supplementary food of the BINP (S-SF), 65 received supplementary food with added ARF (ARF-SF), and 66 received supplementary food with added water (W-SF). The children were studied for six weeks.

Results

The mean ± SD intake of supplementary food from a single meal by children completing six weeks on the diets was higher for children receiving ARF-SF (33.91 ± 8.25 g) than for those receiving S-SF (25.66 ± 6.73 g) or W-SF (30.26 ± 8.39 g) (p < .05 for both comparisons). The weight of vomited food was significantly higher for children receiving W-SF than for children in the other two groups. Weight gain and increments in length and weight-for-height were higher for children who received ARF-SF than for children in the other two groups, but the differences were not statistically significant. The acceptability of ARF-SF was higher than that of the two other diets. The additional cost of adding 2 g of ARF to the diet was about Taka 0.25 (US$1 = Taka 48).

Conclusions

Addition of ARF to existing standard supplementary food, as used under the BINP program, is a simple and effective means to increase the intake of food by changing its consistency, thus making it easier for malnourished children to ingest.
Physical Fitness, Body Composition, Blood Pressure, and Blood Metabolic Profile among Young Guatemalan Adults
Authors: Ramírez-Zea Manuel , Melgar Paúl , Flores Rafael , Hoddinott John , Ramakrishnan Usha , Stein Aryeh D.
Published: November 2015

We assessed the distribution of several risk factors related to health: muscular strength (handgrip strength), cardiovascular endurance (step test), flexibility (sit and reach test), anthropometry and body composition, blood pressure, fasting plasma glucose, lipid profile, and hemoglobin in a cohort of Guatemalan adults who were born in four rural villages between 1962 and 1977. By 2002 approximately 32% had migrated to Guatemala City or elsewhere in the country. Men are more physically fit and leaner than women. Fatness, poor physical fitness, and metabolic syndrome are highly prevalent in women living in both rural and urban areas. Risk profiles worsen with increasing age. Men who migrated to Guatemala City have lower physical fitness, greater fatness and systolic blood pressure, and worse lipid profile than men who still live in their original villages. Such a pattern was not evident in women, except that blood pressure was higher in urban women than in women who lived in their original villages.
Labor Force Activities and Income among Young Guatemalan Adults
Authors: Hoddinott John , Behrman Jere R. , Martorell Reynaldo
Published: November 2015

This paper considers labor force activities among adults (26 to 41 years of age in 2003) who participated as children in a nutrition supplementation trial in Guatemala. The vast majority of men are engaged in some type of income-generating activity in 2002–04. However, unlike their fathers, these men are much more likely to be engaged in wage labor, even if they remain in the original study villages. Those engaged in wage employment appear to do so steadily. Women are much more likely to be engaged in some type of income-generating activity than their mothers. For both men and women, there appears to be considerable movement in and out of own business activities. In Guatemala City, wage work is the predominant economic activity with more than half of the women interviewed working for wages; elsewhere operating non-farm businesses is the most often cited activity. For both men and women, agriculture now appears to be very much a secondary activity.
Can the Provision of Breakfast Benefit School Performance?
Authors: Grantham-McGregor Sally
Published: November 2015

Studies of an association between school performance (enrollment, attendance, achievement, classroom behavior, and school drop-out) and nutritional status are discussed and the evidence of an effect of school meals evaluated. Many studies have shown associations between hunger, poor dietary intakes, stunting, underweight, and poor school performance after controlling for socioeconomic conditions. However, it remains possible that unmeasured socioeconomic variables could explain the relationship. Rigorous short-term studies of missing breakfast have generally found detrimental effects on children's cognition whereas studies of providing breakfast have shown benefits particularly in malnourished children. Classroom conditions may modify the effects of breakfast on behavior. There are extremely few longer term studies of the effects of giving school meals. Nearly all involved breakfast and very few had randomized controlled designs. Studies comparing participants with non-participants or comparing matched schools have found benefits (but bias due to self-selection) of receiving breakfast; inadequate matching of schools also remains possible. One longer term randomized controlled trial found benefits associated with attendance and arithmetic performance. In conclusion, most studies of giving breakfast have found benefits to school performance but many had serious design problems, were short-term, and were not conducted in the poorest countries. In order to advise policy makers correctly, there is an urgent need to run long-term randomized controlled trials of giving school meals in poor countries and to determine the effects of age and nutrition status of the children, the quality of the school, and the timing of the meal. The special needs of orphans should also be considered.
E-Learning: A Nutritionally Ripe Environment
Authors: Savige Gayle S.
Published: November 2015

Schools provide a social context in which children learn and develop; thus, schools are a desirable environment for nutrition promotion. The kidsfoodclub.org is a web-based technology that has been used in Australian primary schools as a model for nutrition promotion. It provides interactive activities, role models, and opportunities for children to learn from their peers through a bulletin board and story telling. This web-based technology is readily accessible to all schools, thereby overcoming problems associated with geographic location and socioeconomic status. This model can be adapted to meet the needs of different school communities and has the capacity to connect children from different backgrounds and cultures.
Obesity among Schoolchildren in Developing Countries
Authors: Galal Osman M. , Hulett Judie
Published: November 2015

The threat of worldwide obesity in children is a reality and has become pandemic. Previously a concern of only developed countries, rapid, escalating rates of overweight children now dominate the public health concerns of middle-and low-income nations as well. There are, of course, many influences that have literally shaped the global population, but there is also a recent observable pattern that is shared by those developing countries with increasingly obese children: a grand structural shift in diet and activity levels on every continent and in every region has occurred in the last quarter century, accompanied by rising rates of obesity. Two central public health concerns drive the need for effective interventions: the immediate health of children and the imminently crushing blow that is coming to health care systems and developing economies due to high rates of chronic disease. In developed nations, the role of gatekeeper has shifted to childcare providers, media, and schools, but in the developing world the traditional role of the mother as home manager has remained intact. Accepting the mother as the primary care provider within the child's nuclear environment places the mother as the guardian of the family's resources, which may be a viable alternative to the types of health-promotion efforts found in past ineffective models.