bluuebunny/crossref_metadata_2025 huggingface dataset:
Improvement in Fatigue, Quality of Life and Cognitive Function Following Oral Iron Supplementation for Treatment of Iron Deficiency in Patients who have had Bariatric Surgery
Authors: Miller Nana Gletsu , Mischler Renee A , Armah Seth M , Redick Thomas , Rosen Arthur D , Choi Jennifer N
Published: November 2023

Background

Iron deficiency (ID) and associated anemia is common following bariatric surgery and patients experience fatigue, pica and anemia which impair quality of life. Oral iron supplementation is recommended as the first line of therapy, however its effectiveness on improvement of iron status and clinical symptoms is controversial.

Objectives

To evaluate improvements in iron status as well as in perceived energy, quality of life and cognitive outcomes following treatment of ID using iron supplementation in gastric bypass (GB) and sleeve gastrectomy (SG) patients.

Methods

Women who had undergone GB and SG previously and were ID were eligible. Iron status was determined using blood concentrations of ferritin, serum transferrin receptor and total iron binding capacity. Before and after 8 weeks of high dose oral iron supplementation using FeSO4, we determined quality of life (QOL), fatigue, and cognitive function, measured by Short Form health survey (SF‐36), Multidimensional Fatigue Inventory, and computerized tests (Psychomotor Vigilance), respectively. Mean and standard deviations are reported; Wilcoxson sign‐ranked tests were used.

Results

Eight women completed the 8 week study; their characteristics were age 43.8 ± 4.9 years, body mass index 34.6 ± 5.7 kg/m2, and they were 8.4 ± 3.8 years post‐surgery. Resolution of ID and anemia occurred in 63% and 88% of participants. Concomitantly, participants experienced reduction in general fatigue (16.6 to 13.0, p=0.04) and energy‐based fatigue (28.1 to 45.0, p = 0.05); additionally emotional well‐being (71.1 to 79.4, p=0.07); as well as reaction time (75.5 [73.5, 77] to 78.5 [75.5, 79.5], p=0.07) tended to improve.

Conclusions

Oral iron supplementation is effective for resolution of ID in patients who have had bariatric surgery. Benefits of treatment include improvements in energy and QOL, and potentially in cognition, which support the recommendations for treatment of ID using oral iron supplementation.

Support or Funding Information

Purdue University;

• Clinical Research Center support (CRC) (Grant # UL1TR001108)
Infant and Young Child Feeding (IYCF) Indicators in Madagascar: Analysis of the Demographic and Health Survey
Authors: Rakotomanana Hasina , Gates Gail , Hildebrand Deana , Stoecker Barbara J
Published: November 2023

Child nutrition during the first two years of life is critical for growth and development. The WHO developed a validated set of indicators to assess infant and child feeding practices across countries. The association between the WHO infant and young child feeding (IYCF) indicators and stunting was assessed using the latest Demographic and Health Survey (DHS) data for Madagascar. Determinants of inappropriate child feeding practices were also identified for a total of 1956 infants aged 0–23 months included in the analysis. The rates of initiation of breastfeeding within one hour after birth (78.1%), continued breastfeeding at one year (99.6%) and timely introduction of solid, semi‐solid or soft foods at 6–8 months (77.2%) were high. Exclusive breastfeeding under 6 months (49%) was relatively low and attaining minimum dietary diversity (17.4%) and consumption of iron‐rich foods (1.8%) were extremely low. Stunting was not associated with any of the indicators assessed. Infants born to mothers who had first given birth at an age younger than 19 were more likely not to be breastfed within one hour after birth, not to be exclusively breastfed and not to have the recommended dietary diversity. A measure of low household resources was associated with higher odds of not meeting the minimum dietary diversity. The poor IYCF indicators confirm the need for more effective programs for improving child feeding practices in Madagascar. The identified risk factors for inappropriate feeding practices could be used in directing future nutrition sensitive and specific interventions.

Support or Funding Information

Fulbright Program for Foreign Students and Oklahoma State University
Creating Healthy Food Interventions in Food Pantries: First and Separately Seen is Selected
Authors: Wansink Brian , Bhana Hiershenee
Published: November 2023

Can behavioral science be used to help food pantries guide their clients to make healthier selections in the absence of explicit education? In a New York City food pantry, the location of a healthy whole grain cereal was altered to two conditions: located along with all other (less healthy) cereals or located ahead of (and separate from) alternative cereals. Inventory records of these cereals were tracked and pre‐post intervention surveys conducted in treatment and control pantries (n = 506). When healthy cereals were placed separately and ahead of competitive cereals, reported selection rose from 8.4% to 32% (p< .0001) compared to the control pantry. This preliminary field study underscores two important findings: (1) small, easy, no‐cost changes can improve food selections from pantry clients; (2) contrary to prior work, healthier food should be seen first and seen separately from less healthy competing foods in order to encourage selection. Leveraging principles of choice architecture and behavioral economics has implications for healthier food selection in pantry settings for the most at risk populations.
The Impact of Nutritional Interventions on Linear Growth After 2 y of Life: a Systematic Review and Meta‐Analysis of Controlled Trials
Authors: Roberts Joseph L , Stein Aryeh D
Published: November 2023

A large body of evidence suggests that the first 1000 days is a critical window in which interventions to address malnutrition will be most effective, but little is known about the impact on linear growth of nutritional interventions in children ≥2 y. The aim of this analysis was to evaluate the effectiveness of several nutrition‐based interventions, specifically (1) iron; 2) zinc; 3) calcium; 4) iodine; 5) vitamin A; 6) multiple (≥2) micronutrients; 7) protein; and 8) food, at improving growth in healthy children ≥2 y. A systematic search of MEDLINE and EMBASE retrieved 7,794 articles. A total of 69 studies met pre‐specified inclusion criteria. Data were pooled using the generic inverse variance method and expressed as standard mean differences (SMD) with 95% confidence intervals (CIs). Analyses were first conducted using a fixed effects model. If significant heterogeneity was observed (P‐value <0.05, I2 statistic >50%), analyses were repeated assuming a random effects model. Baseline height for age z‐score (HAZ), age, nutrient dose, study duration, and nutritional status were examined as potential sources of heterogeneity. Zinc (mean effect size 0.15; 95% CI: 0.06, 0.24), vitamin A (0.05, 95% CI: 0.01, 0.09), multiple micronutrient (0.26; 95% CI: 0.13, 0.39), and protein (0.68; 95% CI: 0.30, 1.05) had significant positive effects on linear growth with baseline HAZ a significant inverse predictor of the effect size. Iron (0.10; 95% CI: −0.04, 0.24), calcium (0.03; 95% CI: −0.09, 0.14), iodine (0.07; 95% CI: −0.10, 0.25), and food‐based (0.19; 95% CI: −0.28, 0.66) interventions had no significant effect on growth. Age at baseline, study duration and dose were not related to effect size for any nutrient examined. Further restricting our analysis to study populations with baseline iron, calcium, and zinc deficiency did not alter our conclusions for each respective nutrient. Our study suggests that zinc, vitamin A, multiple micronutrient, and protein interventions delivered after 24 mo of age can have a positive effect on linear growth, especially in populations that have experienced growth failure.

Support or Funding Information

This work was supported by National Institutes of Health award T32 DK007734.
The Association Between Animal Source Foods and Stunting in Children Aged 6 Months to 5 Years: A Systematic Review
Authors: Shapiro Myra Joy , Downs Shauna , Quelhas Diana , Kreis Katharine , Kraemer Klaus , Fanzo Jessica
Published: November 2023

Children under the age of 5 are at a critical stage of growth and development requiring the support of adequate nutrition. Stunting is a measure of failure to reach linear growth potential and can be used as an indicator of reductions in neurodevelopment and cognitive function, elevated risk of morbidity and mortality in childhood and chronic disease in adulthood. The aim of this study was to examine the relationship between the consumption of animal source foods (ASF) and stunting in low‐ and middle‐income countries. A systematic review was conducted using the CINAHL, Embase, Global Index Medicus, PubMed, and Web of Science databases. To identify gray literature, the sources examined were the International Food Policy Research Institute publications, the New York Academy of Medicine Grey Literature Report, OpenGrey, and Proquest Digital Dissertations. Studies that quantified ASF consumption by frequency, quantity, or both in children 6 to 59 months in low‐ and middle‐income countries were included in the review. The primary outcome was linear growth and the secondary outcomes were micronutrient deficiencies. Study titles, abstracts, and full texts obtained in the searches were independently screened by two reviewers. The title review contained 13,431 references; 205 were eligible for abstract review. Of the 89 full texts eligible for review, the majority were excluded for ASF consumption that was not adequately quantified for analysis (n=26). Other exclusion reasons included growth and/or micronutrient deficiency outcomes absent or the relationship between outcomes and ASF consumption not established (n=24), children <6 months or >59 months (n=11), data from a high‐income country (n=3), excluded language (n=1) and review articles (n=1). A total of 19 studies (23 articles) were included in the final review. The majority of studies were observational (n=13); the designs were longitudinal (n=8) and cross‐sectional (n=5). The majority of observational studies (n=9) used a 24‐hour recall to collect ASF consumption, but the consumption variables varied widely from binary measures of dietary ASF to counts of daily ASF consumed to grams of ASF protein intake. Intervention studies (n=6) examined the use of a variety of foods from caterpillar cereal to meat and fish powders. This review found a diverse range of studies examining ASF and stunting in young children, however, the heterogeneity of ASF consumption measures is a challenge for direct comparisons of results.
Nutrient Analysis of Farmed Palm Weevil Larvae for the Advancement of Edible Insects in Ghana
Authors: Parker Megan , Zobrist Stephanie , Mansen Kimberly , Soor Shobhita , Laar Amos , Asiedu Cyril , Lutterodt Herman
Published: November 2023

Background

Due to the rising cost of and increased demand for animal protein, food insecurity, environmental pressures, and population growth, edible insects, particularly where already commonly consumed, have emerged as an especially relevant food in the 21st century.

Objective

To examine the nutrient content of palm weevil larvae (Akokono), a traditionally consumed edible insect in Ghana.

Methods

We examined the nutrient profile of palm weevil larvae (Akokono) in three ‘unprocessed’ forms: raw, boiled, and roasted. Three ‘processed’ forms were also developed: Akokono flour, Akokono‐yam biscuit, and Akokono‐groundnut paste. Akokono‐groundnut paste was chosen as the top product for further testing and development as a complementary food for children. Macronutrient composition, amino acid profile, fatty acid profile, and micronutrient tests were conducted on the raw, boiled, and roasted forms in addition to the Akokono‐groundnut paste. Macronutrient composition was determined by standard AOCS methods. The amino acid and fatty acid profiles were examined using ion exchange chromatography. Vitamin content of A, D, E, and most B‐vitamins was determined using High Performance Liquid Chromatography (HPLC); vitamin B12 content was determined using microbiological method AOAC 952. Mineral content (iron, zinc, calcium, potassium, magnesium, and copper) was determined by atomic absorption spectroscopy methods. All tests were conducted at Kwame Nkrumah University of Science and Technology and Eurofins Scientific.

Results

All forms of Akokono tested were high in fat (53–56%), protein (32–34%), and contained medium to high concentrations of all nine essential amino acids. The fatty acid profile is still under analysis. Raw, boiled, and roasted forms of Akokono were rich sources of most B‐vitamins (niacin [4.0–4.8mg/100g], riboflavin [0.6–0.8mg/100g], vitamin B6 [0.2–0.3mg/100g], folate [200ug/100g], and B12 [16–18ug/100g]), vitamin E (1.1–1.9mg/100g), and three minerals (zinc [3.6–3.9mg/100g], magnesium [23–26mg/100g], and copper [300–900ug/100g]). In comparison to the unprocessed forms, Akokono‐groundnut paste had slightly lower concentration of riboflavin, folate, and B12 but significantly higher concentrations of niacin (7.9mg/100g), vitamin E (15mg/100g), potassium (240mg/100g), calcium (43mg/100g), and iron (2.0mg/100g).

Conclusion

Akokono, traditionally consumed as food in West Africa, are a rich source of fat and protein, essential amino acids, B‐vitamins, and zinc. Akokono‐groundnut paste can be further refined for enhanced nutritional benefit to prevent micronutrient deficiencies.

Support or Funding Information

This project was supported by a grant from The Bill & Melinda Gates Foundation, Seattle, WA.
Infant and young child feeding (IYCF) practices and nutritional status under 2 years of age in Bhutan
Authors: Campbell Rebecca K. , Kang Yunhee , West Keith P.
Published: November 2023

In South Asia, while childhood undernutrition persists, overweight is gradually becoming common. IYCF practices (e.g., exclusive breastfeeding, timely complementary feeding, diet diversity) promote healthy growth, but little is known about IYCF and their link to children's nutritional status in Bhutan, explored here in data collected during the 2015 Bhutan National Nutrition Survey. In this nationally‐representative survey, household (HH) membership and socioeconomic status (SES), youngest preschool child anthropometry and derived WHO/UNICEF IYCF indicators were assessed. IYCF and anthropometry data were available for 441 children < 24 mo of age. Length‐for‐age (LAZ), weight‐for‐length (WLZ) and weight‐for‐age (WAZ) Z‐scores were derived relative to the WHO reference. 15%, 5% and 12% of children were stunted, wasted and underweight (< −2 Z), respectively, while 6% were overweight (WLZ > 2). HH assets owned (e.g., TV, 66% and sofa set, 28%) reflected an SES above neighboring Nepal and Bangladesh, but 40% of mothers had no schooling. Exclusive breastfeeding (BF) to 6 mo was reported by 52% of mothers and 92% and 61% reported continuing breastfeeding through the 1st and 2nd years, respectively. Timely introduction of complementary foods was reported for 93%, while only 18% of children met the minimum dietary diversity cutoff (≥ 4 food groups in past 24 hrs). Survey design‐adjusted regression analysis suggested girls were far less likely than boys (referent) to be exclusively breastfed under 6 mo of age: OR=0.2 (95% CI: 0.1–0.9). SES was associated with complementary feeding diet quality: ORs of reaching minimum dietary diversity were 5.3 (1.1–25.2) and 7.8 (1.3–46.9) in HHs classified into the 4th and 5th vs 1st quintiles of a wealth index. No IYCF indicator was associated with stunting or wasting, while exclusive and predominant BF < 6 mo and continued BF to 2 years were protective against overweight (OR=0.1 (0.0–1.0), 0.1 (0.0–0.6) and 0.0 (0.0–0.4), respectively). Acceptable breast and complementary feeding practices along with low rates of under‐ and over‐nutrition suggest a situation of moderately low nutritional risk, but sex differences in breastfeeding practices, protective effects for overweight of BF according to guidelines and close associations between SES and complementary food quality suggest directions for potential programmatic interventions.

Support or Funding Information

UNICEF Regional Office for South Asia, Kathmandu, Nepal
Mother, woman, person: An ethical analysis of current rhetoric around maternal nutrition
Authors: Fox Elizabeth Lorraine , Fanzo Jessica
Published: November 2023

Maternal nutrition plays a key role in fetal and postnatal growth and development, as well as birth outcomes. As a result, interventions for women during pregnancy and lactation largely focus on infant health and developmental outcomes. Often, they do not explicitly involve the mother or the mother's health and well‐being, despite mothers comprising part of the mother‐infant dyad. This is an ethical issue. This paper compares the social justice ethical approach proposed by Powers and Faden (2006) and the rights‐based ethical approach described by Rawls (1986) to explore current rhetoric and interventions focused on maternal and women's nutrition. Using an ethical lens, we examine a number of different programs and delivery platforms targeting women and their own health, including school and education‐based programs, social safety nets, and health center‐based and community programming. There are ethical reasons to maintain a focus on the infant from a social justice perspective. From this perspective, meeting the nutritional needs of women during pre‐conception, pregnancy and lactation is directly related to their ability to bear healthy infants. However, framing the needs of women exclusively in reference to the needs of their children in these interventions diminishes the importance of good health and nutrition for the woman herself. From a rights‐based approach, we can conceptualize women as a vulnerable group that has the right to basic liberties, such as good health and nutrition. When accounting for transitioning demographics and more women choosing not to have children (or to have fewer children), the current focus of maternal health and nutrition as a means to the infant's health creates a gap that fails to account for a major sector of the world population. Focusing on women's nutrition as a human right redirects current rhetoric and interventions such that they focus on the right of all women to good nutrition, regardless of their choice to have children or not.
Socio‐Demographic, Clinical and Behavioral Characteristics of Brazilian Dyslipidemic Adults Enrolled in a Lifestyle Modification Program
Authors: Kano Hugo T , Vilches Gabriel Nogueira , Barros Layene Peixoto , Teixeira Okesley , Manda Rodrigo Minoru , Burini Roberto Carlos
Published: November 2023

PURPOSE

The study aimed to characterize higher triglycerides (TG), total cholesterol (tCHOL) and non‐HDL (nHDL) cholesterol and lower HDL‐cholesterol (HDL) in free‐living adults spontaneously demanding for a lifestyle modification program.

METHODS

The lifestyle changing program “Mexa‐se Pró‐Saúde [Move for Health]” is a community based project with spontaneous access to adults (>35 yrs old) from both genders that come to the clinic for preventive health examination and further interventions including nutrition re‐education, supervised physical exercise and other lifestyle factors. This cross sectional study used baseline data from 910 participants (from the years of 2005 to 2015) screened for physical activity level, socio‐demographic characteristics (IPAQ version 8 ‐ long form), dietary intake (24‐hour dietary recall and Healthy Eating Index‐HEI calculation), anthropometrics, cardio‐respiratory capacity (Balke's treadmill protocol) clinical and fasting‐plasma biochemistry. The statistics comparisons were performed (for p<0.05) using SAS, version 9.2.

RESULTS

The sample composition was 79.3% females, 2/3 between 35 to 60 years old, having uncompleted elementary grade, mostly married (2/3), living in a family with monthly income less than 5 minimum wage (< US $ 1250). However, they referred themselves as being in good state of health. The Inadequate HEI rate was 91.1%. The dyslipidemic rate reached 79.2% showing tCHOL as the most prevalent (48.5%) notwithstanding, altered TG and HDL were also at the levels of 40%. The proportion of non‐medicated dyslipidemics varied from 61.8% to 68.1%, similarly in all 4 plasma lipids. This similarity was found also for the proportions of medicated non‐controlled patients, varying from 14.4% to 17%. The dyslipidemic quartile (higher tCHOL and nHDL‐chol, lower HDL and higher TG) was similarly distributed among demographic and socioeconomic classes. They all presented a dietary ‐inadequate quality, low recommended physical activity and low aerobic capacity. Higher energy and CHO intakes discriminated top quartiles of both, tCHOL and TG along with saturated fat ‐low fiber for the total‐chol. and high CHO refined products for TG top quartile. Lower intake of MUFA was the food intake marker for the lower HDL quartile. The main plasma changes linked to dyslipidemia were in direction to pro inflammatory (hs‐CRP) and/or insulin resistance (HOMA‐IR) states.

CONCLUSION

The found high prevalent dyslipidemia was mostly in medicated but not controlled subjects regardless their socio‐demographic factors but, associated with higher body fatness (mainly abdominal), intake of low‐quality diet and lower aerobic fitness.

Support or Funding Information

Support CNPq, FAPESP
The Non‐Caloric Sweeteners Aspartame, Sucralose and Stevia sp. Induce Specific but Differential Responses to Compartmentalized Adipose Tissue Accumulation
Authors: Pliego‐Rivero F. Bernardo , Sosa‐García Betsy Corina , Otero Gloria Bernardo , Oros‐Pantoja Rigoberto Bernardo
Published: November 2023

Obesity is a chronic disease characterized by the increase of adipose tissue, and usually accompanied by metabolic abnormalities predisposing to endocrine and cardiovascular pathologies. With the aim of avoiding such disorders alternatives to the consumption of high energy foods have been developed. Natural and artificial non‐caloric sweeteners (NCS) are now commercialized to meet sweetness without adding nutritional calories to food. So far the metabolic changes associated to NCS chronic intake are not clear and no agreement exists about their risk to health. The chronic consumption (6 weeks) of aspartame, sucralose and Stevia sp. for human consumption was studied in a murine model (Balb/c mice, n=8 per group). A standard murine diet was supplied and NCS dissolved in the drinking water to a sweetness comparable to 1 g sucrose/100 ml H2O. Experimental NCS groups, aspartame, sucralose and Stevia sp., were compared to two C groups, sucrose and water only. Fluid and food intake, weight gain, blood glucose, adipose tissue accumulation in the mesenteric, inguinal and gonadal body compartments, and bioimpedance body composition (ImpediVet B1S) were determined. Complex and statistically significant responses related to NCS intake were observed. Sucrose and all NCS induced increased body weight gain; blood glucose was higher in NCS groups compared to group C water; fat in all body compartments was increased by sucralose; bioimpedance showed a reduction of fat‐free mass in all NCS groups and increased body fat. Each NCS studied elicited a specific but independent physiological response in terms of adipose tissue accumulation.
Consumption of Fortified Infant Foods Reduces Dietary Diversity but Has a Positive Effect on Subsequent Growth in Indonesian Infants
Authors: Diana Aly , Mallard Simonette R , Hazard Jill , Purnamasari Dwi Monik , Nurulazmi Ikrimah , Herliani Pratami Diah , Nugraha Gaga Irawan , Gibson Rosalind S , Houghton Lisa
Published: November 2023

Stunting and underweight among under‐five children in Indonesia are common, raising public health concerns. Whether inappropriate complementary feeding (CF) practices compromise optimal growth during late infancy in Indonesia is uncertain. We therefore characterized and evaluated CF practices in Indonesian infants and investigated their relationship with subsequent growth. We enrolled breastfed infants at 6 months of age (n=230); and followed them at 9 (n=202) and 12 months of age (n=190). We collected socio‐demographic and anthropometric data and two‐day in‐home weighed food records. Relations between WHO CF indicators, sentinel foods, and energy and micronutrient intakes at 9 months and growth at 12 months were explored using multiple linear regression. Stunting and underweight increased from 15.8% and 4.4% at 6 months to 22.6% and 10.5% at 12 months, respectively. Median intakes of calcium, iron, and zinc were below WHO recommendations. Infants consuming fortified infant foods (FIFs) at 9 months had diets with a lower dietary diversity (DD) score (2.3 vs 3.0), energy density (1.2 vs. 1.5 kcal/g), and energy (250 vs. 310 kcal/d) and protein (6.5 vs. 9.1 g/d) intake than non‐consumers (P < 0.01), despite higher intakes of calcium, iron, and vitamins A and C (P < 0.001). Positive relations existed for 9‐month consumption of iron‐rich/iron fortified infant foods with length‐for‐age Z‐score (LAZ) at 12 months (β = 0.22; 95% CI: 0.01, 0.44; P = 0.04), and for fortified infant foods alone with both LAZ (β = 0.29; 95% CI: 0.09, 0.48; P = 0.04) and weight‐for‐age Z‐score (β = 0.14; 95% CI: 0.02, 0.26; P = 0.02) at 12 months. The positive effect of FIFs on subsequent growth may be associated with their content of both powdered cow's milk and multi‐micronutrient fortificants. Nonetheless, mothers should not be encouraged to over‐rely on FIFs as they reduce DD.

Support or Funding Information

Meat and Livestock Australia and Otago University Research Grant
Preconceptional Lipid‐Based Micronutrient Supplementation Reduced Circulating Branched Chain Amino Acids in Guatemalan Women Who are Overweight or Obese at 12 Weeks Gestation: A Pilot Study
Authors: Borengasser Sarah , Kerns Mattie , Palacios Alexander , Baker Peter , Kemp Jennifer , Morrison Seth , Westcott Jamie , Friedman Jacob , Garces Ana Lucia , Figueroa Lester , Hambidge Michael , Krebs Nancy
Published: November 2023

Childhood obesity is a global health concern. Estimates project 60 million preschool‐aged children worldwide will be overweight or obese (OW/OB) by 2020. Recent reports suggest that low‐ and middle‐income countries are suffering from a “double burden” of undernutrition (growth stunting) and overnutrition (obesity). The developmental origins hypothesis has demonstrated that in utero exposure to maternal under‐ or overnutrition contributes to detrimental growth and metabolic outcomes in later life. Elevated branched chain amino acids (BCAAs: Valine, Leucine, and Isoleucine) are established biomarkers of insulin resistance (IR). The objective of this pilot study was to examine if circulating BCAA levels can serve as biomarkers for obesity‐associated IR and test whether a daily lipid‐based micronutrient supplement (LNS) consumed prior to and during pregnancy can improve metabolic status in Guatemalan women experiencing stunted growth and/or obesity during early pregnancy. Using an ongoing international RCT (Women First), Guatemalan women were studied who were normal weight (NW, BMI = 20.1–24.1) or OW/OB (BMI = 25.6–31.9), and divided into two arms (n = 9–10 per group): 1) those who consumed daily LNS at least 3 mos prior to conception (+LNS), or 2) no LNS (‐LNS). LNS compliance was greater than 80% and carefully monitored by on‐site personell via bi‐weekly collection of empty satchets, compliance calendars, and random audits. BCAAs were assessed by tandem mass spectroscopy and maternal serum parameters were measured using immunoassays for insulin, adiponectin, and leptin at 12 wk gestation (n = 9–10 per group). We found circulating BCAAs were elevated in OW/OB‐LNS at 12 wk compared to NW‐LNS (p = 0.001). OW/OB+LNS had reduced BCAAs compared to OW/OB‐LNS (p = 0.007), while no differences were detected between NW+LNS and NW‐LNS, suggesting LNS may improve metabolic status in OW/OB mothers and reduce detrimental fetal exposures. Similarly, circulating maternal insulin mIU/ml (r = 0.409, p = 0.013) and leptin/adiponection ratio (r = 0.440, p = 0.010) were positively associated with BMI at 12 wk gestation. These preliminary findings suggest that preconceptional LNS may impact maternal metabolic health.

Support or Funding Information

Bill & Melinda Gates Foundation OPPI 055867, NIH & ODS #U10 HD076474, & NIH 1K01DK109077‐01
Maternal Perceptions of Children's Linear Growth in Bangladesh: Perspectives from Urban and Rural Caregivers of Diverse Parenting Experience
Authors: Ickes Scott Bradley , Hossain Muttaquina , Rice Lauren , Naila Nurun , Nahar Baitun , Denno Donna , Ahmed Tahmeed , Walson Judd
Published: November 2023

Background

Linear growth faltering often begins in utero and results in stunting (height‐for age Z score < −2), which increases the risk for mortality and chronic diseases, and contributes to reductions in school attainment, and lifetime earning potential. In South Asia, nearly 40% of children are stunted, creating a context where impaired linear growth is normative, and may be imperceptible to caregivers.

Objective

To 1) understand the information that caregivers use to interpret their children's linear growth, and to 2) identify the cultural meaning and risks associated with poor height attainment among children by their caregivers.

Methods

We conducted 12 focus groups among mothers and alternate caregivers (n=81) in a rural and an urban slum setting in Bangladesh.

Results

Caregivers recognize that as a child ages, weight gain coincides with linear growth and is related to proper feeding and avoiding illness. Mothers mainly use visual cues, such as comparing children to siblings and other similarly aged children from the community, to understand if their children have appropriate linear growth. No concern was expressed about children failing to attain a “growth potential.” Further, caregivers did not clearly differentiate between stunting and familial short stature, highlighting the difficulty that many mothers face in interpreting appropriate linear growth in young children. Experience with growth monitoring services from the health system was not common among participants. “Genetics” and “hidden illness” were frequently cited reasons for poor height attainment. However, parents interpreted the risks of poor height attainment to be mainly social (unattractive physical appearance, limited marriage prospects) and economic (fewer job opportunities), and cite few health risks. Urban mothers were more likely to connect linear growth to poor nutrition during pregnancy. Alternate caregivers who had more parenting experience deemed themselves more equipped to detect appropriate linear growth according to age compared to mothers who, due mainly to employment or being first time mothers, have limited feeding engagement with their children.

Conclusions

The interpretation of linear growth among Bangladeshi caregivers is determined more by community norms, than by guidance from nutrition programming or the health system concerning children's growth potential. The practice of assessing the appropriateness of children's linear growth by comparing children to peers and siblings is problematic in settings where the average child is stunted. Efforts to raise awareness about the risks of linear growth faltering may consider messaging that emphasize factors that resonate with caregivers, such as the social and economic outcomes of stunting.

Support or Funding Information

Supported by the Bill and Melinda Gates Foundation (OPP1136759).
Healthy Eating, Mindfulness, Exercise, and Lifestyle in Overweight and Obese Postmenopausal Breast Cancer Survivors (HEELS): A Pilot Study‐Approach, Feasibility, and Acceptability
Authors: Sattler Elisabeth Lilian Pia , Washington Annette Monique , Young Henry Nolan , Cobran Ewan , Hartzell Diane , Dunagan Kelli Amanda , Davis Melissa
Published: November 2023

The objective if this study was to describe the approach, feasibility, and acceptability of implementing a mindful eating intervention in overweight and obese postmenopausal breast cancer survivors. A clinical trial assessed the impact of a mindful eating intervention in overweight and obese post‐menopausal breast cancer survivors on markers of prognosis and survival, including obesity, cardiometabolic, and lifestyle‐related markers, and biomarkers. The study targeted postmenopausal breast cancer survivors in remission aged 50+ years with a BMI of ≥ 25 kg/m2 and potential participants were recruited through local physician's offices, cancer support centers, and newspaper advertisements in Athens, GA, in 2016. Participants attended 8 weekly 2‐hour Mindful Eating Workshop© group sessions, led by a certified mindfulness instructor. The workshop addressed mindless, stress‐related, or emotional related eating, and disordered eating patterns through mindfulness meditation and group discussion. Data were collected at the University of Georgia Clinical and Translational Research Unit at 2 time points: baseline (weeks 1–2) and follow‐up (weeks 11–12), and included obesity, cardiometabolic, and lifestyle‐related markers, and selected biomarkers. Regarding the feasibility, 19 of the 29 screened individuals were eligible to participate, 13 consented to participate (accrual rate: 68.0%), and 11 completed the study (retention rate: 84.6%). Qualitative data indicated that participants had an overall positive experience with the intervention. Newly gained mindfulness knowledge, skills, and the supportive group environment were particularly appreciated. Suggested modifications included tailoring the intervention specifically towards experiences of breast cancer survivors, changing the format to more frequent, shorter sessions to reinforce mindfulness practices, and integrating nutrition and exercise sessions in the intervention. In conclusion, the mindful eating intervention in overweight and obese postmenopausal breast cancer survivors was feasible and acceptable to the target population. Changed session format and application of materials to breast cancer survivorship could further improve acceptability.

Support or Funding Information

The study was funded through the University of Georgia Clinical and Translational Research Unit seed grant.
Pilot Study on Influencing Healthy Food Acceptance in Young Children Through Play‐Based Activities and Food Exposures
Authors: Taetzsch Amy Gitschier , Hennessy Erin , Taylor Salima , Maaliki Adele , Rao Dharani , Ng Lienne , Krauss Amy , Wolfgang Andrea , Fleming Aubrey , Das Sai Krupa , Economos Christina D , Roberts Susan B
Published: November 2023

Healthy food consumed during early childhood provides the nutrients needed for physical health, cognition and learning throughout life. Current literature suggests the majority of American children do not consume a healthy diet, this is found to be especially prevalent in low income and minority communities. Published nutrition interventions attempting to change children's preferences have generally been successful in improving health knowledge but have had limited success in changing food consumption patterns. We developed a new intervention for improving eating habits of preschool children, specifically using play‐based activities to improve the acceptance of healthy foods by young children via repeated exposure and familiarity.

Thirty‐eight predominately minority children, aged 2.9–4.2 years old, from two classrooms in a Boston early childhood education program are participating in a pilot study to test the new intervention. Half of the children are in the intervention classroom, which receives 8 weeks of food‐related activities and target foods substituted for usual classroom activities and foods. The other half are in the control classroom, which is an assessment‐only group with no intervention. The intervention activities are 20–40 minutes in length per day and focus on familiarizing children with the target foods through games, art, cooking, gardening and tasting. The target foods are green leafy vegetables, carrots, tomatoes, whole grains, berries, grapes, apples, and a fortified bar providing nutrients and phytochemicals anticipated to be beneficial for cognition.

The study is currently ongoing. The primary outcome is food intake during snacks and lunch in the classroom, made at baseline and endline for both classrooms and during the intervention weeks in the intervention classroom. Additional outcomes include children's food preferences, height, weight, hemoglobin, carotenoids, and cognitive function. Programs that effectively facilitate acceptance of nutritious foods by young children are urgently needed and would have substantial value in improving the health and possibly also the cognition of American children.
Labeling Policy for Genetically Modified and Organic Food: Impact on Consumer Choice
Authors: Wunderlich Shahla M. , Gatto Kelsey A. , Mangano Marielle
Published: November 2023

Objectives

The purpose of this study was to investigate the current Genetically Modified Organism (GMO) and organic labeling policies and to determine the impact on consumer choice.

Methods

One hundred twenty‐three participants 18 years and older completed an online survey about Genetically Modified (GM) and organic food labeling. Participants responded to specific questions about how GM labeling influences their purchasing behaviors. Demographic data was also collected and analyzed by one‐way ANOVA tests to assess the significance. The study was approved by the Institutional Review Board (IRB)

Results

The participants were mostly female (82.9%) and white (90.5%), with mean age of 40.3 years. Household income was relatively high, with 39.0% reporting over $100,000. The sample also had high levels of education as well: 24.4% hold a doctorate degree, 33.3% hold a Master's degree. The majority of participants were familiar with the term Genetically Modified Food (or GMO and 82.1% reported that they have noticed non‐GMO labeled foods in New Jersey supermarkets, with 75.6% of participants reporting seeing these labels in the supermarkets they frequent most often. More than half of participants (68.3%) expressed that they prefer to purchase foods with a non‐GMO label versus foods without a non‐GMO label. Furthermore, a majority of participants (87.8%) would like to see more labeling that distinguishes non‐GMO and organic from GMO products. However, a small number of participants (24.4%) report that GMO food labeling impacts their purchasing decisions all the time, while approximately half of participants (51.2%) reported that GMO labeling affects their purchasing decisions only sometimes. Combined, 75.6% of participants allow GMO labeling to influence their purchasing decisions. Those who believe organic foods have a beneficial impact on the environment reported that their views impact their purchasing decisions more frequently than those who were unsure of their effects (p<0.01). There was also a near significant difference between those who believed organic food production system was beneficial and those who believed it was harmful, with those who believe in the benefits allowing their beliefs to impact purchasing more frequently (p=0.114). Those who believe GMOs foods have a harmful impact on the environment reported their views impact purchasing decisions more frequently than those who believe they have a beneficial effect (p<0.05).

Conclusions

There is a need for clearer labeling policies regarding GMO foods. If GMO foods were labeled more clearly, consumers would be able to make more educated purchasing decisions and exercise their beliefs and preferences accordingly.

Support or Funding Information

Montclair State University FSP support. No other funding.
Half‐Carts: Partitioned or Divided Grocery Carts Lead to Greater Fruit and Vegetable Purchases in Supermarkets
Authors: Wansink Brian , Solman Dilip , Herbst Kenneth
Published: November 2023

Before food portions are determined at home, they are determined at the supermarket. Building on the notion of implied social norms, we propose that partitioning a shopping cart for targeted healthy foods (such as fruits and vegetables) may increase their sales. A concept test for on‐line shopping (Study 1) suggests that partitions may be effective because they suggest purchase norms. An in‐store study in a supermarket (Study 2) reinforces the potential power of partitioned carts by showing that most shoppers purchased fruits and vegetables in quantities that were in proportion to the size of their allocated partition within a shopping cart. Using divided shopping carts (such as half‐carts) could be useful to retailers who want to sell more high‐margin produce, but they could also be useful to consumers who, in order to shop healthier, can choose to divide their own shopping cart in half with their jacket, purse, or briefcase.
Impact of the National Crusade against Hunger (CNCH) on anemia and dietary diversity among Mexican children
Authors: ROSAS VERONICA MUNDO , Levy Teresa Shamah , Tapia Brenda Martínez , Gómez‐Humarán Ignacio Méndez
Published: November 2023

The National Crusade against Hunger (CNCH by its initials in Spanish) is a social inclusion and wellbeing strategy aimed at combating poverty, social marginalization and malnutrition in Mexico. The CNCH intervention was launched in Mexico during the current presidential term (2013 – 2018).

Objective

To assess the impact exerted by CNCH food assistance programs on the dietary diversity and nutritional status of children at one‐year follow‐up.

Methods

A comparative study was conducted with two cohorts of children under five years of age: 1. CNCH intervention group (n=1500) and 2. Control group (n=800). Assessment was performed in two stages: at baseline (2014) and at one‐year follow‐up (2015). The study used a randomized, probabilistic design based on a nationally representative sample. The children in both cohorts were residents of highly and very highly marginalized localities. A differences‐in‐differences estimator was combined with generalized linear models to estimate CNCH impact on anemia and dietary diversity indicators.

Results

The probability of suffering from anemia was lower in the CNCH than in the control group children (p=0.021). Furthermore, those in the CNCH group were more likely to consume cereals (p=0.022), leguminous vegetables (p<0.001), and fruit and vegetables (p=0.006) than were those in the control group (p=0.001).

Conclusion

The CNCH social food assistance programs contribute to [U1] dietary diversity and anemia reduction in children under five. It is recommended to monitor the care strategies in each program and to improve targeting in the most socially deprived households.
Vegetable Velocity: More Time In Aisle Means More Produce In Carts
Authors: Wansink Brian , Mukund Anupama
Published: November 2023

Does the time a shopper spends in a supermarket section relate to sales and when does this increase fruit and vegetable purchases? In an observational study of 1026 shoppers, the time spent for each of four sections – Produce, Dairy, Meat, and Cereal – – was measured along with how much was purchased. While the average shopper spends about 3 minutes in each of these sections, the number of different items purchased per minute was 0.86, 1.31, 0.65, and 0.77. The first five minutes in a section have the highest shopping velocity, but this drops dramatically when shopping for meat and cereal, less for produce. A more detailed evaluation of the produce section showed that shopping with kids, approaching shopping with a positive attitude, and keeping a specific travel route throughout the store can result in significantly higher purchases and may provide the key to useful rules‐of‐thumb to help shoppers select more produce.
Conducting Behavioral Field Research in Food Pantries: Lessons and Tactics for Testing Nutrition Interventions
Authors: Wansink Brian , Bhana Hiershenee
Published: November 2023

This study provides recommendations of specific actions and methodological considerations that practitioners/researchers can use to develop viable and effective interventions in this setting. The CAN framework (convenient, attractive, normal) was employed to develop a series of 8 health‐promoting interventions in two matched urban client‐choice pantries (pantries which operate in a fashion similar to a grocery store), where one was a treatment site and one was a controlled site. Pantry clients of each pantry (mostly female, African American and Hispanic n=506) were surveyed and the results between the control and treatment sites were compared using Chi‐square analysis. Common barriers to successful intervention execution and evaluation: (1) site‐specific disruptions; (2) difficulty maintaining fidelity; (3) difficulty ensuring intervention strength; and (4) difficulty measuring and collecting data. Solutions derived from these studies and other literature include: bolstering staff buy‐in at all staffing levels; employing logic models and transition plans; considering multi‐modal assessments; conducting needs assessments with target versus service populations; and considering competing operation strategies and services offered. Simple methodological and procedural considerations can be valuable in guiding researchers to develop and test viable and effective interventions to help pantry clients make more nutrition selections.
A Comparative Study on Dietary Habit and Nutrition Knowledge of Middle School Students in Seoul area, Korea
Authors: Kim Young A , Cho Suyeon
Published: November 2023

This study was conducted to provide basic information for nutrition education to establish growing students' dietary habit. 518 middle school students(276 boys and 242 girls) were cross‐sectional surveyed in the region of Seoul, the capital of Korea. Data were analyzed with SPSS 18.0 program.

The average Body Mass Index (BMI) of male and female students was 19.5 kg/m2 in the normal weight range. In the aggregate, 43.8% of students had unbalanced eating habit, the girls had higher ratio of having unbalanced eating habit than the boys. But there was no significant differences according to BMI. And unbalanced‐eating students tended to leave vegetables significantly more than students with balanced eating habit(p<.05).

According to their nutrition knowledge test, the students were categorized into 3 groups, 28.8% of ‘high’, 31.5% of ‘middle’ and 39.8% of ‘low’, while 30.3% of entire students had experienced nutrition education program at school. 80.9% of the students agreed with the essentiality of nutrition education, while there was a significant difference according to the degree of Nutrition knowledge (p<.005). Two major reasons for essentiality of nutrition education were ‘proper growth’ (45.9%) and ‘good dietary habit’ (15.3%). And they preferred an active program including “cooking practice” by professional nutrition teacher.

Therefore, the correlation between nutrition education and students' dietary life was proven and continuous nutrition education programs for growing students are required to enhance their dietary life.

Support or Funding Information

Grant Funding Source: Inha University