bluuebunny/crossref_metadata_2025 huggingface dataset:
From Sago to Rice, from Forest to Town: The Consequences of Sedentarization for the Nutritional Ecology of Punan Former Hunter-Gatherers of Borneo
Authors: Dounias Edmond , Selzner Audrey , Koizumi Miyako , Levang Patrice
Published: November 2015

Background

The last nomadic peoples of the world are facing strong governmental incentives to renounce their foraging lifestyle. Nevertheless, the shift to a sedentary way of life and the adoption of agriculture do not always result in the promised improvement in diet and health conditions.

Objective

We compared the dietary regime and nutritional status of three groups of former hunter-gatherers, the Punan of Borneo. All three groups adopted extensive upland rice cultivation almost 6 decades ago, but each has some degree of dependence on agriculture versus forest resources, which varies along a gradient of accessibility of urban facilities.

Methods

The diet of three distinct Punan groups living in the dipterocarp forest of East Kalimantan was assessed both qualitatively and quantitatively and analyzed in relation to the seasonality of resources and human activities. The physical fitness of the Punan was also estimated from repeated anthropometric measurements.

Results

The more remote the Punan community was from urban facilities, the more diversified was the diet and the better were its nutritional status and physical fitness. The contribution of forest resources to the dietary regime also decreased with urban proximity. However, the higher dependency on agriculture is not the proximate cause of the deterioration in diet and physical fitness, which is rather due to the transition from the nomadic to the settled way of life.

Conclusions

The brutal shift in lifestyle among the Punan of Borneo has profoundly affected the integrity of these societies and impacted their social, cultural, symbolic, and political features. In the long run, this may compromise their health status and ecological success.
Illness, Death, and Macronutrients: Adequacy of Rural Mozambican Household Production of Macronutrients in the Face of HIV/AIDS
Authors: Donovan Cynthia , Massingue Jaquelino
Published: November 2015

Background

As the public sector and civil society develop intervention programs to deal with the HIV/ AIDS epidemic, there has been an increasing emphasis on the relationship between nutrition and the disease. Drug interventions may be ineffective, and the progression from HIV infection to full-blown AIDS may be accelerated without adequate nutrition. Mozambique is still fighting an increasing prevalence rate of HIV, including in rural areas. Rural households in Mozambique rely heavily on their own agricultural production for the basic macronutrients.

Objectives

To evaluate the extent to which household agricultural production of basic staples meets overall household needs for major macronutrients, comparing households affected and not directly affected by HIV/ AIDS and other major illnesses over two time periods.

Methods

This research analyzes nationally representative panel data from rural household surveys conducted in 2002 and 2005 to evaluate whether households that have suffered the chronic illness or illness-related death of prime-age adult members (15 to 49 years of age) are more vulnerable to macronutrient gaps.

Results

Households in the South and in the North with a male illness or death in 2002 produced significantly less macronutrients from crops in 2005 than nonaffected households. These households also had significantly lower income per adult equivalent.

Conclusions

Mortality or illness from HIV/AIDS affects the ability of agricultural households dependent on own-food production to produce macronutrients. Interventions to improve access to food may be needed for affected households, particularly in light of their inability to recover over time. More analysis is needed to understand income sources, crop diversification, and access to macronutrients through the market.
Folic Acid Metabolism and Malaria
Authors: Metz Jack
Published: November 2015

Folate is essential for DNA synthesis and the survival and growth of the malaria parasite. Folate sufficiency may be associated with an increased risk of malaria. Antifolate antimalarial drugs are of major importance in the prophylaxis and treatment of malaria. Folic acid reverses the inhibition by antifolate drugs of plasmodial growth or survival in vitro, and folic acid supplements given to children with malaria may increase the failure rate of treatment with antimalarials. There is no convincing evidence of a significant prevalence of folate deficiency in children in malarious areas, nor of a beneficial effect of folic acid supplementation on malarial anemia. In areas where Plasmodium falciparum malaria is holoendemic, universal supplementation of children with iron and folic acid may increase the incidence of severe morbidity and mortality. These regions should be excluded from the World Health Organization recommendation of universal folic acid supplementation of children in areas of high prevalence of anemia. This does not apply to supplementation of pregnant women with folic acid.
Application of Retinol-Binding Protein Enzyme Immunoassay to Dried Blood Spots to Assess Vitamin A Deficiency in a Population-Based Survey: The Uganda Demographic and Health Survey 2006
Authors: Baingana Rhona Kezabu , Matovu Denis Kasozi , Garrett Dean
Published: November 2015

Background

Vitamin A deficiency is a public health problem in most developing countries. The technological challenges associated with the measurement of serum retinol have limited the epidemiologic assessment of vitamin A deficiency. The combination of retinol-binding protein (RBP) enzyme immunoassay and dried blood spots offers a rapid, inexpensive, and reliable tool for the population-level assessment of vitamin A deficiency in resource-poor settings.

Objective

To report on the application of RBP enzyme immunoassay and dried blood spots to assess serum retinol concentrations as an indicator of vitamin A status in the Uganda Demographic and Health Survey 2006.

Methods

A total of 5,642 capillary blood spot samples were collected by fingerprick onto filter paper cards from women (15–49 years) and children (6–59 months) in a representative probability sample of 9,864 households between May and October 2006. The cards were dried, packed individually with desiccant, and kept at 4°C in a portable refrigerator in the field and at –20°C in the laboratory. Prior to analysis, the RBP enzyme immunoassay was optimized with the use of matched serum and dried blood spots.

Results

The correlation between RBP values determined by matching serum and dried blood spots was excellent ( r = 0.79, p < .00001). The prevalence of vitamin A deficiency in women (RBP < 1.24 μmol/L) and children (RBP < 0.825 μmol/L) was 19.4% and 20.4%, respectively.

Conclusions

The combination of RBP enzyme immunoassay and dried blood spots is a simple, reliable, and cost-effective tool for the estimation of vitamin A deficiency in population-level surveys in resource-poor settings.
Review of the Magnitude of Folate and Vitamin B12 Deficiencies Worldwide
Authors: McLean Erin , de Benoist Bruno , Allen Lindsay H.
Published: November 2015

Human deficiencies of folate and vitamin B12 result in adverse effects which may be of public health significance, but the magnitude of these deficiencies is unknown. Therefore, we examine the prevalence data currently available, assess global coverage of surveys, determine the frequency with which vitamin status assessment methods are used, and identify patterns of status related to geographical distribution and human development. Surveys were identified through PubMed and the Vitamin and Mineral Nutrition Information System at the World Health Organization (WHO). Since different thresholds were frequently used to define deficiency, measures of central tendency were used to compare blood vitamin concentrations among countries. The percentage of countries with at least one survey is highest in the WHO Regions of South-East Asia and Europe. Folate and vitamin B12 status were most frequently assessed in women of reproductive age (34 countries), and in all adults (27 countries), respectively. Folate status assessment surveys assessed plasma or serum concentrations (55%), erythrocyte folate concentrations (21%), or both (23%). Homocysteine was assessed in one-third of the surveys of folate and vitamin B12 status (31% and 34% respectively), while methylmalonic acid was assessed in fewer surveys of vitamin B12 status (13%). No relationship between vitamin concentrations and geographical distribution, level of development, or population groups could be identified, but nationally representative data were few. More representative data and more consistent use of thresholds to define deficiency are needed in order to assess whether folate and vitamin B12 deficiencies are a public health problem.
Gene–Nutrient Interactions: Importance of Folic Acid and Vitamin B12 During Early Embryogenesis
Authors: Finnell Richard H. , Shaw Gary M. , Lammer Edward J. , Rosenquist Thomas H.
Published: November 2015

The role that nutritional factors play in mammalian development has received renewed attention over the past two decades as the scientific literature has exploded with reports that folic acid supplementation in the periconceptional period can protect embryos from a number of highly significant malformations. As is often the case, the relationship between B vitamin supplementation and improved pregnancy outcomes is more complicated than initially perceived, as the interaction between nutritional factors and selected genes must be considered. In this review, we attempt to summarize the complex clinical and experimental literature on nutritional factors, their biological transport mechanisms, and interactions with genetic polymorphisms that impact early embryogenesis. While not exhaustive, our goal was to provide an overview of important gene–nutrient interactions, focusing on folic acid and vitamin B12, to serve as a framework for understanding the multiple roles they play in early embryogenesis.
National Food-Fortification Program with Folic Acid in Chile
Authors: Hertrampf Eva , Cortés Fanny
Published: November 2015

The Chilean Ministry of Health legislated to add folic acid (2.2 mg/100 g) to wheat flour to reduce the risk of neural tube defects (NTD), beginning in January 2000. This policy resulted in a significant increase in serum and red blood cell folate in women of childbearing age 1 year after fortification. The frequency of NTD was studied in all births, both live and stillbirths, in a prospective hospital-based design including 25% of national births during 1999–2000 (prefortification period) and 2001–2002 (postfortification period). During the prefortification period, there was a total of 120,566 newborns, and the NTD rate was 17.1/10,000 births. During the postfortification period (2001–2002) there was a total of 117,704 newborns, and the NTD rate was significantly reduced by 43% to 9.7/10,000 births (RR = 0.57; 95% CI, 0.45 to 0.71). This implies a reduction of 43% in the rate of NTD. The costs per NTD case and infant death averted were 1,200 international dollars (I$) and I$11,000, respectively. The cost per disability-adjusted life year (DALY) averted was I$91, or 0.8% of the country's per capita GDP. On the overall, fortification resulted in net cost savings of I$1.8 million.

Fortification of wheat flour with folic acid has proven to be an effective and cost saving strategy for the primary prevention of NTD in a middle-income country in a postepidemiological transition, and in a dramatically short period of time.
The Potential Role of Private Pharmacies in Maternal Iron Supplementation in Rural Tanzania
Authors: Young Sera , Ali Said Mohammed , Beckham Sam Wilson
Published: November 2015

Background

The reduction of maternal anemia is an agreed public health goal but one that has been very difficult to achieve. On Pemba Island, Tanzania, more than 90% of pregnant women are anemic, despite government efforts to identify and treat anemia during antenatal clinic visits.

Objective

To investigate the potential of private pharmacies to be accessed for iron supplements for maternal anemia.

Methods

We compared and contrasted the care given at private pharmacies and public clinics in terms of six characteristics: accuracy, affordability, availability, geographic accessibility, accommodation, and acceptability. We used data from in-depth interviews, surrogate customer encounters, governmental medicine record reviews, and participant observation.

Results

The accuracy of health care workers' advice about the treatment of anemia at private pharmacies and government clinics was similar. Supplements purchased at pharmacies were sometimes cheaper than the free supplements from the government, when the costs of transportation and time spent at the clinic were considered. Supplements at private pharmacies were always available, whereas the supply at government clinics was erratic. Private pharmacies were physically closer, socially less distant, and more accommodating than government clinics. Both clinics and private pharmacies were socially acceptable to pregnant women, although government clinics were typically not attended until later in pregnancy.

Conclusions

The private sector probably has untapped potential for the reduction of maternal anemia in settings in which public health services fall short. Private pharmacies can contribute to the reduction of maternal anemia on Pemba Island and beyond.
A Comparative Evaluation of the Macronutrient and Micronutrient Profiles of Soybean-Fortified Gari and Tapioca
Authors: Kolapo Adelodun Lawrence , Sanni Morenike Olayinka
Published: November 2015

Background

Gari and tapioca are storage-cupboard convenience foods obtained from the tubers of cassava ( Manihot esculenta Crantz). They are important staples in Nigeria and many African countries where malnu- trition is a major problem. Tapioca is a quick-cooking food made from partly gelatinized starch and gari is a fermented, roasted, granular food made from cassava pulp.

Objective

Gari and tapioca are nutritionally inferior and need to be fortified. This paper reports the macro- and micronutrient profiles of soybean-fortified gari and tapioca.

Methods

Gari and tapioca were fortified with soybean flour or soybean residue at 25% of dry weight. Standard methods were used for the determination of proximate parameters such as crude protein, fat, ash, carbohydrate and moisture content. All the samples were analyzed for phosphorus, calcium, magnesium, potassium, sodium, manganese, iron, copper and zinc.

Results

Unfortified tapioca had significantly lower ( p < .05) proximate values (protein: 0.31%; fat: 0.17%; ash: 0.34%) than unfortified gari (protein: 1.50%; fat: 1.56%; ash: 1.35%). The fortification of both gari and tapioca significantly ( p < .05) increased the contents of crude protein, phosphorus, fat, and ash as well as all the monitored macro- and micronutrients. These values (%) increased from 1.50–9.31, 0.06–0.11, 1.56–4.31 and 1.35–1.64 for gari-soybean fortified gari; and 0.31–12.56, 0.03–0.12, 0.17–5.45 and 0.34–1.41 for tapioca to soybean fortified tapioca respectively. Soybean flour increased the nutrient content of the fortified gari and tapioca compared to soybean residue. Data from this study suggest that both soybean flour-fortified tapioca and soybean flour-fortified gari are effective means of meeting the daily requirements of minerals, protein, and energy.

Conclusions

Both soybean flour-fortified tapioca and soybean flour-fortified gari could be used to fight macronutrient and micronutrient deficiencies, not only in Nigeria and other African countries where these two cassava products are staples, but also in other cassava- consuming developing nations.
Recent Advances in Knowledge of Zinc Nutrition and Human Health
Authors: Hess Sonja Y. , Lönnerdal Bo , Hotz Christine , Rivera Juan A. , Brown Kenneth H.
Published: November 2015

Zinc deficiency increases the risk and severity of a variety of infections, restricts physical growth, and affects specific outcomes of pregnancy. Global recognition of the importance of zinc nutrition in public health has expanded dramatically in recent years, and more experience has accumulated on the design and implementation of zinc intervention programs. Therefore, the Steering Committee of the International Zinc Nutrition Consultative Group (IZiNCG) completed a second IZiNCG technical document that reexamines the latest information on the intervention strategies that have been developed to enhance zinc nutrition and control zinc deficiency. In particular, the document reviews the current evidence regarding preventive zinc supplementation and the role of zinc as adjunctive therapy for selected infections, zinc fortification, and dietary diversification or modification strategies, including the promotion and protection of breastfeeding and biofortification.

The purposes of this introductory paper are to summarize new guidelines on the assessment of population zinc status, as recommended by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the International Atomic Energy Agency (IAEA), and IZiNCG, and to provide an overview on several new advances in zinc metabolism. The following papers will then review the intervention strategies individually.
Impact of Zinc Fortification on Zinc Nutrition
Authors: Hess Sonja Y. , Brown Kenneth H.
Published: November 2015

Food fortification is increasingly recognized as an effective approach to improve a population's micronutrient status. The present report provides a critical review of the scientific evidence currently available on the impact of zinc fortification on zinc nutrition.

The available studies clearly show that zinc fortification can increase dietary zinc intake and total daily zinc absorption. Most absorption studies also indicate that adding zinc to food does not adversely affect the absorption of other minerals, such as iron. Despite the positive effect of zinc fortification on total zinc absorption, only a few studies have found positive impacts of zinc fortification on serum zinc concentrations or functional indicators of zinc status. The reasons for these inconsistent results are uncertain but may relate to the choice of food vehicles, the age group and zinc status of the study populations, or particular aspects of the study design. Thus, additional research is needed to determine the impact of zinc fortification, with or without other micronutrients, in populations at risk for zinc deficiency.

Because of the benefits of increasing intake in populations at high risk for zinc deficiency, the documented increase in total zinc absorption that occurs following zinc fortification, the absence of any adverse effects, and the relatively low cost of adding zinc, public health planners should consider including zinc in mass and targeted fortification programs in such populations. Because of the limited available information on program impact, it will be important to evaluate the outcomes of such programs.
An Effectiveness Trial of Multiple Micronutrient Supplementation during Pregnancy in Vietnam: Impact on Birthweight and on Stunting in Children at around 2 Years of Age
Authors: Huy Nguyen Do , Hop Le Thi , Shrimpton Roger , Hoa Cao Viet
Published: November 2015

Background

Multiple micronutrient deficiencies during pregnancy in Vietnam may contribute to poor fetal growth and stunting, which are major determinants of the health and development of future generations.

Objective

We assessed the effects of prenatal multiple micronutrient supplementation on maternal weight gain during pregnancy, infant birthweight, and height of the child at around 2 years of age.

Methods

We conducted a nonrandomized, nonblinded, side-by-side effectiveness trial in a normal program setting in three districts in the Red River Delta in the north of Vietnam. Women in one district received the standard iron–folic acid supplement during prenatal care; women in the second district received the multiple micronutrient supplement; in the third district, gender training was provided in addition to the multiple micronutrient supplement. Cluster surveys were carried out in the three districts at the end of the trial to verify low birthweight (LBW) and at around 2 years after the trial to measure children's height and weight, as well as to collect demographic data on the mothers.

Results

Mean birthweight was higher in the districts receiving multiple micronutrient supplements than in the district receiving iron–folic acid tablets. The mean birthweight was 166 g higher in the district receiving multiple micronutrients and 105 g higher in the district receiving multiple micronutrients with gender training than in the district receiving iron–folic acid (p < .05). The prevalence of LBW children (< 2,500 g) was lower in the district receiving multiple micronutrients (4.0%) and the district receiving multiple micronutrients plus gender training (5.8%) than in the district receiving iron–folic acid (10.6%) (p < .05). Children at around 2 years of age were taller in the district receiving multiple micronutrients (82.66 cm) and the district receiving multiple micronutrients plus gender training (83.61 cm) than in the district receiving iron–folic acid (81.64 cm), and the stunting rates were about 10% lower than in the district receiving iron-folic acid.

Conclusions

Multiple micronutrient supplementation during pregnancy could be an important intervention to help reduce stunting rates in Vietnam.
Multiple Micronutrient Supplementation during Pregnancy in Low-Income Countries: A Meta-Analysis of Effects on Birth Size and Length of Gestation
Authors: Fall Caroline H. D. , Fisher David J. , Osmond Clive , Margetts Barrie M.
Published: November 2015

Background

Multiple micronutrient deficiencies are common among women in low-income countries and may adversely affect pregnancy outcomes.

Objective

This meta-analysis reports the effects on newborn size and duration of gestation of multiple micronutrient supplementation mainly compared with iron plus folic acid during pregnancy in recent randomized, controlled trials.

Methods

Original data from 12 randomized, controlled trials in Bangladesh, Burkina Faso, China, GuineaBissau, Indonesia, Mexico, Nepal, Niger, Pakistan, and Zimbabwe, all providing approximately 1 recommended dietary allowance (RDA) of multiple micronutrients to presumed HIV-negative women, were included. Outcomes included birthweight, other birth measurements, gestation, and incidence of low birthweight (LBW) (< 2,500 g), small-for-gestational age birth (SGA, birthweight below the within-each-population 10th percentile), large-for-gestational age birth (LGA, birthweight above the within-each-population 90th percentile), and preterm delivery (< 37 weeks).

Results

Compared with control supplementation (mainly with iron–folic acid), multiple micronutrient supplementation was associated with an increase in mean birthweight (pooled estimate: +22.4 g [95% CI, 8.3 to 36.4 g]; p = .002), a reduction in the prevalence of LBW (pooled OR = 0.89 [95% CI, 0.81 to 0.97]; p = .01) and SGA birth (pooled OR = 0.90 [95% CI, 0.82 to 0.99]; p = .03), and an increase in the prevalence of LGA birth (pooled OR = 1.13 [95% CI, 1.00 to 1.28]; p = .04). In most studies, the effects on birthweight were greater in mothers with higher body mass index (BMI). In the pooled analysis, the positive effect of multiple micronutrients on birthweight increased by 7.6 g (95% CI, 1.9 to 13.3 g) per unit increase in maternal BMI (p for interaction = .009). The intervention effect relative to the control group was + 39.0 g (95% CI, +22.0 to +56.1 g) in mothers with BMI of 20 kg/m 2 or higher compared with −6.0 g (95% CI, −8.8 to +16.8 g) in mothers with BMI under 20 kg/m2. There were no significant effects of multiple micronutrient supplementation on birth length or head circumference nor on the duration of gestation (pooled effect: +0.17 day [95% CI, −0.35 to +0.70 day]; p = .51) or the incidence of preterm birth (pooled OR = 1.00 [95% CI, 0.93 to 1.09]; p = .92).

Conclusions

Compared with iron–folic acid supplementation alone, maternal supplementation with multiple micronutrients during pregnancy in low-income countries resulted in a small increase in birthweight and a reduction in the prevalence of LBW of about 10%. The effect was greater among women with higher BMI.
Nutrition, Poverty Alleviation, and Development in Central America and Panama
Authors: Immink Maarten D. C.
Published: November 2015

This paper reviews research with policy relevance for food and nutrition in Central America and similar areas. The research was conducted by the Institute of Nutrition of Central America and Panama (INCAP) during the last three decades of the past millennium (1970–99). Six policy areas were selected for this review: agricultural commercialization and rural development; wage and price policies; human resource development; social safety nets, particularly complementary food programs; multi-sectoral nutrition planning; and food and nutrition monitoring for policy formulation. The contents and major conclusions of the work are described, as well as their public policy implications.
Nutritional Status of Primary Schoolchildren in Garhwali Himalayan Villages of India
Authors: Osei Akoto , Houser Robert , Bulusu Saraswati , Joshi Tripti , Hamer Davidson
Published: November 2015

Background

Anemia and micronutrient deficiencies are common among Indian schoolchildren. However, past studies have narrowly focused on only a few micronutrients and have not carefully evaluated the association between sociodemographic factors and nutritional status of schoolchildren.

Objective

To assess the nutritional status of schioolchildren in Himalayan villages of India and to determine the relationships between their nutritional status, intestinal helminth infection, and sociodemographic characteristics.

Methods

A random sample of 499 children 6 to 10 years of age from 20 public primary schools was selected. Household sociodemographic data and morbidity data on children were collected through interviews with their caretakers. Height and weight were measured, and venous blood was drawn for assessment of hemoglobin, serum ferritin, soluble transferrin receptor, retinol, zinc, folic acid, vitamin B12, and C-reactive protein. Stool samples were analyzed for parasitic infections.

Results

Underweight, stunting, and wasting were present in 60.9%, 56.1%, and 12.2% of schoolchildren, respectively. Anemia, iron-deficiency anemia, and low serum concentrations of ferritin, zinc, retinol, folate, and vitamin B12 were found in 36.7%, 10.2%, 24.1%, 57.1%, 56.1%, 67.9%, and 17.4% of the children, respectively. One-fifth of the children had intestinal parasites. Being underweight was associated with lower household wealth ( p < .05). Helminth infection was associated with stunting, anemia, and low serum retinol ( p < .05). Living at higher altitude was associated with low serum levels of ferritin, retinol, and vitamin B12. There were no associations between any sociodemographic variables and serum zinc or folate.

Conclusions

Growth impairment and micronutrient deficiencies are prevalent among schoolchildren in Himalayan villages of India.
Magnitude and Distribution of Vitamin A Deficiency in Ethiopia
Authors: Demissie Tsegaye , Ali Ahmed , Mekonen Yared , Haider Jemal , Umeta Melaku
Published: November 2015

Background

Several surveys conducted over a period of 40 years have shown that vitamin A deficiency is a serious public health problem in Ethiopia. To address the problem effectively, up-to-date, comprehensive information on the magnitude and distribution of vitamin A deficiency is needed.

Objective

A national vitamin A survey was conducted to assess the national and regional prevalence rates of vitamin A deficiency in Ethiopia.

Methods

The survey employed a multistage, cluster-sampling approach and a cross-sectional study design. A total of 23,148 children aged 6 to 71 months and their respective mothers were examined for clinical signs and symptoms, and blood samples were collected from 1,200 systematically selected children for serum retinol analysis.

Results

The findings indicated national prevalence rates of 1.7% for Bitot's spots among children. 0.8% for night-blindness among children, and 1.8% for night-blindness among mothers. Nationally, 37.7% of children (95% CI, 35.6% to 39.9%) had deficient serum retinol levels, 50.7% had been sick in the previous 15 days, and 22.6% had received vitamin A supplements in the previous 6 months. The prevalence of clinical vitamin A deficiency was significantly (p < .05) higher among children who were male, older, or rural residents.

Conclusions

The study confirmed that vitamin A deficiency is a serious public health problem in Ethiopia. Intensification of the ongoing vitamin A supplementation program, postpartum vitamin A supplementation for mothers, intensifying efforts to improve the health status of preschool age children, and promotion of production and consumption of fruits and vegetables are recommended.
Nutritional Value of Locally Produced Foods and Potential for Developing Age-Appropriate Complementary Foods for Children under 2 Years of Age in Mali
Authors: Ag Ayoya Mohamed , Kodio Joseph , Ag Iknane Akory , Sodjinou Roger
Published: November 2015

Background

Promotion of dietary diversity using locally available nutritious foods is an effective approach in low-income areas to improve the quality of young children's diet and, hence, their growth and development.

Objective

To identify the nutritional values of locally acceptable, feasible, affordable, and sustainable foods and develop a number of recipes that could be used to complement effectively nutrient intakes provided through breastfeeding to children 6 to 23 months of age in Bandiagara, Mali.

Methods

Structured questionnaires were used to obtain lists of all locally available foods during village assembly meetings and identify the food basket of house-holds and child feeding practices during interviews with mothers and fathers. The nutritional values of the foods were estimated, and the Malian food composition table was used to identify the combinations that would result in the most nutritious recipes.

Results

Breastfeeding was widely practiced, but the rate of exclusive breastfeeding during the first 6 months of life was extremely low (7%). The practice of early introduction of water and complementary foods was a problem. Forty recipes for improved dishes, including puddings, drinks and juices, purées, salads, and soups, were proposed. The nutritional values of the 10 most nutritious of these recipes, the types and quantities of the ingredients, and the method of preparation of each recipe are described.

Conclusions

Locally produced indigenous foods in rural Mali were used to develop energy- and nutrientdense complementary foods for children. Further research is needed to test the short- and long-term effects of consuming these dishes on the nutritional status of children 6 to 23 months of age in Mali.
Psychomotor Development in Children with Iron Deficiency and Iron-Deficiency Anemia
Authors: Pala Emin , Erguven Muferet , Guven Sirin , Erdogan Makbule , Balta Tulin
Published: November 2015

Background

Iron deficiency and iron-deficiency anemia are the most common nutritional deficiencies in children, especially in developing countries. Iron-deficiency anemia in infancy is associated with impaired neurodevelopment. Studies have shown an association between iron deficiency without anemia and adverse effects on psychomotor development.

Objective

To determine the effects of iron deficiency and iron-deficiency anemia on psychomotor development in childhood.

Methods

We evaluated psychomotor development in healthy children with iron deficiency and iron-deficiency anemia with the use of the Denver II Developmental Screening Test (DDST-II). If the child score was more than 90th percentile compared to children in the same age group, the test was scored as “delay”; it was scored as a “caution” if the child score was between the 75th and 90th percentiles. The test result was interpreted as “normal,” if there was no delay and only one “caution” for any item. If the child had one or more “delays” or more than two “cautions,” the result was classified as “abnormal.”

Results

DDST-II scores were abnormal in 67.3% of subjects with iron-deficiency anemia, 21.6% of those with iron deficiency, and 15.0% of control subjects. The difference from the control group in the percentage of abnormal scores was significant for subjects with iron-deficiency anemia ( p < .01) but not for those with iron deficiency (p = 0.203); p > .05. (p-value, post-hoc comparison of 2 groups.)

Conclusions

Iron-deficiency anemia impaired psychomotor development during childhood. However, the evidence on the adverse effects of iron deficiency remains controversial. The Denver II Developmental Screening Test is a valuable test to detect early developmental delays, especially in infants with risk factors.
Impact of Vaccination against Chicken Newcastle Disease on Food Intake and Food Security in Rural Households in Tanzania
Authors: Knueppel Danielle , Cardona Carol , Msoffe Peter , Demment Montague , Kaiser Lucia
Published: November 2015

Background

Small-scale poultry production has the potential to increase animal-source food consumption, improve household income, and reduce food insecurity.

Objective

To assess the impact of a chicken Newcastle disease vaccination program on consumption of chicken and eggs among women and children, income, and food insecurity in rural Tanzanian households.

Methods

Comparisons were made between house-holds from three project villages, which participated in a Newcastle disease vaccination program for chickens, and three control villages, which did not participate. Household interviews were done with mothers from a random sample in March 2008 (237 households) and March 2009 (261 households).

Results

After the first year of vaccinations (three rounds), project households kept significantly more chickens and tended to be more food secure than control households. Mothers from project households ate significantly more eggs than their counterparts in control households. A similar trend was observed among children. In 2009, fewer chickens were vaccinated in the project villages than in 2008, and more chickens were independently vaccinated in the control villages. This corresponded with an increase in ownership of chickens, a reduction in food insecurity, and improved consumption of eggs in control villages, whereas chicken ownership and egg consumption decreased and food insecurity remained relatively stable in project villages. We saw no differences between project and control villages in income earned from chicken and egg sales.

Conclusions

Our findings suggest that an increase in chicken Newcastle disease vaccination can lead to an increase in ownership of chickens and egg consumption and may also have an effect on reducing household food insecurity.
Are Peanut Allergies a Concern for Using Peanut-Based Formulated Foods in Developing Countries?
Authors: Yang Zhenyu
Published: November 2015

Background

Peanut allergy is relatively common among children in developed countries and may have severe outcomes, including anaphylaxis. However, few data about peanut allergy in developing countries are available. Meanwhile, formulated foods with peanuts as a major ingredient are being promoted to prevent and control malnutrition in developing countries.

Objective

The objectives of the paper are to review the existing epidemiologic data about peanut allergy, to determine whether the prevalence of peanut allergy is lower in developing countries, and to explore the possible reasons for onset of peanut allergy.

Methods

Publications relevant to peanut allergy were searched via Pubmed, and prevalence and etiological factors of peanut allergy were reviewed.

Results

Data about peanut allergy were scarce in most developing countries. The existing data support the conclusion that peanut allergy is not as common in developing countries as in developed countries and may not be a major concern for programs promoting formulated food containing peanuts for control of malnutrition. However, plans for treatment of individuals with peanut allergy could be incorporated into these formulated food supplementation programs. A few risk factors (late introduction of peanuts to children, peanut processing technology, non-oral peanut exposure, and maternal peanut exposure during pregnancy and lactation) have been hypothesized to be associated with peanut allergy. However, more conclusive data are needed to verify or disprove these hypotheses.

Conclusions

Peanut allergy is not as common in developing countries as in developed countries and may not be a major concern for programs promoting formulated food containing peanuts for control of malnutrition. However, more research about prevalence of peanut allergy is warranted in developing countries.
Revisiting the Concept of Growth Monitoring and its Possible Role in Community-Based Nutrition Programs
Authors: Mangasaryan Nuné , Arabi Mandana , Schultink Werner
Published: November 2015

Background

Community-based growth monitoring (GM) and growth monitoring and promotion (GMP) have been implemented worldwide. The literature provides controversial messages regarding their effectiveness. Numerous countries have GM as their main community-based activity and need guidance for future programming. The notion of GM is usually clear, but the follow-up actions include a range of activities and interventions, all under the heading of “promotion.”

Objective

We suggested definitions, objectives, and outcomes of the GM and GMP. By providing some clarity on these conceptual issues we attempted to provide a basis for consensus building and development of recommendations on when this activity should be promoted or discouraged.

Methods

We reviewed basic concepts and global experience of GM and GMP using publications about GM and GMP, UNICEF country reports and other publications, field observations, and reports of recent expert consultations.

Results

Realistic added benefits are suggested as compared with general counseling that could also be delivered outside the GM session. We provide a narrow definition of “promotion” in GMP, in which actions are tailored to the results of monitoring, as well as suggest quality implementation criteria.

Conclusions

GM, even if complemented by a promotional package, can have only a limited impact if it is not part of a comprehensive program. GMP cannot be viewed as a competitor to highly effective interventions, but may serve as a possible platform for their delivery. The decision to build community-based programs on a GMP platform should be based on consideration of benefits, feasibility of quality implementation, and capacity of human resources.
Validation of the Malaysian Coping Strategy Instrument to Measure Household Food Insecurity in Kelantan, Malaysia
Authors: Sulaiman Norhasmah , Shariff Zalilah Mohd , Jalil Rohana Abdul , Taib Mohd Nasir Mohd , Kandiah Mirnalini , Samah Asnarulkhadi Abu
Published: November 2015

Background

Food insecurity occurs whenever people are not able to access enough food at all times for an active and healthy life or when adequate and safe food acquired by socially acceptable ways is not available.

Objective

To validate the Malaysian Coping Strategy Instrument (MCSI) to measure household food insecurity in Kelantan, Malaysia.

Methods

A cross-sectional study was conducted on 301 nonpregnant, nonlactating Malay women, aged between 19 and 49 years, living in rural and urban areas. The respondents were interviewed with the use of a structured questionnaire to obtain information on their demographic and socioeconomic characteristics, household food security, and dietary intake.

Results

Demographic and socioeconomic characteristics (household size, number of children, number of children attending school, household income, and per capita income) were significantly associated with household food-security status in rural and urban areas. Energy intake, fat intake, percentage of energy from fat, and number of servings of meat, fish, or poultry and legumes were significantly associated with household food-security status in rural areas. The dietary diversity score was significantly associated with household food-security status in rural and urban areas.

Conclusions

Validating the MCSI in other areas of Malaysia as well as in similar settings elsewhere in the world before it is used to measure household food insecurity in the population is strongly recommended. In this study, the MCSI was found to be a reliable and valid measure of household food insecurity based on criterion-related validity, particularly in terms of demographic and socioeconomic characteristics and dietary diversity.
Food Prices, Household Income, and Resource Allocation: Socioeconomic Perspectives on Their Effects on Dietary Quality and Nutritional Status
Authors: Bouis Howarth E. , Eozenou Patrick , Rahman Aminur
Published: November 2015

Background

The recent rise in agricultural commodity prices has been dramatic, and food prices are likely to follow an upward trend, at least in the medium term. Moreover, the recent financial crisis has also lowered incomes and increased food prices. Not only does this reduce dietary quality, but expenditures for health, sanitation, and education will decline, all of which will have a detrimental effect on health and nutrition outcomes.

Objective

To provide some perspectives on the role of major socioeconomic factors in driving health and nutrition outcomes.

Methods

We use demand elasticity parameters estimated from household-level survey data to simulate an increase in food prices, which is then mapped into energy and nutrient intakes. Furthermore, we also use house-hold-level data to analyze the implications of unequal intrahousehold distribution of food for the nutritional status of adult women and female children.

Results

A 50% increase in food prices results in a decrease in energy intake of 5% to 15% and in a decrease in iron intake of 10% to 30%, depending on the strength of the induced income effect. In a country like the Philippines, this would be equivalent to an increase of 25 percentage points in the proportion of women not meeting their requirements for iron intake.

Conclusions

Increasing food prices will make fighting micronutrient malnutrition in developing countries more difficult. In societies where preference is given to males in the intrahousehold distribution of nonstaple foods, this objective will be even more challenging.
Biofortification: A New Tool to Reduce Micronutrient Malnutrition
Authors: Bouis Howarth E. , Hotz Christine , McClafferty Bonnie , Meenakshi J. V. , Pfeiffer Wolfgang H.
Published: November 2015

Background

The density of minerals and vitamins in food staples eaten widely by the poor may be increased either through conventional plant breeding or through the use of transgenic techniques, a process known as biofortification.

Objective

HarvestPlus seeks to develop and distribute varieties of food staples (rice, wheat, maize, cassava, pearl millet, beans, and sweet potato) that are high in iron, zinc, and provitamin A through an interdisciplinary, global alliance of scientific institutions and implementing agencies in developing and developed countries.

Methods

In broad terms, three things must happen for biofortification to be successful. First, the breeding must be successful—high nutrient density must be combined with high yields and high profitability. Second, efficacy must be demonstrated—the micronutrient status of human subjects must be shown to improve when they are consuming the biofortified varieties as normally eaten. Thus, sufficient nutrients must be retained in processing and cooking and these nutrients must be sufficiently bioavailable. Third, the biofortified crops must be adopted by farmers and consumed by those suffering from micronutrient malnutrition in significant numbers.

Results

Biofortified crops offer a rural-based intervention that, by design, initially reaches these more remote populations, which comprise a majority of the under-nourished in many countries, and then penetrates to urban populations as production surpluses are marketed. In this way, biofortification complements fortification and supplementation programs, which work best in centralized urban areas and then reach into rural areas with good infrastructure.

Conclusions

Initial investments in agricultural research at a central location can generate high recurrent benefits at low cost as adapted, biofortified varieties become available in country after country across time at low recurrent costs.
Mixture of Ferric Sodium Ethylenediaminetetraacetate (NaFeEDTA) and Ferrous Sulfate: An Effective Iron Fortificant for Complementary Foods for Young Chinese Children
Authors: Chang Suying , Huang Zhenwu , Ma Yuxia , Piao Jianhua , Yang Xiaoguang , Zeder Christophe , Hurrell Richard F. , Egli Ines
Published: November 2015

Background

Ferric sodium ethylenediaminetetraacetate (NaFeEDTA) enhances iron absorption in the presence of phytate. However, the amount of NaFeEDTA that would have to be added to a complementary food to provide the necessary intake of iron for an infant or young child if NaFeEDTA were the sole iron fortificant exceeds the Acceptable Daily Intake (ADI) of EDTA for this age group. EDTA increases iron absorption at a molar ratio EDTA:iron of less than 1:1.

Objective

To determine whether iron absorption is enhanced with a mixture of ferrous sulfate (FeSO4) and NaFeEDTA.

Methods

Two studies with a crossover design were conducted in separate groups of 14 and 15 children aged 24 to 31 months. A complementary food consisting of millet porridge with cabbage, tofu, and pork-filled wheat flour dumplings was fortified with 2 mg iron as either FeSO4 or NaFeEDTA (study 1) or 4 mg iron as FeSO4 or a mixture of 2 mg each of FeSO4 and NaFeEDTA (study 2). Iron absorption was determined based on erythrocyte incorporation of stable iron isotopes.

Results

In study 1, the geometric mean (± SD) iron absorption was 8.0% (3.1, 20.8) and 9.2% (3.1, 27.0) from food fortified with FeSO4 and NaFeEDTA, respectively. In study 2, iron absorption was significantly higher from food fortified with 4 mg iron as 1:1 mixture of FeSO4/NaFeEDTA than from food fortified with FeSO4; the geometric mean iron absorption was 6.4% (3.0, 13.5) and 4.1% (1.9, 8.9), respectively.

Conclusions

The enhancing effect of EDTA on iron absorption is less strong in composite meals containing enhancers; nevertheless, the equal mixture of FeSO4 and NaFeEDTA significantly enhanced iron absorption and can be a strategy to ensure adequate iron absorption from phytate-containing complementary foods.