bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptability and Safety of Novel Infant Porridges Containing Lyophilized Meat Powder and Iron-Fortified Wheat Flour
Authors: Pachón Helena , Domínguez María Reyna Liria , Creed-Kanashiro Hilary , Stoltzfus Rebecca J. 
Published: November 2015

Background Lyophilized meat powder with iron-fortified wheat flour can be used to produce an infant porridge with bioavailable iron, but its acceptability and safety are unknown. Objective To evaluate the acceptability and safety of porridges containing lyophilized meat powder and iron-fortified wheat flour. Methods Peruvian mothers' input was used to develop porridges without (no meat) and with meat powder (low or high chicken liver, low or high chicken thigh). Acceptability was determined by maternal hedonic scoring, 9-day infant intake, and videotape analysis of how well infants liked each porridge. Dry and cooked porridges and meat ingredients were tested for microorganisms; meats were tested for pesticides. Results Mothers gave higher acceptability scores to the no-meat porridge, followed in order by low and high quantities of meat powder (e. g., mean ± SD “taste” scores were 4.5 ± 0.9 for the no-meat, 3.7 ± 1.1 for the low-liver, and 3.3 ± 1.1 for the high-liver porridges, p = .0001). Infants' porridge intake did not differ: 61.4 ± 47.1 g of no-meat, 62.1 ± 44.9 g of low-thigh, and 67.5 ± 42.0 g of low-liver (p = .7), as supported by the video analysis. Microbiologic safety was acceptable except for marginally acceptable molds and yeasts in dry ingredients. No pesticide residues were detected. Conclusions Despite mothers' clear preference for no-meat porridges, infants consumed equal amounts of porridges with and without meat. Thus, if mothers can be convinced to feed the meat-containing porridges to the infants despite their own preferences, the infants will consume these porridges. The mold and yeast content of the porridge ingredients must be reduced.
Effect of Daily versus Once-Weekly Home Fortification with Micronutrient Sprinkles on Hemoglobin and Iron Status among Young Children in Rural Bangladesh
Authors: Hyder S.M. Ziauddin , Haseen Farhana , Rahman Mizanur , Tondeur Mélody C. , Zlotkin Stanley H. 
Published: November 2015

Background The effectiveness of commonly suggested public health interventions to control childhood iron- deficiency anemia has been low. Objective To determine whether iron provided in Sprinkles daily or in a higher dose once weekly affected hemoglobin, serum ferritin levels, and serum transferrin receptor levels, and to determine whether there were dif- ferences in the effects of the two regimens. Methods In this cluster-randomized, community- based trial conducted in rural areas of Bangladesh, 136 children aged 12 to 24 months with mild to moderate anemia (hemoglobin 70–109 g/L) were randomly allo- cated to receive Sprinkles daily (12.5 mg of elemental iron, n = 79) or once weekly (30 mg of elemental iron, n = 73) for 8 weeks. Hemoglobin, serum ferritin, and serum transferrin receptor were assessed at the start and end of the intervention. Results In both groups, there were significant increases in hemoglobin and serum ferritin and a significant decrease in serum transferrin receptor ( p < .01). There were no significant differences between the groups in the increases in hemoglobin (16.1 ± 13.2 g/L for the group receiving Sprinkles daily and 12.3 ± 13.3 g/L for the group receiving Sprinkles once weekly) and serum ferritin (10.6 and 5.7 μg/L, respectively). The decrease in serum transferrin receptor also did not significantly differ between the groups (median, −2.5 and −1. 8 mg/L, respectively). The prevalence rates of iron-deficiency anemia, depleted iron stores, and tissue iron deficiency decreased significantly within each group ( p < .01), with no significant differences between the groups. Conclusions Home fortification of complementary foods with Sprinkles given either daily or once weekly improved iron-deficiency anemia and iron status among young children.
Assessment of the Nutritional Status of Preschool-Age Children during the Second Intifada in Palestine
Authors: Abdeen Ziad , Greenough P. Gregg , Chandran Aruna , Qasrawi Radwan 
Published: November 2015

Background The Palestinian economy has dramatically deteriorated at all levels since the Al-Aqsa Intifada (uprising) began in 2000, resulting in an unprecedented catastrophe to the livelihoods of the Palestinians residing in the West Bank and Gaza. It was also marked by lack of household physical and financial access to food and health care, which placed children at increased risk of malnutrition and poor health. This prompted a significant increase in food aid from 2002 until the summer of 2003. Objectives To assess the nutritional status of children 6 to 59 months of age after 1 year of food assistance. Methods In the West Bank and Gaza, a nationally representative sample of children 6 to 59 months of age was randomly selected with a validated multistage clustered design, with the Health Survey 1999 sample used as the sampling frame. The sample was stratified according to governorate, place of residence (urban, nonurban, or refugee camp), locality, and size of locality (number of households). A cross-sectional survey of nutritional status was carried out. Data were collected by interviews with the primary caregivers of the children. Measurements were made of children's weight and height or length. Food-intake data were collected by the 24-hour food-recall method with the use of a booklet of photographs of foods commonly eaten in Palestine. Results A total of 3,089 children were assessed, of whom 3.1% in the West Bank and 3.9% in the Gaza Strip were suffering from acute malnutrition; the prevalence of chronic malnutrition was 9.2% in the West Bank and 12.7% in the Gaza Strip ( p = .02). Sex, refugee status, locality, and maternal education were not significantly associated with acute malnutrition by logistic regression analysis, whereas infants 6 to 23 months of age were significantly at risk. Calorie and protein intakes were generally lower than recommended dietary allowances. Conclusions The prevalence rates of both acute and chronic malnutrition among children in the West Bank and Gaza are significantly higher than the national Palestinian averages. There is a need to establish nutritional surveillance systems to monitor the nutritional status of children in conflict areas.
Ferritin Concentration and Pregnancy Outcome: Linear Models for Predicting Birthweight and Birth Length
Authors: Vazirinejad Reza , Esmaeili Abbas , Vazirinejad Hassan , Hassanshahi Gholamhossien 
Published: November 2015

Background Iron-deficiency anemia can have negative consequences for pregnant women. Previous investigations conducted to explore the association between iron-related components of mothers' serum and the outcome of pregnancy have had diverse results. Objective This study aimed to investigate the correlation between ferritin concentration (as the index of stored iron) of mothers' serum during the last 24 hours of pregnancy and birth outcome. Methods Respondents were chosen from the list of all women who had given birth between January 1 and March 30, 2006, in a Rafsanjan county maternal hospital in southeast Iran. The study checklist was completed for 600 to 900 mothers (over a period of 30 days), and about 600 were eligible to participate. Blood samples were taken from 120 eligible women who were randomly selected after they had given their second consent. Data, including birthweight and birth length, were analyzed with SPSS; parametric ( t-test, correlation, logistic regression) and nonparametric (chi-square, Mann-Whitney U) tests were used where appropriate. Results No significant differences between different groups of respondents were found in birthweight, birth length, or the ferritin concentration of mothers' serum, indicating that the effect of confounder variables (e.g., baby's sex, mother's educational status, mother's age, gestational age, etc.) was controlled successfully. Significant positive correlations were found between the mother's ferritin concentration and the baby's birthweight ( r = 0.434, N = 120, p < .001) and birth length ( r = 0.396, N = 120, p < .001). Linear models revealed that the ferritin concentration of mothers' serum during the last 24 hours of pregnancy could be suitable to predict both birthweight and birth length. Conclusions This study confirms that provision of sufficient amounts of iron-related components to pregnant women is necessary to improve pregnancy outcome.
Relationships among Production Systems, Preschool Nutritional Status, and Pesticide-Related Toxicity in Seven Ecuadorian Communities: A Multi-Case Study Approach
Authors: Orozco Fadya , Cole Donald C. , Muñoz Verónica , Altamirano Ana , Wanigaratne Susitha , Espinosa Patricio , Muñoz Fabian 
Published: November 2015

Background Among small Andean potato farmers, greater pesticide use and better linkage to markets are promoted as ways to improve farm outputs and incomes. The health of household members is assumed to improve with higher incomes, although evidence to support such an assumption remains scarce. Objective Using a multidisciplinary approach, we sought to characterize agricultural systems producing potatoes and to assess relationships between these characteristics and farm household health indicators. Methods We included seven communities linked to a regional agricultural potato production platform (socio-organizational “space” for potato commercialization) in Chimborazo, Ecuador. The unit of analysis was the community, each of which was classified according to its level of intensity of potato production as more intensive, intermediate, or less intensive. Data on crop management, household food intake, child anthropometry, and impacts of pesticide use on adult health were collected by survey. Results The net income from potato production was similar in communities with more intensive and intermediate production systems and lower in those with less intensive systems. However, deficits in protein intake were more common among children in communities with more intensive systems (63%) than among those in communities with intermediate (53%) and less intensive (37%) systems. Deficits in thiamin and riboflavin intake were more prevalent in communities with more and less intensive systems than in those with intermediate systems. In contrast, the prevalence of moderate chronic malnutrition, as measured by height-for-age, was greater among children in communities with less intensive systems (27%) than among those in communities with intermediate (5%) and more intensive (7%) systems. Across all intensities, frequent use of highly hazardous pesticides was associated with adverse health effects. Conclusions Agricultural development programs need to work more cross-sectorally to realize the potential health benefits associated with intensification of production.
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.
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.
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.