bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.