bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Challenging Nutritional Problems among Adolescents in Sri Lanka
Authors: Jayatissa Renuka , Ranbanda R. M. 
Published: November 2015

Background Although 21% of the population of Sri Lanka consists of adolescents, studies of nutritional status among this group are limited. Objective To assess nutritional problems and dietary and activity patterns among adolescents in Sri Lanka. Methods A nationally representative cross-sectional study was conducted on 6,264 adolescents 10 to 15 years of age. All subjects were clinically examined for Bitot's spots, and their weights and heights were measured. The subjects were interviewed during regular class time. Hemoglobin concentration and dietary and activity patterns were assessed among a subsample ( n = 787) of 1,521 adolescents. The World Health Organization age- and sex-specific references for body-mass index and height-for-age were used to estimate the prevalence of underweight and stunting, respectively. The International Obesity Task Force age- and sex-specific reference for body-mass index was used to estimate the prevalence of overweight. Age-specific WHO-defined cutoff points were used to estimate the prevalence of anemia. Results The prevalence rates of underweight, stunting, and overweight were 47.2%, 28.5%, and 2.2%, respectively. The prevalence rates of anemia and vitamin A deficiency were 11.1% and 0.4%, respectively. During the previous 6 months, 10.4% of the subjects had usually not eaten breakfast before going to school. During the week before the interview, 24.4% of the children had not consumed green leafy vegetables, 26.6% had not consumed fruit, 19.0% had not participated in physical activities, and 27.5% had watched television for more than 2 hours per day. Conclusions The nutritional problems of adolescents aged 10 to 15 years should be addressed through the schools. Specific policies should be developed in collaboration with the Ministry of Health and Education to control nutritional problems among adolescents.
The Sustainability of Community-Based Therapeutic Care (CTC) in Nonemergency Contexts
Authors: Gatchell Valerie , Forsythe Vivienne , Thomas Paul-Rees 
Published: November 2015

Background Concern Worldwide is an international humanitarian nongovernmental organization that piloted and is now implementing and researching community-based therapeutic care (CTC) approaches to managing acute malnutrition. Experience in several countries suggests that there are key issues to be addressed at the international, national, regional, and community levels for community-based treatment of acute malnutrition to be sustainable. National level At the national level there must be demonstrated commitment to a clear health policy and strategy to address outpatient treatment of acute malnutrition. In addition, locally available, affordable ready-to-use therapeutic food (RUTF) must be accessible. Regional level At the regional level a functional health system and appropriate capacity for service provision are required. Integration of outpatient services should be viewed as a process with different levels of inputs at different phases depending on the capacity of the Ministry of Health (MOH). There is a need for indicators to facilitate scale-up and scale-back for future emergency response. Community level Strong community participation and active screening linked to health service provision at the local level is paramount for sustainable assessment and referral of severe acute malnutrition. Future challenges to sustain community-based therapeutic care Key challenges to the sustainable treatment of severe acute malnutrition include the development of locally produced RUTF, development of international standards on local RUTF production, the integration of outpatient treatment protocols into international health and nutrition guidelines, and further operational research into integration of community-based treatment of severe acute malnutrition into health systems in nonemergency contexts.
Baseline Evaluation of Nutritional Status and Government Feeding Programs in Chiclayo, Peru
Authors: Gross Rainer , Lechtig Aarón , de Romaña Daniel López 
Published: November 2015

Background Because of the rapid growth of the urban population in Peru, food and nutrition insecurity will occur increasingly in this population. For appropriate policy setting and programming, the food and nutrition situation of the urban poor requires better understanding. Objective To gain information about the nature, magnitude, severity, and causes of the nutritional problems of the population in low-income areas of the city of Chiclayo, Peru. Methods A cross-sectional nutrition survey was conducted in 1,604 households, covering children under 5 years of age and their parents. Results The prevalence rates of stunting, wasting, overweight. and anemia in children were 15.4%, 1.3%, 4.6%, and 65.7%, respectively; one third of adults were overweight, and one tenth were obese; 2.1% of the mothers were underweight; and 34.3% of mothers and 12.2% of fathers had anemia. Governmental feeding programs did not address these problems adequately. Conclusions Interventions must have adequate targeting; address appropriate responses at the household, community, and national levels; and reduce stunting, obesity, and iron-deficiency anemia.
Effectiveness of the Communication Program on Compliance in a Weekly Multimicronutrient Supplementation Program in Chiclayo, Peru
Authors: Gross Ursula , Diaz Marita Mamani , Valle Claudia 
Published: November 2015

Background Compliance with daily micronutrient supplementation is usually poor and the question arises whether compliance with a weekly regimen would be better. Objectives The inputs (messages and channels), output (increase of knowledge), and outcome (behavior changes) of a communication campaign in a micronutrient supplementation program for women and adolescent girls 12 through 44 years of age and children under 5 years of age (primary audience) were analyzed. Methods The communication program addressed not only the primary, but also the secondary (facilitators) and tertiary audiences. Formative research and descriptive statistics were used to analyze the communication campaign. Results Nearly all women and adolescent girls (89%) and children (91%) took at least 75% of the supplements over the 3-month period. The incidence rates of reported negative side effects of supplementation in children and in women and adolescent girls were less than 10%. Knowledge of micronutrient nutrition among facilitators of all ages and education levels increased significantly (p < .001). Conclusions A thoroughly planned and implemented nutrition communication program can secure high compliance of the beneficiaries of micronutrient supplementation programs. The necessary supplies should be available at least 3 months before program implementation. With an adequate communication program, supplementation programs can be used to foster food-based approaches for the target audience.
Cross-Sectional Growth References and Implications for the Development of an International Growth Standard for School-Aged Children and Adolescents
Authors: Seidell Jacob C. , Doak Colleen M. , de Munter Jeroen S. L. , Kuijper Lothar D. J. , Zonneveld Cor 
Published: November 2015

Normative data are needed to create a reference that indicates optimal development of weight in relation to height and age, particularly in the face of the unfolding obesity epidemic. The body-mass index (BMI) has some serious limitations: it is a relatively poor predictor of current and future fatness. Currently, however, there are few available alternatives, with the possible exception of waist circumference or skinfolds. The use of cross-sectional references to construct a BMI-reference curve is problematic when there are period and cohort effects. Ideally, a reference would be based on longitudinal data in populations with little underweight, overweight, and obesity. In the meantime cross-sectional data in appropriate populations could be used to construct BMI percentiles linking BMI values at age 5 to those at age 18 (or 21) that would correspond with adult BMI values reflecting optimal health (e.g., that would correspond to adult BMI values between 21 and 23 kg/m2).
Effect of Household Processing on the In Vitro Bioavailability of Iron in Mungbean (Vigna Radiata)
Authors: Barakoti Lotika , Bains Kiran 
Published: November 2015

Background Mungbean (Vigna radiata) is a major source of energy and protein in developing countries, especially for the vegetarian population. Improvement of the bioavailability of iron in mungbean by common household processes could make a significant contribution to the nutrition of people in countries where iron-deficiency anemia is widespread. Objective The study was conducted to determine the effect of common household processes on nutritional and antinutritional factors as well as in vitro bioavailability of iron in mungbean. Methods Mungbean was subjected to various domestic processes such as dehulling, pressure cooking, germination, and fermentation. The effects of these processes on proximate composition, antinutritional factors (phytin phosphorus, polyphenols, and neutral detergent), and iron, including ionizable iron, were determined. Results No significant change in crude protein content was observed. There was a significant (p≤.05) increase in fiber content after germination. Ash content decreased significantly (p≤.05) after all processing methods. The processing methods resulted in a significant (p≤.05) reduction in phytin phosphorus and polyphenols. Pressure cooking significantly (p≤.05) decreased the neutral detergent fiber, whereas fermentation and germination increased it. The phytate:iron molar ratio of processed mungbean revealed that the maximum reduction was in germinated and fermented samples. Ascorbic acid content increased significantly (p ≤ .05) after germination. The in vitro bioavailability of iron in raw mungbean was 7.32%. All of the processing methods resulted in an increase in iron bioavailability in vitro; the maximum bioavailability was in germinated cooked mungbean (12.52%), followed by fermented cooked mungbean and germinated raw mungbean (both 11.04%). Conclusions Suitable processing techniques can improve the in vitro bioavailability of iron from mungbean. If mungbean products with enhanced iron bio-availabilty are developed, they could help improve the iron status of the population.
Effect of Iodine Status and other Nutritional Factors on Psychomotor and Cognitive Performance of Filipino Schoolchildren
Authors: Amarra Ma. Sofia V. , Bongga Demetria C. , Peñano-Ho Leticia , Cruz Federico B. , Solis José S. , Barrios Erniel B. 
Published: November 2015

Background Until 1998, iodine deficiency was a public health problem in the Philippines. A law entitled “An Act Promoting Salt Iodization Nationwide” (ASIN) has been passed and implemented by the government to eliminate iodine deficiency. The contribution of salt iodization, as well as dietary, health, and environmental factors, to improving the intellectual performance of Filipino schoolchildren remains to be determined. Objective The objectives of the study were to determine the relationship between iodine status and levels of psychomotor and cognitive performance in first-grade children aged 6 to 10 years, and to examine the extent to which dietary, biochemical, health, and environmental factors contribute to children's mental performance. Methods Two hundred ninety children in six classroom sections from a public school in Manila were examined by measurement of urinary iodine excretion (UIE) and thyroid palpation. The median UIE level for each section was determined. Sixty-five children classified as iodine deficient (UIE < 90 μg/L with grade 1 goiter, n = 34) and non-iodine deficient (UIE > 100 μg/L without goiter, n = 31) were given psychomotor and cognitive function tests (Bender–Gestalt and Raven's Colored Progressive Matrices). Scores from the two tests were used to determine each child's general ability percentile rank. Other variables examined were dietary intake (% RDA of nutrients ingested based on two nonconsecutive 24-hour recalls); deficiencies in iron, vitamin A, and selenium; parasitic infection; coliform contamination of drinking water; household use of iodized salt; illness in the past 2 weeks; and wasting and stunting. Results Children whose general ability scores were at or above the 50th percentile had higher UIE levels, but the relationship was not significant. Children from sections with higher median UIE levels had higher percentile ranks for general ability (p =.002). Backward logistic regression showed that the variance in deficient and adequate mental performance was explained by dietary intakes that met ≥ 80% of the RDA for energy, protein, thiamin, and riboflavin; the use of iodized salt; child's iodine status; and stunting (R2 =.520, p =.0016). Higher class median UIE was associated with better psychomotor and cognitive performance in children who were tested. Factors that contributed to better performance include higher intakes of energy, protein, thiamin, and riboflavin; household use of iodized salt; normal iodine status; and absence of stunting or chronic malnutrition. Conclusions Salt iodization, accompanied by adequate intakes of energy, protein, and foods rich in thiamin and riboflavin, can contribute to improved mental performance in Filipino schoolchildren. Longer-term factors that can contribute to improved performance are achievement of normal iodine status and elimination of protein–energy malnutrition.
Outbreak of Beriberi in a Prison in Côte D'Ivoire
Authors: Ahoua Laurence , Etienne William , Fermon Florence , Godain Graziella , Brown Vincent , Kadjo Kassy , Bouaffou Kouamé , Legros Dominique , Guerin Philippe Jean 
Published: November 2015

Background A beriberi outbreak occurred in the Maison d'Arrêt et de Correction d'Abidjan (MACA), a detention center in Abidjan, Côte d'Ivoire, between October 2002 and April 2003. Objective A retrospective investigation was conducted to document the outbreak in April 2003. Methods A descriptive analysis and a case–control study were performed. A probable case patient was defined as a person detained in the center between October 2002 and April 2003 with at least two of the following symptoms: bilateral leg edema, dyspnea, positive squat test, motor deficiencies, and paresthesia. A definite case patient was defined as a probable case patient who showed clinical improvement under thiamin treatment. Results Of 712 cases reported, 115 (16%) were probable and 597 (84%) were definite. The overall attack rate was 14.1%, and the case fatality rate was 1.0% (7/712). The highest attack rate was reported in the building housing prisoners with long-term sentences (16.9%). All patients were male, and the mean age was 28 years. During the period studied, the penal ration provided a fifth of the quantity of thiamin recommended by international standards. After adjustment for potential confounders, a history of cholera infection (adjusted odds ratio [ORa], 12.9; 95% confidence interval [CI], 2.9 to 54.1) and incarceration in the building for severe penalties (ORa, 4.8; 95% CI, 1.3 to 18.5) were associated with the disease. Conclusions Beriberi has been underreported among prisoners. Further attention should be given to its risk factors, especially a history of acute diarrhea. Systematic food supplementation with vitamins and micronutrients should be discussed when the penal ration does not provide the necessary nutrient intake recommended according to international standards.
Estimating the Global Costs of Vitamin A Capsule Supplementation: A Review of the Literature
Authors: Neidecker-Gonzales Oscar , Nestel Penelope , Bouis Howarth 
Published: November 2015

Background Vitamin A supplementation reduces child mortality. It is estimated that 500 million vitamin A capsules are distributed annually. Policy recommendations have assumed that the supplementation programs offer a proven technology at a relatively low cost of around US$0.10 per capsule. Objectives To review data on costs of vitamin A supplementation to analyze the key factors that determine program costs, and to attempt to model these costs as a function of per capita income figures. Methods Using data from detailed cost studies in seven countries, this study generated comparable cost categories for analysis, and then used the correlation between national incomes and wage rates to postulate a simple model where costs of vitamin A supplementation are regressed on per capita incomes. Results Costs vary substantially by country and depend principally on the cost of labor, which is highly correlated with per capita income. Two other factors driving costs are whether the program is implemented in conjunction with other health programs, such as National Immunization Days (which lowers costs), and coverage in rural areas (which increases costs). Labor accounts for 70% of total costs, both for paid staff and for volunteers, while the capsules account for less than 5%. Marketing, training, and administration account for the remaining 25%. Conclusions Total costs are lowest (roughly US$0.50 per capsule) in Africa, where wages and incomes are lowest, US$1 in developing countries in Asia, and US$1.50 in Latin America. Overall, this study derives a much higher global estimate of costs of around US$1 per capsule.
Anthropometric, Metabolic, and Dietary Fatty Acids Characteristics in Lean and Obese Dyslipidemic Asian Indian Women in Calcutta
Authors: Ghosh Arnab 
Published: November 2015

Background The precise etiology and mechanisms leading to the development of increasing incidence of coronary heart disease (CHD) in Asian Indians remains incompletely understood. There is evidence that women in this population may have comparatively greater risk factors (e.g., dyslipidemia) for CHD than men. Objective To determine how dietary fatty acids composition could be used to identify Asian Indian women who are at greater risk of obesity and dyslipidemia. Methods The present cross-sectional study comprised of 130 (Group I: lean control, n = 40; Group II: lean dyslipidemic, n = 45; and Group III: obese dyslipidemic, n = 45) Asian Indian women (≥ 30 years) living in Calcutta, India and the surrounding suburbs. Anthropometric measures, lipoproteins, plasma glucose, and intake of dietary fatty acids were obtained from each participant. Obesity measures were subsequently calculated from anthropometric measures. Conversion of foods into nutrients was done according to standard nutritive values of Indian foods. Results ANOVA with Duncan's post-hoc test revealed significant group differences for anthropometric measures, lipids profiles, blood glucose, and dietary fatty acids. Pearson's partial correlations (controlling for age) also revealed that central obesity measure had a significant association with dietary fatty acids and their ratios. Discriminant function analysis revealed that overall, 80% of all entries were positively (correctly) classified in three groups using fatty acids and their ratios. Conclusions Dietary fatty acids composition is related to indicators of obesity. The recent shift in dietary habits may have caused an increase in the prevalence of obesity and dyslipidemia in this region.
Promoting Healthy Diets and Tackling Obesity and Diet-Related Chronic Diseases: What are the Agricultural Policy Levers?
Authors: Hawkes Corinna 
Published: November 2015

Background Diet-related chronic diseases are now a serious global public health problem. Public health groups are calling for the agricultural sector to play a greater role in tackling the threat. Objective To identify potential points of policy intervention in the agricultural sector that could be leveraged to promote healthy diets and tackle obesity and diet-related chronic diseases. Methods A review of the literature on the dietary implications of agriculture, a conceptual analysis of the issues, and the identification of relevant examples. Results There are two main potential points of intervention in the agricultural sector that could be leveraged to promote healthy diets: agricultural policies and agricultural production practices. Agricultural policies and practices affect diet through their influence on food availability, price, and nutrient quality, which in turn affects food choices available to consumers. Agricultural policies amenable to intervention include input, production, and trade policies; agricultural production practices amenable to intervention include crop breeding, crop fertilization practices, livestock-feeding practices, and crop systems diversity. Conclusions It is well-known that agricultural policies and production practices influence what farmers choose to grow. Agricultural policies and production practices could also play a role in influencing what consumers choose to eat. To identify how agricultural policies and practices can usefully contribute toward promoting healthy diets and tackling obesity and diet-related chronic diseases, health policymakers need to examine whether current agricultural policies and production practices are contributing to—or detracting from—efforts to attain dietary goals; where and how could agricultural intervention help achieve dietary goals; and whether there are trade-offs between these interventions and other important concerns, such as undernutrition and the livelihoods of agricultural producers. Given the potential of agriculture to contribute to large-scale, population-level dietary improvements, these questions warrant closer attention from health policymakers.
Aflatoxin Exposure in Developing Countries: The Critical Interface of Agriculture and Health
Authors: Wild Christopher Paul 
Published: November 2015

Background Aflatoxins are common contaminants of staple foods in sub-Saharan Africa. These toxins are human liver carcinogens, especially in combination with chronic infection with hepatitis B virus. However, in an agricultural setting, the effects on growth, immune status, and susceptibility to infectious disease in farm animals are also well recognized. These latter effects have been far less explored in human populations. Objectives To review some of the more recent work on aflatoxins where the health outcomes seen in the agricultural setting, including growth impairment and immune suppression, have been investigated in human populations. The paper draws largely on examples from West Africa. The paper also sets out how knowledge gained about aflatoxins in the agricultural setting can be used to design intervention studies in human populations. Methods A review of the relevant literature. Results Human exposure to aflatoxins begins early in life, and recent studies in West Africa have demonstrated an association between exposure and growth faltering, particularly stunting, in young children. At present the underlying mechanisms for the latter effects are unknown but may include impairment of immunity and increased susceptibility to infections. Simple postharvest intervention strategies were successful in reducing aflatoxin exposure in a subsistence farm setting, providing a rationale for prevention of aflatoxin-related disease. Conclusions There are potential benefits to public health from intervention strategies combining expertise in the agricultural and health settings to address the aflatoxin problem.