bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Review of Vitamin D Fortification: Implications for Nutrition Programming in Southeast Asia
Authors: Yang Zhenyu , Laillou Arnaud , Smith Geoffry , Schofield Dominic , Moench-Pfanner Regina 
Published: November 2015

Background Vitamin D is vital for bone health and has important roles in nonskeletal health and organ function. Most vitamin D is generated in the body by exposure to sunlight, with limited amounts added by the diet. Despite the presence of regular sunshine in Southeast Asia, vitamin D deficiency or insufficiency is being found there more commonly, primarily due to reduction of sunlight exposure as a result of lifestyle changes. Some of these lifestyle changes are unlikely to be reversed, and foods naturally containing vitamin D are not widely consumed, so fortification of foods with vitamin D may raise vitamin D status. Methods The literature database was searched for studies of vitamin D fortification, and we estimated potential vitamin D intakes from fortified vegetable oil. Results Almost all of the studies showed that circulating vitamin D (25-hydroxyvitamin D [(25OHD]) increased in a dose-dependent manner with increased intake of vitamin D–fortified foods. However, in a number of studies the additional intake was insufficient to increase vitamin D levels to 50 nmol/L. Vegetable oil fortified with vitamin D at a level of 10 μg/100 g could provide 3.9% to 21% of the Institute of Medicine Estimated Average Requirement (EAR) of vitamin D for adults in Southeast Asia. Conclusions Fortification of widely consumed foods, such as edible oil, with vitamin D could contribute to improved vitamin D status in Southeast Asian countries. Intake modeling studies should be conducted to calculate the resulting additional intakes, and fortification of additional foods should be considered. More nationally representative studies of vitamin D status in the region are urgently needed.
Learning from the Design and Implementation of Large-Scale Programs to Improve Infant and Young Child Feeding
Authors: Baker Jean , Sanghvi Tina , Hajeebhoy Nemat , Abrha Teweldebrhan Hailu 
Published: November 2015

Background Improving and sustaining infant and young child feeding (IYCF) practices requires multiple interventions reaching diverse target groups over a sustained period of time. These interventions, together with improved maternal nutrition, are the cornerstones for realizing a lifetime of benefits from investing in nutrition during the 1000 day period. Objective Summarize major lessons from Alive & Thrive's work to improve IYCF in three diverse settings—Bangladesh, Ethiopia, and Vietnam. Methods Draw lessons from reports, studies, surveys, routine monitoring, and discussions on the drivers of successful design and implementation of IYCF strategies. Results Teaming up with carefully selected implementing partners with strong commitment is a critical first step. As programs move to implementation at scale, strategic systems strengthening is needed to avoid operational bottlenecks. Performance of adequate IYCF counseling takes more than training; it requires rational task allocation, substantial follow up, and recognition of frontline workers. Investing in community demand for IYCF services should be prioritized, specifically through social mobilization and relevant media for multiple audiences. Design of behavior change communication and its implementation must be flexible and responsive to shifts in society's use of media and other social changes. Private sector creative agencies and media companies are well equipped to market IYCF. Scaling up core IYCF interventions and maintaining quality are facilitated by national-level coordinating and information exchange mechanisms using evidence on quality and coverage. Conclusions It is possible to deliver quality IYCF interventions at scale, while creating new knowledge, tools, and approaches that can be adapted by others and contribute to accelerated scale up of IYCF programs globally.
Childhood Dual Burden of Under- and Overnutrition in Low- and Middle-inCome Countries: A Critical Review
Authors: Tzioumis Emma , Adair Linda S. 
Published: November 2015

Background In low- and middle-income countries, the distribution of childhood nutritional diseases is shifting from a predominance of undernutrition to a dual burden of under- and overnutrition. This novel and complex problem challenges governments and health organizations to tackle opposite ends of the malnutrition spectrum. The dual burden may manifest within a community, household, or individual, but these different levels have not been addressed collectively. Objective To critically review literature on the prevalence, trends, and predictors of the dual burden, with a focus on children from birth to 18 years of age. Methods We reviewed literature since January 1, 1990, published in English, using the PubMed search terms nutrition transition, double burden, dual burden, nutrition status, obesity, overweight, underweight, stunting, body composition, and micronutrient deficiencies. The findings were classified and described according to dual burden level (community, household, or individual). Results Global trends indicate decreases in diseases of undernutrition, while overnutrition is increasing. On the community level, economic status may influence the extent of the dual burden, with obesity increasingly affecting the already undernourished poor. In a household, shared determinants of poor nutritional status among members can result in disparate nutritional status across generations. Within an individual, obesity may co-occur with stunting or anemia due to shared underlying determinants or physiologic links. Conclusions The dual burden of malnutrition poses a threat to children's health in low- and middle-income countries. We must remain committed to reducing undernutrition while simultaneously preventing over-nutrition through integrated child health programs that incorporate prevention of infection, diet quality, and physical activity.
Comparison of the Effects of Conditional Food and Cash Transfers of the Ethiopian Productive Safety Net Program on Household Food Security and Dietary Diversity in the Face of Rising Food Prices: Ways Forward for a more Nutrition-Sensitive Program
Authors: Baye Kaleab , Retta Negussie , Abuye Cherinet 
Published: November 2015

Background In light of the continuing rise in food prices during and after the 2008 world food crisis, whether food and cash transfers are equally effective in improving food security and diet quality is debatable. Objective To compare the effects of conditional food and cash transfers of the Ethiopian Productive Safety Net Program (PSNP) on household food security and dietary diversity. Methods Data on household dietary diversity, child anthropometry, food security, and preference of transfer modalities (food, cash, or mixed) were generated from a cross-sectional survey of 195 PSNP beneficiary households (67 receiving food and 128 receiving cash) in Hawella Tulla District, Sidama, southern Ethiopia. Results Most beneficiaries (96%) reported food shortages, and 47% reported food shortages that exceeded 3 months. Households receiving cash had better household dietary diversity scores ( p = .02) and higher consumption of oils and fats ( p = .003) and vitamin A–rich foods ( p = .002). Compared with households receiving food, households receiving cash were more affected by increases in food prices that forced them to reduce their number of daily meals ( p < .001) and spend less on nonstaples ( p < .001). While most households receiving food (82%) preferred to continue receiving food, households receiving cash (56%) preferred a mix of food and cash. Conclusions Households receiving cash had better household dietary diversity than households receiving food, a result suggesting that cash transfers may be more effective. However, the continuing rise in food prices may offset these benefits unless cash transfers are index-linked to food price fluctuations.
Community Development and Livestock Promotion in Rural Nepal: Effects on Child Growth and Health
Authors: Miller Laurie C. , Joshi Neena , Lohani Mahendra , Rogers Beatrice , Loraditch Meghan , Houser Robert , Singh Padma , Mahato Shubh 
Published: November 2015

Background More than 50% of children in Nepal are malnourished. Economic growth and poverty reduction are not always sufficient to improve the health and nutritional status of children. Heifer Nepal uses livestock training as a tool for community development and poverty alleviation but does not directly address child health and nutrition. Objective To systematically assess the effects of Heifer activities on child health and nutrition. Methods The study was a 2-year, longitudinal, randomized, controlled trial in six communities in Nepal (both Terai and hills), pair-matched for specific characteristics, randomly assigned to receive Heifer community development activities at baseline (intervention) or 1 year (control). At 6-month intervals over a period of 2 years, child anthropometric and comprehensive household surveys were performed. Results Four hundred fifteen households were enrolled containing 607 children 6 months to 5 years of age. The intervention and control communities were equivalent for baseline socioeconomic status, household size, ownership of land and animals, and child nutrition and health. At 12 months (prior to animal donations), the Terai intervention group had improved child weight ( p = .04), improved child height ( p = .05), and reduced sick days ( p = .03), as well as increased household income ( p = .004), increased ownership of animals ( p = .04) and land ( p = .04), and improved sanitation practices ( p < .01). In all districts, longer participation in Heifer activities corresponded to more improvement in child height-for-age z-scores. Conclusions Heifer interventions resulted in improved socioeconomic status and household income per family member. Children under 60 months of age in the intervention group had greater incremental improvement in height-for-age and weight-for-age z-scores than children in the control group, and longer participation in Heifer activities was associated with better growth. Poverty alleviation programs, such as Heifer, may indirectly benefit child growth.
Nutritional and Sensory Evaluation of a Complementary Food Formulated from Rice, Faba Beans, Sweet Potato Flour, and Peanut Oil
Authors: Mahmoud Amal H. , Anany Ayman Mohammed El 
Published: November 2015

Background Childhood malnutrition is a common disorder in developing countries. Objective To formulate a complementary food from rice, germinated-decoated faba bean, orange-fleshed sweet potato flour, and peanut oil (RFPP formula) for infants aged 6 to 24 months. Methods The nutritional and sensory characteristics of the RFPP complementary food in comparison with those of a commercial complementary food were determined using standard official procedures. Results The levels of protein (17.89 g/100 g), fat (10.35 g/100 g), carbohydrate (67.82 g/100 g), and energy (435.99 kcal/100 g) of the RFPP complementary food met the specifications of the Codex standard (1991) and the Egyptian Standard No. 3284 (2005). The essential amino acid contents of the RFPP complementary food were higher than the amino acid profile of the Food and Agriculture Organization/World Health Organization/United Nations University (2002) reference protein for children 0.5 to 1 and 1 to 2 years of age. The RFPP complementary food had high levels (54.00%) of monounsaturated fatty acids. However, the highest level of saturated fatty acids (51.10%) was recorded for the commercial complementary food. The sensory evaluation results, using a nine-point hedonic scale ranging from 1 (dislike extremely) to 9 (like extremely), show that the RFPP complementary food was acceptable in appearance (7.20), color (6.35), aroma (6.75), taste (7.25), and mouthfeel (7.10) and had an overall acceptability of 6.40. Conclusions The RFPP formulated complementary food was acceptable and adequate in nutrients for weaning purposes.
Health in Action Program, Brazil: A Program Impact Pathways (PIP) Analysis
Authors: Slater Emily , Lasco Mary-Lynne , Capelli Joyce , Pen Gabriela 
Published: November 2015

Background The Health in Action Program was established in Brazil in 2010 to address the critical issues of health and nutrition among vulnerable children in the northeast and southeast regions of the country. By offering school-based nutrition education and increased access to nutritious foods from school gardens, the program has benefited more than 200,000 children aged 6 through 14 years in 430 schools and an additional 670,000 family and community members. The program is now expanding to reach an additional 260,000 students in 570 schools. Objective The purpose of this study was to perform a Program Impact Pathways (PIP) analysis to identify Critical Quality Control Points (CCPs) and a suite of impact indicators in order to better understand and illustrate the impact of the program. Methods The analyses of the PIP and the suite of impact indicators were conducted in collaboration with INMED Brasil's program management and evaluation team and the international evaluation team of INMED Partnerships for Children. INMED presented the results at a seven-country Healthy Lifestyles Program Evaluation Workshop held in Granada, Spain, 13–14 September 2013, hosted by the Mondelēz International Foundation, where it received feedback from evaluation experts. Results The PIP analysis enabled INMED to clarify the goals of the program, understand the ways in which program activities lead to stated goals, identify CCPs to monitor, and select achievable impact indicators, including changes in diet, physical activity, and knowledge, attitudes, and behaviors, as well as body mass index. Conclusions While the program had previously demonstrated benefits through internal impact evaluation, the PIP Healthy Lifestyles Program Evaluation Workshop led to the identification of potential improvements in program processes and activities, as well as corresponding evaluation methodologies.
WinFood Data from Kenya and Cambodia: Constraints on Field Procedures
Authors: Owino Victor O. , Skau Jutta , Omollo Selina , Konyole Silvenus , Kinyuru John , Estambale Benson , Owuor Bethwel , Nanna Roos , Friis Henrik ,   The WinFood Project Team
Published: November 2015

Background Researchers face myriad challenges in the design and implementation of randomized, controlled trials. Apart from summaries on limitations, these challenges are rarely documented in detail to inform future research projects. Objective To describe methodological challenges encountered during randomized, controlled trials (WinFood Study) designed to assess the efficacy of locally produced complementary foods based on traditional animal-source foods (edible termites and spiders) to support growth and nutritional status in Kenyan and Cambodian infants. Methods In a randomized, controlled design, infants received WinFood or corn—soy blend (CSB) for 9 months from 6 to 15 months of age. Lean mass accrual and blood nutrition indicators (lipid profile, iron and zinc status) were measured cross-sectionally at 9 and 15 months of age, respectively. Lean mass was determined by measuring deuterium oxide enrichment in saliva samples following a standard dose of deuterium solution (0.5 g/kg body weight) to infants. Blood nutrition indicators were determined following the drawing of 3 mL of blood by venipuncture. Results Challenges included rapid depletion of food rations, high rate of loss to follow-up, delayed ethical approval, lack of local food-processing capacity, low capacity among staff to draw blood, and lack of laboratory capacity to perform both deuterium oxide and micronutrient status measurements. Spillage of deuterium oxide solution during dosing was a major challenge in the Kenya context. A high rate of morbidity among infants made some assessments very difficult, especially drawing of blood and saliva samples. Conclusions The challenges were largely contextual. Improvement of local laboratory capacity, training of staff, and sensitization of the communities and the Ethics Review Committee are highly recommended.
Multiple Fortification of Beverages
Authors: Barclay Denis 
Published: November 2015

Diet-related micronutrient deficiencies rarely occur in isolation; deficiencies of iodine and vitamin A or of iron and vitamin A or zinc are often observed in the same populations. In addition, widespread deficiencies of some micronutrients, for example, zinc and calcium, may often go undiagnosed because of the absence of specific and sensitive status indicators. Multiple micronutrient supplementation can be more effective in improving nutritional status than supplementation with single key micronutrients; therefore, the multiple fortification of appropriate food vectors, including beverages, is of interest from the nutritional standpoint. Beverages fortified with multiple micronutrients include dairy products, chocolate beverages, fruit juices, and soya-based drinks. As well as the documented or estimated micronutrient deficiencies and the requirements of the target population or consumer group, the conception of such a multiply fortified beverage must take into account a number of other important factors. The choice of the chemical form of the fortification micronutrients should be made with consideration of bioavailability, the effects on the organoleptic characteristics of the particular beverage, and cost. The initial calculation of the composition of the micronutrient premix should include the levels of micronutrients in the raw materials used and the estimated losses of specific micronutrients during processing and storage. Preliminary production and storage trials are then needed to determine the actual losses. The composition of the micronutrient premix may then be finalized. Interactions, both positive and negative, between fortification micronutrients may also need to be considered. For example, the bioavailability of iron may be enhanced by the addition of vitamin C, whereas mineral–vitamin and vitamin–vitamin interactions can accelerate the destruction of some vitamins. To render quality control procedures simple and cost-effective, only a limited number of fortification micronutrients, which are especially sensitive to losses and which are easy to measure, may be analysed. Simple, inexpensive, and rigorous analytical methods for such measurements are now available.
Anaemia in Central Asia: Demographic and Health Survey Experience
Authors: Sharmanov Almaz 
Published: November 2015

Nationally representative anaemia levels among women and children were recently determined in conjunction with the Demographic and Health Surveys in Kazakstan (1995), Uzbekistan (1996), and the Kyrgyz Republic (1997). Anaemia was assessed by measuring the haemoglobin level in capillary blood of women aged 15 to 49 and their children under the age of 3 using the photometric Hemocue technique. The numbers of women tested were 3,658, 4,333, and 3,760 in Kazakstan, Uzbekistan, and the Kyrgyz Republic, respectively. All three Central Asian republics had a high prevalence of anaemia. The highest overall rates were in the regions of Kazakstan and Uzbekistan near the Aral Sea, which are characterized by severe agrochemical pollution and other environmental and socio-economic problems. Approximately half (49%) of the women in Kazakstan, 60% of the women in Uzbekistan, and 40% of the women in the Kyrgyz Republic suffered from some degree of anaemia. Mild anaemia (haemoglobin level, 10.0–11.9 g/dl; 10.0–10.9 g/dl for pregnant women) was diagnosed in 37%, 45%, and 28% of the women in Kazakstan, Uzbekistan, and the Kyrgyz Republic, respectively. Eleven percent of the women in Kazakstan, 14% in Uzbekistan, and 9% in the Kyrgyz Republic had moderate anaemia (haemoglobin level 7.0–9.9 g/dl). Severe anaemia (haemoglobin level less than 7.0 g/dl) was found among 1% of the women in all three Central Asian republics. In Kazakstan, 69% of the children under the age of three suffered from some degree of anaemia. About the same number of children had mild (30%) and moderate (34%) anaemia. A smaller, but substantial, proportion of children (5%) were severely anaemic. In Uzbekistan and the Kyrgyz Republic, 61% and 50% of children, respectively, suffered from anaemia. The percentages of children with mild, moderate, and severe anaemia were 34%, 26%, and 1%, respectively, for Uzbekistan, and 24%, 24%, and 1%, respectively, for the Kyrgyz Republic. There is sufficient evidence to suggest that negative iron balance is probably a major cause of anaemia among both women and children in Central Asia. Our findings provide important information for the development of health intervention programmes to prevent iron-deficiency anaemia among women of certain ethnic, educational, and residential groups in this region. Based on the results of the Demographic and Health Survey as well as other geographically focused studies, the UNICEF Area Office for the Central Asian Republics and Kazakstan proposed an integrated strategy of education, supplementation, fortification, and research to address the problem and called for donors' support. It is expected that this approach can considerably improve maternal and child health in Central Asia.
Hydrothermal alteration of chevkinite-group minerals. Part 2. Metasomatite from the Keivy massif, Kola Peninsula, Russia
Authors: Macdonald R. , Bagiński B. , Kartashov P. M. , Zozulya D. , Dzierżnowski P. 
Published: November 2015

AbstractChevkinite-(Ce) in a mineralized quartz-epidote metasomatite from the Keivy massif, Kola Peninsula, Russia, underwent at least two stages of low-temperature alteration. In the first, it interacted with hydrothermal fluids, with loss of Ca, Fe, LREE and Si and strong enrichment in Ti. The altered chevkinite was then rimmed and partially replaced by a zone of ferriallanite-(Ce) and davidite-(La), in turn rimmed by a zone of allanite-(Ce) richer in the epidote component. The allanite zone was in turn partially replaced by rutile-titanite-quartz assemblages, the formation of titanite postdating that of rutile. Aeschynite-(Y), aeschynite-(Ce) and REE-carbonates are accessory phases in all zones. The hydrothermal fluids were alkaline, with significant proportions of CO2 and F. At various alteration stages, the Ca, Si ± Al activities in the fluid were high. Formation of the aeschynite is discussed in relation to its stability in broadly similar parageneses; it was a primary phase in the unaltered chevkinite zone whereas in other zones it formed from Nb, Ti, REE and Th released from the major phases.