bluuebunny/crossref_metadata_2025_split huggingface dataset:
Costs of the Multimicronutrient Supplementation Program in Chiclayo, Peru
Authors: Lechtig Aarón , Gross Rainer , Paulini Javier , de Romaña Daniel López 
Published: November 2015

Background There is little information on the cost parameters of weekly multimicronutrient supplementation programs. Objective To assess the cost parameters and cost-effectiveness of a weekly multimicronutrient supplementation program in an urban population of Peru. Methods Data from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]), which distributed capsules and foodlets to women and adolescent girls and to children under five, were extrapolated to a population of 100,000 inhabitants. Results The annual cost per community member was US$1.51. The cost-effectiveness ratio was US$0.12 per 1% of prevented anemia per community member. Conclusions These costs are in the upper margin of iron supplementation alone. They will decrease notably when weekly multimicronutrient supplementation programs are integrated into health packages and participation by women increases. Focusing on micronutrient deficiencies would prevent these problems, and fooddistribution programs would be effectively targeted to food-deficient populations.
Sensitivity and Specificity of a Short Questionnaire for Food Insecurity Surveillance in Iran
Authors: Dastgiri Saeed , Tutunchi Helda , Ostadrahimi Alireza , Mahboob Soltanali 
Published: November 2015

Background Food insecurity is frequent in both developed and developing countries, affecting from 5% to 25% of the general population. It has considerable health impacts on the physical, social, and psychological status of individuals in communities suffering from food insecurity. Objective The aim of this study was to document the epidemiologic features of food insecurity in the northwest region of Iran and to evaluate the sensitivity and specificity of a short-form (six items) questionnaire for screening of food insecurity in the region. Methods This cross-sectional study was conducted on 300 subjects (132 male and 168 female) selected randomly in the Asadabadi area of the northwest of Iran. Information on food consumption was obtained by a 24-hour food-recall questionnaire for 3 days in a week. This information was compared with the data from the Household Food Security Scale (six-item short questionnaire) to assess the applicability of this short scale for the surveillance of food insecurity. Hunger was defined as inadequate intake of energy. Hidden hunger was defined as adequate intake of energy and inadequate intake of one (or more) of four key nutrients (protein, calcium, vitamin A, and vitamin B2). Results The prevalence of hunger and hidden hunger in the area according to the 24-hour food-recall questionnaire was 26% and 42%, respectively. Only 32% of the study population was secure in terms of having access to all key nutrients. The sensitivity, specificity, and accuracy of the short questionnaire for screening for hunger in the population were 98.7%, 85.5%, and 89%, respectively; and the corresponding values for hidden hunger were 23.5%, 96.9%, and 56.3%. Conclusions Our findings indicate that food insecurity is prevalent in the northwest of Iran. The short questionnaire (six items) may be used as a simple, low-cost, rapid, and useful tool for the screening of food insecurity and energy intake in similar areas.
Food-Poverty Status and Food Insecurity in Rural West Lombok Based on Mothers' Food Expenditure Equivalency
Authors: Rosalina Tina , Wibowo Lindawati , Kielmann Arnfried A. , Usfar Avita Aliza 
Published: November 2015

Background When the Central Bureau for Statistics (CBS) developed a national food-poverty line for Indo- nesia, some aspects, such as food availability, food beliefs, and food habits, were not considered. In addition, the reference population was determined on the basis of their nonfood expenditures. Objective To develop and use a method applicable in any given sociocultural setting, as well as to determine food-poverty status in rural West Lombok, Indonesia, using mothers' food expenditure equivalency (FEE). Method Mothers' actual food intake determined by a modified 24-hour recall served to establish FEE. The results were verified with household food-security meas- ures based on the US Household Food Security/Hunger Measurement (US HFSSM), and the mothers' nutritional status was assessed by the body-mass index (BMI). Results Most mothers (72%) were food-poor and 79% were also food-insecure. Food poverty has a positive correlation with household food insecurity. The severely food poor also had the highest risk of household food insecurity. The nutritional status of mothers showed no correlation with food-poverty status and therefore was not found to be an appropriate indicator of food poverty in this cultural setting. Conclusions Because most food consumed by moth- ers was purchased, financial security plays a key role in determining family food sufficiency, in terms of both quantity and variety. Mothers' BMI status differed between the food-poor and non–food-poor groups, but the difference was not statistically significant, suggesting that in our setting the food-poverty line cannot be used to identify physiological need but is rather more of a social and economic indicator. We suggest the use of US HFSSM questionnaires as a simple alternative means to assess both food-poverty and food-security status, mainly because the method is simple to apply and corroborates our findings using area-specific FEEs. Finally, our study results suggest a number of follow-up investigations.
Variation in the Diets of Filipino Women over 9 Months of Continuous Observation
Authors: Beard John L. , Murray-Kolb Laura E. , Lawrence Frank , Felix Angelina , del Mundo Angelita , Haas Jere D. 
Published: November 2015

Background The variability in habitual intakes of most components in the Philippine diet is unknown. Objective To perform a quantitative evaluation of the traditional Philippine diet using data collected over an extended period of time. We sought to identify seasonal variations and within-subject components of variation in nutrient intake. Methods A quantitative evaluation of the Philippine diet was conducted in convents in metropolitan Manila as part of an efficacy trial to examine biofortified rice as an approach to improve iron nutritional status. Weighed food intakes were conducted on 54 days in each of more than 300 religious sisters over 9 months in 10 convents. The sisters consumed their habitual diets except for the substitution of one variety of rice for another. Results More than 40% of calories were derived from rice, with protein from meat and fish comprising 18% of calories. There were significant variations in macronutri- ent and micronutrient intakes across seasons of the year, with more rice consumed in the wet season and more fruits, eggs, milk, and beverages consumed in the dry season. The day-to-day within-subject variation (CV) in median intake was 23% for energy, 31% for protein, 42% for iron, and 138% for vitamin A. Conclusions These novel data show that traditional Filipino dietary patterns have substantial individual variation and are inadequate in certain micronutrients. This quantitative evaluation of diet can provide a reference point for dietary adequacy.
Constraints on the Delivery of Animal-Source Foods to Infants and Young Children: Case Studies from Five Countries
Authors: Pachón Helena , Simondon Kirsten B. , Fall Safiètou T. , Menon Purnima , Ruel Marie T. , Hotz Christine , Creed-Kanashiro Hilary , Arce Blanca , Domínguez María Reyna Liria , Frongillo Edward A. , Brown Dan L. 
Published: November 2015

Background Optimal feeding of infants and young children in developing countries includes daily feeding of animal-source foods. Objective To evaluate constraints on the availability of animal-source foods at the community level, access to animal-source foods at the household level, and intake of animal-source foods at the individual level among children under 3 years of age in case studies in five developing countries: Mexico, Peru, Haiti, Senegal, and Ethiopia. Methods Data were obtained from published and unpublished research and from program experiences of health and agriculture specialists. Results In Ethiopia, 27% to 51% of case-study chil- dren had consumed an animal-source food on the previous day; from 56% to 87% of children in the other case-study sites had consumed an animal-source food on the previous day. Data on intake of animal-source foods in grams were only available for the Latin American case-study sites, where daily milk intake was high in Mexico and Peru (195 and 180 g/day, respectively) and the intakes of meat, fish, and poultry (MFP) (29.0 and 13.6 g/day) and of egg (18.4 and 4.9 g/day) were low. The conceptual model guiding this work identified more constraining factors at the community and household levels than at the individual level. The most common constraints on feeding animal-source foods to young children were poverty, animal health, and land degradation at the community level; cost of animal-source foods and limited livestock holdings at the household level; and caregivers' perceptions of giving animal-source foods to children at the individual level. Conclusions For program planning, it is useful to simultaneously consider factors that affect community availability of, household access to, and children's intake of animal-source foods. Efforts to overcome individual- level constraints on intake of animal-source foods should be coupled with activities to address community and household constraints.
Suitability of Instant Noodles for Iron Fortification to Combat Iron-Deficiency Anemia among Primary Schoolchildren in Rural Vietnam
Authors: Le Huong Thi , Brouwer Inge D. , de Wolf Corine A. , van der Heijden Lidwien , Nguyen Khan Cong , Kok Frans J. 
Published: November 2015

Background Anemia is a significant public health problem among schoolchildren in Vietnam. Food fortification is considered one of the most sustainable long-term strategies to control iron-deficiency anemia in Vietnam. The success of a food-fortification program depends on the choice of the food vehicle. Objectives The aim of the present study was to identify an appropriate vehicle for iron fortification to be used in a school-feeding program aimed at improving the iron and anemia status of schoolchildren in rural Vietnam. Methods Children 6 to 8 years of age in two primary schools in Tam Nong District, Phu Tho Province, and their parents were included in this study. The study consisted of three substudies: a food-consumption study with 24-hour recalls of two nonconsecutive days; a food-beliefs study, with focus group discussions, a pile-sorting test, and a food attributes and differences exercise; and a food-acceptance study using noodles and biscuits fortified with sodium iron ethylenediaminetetraacetic acid (NaFeEDTA). Results The average number of meals consumed daily was 3.2 ± 0.4, and the average intakes of energy and iron were 1,218 ± 406 kcal and 7.5 ± 4.0 mg, respectively. Compared with biscuits and instant rice soup, instant noodles were consumed more frequently and in larger portion sizes and are more acceptable as children's food in the culture of the local people. The iron level of the fortified product did not affect the mean consumption of noodles, but a higher level of iron was associated with a lower mean consumption of biscuits ( p < .05). The production process did not affect the NaFeEDTA level in noodles; however, during preparation at least 70% of the iron is leaked into the soup. Conclusions Instant noodles are a suitable vehicle for iron fortification for use in school-based intervention to improve iron-deficiency anemia among primary schoolchildren in rural Vietnam.
Beyond Recommendations: Implementing Food-Based Dietary Guidelines for Healthier Populations
Authors: Smitasiri Suttilak , Uauy Ricardo 
Published: November 2015

To reduce the increased burden of diet-related disease and promote human potential through food and nutrition globally, harmonization of efforts is urgently needed. This article examines the concept of food-based dietary guidelines (FBDGs) and discusses the possibilities and challenges of harmonizing the process of developing and implementing dietary guidelines. The authors argue that while the development of FBDGs has contributed to the understanding of the role of nutrients and foods in achieving optimal health, the impact of these guidelines on human health has been limited. Science or evidence must be used in FBDG development; nevertheless, there are limitations in current nutrition science. FBDGs should address the health consequences of dietary insufficiency, excess, or imbalance with a broader perspective, considering the totality of the effects of a given dietary pattern, rather than focusing on single nutrients alone. Moreover, the food selection guideline should be seen as complementary to a strategic, comprehensive, and culturally appropriate dietary and health promoting intervention, and not only as a tool for providing nutrition policy and information. Technically, a single unified global set of FBDGs may be desirable and even achievable. This concept, however, presents novel challenges on how to address cultural diversity and the complex social, economic, and political interactions between humans and the food supply, not to mention the complexity of its communication and implementation. Therefore, global harmonized efforts in support of strategic dietary interventions, together with strong global scientific support and facilitation for the development and communication of FBDGs at national or regional levels, are proposed to implement FBDGs for healthier populations.
Research Approaches for Improved Pro-Poor Control of Zoonoses
Authors: Schelling Esther , Grace Delia , Willingham A. Lee , Randolph Tom 
Published: November 2015

Background Developing countries face difficulties in sustainably utilizing tools to effectively implement control measures for zoonoses. This is mainly due to dispersed and heterogeneous smallholder livestock systems, predominance of informal markets, poor infrastructure and lack of resources to deliver information, interventions, and regulations. In addition, developing countries lack an evidence base for planning and targeting control efforts. Zoonotic infections are receiving more and more international attention as diseases of neglected and impoverished communities, at the intersection between livestock production, human health, and poverty. Objective To review research innovations and trends that can help identify and test targeted control strategies for zoonoses tailored to poor communities, focusing particularly on Africa. Methods Review of recommendations of relevant working groups and scientific literature. Results New and innovative research approaches promise to better capture the impact of zoonoses from a societal perspective and the perspective of poor livestock owners through more comprehensive frameworks that consider benefits of the control of zoonoses to the public health, livestock, and private sectors. It is challenging to better assure food safety in informal markets. Risk-based approaches with participatory elements provide a framework in which stakeholders can decide an appropriate level of protection to balance the needs for safe food, cheap food, and pro-poor economic growth. Appropriate information for all stakeholders and capacity-building of national and regional authorities is an important element of this process. New diagnostic tools that are accurate and easily used in developing-country health centers and markets can assist in reporting of cases, detection of patients, and testing of control strategies. Conclusions A research agenda on zoonoses of the livestock sector should be interdisciplinary and participatory and include intersectoral collaborations, notably between the livestock and public health sectors.
Health and Child Labor in Agriculture
Authors: Hurst Peter 
Published: November 2015

Background Seventy percent of child laborers—more than 150 million girls and boys under 18—are agricultural workers. They are harshly exploited, toiling in poor to appalling conditions, performing dangerous jobs with little or no pay, and are deprived of an education. Because children's bodies and minds are still growing and developing, exposure to workplace hazards and risks can be more devastating and long-lasting for them. The line between what is acceptable work and what is not is easily crossed. However, not all work that children undertake in agriculture is bad for them. Age-appropriate, lower-risk tasks that do not interfere with schooling and leisure time are not at issue here. Objectives The goal of this paper is to examine the links between health and child labor in agriculture. It aims to explain why the International Labour Organization's goal of eliminating all of the worst forms of child labor by 2016 will only be possible if more work is done in agriculture. Methods Review of the relevant literature and data on the hazards of child labor and the reasons why agricultural child labor is particularly difficult to tackle. Results Children who work in agriculture are exposed to a large number of health hazards, and yet the problem is particularly difficult to tackle because of the large numbers involved, the young age at which children start to work, the hazardous nature of the work, lack of regulation, invisibility of child laborers, denial of education, the effects of poverty, and ingrained attitudes and perceptions about the roles of children in rural areas. Conclusions Policies for preventing and reducing agricultural child labor should mainstream and integrate child labor issues at the national and international levels with increasing emphasis on poverty alleviation and expanding and improving institutional mechanisms for education, law enforcement, health, and so forth. Cooperation between the International Labour Organization and international agricultural organizations is needed to ensure that child labor in agriculture is a thing of the past.
Pesticide Practices and Suicide among Farmers of the Sundarban Region in India
Authors: Chowdhury Arabinda N. , Banerjee Sohini , Brahma Arabinda , Weiss M. G. 
Published: November 2015

Background Deliberate self-poisoning by ingesting pesticides is a serious health problem among farmers, especially in low- and middle-income countries. Preventing these suicides is a priority for a public mental health agenda. Objective To examine the role of pesticide poisoning in suicide and nonfatal deliberate self-harm, and clarify awareness of risks, safe practices concerning storage and use of pesticides, and associated self-injury, both unintentional and intentional, within farmer households of the Sundarban region, India. Methods Retrospective record review of adult cases of deliberate self-poisoning at the Block Primary Health Centres of 13 Sundarban Blocks was performed to analyze the relative roles of various methods of self-harm and their lethality. Focus group discussions, questionnaires, and in-depth interviews were undertaken in a community study of farmer households to examine pesticide-related views and practices, with particular attention to storage, use, and health impact. Results Pesticide poisoning was the most common method of deliberate self-harm in both men and women. Pesticide storage in most households was unsafe and knowledge was inadequate concerning adverse effects of pesticides on health, crops, and the environment. Conclusions An intersectoral approach linking the interests of public health, mental health, and agriculture is well suited to serve the collective interests of all three agendas better than each in isolation. Such an approach is needed to reduce morbidity and mortality from unintentional and intentional self-injury in low-income agricultural communities like those of the Sundarban region.
Nutritional Status and its Correlates in Equatorial Guinean Preschool Children: Results from a Nationally Representative Survey
Authors: Custodio Estefanía , Descalzo Miguel Ángel , Roche Jesús , Sánchez Ignacio , Molina Laura , Lwanga Magdalena , Bernis Cristina , Villamor Eduardo , Baylin Ana 
Published: November 2015

Background In Equatorial Guinea, as a result of the recent growth of the oil industry, there is an opportunity to address important public health problems through public and private initiatives. To propose effective nutrition and public health strategies, it is important first to have reliable information on the nutritional status of the population and the underlying factors affecting it. Objective To assess the nutritional status and the prevalence of anemia among Equatoguinean children in a nationally representative sample and to identify the risk factors associated with the nutritional problems detected. Methods The study was a cross-sectional survey using a multistaged, stratified, cluster-selected sample. The survey included a sociodemographic, health, and dietary questionnaire and measurement of hematocrit and anthropometric features, from which nutritional indicators based on the National Center for Health Statistics (NCHS) reference and the World Health Organization (WHO) standards were calculated. Logistic regression models were used for the multivariate analysis. A total of 552 children aged 0 to 60 months were surveyed. Results The overall prevalence of stunting (< −2 height-for-age z-scores [HAZ]) was 29.7% based on the NCHS reference and 35.2% based on WHO standards; the risk factors associated with stunting were age ( p < .0001), low socioeconomic status ( p = .01), and fishing by a member of the household ( p = .003) The prevalence of mild anemia (hemoglobin < 110 g/L) was 69.3%, and that of moderate or severe anemia (hemoglobin < 80 g/L) was 8.3%. The only significant risk factor associated with moderate to severe anemia was low household socioeducational level ( p = .01). Conclusions Stunting and anemia are public health problems in Equatorial Guinea. Integrated strategies, including fighting poverty and improving maternal education, should be undertaken.
The Potential Contribution of Bread Buns Fortified with β-Carotene–Rich Sweet Potato in Central Mozambique
Authors: Low Jan W. , van Jaarsveld Paul J. 
Published: November 2015

Background Orange-fleshed sweet potato is an efficacious source of vitamin A. Substituting wheat flour with orange-fleshed sweet potato in processed products could reduce foreign exchange outlays, create new markets for producers, and result in increased vitamin A consumption among consumers provided there is adequate retention of β-carotene during processing. Objective To explore whether substituting 38% of wheat flour (by weight) in bread buns (“golden bread”) with boiled and mashed orange-fleshed sweet potato from fresh roots or rehydrated chips would produce economically viable β-carotene–rich products acceptable to Mozambican rural consumers. Methods Modified local recipes maximized sweet potato content within the limits of consumer acceptability. Sensitivity analysis determined parameters underlying economic viability. Two samples each of buns from five varieties of orange-fleshed sweet potato were analyzed for β-carotene content. Processed products with at least 15 μg/g product of trans-β-carotene were considered good sources of vitamin A. Results Golden bread made from fresh roots of medium-intensity orange-fleshed sweet potato varieties met the good source criterion, but bread from lighter-intensity sweet potato varieties did not. Bread from rehydrated dried chips was not economically viable. Consumers strongly preferred golden bread over pure wheat flour bread because of its heavier texture and attractive appearance. The ratio of the price of wheat flour to that of raw sweet potato root varied from 3.1 to 3.5 among the bakers, whose increase in profit margins ranged from 54% to 92%. Conclusions Golden bread is a good source of β-carotene and is economically viable when the price ratio of wheat flour to raw orange-fleshed sweet potato root is at least 1.5. Widespread adoption during sweet potato harvesting periods is feasible; year-round availability requires storage.