bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Orphanhood on Underweight Prevalence in Sub-Saharan Africa
Authors: Rivers Jonathan , Mason John , Silvestre Eva , Gillespie Stuart , Mahy Mary , Monasch Roeland 
Published: November 2015

Background In Africa, approximately 25 million people live with HIV/AIDS and 12 million children are orphaned. Although evidence indicates that orphans risk losing opportunities for adequate education, health care, and future employment, the immediate effects of orphanhood on child nutritional status remain poorly understood. Objective This paper assesses the nutritional impact of orphanhood, with particular emphasis on taking account of various factors potentially confounding or masking these impacts. Methods Child anthropometry and orphan status were examined in 23 Multiple Indicator Cluster Surveys and Demographic and Health Surveys throughout sub-Saharan Africa, which were subsequently merged into larger, region-specific datasets (East, West, and Southern Africa). To compare orphans and nonorphans, linear regression and probit models were developed, taking account of orphan status and type, presence of a surviving parent in the household, household structure, child age and sex, urban versus rural residence, and current wealth status. Results Few differences emerged between orphans and nonorphans in controlled and uncontrolled comparisons, regardless of orphan type, presence of surviving parent, or household structure. Age differentials did confound nutritional comparisons, although in the counterintuitive direction, with orphans (who were 8 months older on average) becoming less malnourished when age differences were taken into account. Wealth did appear to be associated with orphanhood status, although it did not significantly confound nutritional comparisons. Conclusions Orphans were not consistently more malnourished than nonorphans, even when potential confounding variables were examined. Since household wealth status is likely to change after becoming affected by HIV, ruling out wealth as a potential confounder would require more detailed, prospective studies.
Impact of Pilot Project of Rural Maintenance Programme (RMP) on Destitute Women: CARE, Bangladesh
Authors: Roy Swapan Kumar , Bilkes Farzana , Islam Khaleda , Ara Gulshan , Tanner Phillip , Wosk Irena , Rahman Ahmed Shafiqur , Chakraborty Barnali , Jolly Saira Parveen , Khatun Wahjiah 
Published: November 2015

Background The rate of malnutrition among women in Bangladesh is high, but historically there has not been a specific program focusing on the improvement of the nutritional status of Bangladeshi women. Objective To observe changes in the nutritional status of destitute women of the Rural Maintenance Programme (RMP) by incorporating a health and nutrition intervention package with RMP ongoing activities. Methods An intervention study involving 1,275 poor destitute women was conducted from July 2004 to June 2005 in 17 districts in Bangladesh under two field offices, Mymensingh and Jessore, covering 8 and 9 districts, respectively. The respondents were divided into intervention, comparison, and control groups. All participants in the intervention and comparison groups were paid as part of the RMP and received weekly 30-minute nutrition interventions for 7 weeks in addition to routine training. The comparison group also received RMP training. The control group consisted of women with similar demographic characteristics to the intervention and comparison groups who did not receive pay or any intervention. The intervention was a unique combination of the three components of the UNICEF triangle model (food security, caring practices, and disease contol). Data on socioeconomic and anthropometric characteristics, immunization, and vitamin A capsule intake were also collected with the use of a structured questionnaire. Results After the intervention, the mean body weight had significantly increased by 1,333 g in the intervention group and had decreased by 277 g in the control group and 147 g in the comparison group. The body mass index of women in the intervention group had also significantly increased at the end of the study ( p < .001). There was a significant increase in the intake of iodized salt in the intervention group as well as increased immunization coverage in all groups. Intake of the first vitamin A capsule by children increased (from 60% to 97%) in the intervention group only. Conclusions The nutrition pilot intervention was highly effective in improving the nutritional status of women in the RMP.
Insulin Resistance and Impaired Glucose Tolerance in Overweight and Obese Costa Rican Schoolchildren
Authors: Holst-Schumacher Ileana , Nuñez-Rivas Hilda , Monge-Rojas Rafael , Barrantes-Santamaría Mauro 
Published: November 2015

Background Worldwide obesity has become an unprecedented public health challenge. In addition, a notable increase in the risk of insulin resistance and type 2 diabetes mellitus has emerged. In Costa Rica, there are no epidemiological data to establish the prevalence of type 2 diabetes in the pediatric population. However, information from the Endocrinology Department of the Children's National Hospital indicates an increased number of cases in the last 2 to 3 years. Objective To determine the prevalence of insulin resistance and impaired glucose tolerance in overweight and obese schoolchildren. Methods This cross-sectional study was conducted among 214 healthy 8- to 10-year-old children from urban schools of San José, Costa Rica. Anthropometric measurements and blood determinations of glucose, insulin, proinsulin, glycosylated hemoglobin, C-peptide, and leptin were performed. Indexes were calculated to assess insulin resistance. Information on social and lifestyle variables was obtained from questionnaires, and acanthosis nigricans was certified by a physician. Statistical analysis was performed with SPSS software for Windows, version 10.0. Results The prevalence of type 2 diabetes mellitus was very low (0.5%) in the studied population. However, hyperinsulinemia and impaired glucose tolerance were present in 20.6% and 6.5% of the subjects, respectively. On the basis of the Fasting Glucose-to-Insulin Resistance Ratio (FGIR), 46.7% of the children showed insulin resistance. Girls and obese children (body mass index ≥ 95th percentile) were more likely to have higher serum insulin levels and insulin resistance than boys and over-weight children (BMI ≥ 85th percentile). Compared with the lowest quintile, children in the highest quintile of body-fat tissue had higher insulin resistance but had similar serum concentrations of glucose, C-peptide, and proinsulin. Positive family histories of type 2 diabetes mellitus and sedentarism (73.7% and 40.7%, respectively) were highly prevalent among overweight and obese children. Conclusions The prevalence of impaired glucose tolerance and insulin resistance in obese children indicates a worrisome trend in the incidence of type 2 diabetes in Costa Rica. Strategies for weight reduction, obesity prevention, and promotion of healthy lifestyles are necessary to prevent the onset of type 2 diabetes during childhood and adolescence.
Vitamin B12 Status of Pregnant Indian Women and Cognitive Function in their 9-year-old Children
Authors: Bhate Vidya , Deshpande Swapna , Bhat Dattatray , Joshi Niranjan , Ladkat Rasika , Watve Sujala , Fall Caroline , de Jager Celeste A. , Refsum Helga , Yajnik Chittaranjan 
Published: November 2015

Background Recent research has highlighted the influence of maternal factors on the health of the offspring. Intrauterine experiences may program metabolic, cardiovascular, and psychiatric disorders. We have shown that maternal vitamin B12 status affects adiposity and insulin resistance in the child. Vitamin B12 is important for brain development and function. Objective We investigated the relationship between maternal plasma vitamin B12 status during pregnancy and the child's cognitive function at 9 years of age. Methods We studied children born in the Pune Maternal Nutrition Study. Two groups of children were selected on the basis of maternal plasma vitamin B12 concentration at 28 weeks of gestation: group 1 ( n = 49) included children of mothers with low plasma vitamin B12 (lowest decile, < 77 pM) and group 2 ( n = 59) children of mothers with high plasma vitamin B12 (highest decile, > 224 pM). Results Children from group 1 performed more slowly than those from group 2 on the Color Trail A test (sustained attention, 182 vs. 159 seconds; p < .05) and the Digit Span Backward test (short-term memory, p <.05), after appropriate adjustment for confounders. There were no differences between group 1 and group 2 on other tests of cognitive function (intelligence, visual agnosia). Conclusions Maternal vitamin B12 status in pregnancy influences cognitive function in offspring.
Establishing Safe and Potentially Efficacious Fortification Contents for Folic Acid and Vitamin B12
Authors: Dary Omar 
Published: November 2015

Determining the micronutrient contents in fortified foods depends not only on the health goal (additional intake to complement the diet), but also on ensuring that fortification does not raise micronutrient intakes beyond the Tolerable Upper Intake Level (UL), i.e., the safe limit. Technological incompatibility and cost may also restrict the fortification contents. For folic acid, the limiting factor is safety, while for vitamin B12, it is cost. However, adequate fortification contents that are both safe and efficacious can be estimated for both nutrients. In order to obtain the maximum benefit from the fortification programs, three different formulas responding to three categories of consumption, as specified by the median and 95th percentile of consumption, are proposed. The model presented is based on the estimation of a Feasible Fortification Level (FFL), which then is used to determine the average, minimum, and maximum contents of the nutrients during production, taking into consideration the acceptable variation of the fortification process. Finally, the regulatory parameters, which support standards and enforcement, are calculated by reducing the proportion of the nutrient that is degraded during the usual marketing process of the fortified food. It is expected that this model will establish a common standard for food fortification, and improve the reliability and enforcement procedures of these programs. The model was applied to flours as vehicles for folic acid in the United States, Guatemala, and Chile. Analysis of the data revealed that, with the exception of Chile, where wheat flour consumption is very high and probably within a narrow range, supplementation with folic acid is still needed to cover individuals at the low end of consumption. This is especially true when the difference in flour consumption is too wide, as in the case of Guatemala, where the proportional difference between consumption at the 95th percentile of the nonpoor group is as high as 100 times the consumption at the 5th percentile of the extremely poor group. Adoption of fortification content for staple foods near the safe limit brings together the need of restricting the voluntary addition of the specific nutrient to other foods and to dietary supplements.
Antioxidant System for the Preservation of Vitamin A in Ultra Rice
Authors: Li Yao Olive , Lam Jane , Diosady Levente L. , Jankowski Shirley 
Published: November 2015

Background Ultra Rice grains are micronutrient-fortified, extruded rice grains designed to address specific nutritional deficiencies in populations where rice is a staple food. Vitamin A and some of the B vitamins, as well as iron and zinc, are target nutrients for fortification through Ultra Rice technology. Vitamin A is sensitive to degradation. Therefore, the original Ultra Rice formulations included stabilizers, some of which were not approved as food additives in all of the receiving markets. Objective To develop a new antioxidant system for improving vitamin A storage stability in Ultra Rice grains, while complying with international food regulations. Methods Ten formulations were prepared containing various combinations of hydrophilic and hydrophobic antioxidants, as well as moisture stabilizers. Accelerated vitamin A storage stability tests were conducted at 25°, 35°, and 45°C with 70% to 100% relative humidity. Results The most stable samples contained one or more phenolic antioxidants, a water-soluble antioxidant, and stabilizing agents. The best results were obtained by using butylated hydroxyanisole (BHA) in combination with butylated hydroxytoluene (BHT) as the hydrophobic antioxidants and ascorbic acid as the hydrophilic anti-oxidant. Citric acid and sodium tripolyphosphate (STPP) were used to chelate metal ions and to stabilize moisture, respectively. The best formulations retained more than 85% and approximately 70% of the added vitamin A at 25° and 45°C, respectively, after 24 weeks storage. Conclusions The best antioxidant system, composed of generally accepted food additives, improved vitamin A stability while reducing the price, thus greatly improving the commercial viability of Ultra Rice grains for use as a rice fortificant.
Impact of a Positive Deviance Approach to Improve the Effectiveness of an Iron-Supplementation Program to Control Nutritional Anemia among Rural Senegalese Pregnant Women
Authors: Ndiaye Mamadou , Siekmans Kendra , Haddad Slim , Receveur Olivier 
Published: November 2015

Background Iron supplementation through prenatal care remains the most widespread strategy to control anemia during pregnancy, but its effectiveness is only partial, showing the need to address other approaches. Objective This study was conducted to measure the impact of a positive deviance approach to improve an iron-supplementation program among pregnant women in a rural Senegalese area. Methods A positive deviance approach (PD Micah) was compared with an ongoing integrated nutrition and health program intervention (Micah) in a rural Senegalese area. A pre-post evaluation was conducted using independent cross-sectional samples with a total of 371 pregnant women. A sociodemographic questionnaire was administered, and biologic and anthropometric measurements were performed. Results After 9 months of activities, the mean hemoglobin level rose from 93.9 to 100.7 g/L in the PD Micah group. Distribution of iron supplements through community volunteers and implementation of healthy pregnancy promotion sessions on a monthly basis improved the accessibility to 23.3% in the PD Micah group. No significant change was observed in the Micah group. Logistic regression analysis showed a significantly reduced risk of anemia in the PD Micah area (adjusted odds ratio, 0.25; 95% confidence interval, 0.12 to 0.53). Conclusions This intervention shows that a community-based strategy, such as the positive deviance approach, can contribute to improving the effectiveness of iron supplementation during pregnancy.
Use of the new World Health Organization Child Growth Standards to Describe Longitudinal Growth of Breastfed Rural Bangladeshi Infants and Young Children
Authors: Saha Kuntal K. , Frongillo Edward A. , Alam Dewan S. , Arifeen Shams E. , Persson Lars Å. , Rasmussen Kathleen M. 
Published: November 2015

Background Although the National Center for Health Statistics (NCHS) reference has been widely used, in 2006 the World Health Organization (WHO) released new standards for assessing growth of infants and children worldwide. Objective To assess and compare the growth of breastfed rural Bangladeshi infants and young children based on the new WHO child growth standards and the NCHS reference. Methods We followed 1,343 children in the Maternal and Infant Nutrition Intervention in Matlab (MINIMat) study from birth to 24 months of age. Weights and lengths of the children were measured monthly during infancy and quarterly in the second year of life. Anthropometric indices were calculated using both WHO standards and the NCHS reference. The growth pattern and estimates of undernutrition based on the WHO standards and the NCHS reference were compared. Results The mean birthweight was 2,697 ± 401 g, with 30% weighing < 2,500 g. The growth pattern of the MINIMat children more closely tracked the WHO standards than it did the NCHS reference. The rates of stunting based on the WHO standards were higher than the rates based on the NCHS reference throughout the first 24 months. The rates of underweight and wasting based on the WHO standards were significantly different from those based on the NCHS reference. Conclusions This comparison confirms that use of the NCHS reference misidentifies undernutrition and the timing of growth faltering in infants and young children, which was a key rationale for constructing the new WHO standards. The new WHO child growth standards provide a benchmark for assessing the growth of breastfed infants and children.
Development of an Improved Local-Ingredient-Based Complementary Food and Technology Transfer to Rural Housewives
Authors: Ouédraogo Hermann Z. , Traoré Tahirou , Zèba Augustin , Tiemtoré Saïdou , Dramaix-Wilmet Michèle , Hennart Philippe , Donnen Philippe 
Published: November 2015

Background Food technology transfer to rural households, based on local ingredients, is a relevant and sustainable strategy to ensure better nutrition of young children. Objective To develop an improved mush based on local ingredients and evaluate the potential for transferring its technology to rural housewives. Methods We developed a flour-based food using Alicom software and performed laboratory trials to evaluate its actual nutritional quality. Then we recruited housewives from each of the 27 project villages and trained them in flour production and mush preparation twice daily, 6 days a week, for 26 weeks. Mush was sampled during the training session and at weeks 4, 12, and 22 and evaluated for actual flow distance and dry matter content, which served to estimate energy density and iron and zinc contents. Results The laboratory trials reported average energy densities of 103 kcal/100 g, iron contents of 2.6 mg/100 kcal, and zinc contents of 1.2 mg/100 kcal. The average ( ± SD) energy densities of the mush samples obtained during the training session and at weeks 4, 12, and 22 were 103.0 ± 5.6,103.3 ± 5.2,107.9 ± 11.5, and 101.3 ± 8.7 kcal/100 g, respectively. The average iron contents were 2.3 ± 0.5,2.3 ± 0.5,2.6 ± 0.3, and 1.8± 0.8 mg/ 100 kcal, respectively, and the average zinc contents were 1.6± 0.1, 1.6± 0.1,1.7 ± 0.1, and 1.6± 0.2 mg/100 kcal. Conclusions Developing a suitable complementary food from local ingredients and educating households in nutrition and use of local products are feasible. Such education should come with measures aimed at improving the accessibility of some ingredients to ensure feasibility and sustainability.
Iron in Vitro Bioavailability and Iodine Storage Stability in Double-Fortified Salt
Authors: Li Yao Olive , Diosady Levente L. , Wesley Annie S. 
Published: November 2015

Background Ferrous fumarate is useful in iron fortification because of its high bioavailability, mild taste, and relatively low cost. A ferrous fumarate premix for incorporation into salt has been developed by agglomerating ferrous fumarate with appropriate binder materials into salt-size particles followed by microencapsulation. Objective The bioavailability of iron is critical for the usefulness of double-fortified salt. This study examined the in vitro bioavailability of various iron forms in double-fortified salt and microencapsulated ferrous fumarate premixes prepared by various techniques in an effort to identify key processing factors affecting iron bioavailability. Methods Iron in vitro bioavailability was approximated through the rate of dissolution of iron in 0.1 N HCl, which closely approximates the acid in gastric juice. Iron in vivo bioavailability was tested using the hemoglobin repletion assay in rats. Results The materials and techniques used in microencapsulating ferrous fumarate had little effect on iron in vivo bioavailability: more than 90% of iron in the premixes was released during 2 hours of digestion in the simulated gastric fluid. By incorporating titanium dioxide in the coating materials, the dark reddish-brown color of ferrous fumarate was effectively masked, resulting in acceptable sensory qualities, while maintaining the stability of iodine in the salt. Iron in vivo tests in rats have confirmed that the ferrous fumarate microencapsulated in a lipid is highly bioavailable, with a bioavailability of 95% relative to ferrous sulfate. Conclusions These findings were corroborated by field tests in southern India which demonstrated that double-fortified salt containing microencapsulated ferrous fumarate was effective in reducing the prevalence of iron-deficiency anemia and iodine-deficiency disorders.
Relationship between Food Aid and Acute Malnutrition following an Earthquake
Authors: Hossain S. M. Moazzem , Maggio David M. , Sullivan Kevin M. 
Published: November 2015

Background The relationship between food aid and acute malnutrition among children under 5 years of age was assessed in northern Pakistan following the 2005 earthquake. Methods Separate cross-sectional household-based surveys were performed in Mansehra and Muzaffarabad districts. Probability proportional to size (PPS) was used to select clusters in each district, and households were randomly selected within each cluster. Information collected included receipt of food aid, child health, level of household damage, water sources, and excreta disposal. Results Children in households receiving food aid had a lower prevalence of acute malnutrition in Mansehra (adjusted OR, controlled for confounders, 0.40; 95% CI, 0.13 to 1.22) and Muzaffarabad (adjusted OR, 0.72; 95% CI, 0.36 to 1.44). Communities with higher levels of complete household destruction were more likely to receive food aid. Conclusions Children in households receiving food aid had a lower prevalence of acute malnutrition than those in households not receiving food aid, even after accounting for various confounding variables, although this difference was not statistically significant.
Total Daily Water Intake in Guatemalan Children
Authors: Montenegro-Bethancourt Gabriela , Vossenaar Marieke , Doak Colleen M. , Solomons Noel W. 
Published: November 2015

Background Water is an essential nutrient, but recommendations for total water requirements only emerged in 2005, in the context of estimated average population targets in the Dietary Reference Intakes (DRIs) for US and Canadian societies. Objective To assess total daily water acquisition, and the contribution of water acquired from all possible sources, among Guatemalan children. Methods A total of 449 urban Guatemalan schoolchildren, aged 8 to 11 years, evenly divided between two socioeconomic strata, completed a 1-day pictorial registry of all foods and beverages consumed. Estimated energy intake, total water intake, and the contributions of water from drinking water, beverages, intrinsic and extrinsic water in foods, and the oxidation of macronutrients were assessed. Results The contribution of water from the examined water sources was 8% for drinking water, 49% for beverages, 29% for all foods, and 14% for metabolism of macronutrients, with only slight variance across sexes and social class. The average total daily water acquisition was 1,841 ± 572 mL for boys and 1,834 ± 484 mL for girls, which fall short of the North American DRI recommendations of 2.4 and 2.1 L, respectively. There was correspondingly lower average consumption of dietary liquids. Conclusions Foods play an important role in the acquisition of water from their hydration and metabolic oxidation, contributing 43.8% of the daily supply to these children. There is still a calculated shortfall of daily water acquisition, as compared with the DRI recommendations, which could be overcome by greater intake of plain water and low-energy fresh produce.