bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addressing Tuberculosis in the Context of Malnutrition and HIV Coinfection
Authors: Semba Richard D. , Darnton-Hill Ian , de Pee Saskia 
Published: November 2015

Background Tuberculosis is the second leading cause of infectious disease mortality (1.8 million/year), after HIV/AIDS. There are more than 9 million new cases each year. One-third of the world's population, and 50% of adults in sub-Saharan Africa, South Asia, and South-East Asia, are infected, representing an enormous pool of individuals at risk for developing the disease. The situation is complicated by the HIV/AIDS pandemic, widespread undernutrition, smoking, diabetes, increased mobility, and emergence of multi- and extensively drug-resistant tuberculosis. Objective To review the scientific evidence about the interactions among tuberculosis, nutrition, and HIV coinfection. Results HIV infection and malnutrition lower immunity, increasing the risk of reactivation tuberculosis and primary progressive disease. Having either tuberculosis or HIV infection causes weight loss. Malnutrition markedly increases mortality among both tuberculosis and HIV/AIDS patients and should be treated concurrently with treatment of the infections. Tuberculosis treatment is a prerequisite for nutritional recovery, in addition to intake of nutrients required for rebuilding tissues, which is constrained in food-insecure households. Additional pharmaceutical treatment to reduce the catabolic impact of inflammation or promote growth may be needed. Specific nutrients can contribute to faster sputum smear clearance, which is important for reducing transmission, as well as faster weight gain when combined with an adequate diet. Adequate nutrition and weight gain in undernourished populations might reduce the incidence of tuberculosis. Conclusions The many risk factors for the development of tuberculosis need to be addressed simultaneously, especially HIV/AIDS and food insecurity and undernutrition. For stronger evidence-based guidelines, existing recommendations and clinical applications need to be more widely applied and evaluated.
Diarrhea and Novel Dietary Factors Emerge as Predictors of Serum Vitamin B12 in Panamanian Children
Authors: Scatliff Candice E. , Koski Kristine G. , Scott Marilyn E. 
Published: November 2015

Background The role of gastrointestinal infection as a factor determining vitamin B12 status in populations with low intake of animal-source foods is unclear. Objective To determine dietary adequacy and serum concentrations of vitamin B12 in an extremely impoverished indigenous population of Panamanian children aged 12 to 60 months, and to identify predictors of both dietary and serum vitamin B12. Methods A previous community-based survey provided the usual dietary intake and personal, household, and infection (Ascaris and diarrheal disease) information for 209 weaned children. Serum vitamin B12 was assayed using electrochemiluminescence for 65 of these children. Children with adequate or inadequate dietary vitamin B12 intake were compared, and predictors of dietary and serum vitamin B12 were identified using step-wise regression analyses of one index child per household. Results Dietary vitamin B12 intake was inadequate in 43% of children; these children were poorer, had less frequent diarrhea, and obtained a higher percentage of their energy from carbohydrate than children with adequate intake. Energy intake positively predicted dietary vitamin B12 intake. In contrast, serum vitamin B12 concentrations were normal in all but 3% of the children. Serum vitamin B12 was positively associated with weekly servings of fruit, corn-based food, and ñame (a traditional starchy food), but not with animal-source foods. Finally, serum vitamin B12 was not associated with Ascaris intensity but was lowered with increasing frequency of diarrhea. Conclusions Although inadequate dietary intake of vitamin B12 was common, most serum values were normal. Nevertheless, diarrheal disease emerged as a negative predictor of serum vitamin B12 concentration.
Negative Impact on Calorie Intake Associated with the 2006–08 Food Price Crisis in Latin America
Authors: Iannotti Lora , Robles Miguel 
Published: November 2015

Background From 2006 to 2008, there were sharp increases in the prices of major food commodities globally, including maize, rice, and wheat. Few studies have contributed empirical evidence of the nutritional impacts of this food price crisis. Objective To assess changes in energy intake in response to food price shocks and in relation to calorie adequacy levels in seven Latin American countries. Methods Data were drawn from nationally representative household budget surveys. The quadratic almost ideal demand system (QUAIDS) model characterized change patterns in consumption for six food groups and one nonfood group under two scenarios: actual change in food prices by country, and standardized 10% increase in prices across all countries. Energy intakes before and after the crisis were determined once calories were assigned to food items from the ProPAN and US Department of Agriculture food composition databases. Results Energy intakes were reduced by 8.0% (range, 0.95% to 15.1%) from precrisis levels across all countries. Ecuador and Panama were the worst affected, followed by Haiti and Nicaragua. There was a consistent, direct relationship between wealth quintile and change in energy intake. Rural areas were affected to the same extent as or a greater extent than urban areas. High positive increases in calorie consumption were found in the richest wealth quintile, exceeding 10% of previous levels in five countries. Conclusions Policies and programs targeting the poorest households in both rural and urban areas may be needed to offset the energy deficits associated with food price increases. More research is needed on the effect of food prices and micronutrient nutrition.
Why Does Nutrition Deteriorate Rapidly among Children under 2 Years of Age? Using Qualitative Methods to Understand Community Perspectives on Complementary Feeding Practices in Bangladesh
Authors: Rasheed Sabrina , Haider Rukhsana , Hassan Nazmul , Pachón Helena , Islam Sanjeeda , Jalal Chowdhury S. B. , Sanghvi Tina G. 
Published: November 2015

Background Child undernutrition remains high in South Asian and sub-Saharan African countries. Rapid declines in nutritional status occur before the age of 2 years, particularly during the period of complementary feeding. Improving complementary feeding practices is a neglected area in nutrition programs. Objective To understand community perspectives on complementary feeding practices in order to inform the design of future interventions for improved complementary feeding. Methods From May through August 2009, data were collected in two rural locations and one urban location in Bangladesh through semistructured interviews, food attributes exercises, 24-hour dietary recalls, opportunistic observations, and trials of improved practices (TIPs). Key informant interviews and focus group discussions were also carried out among family members and community opinion leaders. Results Lay perceptions about complementary feeding differ substantially from international complementary feeding recommendations. A large proportion of children do not consume sufficient amounts of complementary foods to meet their energy and micronutrient needs. There was a gap in knowledge about appropriate complementary foods in terms of quality and quantity and strategies to convert family foods to make them suitable for children. Complementary feeding advice from family members, peers, and health workers, the importance given to feeding young children, and time spent by caregivers in feeding influenced the timing, frequency, types of food given, and ways in which complementary feeding occurred. Conclusions Perceptions and practices related to complementary feeding need to be effectively addressed to improve the levels of child undernutrition. Lack of understanding of children's nutritional needs and insufficient time for feeding children are key barriers to complementary feeding.
Relationship of the Availability of Micronutrient Powder with Iron Status and Hemoglobin among Women and Children in the Kakuma Refugee Camp, Kenya
Authors: Ndemwa Philip , Klotz Christine L. , Mwaniki David , Sun Kai , Muniu Erastus , Andango Pauline , Owigar Joyce , Rah Jee Hyun , Kraemer Klaus , Spiegel Paul B. , Bloem Martin W. , de Pee Saskia , Semba Richard D. 
Published: November 2015

Background Micronutrient powder is a potential strategy to improve iron status and reduce anemia in refugee populations. Objective To evaluate the effect of the availability of home fortification with a micronutrient powder containing 2.5 mg of sodium iron ethylenediaminetetraacetate (NaFeEDTA) on iron status and hemoglobin in women and children in the Kakuma Refugee Camp in northwest Kenya. Methods Hemoglobin and soluble transferrin receptor were measured in 410 children 6 to 59 months of age and 458 women of childbearing age at baseline (just before micronutrient powder was distributed, along with the regular food ration) and at midline (6 months) and endline (13 months) follow-up visits. Results At the baseline, midline, and endline visits, respectively, the mean (± SE) hemoglobin concentration in women was 121.4 ± 0.8, 120.8 ± 0.9, and 120.6 ± 1.0 g/L ( p = .42); the prevalence of anemia (hemoglobin < 120 g/L) was 42.6%, 41.3%, and 41.7% ( p = .92); and the mean soluble transferrin receptor concentration was 24.1 ± 0.5, 20.7 ± 0.7, and 20.8 ± 0.7 nmol/L ( p = .0006). In children, the mean hemoglobin concentration was 105.7 ± 0.6, 109.0 ± 1.5, and 105.5 ± 0.3 g/L ( p = .95), respectively; the prevalence of anemia (hemoglobin < 110 g/L) was 55.5%, 52.3%, and 59.8% ( p = .26); and the mean soluble transferrin receptor concentration was 36.1 ± 0.7, 29.5 ± 1.9, and 28.4 ± 3.2 nmol/L ( p = .02), in models that were adjusted for age using least squares means regression. Conclusions In children and in women of childbearing age, the availability of micronutrient powder was associated with a small improvement in iron status but no significant change in hemoglobin in this refugee camp setting.
Consumption of Micronutrient-Fortified Milk and Noodles is Associated with Lower Risk of Stunting in Preschool-Aged Children in Indonesia
Authors: Semba Richard D. , Moench-Pfanner Regina , Sun Kai , de Pee Saskia , Akhter Nasima , Rah Jee Hyun , Campbell Ashley A. , Badham Jane , Bloem Martin W. , Kraemer Klaus 
Published: November 2015

Background Stunting is highly prevalent in developing countries and is associated with greater morbidity and mortality. Micronutrient deficiencies contribute to stunting, and micronutrient-fortified foods are a potential strategy to reduce child stunting. Objective To examine the relationship between the use of fortified powdered milk and noodles and child stunting in a large, population-based sample of Indonesian children. Methods Consumption of fortified milk and fortified noodles was assessed in children 6 to 59 months of age from 222,250 families living in rural areas and 79,940 families living in urban slum areas in Indonesia. Results The proportions of children who consumed fortified milk and fortified noodles were 34.0% and 22.0%, respectively, in rural families, and 42.4% and 48.5%, respectively, in urban families. The prevalence of stunting among children from rural and urban families was 51.8% and 48.8%, respectively. Children from rural and urban families were less likely to be stunted if they consumed fortified milk (in rural areas, OR = 0.87; 95% CI, 0.85 to 0.90; p < .0001; in urban areas, OR = 0.80; 95% CI, 0.76 to 0.85; p < .0001) or fortified noodles (in rural areas, OR = 0.95; 95% CI, 0.91 to 0.99; p = .02; in urban areas, OR = 0.95; 95% CI, 0.91 to 1.01; p = .08) in multiple logistic regression models adjusted for potential confounders. In both rural and urban families, the odds of stunting were lower when a child who consumed fortified milk also consumed fortified noodles, or when a child who consumed fortified noodles also consumed fortified milk. Conclusions The consumption of fortified milk and noodles is associated with decreased odds of stunting among Indonesian children. These findings add to a growing body of evidence regarding the potential benefits of multiple micronutrient fortification on child growth.
REACH: An Effective Catalyst for Scaling up Priority Nutrition Interventions at the Country Level
Authors: Pearson Brenda L. , Ljungqvist Björn 
Published: November 2015

Background Renewed Efforts Against Child Hunger (REACH) is the joint United Nations initiative to address Millennium Development Goal (MDG) 10, Target 3, i.e., to halve the proportion of underweight children under 5 years old by 2015. The United Nations Food and Agriculture Organization (FAO), the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the World Food Programme (WFP), and the International Fund for Agricultural Development (IFAD) developed and tested a facilitation mechanism to act as a catalyst for scaling up multisectoral nutrition activities. Objective The UN-REACH partners developed pilot projects in Mauritania and Lao PDR from 2008 to 2010 and deployed facilitators to improve nutrition governance and coordination. Review missions were conducted in February 2011 to assess the REACH approach and what it achieved. Methods The UN review mission members reviewed documents, assessed policy and management indicators, conducted qualitative interviews, and discussed findings with key stakeholders, including the most senior UN nutrition directors from all agencies. Results Among other UN-REACH achievements, the Prime Minister of Mauritania agreed to preside over a new National Nutrition Development Council responsible for high-level decision-making and setting national policy objectives. REACH facilitated the completion of Lao's first national Nutrition Strategy and Plan of Action and formation of the multistakeholder Nutrition Task Force. During the REACH engagement, coordination, joint advocacy, situation analysis, policy development, and joint UN programming for nutrition were strengthened in Lao PDR and Mauritania. Conclusions Improvements in the nutrition governance and management mechanisms in Mauritania and Lao PDR were observed during the period of REACH support through increased awareness of nutrition as a key development objective, establishment of governmental multisectoral coordinating mechanisms, improved government capacity, and new joint UN–government nutrition programming.
Development, Acceptability, and Nutritional Characteristics of a Low-Cost, Shelf-Stable Supplementary Food Product for Vulnerable Groups in Kenya
Authors: Kunyanga Catherine , Imungi Jasper , Okoth Michael , Vadivel Vellingiri , Biesalski Hans Konrad 
Published: November 2015

Background Food-based approaches have been advocated as the best strategies to curb hunger and malnutrition in developing countries. The use of low-cost, locally available, nutritious foods in the development of supplementary foods has been recommended. Objective To develop low-cost food supplements using different traditionally processed local foods, consisting of cereals, legumes, nuts, fish, and vegetables, to meet the nutrient requirements for vulnerable groups in Kenya. Methods Four food supplements were developed and evaluated by taste panel procedures. The product containing amaranth grain, pigeon pea, sweet potato, groundnuts, and brown sugar was found to be the most acceptable supplement. Evaluation of nutritional composition, shelf-life, and cost analysis of the acceptable supplement was carried out to assess if it could satisfactorily provide more than 50% of the Recommended Dietary Allowances (RDAs) of the basic nutrients for vulnerable groups. Results The acceptable supplement contained 453.2 kcal energy, 12.7 g crude protein, 54.3 g soluble carbohydrates, 20.8 g crude fat, and 10.1 g crude fiber per 110 g. The micronutrient contents were 93.0 mg calcium, 172.4 mg magnesium, 2.7 mg zinc, 5.7 mg iron, 0.8 mg vitamin B1, 0.2 mg vitamin B2, 7.9 mg niacin, 100 μg folic acid, and 140 μg retinol equivalent per 110 g. The supplement also contained 21% total essential amino acid in addition to appreciable levels of palmitic, stearic, oleic, linoleic, and α-linolenic fatty acids. The shelf-life study showed that it could be stored in different packaging materials (polythene bags, gunny bags, and kraft paper) at 26°C without deleterious effects on its chemical composition for up to 4 months. Cost analysis of the supplement indicated that the product could be competitively sold at US$0.812/kg (KES 65.50/kg). Conclusions Locally available indigenous foods can be used in the formulation of acceptable, low-cost, shelf-stable, nutritious supplementary foods for vulnerable groups.
The Adult Male Equivalent Concept and its Application to Household Consumption and Expenditures Surveys (HCES)
Authors: Weisell Robert , Dop Marie Claude 
Published: November 2015

Background Knowledge of the amount and quality of food consumed by a population is essential in determining the adequacy of the food availability and supply. Since its founding, the Food and Agriculture Organization (FAO) has developed methods for determining food availability and consumption that may be useful to other investigators. Objective Based on FAO's 60 years of experience in conducting Household Consumption and Expenditures Surveys (HCES), to explain and demonstrate the advantages and use of the Adult Male Equivalent (AME) and Equivalent Nutrition Unit (ENU) concepts. Methods The important factors related to the AME and ENU, such as energy requirements, size and composition of the food consumer unit, and attendance at meals, are explained through the examples of two hypothetical families: a family consisting of a father, a mother, a 12-year old daughter, and a 3-year old son plus an adult guest; and a family consisting of a single mother, a 10-year old son, and two daughters, 6 and 4 years of age. The reader is guided through the steps in calculating the AME and ENU. Results The various scenarios of the composition, size, and attendance at meals of the consumer unit show that the calculated food energy adequacy can range from +2% to −29%. Conclusions Care and attention must be given to correctly attributing the consumers of the food intake measured or estimated. In addition, use of these concepts allows for a valid comparison of food consumption units of various sizes and compositions.
Less than Adequate Vitamin D Status and Intake in Latin America and the Caribbean: A Problem of Unknown Magnitude
Authors: Brito Alex , Cori Héctor , Olivares Manuel , Mujica María Fernanda , Cediel Gustavo , de Romaña Daniel López 
Published: November 2015

Background The prevalence of vitamin D deficiency in Latin America and the Caribbean is unknown. Objective To examine the prevalence data available on vitamin D deficiency in Latin America and the Caribbean. Methods A systematic review was conducted in 2011. Studies using biochemical biomarkers and dietary intake estimation were included. Studies conducted in apparently healthy individuals, independently of age, latitude, skin pigmentation, and season of the year at the time of blood collection, were included. Results A total of 243 studies were identified. The final number of selected studies was 28, including two National Health Surveys (Mexico and Argentina). There are studies that report the vitamin D status of specific subgroups conducted in Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, and Mexico. However, the small sample sizes in these studies and thus the low national representativeness of the reported data do not allow for an accurate assessment of vitamin D status at the regional level. In the majority of the countries with available data, we observed that vitamin D insufficiency was classified as a mild, moderate, or severe public health problem. The only country with a nationally representative sample was Mexico, which found 24%, 10%, 8%, and 10% prevalence rates of vitamin D insufficiency (25-hydroxyvitamin D < 50 nmol/L) in preschoolers, schoolchildren, adolescents, and adults, respectively. The prevalence of vitamin D deficiency (25-hydroxyvitamin D < 20 nmol/L) was less than 1% for all groups. Conclusions There is some indication that vitamin D insufficiency may be a public health problem in Latin America and the Caribbean, but the exact magnitude is currently unknown.
The Importance of Using Food and Nutrient Intake Data to Identify Appropriate Vehicles and Estimate Potential Benefits of Food Fortification in Uganda
Authors: Kyamuhangire William , Lubowa Abdelrahman , Kaaya Archileo , Kikafunda Joyce , Harvey Philip W. J. , Rambeloson Zo , Dary Omar , Dror Daphna K. , Allen Lindsay H. 
Published: November 2015

Background Concern over micronutrient inadequacies in Uganda has prompted the introduction of mass fortification. Objective To use food intake to determine nutrient inadequacies in children aged 24 to 59 months and nonpregnant women of reproductive age, and to model the adequacy of mass fortification. Methods Data were collected by the 24-hour recall method in three regions. Usual nutrient intakes were calculated by adjusting actual intake distribution for the intraindividual variance. The impact of fortification on intake adequacy was simulated. Results The nutrients with the highest prevalence of inadequate intake across regions were vitamin A (30% to 99%), vitamin B12 (32% to 100%), iron (55% to 89%), zinc (18% to 82%), and calcium (84% to 100%). According to simulations, fortification of vegetable oil and sugar with vitamin A would reduce the prevalence of vitamin A inadequacy in the Western and Northern regions; in Kampala it would eliminate vitamin A inadequacy but would cause 2% to 48% of children to exceed the Tolerable Upper Intake Level (UL). The proposed fortification of wheat flour would reduce the prevalence of inadequate intakes of thiamine, riboflavin, folate, and niacin in Kampala, but would have little impact in the other two regions due to low flour consumption. Conclusions Micronutrient fortification of vegetable oil and sugar in all regions and of wheat flour in Kampala would reduce the prevalence of micronutrient inadequacies. However, the wheat flour formulation should be modified to better meet requirements, and the vitamin A content in sugar should be reduced to minimize the risk of high intakes. Maize flour may be suitable for targeted fortification, but prior consolidation of the industry would be required for maize flour to become a good vehicle for mass fortification.