bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concordance with Selected Population Recommendations for Cancer Prevention among Third- and Fourth-Grade Schoolchildren in Quetzaltenango, Guatemala
Authors: Vossenaar Marieke , Sinak Christine , Montenegro-Bethancourt Gabriela , Bermudez Odilia I. , Groeneveld Iris , Doak Colleen M. , Solomons Noel W. 
Published: November 2015

Background The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) 1997 recommendations for cancer prevention were meant to apply to children as well as adults. Objective To assess the concordance of behaviors and body composition of urban Guatemalan schoolchildren with the tenets of the WCRF/AICR 1997 recommendations. Methods A survey was conducted involving determination of 24-hour consumption of foods and beverages by a pictorial registry and height and weight measurements in 355 third- and fourth-grade schoolchildren in the western highland city of Quetzaltenango, Guatemala. Based on a previous, exhaustive parsing of the population goal recommendations of the WCRF/AICR 1997 report, 25 subcomponents were identified. Eleven could be evaluated with the survey data collected. Adult population criteria could be applied in seven, whereas four components had unique criteria adapted to this juvenile survey setting. Results The study sample was concordant on seven components—nutrient adequacy, total variety of foods consumed, plant-based diets, body mass index, vegetable and fruit intake, limitation of red meat consumption, and limitation of total fat consumption, and nonconcordant on four—variety of fruits and vegetables consumed, variety of starchy foods consumed, total intake of starchy foods, and limitation of sugar consumption. Conclusions Educational and public health actions need to be conceived and implemented to further improve the rate of concordance of these 11 components with the WCRF/AICR 1997 recommendations for cancer prevention.
Determinants of Infant and Young Child Feeding Practices in Bangladesh: Secondary Data Analysis of Demographic and Health Survey 2004
Authors: Mihrshahi Seema , Kabir Iqbal , Roy S. K. , Agho Kingsley E. , Senarath Upul , Dibley Michael J. ,   for the South Asia Infant Feeding Research Network (SAIFRN)*
Published: November 2015

Background In Bangladesh, poor infant and young child feeding practices are contributing to the burden of infectious diseases and malnutrition. Objective To estimate the determinants of selected feeding practices and key indicators of breastfeeding and complementary feeding in Bangladesh. Methods The sample included 2,482 children aged 0 to 23 months from the Bangladesh Demographic and Health Survey of 2004. The World Health Organization (WHO)-recommended infant and young child feeding indicators were estimated, and selected feeding indicators were examined against a set of individual-, household-, and community-level variables using univariate and multivariate analyses. Results Only 27.5% of mothers initiated breastfeeding within the first hour after birth, 99.9% had ever breastfed their infants, 97.3% were currently breastfeeding, and 22.4% were currently bottle-feeding. Among infants under 6 months of age, 42.5% were exclusively breastfed, and among those aged 6 to 9 months, 62.3% received complementary foods in addition to breastmilk. Among the risk factors for an infant not being exclusively breastfed were higher socioeconomic status, higher maternal education, and living in the Dhaka region. Higher birth order and female sex were associated with increased rates of exclusive breastfeeding of infants under 6 months of age. The risk factors for bottle-feeding were similar and included having a partner with a higher educational level (OR = 2.17), older maternal age (OR for age ≥ 35 years = 2.32), and being in the upper wealth quintiles (OR for the richest = 3.43). Urban mothers were at higher risk for not initiating breastfeeding within the first hour after birth (OR = 1.61). Those who made three to six visits to the antenatal clinic were at lower risk for not initiating breastfeeding within the first hour (OR = 0.61). The rate of initiating breastfeeding within the first hour was higher in mothers from richer households (OR = 0.37). Conclusions Most breastfeeding indicators in Bangladesh were below acceptable levels. Breastfeeding promotion programs in Bangladesh need nationwide application because of the low rates of appropriate infant feeding indicators, but they should also target women who have the main risk factors, i.e., working mothers living in urban areas (particularly in Dhaka).
Nutritional Status of Under-Five Children in HIV-Affected Households in Western Kenya
Authors: Ndirangu Murugi , Wariero James O. , Sachs Sonia Ehrlich , Masibo Peninah , Deckelbaum Richard J. 
Published: November 2015

Background Households affected by HIV/AIDS are at an increased risk for food insecurity and malnutrition. Poor nutrition contributes to more than a third of all deaths associated with infectious diseases among children under 5 years of age in developing countries. With increased household food insecurity, and a greater disease burden associated with HIV/AIDS, the growth of children under five could be impacted, resulting in increased malnutrition for this vulnerable group. Objective To determine whether there is an association between the type of household (HIV-affected compared with HIV-unaffected) and the nutritional status of children under 5 years of age residing in these households. Methods The study was set in a Millennium Village Project site in western Kenya and used a cross-sectional design to compare the stunting, wasting, and under-weight status among 102 and 99 under-five children living in HIV-affected and -unaffected households, respectively. Height-for-age, weight-for-age, and weight-for-age z-scores were calculated based on the World Health Organization growth standards and compared. Proportions, means, and standard deviations were used to describe the data. The data were analyzed with the use of the chi-square test for comparison of proportions and the independent t-test for comparison of means. Results Children in HIV-affected households had a significantly higher degree of stunting (height-for-age < −2 SD) than children in unaffected households (25.5% vs. 9.1%, p = .002). The degree of wasting and under-weight did not differ significantly between HIV-affected and -unaffected households. Conclusions Residing in HIV-affected households is associated with stunting in children under 5 years of age.
Hazard Identification and Exposure Assessment for Bacterial Risk Assessment of Informally Marketed Milk in Abidjan, Côte d'Ivoire
Authors: Kouamé-Sina Sylvie Mireille , Makita Kohei , Costard Solenne , Grace Delia , Dadié Adjehi , Dje Marcellin , Bonfoh Bassirou 
Published: November 2015

Background Animal-source foods are important causes of food-borne illness, and milk and dairy products can contain pathogenic microorganisms. Objective We conducted a stochastic assessment of the risk of ingesting milk contaminated with specific microbial pathogens ( Escherichia coli, Staphylococcus aureus, and Enterococcus spp.) in Abidjan, Côte d'Ivoire. Methods We carried out structured interviews and focus group discussions with farmers ( n = 15), vendors ( n = 17), and consumers ( n = 188) to characterize dairy production systems and milk consumption behavior. Microbiological sampling was conducted at different points between milking and sale. A risk model was developed, and the risk of consuming contaminated raw milk was estimated by Monte Carlo simulation. Results The investigation into local raw milk consumption patterns showed that the proportion of raw milk consumption was 51.6% in people who consume milk. The probability of ingestion of marketed raw milk that failed to meet standards for this group of bacteria was 29.9% and about 652 consumers per day were estimated to ingest contaminated milk. Microbiological tests from the farm showed that 7.2% of samples taken from milkers' hands, 4.4% of water samples (water used to rinse milk containers or milking utensils (calabash, plastic bottle, filters, buckets), 4.4% of environmental samples (air pollution), 13.2% of samples from milking utensils, and 4.9% of samples from cows' udders were contaminated with one or more of these pathogens. About 624.6 L of marketed raw milk would need to be discarded per day if discarding milk was chosen as the option of risk reduction. The destruction of this milk would result in a potential loss of €623.9 per day for all producers. Conclusions The risk of human illness from consumption of raw milk could be mitigated by raising awareness about heat treatment of milk and good hygiene practices in the dairy chain.
Should Household Consumption and Expenditures Surveys (HCES) be Used for Nutritional Assessment and Planning?
Authors: Murphy Suzanne , Ruel Marie , Carriquiry Alicia 
Published: November 2015

Background Household Consumption and Expenditures Surveys (HCES) are routinely conducted in several countries on nationally representative samples, often on a regular basis. The HCES have been considered as a potential alternative to more expensive surveys of individuals' food intakes for use in nutritional assessment and in planning programs such as food fortification. HCES gather information on household food availability (purchased, produced, or received as gifts) and use over a given period of time, often the past week or month. Objective To discuss the potential usefulness of HCES consumption data for nutritional assessment and planning for populations of households and individuals within the households. Conclusions There are several limitations to the HCES, most notably the difficulty of estimating the intrahousehold allocation of foods and therefore of quantifying the actual food intake of individual household members. Another concern is the lack of information on the variability of consumption over time, making it difficult to estimate the distribution of usual consumption, and thus the prevalence of nutrient inadequacies or excesses. Other potential limitations might be addressed by improvements to the HCES questionnaires, such as including information on foods that are available but not consumed and those that are consumed outside the home. Research is needed to better understand both the strengths and the weaknesses of the HCES data when used to assess and plan intakes at the household and individual levels
Fortification of Indonesian Unbranded Vegetable Oil: Public—Private Initiative, from Pilot to Large Scale
Authors: Soekirman  , Soekarjo Damayanti , Martianto Drajat , Laillou Arnaud , Moench-Pfanner Regina 
Published: November 2015

Background Despite improved economic conditions, vitamin A deficiency remains a public health problem in Indonesia. Objective This paper aims to describe the development of the Indonesian unbranded cooking oil fortification program and to discuss lessons learned to date and future steps necessary for implementation of mandatory, large-scale oil fortification with vitamin A. Methods An historic overview of the steps involved in developing the Indonesian unbranded cooking oil fortification program is given, followed by a discussion of lessons learned and next steps needed. Results Indonesia's low-income groups generally consume unbranded vegetable oil, with an average consumption of approximately 25 g/day. Unbranded oil constitutes approximately 70% of the total oil traded in the country. In 2007–10, a pilot project to fortify unbranded vegetable oil was carried out in Makassar, and an effectiveness study found that the project significantly improved the serum retinol concentrations of schoolchildren. In 2010, the pilot was expanded to two provinces (West Java and North Sumatra) involving the biggest two national refineries. In 2011, a draft national standard for fortified oil was developed, which is currently under review by the National Standard Body and is expected to be mandated nationally in 2013 as announced officially by the Government of Indonesia in national and international meetings. Conclusions Indonesia is a leading world supplier of cooking oil. With stakeholder support, the groundwork has been laid and efforts are moving forward to implement mandatory fortification. This project could encourage Indonesian industry to fortify more edible oils for export, thus expanding their market potential and potentially reducing vitamin A deficiency in the region.
Relative Contribution of Physical Activity, Sedentary Behaviors, and Dietary Habits to the Prevalence of Obesity among Kuwaiti Adolescents
Authors: Al-Haifi Ahmad R. , Al-Fayez Mohammad A. , Al-Athari Buthaina I. , Al-Ajmi Fahhad A. , Allafi Ahmad R. , Al-Hazzaa Hazzaa M. , Musaiger Abdulrahman O. 
Published: November 2015

Background The increasing rate of obesity among Kuwaiti adolescents is associated with immediate and long term-risks to their health and well-being. Objective To update data on the prevalence of overweight and obesity among Kuwaiti adolescents and to examine the relative contribution of selected lifestyle factors to overweight and obesity in this population. Methods The present study is part of the Arab Teens Lifestyle Study (ATLS). A total of 906 adolescents (463 boys and 443 girls) aged between 14 and 19 years were selected from Kuwaiti schools by a multistage stratified randomization process. A validated questionnaire was used to collect data on physical activity, sedentary lifestyle, and eating habits. The International Obesity Task Force (IOTF) cutoff values for adolescents under 18 years of age were used to define overweight and obesity. Total energy expenditure was calculated using metabolic equivalent-minutes per week. A general linear model was used to establish the proportion of the variance (expressed in partial eta squared) in excess weight attributable to differences in eating habits and physical activity. Results The prevalence of overweight and obesity was 50.5% in boys and 46.5% in girls. Among boys, moderate and vigorous activities were found to be significantly negatively associated with overweight and obesity ( p < .05), whereas in girls, only those with not less than moderate activities were negatively associated with overweight and obesity ( p < .05). Sedentary behaviors, time spent watching television, and time spent working on the computer were not significantly associated with obesity in either sex. Consumption of breakfast, vegetables, and fast foods (boys and girls) and potatoes, cakes and doughnuts, and sweets (girls only) was significantly associated with overweight and obesity ( p < .05). In general, the partial eta square explained by physical activity was less than 3.6% in boys compared with less than 1.0% in girls, and eating habits explained less than 1.8% in boys compared with 2.5% in girls. Conclusions Physical activity explains a greater proportion of variation in body mass index than do eating habits, particularly in boys. Eating habits explain a greater proportion of variation in body mass index than does physical activity in girls. Prospective studies are needed to clarify the relative effects of sedentary behaviors on overweight in adolescents.
Derivation of Nutrient Requirements for Disaster-Affected Populations: Sphere Project 2011
Authors: Seal Andrew , Thurstans Susan 
Published: November 2015

Background Nutritional requirements have been previously calculated for emergency-affected populations and are widely used for planning and assessing the nutritional adequacy of humanitarian food assistance. The Sphere Project is an interagency collaboration that defines minimum standards and indicators for humanitarian responses, including food and nutrition. It last published population nutritional requirements in 2004, but a revision was required due to the release of new Reference Nutrient Intakes (RNIs) by the World Health Organization and Food and Agriculture Organization (WHO/FAO). Objective To review and revise the list of specified nutrients and recalculate population requirements using RNIs published by WHO/FAO. Methods Review of published normative documents, consultation with experts and participants in the Sphere revision process, construction of a reference demographic profile, and calculation of population nutrient requirements for use in designing emergency general rations. Results Twenty-one nutrients and energy were selected for inclusion, and a demographic profile was constructed to represent a typical beneficiary population. Compared with the previous version of the Sphere Handbook, population requirements for nine vitamins and minerals were found to have increased as a result of the new WHO/FAO RNIs. Conclusions The calculated requirements were adopted and published as part of the Sphere 2011 Handbook. The incorporation of these requirements into planning, monitoring, and evaluation practices for food assistance will help to ensure that populations receive appropriate nutritional support during crises.
Estimates of Exclusive Breastfeeding Rates among Mother—Infant Dyads in Quetzaltenango, Guatemala, Vary According to Interview Method and Time Frame
Authors: Van Beusekom Ilse , Vossenaar Marieke , Montenegro-Bethancourt Gabriela , Doak Colleen M. , Solomons Noel W. 
Published: November 2015

Background The World Health Organization (WHO) recommends exclusive breastfeeding, defined as receiving only breastmilk, through the first 6 months of life to optimize survival, health, and development. Objective To assess exclusive and predominant breastfeeding rates, as defined by WHO, in a sample of Guatemalan infants using three dietary assessment methods. Methods Mothers of 156 infants (78 boys and 78 girls) in the 6th month of life, attending a public health center in Quetzaltenango, an urban area located in the Highlands of Guatemala, were recruited. A single face-to-face interview was performed to assess infant dietary intake using three methods: previous day dietary recall (as suggested by WHO), current feeding practices, and recall of feeding practices since birth. Results Based on the previous day dietary recall method, exclusive breastfeeding was reported by 87 (56%) of the mothers. Exclusive breastfeeding rates were much lower when estimated by current feeding practices questions (20%) and even lower when based on recall of feeding practices since birth (9%). The sum of exclusive and predominant breastfeeding (full breastfeeding) rates was 58%, 49%, and 31% based on previous day dietary recall, current feeding practices, and recall of feeding practices since birth, respectively. Conclusions The WHO method of dietary assessment, based solely on the previous day dietary recall, overestimates the exclusive breastfeeding rate compared with recall of feeding practices since birth. In our population sample, adherence to the WHO guidelines for feeding in the first semester of infancy was less than ideal and in need of strengthening.
Implications of Acquired Environmental Enteric Dysfunction for Growth and Stunting in Infants and Children Living in Low- and Middle-Income Countries
Authors: Keusch Gerald T. , Rosenberg Irwin H. , Denno Donna M. , Duggan Christopher , Guerrant Richard L. , Lavery James V. , Tarr Philip I. , Ward Honorine D. , Black Robert E. , Nataro James P. , Ryan Edward T. , Bhutta Zulfiqar A. , Coovadia Hoosen , Lima Aldo , Ramakrishna Balakrishnan , Zaidi Anita K. M. , Burgess Deborah Hay C. , Brewer Thomas 
Published: November 2015

Changes in small bowel function early in infancy in developing countries are increasingly being demonstrated, probably accompanied by altered mucosal architecture in most individuals, including reduced enterocyte mass and evidence of immune activation and inflammation in the mucosa. These alterations appear to be the result of factors of uncertain nature in the environment, and may be a cause of growth faltering and stunting in young children. For these reasons, this constellation of findings is being referred to as environmental enteropathy, or as we propose herein, environmental enteric dysfunction. If the causes were known and effective interventions were available, strategies and policies to intervene at—or possibly before—birth could be developed and promoted in order to prevent subsequent malnutrition and recurrent infection, which are known to interact in a cyclical and synergistic manner in a downward clinical course often ending in death. Resources would be mobilized and applied differently, and the emphasis would change from treatment to prevention. In order to move in this highly desired direction, investments in research will be required to establish the criteria to assess environmental enteric dysfunction, determine its predictive value for growth faltering and stunting, identify the causes, and propose and test potential interventions. The concepts and tools are available. What is required is the decision to move forward along this pathway to better health for infants and children in low-income countries.
Effect of Poverty Reduction Program on Nutritional Status of the Extreme Poor in Bangladesh
Authors: Jalal Chowdhury S. B. , Frongillo Edward A. 
Published: November 2015

Background Poverty alleviation programs for the extreme poor improve participants' economic status and may impact other important outcomes that are seldom evaluated. A program targeted to the extreme poor by BRAC, a development organization in Bangladesh, has been successful in significantly alleviating extreme poverty. Objective We hypothesized that the program also improved the nutritional status of women and preschool children. Methods A nonequivalent control, pre- and posttest quasi-experimental design that was longitudinal at the village level was used to test the hypotheses. Data were collected from a random sample of 4,131 children and 3,551 women from 3,409 households in 159 villages of 3 northern districts of Bangladesh in 2002 and 2006. Linear mixed random-intercept models accounted for clustering effects and potential confounders. Results The weight-for-height of children between 24 and 35 months of age from program households was significantly higher ( p < .05) than that of children from control households. We found no significant differences between control and program households in three other growth and body-composition indicators in three other age categories of preschool children or in women. Conclusions These results are important, as this is a large-scale program that has already been extended to more than half the country. The findings will contribute to judging the cost-benefit and cost-effectiveness of the program and in garnering support for the expansion of such programs.