bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combating Hidden Hunger: The Role of International Agencies
Authors: Dalmiya Nita , Schultink Werner 
Published: November 2015

The importance of micronutrient deficiencies or “hidden hunger” was clearly emphasized by the inclusion of specific goals on iron, vitamin A, and iodine deficiency at the 1990 World Summit for Children and other major international nutrition conferences. Significant progress has since been made toward eliminating vitamin A and iodine deficiencies, with less progress made toward reducing the burden of iron-deficiency anemia. The role of international agencies, such as the World Health Organization, United Nations Children's Fund, Food and Agricultural Organization, and World Bank in assisting countries to make progress toward the World Summit for Children goals has been very important. International agencies have played a critical role in advocating for and raising awareness of these issues at the international, regional, and national levels among policymakers and the general population. Using a rights-based approach, UNICEF and other agencies have been instrumental in elevating to the highest political level the discussion of every child's right to adequate nutrition. International agencies have also been very supportive at the national level in providing technical guidance for programs, including monitoring and evaluation. These agencies have played a critical role in engaging the cooperation of other partners, including bilateral donors, non-governmental organizations, and the private sector for micronutrient programs. Furthermore, international agencies provide financial and material support for micronutrient programs. In the future, such agencies must continue to be heavily involved in programs to achieve the newly confirmed goals for 2010. The present paper focuses on the role of international agencies in combating micronutrient deficiencies, drawing on the lessons learned over the last decade. The first section of the paper summarizes the progress achieved since 1990, and the second section describes the specific role of international agencies in contributing to that progress.
Adding An Oxidant Increases the Stability of Iodine in Iodized Salt
Authors: Shi Huimin 
Published: November 2015

It has been shown that moisture plays a critical role in the stability of iodine and that reducing agents in iodized salt reduce the stability of iodine. We question whether this is valid in all cases, and have found that the reducing agent may play a more important role than moisture in decreasing the stability of iodine. We reviewed current methods to enhance iodine retention in iodized salt, and propose methods to produce stable iodized salt and to analyze its stability. Our experiments showed that when reducing impurities are removed, iodine remains stable in iodized salt, even when the salt is “wet.” We suggest that the stability of iodine in iodized salt can be improved by oxidizing iodized salt with sodium hypochloride, and that the iodine content of iodized salt, after heating at 120°C for one hour, can be used to reflect the quality of iodized salt. We have demonstrated that reducing agents play a critical role in the stability of iodine in iodized salt. We have shown a method of purifying salt by removing reducing materials, which can be used to produce iodized salt with sufficient stability at lower cost. We also propose an analytical method to determine the stability of iodine in iodized salt. These methods could be further developed to achieve better accuracy, precision, and reliability and be applied to a greater variety of iodized salts.
Nutrient Addition to Corn Masa Flour: Effect on Corn Flour Stability, Nutrient Loss, and Acceptability of Fortified Corn Tortillas
Authors: Rosado Jorge L. , Cassís Lorena , Solano Lourdes , Duarte-Vázquez Miguel A. 
Published: November 2015

Background Iron, zinc, and vitamin B complex are among the most prevalent nutritional deficiencies in Mexico, with iron deficiency being the leading cause of anemia. Mexico has the highest per capita consumption of corn in the world, consumed mainly as tortilla. Thus, corn flour for making tortillas has been suggested as an effective strategy to overcome malnutrition in developing countries such as Mexico where corn is a staple food. The stability of micronutrients added to food is an important factor for the success of fortification programs. Objective The aim of this study was to evaluate the stability of corn flour fortified with micronutrients, and to measure the effect of micronutrient fortification on the sensory quality and stability of the fortificants in fresh and stored tortilla. Methods A commercially homogenized nonfortified corn flour (NCFC) produced from degermed white corn was fortified with a premix containing iron, zinc, thiamin, and riboflavin. Changes in thiamin, riboflavin, iron, and zinc content in fortified corn flour (FCF) and nonfortified corn flour (NFCF) during storage were investigated. Vitamin B1 and B2 content was determined by fluorescence spectroscopy while iron and zinc content was analyzed by atomic absorption. Results Thiamin content in FCF and NFCF showed a significant ( p < .05) decrease (24% and 37%, respectively) after 90 days of storage. Riboflavin losses of 18% and 22% were observed for FCF and NFCF, respectively. FCF retained over 90% of iron, while zinc content remained constant. Losses of thiamin (27 to 39%) and riboflavin (37%) were produced during the process to convert corn masa flour into tortillas. Conclusions Storage time slightly affected the stability of riboflavin and thiamin in FCF while the cooking process produced considerable losses of both vitamins. Tortillas made from FCF were well accepted by Mexican adults. We conclude that the addition of vitamins and minerals in the forms and quantities used in this study do not modify the shelf-life of corn flour, and neither do they cause sensorial changes in tortillas made from FCF.
Assessment of the Nutritional Impact of Agricultural Research: The Case of Mungbean in Pakistan
Authors: Weinberger Katinka 
Published: November 2015

Background Evaluation of agricultural research often neglects consumption and nutrition aspects. Yet agricultural research can address micronutrient malnutrition by improving both quantity and quality of food intake. Objective To briefly review the conceptual linkages between agriculture and nutrition, to estimate the strength of the relationship between iron intake and productivity outcomes, and to estimate the nutritional benefit of improved mungbean varieties in terms of net present value. This paper presents a methodology for assessing the nutritional impact of mungbean, and summarizes current impact evidence on the path from mungbean research to consumption. Methods A consumption study was conducted among female piece-rate workers in Pakistan to analyze the impact of iron consumption on productivity, measured in wages. A two-stage least-squares analysis was used to estimate the elasticity of iron intake on wages. The results derived from this study were extrapolated to country level using secondary data sources. Results We found that anemia among women was widespread. Approximately two-thirds of women suffered from mild or severe anemia (Hb < 12 g/dL). We found the elasticity of bioavailable iron on productivity measured in wages was 0.056, and the marginal effect was 9.17 Pakistani rupees per additional mg of bioavailable iron consumed. Using the model results we estimated the impact of mungbean research on nutrition, in terms of productivity effects, and found it was substantial, ranging from US$7.6 to 10.1 million cumulative present value (in 1995 US$ at 5% discount rate). Conclusions Agriculture certainly plays an important role in the reduction of malnutrition. Agricultural research has greatly contributed to the reduction of hunger and starvation by providing millions of hungry people with access to low-cost staple foods. Now, as the challenge shifts to the reduction of micronutrient deficiencies, more efforts must be directed toward crops high in micronutrients, such as pulses and vegetables.
Effects of a Food Supplementation Program on the Nutritional Status of Pregnant Women in Bangladesh
Authors: Khan M. Mahmud , Ahmed Shakil , Protik Ali Ehsan , Dhar Badal Chandra , Roy S. K. 
Published: November 2015

Background The Government of Bangladesh implemented a comprehensive nutrition intervention in 1997 to reduce the rates of malnutrition among women and children. The pilot program, the Bangladesh Integrated Nutrition Program (BINP), adopted a multisectoral approach targeting women and children through food supplementation, home gardening, and health and nutrition education. Objective This paper estimates the effectiveness of BINP's food supplementation and nutrition education on the nutritional status of pregnant women. Methods Three effectiveness measures were considered: target efficiency, improvements in the nutritional status of beneficiaries, and the persistence of nutritional effects. To isolate the effects of the intervention, the nutritional status of participants and nonparticipants was compared after controlling for various demographic and socioeconomic characteristics. Data were collected in 2000 from a random sample of 3,262 households in a BINP intervention area. Results Thirty-nine percent of pregnant women were correctly targeted by the program's food supplementation activities. The nutrition program reduced the prevalence of thinness among participant pregnant women by about 3 percentage points per month of enrollment. The prevalence of thinness among program graduates was 62%, which was much higher than that of the matched (nonparticipant) group (35%). This finding is perplexing but it may simply imply that those who enrolled at the initial phase of the project were severely underweight and they fell back to their original status within a short period of time. Conclusions The nutrition program was intended to improve the nutritional status of women in the longer run through the provision of nutrition education during the food supplementation phase. The prevalence of thinness or severe underweight in women who exited the program after completion of the enrollment period was found to be much higher than in women of similar age and socioeconomic status in the community. This apparent lack of persistence of program benefits requires careful re-evaluation of alternative mechanisms for improving the long-term nutritional status of women.
Effect of Iron Supplementation during Pregnancy on Birthweight: Evidence from Zimbabwe
Authors: Mishra Vinod , Thapa Shyam , Retherford Robert D. , Dai Xiaolei 
Published: November 2015

Background Iron deficiency in pregnant women has been shown to reduce the oxygen supply to the fetus, cause intrauterine growth retardation, and increase the risk of premature delivery and reduced birthweight. Yet the effects of iron supplementation programs on pregnancy outcomes are not well documented for developing countries. Objective To examine the relation between iron supplementation of mothers during pregnancy and children's birthweight using data from a national population-based survey in Zimbabwe. Methods The analysis uses information on 3,559 births during the five years preceding the 1999 Zimbabwe Demographic and Health Survey. The effect of iron supplementation during pregnancy on birthweight was estimated by multiple regression, controlling for potential confounding effects of prenatal care, child's sex and birth order, mother's education and nutritional status (measured by body-mass index), household living standard, smoke exposure, and other variables. Results Babies born to mothers who received iron supplementation during pregnancy were 103 g heavier (95% confidence interval, 42–164; p = .001), on average, than babies born to mothers who did not receive iron supplementation during pregnancy. The difference was 64 g (95% confidence interval, 2–125; p = .043) for children whose birthweights were taken from health cards and 163 g (95% confidence interval, 44–281; p = .008) for children whose birthweights were reported by their mothers. Conclusions Iron supplementation during pregnancy is associated with significantly higher birthweight, independent of other pregnancy care factors, mother's nutritional status, smoke exposure, and a number of demographic and socioeconomic factors. Prenatal iron supplementation programs can improve pregnancy outcomes and promote child survival in developing countries.
Power from Below: Enabling Communities to Ensure the Provision of Iodated Salt in Kyrgyzstan
Authors: Schüth Tobias , Jamangulova Tolkun , Janikeeva Shaken , Tologonov Temir 
Published: November 2015

Background In Kyrgyzstan, as in many countries around the world, progress in universal salt iodization has been slow because of difficulties in enforcing existing national regulations. Objective To study the effects of community testing of the iodine content of salt in households, at local retailers, and at wholesale markets on the percentage of households using iodized salt in Naryn Oblast, a region of Kyrgyzstan. Methods In response to a stated community priority to address iodine deficiency in Naryn Oblast, volunteers from village health committees and personnel of Primary Health Care units living in the communities were trained in testing salt using test kits. A phased introduction of two testing components was conducted in 2002–2003 in two areas with a combined population of 160,000. The two components included testing of salt for iodine content by community members in as many households as possible (Component 1) and testing of retail salt for iodate content by community members and by retailers at wholesale markets (Component 2). Results from these two components provided the data for this study. Results For Component 1, salt testing reached 65% of households; coverage of iodized salt increased from 87.6% to 96.8% within 5 to 7 months (averages of the two areas; p < .001), mostly owing to a great decrease in the variation among settlements. For Component 2, in area 1, the percentage of households using iodated salt increased from 71.0% to 90.3% within 5 to 7 months, whereas the percentage of households using iodinated salt decreased from 18.6% to 5.6%. In area 2, the percentage of households using iodated salt increased from 65.2% to 76.2% within 5 to 7 months, with no change in the percentage of households using iodinated salt (21.7% and 20.8%). The differences between areas 1 and 2 are highly significant ( p < .001). At 18 to 21 months, the percentage of households using iodated salt was 97.5% in area 1 and 90.2% in area 2. The intervention cost around US$1,500. Conclusions Testing salt in a large percentage of households is an effective, low-cost approach to increasing the percentage of households using iodized salt to satisfactory levels in a very short time. Empowering community members to check salt at retailers and retailers to check salt at wholesale markets with test kits for iodated salt can rapidly ensure almost exclusive consumption of iodated salt in households.
Accuracy of Child Growth-Monitoring Weights Obtained by Commune Volunteers in Phu Tho Province, Vietnam
Authors: Huong Van Thuy , Duc Thach Tran , Tuan Tran , Ha Tran Thu , Marsh David R. 
Published: November 2015

Background Weight-for-age is a commonly used indicator of the health of children and communities. We determined the accuracy of health volunteers' weight measurements in a nutrition project in Vietnam. Objective To report the accuracy of the volunteers' weight measurements and to assess the likely effect of any inaccuracies. Methods Save the Children /USA trained health volunteers to weigh children (6–36 months old) every other month from December 1999 to August 2000. Trained researchers randomly rechecked 257 weights (range, 24–114 per session). We computed nondirectional and directional differences between the weights measured by volunteers and those measured by researchers. Results The weights recorded by volunteers were lower than those recorded by researchers by an average of 30 g ( p < .05). Almost all of the error occurred during the first weighing session, at which the average weight recorded by volunteers was 280 g below that recorded by researchers ( p = .01). The error at subsequent weighings was minimal (< 20 g below reference at each session). Conclusions One-time directional error suggests bias. Perhaps some communities (or families) influenced the volunteers to report weights lower than those actually observed to justify the programmatic food supplements or to give the impression at subsequent weighings that the level of malnutrition had been successfully reduced from that at the first session. Careful supervision of measurements of weight at baseline is essential.
The Promise of a Community-Based Approach to Managing Severe Malnutrition: A Case Study from Ethiopia
Authors: Chaiken Miriam S. , Deconinck Hedwig , Degefie Tedbabe 
Published: November 2015

Background Community-based therapeutic care (CTC) is a new strategy in the arsenal of techniques to manage complex nutritional emergencies in rural communities. The CTC approach uses a newly developed ready-to-use therapeutic food, Plumpynut, to rehabilitate severely malnourished children in their home communities. Emerging literature has suggested the CTC strategy yielded results that were superior to those of programs limited to therapeutic feeding centers, as measured by rates of coverage and numbers of children rehabilitated. Objective To compare the effectiveness of the CTC strategy in combination with conventional treatments for acute malnutrition. The expectation was that this program would support the growing consensus on the effectiveness of CTC strategies. Methods Data from monitoring the initial phase of program implementation were reviewed to ascertain program impact. The number of children participating and the outcome of their participation were assessed. Results Families became key participants in the rehabilitation of their children, and communities became strengthened through the mobilization of local networks and the improved knowledge base of local health workers. Recovery rates were comparable with international standards, and coverage far exceeded that of traditional center-based care. Conclusions CTC is an important tool to effectively address nutritional emergencies and may be a valuable entry point for long-term development, since it fosters capacity building and improvement in local communities. CTC programs may eventually be viewed as the entry point for more sustained development-oriented interventions, thus helping make the transition from relief to development.
Constraints on Good Child-Care Practices and Nutritional Status in Urban Dar-Es-Salaam, Tanzania
Authors: Kulwa Kissa B. M. , Kinabo Joyce L. D. , Modest Beata 
Published: November 2015

Background Care is increasingly being recognized as a crucial input to child health and nutrition, along with food security, availability of health services, and a healthy environment. Although significant gains have been made in the fight against malnutrition in Tanzania, the nutritional status of preschool children in urban areas is not improving. Objective To assess child-care practices and the nutritional status of infants and young children with the aim of improving feeding practices and child nutritional status. Methods A cross-sectional study was undertaken in urban Dar-es-Salaam, Tanzania. The study involved 100 randomly selected mothers of children 6 to 24 months old from households in Ilala Municipality, one of the three municipalities that constitute the Dar-es-Salaam City Council. Data were collected by a structured questionnaire, spot-check observations, and anthropometric measurements. Results The prevalence rates of stunting, underweight, wasting, and morbidity were 43%, 22%, 3%, and 80%, respectively. The prevalence of exclusive breastfeeding was very low (9%), and most stunted children (88%) were not exclusively breastfed for the first 6 months. The mean age at which complementary foods and fluids were introduced was 3.26 ± 1.12 months (range, 1 to 5 months). The fluids given were mainly water and thin cereal-based porridge. More than half of the households practiced good hygiene. Most of the psychosocial practices (e.g., caregiver's attention, affection, and involvement in child feeding, hygiene, health care, and training) were performed by mothers, except for cooking and feeding the children and child training, which were done mostly by alternative caregivers. Nearly half of the mothers (44%) worked out of the home. The mean number of working hours per day was long (10.32 ± 2.13), necessitating the use of alternative caregivers. A negative correlation was found between height-for-age z-scores and the number of hours mothers worked outside the home. Conclusions The prevalence rates of chronic malnutrition and morbidity are high, and child-feeding practices are inadequate in this urban population. Maternal employment and educational characteristics constrain good child-care practices, and alternative caregivers are taking a more important role in child care as mothers join the work force. We recommend that formative research be conducted to study the actual practices of caregivers in order to form the basis for a child-care education program. There is also a need to strengthen national health system support for improved child feeding.
Weaning Foods and Their Impact on Child-Feeding Practices among Low-Income Nigerian Mothers
Authors: Ijarotimi Oluwole Steve , Ogunsemore Michael Temidayo 
Published: November 2015

Background Many children in rural communities of developing countries die of nutrition-related causes due to lack of nutrition education and low purchasing power of the families, which result in low-quality weaning foods and poor feeding practices. Objective To evaluate the nutritional composition of local weaning foods and their impact on child feeding practices among low-income Nigerian mothers. Methods A cross-sectional survey was conducted between March and June 2005 among 294 randomly selected pairs of nursing mothers and their children who attended the postnatal clinic of State Specialist Hospital and Comprehensive Health Centers in Akure community, Ondo State, Nigeria. A structured, self-or interviewer-administered questionnaire was used to collect information on infant demographic characteristics, feeding, and socioeconomic characteristics of the parents. The children's weights were recorded, and samples of the weaning foods were analyzed. Results The mothers' ages ranged from 22 to 37 years, and the children's from one to 12 months. Among the parents, two-fifths of the respondents worked as drivers, mechanics, carpenters, and the like, while the remaining respondents were civil servants, health professionals, teachers, merchants, and housewives. The educational attainment of the parents ranged from no formal education (1.4%) to higher education (46%); 13% had completed primary school, and 39.6% had completed secondary school. The average monthly family income was between 3,500 and 30,000 naira (US$23.3–$200). Among the children, 58.3% were of normal weight, 41.1% were mildly underweight, 0.3% moderately underweight, and 0.3% severely underweight; 23.1% were exclusively breastfed, 9.5% received breastmilk and traditional medicinal herbs, 15.6% received breastmilk and commercial weaning food, 7.4% received commercial weaning food only, 14.8% received local weaning foods only, 24.1% received local weaning foods plus breastmilk, and 5.8% received the family diet. Conclusions We found that a high proportion of the nursing mothers used local ingredients to formulate weaning foods for their babies. The nutritional compositions of these foods is of high quality and are suitable as weaning foods, particularly for infants of low-income parents who do not have access to commercial weaning foods.