bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute vs. Delayed Iron: Effect on Red Blood Cell Iron Incorporation in Uncomplicated Malaria
Authors: Cusick Sarah E , Georgieff Michael K , Opoka Robert O , John Chandy , Abrams Steven , Mupere Ezekiel 
Published: November 2023

BackgroundGiving iron with anti‐malarial treatment is the standard of care for concurrent iron deficiency and malaria. However, iron given during a malaria episode may not be well absorbed or utilized due to malaria‐induced inflammation and consequent impaired iron absorption and utilization.MethodsWe enrolled 100 children 6–59 months with malaria and hemoglobin 5–9.9 g/dL who presented to Mulago Hospital into a randomized trial of iron supplementation started at the time of vs. four weeks after anti‐malarial treatment. All children received iron stable isotope 57Fe on Day 0 and 58Fe on Day 28, permitting measurement of percentage iron incorporation into red blood cells on those days. Children were randomized to start a 27‐day course of daily oral ferrous sulfate (2 mg/kg) that began the day after antimalarial treatment, on Day 1 (immediate iron group, n=50) or four weeks after antimalarial treatment, on Day 29 (n=50). We compared iron incorporation at the time of the start of supplementation (Day 0 immediate group vs. Day 28 delayed group, Aim 1) and hematological recovery at Day 56 between groups (Aim 2).ResultsIron incorporation was significantly greater at the time of initial supplementation in children whose iron was delayed four weeks (16.3% delayed vs. 8.1% immediate, p=<0.001). However, at Day 56, arithmetic mean (sd) hemoglobin [immediate vs. delayed: 11.6 (1.0) vs. 11.5 (1.2) g/dL, p=0.69], and geometric mean (95% CI) ferritin [40.4 (13.6, 60.0) vs. 39.6 (28.8, 54.6) μg/L, p=0.94], zinc protoporphyrin [115 (101, 130) vs. 132 (114, 152), p=0.14], soluble transferrin receptor [4.7 (4.3, 5.3) vs. 5.7 (4.9, 6.6) mg/L, p=0.05], and hepcidin [32.6 (21.5, 49.4) vs. 31.7 (24.8, 43.1) nmol/L, p=0.91] were not significantly different between the groups.ConclusionsIn children with malaria and anemia, delaying the start of iron supplementation by four weeks is associated with better iron incorporation into red blood cells, but not better hematological recovery after 56 days. Whether longer‐term outcomes of neurobehavioral development are improved with delayed iron remains to be established.Support or Funding InformationR03 5R03HD74262‐2 (NIH/NICHD)KL2 Scholar Award, ULIT000114 (NIH/NCATS)
Filling a dietary data gap? Estimating individual nutrient intakes from household‐level data in Ethiopia and Bangladesh
Authors: Coates Jennifer , Rogers Beatrice , Blau Alexander , Lauer Jacqueline 
Published: November 2023

Dietary intake data are needed for a wide variety of food policy purposes but are not consistently collected in many low‐income countries. Many countries collect household level data in Household Consumption and Expenditure Surveys (HCES), and efforts have been made to use these data to estimate individual food and nutrient intake, often based on the assumption that food is allocated to individual members according to their proportional energy requirements relative to an adult male (called an adult male equivalent, or AME). This study sought to validate the AME‐based method of estimating individual information from household‐level data using data sets from Bangladesh and Ethiopia that measured both household consumption and individual intakes. The study compared the allocation of nutrients (energy, protein, animal protein (ASP), and iron) predicted using the AME assumption with individual intakes across ten age‐sex groups. The study compared the accuracy of using AMEs based on energy with AME based on the relevant nutrient (protein, iron) and assessed the effect of further adjusting the data for meal partakers. Judged against the intakes reported by the food preparer, the energy‐weighted AME predictions resulted in more accurate intake estimates than the nutrient‐specific AME predictions. AME‐based predictions were accurate within ten percentage points of individually reported intakes in most cases, but were inaccurate among certain groups, notably infants 6–23 mo and (for some nutrients) children in Bangladesh. The AME was less accurate in predicting ASP than other nutrients. AME predictions were more accurate in Ethiopia than in Bangladesh. Adjusting for meal partakers did not consistently improve the AME‐based predictions. The authors conclude use of the energy AME can produce useful results for food and nutrition policy analysis but should be complemented with a subsample of individual intake data for further validation.Support or Funding InformationThis research work is made possible by the support of the American people through the United States Agency for International Development (USAID) under Agreement No. AID‐663‐A‐11‐00017. The contents of this document are the sole responsibility of the researcher & do not necessarily reflect the views of USAID or the United States Government.
Lipid profile, glucose and insulin are affected differently by physical activity, nutrition education or their combination in Mexican adolescents
Authors: Valdes‐Ramos Roxana , Velasco Rosa Martha , Tlatempa‐Sotelo Patricia , Guadarrama‐López Ana Laura , Benítez‐Arciniega Alejandra Donají , Martínez‐Carrillo Beatriz Elina 
Published: November 2023

Intervention programs for overweight/obese adolescents have shown limited results. We analyzed changes in the metabolic profile of 12–14 year old overweight/obese adolescents, with a nutritional education (NE), physical activity (PA) or combined program (CP). Six groups of adolescents from public schools in Tuxtla Gutierrez or Toluca in Mexico, participated during 26 weeks. Total, HDL‐and LDL‐cholesterol, triacylglycerols, glucose and insulin were measured at baseline and weeks 14 and 26. We did multivariate analysis. Highly significant (p<0.001) effects in total cholesterol by time and with study site, intervention or both were observed. HDL‐cholesterol showed a highly significant (p<.001) change by time and time by study site, intervention and study site with gender. LDL‐cholesterol, had a highly significant variation (p<0.001) in time and time by study site and a slightly significant effect (p<0.05) by time and intervention. Triacylglycerols did not show specific change patterns, with significant effects of time (p<0.01) and time by study site and intervention (p<0.001). Glucose decreased at week 14; at week 28 increases were found in females with PA and in both genders with NE from Toluca. The same was found for females with PA or NE from Tuxtla Gutiérrez. Significant effects were observed by time (p<0.001), time by study site (p<0.05) and time by intervention (p<0.01). We observed highly significant (p<0.001) effects on insulin of time by study site and a slightly significant (p<0.05) effect of time by intervention and gender. We found no consistent pattern within the programs. Apparently, any intervention can be beneficial in adolescents.Support or Funding InformationThis project was financed by Universidad Autónoma del Estado de México
Child Stunting and Maternal Undernutrition in Two Rural Ethiopian Communities Five Years after the Initiation of the National Nutrition Program
Authors: Lombamo Getahun Ersino , Henry Carol J , Regassa Nigatu , Zello Gordon A 
Published: November 2023

Addressing maternal and child undernutrition is one of the strategic objectives and a priority area agenda for the National Nutrition Program of Ethiopia. We estimated the burden of maternal and child undernutrition in two rural communities (Halaba & Zeway) of Ethiopia and compared outcomes with regional/national reports as well as explored their associations with factors such as gender, socioeconomic‐demographic factors and access‐utilization of health services. In a cross‐sectional study between March and June 2013, we used interviewer administered questionnaire to collect data from mothers in addition to various anthropometric measurements from both mothers and their <5yrs of age children in rural communities of Halaba, south Ethiopia, and Zeway, Oromiya region (n=630 mother‐child pairs, total). Findings showed that maternal undernutrition (% BMI<18.5) ranged from moderate (14%, Zeway) to high (22%, Halaba). We also found alarming levels of stunting and underweight (54% stunting, 36% underweight, in Halaba) and (42% stunting, 21% underweight, in Zeway) among children. Up to 95% of Halaba and 85% of Zeway mothers reported consumption patterns that were ‘same as usual’ or ‘less than usual’ during their most recent pregnancy compared to times of none‐pregnancy/lactation. Up 61% also reported abstaining from consumption of certain nutritious foods for cultural reasons. Factors such as gender and socio‐economic‐demographic structure of the household, including imbalance of power, physiological density, household size and dietary habits during pregnancy showed significant associations with maternal and child undernutrition (p<0.05), warranting further investigation. The observed levels of child and maternal undernutrition, particularly in Halaba areas were unexpected and of serious concern, given that a national nutrition program administered by the government has been in place for some time. This baseline study provides insights to policy and decision makers to revise and/or strengthen the nutrition programs designed to target vulnerable segments of the population in these regions.Support or Funding InformationThe research was supported by the International Development Research Centre (IDRC) and the Department of Foreign Affairs Trade and Development (DFATD), Government of Canada, through the Canadian International Food Security Research Fund (CIFSRF).
Food Sources of Fiber and Micronutrients of Concern in Diets of Young Children
Authors: O'Neill Lynda M , Reidy Kathleen C , Deming Denise M 
Published: November 2023

The Feeding Infants and Toddlers Study (FITS), 2008, identified iron and zinc as the nutrient gaps for infants and vitamin E, potassium and fiber as the nutrient gaps for toddlers, whereas sodium was reported as being consumed in excess among toddlers and preschoolers. Many studies have found vitamin D to be a dietary shortfall during early childhood. Data from FITS was used to assess the relative contributions of foods to said nutrients. Dietary intake interviews (24‐hr recalls) were carried out by telephone with parents or primary caregivers of infants 6–11 months (n=505), toddlers 12–23 months (n=925), and preschoolers 24–47 months (n=1,461). Reported foods and supplements were assigned to one of 71 food groups based on nutrient similarities and uses. Food mixtures were disaggregated into their constituent ingredients and ingredients were classified into one of the 71 groups. The population percentage contribution of each of these foods to total nutrient intake was determined for each nutrient and age group. Infant cereal was the leading source of iron in infants, providing 41% of their iron intake. Infant cereal was also the second source of zinc for infants, providing 16% of their zinc intake, with infant formula being the highest source, providing 48% of zinc intake. The top sources of fiber for all ages were grain products, which provided 14% of infants’ intake and 11% of toddlers’ and preschoolers’ intakes. Salt and seasonings were the major sources of sodium for all children, contributing approximately 20% of their sodium intake. Milk, all types combined, was the major source of potassium for all ages, contributing 46% to 32% of potassium intake, with 100% juice, potatoes and bananas making up the next three sources for both toddlers and preschoolers. Dietary supplements were the leading contributor to vitamin E for toddlers and preschoolers, contributing 22% and 44% of intake, respectively. Milk and butter/margarine were also in the top 5 sources of vitamin E for toddlers and preschoolers. Peanut butter and salty snacks were top sources of vitamin E for preschoolers (5% each) and ready‐to‐eat (RTE) cereals for toddlers (5%). Milk was the major source of vitamin D for all ages, contributing 47% to 74% of vitamin D intakes, depending on age, followed by supplements, which provided 14% to 39% of intake. Overall, supplements and foods that are typically fortified made substantial contributions to micronutrient intakes. Caregivers should be strongly advised to choose lower sodium food options and not depend on supplements for mineral and vitamin intakes. Instead, they should be encouraged to provide a wide variety of nutrient dense foods, which would instill healthy eating habits from the beginning.Support or Funding InformationNestle
Effect of Food Allergies on Growth in Children
Authors: Rhodes Katie , Crook Tina , Phelps Josh , Hakkak Reza 
Published: November 2023

Food allergies result in a food elimination, which can lead to inadequate nutrient intake if not substituted properly. Allergen elimination has been shown to correlate with inadequate growth, especially when the allergen is milk. The purpose of this study was to determine if height and Body Mass Index (BMI) could be affected by the presence of a food allergy. A parent questionnaire was used to determine characteristics of 650 children, ages 0–17 years, who had been seen in a pediatric allergy clinic. Independent‐samples t‐tests were used to determine if differences existed between mean height and BMI z‐scores in the following groups: 1) participants with food allergies compared to those without food allergies, 2) participants ages 0–5 compared to those ages 6–17, 3) participants with milk allergy compared to those with other food allergies, and 4) participants with a milk and/or soy allergy compared to those with other food allergies. Significant differences were found between the following variables: 1) mean BMI z‐scores between participants with food allergies (M= 0.5769, SD= 1.2152) compared to those without food allergies (M= 0.8021, SD= 1.1593); p= 0.023, two‐tailed, 2) mean length/height z‐scores between those with a milk allergy (M= −0.4000, SD= 1.3024) compared to those with other food allergies (M= 0.10137, SD= 1.5322); p= 0.002, two‐tailed, and 3) mean length/height z‐scores between those with a milk and/or soy allergy (M= −0.3931, SD= 1.3469) compared to those with other food allergies, (M= 0.1426, SD= 1.5124); p= 0.001, two‐tailed. Our findings suggest the presence of a milk and/or soy allergy impacts linear growth. This highlights the importance of providing appropriate nutrition education to families and children with food allergies in order to avoid nutrient deficiencies, thus improving growth outcomes.Support or Funding InformationDepartment of Dietetics and Nutrition, University of Arkansas for Medical Sciences
Maternal diet quality during pregnancy and fetal growth outcomes: a pilot study of lower‐income pregnant women
Authors: Leung Cindy W , Epel Elissa S , Bush Nicole R , Coleman‐Phox Kimberly , Adler Nancy E , Laraia Barbara A 
Published: November 2023

The effect of a healthy diet during pregnancy may have a stronger impact on pregnancy and birth outcomes and more public health relevance than the examination of any individual dietary component alone. The objective of our study was to examine the associations between overall diet quality during pregnancy, using a modified Alternate Healthy Eating Index (AHEIP)‐2010 for pregnancy, and fetal growth outcomes in a sample of 91 lower‐income, racially and ethnically diverse, overweight and obese pregnant women enrolled in an 8‐week behavioral intervention program in early pregnancy. Outcomes included birth length, weight, and weight‐for‐length Z‐scores estimated using WHO Child Growth Standards. Out of 110 points, the mean AHEIP‐2010 score in our sample was 44.8 ± 0.9. Adjusting for sociodemographic and health characteristics, infants born to women in the top tertile of AHEIP‐2010 had higher birth weight Z‐scores (β=0.79, 95% CI 0.31, 1.27, P‐trend=0.002) and higher birth length Z‐scores (β=1.17, 95% CI 0.04, 2.29, P‐trend=0.05) compared to the bottom tertile. Associations with birth weight were associated with higher intakes fruit, whole grains, and long‐chain fats, and lower intakes sugar‐sweetened beverages and fruit juice, and red/processed meat. Overall dietary quality during pregnancy, encompassing multiple healthful behaviors, was positively associated with infant birth weight and length, but not infant adiposity as measured by weight‐for‐length.Support or Funding InformationThis study was supported by the National Institutes of Health grants (U01 HL097973 and K99 HD084758 to C.W. Leung).
The Correlation Between Dairy Product Consumption and Gastrointestinal Bleed, Ovarian Cancer, and Diabetes in Infants: A Meta‐Analysis Approach
Authors: Kelly‐Newton Stashauna L , Tulp Orien L , Einstein George P 
Published: November 2023

The incidences of gastrointestinal bleeds, ovarian cancer and Diabetes in infants have recently increased. In one study, during the second six months of life, infants who were fed whole cow's milk experienced a 30% increase in intestinal bleeds and significant iron loss in stools. This is presumed to be linked to the consumption of the protein casein found in mammalian milk. Casein is the name for a family of phosphoproteins (αS1, αS2, β, κ). These proteins are found in mammalian milk, making up 80% of the proteins in cow's milk and between 20% and 45% of the proteins in human milk. Casein may be considered a potentially dangerous carcinogen. The study intends to utilize a Meta‐analysis approach for data interpretation. It intends to show a correlation between the consumption of dairy products and the correlating incidence of gastrointestinal bleeds in infants, ovarian cancers and Diabetes Mellitus. One study found that the consumption of cow's milk was associated with weakened immune function in children, which may lead to recurring infections. High circulating levels of growth factors, such as IGF‐1 and VEGF, are found in cow's milk, which are linked to carcinogens. Another Asian population's study discovered that the incidence of cancer is 1 in 100,000 compared to 1 in 12 in the West. Together these imply a correlation between diary consumption and cancers and other diseases given that there is little to no dairy consumption in the traditional Asian diet but abundant dairy consumption in the Western diet. Evaluating the data will lead to more reformed dietary approaches and further highlight the role that cow's milk and other dairy products may play in the prevalence and incidence of ovarian cancer, gastrointestinal bleed in infants and the incidence Diabetes Mellitus.Support or Funding InformationSupported by Institutional Resources of USAT and the Einstein Institute
Exclusive Breastfeeding DurationandRisk of Anemia inInfants and Young Children
Authors: Li Duo , Wang Fenglei , Liu Huijuan , Guan Yuhong , Huang Tao , Zheng Jusheng 
Published: November 2023

ObjectiveTo assess the association of exclusive breastfeeding duration with risk of anemia in infants of 12 months and children aged 48–71 months in mainland China.Methods65256 children enrolled in the Jiaxing Birth Cohort provided detailed breastfeeding information and anthropometry data at 1, 3, and 6 months of age. Hemoglobin was measured in 28105 children at 12 months and in 36128 children within 48–71 months thereafter. Anemia was defined as hemoglobin concentrations <110 g/L for children aged <60 months and <115 g/L for children aged ≥60 months.ResultsOverall anemia prevalence at 12 months and 48–71 months was 24.9% and 10.0%, respectively. Exclusive breastfeeding≥6 months, but not 3–5 months, was significantly associated with a higher risk of anemia in infants at 12 months age (OR: 1.17; 95% CI: 1.04–1.31), compared with exclusive breastfeeding<3 months. While for young children of 48–71 months of age, it was only marginally significant (OR: 1.14; 95% CI: 0.99–1.30).Prolonged exclusive breastfeeding duration was also associated with a decreased hemoglobin concentration of −0.60 g/L (95% CI: −1.12‐‐0.07) for infants at 12 months ageand −0.97 g/L (95% CI: −1.41‐‐0.53) for young children of 48–71 months of age.ConclusionsExclusive breastfeeding ≥6 months was associated with an increased risk of anemia in infants aged 12 months and lower hemoglobin concentrations in both infants and young children aged 48–71 months. Parents should be vigilant to prevent infant anemia and iron deficiency in infants exclusively breastfed for longer than 6 months.Support or Funding InformationThis study was funded by the Ph.D. Programs Foundation of Ministry of Education of China (J20130084).
The Importance of Vitamin A Supplementation Dose, Frequency and Duration On All‐Cause Mortality in Children under 5 Years
Authors: Pimpin Laura , Kranz Sarah , Fawzi Wafaie , Duggan Christopher , Mozaffarian Dariush 
Published: November 2023

BACKGROUNDPrior meta‐analyses indicated that Vitamin A supplementation reduces child mortality, but the influence of dose, frequency and duration are unclear.OBJECTIVETo investigate the effect of Vitamin A supplementation dose, frequency and duration on all‐cause mortality in children up to 5 years.METHODSWe identified and extracted de novo information on all individual publications included in the most recent and relevant meta‐analysis. We included any study using the standard WHO Vitamin A dose (50,000 International Unit (IU) < 6 months old, 100,000 IU 6–11 months, 200,000 IU >12 months). We extracted information on study identifiers, dose and frequency of vitamin A supplementation, number of participants, and numbers of deaths, as well as the original estimate of effects and associated uncertainty. We conducted univariate and multi‐variate meta‐regression on frequency of doses (per year), duration of supplementation (years) and total age‐standardized dose (IU). We conducted sensitivity analyses with and without one large controversial trial (DEVTA).RESULTSWe identified 16 trials including 204,494 children aged 33 months (SD 14.5) on average at randomization. Frequency of supplementation ranged from 4 times a year to once in 2 years. Duration of supplementation ranged from 5 months to 5 years (mean=18.5; SD 13.8). Total age‐standardized cumulative dose ranged from 200,000 to 1,400,000 IU. Overall, vitamin A compared to none reduced mortality by 26% (95%CI 13, 37); P=0.001. Increasing frequency of supplementation, per dose per year OR=1.04 95%CI=0.95, 1.14; P=0.368 did not affect the protective effect of Vitamin A on mortality. Similarly, neither did increasing the duration of supplementation (per year) OR=1.01 95%CI=0.66, 1.54; P=0.951 nor the total age‐adjusted cumulative dose (total IU) OR=1.00 95%CI=0.99, 1.00; P=0.368.Multivariate analyses showed similar results. The inclusion or exclusion of the DEVTA trial to the analyses did not affect the overall results.CONCLUSIONThe results confirmed beneficial effect of vitamin A supplementation in children less than 5 years, without significant influence of dose frequency, duration of dosing or age‐standardized total dose within these ranges. These novel findings can help inform the development and efficiency of Vitamin A supplementation policies.Support or Funding InformationBill & Melinda Gates Foundation