bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multisectoral Nutrition: Feasible or Fantasy?
Authors: Pelletier David , Gervais Suzanne , Hafeez‐ur‐Rehman Hajra , Sanou Dia , Tumwine Jackson 
Published: November 2023

Undernutrition has received unprecedented attention, financing and policy focus in recent years. One example is the Scaling Up Nutrition (SUN) movement, with over fifty countries engaged and pursuing a multisectoral nutrition (MSN) approach. This presentation describes the extraordinarily high requirements for MSN to achieve impact and assesses the likelihood of countries achieving impact under current conditions. It is based on the results of a two‐year, prospective study of the challenges, strategies and accomplishments in implementing a multisectoral approach to stunting reduction in four of the African SUN countries: Burkina Faso, Ethiopia, Mali and Uganda. The requirements for effective MSN include various forms of commitment, coordination and capacity at individual, organizational and system levels, involving multiple government organizations, donors, implementing agencies, civil society organizations and the private sector, extending from national to community levels. Few of these requirements were met in the four study countries, yet each of them made significant progress in four major areas: Strengthening the enabling environment, cascading MSN to sub‐national levels, aligning stakeholders and the practice of adaptive management and learning. While this progress is encouraging, these countries remain at fairly early stages of building the MSN system and continue to face many challenges. Most of these challenges can be addressed by placing a high priority on three high leverage system investments: strengthening human resources in the MSN coordinating unit, creating a small but full‐time implementation team and ensuring that accurate information on critical bottlenecks is conveyed and acted upon in a timely fashion by high level decision makers in government and partner organizations. In the absence of such investments it is uncertain whether or how MSN can become effective or sustainable within a time frame that is acceptable to politicians and international donors.Support or Funding InformationUNICEF Regional Offices in Western/Central Africa and Eastern/Southern Africa.
The Role of Women's Status in Agricultural Commercialization, Production Diversity and Dietary Diversity in Ethiopia: Results from a 2012 National Integrated Agriculture and Socio‐economic Survey
Authors: Coates Jennifer , Galante Tina 
Published: November 2023

Evidence of the relationships between increased production of nutritious food crops, the diversity of crop production, and linkages to improved overall dietary quality is inconclusive. Similarly, there is controversy over whether agricultural commercialization leads to healthier, more diverse diets and for whom. The study of smallholder households in Ethiopia sought to answer the following 3 questions: 1) is agricultural commercialization associated with greater household dietary diversity and, if yes, under what circumstances? 2) Is greater food production diversity associated with dietary diversity? To what extent does the production of a specific food group increase the likelihood of its consumption? 3) To what extent do female headship and women's empowerment mediate these relationships?An OLS regression model using data from the 2012 Living Standards Measurement Study‐Integrated Surveys on Agriculture (LSMS‐ISA): Ethiopia Rural Socioeconomic Survey found that greater income from agricultural sales, controlling for non‐agricultural income and other confounding variables, was associated with higher household dietary diversity, with female‐headed households experiencing greater diet diversity from commercialization than male‐headed households.Regardless of headship, dietary diversity was greater in households where a female owned at least one large asset, intended as an indicator of empowerment. The same model demonstrated that greater food crop production diversity was not significantly associated with greater dietary diversity, while cash crop diversity was found to be positively associated with dietary diversity. Furthermore, results from logistic regression models showed that households producing vegetables, fruit, pulses, dairy, and eggs had a higher chance of consuming these foods than those that did not produce the foods at all. The results suggest that smallholder agricultural commercialization may improve household diet through increased income. Additionally, policies that focus on increasing production of nutrient‐rich foods and policies that empower women and enable them to have greater control over assets and other decision‐making may likely see improved dietary diversity both together with, and independent of, commercialization efforts.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.
Meal Consumption Patterns Among Recipient of the School Nutrition Programme in Trinidad and Tobago
Authors: Francis Marlon , Nichols Selby 
Published: November 2023

The National Dietary Services Limited makes available over 90,000 lunches to primary and secondary schools in Trinidad and Tobago. The purpose of this study was to evaluate the factors influence meal consumption among recipients.Methods3,120 school lunches were randomly assigned to participant attending 52 randomly selected primary schools in Trinidad and Tobago. Participants in receipt of the specially marked boxes were advised by the class teachers to return the boxed to designation stations when there were finished with their meal. The remnants of the meals were analyses and recorded by quality officers specially trained for the investigation. We used a cutoff of 75% of more of meals consume as our cutoff for adequacy of consumption of that particular meal component. Approvals was granted by the Ministry of Education to conduct this survey. Participation by the students was voluntary.Results2009 or 65% of specially marked boxes were returned for analyses. Overall, we found significant linear trends in the adequacy of consumption of foods from animals and staples with age. Male were significant more likely that their female counterparts to have adequate consumption of staples. Vegetables were generally poorly consumed.ConclusionMeals uptakes were influenced by age, sex and the nature of the meal served.
The impact of a pricing and communications intervention on stocking and sales of healthier foods in small Baltimore City food stores
Authors: Budd Nadine , Kharmats Anna , Jeffries Jayne K , Jones‐Smith Jessica , Gittelsohn Joel 
Published: November 2023

Improving food environments and increasing access to healthy foods has been identified as a key strategy for obesity prevention and reduction. B'More Healthy Retail Rewards was a 6‐month factorial randomized controlled trial that tested the impact of a communications and pricing intervention on the stock and sales of healthier foods, including drinks, staple foods, and snacks, at multiple levels of the local food system. Twenty‐four small food stores in low‐income areas of Baltimore City were randomized to one of four treatment groups: pricing only (G1), communications only (G2), combined pricing and communications (G3), and control (G4). Pricing stores (n=12) received a 10–30% discount on promoted foods from their local wholesaler. Communications stores (n=12) received signage, small refrigerators, and other materials to help increase stock and sales of promoted foods. Regression‐based difference‐in‐difference models using linear generalized estimating equations were used to estimate treatment effects from baseline to post‐intervention (Δ outcome for treatment group ‐Δ outcome for control). Intervention effects were observed for stocking scores of promoted foods for all treatment groups verses control group, with the greatest effects seen among the two pricing interventions (G1: β=3.6, 95% CI 1.3–5.9; G2: β=2.5, 95% CI 0.7–4.3; G3: β=3.5, 95% CI 0.8–6.2). There was a significant treatment effect for daily unit sales of healthy snacks for the combined pricing and communications intervention (β=6.4, 95% CI 0.9–11.9) versus control, but not for other intervention groups. These findings suggest that store‐directed pricing interventions are most effective in motivating store owners to stock healthier foods, with additional integration of targeted communication strategies further motivating customers to purchase these foods.Support or Funding InformationFunding was received by National Heart, Lung & Blood Institute (Grant #1R21HL102812‐01A1), the Abell foundation, and Johns Hopkins Global Obesity Prevention Center.
Vitamin A fortification of vegetable oil in Bangladesh
Authors: Raghavan Ramkripa , Aaron Grant J , Neufeld Lynnette M , Rahman Sabuktagin , Nahar Baitun , Knowles Jacky 
Published: November 2023

ObjectiveMandatory fortification of vegetable oil (soybean and palm oil) with vitamin A was decreed in Bangladesh in 2013, but there is a dearth of data on the availability and consumption of vitamin A fortifiable and fortified oil at retailer and household (HH) level.MethodsData on household use and purchase of edible oil was collected as part of a 2015 national iodized salt coverage survey. Stratification was done by urban and slum (combined), rural low performing (program performance for salt iodization) and rural other. The survey included collection of information about household vulnerability to poverty (deprivation) to assess equity of access to fortified/fortifiable products. Individual oil consumption was estimated based on reported frequency and quantity of oil purchased and expected intra‐HH distribution according to FAO recommended adult male consumption (AME) method. Commercially produced soy and palm oil samples were also collected from local retail outlets for analysis of vitamin A content. The final national sample included 1512 HH and 756 retailer shops from 126 primary sampling units nationwide.ResultsPurchase of commercially produced fortifiable vegetable oil was high (86.5% HHs) but varied significantly by strata, being highest in urban areas (93.9%) and lowest in rural low performing areas (80.4%). More deprived HHs were less likely to purchase fortifiable vegetable oil (81.4%) when compared to non‐deprived HHs (89.7%) ‐ p value ‐ <0.001 for all above differences. Estimated individual fortifiable oil consumption was highest among Women of Reproductive Age (WRA) in urban areas (27.20 g/day), and lowest in rural‐low performing areas (18.94 g/day). A similar pattern of statistically significant differences in fortifiable oil consumption between strata was observed for all age groups except for 12–23 month olds in rural low performing vs. rural‐other. Preliminary analysis suggests that if commercially produced oil were fortified at recommended level of 19ppm (suggested range 15–30 ppm), it would meet 26.5% and 51.2% vitamin A RNI for children (12–59 months old) and WRA respectively.ConclusionThis survey indicates wide availability (>80%) of commercially produced (fortifiable) oils among all population groups, together with widespread consumption of oil for children 12–59 months old (8.28 g/day vs. 9.97 g/day in more and less deprived HH, respectively) and WRA (20.11 g/day vs. 25.37 g/day in more and less deprived HH, respectively). These data show that soybean and palm oils are appropriate vehicles for vitamin A fortification, and even deprived households can be reached using this vehicle. Future work will include an assessment of current actual additional vitamin A intake estimates, based on the results of the oil sample retinol analysis.
The Influence of Korean high school students’ midnight snacks on their breakfast‐skipping pattern
Authors: Kim Young A , Kim Ji‐Hyun 
Published: November 2023

This study was conducted to provide basic information about the influence of midnight snacks on high school students’ breakfast‐skipping pattern. 1,010 students from 5 high schools were surveyed using a questionnaire in the region of Incheon and Bucheon, the metropolitan area of Korea. In the aggregate, 71.2% of the students had a midnight snacks more than once a week. Boys (74.9%) had more midnight snacks than girls(67.4%). When the students purchased foods midnight snack‐taking group gave higher priority on taste (66.9%) and quantity (8.6%) than the other students (54.0% and 7.2%). Boys tended to choose (50.4%) and have (34.0%) midnight snack alone, while girls do with their families (41.5%, 37.6%). 42% of students used to skip breakfast meal more than 3 times a week, and the ratio found higher with the students got up late in the morning (67%).The students who have midnight snacks once or more in a week appeared lower having breakfast ratio (43.8%) than others (56.4%). Also the students who have midnight snacks had less desirable eating habits (examined with 17 criteria) than others. But most of the students (75.8%) did not notice the relationship between midnight snacks and breakfast.Therefore, proper nutrition education to let students know about the effect of midnight snack is strongly required to reduce breakfast skipping ratio of the students.Support or Funding InformationGrant Funding Source: Inha University
Cooking Meals More Frequently, Eating More Fruits and Vegetables, and Less Fast‐Foods among Students in Nutritional Sciences Majors than Non‐majors
Authors: Taylor Brittney R. , Pope Benjamin T. , Franklin Alexandra M. , Harris Preston R. , Wyatt Bobby , Hongu Nobuko 
Published: November 2023

BackgroundResearch shows that cooking meals improves diet quality among students. However, there is no evidence that undergraduate students in nutrition or dietetics programs cook more meals while they are learning about foods and its impacts on human health. The purpose of this study was to examine the types and frequency of meal preparations among undergraduate students in the nutritional sciences department and other departments in a University.MethodsAn 11‐question survey was completed by 238 nutritional science majors (NS‐majors) and 91 non‐nutritional science majors (non‐majors). Questions included demographics, the consumptions of fruits and vegetables and fast‐foods (ready‐to‐eat foods), and number of prepared meals per week. They were asked to specify whether each meal was prepared using one of two techniques. These were: 1) cooking techniques, including meal‐preparation activities such as washing, chopping, mixing, roasting, and seasoning, and 2) preparing techniques, including simple meal preparation, involving a microwave or making a bowl of cereal. Descriptive statistics and multiple linear regression were used to analyze data.ResultsNS‐majors cooked meals more often using cooking techniques than non‐majors (p=0.059). When comparing the students in freshman and senior NS‐majors, senior NS‐majors cooked more meals than freshman NS‐majors (p=0.023). The senior NS‐majors also consumed more vegetables compared to freshman NS‐majors (p=0.001). The students in both NS‐majors and non‐majors who are living in apartments, houses, or condos, or with parents, relatives, or spouses cooked more meals using cooking techniques than students living in dorms (p=0.006). NS‐majors consumed significantly less fast‐foods than non‐majors (p=0.022).ConclusionsThere were significant associations between the level of NS‐majors and numbers of cooked meals, eating more fruits and vegetables, and less consumption of fast food. We are planning to have focus group meetings with NS‐majors to determine factors influencing the increased numbers of cooking meals and improving eating habits, such as increasing consumption of fruits and vegetables.
Practical usage and educational requirement analysis about school meal menu of middle schools in Incheon region
Authors: Kim Young A , Kang Soo‐kyung 
Published: November 2023

The purpose of this study was to examine practical usage and understanding status of school meal menu in Incheon region. 1,090 middle school students (49% boys and 51% girls) were surveyed in Incheon, one of 5 major cities in Korea, using a questionnaire.57.2% of students got the middle rating for the nutrition knowledge test, while 23.7% got high rating, 19.1% got low rating. The students who had better understanding about their school meal menu got much higher score about their nutrition knowledge. The students who usually check up the school meal menu got average nutrition knowledge score 6.26±2.11, while the other students got 5.31±2.72. Also, the students experienced nutrition education scored 6.47±1.91, while the others got 6.00±2.32. The girls got higher score (6.20±2.09) than the boys (6.06±2.36). The major method to check up the school meal menu was the school newsletter, and normally they check the menu up right before the meals. They thought the allergy mark was the most important factor in the school meal menu.72.5% of the students have never experienced any nutrition education, and 46.7% of them acknowledged the necessity of nutrition education. The most wanted factor to be added in the school meal menu was photograph of the real foods.Therefore, proper nutrition educations and improvement of school meal menu are highly required to enhance students’ practical dietary life.Support or Funding InformationGrant Funding Source: Inha University
PAWS (Peer‐education About Weight Steadiness) Club: Rationale and Design for a Randomized Controlled Study
Authors: Muzaffar Henna , Nickols‐Richardson Sharon M. 
Published: November 2023

Overweight has been recognized as a significant problem for children and adolescents in the U.S., and numerous societal sectors support the commitment of resources for school‐based multicomponent programs that include the promotion of a healthy diet and physical activity. Peer leaders have been used successfully as facilitators in behavioral change programs but have not been widely used in childhood obesity prevention programs.The aim of this study is to evaluate the effects of a12‐lesson nutrition and physical activity program (PAWS Club), administered in the Urbana‐Champaign (IL) area middle schools, on basic culinary skills, food and physical activity behaviors, body weight (BW) and body mass index (BMI) percentiles, blood pressure (BP), and social cognitive theory (SCT) variables at the end and 6 months after implementation of the program. A peer‐led mode of program delivery will be compared to an adult‐led mode.The PAWS Club will be delivered as an after‐school program in local middle schools and will target early adolescent children, ages 11–14 y, in support of childhood obesity prevention. The 12‐week program will test a peer‐education mode of delivery vs. adult‐education mode and focus on balancing calories to manage BW, reducing certain foods and food components, increasing selected foods and nutrients, building healthy eating patterns [i.e., fundamental principles of the Dietary Guidelines for Americans (DGAs), 2010] and SCT variables. Parents of the study participants will have the opportunity to participate in 5 parent sessions focused on menu planning, healthy food intake and physical activity behaviors. Data will be collected at baseline (pre‐intervention), after the 12‐week program (post‐intervention) and 6 months after completion of the program (maintenance). Each weekly lesson includes: 1) 20–30 minutes of moderate physical activity; 2) nutrition activities; 3) discussions; 4) self‐reflections; 5) goal setting activities for healthier eating and physical activity; 6) food and beverage tasting experience; and 7) parent‐child reflections. Program items, such as aprons and cooking utensils, will be distributed throughout the 12‐week intervention. Study personnel will be present at each lesson, along with graduate student trainees to monitor each session.The PAWS Club program was pilot‐tested in the Urbana Middle School (IL) as a randomized controlled trial (RCT) in September‐October 2015. In total, 35 adolescents were randomized to the peer‐led (n=14) and adult‐led (n=21) groups.This RCT is one of the first to examine peer‐vs. adult‐led mode of delivery for an obesity prevention program in middle schools. Results of this study will provide support for evidence‐based practice in childhood obesity prevention.Support or Funding InformationFunding disclosure: This material is based upon work that is supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, under award number 2012‐68001‐22032.
A Descriptive Study of the Vital Health Indicators of Four Sub‐Saharan African Countries, 1960–2012
Authors: Klobodu Seth Selorm , Dawson John A , Reed Debra B , Moustaid‐Moussa Naima , Carpio Carlos , Velikova Natalia 
Published: November 2023

BackgroundThe importance of country‐level vital health statistics is recognized globally because of their use in initiating publichealth and development policies. Over the past few decades, economic growth has occurred in sub‐Saharan African countries, resulting in benefits to the population, such as increased access to quality health care and optimum nutrition. However, attaining the best possible levels of infant nutrition and maternal health remains a challenge.MethodsThe main objective of this study is to present aset of detailed time series analyses from 1960 to 2012 for selected health and wellness indicators, using country‐level aggregated data collected by the World Development Index (WDI) database of the World Bank, with specific focus on the countries of Ghana, Togo, Burkina Faso, and the Ivory Coast. The vital health indicators collected for this region can be used to analyze the health status of the vulnerable populations, epidemiological patterns, and the impact of economic growth on health outcomes; thus, we use these indicators to calculate descriptive statistics and identify trends that may inform hypotheses aimed at improving infant nutrition and maternal health. Gaps in the longitudinal record were imputed via polynomial smoothing. Linear trends over time and differences among countries were assessed using simple ANOVA models, and associations within countries were calculated using Spearman's rank correlation.ResultsSome general trends are common across the countries under consideration, but there are divergences. For example, although there has been a steep decline in infant mortality rates in all four countries since 1960, those of Burkina Faso and the Ivory Coast generally tended to be higher over the period of study (p<0.001). Likewise, life expectancy at birth among women, while generally increasing over the period of study, reversed course between the mid‐1980s and 2000 for all four countries. However, this decrease in life expectancy was significantly more pronounced in the Ivory Coast (p<0.001). Interestingly, the vital indicators in Ghana are more strongly associated(either directly on inversely) with each other over time than in Burkina Faso, Togo or the Ivory Coast; this is due to more consistent improvements in these measures over time and more frequent reporting to the WDI. Indeed, all four of these countries had several measures with less than four records across the period of interest.ConclusionsSub‐Saharan Africa has seen a general improvement in selected health indicators, but it has been mixed and inconsistent across countries. Research efforts in this area are hindered by alack of data consistently reported over time.Support or Funding InformationNone