bluuebunny/crossref_metadata_2025_split huggingface dataset:
Women's Dietary Diversity in Rural Bangladesh: Pathways through Women's Empowerment
Authors: Sinharoy Sheela , Waid Jillian , Gabrysch Sabine 
Published: November 2023

ObjectiveTo assess how women's dietary diversity is influenced by enabling resources and to quantify possible pathways through women's agency.MethodsWe analyzed cross‐sectional data collected in early 2015 from 2,600 women during the baseline survey for Food and Agricultural Approaches to Reducing Malnutrition (FAARM), a cluster‐randomized controlled trial in Sylhet Division in northeastern Bangladesh. Resources were measured as years of schooling and household wealth. Agency was measured through a latent factor for decision‐making and a measured variable for mobility. Nutrition was defined as dietary diversity as measured through a standard 10‐Food Group Indicator (FGI‐10R). We used confirmatory factor analysis to create the latent factor for decision‐making and a linear mediation model to estimate indirect effects, direct effects, and total effects, adjusting for women's age.ResultsIn adjusted models, the total effect of schooling on dietary diversity was 0.042 (p<.001). The direct effect of schooling on decision‐making was 0.004 (p=.02) and of schooling on mobility 0.075 (p=.001). Neither decision‐making nor mobility had significant direct effects on dietary diversity (p=.57 and p=.23, respectively). The direct effect of schooling on dietary diversity was 0.041 (p<0.001). For household wealth, the total effect on dietary diversity was 0.104 (p<.001). The direct effect of household wealth on decision‐making was −0.018 (p<.001) and on mobility −0.074 (p=0.004). The direct effect of household wealth on dietary diversity was 0.106 (p<.001).ConclusionsIn our study population in Bangladesh, women with more schooling had higher decision‐making power, mobility, and dietary diversity. Women with greater household wealth also had higher dietary diversity but lower decision‐making power and mobility. The positive effect of schooling and household wealth on dietary diversity is not mediated by women's decision‐making or mobility. Research is needed to examine other possible pathways, potentially through other dimensions of women's agency. Additionally, programs should monitor the potential negative effects of increasing household income on women's empowerment.Support or Funding InformationGerman Federal Ministry for Education and Research; Laney Graduate School, Emory University
Shifting Grounds: Perceptions of Factors that Affect Agricultural and Nutrition Transitions in Remote Hill Villages of Nepal
Authors: Lei Ann Z , Rai Uddhav 
Published: November 2023

Nepal is a landlocked country in South Asia with some of the highest malnutrition rates in the world, with over half of children stunted in rural hill and mountain areas. The Chepang are a highly marginalized indigenous group representing <1% of the Nepali population and often face discrimination because of their ethnicity. Nonetheless, this traditionally nomadic population had experienced an agricultural transition over the past 2 decades, in which they have shifted from khoriya (slash‐and‐burn) cultivation to terraced farming. This has increased both household food access and dietary diversity. However, community perceptions of the factors driving these nutritional transitions have not been explored. This pilot study qualitatively investigated how these factors affected Chepang peoples’ perceptions of their nutritional situation in rural mid‐hill villages of central Nepal.Individual interviews (n=18) and focus group discussions (n=2, 5–12 people each) were conducted in 4 village wards in the Chitwan district in April 2015. Participants were recruited through key informants, snowball sampling, and random household visits. They were all Chepang aged 18‐81y and had lived in their respective village for their entire lifetime. Interviews and discussions focused on perceptions of transitions in agriculture and food access, were translated by a Nepali research assistant, and coded using the software dedoose. Unfortunately, the April 2015 earthquake prematurely terminated the study.Participants believed agricultural improvements such as fertilizer use, terraced farming, and increased farming knowledge improved crop yields. Most households claimed their crops sustain their families for the entire year, compared to <6 months 2 decades beforehand. Factors believed to increase household income and subsequent food access include out‐migration labor to Gulf countries of Southeast Asia and improved animal husbandry through NGO support. Footpaths were the only method of reaching the hilltop villages, but improvements in transportation infrastructure enhanced accessibility to foods in markets and increased opportunities for agricultural knowledge exchange. Although most participants were optimistic about obtaining not only sufficient but also more diverse foods, one village perceived water security and unsuitable, high‐elevation farmland to limit crop productivity.Despite perceived improvements in food access, additional research regarding factors that affect food accessibility and targeted support may have the potential to increase the high‐risk population's food access, especially during post‐earthquake recovery. Identifying these determinants can also assist community leaders and NGOs effectively address existing barriers to food access as well as ones that may have been worsened by the earthquake.Support or Funding InformationThis study was conducted through the Cornell‐Nepal Study Program in partnership with Cornell University and Tribhuvan University.
Consumption of Novel Thiamin‐Fortified Fish Sauce Improves the Thiamin Status of Rural Cambodian Women of Childbearing Age and Their Children <5 Years
Authors: Whitfield Kyly C , Karakochuk Crystal D , Kroeun Hou , Chan Benny , Borath Mam , Lynd Larry D , Li‐Chan Eunice CY , Kitts David D , Green Timothy J 
Published: November 2023

Infantile beriberi, a disease caused by thiamin deficiency, remains a public health concern in Cambodia and other Southeast Asian countries that rely on thiamin‐poor white polished rice as a dietary staple. Infantile beriberi presents in exclusively breastfed infants of thiamin‐deficient mothers, and is often fatal if not treated within ~24 hours. Infantile beriberi has been nearly eradicated in regions where dietary diversity is high, or staple foods are fortified with thiamin. Food fortification is an inexpensive, sustainable, and passive means of improving the diet when micronutrients are lacking. We formulated a novel thiamin‐fortified fish sauce (a traditional condiment consumed daily by rural Cambodians) to determine whether ad libitum consumption over six months could improve erythrocyte thiamin diphosphate concentrations (TDP) among women of childbearing age and their youngest child aged 12–59 m, compared to a control sauce.In this double‐blind, randomized controlled efficacy trial 276 non‐pregnant, non‐lactating women aged 18–45 y and their families in Prey Veng, Cambodia, were randomized to receive one of three fish sauce formulations: low concentration thiamin (LC; ~2g/L), higher concentration thiamin (HC; ~8g/L), or control (C; no thiamin). TDP was analyzed using HPLC‐FLD.Women were 30 ± 6 y, and 71% of women had a normal BMI (18.5–25 kg/m2). Children were 30 ± 15 m at baseline. Women's baseline mean (95% CI) TDP for HC (n=91), LC (n=93), and C (n=92) was 179 nM (167, 191), 172 nM (162, 183), and 150 nM (142, 158), respectively. Children's baseline mean (95% CI) TDP for HC (n=87), LC (n=88), and C (n=87) was 211 nM (197, 225), 194 nM (183, 206), and 172 nM (163, 181), respectively.Fish sauce consumption was not significantly different between groups (p=0.186). In intent‐to‐treat analysis, women's endline TDP (adjusted for baseline) significantly increased among women in HC (53 nM) and LC (49 nM) groups compared to C (p<0.001). Similarly, at endline children's (baseline adjusted) TDP was 47 nM and 36 nM higher in the HC and LC groups, respectively, compared to C (p<0.001).Consumption of thiamin‐fortified fish sauce at concentrations of 2g/L and 8g/L over six months significantly improved biochemical thiamin status of Cambodian women of childbearing age and young children under 5 years. Effectiveness trials, as well as further research to identify the optimal dose for thiamin fortification, are needed.Support or Funding InformationResearch supported by Grand Challenges Canada Stars in Global Health Grant (Round VI), Canadian Institutes of Health Research (CIHR) Doctoral Award, and International Development Research Centre (IDRC) Doctoral Research Award.
Anemia, Iron and Vitamin A Deficits are Still Public Health Issues Among Women and Young Children in Northern Benin
Authors: Alaofe Halimatou , Burney Jennifer , Naylor Rosamond , Taren Douglas 
Published: November 2023

BackgroundMicronutrient deficiencies are major nutritional problems in developing countries: by adversely affecting health, performance, productivity, and income, they are thus a major impediment to economic development. However, little information is available on micronutrient status and associated risk factors among women of childbearing age and children in Benin.ObjectiveThe aim of this study was to assess the prevalence and determinants of micronutrient deficiencies among both populations.MethodIn this cross‐sectional study, a household and health questionnaire was administered to 682 women of child bearing age 15–49 years old and 686 children 6–59 months old in 2014 in Kalalé district of Northern Benin. Blood samples were analyzed for hemoglobin concentration (Hb), serum ferritin, serum retinol, C‐reactive protein (CRP), and alpha‐1‐acid glycoprotein (AGP). Multivariable statistical methods were employed to assess micronutrient deficiencies, anemia, and their association with socioeconomic and dietary factors.ResultsIn women, prevalence of anemia (48%) represented a severe public health problem, whereas prevalences of iron deficiency (ID, 17%), and vitamin A deficiency (VAD, 19%) were considered moderate, and iron deficiency anemia (IDA, 11%) was considered mild. In children, a similar pattern was observed for anemia (82%) whereas prevalences of ID (39%), IDA (33%), and VAD (44%) were also high. Low food diversity was a significant predicator of ID and VAD in women while underweight women had a greater risk for anemia. Child age had a significant effect on anemia, ID, and IDA prevalence, with the youngest age group (6–11 months) having the greatest risk for anemia and 12–23 months old children for the greatest risk for ID and IDA, as compared to other groups. Moreover, female and wasted children, and large family size had a greater risk for ID while the children of the business/salaried group of mothers had the lowest risk for anemia and VAD.ConclusionMicronutrient deficiencies are public health problems among women in childbearing age and their young children, and were greater among low food diversity women, young children and those from large family size. Thus, specific interventions are needed to improve food diversity and quality; improvements in environmental and social conditions could also help to mitigate the problems.
Plasma Proteome Associated with Hepcidin and Iron Status in 6–8 Year Old Children of Rural Nepal
Authors: Baker Sarah , Arguello Margia A , Schulze Kerry J , Lee Sun Eun , Cole Robert , Wu Lee , Nonyane Bareng , Yager James , Groopman John , Christian Parul , West Keith 
Published: November 2023

Iron status remains difficult to assess in settings where iron deficiency coexists with inflammation, and hepcidin has been proposed as an indicator of the body's iron requirement. Hepcidin reduces iron availability in iron sufficiency or inflammation, while low hepcidin may signal the body's need for iron. We sought to identify proteins that may be closely linked to iron metabolism using quantitative proteomics to characterize the plasma proteome in 500 plasma samples, depleted of the 6 most abundant proteins including transferrin, collected from 6–8 year old children in rural Nepal. We related relative abundance of proteins with conventional iron status indicators and hepcidin using linear mixed effects models with an imposed false discovery rate <10%. Among the children, inflammation (by C‐reactive protein, CRP, > 5 mg/L and/or α‐1 acid glycoprotein, AGP, > 1.0 g/L) occurred in 30%, and low iron stores (ferritin < 15 μg/L) were observed in 10% and tissue iron demand (transferrin receptor, TfR, >8.3 mg/L) in 40%. Fifty proteins were associated with hepcidin, 35 with ferritin, and 7 with TfR. A large overlap in the proteomes for hepcidin and ferritin with CRP and AGP, previously characterized, was observed. To further explore for proteins related to iron status independent of inflammation, hepcidin and ferritin were regressed against CRP and AGP, respectively, to generate residuals, to reflect the variability in hepcidin and ferritin unexplained by inflammation indexed by CRP and AGP. Thirty‐seven proteins remained associated with hepcidin, with the majority still associated with the inflammation proteome. These proteins have functions in the immune system (e.g. lipopolysaccharide‐binding protein), complement system (complement component 9 and 8 beta subunit), transcription and translation regulation (RNA polymerase II elongation factor), and glycoprotein formation (mannosyl‐oligosaccharide 1,2‐ α‐mannosidase IA). Nine proteins remained associated with ferritin residuals, but ficolin‐3, with a role in the lectin pathway and complement activation, was the only protein observed in common between hepcidin and ferritin inflammation‐adjusted residuals. Ficolin‐3 may be biologically linked to iron sequestration, given its unique association with hepcidin and ferritin. Plasma proteomics did not reveal new potential markers of iron status per se, but confirmed an extensive and complex association of iron metabolism with inflammation.Support or Funding InformationSupported by Gates Foundation grants OPPGH5241 and GH614 (Global Control of Micronutrient Deficiency).
Vitamin D Insufficiency Among Lactating Women in Southern Ethiopia
Authors: Girma Meron , Tilahun Birkneh , Stoecker Barbara J. 
Published: November 2023

Serum 25(OH)D concentration and its relations with dress habits, sun seeking behavior and skin reflectance were assessed among Ethiopian lactating women (n=120). The subjects were enrolled within 2 wk of delivery in a randomized controlled vitamin D supplementation trial (NCT02210884) being implemented in Sidama Zone (7°N, 38°E), Southern Ethiopia. Baseline data from the trial, reported here, was collected from September, 2014 to January, 2015. Plasma 25(OH)D concentration was determined using the new VDSP (Vitamin D Standardization Program)certified Immunodiagnostic Systems (IDS) 25‐Hydroxy Vitamin DS EIA manual ELISA Kits. Data on demographic characteristics, dress habits and sun seeking behavior were collected using questionnaires. Skin reflectance was measured using a portable colorimeter. Mean (SD) plasma 25(OH)D concentration was 48.5(14.6) nmol/L. Values ranged from 23 nmol/L to 102 nmol/L. In more than half of the participants (55%), 25(OHD) concentrations were between 30 and <50 nmol/L, which is defined as inadequate for bone and overall health. Vitamin D deficiency (< 30 nmol/L) was observed in four (3.3 %) of the women. The 25(OH)D concentrations were adequate (≥ 50 nmol/L) in 41.7%. The majority of the participants (81%) reported taking precautions to avoid direct sunlight exposure. More than half (52.5%) of the participants reported covering their head and most of their body when they go outside. Mean (SD) 25(OH)D concentration was significantly lower among women that wore more coverings outdoors (45.4 nmol/L (11.4)) compared to women who wore less conservative clothes (52.2 nmol/L (16.6)). Furthermore, skin lightness was positively correlated with 25(OH)D concentrations. The 25(OH)D concentrations were negatively correlated with maternal weight and BMI. These findings provide additional evidence that the availability of abundant sunlight does not guarantee attainment of adequate vitamin D status. Conservative dress habits and avoidance of direct sunlight are possible factors that contributed to considerable vitamin D insufficiency in a population residing near the equator.Support or Funding InformationSupported by the Nutricia Research Foundation and the W3002 Multistate Project
Reducing Micronutrient Deficiencies in a Decentralized Setting: Lessons in Food Fortification from the Philippines
Authors: Acuin Cecilia Cristina Santos , Perlas Leah , Duante Charmaine , Serafico Michael , Ducay Apple Joy , Capanzana Mario 
Published: November 2023

Decentralized settings like the Philippines present systems challenges in operationalizing interventions to address micronutrient deficiencies. An assessment of the country's nutrition situation using data from National Nutrition Surveys from the 1990s to 2013 shows substantial reductions in the prevalences of selected micronutrient deficiencies based on the following indicators: anemia, urinary iodine concentrations, and serum retinol. The drop in prevalences occurred in all population groups and coincide with the periods of full implementation of the country's food fortification laws: the 1995 Salt Iodization Law and the 2000 Food Fortification Act. The laws mandated fortification of salt for human consumption with iodine, rice with iron, cooking oil with Vitamin A, and flour with iron and Vitamin A. Micronutrient supplementation for iron and Vitamin A (VAS), while on‐going throughout the same period, alone cannot explain the reduction in unsupplemented groups. Even among supplemented children, levels of deficiency returned to baseline 3–4 months after high‐dose VAS. Vitamin A Deficiency (VAD) decline in supplemented groups was noted only after the fortification law was implemented. Diet diversity patterns were characterized by an over‐all decline in the consumption of fruits and vegetables; the increases in meat and poultry consumption occurred mostly in the richer quintiles who are not likely to be micronutrient deficient to begin with. The reduction in iodine deficiency was sustained despite lowering allowable levels of salt iodination in 2007. While iron deficiency is not the sole cause of anemia in the country, it is plausible that iron fortification of flour, together with intensified malaria control and deworming efforts, contributed substantially towards anemia reduction. Implementation of the food fortification laws are characterized by: 1) substantial oversight and resources from national government including policies and guidelines, commodity procurements, monitoring and evaluation processes, and mass media advocacy campaigns, 2) local government counterparts with supportive local policies and ordinances, salt testing in markets and retail outlets, community‐based distribution of fortified products and of iron and Vitamin A supplements, local level monitoring processes and 3) feedback mechanisms through supervisory visits, program implementation reviews, feedback conferences, and surveys.Support or Funding InformationPhilippine Government, World Bank
Consumption of Roasted Chick Peas Results in Increased Excretion of Oral Bacteria in Feces
Authors: Mai Volker , Waugh Sheldon G , Simpson Damion J , Hadjimiry Farahnaz R , Ukhanova Maria 
Published: November 2023

Dietary fibers, such as those contained in pulses, reach the large intestine and contribute to the maintenance of a healthy commensal microbiota. Targeted modification of microbiota composition and activities by increasing pulse consumption has potential for improving various health parameters. We performed a feeding study in human volunteers to determine how consumption of a minimum of five servings of roasted chick peas/week affects composition and activities of fecal microbiota. 12 adults were recruited from faculty, students and staff at the University of Florida to participate in a 14 day chick pea feeding study. Fecal samples were collected at baseline, during days 7–9 and on day 14 of the study period. Targeted qPCR showed no changes in proportions of Bifido bacteria and Lactic Acid Bacteria during the study. A comprehensive 16S rRNA sequence analysis showed no significant effects on overall microbiota diversity measures or changes in the proportions of bacterial phyla. However, we detected multiple bacterial signatures that changed in their prevalence after chick pea consumption. Among the bacterial signatures that increased during roasted chick pea consumption were two that match closest to oral plaque associated bacteria, Aggregatibacter and Campylobacter. Furthermore, a bacterial signature matching to butyrate producing Fusobacterium also increased during chick pea consumption. We conclude that, likely due to the abrasive nature of the roasted chick pea product, plague associated bacteria were removed from the oral cavity and recovered in feces. Future studies with softer chick pea preparations should confirm if our observation was indeed due to the abrasive nature of the roasted chick peas or other characteristics of the pulses. Also, the observed increase in potentially beneficial butyrate producers needs to be confirmed with other chick pea or pulse preparations.Support or Funding InformationUSA Dry Pea & Lentil Council
The Effect of Consuming a Low‐Glycemic Index Lentil‐Based Sports Nutrition Bar on Recovery after a Soccer Match
Authors: Kaviani Mojtaba , Chilibeck Philip , Gall Spencer , Jochim Jennifer , Zello Gordon 
Published: November 2023

High glycemic‐index (GI) carbohydrates are superior to low glycemic index carbohydrates following an exercise session for the replenishment of glycogen stores; however, studies assessing the effect of GI of foods on recovery of exercise performance are mixed. We compared the effects of post‐exercise feeding with a low GI lentil‐based sports nutrition bar and a commercially available high GI sports nutrition bar, with similar macronutrient content, on recovery of performance after a simulated soccer match. Using a randomized, counterbalanced, crossover design, soccer players (n=7) consumed 1.5 g/kg available carbohydrate from a lentil‐based bar or a high GI bar immediately after a 90 minute simulated soccer match. Participants were required to consume the sports bars within 30 minutes of the end of the simulated soccer match. Participants consumed similar diets for the remainder of the day in the high‐ and low‐GI conditions. Participants returned to the laboratory the following morning to repeat the first half of the simulated soccer match for recovery performance measurements. During this simulated soccer match performance was assessed by speed during an agility course, speed during a ball dribbling drill, sprint speed during a 20m shuttle‐run test, ability to jump at maximal height (to simulate heading a ball) and shooting accuracy. Tests involving agility, ball‐dribbling, and sprinting were analyzed by magnitude‐based inferences, assuming a smallest substantial change in sprint time of 0.8%ResultsDuring the recovery day simulated soccer match, the mean difference in time between low‐GI and high‐GI conditions for the sprint (0.10s, 90% CI −0.17 to 0.38s), agility (0.16s; 90% CI −0.32 to 0.64s), and ball dribbling (0.34s, 90% CI −1.28 to 1.96s) tests represented a 61–68% chance that the low‐GI condition enhanced performance over the high‐GI condition. There was no difference between conditions for jump height or shooting accuracy. Despite previous findings that high‐GI carbohydrates might allow faster glycogen re‐synthesis after exercise, our results indicate consumption of a low‐GI sport nutrition bar may allow better recovery of performance after a simulated soccer match. Athletes can therefore consume low‐GI carbohydrates as a healthier food choice during recovery after soccer matches.Support or Funding InformationSupported by the Saskatchewan Pulse Growers and Agriculture Agri‐Food Canada