bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary pattern with high dairy intake is associated with linear growth in Peruvian infants
Authors: Arsenault Joanne E , de Romaña Daniel Lopez , Penny Mary , Brown Kenneth H 
Published: November 2023

Post‐natal linear growth faltering is a multi‐factorial process that is affected by children's diet and infectious exposures. Little research has documented how young children's dietary patterns are related to growth, so we reanalyzed previously collected data from young children in Trujillo, Peru to assess these relationships.Dietary intakes of children 6–8 months of age at baseline were assessed prior to and at the mid‐point of a 6‐month zinc supplementation trial [Brown, et al. Am J Clin Nutr 2007].Food and breast milk intakes were assessed by direct observation and weighing for 1–2 days at each time. The intakes at the mid‐point when children were 9–11 months of age were used for these analyses, as all children were consuming complementary foods by this age. Dietary pattern factors, with energy from 14 food groups as inputs, were derived by principal components analysis with orthogonal transformation. Linear growth was assessed at baseline and 6‐months. A linear regression model with the change in length‐for‐age z‐score (DLAZ) as the outcome was used with all derived dietary factors entered as independent variables along with covariates including initial LAZ, age, gender, intervention group, low maternal height (<145 cm), persistent diarrhea episodes, an index of socioeconomic status, and total energy.The mean DLAZ was −0.11 (0.41 SD).Five dietary patterns were derived that explained 54% of the variation in the intakes, with the greatest proportions of variation being explained by a ‘potato, meat, vegetable’ pattern (14%) and a ‘dairy’ pattern (12%).The dairy pattern score was positively associated with DLAZ (p=0.008). None of the other dietary patterns were significantly associated with DLAZ. Higher socioeconomic status was also associated with greater DLAZ (p=<0.0001). DLAZ was lower among children whose mothers had low height (p=0.03).While breastfeeding throughout the first year of life is important for young children's healthy growth, the introduction of animal source foods, such as dairy products, to children's diets is important given their nutrient profile that includes high quality protein, bioavailable micronutrients and possibly other bioactive components that are essential for growth. The importance of dietary quality and the multiplicity of nutrient factors in foods should be recognized in efforts to reduce linear growth faltering globally.Support or Funding InformationFunded by the Bill & Melinda Gates Foundation grant # OPP1112895
Cord Blood FGF21 and Leptin as Candidate Biomarkers of Early Infant Linear Growth Velocity in a Low‐ Income Country
Authors: Hack Salma , Papp Eszter , Shi Joy , Dimitris Michelle , Bandsma Robert , Al Mahmud Abdulla , Roth Daniel 
Published: November 2023

BackgroundEarly detection of infant growth faltering may enable timely clinical management and allow for the identification of modifiable biological mechanisms. Fibroblast growth factor 21 (FGF21) and leptin regulate energy metabolism, and their circulating concentrations fluctuate in response to caloric intake. FGF21 increases during times of energy deprivation and leptin increases when satiated. We aimed to preliminarily assess cord blood FGF21 and leptin as potential biomarkers of early infant linear growth.MethodsIn a subset of healthy term infants (n=102) from an ongoing trial of maternal vitamin D supplementation in Dhaka, Bangladesh, cord serum concentrations of FGF21 and leptin were measured using commercial ELISA kits. Infant length was measured at birth and approximately 3 months of age; length‐for‐age z‐scores (LAZ) were derived according to WHO Child Growth Standards to account for sex and actual age at measurement. Conditional velocity (cV) was the infant's change in LAZ from birth to the 3‐month visit, accounting for regression to the mean. Unadjusted associations between cV and each biomarker were explored visually and estimated using linear regression.ResultsMean (SD) LAZ was −1.32 (1.08) at birth and −1.00 (0.93) at 3 months. Median FGF21 and leptin were 18.74 pg/ml (n=94) and 6.59 ng/ml (n=98), respectively. Most FGF21 values (82/94) ranged from undetectable (set to 1.55 pg/mL = 1/2 lowest standard) to 50 pg/ml, and the cV‐FGF21 association appeared linear in this range. For each 10 pg/mL increase in FGF21 (from 0 to 50 pg/mL), cV decreased by 0.12 (95%CI: 0.00, 0.24; p=0.044). When FGF21 was categorized as below limit of detection (0), detectable but below median (I), or at/above median (II) using all data (n=94), the mean difference in cV between 0 and I groups (−0.20; 95%CI: −0.56,0.16) was not significant, but the difference was larger and significant when comparing 0 and II groups (−0.41; 95%CI: −0.78, −0.04). Leptin was not significantly associated with cV (0.2 decrease in cV per 100 ng/ml increase in leptin; 95% CI: −2.1, 1.7; p=0.82).ConclusionHigher FGF21 in cord blood may signal increased risk of slower early infant linear growth in this Bangladeshi cohort. Further research is required to determine if FGF21 is a viable biomarker for early growth, or if the association with FGF21 points to a modifiable mechanism of growth faltering.Support or Funding InformationThe original clinical trial was funded by the Bill and Melinda Gates Foundation.
Comparison of trunk‐to‐leg ratio as assessed by photographic imaging in shorter and taller preschool children of the Western Highlands of Guatemala: Implications regarding the biology of stunting
Authors: Beintema Joni Jade Serena , Solomons Noel W , García‐Meza Rosario , Orozco Mónica N. , Gwaltney Rebecca , Doak Colleen M. 
Published: November 2023

BackgroundLinear growth is very dependent on the differential elongation of the two major body components: trunk and legs. Photographic imaging could help to improve accuracy and limit subject burden. This study aimed to apply photographic images to quantify body segments in preschool children in 2 settings differing by socio‐economic status (SES) in the Western Highlands of GuatemalaMethodsWe measured standing height in children, aged 4–7 y from a lower SES (predominately Mayan‐ascent) and a higher SES (largely European‐ascent) from Sololá and Quetzaltenango, respectively. Height for age z‐scores were calculated using the WHO Growth Standards to identify stunting (as ≤ −2 height for age z‐score). A standard sagittal photograph with the child standing in erect posture with the Frankfort Gaze was taken from a 3‐m distance with a digital camera. The length of the trunk and of the legs was measured in mm from printed images and used to calculate trunk‐to‐leg ratios and to compare between settings.ResultsThe Quetzaltenango children were on average 7.0 cm taller than their Sololá‐counterparts, 5.2 cm of the difference was attributed to leg length. Children in Sololá have a higher prevalence of stunting than children in Quetzaltenango (46.1% vs. 5.9%). The median trunk‐to‐leg ratio was higher in Sololá (0.82) than in Quetzaltenango (0.76).ConclusionPhotographic imaging show the key population differences in these settings relates to the shorter relative leg lengths in Sololá. These findings are congruent with population differences in child stunting as well as ethnicity.
Inter‐ and intra‐rater concordance in estimating height and its components using photographic images in Guatemalan children from the Western Highlands
Authors: Orozco Mónica N. , Beintema Joni Jade Serena , García‐Meza Rosario , Gwaltney Rebecca , Rolker Heike B. , Doak Colleen M. , Solomons Noel W 
Published: November 2023

BackgroundPhotographic imaging may be used to assess height and its components (legs and trunk) in an accurate way. Nonetheless, inter‐ and intra‐rater variations represent a potential source of error in this novel method.ObjectiveTo determine the inter‐and intra‐rater reliability when using photographic imaging for the estimation of total length (TL), leg length (LL) and the trunk‐to‐leg ratio (TLR) in preschool children from the Western Highlands of Guatemala.MethodsPhotographs from 247 preschool children aged 4–7 y were taken from a 3‐m distance with the child standing sideways in front of a color‐coded metric ruler and looking forward with a Frankfort plane gaze. TL and LL were estimated from paper printouts, measured to the nearest mm, and both served to calculate TLR. Height was compared to the gold standard stadiometer. Image‐derived TL and LL were measured on 3 different occasions by the same researcher (R1) for intra‐rater correspondence and by 2 other researchers (R2 & R3) for inter‐rater reliability assessment.ResultsThe mean measured height and estimated photo height were 109.7±0.46 cm (stadiometer) and 109.9±0.45 cm (photo).Mean TL and LL were 228±1.0 mm and 128±0.7mm, respectively. The Pearson correlation coefficients for intra‐rater reliability for TL, LL and TLR on all 3 occasions were consistently higher than 0.9 (p<0.05); and for inter‐rater reliability these values were 0.997, 0.996 & 0.974, (R1 vs. R2), 0.997, 0.996 & 0.979 (R1 vs. R3), and 0.999, 0.997 & 0.982 (R2 vs. R3) (p<0.05).ConclusionThe results from this study highlight strong inter‐ and intra‐rater concordances for height and body components derived from photographic imaging, which makes this innovative method a promising tool for growth studies in humans.
The Influence of Maternal Nutrition on Fetal Size based on Ultrasound Measurements throughout Pregnancy
Authors: Nguyen Phuong , Young Melissa F. , Addo Yaw O , Nguyen Hieu , Pham Hoa , Truong Truong V , Truong Son V , Martorell Reynaldo , Ramakrishnan Usha 
Published: November 2023

Maternal anthropometry are known to influence birth weight, but there is a paucity of information on the relationships between maternal nutritional status and fetal growth during pregnancy. This study aimed to examine the influence of maternal nutritional status before and during pregnancy on fetal size during early (14–20 weeks), mid (20–30 weeks) and late (>30 weeks) pregnancy. We used prospective data collected from women who participated in a randomized controlled trial evaluating the impact of preconceptional micronutrient supplements (PRECONCEPT) on birth outcomes in Vietnam. Data analysis included 1412 women who had at least one ultrasound exam and delivered a singleton live birth. Fetal anthropometric (head circumferences‐ HC, biparietal diameter‐ BD, abdomen circumference‐ AC and femoral length‐FL) measurements were obtained by trained physicians during early, mid and late pregnancy. Maternal pre‐pregnancy weight, height, and hemoglobin were measured before conception. Conditional weight gain (CWG) on pre‐pregnancy body mass index (PPBMI – kg/m2) were calculated respectively with each ultrasound period. The influence of maternal nutritional status before and during pregnancy on fetal size was assessed using generalized linear models, adjusting for potential confounding factors (maternal age, education, treatment group, child gender, household SES, time from enrolment to conception and repeated measure). PPBMI was a significant independent predictor of all measures of fetal size in the third trimester except for FL. A 1 standard deviation (SD) increase in PPBMI was associated with 0.16, 0.13 and 0.18 SD increase in HC, BD and AC, respectively. CWG in the first trimester was positively associated with all measures of fetal size between 20–30 weeks (effect size 0.18–0.28) and at >30 weeks of gestation (effect size 0.21–0.29) except for AC. Similar results was seen for the association between CWG in the second trimester and fetal size at 20–30 weeks (effect size 0.13–0.24) and at >30 weeks (effect size 0.15–0.28). However, CWG in the third trimester and pre‐pregnancy hemoglobin had no significant effect on fetal size. In conclusion, our study has provided evidence that both maternal BMI before pregnancy and weight gain during early and mid‐pregnancy have important and independent effects on fetal growth.Support or Funding InformationFunded by the Mathile Institute for the Advancement of Human Nutrition, the Micronutrient Initiative, and Nestlé Foundation.
Household Expenditures on Fruit and Vegetables are Associated with Significant Increases in zHFA at ages 5, 8 and 12 in Ethiopia, India, Peru and Vietnam
Authors: Humphries Debbie , Dearden Kirk A. , Crookston Benjamin , Woldehanna Tassew , Penny Mary E. , Behrman Jere 
Published: November 2023

Household expenditure surveys, covering fifteen days of household expenditures and including key food groups, are routinely conducted in low and middle income countries. This data may help identify patterns of food expenditure that influence child growth.ObjectivesWe investigated the relationship between household food expenditures and child growth using four different analytic approaches.MethodsWe used data on 6,993 children from Ethiopia, India, Peru and Vietnam at ages 5, 8 and 12 yrs from the Young Lives cohort. We compared associations between household food expenditures and child growth (zhfa) using (a) total household food expenditures, (b) principal components, (c) factor analysis and (d) cluster analysis extracted from household expenditures on 13 different food groups, controlling for total food expenditures, round of data collection, rural/urban residence and child sex.ResultsFactors, principal components and indicators of clusters added significant information about zhfa over and above that provided by total food expenditures. Factors and principal components with loading on animal source foods and/or fruits and vegetables were significantly associated with higher zhfa in all countries except Ethiopia. Factors and principal components with loading on whole grains and pulses were significantly associated with lower zhfa in Peru, and higher zhfa in Ethiopia.ConclusionHousehold food expenditure data provides important insights into household food purchasing patterns that are significant predictors of zhfa. Including food expenditure data in analyses may yield important information about linear growth.Support or Funding InformationThis work was supported by the Bill & Melinda Gates Foundation [Global Health Grant OPP1032713]; Eunice Shriver Kennedy National Institute of Child Health and Development [grant number R01 HD070993]; and Grand Challenges Canada [grant number 0072‐03]. The data used in this study come from Young Lives, a 15‐year survey investigating the changing nature of childhood poverty in Ethiopia, India (Andhra Pradesh), Peru, and Vietnam (www.younglives.org.uk). Young Lives is core‐funded by UK Aid from the Department for International Development (DFID) and was co‐funded from 2010 to 2014 by the Netherlands Ministry of Foreign Affairs. The findings and conclusions contained herein are those of the authors and do not necessarily reflect positions or policies of the Bill & Melinda Gates Foundation, the Eunice Shriver Kennedy National Institute of Child Health and Development, Grand Challenges Canada, Young Lives, DFID, or other funders.
Dietary Intake and Nutritional Status in Infants From the Urban Slums of Mumbai, India
Authors: Venkatramanan Sudha , Haas Jere D , Finkelstein Julia L , Salvi Ashwini , Thorat Aparna , Huey Samantha L , Udipi Shobha A , Ghugre Padmini , Kurpad Anura V , Mehta Saurabh 
Published: November 2023

ObjectiveThis study was conducted to assess dietary intake and nutritional status of infants living in the urban slums of Mumbai, India, in preparation for a randomized efficacy feeding trial of iron‐biofortified pearl millet.MethodsStudy participants (n=37) were infants aged six to 12 months from the slums of Mumbai. Infant dietary intake was assessed by 24‐hour dietary recall, administered to mothers; nutrient intake was calculated using CS dietary software. Anthropometric measurements of infant length and weight were recorded. World Health Organization (WHO) z‐scores for weight‐for‐age (WAZ), length‐for‐age (LAZ), and weight‐for‐length (WLZ) were calculated, and used to define underweight (WAZ<−2), stunting (HAZ<−2), and wasting (WLZ<−2).ResultsIn this study, infants did not meet the Indian recommended dietary allowances (RDA) for energy (78%), fat (86%), and calcium (67%). Dietary intake of iron was 35% of the Indian RDA. The protein intake was above the Indian RDA (>100%). Mean WAZ, LAZ, and WLZ scores were −1.3 (SD: 0.8), −1.8 (SD: 1.0), and −0.5 (SD: 0.8) respectively, and 37% of infants were stunted.ConclusionsDietary intake of iron, calcium, fat, and total energy were low in this population, and more than one–third of infants were stunted. Effective and sustainable nutritional interventions are urgently needed to improve the dietary and nutritional status of infants living in this setting.Support or Funding InformationSupported by HarvestPlus/IFPRI
Perceived iron content in drinking water associated with anemia among women with iron‐poor diets in rural Bangladesh
Authors: Wendt Amanda , Waid Jillian , Gabrysch Sabine 
Published: November 2023

The Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster‐randomized controlled trial in Sylhet, Bangladesh aims to improve micronutrient status of women and their children through a complex nutrition‐sensitive agriculture intervention. Examining etiologies of micronutrient deficiencies is important to understand the intervention impact. Elevated iron content in groundwater in Bangladesh has been cited as a dietary iron source and could therefore be relevant for anemia surveillance. To explore this, we used FAARM baseline data collected in early 2015 among 2,122 women in 96 clusters. The women were 15–40 years old (mean: 25 years), 33% were anemic (mean hemoglobin: 12.4 g/dL), and 35% were underweight (mean BMI: 20). Perceived levels of iron in drinking water were measured by self‐report using a 4‐point scale (none, a little, medium, a lot). Both anemia prevalence and hemoglobin level were significantly associated with iron content in water in a dose‐response manner in bivariable analyses. In a random‐effect logistic regression model adjusted for confounders, we found a significant interaction (p=0.04) between perceived iron content and iron‐rich food consumption on the previous day. For women who consumed an iron‐poor diet, a one‐level increase in perceived iron content of drinking water was inversely associated with anemia prevalence (adjusted OR: 0.77; 95% CI: 0.65, 0.92). For women who consumed iron‐rich foods the day before, no such association was found (adjusted OR: 0.98; 95% CI: 0.86, 1.10). Results were similar for hemoglobin level as a linear outcome. These findings highlight the importance of iron in drinking water to dietary intake among women with low iron consumption through food. Water iron content should thus be considered in future surveys evaluating micronutrient status.Support or Funding InformationThis trial is funded by the German Federal Ministry for Education and Research (BMBF) and surveillance by DFID through the Nutrition Embedding Evaluation Programme (NEEP). The intervention is funded jointly by BMBF, and through the following private donations: the Carrefour Foundation, TWFA, and Best‐in‐Brands.
Effectiveness and Tolerability of Various Ferrous Salts in Correcting Mild to Moderate Iron Deficiency Anemia in Indonesian Women
Authors: Ashmead Stephen , Hartle Jennifer 
Published: November 2023

The purpose of this study was to determine the effectiveness and tolerability of various commercial ferrous sources in correcting mild to moderate iron deficiency anemia in Indonesian women. Ninety four women ages 18–50 with hemoglobin levels of 8–12 mg/dL and ferritin levels less than 45 mcg/L were recruited and randomized to one of five different treatment groups: ferrous bisglycinate (FBG), ferrous aparto‐glycinate (FA), ferrous fumarate (FF), ferrous sulfate (FS), or a malto dextrin placebo (P).All treatment materials were supplied by Albion. Study design was a double blind trial. Subjects receiving iron treatments were dosed with 90 mg elemental iron from the respective source. Treatment period was 30 days with a 7 day follow up period. Blood was drawn at the beginning of the treatment and at the end of treatment and was analyzed for hemoglobin and ferritin content using standard clinical measuring techniques. Additionally, subjects were evaluated for gastrointestinal tolerability of the treatments using self‐reported questionnaires. The results of the questionnaires were scored for analysis. At the end of the study it was found that all of the iron treatments significantly increased (p<0.05) the hemoglobin values with FBG and FF having the greatest change followed by FA and FF. Ferritin values were increases significantly (p<0.05) from baseline values in all iron treatments. There was no statistical difference between treatments, although FA treatment resulted in the greatest numerical change followed closely by FF and FBG. Compliance, as determined by counting doses taken, was very high (>95%) and there were no significant differences between groups. At the end of the treatment period, FBG had the greatest improvement in tolerability score followed by FF, P and FS. At the post treatment 7 day follow up period, FBG, FF and P continued to have increased tolerability scores while all other iron treatments tended to return to baseline values. It was concluded that FBG was the most effective treatment as determined by changes in hemoglobin and ferritin values combined with the high gastrointestinal tolerability.Support or Funding InformationThis research was funded by Albion, Clearfield Utah.