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Passarelli S, Ambikapathi R, Gunaratna NS, Madzorera I, Canavan CR, Noor AR, Worku A, Berhane Y, Abdelmenan S, Sibanda S, Munthali B, Madzivhandila T, Sibanda LM, Geremew K, Dessie T, Abegaz S, Assefa G, Sudfeld C, McConnell M, Davison K, Fawzi W. A Chicken Production Intervention and Additional Nutrition Behavior Change Component Increased Child Growth in Ethiopia: A Cluster-Randomized Trial. J Nutr 2020; 150:2806-2817. [PMID: 32652012 PMCID: PMC7549301 DOI: 10.1093/jn/nxaa181] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/28/2020] [Accepted: 06/05/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Chicken production in the context of nutrition-sensitive agriculture may benefit child nutrition in low-income settings. OBJECTIVES This study evaluated effects of 1) a chicken production intervention [African Chicken Genetic Gains (ACGG)], and 2) the ACGG intervention with nutrition-sensitive behavior change communication (BCC) [ACGG + Agriculture to Nutrition (ATONU)], on child nutrition and health outcomes and hypothesized intermediaries. METHODS Forty ACGG villages received 25 genetically improved chickens and basic husbandry guidance; of these, 20 ACGG + ATONU villages in addition received a nutrition-sensitive behavior change and homegardening intervention; 20 control clusters received no intervention. We assessed effects of the interventions on height-for-age z scores (HAZ), weight-for-age z scores (WAZ), and weight-for-height z scores (WHZ) at 9 (midline) and 18 mo (endline) through unadjusted and adjusted ordinary least squares (OLS) regressions. We examined the interventions' effects on hypothesized intermediaries including egg production and consumption, dietary diversity, women's empowerment, income, child morbidities, anemia, and chicken management practices through OLS and log binomial models. RESULTS Data included 829 children aged 0-36 mo at baseline. ACGG + ATONU children had higher midline HAZ [mean difference (MD): 0.28; 95% CI: 0.02, 0.54] than controls. The ACGG group had higher HAZ (MD: 0.28; 95% CI: 0.05, 0.50) and higher WAZ (MD: 0.18; 95% CI: 0.01, 0.36) at endline than controls; after adjusting for potential baseline imbalance, effects were similar but not statistically significant. At endline, differences in ACGG + ATONU children's HAZ and WAZ compared with controls were similar in magnitude to those of ACGG, but not statistically significant. There were no differences in anthropometry between the intervention groups. ACGG + ATONU children had higher dietary diversity and egg consumption than ACGG children at endline. Both interventions showed improvements in chicken management practices. The interventions did not increase anemia, diarrhea, fever, or vomiting, and the ACGG + ATONU group at midline showed reduced risk of fever. CONCLUSIONS A chicken production intervention with or without nutrition-sensitive BCC may have benefited child nutrition and did not increase morbidity.This trial was registered at clinicaltrials.gov as NCT03152227.
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Affiliation(s)
- Simone Passarelli
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Ramya Ambikapathi
- Department of Public Health, Purdue University, West Lafayette, IN, USA
| | | | - Isabel Madzorera
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Chelsey R Canavan
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Abdallah R Noor
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Amare Worku
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | | | - Simbarashe Sibanda
- Food, Agriculture and Natural Resources Policy Analysis Network, Pretoria, South Africa
| | - Bertha Munthali
- Food, Agriculture and Natural Resources Policy Analysis Network, Pretoria, South Africa
| | | | - Lindiwe M Sibanda
- Food, Agriculture and Natural Resources Policy Analysis Network, Pretoria, South Africa
| | | | - Tadelle Dessie
- International Livestock Research Institute, Addis Ababa, Ethiopia
| | - Solomon Abegaz
- Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
| | - Getnet Assefa
- Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
| | - Christopher Sudfeld
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Margaret McConnell
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | | | - Wafaie Fawzi
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
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Prado EL, Maleta K, Caswell BL, George M, Oakes LM, DeBolt MC, Bragg MG, Arnold CD, Iannotti LL, Lutter CK, Stewart CP. Early Child Development Outcomes of a Randomized Trial Providing 1 Egg Per Day to Children Age 6 to 15 Months in Malawi. J Nutr 2020; 150:1933-1942. [PMID: 32286620 PMCID: PMC7330477 DOI: 10.1093/jn/nxaa088] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/27/2020] [Accepted: 03/11/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Eggs are a rich source of nutrients important for brain development, including choline, riboflavin, vitamins B-6 and B-12, folate, zinc, protein, and DHA. OBJECTIVE Our objective was to evaluate the effect of the consumption of 1 egg per day over a 6-mo period on child development. METHODS In the Mazira Project randomized controlled trial, 660 children aged 6-9 mo were randomly allocated into an intervention or control group. Eggs were provided to intervention households during twice-weekly home visits for 6 mo. Control households were visited at the same frequency. At enrollment, blinded assessors administered the Malawi Developmental Assessment Tool (MDAT), and 2 eye-tracking tasks using a Tobii-Pro X2-60 eye tracker: a visual paired comparison memory task and an Infant Orienting with Attention task. At endline, 6-mo later, blinded assessors administered the MDAT and eye-tracking tasks plus an additional elicited imitation memory task. RESULTS At endline, intervention and control groups did not significantly differ in any developmental score, with the exception that a smaller percentage of children were delayed in fine motor development in the intervention group (10.6%) compared with the control group (16.5%; prevalence ratio: 0.59, 95% CI: 0.38-0.91). Among 10 prespecified effect modifiers for the 8 primary developmental outcomes, we found 7 significant interactions demonstrating a consistent pattern that children who were less vulnerable, for example, those with higher household wealth and maternal education, showed positive effects of the intervention. Given multiple hypothesis testing, some findings may have been due to chance. CONCLUSION The provision of 1 egg per day had no overall effect on child development in this population of children, however, some benefits may be seen among children in less vulnerable circumstances. This trial was registered at clinicaltrials.gov as NCT03385252.
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Affiliation(s)
| | - Kenneth Maleta
- School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi
| | - Bess L Caswell
- Department of Nutrition and Institute for Global Nutrition, University of California Davis, Davis, CA, USA
| | - Matthews George
- School of Public Health and Family Medicine, University of Malawi College of Medicine, Blantyre, Malawi
| | - Lisa M Oakes
- Department of Psychology and Center for Mind and Brain, University of California Davis, Davis, CA, USA
| | - Michaela C DeBolt
- Department of Psychology and Center for Mind and Brain, University of California Davis, Davis, CA, USA
| | - Megan G Bragg
- Department of Nutrition and Institute for Global Nutrition, University of California Davis, Davis, CA, USA
| | - Charles D Arnold
- Department of Nutrition and Institute for Global Nutrition, University of California Davis, Davis, CA, USA
| | - Lora L Iannotti
- Brown School, Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA
| | - Chessa K Lutter
- RTI International, Washington DC, School of Public Health, University of Maryland, College Park, MD, USA
| | - Christine P Stewart
- Department of Nutrition and Institute for Global Nutrition, University of California Davis, Davis, CA, USA
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Raiten DJ, Allen LH, Slavin JL, Mitloehner FM, Thoma GJ, Haggerty PA, Finley JW. Understanding the Intersection of Climate/Environmental Change, Health, Agriculture, and Improved Nutrition: A Case Study on Micronutrient Nutrition and Animal Source Foods. Curr Dev Nutr 2020; 4:nzaa087. [PMID: 32617451 PMCID: PMC7319726 DOI: 10.1093/cdn/nzaa087] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/12/2020] [Accepted: 05/19/2020] [Indexed: 11/14/2022] Open
Abstract
With a growing global population, the demand for high-quality food to meet nutritional needs continues to increase. Our ability to meet those needs is challenged by a changing environment that includes constraints on land and water resources and growing concerns about the impact of human activity including agricultural practices on the changing climate. Adaptations that meet food/nutritional demands while avoiding unintended consequences including negatively affecting the environment are needed. This article covers a specific case study, the role of animal source foods (ASFs) in meeting micronutrient needs in a changing environment. The article covers our understanding of the role of ASFs in meeting micronutrient needs, evidence-based approaches to the development of nutrition guidance, the current issues associated with the relation between animal production practices and greenhouse gas emissions, and examples of how we might model the myriad sources of relevant data to better understand these complex interrelations.
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Affiliation(s)
- Daniel J Raiten
- Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA
| | - Lindsay H Allen
- Agricultural Research Service Western Human Nutrition Research Center, USDA, Davis, CA, USA
| | - Joanne L Slavin
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN, USA
| | | | - Gregory J Thoma
- Ralph E Martin Department of Chemical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Patricia A Haggerty
- Office of the Director, Division of Extramural Activities, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - John W Finley
- Agricultural Research Service National Program Staff, USDA, Beltsville, MD, USA
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Playford RJ, Garbowsky M, Marchbank T. Pasteurized Chicken Egg Powder Stimulates Proliferation and Migration of AGS, RIE1, and Caco-2 Cells and Reduces NSAID-Induced Injury in Mice and Colitis in Rats. J Nutr 2020; 150:1434-1442. [PMID: 32286629 DOI: 10.1093/jn/nxaa083] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/29/2020] [Accepted: 03/09/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Chicken eggs and bovine colostrum contain proteins possessing antimicrobial, immunoregulatory, and growth factor activity. The ability of eggs to influence gut defense and repair is largely unexplored. OBJECTIVE We examined the effect of pasteurized spray-dried egg on gastrointestinal injury using cell culture and animal models and sought to determine whether adding colostrum provided extra benefit. METHODS Egg alone, colostrum alone, and a 40:60 egg: colostrum combination were tested for proliferative (Alamar blue) and migratory (wounded monolayer) activity at 1 mg.mL-1 using human colon adenocarcinoma (Caco-2), human gastric cancer (AGS), and rat intestinal epithelioid-1 (RIE1) cells. Four groups of adult male C57BL/6 mice received 20 mg.kg-1.d-1 test products in drinking water for 7 d and indomethacin (85 mg.kg-1, administered subcutaneously) on day 7. Villus height and morphology were assessed. Three groups of adult male Sprague Dawley rats received 20 mg.kg-1.d-1 test product by gavage for 9 d and dextran sodium sulfate (DSS, 4% in drinking water) for the final 7 d. Histology, microscopic damage scoring, and myeloperoxidase were assessed. RESULTS Egg or colostrum alone caused 3-fold increases in cell proliferation and migration (P < 0.05 compared with baseline). Heating the egg removed its bioactivity. Addition of neutralizing antibodies or tyrphostin showed that ovomucoid, ovalbumin, and the epidermal growth factor receptor mediated the effects of egg (all P < 0.05 compared with egg). Egg reduced shortening of villi caused by indomethacin in mice by 34% and reduced DSS-induced colonic damage in rats by 44-61% (P < 0.05 compared with DSS). Similar results were seen using colostrum alone. In each assay, the 40:60 combination gave improved results compared with the same dose of egg or colostrum alone (P < 0.05). CONCLUSIONS Studies using AGS, RIE1, and Caco-2 cells, C57BL/6 mice, and Sprague Dawley rats showed protective effects of egg against gut injury. Enhanced results were seen if colostrum and egg were coadministered. Egg powder with or without colostrum may have therapeutic value for prevention and treatment of gut injuries.
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Affiliation(s)
- Raymond J Playford
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK.,Pantheryx Inc., Boulder, CO, USA
| | | | - Tania Marchbank
- Pantheryx Inc., Boulder, CO, USA.,Centre of Immunobiology, Blizard Institute, Barts and The London School of Medicine, Queen Mary, University of London, London, UK
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Broaddus-Shea ET, Manohar S, Thorne-Lyman AL, Bhandari S, Nonyane BAS, Winch PJ, West KP. Small-Scale Livestock Production in Nepal Is Directly Associated with Children's Increased Intakes of Eggs and Dairy, But Not Meat. Nutrients 2020; 12:nu12010252. [PMID: 31963752 PMCID: PMC7019975 DOI: 10.3390/nu12010252] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 12/31/2022] Open
Abstract
Animal source foods (ASF) provide nutrients essential to child growth and development yet remain infrequently consumed in rural Nepal. Agriculture and nutrition programs aim to increase ASF intake among children through small-scale animal husbandry projects. The relationship between livestock ownership and children's consumption of ASF, however, is not well established. This study examined associations between livestock ownership and the frequency with which Nepali children consume eggs, dairy, and meat. We analyzed longitudinal 7-day food frequency data from sentinel surveillance sites of the Policy and Science of Health, Agriculture and Nutrition (PoSHAN) study. Data consisted of surveys from 485 Nepali farming households conducted twice per year for two years (a total of 1449 surveys). We used negative binomial regression analysis to examine the association between the number of cattle, poultry, and meat animals (small livestock) owned and children's weekly dairy, egg, and meat intakes, respectively, adjusting for household expenditure on each food type, mother's education level, caste/ethnicity, agroecological region, season, and child age and sex. We calculated predicted marginal values based on model estimates. Children consumed dairy 1.4 (95% CI 1.1-2.0), 2.3 (1.7-3.0) and 3.0 (2.1-4.2) more times per week in households owning 1, 2-4 and >4 cattle, respectively, compared to children in households without cattle. Children consumed eggs 2.8 (2.1-3.7) more times per week in households owning 1 or 2 chickens compared to children in households without chickens. Child intake of meat was higher only in households owning more than seven meat animals. Children's intakes of dairy, eggs, and meat rose with household expenditure on these foods. Small-scale animal production may be an effective strategy for increasing children's consumption of eggs and dairy, but not meat. Increasing household ability to access ASF via purchasing appears to be an important approach for raising children's intakes of all three food types.
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Affiliation(s)
- Elena T. Broaddus-Shea
- Center for Human Nutrition and Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; (S.M.); (A.L.T.-L.); (B.A.S.N.); (P.J.W.)
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, 13001 E. 17th Place, Aurora, CO 80045, USA
- Correspondence:
| | - Swetha Manohar
- Center for Human Nutrition and Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; (S.M.); (A.L.T.-L.); (B.A.S.N.); (P.J.W.)
| | - Andrew L. Thorne-Lyman
- Center for Human Nutrition and Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; (S.M.); (A.L.T.-L.); (B.A.S.N.); (P.J.W.)
| | - Shiva Bhandari
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene St., Columbia, SC 29208, USA;
| | - Bareng A. S. Nonyane
- Center for Human Nutrition and Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; (S.M.); (A.L.T.-L.); (B.A.S.N.); (P.J.W.)
| | - Peter J. Winch
- Center for Human Nutrition and Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; (S.M.); (A.L.T.-L.); (B.A.S.N.); (P.J.W.)
| | - Keith P. West
- Center for Human Nutrition and Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA; (S.M.); (A.L.T.-L.); (B.A.S.N.); (P.J.W.)
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Abstract
The human body grows in length from conception to the maximal adult height over two decades. The shortest male population averages ∼150 cm and the tallest ∼183 cm. Nonetheless the dimensions of head and trunk are highly comparable, with the vast difference in the leg length. Stunting is a personal condition in which an individual has a standing height-for-age (HAZ) of less than two standard deviations of the standard curve median. It is associated with increased mortality, morbidity, and functional deficits. The process of losing relative stature is known as linear growth retardation, first attributed to chronic protein deficiency, then to an assortment of micronutrient deficiencies, and most recently to inflammation from unhygienic environmental conditions. Public health intervention trials responding to each of these possibilities have failed to produce true reversal responses measured in the 10s of centimeters. As to biological insights, there is no convenient way to separate weight from length growth with sonographic monitoring, but a third of infants can be born stunted. Normative growth (standard curves) competes with epigenetic adaptation (programming) as the beacon for in utero growth. Major investments into field trials allow us to discard multiple micronutrients and water/sanitation/hygiene interventions as measures to reverse established stunting. The preponderance of evidence is against catch-up growth during puberty. Future publications will be in the conceptual domain, resolving metrics, while the full range of stimuli and exposures impeding growth will be elucidated. Advances in measurement techniques in anthropometry and immunology and endocrinology will be mobilized to the literature.
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Affiliation(s)
- Noel W. Solomons
- Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala
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