Relationship between agricultural biodiversity and dietary diversity of children aged 6-36 months in rural areas of Northern Ghana

The medium-term impact of a micronutrient powder intervention on anemia among young children in Rural China

BACKGROUND

Poor development of young children is a common issue in developing countries and it is well established that iron deficiency anemia is one of the risk factors. Research has shown that iron deficiency is a common micronutrient deficiency among children in rural China and can result in anemia. A previous paper using data from the same trial as those used in the current study, but conducted when sample children were younger, found that after 6 months of providing caregivers of children 6-11 months of age free access to iron-rich micronutrient powder (MNP) increased the hemoglobin concentrations (Hb) of their children. However, no effects were found 12 and 18 months after the intervention. The current study followed up the children four years after the start of the original intervention (when the children were 4-5 years old) and aims to assess the medium-term impacts of the MNP program on the nutritional status of the sample pre-school-aged children, including their levels of Hb, the prevalence of anemia, and the dietary diversity of the diets of the children.

METHODS

At baseline, this study sampled 1,802 children aged 6-11 months in rural Western China. The intervention lasted 18 months. In this medium-term follow-up study that successfully followed 81% (n = 1,464) of children (aged 49-65 months) from the original study population 4 years after the start of the intervention, we used both intention-to-treat (ITT) effect and average treatment on the treated effect (ATT) analyses to assess the medium-term impacts of the MNP distribution program on the nutritional status of sample children.

RESULTS

The ITT analysis shows that the MNP intervention decreased the prevalence of anemia of young children in the medium run by 8% (4 percentage points, p < 0.1). The ATT analysis shows that consuming 100 (out of 540) MNP sachets during the initial intervention led to a decrease in anemia of 4% (2 percentage points, p < 0.1). Among children with moderate anemia at baseline (Hb < 100 g/L), the intervention reduced the probability of anemia by 45% (9 percentage points, p < 0.1), and, for those families that complied by consuming 100 (out of 540) sachets, a 25% (5 percentage points, p < 0.05) reduction in the anemia rate was found. The MNP intervention also led to a persistent increase in dietary diversity among children that were moderately anemic at baseline. The results from the quantile treatment effect analysis demonstrated that children with lower Hb levels at baseline benefited relatively more from the MNP intervention.

CONCLUSIONS

The findings of the current study reveal that the MNP intervention has medium-term effects on the nutritional status of children in rural China. The impacts of the MNP program were relatively higher for children that initially had more severe anemia levels. Hence, the implications of this study are that programs that aim to increase caregiver knowledge of nutrition and improve their feeding practices should be encouraged across rural China. Families, policymakers, and China's society overall need to continue to pay more attention to problems of childhood anemia in rural areas. This is particularly crucial for families with moderately anemic children at an early age as it can significantly contribute to improving the anemia status of children across rural areas of China.

TRIAL REGISTRATION

ISRCTN44149146 (15/04/2013).

Agricultural diversification and intra-household dietary diversity: Panel data analysis of farm households in Bangladesh

This paper investigates the associations between agricultural diversification and dietary diversity among men, women and children of farm households in Bangladesh. Using three waves of nationally representative Bangladesh Integrated Household Survey (BIHS- 2011-12, 2015 and 2018) data and a panel data model, the study found that agricultural production diversification can emphasize the dietary diversification across the life cycle of farm household members. The balanced panel data reveals that agricultural production diversification has a statistically significant and positive impact on dietary diversity of individual members (men, women and children) of farm households. Moreover, other important factors that impact on agricultural diversification and improve dietary diversity like women's education and employment, commercialization of farm households, access to non-farm income sources, and access to information facilities also have a strong association in improving dietary status, food and nutritional security as well. Although there is currently limited diversity in the diets of adult men, women and children of rural farm households, the situation can be improved over time with proper and consistent support. The findings suggest policy interventions should target not only agricultural diversification but also improve women's education and on and off farm employment opportunities and facilitate better access to information for rural households. These recommendations can support improved dietary diversity for all household members under different settings.

Contribution of the biodiversity of edible plants to the diet and nutritional status of women in a Zapotec communities of the Sierra Norte, Oaxaca, Mexico

We explored the relationship between the diversity of edible plants and the nutritional status of housewives from a Zapotec municipality in Oaxaca, Mexico, during the dry and rainy seasons, and analyzed how sociodemographic variables influences this relationship. Edible plant availability, women's dietary diversity score (WDDS), nutrient intake, and body mass index (BMI) were calculated. WDDS, intakes of energy and nutrients were mainly influenced by seasonality. Older housewives with less schooling had a higher consumption of edible plants, and better nutritional status.

Relationships between land tenure insecurity, agrobiodiversity, and dietary diversity of women of reproductive age: Evidence from Acholi and Teso subregions of Uganda

Land tenure security is central to food security of rural agricultural-dependent communities, but there is limited evidence linking the state of agrobiodiversity to perception of land tenure security and access to and quality of food eaten. This study explores this relationship using data captured from 1,279 households in Acholi and Teso subregions of Uganda, and the relationships are established using a study sample of 1,227 women of reproductive age (WRA). Sixteen percent of respondents perceived themselves to be land tenure insecure. Although approximately 275 species were reported available for food, household access to a variety of plant and animal species is limited to <10 species by 69% of the study population. Dietary diversity was also low, with 53% of women meeting minimum diet diversity. Evidence from estimation of a generalized Poisson regression reveals that dietary diversity of WRA is consistently, positively correlated with species diversity available for food and negative with land tenure insecurity. A unit increase in species diversity led to 18% increase in dietary diversity of WRAs. Land tenure insecurity was likely to reduce dietary diversity of WRAs by 26% (p < .05). Interventions with an aim to increase species diversity can deliver positive dividends for food and nutrition security. Land policy reforms and interventions that strengthen land tenure security for both men and women are likely to contribute positively to dietary diversity leading to improved food and nutrition security of vulnerable communities in rural areas.

Factors associated with dietary diversity and length-for-age z-score in rural Ethiopian children aged 6-23 months: A novel approach to the analysis of baseline data from the Sustainable Undernutrition Reduction in Ethiopia evaluation

Infants and young children need diets high in nutrient density and diversity to meet the requirements of rapid growth and development. Our aim was to evaluate sociodemographic, agricultural diversity, and women's empowerment factors associated with child dietary diversity and length-for-age z-score (LAZ) in children 6-23 months using data collected as part of the Sustainable Undernutrition Reduction in Ethiopia (SURE) evaluation study baseline survey in May-June 2016. We here present a novel analysis using directed acyclic graphs (DAGs) to represent our assumptions about the causal influences between the factors of interest and the outcomes. The causal diagrams enabled the identification of variables to be included in multivariable analysis to estimate the total effects of factors of interest using ordinal logistic/linear regression models. We found that child dietary diversity was positively associated with LAZ with children consuming 4 or more food groups having on average an LAZ score 0.42 (95% CI [0.08, 0.77]) higher than those consuming no complementary foods. Household production of fruits and vegetables was associated with both increased child dietary diversity (adjusted OR 1.16; 95% CI [1.09, 1.24]) and LAZ (adjusted mean difference 0.05; 95% CI [0.005, 0.10]). Other factors positively associated with child dietary diversity included age in months, socio-economic status, maternal education, women's empowerment and dietary diversity, paternal childcare support, household food security, fruit and vegetable cultivation, and land ownership. LAZ was positively associated with age, socio-economic status, maternal education, fruit and vegetable production, and land ownership.

Determinants of dietary diversity among women of reproductive age in two different agro-ecological zones of Rongai Sub-County, Nakuru, Kenya

Background

Empirical evidence on the link between agrobiodiversity and dietary diversity appears to be inconclusive. Thus, there arises a need to determine other factors that could significantly influence dietary diversity in different agro-ecological zones, as factors may vary from region to region.

Objective

The objective of this study was to document the status of agrobiodiversity and dietary diversity and to assess the determinants of dietary diversity among women of reproductive age in two different agro-ecological zones of Rongai Sub-County in Kenya.

Design

A cross-sectional study of 384 women aged 18-49 years was conducted. Agrobiodiversity was measured using the Shannon-Wiener index, species richness (count) and production diversity score. A 24-hour dietary recall was used to determine minimum dietary diversity for women (MDD-W) of reproductive age.

Results

Although the level of agrobiodiversity was different between the low and high agro-ecological zones (using Shannon-Wiener index); the women's dietary diversity was not different (p > 0.05) between low (3.78 ± 0.99) and high potential areas (3.84 ± 1.05). In multivariate logistic regression, there was no association (p > 0.05) between agrobiodiversity indicators and dietary diversity across the two agricultural zones. Factors influencing MDD-W in two agricultural zones were different. In low potential areas, woman's education level positively determined dietary diversity, while in high potential areas household gender, woman's education level, woman's age and family size influenced MDD-W.

Conclusion

The proportion of women who met minimum dietary diversity was low. Although agrobiodiversity was different in the two agro-ecological zones, women's dietary diversity scores were similar. In low agricultural potential areas, only education level influenced women's dietary diversity while household gender, education level, age and family size were the important determinants in high agricultural potential areas. Therefore, it is recommended that nutrition interventions focusing on lessening malnutrition and improving dietary quality should pay special attention to differences in agro-ecological zones to develop region-specific interventions instead of generalizing interventions.

Perbedaan Tingkat Keragaman Pangan Balita dan Tingkat Pendidikan Orang Tua di Rumah Tangga Kawasan Rumah Pangan Lestari (KRPL) Dan Non KRPL

Background: Sustainable Reserve Food Garden Area (KRPL) is program that to increase family dietary diversity, such as children. Children’s dietary diversity can affect to nutritional adequacy and can impact to growth process. The factor that can affect successful of KRPL program is parents’ education level.Objectives: The purpose of this study was to identify the difference between children’s dietary diversity level, household income level, and parents’ education level in sustainable reserve food garden area (KRPL) and non KRPL household in Kamal sub-district, Bangkalan district, Madura.  Method: This was an observational study with case control comparative study design was conducted among 25 children in KRPL area and 25 children in non KRPL area with mother or other family member as respondents. Simple random sampling method was used to select the samples. Children and parents’ characteristic were asked to answer structured questionnaire. Children dietary diversity level was asked by Individual Dietary Diversity Score (IDDS) instrument. The data was analyzed with Mann Whitney statistic test. Result: Children that involved in this study, either in KRPL or non KRPL area, was less than the same 35 months old (52%). Children from KRPL area was mostly girls (64%), while children from non KPRL area was mostly boys (56%). Children dietary diversity condition in KRPL area was low (52%), while children dietary diversity level in non KRPL area was sufficient (64%). Children who lived in KRPL area not always have diverse intake. The result showed that there was no difference between children dietary diversity level in KRPL and non KRPL area (p=0.259). Household income level on KRPL area was higher (68%) if compared to household on non KRPL area (44%). Parents’ education level in KRPL area was classified high (father=88%, mother=88%), while that parents’ education level in non KRPL area classified low (father=88%, mother=100%) (p=0.000). Parents in KRPL area have higher education level compare to parents in non KPRL area. Conclusion: Children dietary diversity in KRPL area are not different with non KRPL area. Children who lived in KRPL area not always have diverse intake. There is difference between household’s income level and parents’ education level. Household in KRPL area have higher income and parents in KRPL area have higher education level compare to households and parents in non KPRL area. ABSTRAKLatar Belakang: Kawasan Rumah Pangan Lestari (KRPL) merupakan program yang bertujuan untuk memperbaiki dan meningkatkan keragaman pangan keluarga, salah satunya balita. Keragaman pangan pada balita dapat berpengaruh pada kecukupan kebutuhan gizi dan berdampak pada proses pertumbuhannya. Salah satu faktor yang dapat mempengaruhi keberhasilan program KPRL adalah tingkat pendidikan orang tua.Tujuan: Tujuan dari penelitian ini adalah untuk mengidentifikasi perbedaan tingkat keragaman pangan balita dan tingkat pendapatan keluarga, dan tingkat pendidikan orang tua di rumah tangga Kawasan Rumah Pangan Lestari (KRPL) dan non KRPL Kecamatan Kamal, Kabupaten Bangkalan, Madura.Metode: Penelitian observasional dengan rancang bangun penelitian potong lintang komparatif dilakukan pada subjek penelitian yang terdiri dari 25 balita di wilayah KRPL dan 25 balita di wilayah non KRPL dengan ibu atau anggota keluarga lainnya sebagai responden. Metode simple random sampling digunakan untuk memilih sampel. Karakteristik balita dan orang tua ditanyakan melalui kuesioner. Tingkat keragaman pangan balita ditanyakan melalui instrumen Individual Dietary Diversity Score (IDDS) Data dianalisis menggunakan uji statistik Mann Whitney.Hasil: Balita yang terlibat dalam penelitian ini, baik di area KPRL maupun non KPRL, sebagian besar berusia kurang dari sama dengan 35 bulan (52%). Balita yang berasal dari wilayah KRPL sebagian besar perempuan (64%), sedangkan dari wilayah non KPRL sebagian besar laki-laki (56%). Kondisi tingkat keragaman pangan balita di wilayah KRPL tergolong rendah (52%), sedangkan tingkat keragaman pangan balita di wilayah non KRPL tergolong cukup (64%). Balita yang tinggal di rumah tangga KRPL tidak selalu mengonsumsi makanan yang beragam. Hasil penelitian menunjukkan bahwa tidak terdapat perbedaan tingkat keragaman pangan balita di wilayah KRPL dan non KPRL (p=0,259). Tingkat pendapatan keluarga balita di wilayah KRPL lebih tinggi (68%) apabila dibandingkan dengan wilayah non KPRL (44%). Tingkat pendidikan orang tua di wilayah KRPL tergolong tinggi (ayah=88%, ibu=88%), sedangkan tingkat pendidikan orang tua di wilayah non KRPL tergolong rendah (ayah=88%, ibu=100%) (p=0,000).Kesimpulan: Tingkat keragaman pangan balita di area KRPL tidak berbeda dengan balita di area non KPRL. Terdapat perbedaan tingkat pendapatan keluarga dan tingkat pendidikan orang tua balita. Keluarga di wilayah KRPL memiliki tingkat pendapatan yang lebih tinggi dan orang tua di area KRPL memiliki tingkat pendidikan lebih tinggi apabila dibandingkan dengan rumah tangga dan orang tua di wilayah non KPRL.

Nutrition education, farm production diversity, and commercialization on household and individual dietary diversity in Zimbabwe

Background

Nutrition education is crucial for improved nutrition outcomes. However, there are no studies to the best of our knowledge that have jointly analysed the roles of nutrition education, farm production diversity and commercialization on household, women and child dietary diversity.

Objective

This article jointly analyses the role of nutrition education, farm production diversity and commercialization on household, women and children dietary diversity in Zimbabwe. In addition, we analyze separately the roles of crop and livestock diversity and individual agricultural practices on dietary diversity.

Design

Data were collected from 2,815 households randomly selected in eight districts. Negative binomial regression was used for model estimations.

Results

Nutrition education increased household, women, and child dietary diversity by 3, 9 and 24%, respectively. Farm production diversity had a strong and positive association with household and women dietary diversity. Crop diversification led to a 4 and 5% increase in household and women dietary diversity, respectively. Furthermore, livestock diversification and market participation were positively associated with household, women, and children dietary diversity. The cultivation of pulses and fruits increased household, women, and children dietary diversity. Vegetable production and goat rearing increased household and women dietary diversity.

Conclusions

Nutrition education and improving access to markets are promising strategies to improve dietary diversity at both household and individual level. Results demonstrate the value of promoting nutrition education; farm production diversity; small livestock; pulses, vegetables and fruits; crop-livestock integration; and market access for improved nutrition.