Providing Micronutrients through Food-Based Solutions: A Key to Human and National Development

Village chicken production and food security: a two-decade bibliometric analysis of global research trends

Background

The present study aimed to reveal outputs of research works on village chicken production as a tool to combat food insecurity, taking into account the recurring challenge posed by food shortage and high rise in hunger among vulnerable people of several countries.

Results

On aggregate, 104 publications were obtained in a BibTeX design for analysis using bibliometric package in R studio. The obtained data comprised, but not limited to authors, citations, institutions, key words and journals. Published articles on village chicken production with relation to food security retrieved from web of science (WOS) and Scopus data banks were utilized with a rise in research publications of a yearly growth of 12.93% during the study period. With regard to country, USA was ranked first with an aggregate sum of publications (n = 16), and a huge global academic influence with most top article citations (n = 509). The frequently used authors’ keywords in this studied research area were food security (n = 23), poultry (n = 9), chickens (n = 7), backyard poultry (n = 5), gender (n = 4), which all together created a hint on related studies on village chicken production and food security.

Conclusions

The present study provides a worldwide situation that traverse the intellectual quandary on village chicken production and food security research, and a direction for further researches in this field. It is very vital to emphasize that the current study only dealt with principal areas of village chicken production as related to food security research, hence, it is projected that new empirical research and prospective research findings would afford new knowledge and insight on village chicken production as a means to address food security challenges as new studies evolves.

A Randomized Pilot Trial of Micronutrient Supplementation for Under-5 Children in an Urban Low-Cost Flat Community in Malaysia: A Framework for Community-Based Research Integration

Early childhood nutritional deficiency has detrimental consequences on physical and cognitive development. We conducted a single-center, single-blind, two-arm pilot randomized no-treatment controlled trial (the Child of Urban Poverty Iron Project (CUPIP); NCT03819530) in a people’s housing project locale in Selangor, Malaysia, between September 2019 and February 2020, to assess the trial’s general feasibility and preliminary benefits of daily micronutrient supplementation for iron storage and anthropometric outcomes in under-5 children. Those with history of premature births, congenital abnormalities, or baseline hemoglobin <70 g/L were excluded. Participants received baseline deworming and were simply randomized in a 1:1 ratio to either micronutrient (4-month daily micronutrient packets) or control (no micronutrient supplementation) groups. Information on anthropometric, erythrocytic, and iron storage endpoints were collected. Overall, 45 (25 micronutrient and 20 controls) participants were enrolled and completed 4-month endpoint assessments. Micronutrient recipients demonstrated higher median mean corpuscular volume, serum ferritin level with no significant differences in all anthropometric endpoints. In conclusion, this pilot trial was implementable, demonstrating that micronutrient supplementation significantly improved hematological, but not anthropometric, endpoints, of under-5-year-old children living in an underprivileged environment. A definitive well-designed trial with larger sample sizes and greater attrition control should be contemplated in the future.

Nutritional policies and anaemia among under-five children in selected south Asian countries: 1950-2016

Background

Despite policies and social development, childhood malnutrition remains a significant public health and social challenge in many south Asian countries. Also, there is a lack of study for a comparative understanding between the nutrition policies and nutritional status of under-5 children in south Asian countries. In this context, the present study aims to understand the comparative evolution of nutritional policies and programs in south Asian countries between 1950 to 2016 and assess current nutritional status of children under the age of 5 in Bangladesh, India, Nepal, and Pakistan.

Methods

This study obtained yearly anaemia data from the Global Health Observatory Data Repository (World Health Statistics) from 1990 to 2016 for comparative analysis. The most recent Demographic Health Survey (DHS) rounds have been taken for four south Asian nations. Bivariate analysis and classical figures have been utilised to demonstrate the findings.

Results

In Bangladesh, Nepal, India, and Pakistan, the prevalence of anaemia decreased by 33%, 31%, 20%, and 12% from 1990 to 2016, respectively. While analysis of the policy and programs, the problem of under-nutrition in all selected countries stems from the lack of serious implementation of National Nutrition Policies.

Conclusion

This study suggests that the national nutrition programs require inter-sectoral coordination between central ministries within countries to reduce the anaemia level. In light of Sustainable Development Goals (SDG), a multi-faceted policy should be implemented to prevent and control malnutrition problems in these countries.

Foliar Zinc-Selenium and Nitrogen Fertilization Affects Content of Zn, Fe, Se, P, and Cd in Wheat Grain

The grain yield and concentrations of Fe, Zn, Se, Cd, and P in two winter wheat genotypes and in vitro bioaccessibility of Fe and Zn under the effect of different nitrogen fertilization and Zn-Se foliar application were evaluated. The total grain Fe, Zn, and Se concentrations, as well as Fe and Zn concentrations, after in vitro digestion were under the strongest effect of foliar Zn-Se application. On the other hand, Fe and Zn bioaccessibility (%) were under the most substantial effect of genotype. Regarding the need to increase concentrations of essential micronutrients in wheat grain, foliar Zn-Se application is a reliable and accepted agricultural practice, but to improve mineral bioaccessibility in human nutrition, foliar Zn-Se application should be combined with the most responsive genotypes. For this reason, further research on the genotype specificity of wheat regarding micronutrient bioaccessibility should be carried out.

Variation in Nutrient Composition of Seafood from North West Africa: Implications for Food and Nutrition Security

Fish and seafood may play an important role for nutrition and food security as they contain essential vitamins, minerals, and essential fatty acids. The aim of this study was to describe the nutrient composition, including fatty acids, amino acids, vitamins, and minerals, in commonly consumed fish species (fillet- and whole fish samples) sampled off the Northwest African coast. Furthermore, we assessed the species' contributions to the recommended nutrient intake (RNI) values from the World Health Organization (WHO). Samples of commercially important fish species (Sardina pilchardus, Engraulis encrasicolus, Trachurus trachurus, Pagellus acarne) were collected using trawling on the R/V Dr. Fridtjof Nansen in May 2017 and analyzed for nutrients at the Institute of Marine Research as individual and composite samples. All the analyzed fish species were good dietary sources of several vitamins and minerals and whole fish were substantially more nutrient dense than fillet samples, especially with regard to vitamin A, iodine, zinc, calcium, and iron. Including 100 g of sardine or anchovy (whole fish) in the diet, would contribute substantially to the RNI for vitamin B12, vitamin D and vitamin A, EPA and DHA as well as the minerals iodine, zinc, and calcium. This study shows that fish consumed with skin, bone, and viscera may be very nutrient dense and important for local food and nutrition security.

Comparison of cricket diet with peanut-based and milk-based diets in the recovery from protein malnutrition in mice and the impact on growth, metabolism and immune function

Some evidence suggests that edible insects could be used to treat malnutrition following protein deficiency. However, additional studies are needed to better assess the potential of edible insects as a therapeutic food supplement and their long-term impact on recovery from malnutrition. The goals of this study were to investigate the effectiveness of a cricket-based diet in recovery from protein-malnutrition in early life, and to compare cricket protein to more traditional sources used for food fortification and supplementation. Protein-malnutrition was induced by administration of an isocaloric hypoprotein diet (5% protein calories) in young male mice for two weeks during puberty, followed by a six-week recovery period using a cricket-, peanut- or milk-based diet. We examined the impact of protein-malnutrition and subsequent recovery on body weight, growth and select biomarkers of inflammation and metabolism. Protein-malnutrition resulted in growth retardation, downregulation of inflammatory markers in spleen tissue, decreased levels of serum triglycerides, and elevated serum levels of leptin and adiponectin. The cricket-based diet performed equally well as the peanut- and milk-based diets in body weight recovery, but there were differences in immune and metabolic markers among the different recovery diets. Results suggest edible crickets may provide an alternative nutrient-dense protein source with relatively low environmental demands for combating the effects of early-life malnutrition compared to more traditional supplementation and fortification sources. Additional investigations are needed to examine the short and long term impacts of different recovery diets on metabolism and immune function.

Nutrient and Chemical Contaminant Levels in Five Marine Fish Species from Angola-The EAF-Nansen Programme

Fish is a rich source of several important nutrients and an important part of the otherwise plant-dominated diet present in Angola. However, fish may also be a source of contaminants. The aim of this study was to analyse the nutrient contents and the levels of chemical contaminants, including arsenic, cadmium, mercury, and lead, in five commonly consumed marine fish species sampled during a survey with the research vessel Dr. Fridtjof Nansen in Angola. The species' contribution to recommended nutrient intakes (RNI) for women and children was assessed and compared to that of food products of terrestrial animal origin. All the sampled species are good sources of protein and micronutrients if included in the diet, and inter-species variation is evident. The species were identified to contribute 5-15% of the RNI for calcium, iron, iodine, and zinc and exceeded the contribution to protein and iron intakes of food products of terrestrial animal origin. Furthermore, the potential consumer exposure to chemical contaminants in the species was assessed. None of the species exceeded the maximum levels for cadmium, mercury, and lead, and the potential consumer exposure to cadmium and methylmercury was considered low. The data presented in this study represent an important contribution to African food composition tables.

Interventions to Improve Micronutrient Status of Women of Reproductive Age in Southeast Asia: A Narrative Review on What Works, What Might Work, and What Doesn't Work

Objectives To provide an overview of nutrition-specific and nutrition-sensitive interventions that could improve micronutrient status of women of reproductive age. Methods This narrative review has a special focus on Southeast Asia, as the work was undertaken within the framework of the SMILING (Sustainable Micronutrient Interventions to controL deficiencies and Improve Nutrition status and General health in Southeast Asia) project. Results In order for new interventions to become accepted, comprehension and interpretation of potential impact of different strategies by policymakers and non-nutritionists is needed. By presenting a wide overview of strategies, and discussing the context and current consensus on these strategies, the review aims to help with the formulation of new recommendations for national programs in Southeast Asia. Conclusions Current policies in Southeast Asia to improve micronutrient status of women of reproductive age are focused too much on single micronutrient supplementation for pregnant women (iron and folic acid supplements). A more holistic approach, including both nutrition-specific and nutrition-sensitive interventions, is needed.

Effectiveness of provision of animal-source foods for supporting optimal growth and development in children 6 to 59 months of age

BACKGROUND

Adequate nutrients early in life promote cognitive development and are critical for proper growth and functioning. The effect of individual nutrients consumed through food is often not the same as consuming the same nutrients in supplementary form due to 'food synergy', the biological and chemical interrelations that occur between nutrients. Animal-source foods, such as eggs, meat, fish, and dairy, are energy dense and contain multiple micronutrients and essential fatty acids with high bioavailability. The benefits of animal-source foods may include higher food synergy relative to fortified foods as well as decreasing dependence on external suppliers of fortified foods.

OBJECTIVES

To assess the effectiveness of animal-source foods compared to any other feeding interventions or no intervention in improving growth and developmental outcomes in children aged 6 to 59 months.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, CINAHL, 18 other databases, and three trials registers up to August 2018. We also contacted authors and known experts in the field for assistance in identifying ongoing or unpublished data, and searched the reference lists of included studies and reviews, and websites of relevant organizations, for other studies that may not have been captured by our electronic searches.

SELECTION CRITERIA

We included randomized controlled trials and quasi-randomized controlled trials of any duration, where children between 5 months and 59 months (6 years) of age were provided with an animal-source food (e.g. consumption of milk, meat, or eggs), prepared with any cooking method, compared with any intervention or no intervention.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed trial eligibility using prespecified criteria, extracted data, assessed risk of bias, and graded the quality of the evidence using the GRADE approach.

MAIN RESULTS

Study characteristicsWe included 6 studies that analyzed data from 3036 children aged 5 to 50 months. The studies were conducted in China, the Democratic Republic of Congo, Ecuador, Guatemala, Pakistan, the USA, and Zambia, and lasted between 5 and 12 months. Three studies were funded, in part, by government entities; one study was supported by a nonprofit organization. Two studies did not report a funding source.Three studies compared the effects of feeding an animal-source food with a fortified (iron or iron and zinc), or unfortified cereal; two used a control group with no intervention; one compared a meat-based diet to a dairy-based diet. The types of animal-source foods tested included yogurt, eggs, cheese, lyophilized (freeze-dried) beef product, ground and frozen pork, puréed and jarred beef with gravy or pork, and powdered whey protein.We judged four studies to be at unclear risk of bias overall; three studies because they were funded by an industry with a plausible interest in the outcome of the intervention; and one study because there was insufficient information to assess five of the seven bias 'Risk of bias' domains. We judged two of the six studies to be at high risk of bias overall; one study because there was significant baseline imbalance in length-for-age z scores (LAZ) between groups and evidence of selective reporting; the other study because there there was both a significant baseline imbalance in LAZ and weight-for-age z scores (WAZ) between groups, and a large-scale social media campaign that may have influenced care received at home in the control group.Key resultsAnimal-source foods versus cereal-based foods or no interventionFive studies (2972 children) measured change in linear growth with either height-for-age z scores (HAZ) or LAZ. Three studies (592 children) reported a significant increase in HAZ and LAZ in the intervention group compared to the control group. Two studies (2380 children) reported a decline in LAZ in both groups. In one study (1062 children) there was no difference between the groups in the rate of decline; in the other (1318 children) the decrease in LAZ was significantly smaller in the intervention group.Five studies (2972 children) measured weight gain using WAZ. Three studies (592 children) reported a significant increase in WAZ in the intervention group compared to the control group. In two studies (2380 children), WAZ decreased in both groups. In one of these studies (1318 children), the decrease in the intervention group was significantly smaller than in the control group. In the other study (1062 children), there was no difference between the groups.Three studies (1612 children) reported impacts on all-cause morbidity, but metrics were inconsistent between studies. One study with yogurt (402 children) reported a significant reduction in duration and incidence of diarrhea and upper respiratory infections in the intervention group. One study with eggs (148 children) reported a significant increase in the incidence of diarrhea in the intervention group, but this may have been due to cultural associations with eggs and gastrointestional problems. There were no other significant differences in fever, respiratory infections, or skin conditions between groups. The third study (1062 children) found no differences between intervention and control groups across morbidity measures.No studies reported data on anemia.Meat-based diet versus dairy-based dietOne study (64 children) measured change in LAZ and WAZ in infants fed either a meat-based diet or dairy-based diet. There was a significant increase in LAZ among infants consuming the meat-based diet and a significant decrease in LAZ among infants consuming a dairy-based diet. WAZ increased in both groups, with no significant difference between groups.The study did not assess all-cause morbidity or anemia.Quality of the evidenceWe rated the quality of the evidence as very low overall due to baseline imbalances between intervention and control groups, high heterogeneity in meta-analysis, and imprecision due to wide confidence intervals and inconsistent direction of effects. We have little confidence in the results; further research is likely to change the estimate of magnitude and direction of treatment effect.

AUTHORS' CONCLUSIONS

Given the limited quality of the evidence, we are uncertain of the effects of the provision of animal-source food versus cereal products or no intervention on the growth or development of children. More adequately powered trials with deliberately selected animal-source foods are needed.

Household dairy production and child growth: Evidence from Bangladesh

Research from richer countries finds that dairy consumption has strong positive associations with linear growth in children, but surprisingly little evidence exists for developing countries where diets are far less diversified. One exception is a recent economics literature using the notion of incomplete markets to estimate the impacts of cattle ownership on children's milk consumption and growth outcomes in Eastern Africa. In addition to external validity concerns, an obvious internal validity concern is that dairy producers may systematically differ from non-dairy households, particularly in terms of latent wealth or nutritional knowledge. We re-examine these concerns by applying a novel double difference model to data from rural Bangladesh, a country with relatively low levels of milk consumption and high rates of stunting. We exploit the fact that a cow's lactation cycles provide an exogenous source of variation in household milk supply, which allows us to distinguish between a control group of households that do not own cows, a treatment group that own cows that have produced milk, and a placebo group of cow-owning households that have not produced milk in the past 12 months. We find that household dairy production increases height-for-age Z scores by 0.52 standard deviations in the critical 6-23 month growth window, though in the first year of life we find that household dairy supply is associated with a 21.7 point decline in the rate of breastfeeding. The results therefore suggest that increasing access to dairy products can be extremely beneficial to children's nutrition, but may need to be accompanied by efforts to improve nutritional knowledge and appropriate breastfeeding practices.

A Randomized, Double-Blind Study Assessing Changes in Cognitive Function in Indian School Children Receiving a Combination of Bacopa monnieri and Micronutrient Supplementation vs. Placebo

Several studies have indicated a chronic cognitive enhancing effect of Bacopa monnieri across different ages and cognitive impairment associated with vitamin and mineral deficiencies in children. Therefore, we investigated the effects of 4-month supplementation with a combination of B. monnieri extract and multiple micronutrients on cognitive functions in Indian school children aged 7–12 years. This was a randomized, double-blind, parallel design, single-center study in which 300 children were randomized to receive a beverage either fortified with B. monnieri and multiple micronutrients (“fortified”) or a non-fortified isocaloric equivalent (“control”) twice-daily for 4 months. Cognitive function was assessed by the Cambridge Neuropsychological Automated Test Battery (CANTAB) administered at baseline, Day 60 and Day 121. The primary endpoint was change in short-term memory (working memory) from baseline in subjects receiving “fortified” vs. “control” beverages after 4 months. Secondary endpoints included sustained attention, episodic memory, and executive function. The “fortified” beverage did not significantly improve short-term memory or any of the secondary outcomes tested relative to the “control” beverage. However, the spatial working memory “strategy” score showed significant improvement on Day 60 (difference between groups in change from baseline: −0.55; p < 0.05), but not on Day 121 due to the active intervention. Study products were well-tolerated. Reasons for these unexpected findings are discussed.

Genome-nutrition divergence: evolving understanding of the malnutrition spectrum

Humans adapted over a period of 2.3 million years to a diet high in quality and diversity. Genome-nutrition divergence describes the misalignment between modern global diets and the genome formed through evolution. A survey of hominin diets over time shows that humans have thrived on a broad range of foods. Earlier diets were highly diverse and nutrient dense, in contrast to modern food systems in which monotonous diets of staple cereals and ultraprocessed foods play a more prominent role. Applying the lens of genome-nutrition divergence to malnutrition reveals shared risk factors for undernutrition and overnutrition at nutrient, food, and environmental levels. Mechanisms for food system shifts, such as crop-neutral agricultural policy, agroecology, and social policy, are explored as a means to realign modern diets with the nutritional patterns to which humans may be better adapted to thrive.

Food composition tables in resource-poor settings: exploring current limitations and opportunities, with a focus on animal-source foods in sub-Saharan Africa

Animal-source foods (ASF) have the potential to enhance the nutritional adequacy of cereal-based diets in low- and middle-income countries, through the provision of high-quality protein and bioavailable micronutrients. The development of guidelines for including ASF in local diets requires an understanding of the nutrient content of available resources. This article reviews food composition tables (FCT) used in sub-Saharan Africa, examining the spectrum of ASF reported and exploring data sources for each reference. Compositional data are shown to be derived from a small number of existing data sets from analyses conducted largely in high-income nations, often many decades previously. There are limitations in using such values, which represent the products of intensively raised animals of commercial breeds, as a reference in resource-poor settings where indigenous breed livestock are commonly reared in low-input production systems, on mineral-deficient soils and not receiving nutritionally balanced feed. The FCT examined also revealed a lack of data on the full spectrum of ASF, including offal and wild foods, which correspond to local food preferences and represent valuable dietary resources in food-deficient settings. Using poultry products as an example, comparisons are made between compositional data from three high-income nations, and potential implications of differences in the published values for micronutrients of public health significance, including Fe, folate and vitamin A, are discussed. It is important that those working on nutritional interventions and on developing dietary recommendations for resource-poor settings understand the limitations of current food composition data and that opportunities to improve existing resources are more actively explored and supported.

Implementing Perennial Kitchen Garden Model to Improve Diet Diversity in Melghat, India

Lack of diet diversity causing micronutrient deficiency is common in developing countries and is gaining attention due to the hidden consequences of impaired physical and cognitive development. This paper describes the propagation of a sustainable perennial kitchen garden (KG) model to address household (HH) diet diversity in Melghat. Nutrient dense plants, comprising of minimum one tree (perennial) and one green leafy vegetable (GLV) were given to participating HHs along with qualitative interventions. Baseline survey was conducted in winter 2011 followed by seasonal surveys over 2 years to record changes in KG practices, dietary intake and childcare practices. Marked increase from 4% at baseline to 95% at endline was seen in the KG maintainance. Increased diversity was seen in all food categories other than cereals and pulses. Variety of GLVs consumed increased over the two winters as well as the 2 summers. However, no change in the quantity of GLV consumed was noted which was attributed to the duration of the study period being insufficient for the trees to grow and provide adequate leaves for consumption. Notably, livelihood component was not promoted and HHs were encouraged to harvest and distribute excess seeds to relatives and neighbours. The study generated huge demand from HHs within the intervention and neighbouring villages. It concludes that a well designed perennial KG along with imparting adequate knowledge can be a sustainable practice to increase diet diversity and GLV intake which would help address micronutrient deficiencies in the community.

Community development and livestock promotion in rural Nepal: effects on child growth and health

BACKGROUND

More than 50% of children in Nepal are malnourished. Economic growth and poverty reduction are not always sufficient to improve the health and nutritional status of children. Heifer Nepal uses livestock training as a tool for community development and poverty alleviation but does not directly address child health and nutrition.

OBJECTIVE

To systematically assess the effects of Heifer activities on child health and nutrition.

METHODS

The study was a 2-year, longitudinal, randomized, controlled trial in six communities in Nepal (both Terai and hills), pair-matched for specific characteristics, randomly assigned to receive Heifer community development activities at baseline (intervention) or 1 year (control). At 6-month intervals over a period of 2 years, child anthropometric and comprehensive household surveys were performed.

RESULTS

Four hundred fifteen households were enrolled containing 607 children 6 months to 5 years of age. The intervention and control communities were equivalent for baseline socioeconomic status, household size, ownership of land and animals, and child nutrition and health. At 12 months (prior to animal donations), the Terai intervention group had improved child weight (p = .04), improved child height (p = .05), and reduced sick days (p = .03), as well as increased household income (p = .004), increased ownership of animals (p = .04) and land (p = .04), and improved sanitation practices (p < .01). In all districts, longer participation in Heifer activities corresponded to more improvement in child height-for-age z-scores.

CONCLUSIONS

Heifer interventions resulted in improved socioeconomic status and household income per family member. Children under 60 months of age in the intervention group had greater incremental improvement in height-for-age and weight-for-age z-scores than children in the control group, and longer participation in Heifer activities was associated with better growth. Poverty alleviation programs, such as Heifer, may indirectly benefit child growth.

A bioeconomic approach to marriage and the sexual division of labor

Children may be viewed as public goods whereby both parents receive equal genetic benefits yet one parent often invests more heavily than the other. We introduce a microeconomic framework for understanding household investment decisions to address questions concerning conflicts of interest over types and amount of work effort among married men and women. Although gains and costs of marriage may not be spread equally among marriage partners, marriage is still a favorable, efficient outcome under a wide range of conditions. This bioeconomic framework subsumes both cooperative and conflictive views on the sexual division of labor. We test hypotheses concerning marriage markets, assortative mating, and men’s labor motivations among Tsimane forager-horticulturalists of Bolivia and find that: (1) men and women both value work effort in marital partners, (2) marital labor contributions are complementary, (3) work effort is correlated between spouses, (4) total production is correlated with total reproduction, and (5) better hunters have higher fitness gains within marital unions.

Meat supplementation increases arm muscle area in Kenyan schoolchildren

The present study examines the effect of animal-source-food (ASF) intake on arm muscle area growth as part of a larger study examining causal links between ASF intake, growth rate, physical activity, cognitive function and micronutrient status in Kenyan schoolchildren. This randomised, controlled feeding intervention study was designed with three isoenergetic feeding interventions of meat, milk, and plain traditional vegetable stew (githeri), and a control group receiving no snack. A total of twelve elementary schools were randomly assigned to interventions, with three schools per group, and two cohorts of 518 and 392 schoolchildren were enrolled 1 year apart. Children in each cohort were given feedings at school and studied for three school terms per year over 2 years, a total of 9 months per year: cohort I from 1998 to 2000 and cohort II from 1999 to 2001. Food intake was assessed by 24 h recall every 1-2 months and biochemical analysis for micronutrient status conducted annually (in cohort I only). Anthropometric measurements included height, weight, triceps skinfold (TSF) and mid-upper-arm circumference (MUAC). Mid-upper-arm muscle area (MAMA) and mid-upper-arm fat area (MAFA) were calculated. The two cohorts were combined for analyses. The meat group showed the steepest rates of gain in MUAC and MAMA over time, and the milk group showed the next largest significant MUAC and MAMA gain compared with the plain githeri and control groups (P< 0.05). The meat group showed the least increase in TSF and MAFA of all groups. These findings have implications for increasing micronutrient intake and lean body mass in primary schoolchildren consuming vegetarian diets.

Decreased parasite load and improved cognitive outcomes caused by deworming and consumption of multi-micronutrient fortified biscuits in rural Vietnamese schoolchildren

Micronutrient deficiencies are associated with impaired growth and cognitive function. A school-based fortification program might benefit schoolchildren but a high prevalence of parasite infestation might affect effectiveness. A randomized, double-blind, placebo-controlled 2 × 2 factorial trial was conducted to assess the efficacy of multi-micronutrient fortified biscuits with or without de-worming on growth, cognitive function, and parasite load in Vietnamese schoolchildren. Schoolchildren (n = 510), 6-8 years of age were randomly allocated to receive albendazole or placebo at baseline and four months of multi-micronutrient fortified biscuits (FB) or non-fortified biscuits. Children receiving FB for four months scored higher on two cognitive tests: Raven's Colored Progressive Matrices and the Digit Span Forward test. Children receiving albendazole plus FB had the lowest parasite load after four months. In children receiving FB, mid-upper arm circumference was slightly improved (+0.082 cm) but there were no differences in other indexes of anthropometry. Combining multi-micronutrient fortified biscuits with de-worming is an effective strategy.

How diverse is the diet of adult South Africans?

Background

The objective of the current study was to measure dietary diversity in South Africans aged 16 years and older from all population groups as a proxy of food security.

Methods

A cross-sectional study representative of adults from all specified ages, provinces, geographic localities, and socio-economic strata in South Africa was used (n = 3287). Trained interviewers visited participants at their homes during the survey. Dietary data was collected by means of a face validated 24 hour recall which was not quantified. A dietary diversity score (DDS) was calculated by counting each of 9 food groups. A DDS <4 was regarded as reflecting poor dietary diversity and poor food security.

Results

The provinces with the highest prevalence of poor dietary diversity (DDS <4) were Limpopo (61.8%) and the Eastern Cape (59.6%). By contrast, only 15.7% of participants in Western Cape had a low score. Participants in tribal areas (63.9%) and informal urban areas (55.7%) were by far the worst affected. There were significant differences in DDS by Living Standards Mean (LSM) analysis (p < 0.05) with the lowest LSM group having the lowest mean DDS (2.93).The most commonly consumed food groups were cereals/roots; meat/fish; dairy and vegetables other than vitamin A rich. Eggs, legumes, and vitamin A rich fruit and vegetables were the least consumed.

Conclusion

Overall the majority of South Africans consumed a diet low in dietary variety. The tribal areas and informal urban areas were worst affected and eggs, legumes and vitamin A rich fruit and vegetables, were the least consumed.

Accelerated hydrolysis method to estimate the amino acid content of wheat (Triticum durum Desf.) flour using microwave irradiation

The technique of microwave-assisted acid hydrolysis was applied to wholegrain wheat (Triticum durum Desf. cv. Balcali 2000) flour in order to speed the preparation of samples for analysis. The resultant hydrolysates were chromatographed and quantified in an automated amino acid analyzer. The effect of different hydrolysis temperatures, times and sample weights was examined using flour dispersed in 6 N HCl. Within the range of values tested, the highest amino acid recoveries were generally obtained by setting the hydrolysis parameters to 150 °C, 3 h and 200 mg sample weight. These conditions struck an optimal balance between liberating amino acid residues from the wheat matrix and limiting their subsequent degradation or transformation. Compared to the traditional 24 h reflux method, the hydrolysates were prepared in dramatically less time, yet afforded comparable ninhydrin color yields. Under optimal hydrolysis conditions, the total amino acid recovery corresponded to at least 85.1% of the total protein content, indicating the efficient extraction of amino acids from the flour matrix. The findings suggest that this microwave-assisted method can be used to rapidly profile the amino acids of numerous wheat grain samples, and can be extended to the grain analysis of other cereal crops.

The role of food and nutrition system approaches in tackling hidden hunger

One of the World's greatest challenges is to secure sufficient and healthy food for all, and to do so in an environmentally sustainable manner. This review explores the interrelationships of food, health, and environment, and their role in addressing chronic micronutrient deficiencies, also known as "hidden hunger", affecting over two billion people worldwide. While the complexity and underlying determinants of undernutrition have been well-understood for decades, the scaling of food and nutrition system approaches that combine sustainable agriculture aimed at improved diet diversity and livelihoods have been limited in their development and implementation. However, an integrated system approach to reduce hidden hunger could potentially serve as a sustainable opportunity.

Impact of vaccination against chicken Newcastle disease on food intake and food security in rural households in Tanzania

BACKGROUND

Small-scale poultry production has the potential to increase animal-source food consumption, improve household income, and reduce food insecurity.

OBJECTIVE

To assess the impact of a chicken Newcastle disease vaccination program on consumption of chicken and eggs among women and children, income, and food insecurity in rural Tanzanian households.

METHODS

Comparisons were made between households from three project villages, which participated in a Newcastle disease vaccination program for chickens, and three control villages, which did not participate. Household interviews were done with mothers from a random sample in March 2008 (237 households) and March 2009 (261 households).

RESULTS

After the first year of vaccinations (three rounds), project households kept significantly more chickens and tended to be more food secure than control households. Mothers from project households ate significantly more eggs than their counterparts in control households. A similar trend was observed among children. In 2009, fewer chickens were vaccinated in the project villages than in 2008, and more chickens were independently vaccinated in the control villages. This corresponded with an increase in ownership of chickens, a reduction in food insecurity, and improved consumption of eggs in control villages, whereas chicken ownership and egg consumption decreased and food insecurity remained relatively stable in project villages. We saw no differences between project and control villages in income earned from chicken and egg sales.

CONCLUSIONS

Our findings suggest that an increase in chicken Newcastle disease vaccination can lead to an increase in ownership of chickens and egg consumption and may also have an effect on reducing household food insecurity.

Assessing Impact and Impact Pathways of a Homestead Food Production Program on Household and Child Nutrition in Cambodia

Background

Homestead food production programs have the potential to improve maternal and child health and nutrition through multiple pathways.

Objective

To evaluate the impact of a homestead food production program in Cambodia on household production and consumption of micronutrient-rich foods and on maternal and child health and nutrition (intake of micronutrient-rich foods, anthropometry, hemoglobin, and anemia prevalence); and to assess pathways of impact on maternal and child health and nutrition.

Methods

Two cross-sectional surveys (baseline and endline) were used to assess differences between intervention ( n = 300) and control ( n = 200) households using t-tests and chi-square tests. Using endline data and multivariate analyses, we examined the pathways of impact of the program on maternal and child health and nutrition.

Results

Intervention and control households were similar at baseline in sociodemographic characteristics, but more intervention households owned animals, earned income from homestead food production, and produced and consumed micronutrient-rich foods. At endline, some of these differences had widened; more intervention households produced and consumed more vegetables, had higher dietary diversity, and had a lower prevalence of fever among children under 5 years of age. In the intervention group, more children consumed more eggs and more mothers consumed micronutrient-rich food more frequently than in the control group. There were no other differences between the groups in maternal and child health and nutrition. Greater household production of fruits and vegetables was associated with greater household dietary diversity, which was associated with dietary diversity among mothers and children. Dietary diversity was not associated with other maternal and child health and nutrition outcomes.

Conclusions

Cambodia's homestead food production program increased household production and consumption of micronutrient-rich foods and maternal and child intake (or frequency of intake) of some of these foods. Weaknesses in the evaluation design (e.g., lack of comparability between groups at baseline, failure to control for self-selection of households into the intervention, and collection of baseline and endline data during different seasons) prevent drawing firm conclusions about the program impacts. Analysis of impact pathways also shows that household-level benefits from the program did not translate into significant improvements in maternal and child health and nutrition. A careful redesign and rigorous assessment of the program using a program theory framework would help unleash its true potential to improve maternal and child health and nutrition outcomes.

Liposomal Delivery Systems for Encapsulation of Ferrous Sulfate: Preparation and Characterization

Liposomal delivery systems for water-soluble bioactives were prepared using the pro-liposome and the microfluidization technologies. Iron, an essential micronutrient as ferrous sulfate and ascorbic acid, as an antioxidant for iron were encapsulated in the liposomes. Liposomes prepared by the microfluidization technology using 6% (w/w) concentration of the lipid encapsulated with ferrous sulfate and ascorbic acid had particle size distributions around 150 to 200 nm, whereas liposomes from the pro-liposome technology resulted in particle sizes of about 5 microm. The encapsulation efficiency of ferrous sulfate was 58% for the liposomes prepared by the microfluidization using 6% (w/w) lipid and 7.5% of ferrous sulfate concentrations, and it was 11% for the liposomes from pro-liposome technology using 1.5% (w/v) lipid and 15% of ferrous-sulfate concentration. Both the liposomes exhibited similar levels of oxidative stability, demonstrating the feasibility of microfluidization-based liposomal delivery systems for large-scale food/nutraceutical applications.

Invited review: Role of livestock in human nutrition and health for poverty reduction in developing countries

Livestock keeping is critical for many of the poor in the developing world, often contributing to multiple livelihood objectives and offering pathways out of poverty. Livestock keeping also affects an indispensable asset of the poor, their human capital, through its impact on their own nutrition and health. This paper outlines the linkages between livestock keeping and the physical well-being of the poor, and examines a number of commonly held beliefs that misrepresent livestock development issues related to these linkages. These beliefs limit the scope of intervention programs to promote livestock and limit their potential contribution to poverty reduction. Recognition of the complexity of the role livestock play in household decision-making and of the opportunities foregone due to these misconceptions can enhance the ability of livestock to contribute to human well-being in the developing world.

Health, livelihoods, and nutrition in low-income rural systems

BACKGROUND

Absolute poverty remains a major challenge: the proportion of the world population living with hunger, food insecurity, and undernutrition has fallen, but the absolute number remains stubbornly large. An even larger number of people have enough to eat but suffer from severe micronutrient deficiencies.

OBJECTIVES

To provide a conceptual framework showing the interdependence of hunger and poverty with ill health among the rural poor.

METHODS

Review of the relevant health, nutrition, agriculture, and economics literature and organization of the findings into a systems framework.

RESULTS

Economic growth is not a sufficient answer to rural poverty. The predicament of poor households can be represented in terms of a self-reinforcing cycle involving nutrition, health, and productivity. The degree of poverty limits the quantity and quality of food intake. Macro- and micronutrient deficiencies interfere with child growth and development and impair immune function, resulting in a predisposition to infectious diseases. Health status strongly influences the quantity and quality of labor and achieved educational status. The high risk of child mortality prevents households from going through the demographic transition to smaller families and better-educated children. The death of a working adult may be catastrophic for the household. This self-reinforcing cycle means that the beneficial effects of an intervention are propagated around the cycle, potentiating its impact. Each main element--nutrition, health, and productivity--also has numerous other determinants and can be influenced by interventions. Interventions that increase the carrying capacity of the household's environment are likely to be more sustainable than "technical fixes," such as lifesaving medical treatment.

CONCLUSIONS

The self-reinforcing cycle is likely to be self-perpetuating without outside intervention. For any rural area where poverty reduction is planned, the key bottlenecks need to be identified. This can be done by using a causal diagram, as described in this paper.

National fortification of staple foods can make a significant contribution to micronutrient intake of South African adults

BACKGROUND

A national survey found that micronutrient deficiencies are prevalent in South African children, particularly calcium, iron, zinc, riboflavin, niacin, vitamin B6, folate, vitamin A, E and C. Mandatory fortification of maize meal and wheat flour were introduced in 2003 to combat some of the deficiencies found in children. To date however, there has not been a national survey on dietary intake in adults.

OBJECTIVES

The main objectives of this study were to evaluate the micronutrient intake of the diet consumed by the average adult South African by means of secondary data analyses and secondly to evaluate the effects of fortification on selected nutrient intakes.

STUDY DESIGN

Secondary data analysis was carried out with numerous dietary surveys on adults to create a database that included sampling (and weighting) according to ethnic/urban-rural residence in line with the population census, of which 79% were black Africans and the majority resided in rural areas. The effect of fortification was evaluated by substituting fortified foods in the diet for the unfortified products.

SUBJECTS

The combined database used in this study comprised 3229 adults.

RESULTS

Mean calcium, iron, folate and vitamin B6 intakes were very low particularly in women. Mean intakes of most micronutrients were lower in rural areas. Fortification of maize meal and wheat flour (bread) raised mean levels of thiamine, riboflavin, niacin, vitamin B6 and folate above the recommended nutrient intakes (RNIs). In women, despite fortification, mean iron intakes remained below the RNIs, as did calcium since it was not in the fortification mix.

CONCLUSION

The average dietary intake of adults was of poor nutrient density, particularly in rural areas. Fortification of maize meal and wheat flour (bread) considerably improved mean vitamin B6, thiamine, riboflavin, niacin, folate and iron intakes as well as the overall mean adequacy ratio of the diet.

Plant breeding to control zinc deficiency in India: how cost-effective is biofortification?

OBJECTIVE

To estimate the potential impact of zinc biofortification of rice and wheat on public health in India and to evaluate its cost-effectiveness compared with alternative interventions and international standards.

DESIGN

The burden of zinc deficiency (ZnD) in India was expressed in disability-adjusted life years (DALYs) lost. Current zinc intakes were derived from a nationally representative household food consumption survey (30-day recall) and attributed to household members based on adult equivalent weights. Using a dose-response function, projected increased zinc intakes from biofortified rice and wheat were translated into potential health improvements for pessimistic and optimistic scenarios. After estimating the costs of developing and disseminating the new varieties, the cost-effectiveness of zinc biofortification was calculated for both scenarios and compared with alternative micronutrient interventions and international reference standards.

SETTING

India.

SUBJECTS

Representative household survey (n = 119 554).

RESULTS

The calculated annual burden of ZnD in India is 2.8 million DALYs lost. Zinc biofortification of rice and wheat may reduce this burden by 20-51% and save 0.6-1.4 million DALYs each year, depending on the scenario. The cost for saving one DALY amounts to $US 0.73-7.31, which is very cost-effective by standards of the World Bank and the World Health Organization, and is lower than that of most other micronutrient interventions.

CONCLUSIONS

Not only may zinc biofortification save lives and prevent morbidity among millions of people, it may also help accommodate the need to economise and to allocate resources more efficiently. Further research is needed to corroborate these findings.

Meat supplementation improves growth, cognitive, and behavioral outcomes in Kenyan children

A randomized, controlled school feeding study was conducted in rural Embu District, Kenya to test for a causal link between animal-source food intake and changes in micronutrient nutrition and growth, cognitive, and behavioral outcomes. Twelve primary schools were randomly assigned to 1 of 4 groups. Children in Standard I classes received the local plant-based dish githeri as a midmorning school snack supplemented with meat, milk, or fat added to equalize energy content in all feedings. The Control children received no feedings but participated in data collection. Main outcome measures assessed at baseline and longitudinally were 24-h food intake recall, anthropometry, cognitive function, physical activity, and behaviors during school free play. For cognitive function, the Meat group showed the steepest rate of increase on Raven's Progressive Matrices scores and in zone-wide school end-term total and arithmetic test scores. The Plain githeri and Meat groups performed better over time than the Milk and Control groups (P < 0.02-0.03) on arithmetic tests. The Meat group showed the greatest increase in percentage time in high levels of physical activity and in initiative and leadership behaviors compared with all other groups. For growth, in the Milk group only younger and stunted children showed a greater rate of gain in height. The Meat group showed near doubling of upper midarm muscle area, and the Milk group a smaller degree of increase. This is the first randomized, controlled feeding study to examine the effect of meat- vs. milk- vs. plant-based snacks on functional outcomes in children.

Caregiver knowledge, attitudes and practices regarding vitamin A intake by Dominican children

Vitamin A deficiency (VAD) is a major concern in the Dominican Republic. Successful educational interventions are based on needs assessment data specific to the population for which behavioural change is desired. The purpose of this study was to establish a foundation for nutrition education efforts for caregivers of young children to prevent VAD in the Dominican Republic. A cross-sectional survey was administered to caregivers (N = 151) from rural/peri-urban villages in five provinces to assess vitamin A knowledge and attitudes, frequency of consumption of foods rich in vitamin A by an index child (age range 3-9 years), and food-related practices contributing to vitamin A intake. Caregiver knowledge regarding vitamin A was low in all villages regardless of differences in socio-economic status and level of education. A majority of the caregivers (67%) reported having a garden, but produce from the garden was thought mainly to provide a financial benefit vs. a nutritional benefit for the family. Several vegetables rich in vitamin A used as seasoning, mango, and unripe banana and plantain were commonly consumed by children as reported by caregivers. Educational interventions should focus on basic vitamin A knowledge regarding sources as well as symptoms of deficiency. Education should also emphasize increasing the variety of foods rich in provitamin A carotenoids grown in home gardens.

Agricultural biodiversity, nutrition, and health: making a difference to hunger and nutrition in the developing world

BACKGROUND

In spite of the strides made globally in reducing hunger, the problems of micronutrient deficiencies and coexisting obesity and related cardiovascular and degenerative diseases constitute a formidable challenge for the future. Attempts to reverse this trend with single-nutrient intervention strategies have met with limited success, resulting in renewed calls for food-based approaches. The deployment of agricultural biodiversity is an approach that entails greater use of local biodiversity to ensure dietary diversity.

OBJECTIVE

To outline a new strategy proposed by the International Plant Genetic Resources Institute (IPGRI) that employs agricultural biodiversity as the primary resource for food security and health.

METHODS

The authors carried out a meta-analysis to review and assemble existing information on the nutritional and healthful properties of traditional foods based on a diverse set of case studies and food composition and nutritional analysis studies. The methods highlight particular examples of foods where analysis of nutrient and non-nutrient composition reveals important traits to address the growing problems of malnutrition associated with the rise of chronic diseases. Finally, the authors analyze social, economic, and cultural changes that undermine the healthful components of traditional diets.

RESULTS

Based on this multidisciplinary and comparative approach, the authors suggest a holistic food-based approach that combines research to assess and document nutritional and healthful properties of traditional foods, investigating options in which nutritionally valuable traditional foods can contribute to better livelihoods, and ways that awareness and promotional campaigns can identify healthful components of traditional diets that fit the needs of urban and market-oriented consumers.

CONCLUSIONS

There is an urgent need for agricultural research centers, national agricultural research systems, universities, and community-based organizations to work together under a shared policy framework with the aim of developing a strong evidence base linking biodiversity, nutrition, and health. Although these initiatives are still ongoing, the gains realized in small-scale and local pilot efforts have encouraged IPGRI to work with local partners toward the implementation of scale-up efforts in various regions.

Iron availability from whey protein hydrogels: an in vitro study

The influence of whey protein hydrogel microstructure, filamentous versus particulate, on iron delivery was studied under different conditions, including simulated gastrointestinal conditions. Experiments were initially conducted to determine the impact of pH and enzymes on iron release. The results show that different iron release profiles can be obtained from filamentous and particulate gels. Particulate gels released more iron than filamentous gels at acidic pH, but the opposite was observed at alkaline pH. In the presence of pepsin at pH 1.2 or pancreatin at pH 7.5, both gel types showed increased protein hydrolysis, but only filamentous gels showed increased iron release, suggesting that matrix structure plays an important role in iron delivery. A dissolution test was carried out under gastrointestinal conditions to mimic the in vivo dissolution process. Filamentous gel released most of its iron during the intestinal phase of a simulated digestion, hence protecting iron during its transit in the gastric zone. Absorption of iron by the Caco-2 system, used to estimate intestinal absorption, revealed that filamentous gels favored intracellular iron absorption. These results suggest that filamentous gels show promise as matrices for transporting iron and promoting its absorption and therefore should be of major interest in the development of innovative functional foods.

Antimicrobial resistance in countries with limited resources: unique challenges and limited alternatives

The haphazard use of antimicrobial agents has caused these essential drugs to lose their effectiveness. In the resource-poor parts of the world, the problem is complex, involving inadequate access to antimicrobial agents in the poorest countries along with an excessive variety of drugs in middle-income countries that have inadequate capability to use them well or to control the unnecessary emergence of resistant microbes. Both circumstances may result in the rapid dissemination of antimicrobial resistance. Resistant organisms, which in wealthy countries would result in the increased expense or inconvenience of alternative agents, in poor countries may cause infections that for practical purposes are untreatable. The basic requirements for controlling drug-resistant problems in resource-poor and wealthy countries alike include first-line prevention of infectious diseases, laboratory support for etiologic diagnosis, adequate surveillance and epidemiological information, appropriate drug selection, locally appropriate guidelines for treatment, and proper education about infectious diseases in all levels. These requirements generally are lacking in resource-poor countries. The most important key to success in these countries is a strong central commitment and governmental support for minimizing drug-resistance problems while maintaining the highest effectiveness of health care within the limits of available resources.