Are there changes in the nutritional status of children of Oportunidades families in rural Chiapas, Mexico? A cohort prospective study

Household dietary diversity and associated factors in rural and peri-urban areas of Mbale District, Eastern Uganda

BACKGROUND

Globally, the importance of dietary diversity in addressing malnutrition and promoting overall health is increasingly being recognized. However, increasing urbanization has led to shifts in dietary preferences, food consumption patterns, and a greater reliance on less nutritious processed foods. Efforts to address these challenges have been futile, as nutrition in peri-urban areas often receives less attention, with food and nutrition insecurity typically seen as a rural issue. This study, therefore, examined dietary diversity (DD) and its socio-economic and demographic predictors in rural and peri-urban households.

METHODS

A cross-sectional study of 221 households in rural and peri-urban Eastern Uganda collected data on DD, socio-economic and demographic factors using the Household Dietary Diversity Score (HDDS) and structured questionnaires, respectively. The data were analyzed in SPSS using descriptive statistics, and independent sample t-tests compared mean DD scores between rural and peri-urban areas. Pearson Chi-square tested differences in food group consumption, while binary logistic regression in STATA identified socio-economic and demographic predictors of household dietary diversity.

RESULTS

There was no significant difference in dietary diversity (DD) between rural and peri-urban households, with mean DD scores of 6.64 ± 1.60 and 6.55 ± 1.30, respectively, indicating a medium level in both areas. However, significant differences were observed in the consumption of cereals and roots/tubers/plantains (p < 0.05), while intake of animal-source foods and fruits remained generally low across both settings. In rural areas, household DD was significantly influenced by the education levels of the household head (β: -1.276) and spouse (β: -1.123), as well as access to credit (β: 1.136), while in peri-urban areas, average monthly income (β: -0.801) was a significant predictor of household DD.

CONCLUSION

The study showed that dietary diversity was similar and at a medium level in both rural and peri-urban households, and mainly consisted of plant-based foods, with limited consumption of fruits and animal-sourced foods. Socio-economic factors, including level of education, access to credit, and income, significantly influenced DD. These results highlight the role of socio-economic and demographic factors in shaping household diets and underscores the need for targeted interventions to improve dietary diversity and address nutritional gaps in the study area.

Impact of Early Childhood Malnutrition on Cardiometabolic Risk Factors in Young Adults from Marginalized Areas of Chiapas, Mexico

The presence of malnutrition in early life is a determining factor in the onset of metabolic alterations and chronic diseases in adults. Therefore, the objective of this study was to determine the impact of malnutrition in early childhood with the presence of cardiometabolic risk factors in adulthood in marginalized populations from Chiapas, Mexico. The present investigation was based on a prospective cohort study that began in 2002, with young adults aged 18 to 25 years belonging to De Los Bosques region in Chiapas, Mexico. Sociodemographic, anthropometric, clinical and biochemical data were obtained in adulthood. Binary logistic regression models with 95% confidence intervals were fitted to assess the association between nutritional status in childhood (≤5 years of age) and cardiometabolic risk in adulthood. Individuals with overweight/obesity in childhood were more likely to have overweight/obesity (OR = 2.65, 95% CI: 1.09-6.45), high waist circumference (3.78, 95% CI: 1.55-9.24), high waist to height ratio (OR = 5.38, CI 95%: 1.60-18.10), elevated total cholesterol (OR = 3.95, 95% CI: 1.36-11.43) and metabolic syndrome (OR = 4.71, 95% CI: 1.49-14.90) in adulthood. In conclusion, malnutrition presented in early childhood increased the probability of developing cardiometabolic alterations in young adults from southern Mexico.

Heavy metal concentrations in drinking water sources in two mining districts in Ghana

- In Ghana, mining of minerals at small-scale and large-scale is widespread across many districts, leading to significant heavy metal pollution in the environment. In this study, the concentrations of iron (Fe), manganese (Mn), arsenic (As), and mercury (Hg) in the different drinking water samples collected from households, institutions, water points and surface water in two mining districts namely the Wassa East and Asutifi North were analyzed. The water types collected included boreholes, wells, piped water into yards, public standpipes, rainwater, sachet water, and surface water. The results indicated that the levels of Fe and Mn were higher than As and Hg in all the drinking water samples. The levels of As and Hg in drinking water from households and institutions were higher in the Wassa East district compared to the Asutifi North district. However, the metal levels at water points were similar in both districts. In surface water, Fe levels were higher in the Wassa East district compared to the Asutifi North district with median values of 1243 μg/L and 860 μg/L for the Wassa East and Asutifi North districts, respectively. In contrast, the Mn levels were higher in the Asutifi North district than the Wassa East district with median values of 9.5 μg/L and 90 μg/L for Wassa East and Asutifi North districts, respectively. All the metals (Mn, As, and Hg) studied except Fe were within the recommended WHO level. The Heavy Metal Pollution Index (HPI) values for the different water types in households, institutions and water points were all below the critical limit of 100. The Water Quality Index (WQI) indicates that the boreholes, piped water into yards, and public standpipes in both districts were classified as excellent or good, making them suitable for drinking. However, the wells and surface water in both districts were classified as very poor and unfit for drinking, respectively.

Maternal dietary diversity increases with women's high decision-making autonomy in Northwest Ethiopia, 2022

Background

Dietary diversification is one of several approaches for improving micronutrient levels in women of reproductive age. Therefore, this study aimed to assess the magnitude of minimum dietary diversity among pregnant women, explore the association between women's decision-making autonomy and dietary diversity, and identify other potential determinants of dietary diversity in Northwest Ethiopia.

Method

A community-based cross-sectional study of 621 pregnant women was conducted from November 2022 to December 2022. A cluster random sampling technique was employed. A binary logistic regression model was used to explore the association between dietary diversity and women's decision-making autonomy. Adjusted odds ratios with 95 % CIs were estimated to identify factors associated with the dietary diversity of pregnant women, and they were considered to be statistically significant at a P-value <0.05.

Results

The minimum dietary diversity among pregnant women was 22.4 %. The study revealed a significant association between dietary diversity and women's decision-making autonomy (AOR: 2.82, 95 % CI: 1.73, 4.59; p value: 0.001). Primary education and above (AOR = 4.0, CI: 2.1, 7.67), monthly income 1000-2000 ETB (AOR = 4.46, CI: 2.53, 7.87) and >2000 ETB (AOR = 6.05, CI: 3.16, 11.59), having nutritional information (AOR = 2.15, CI: 1.32, 3.51), being food secure (AOR = 2.63, CI:1.6, 4.34), morbidity status (AOR: 0.278, CI: 0.14, 0.56), ANC visits one time (AOR = 2.08, CI = 1.003, 4.33) and two or three times (AOR = 2.45, CI: 1.15, 5.24) were potential predictors of pregnant women's dietary diversity.

Conclusion

Maternal dietary diversity was significantly associated with women's decision-making autonomy. Thus, the government should strengthen women's empowerment, rights, access to education, and economic opportunities.

Can women empowerment boost dietary diversity among children aged 6-23 months in sub-Saharan Africa?

BACKGROUND

The empowerment of women has implications on the health and dietary needs of children. Using the survey-based women's empowerment index (SWPER), we examined the association between women's empowerment and dietary diversity among children aged 6-23 months in sub-Saharan Africa.

METHODS

Data from the Demographic and Health Surveys of 21 countries were utilized. Descriptive spatial map was used to present the proportions of dietary diversity among the children. Multilevel binary logistic regression was used to examine the association between SWPER and dietary diversity.

RESULTS

Overall, 22.35% of children aged 6-23 months had adequate minimum dietary diversity (MDD) in sub-Saharan Africa. The countries with the highest proportions of adequate MDD were Angola, Benin, Madagascar, Rwanda, Sierra Leone, and South Africa. South Africa had the highest proportion of MDD (61.00%), while Liberia reported the least (9.12%). Children born to mothers who had high social independence were more likely to have adequate MDD compared to those with low social independence [aOR = 1.31, 95% CI 1.21, 1.41]. In addition, children born to women with medium [aOR = 1.12; 95% CI 1.03, 1.21] and high decision-making [aOR = 1.25, 95% CI 1.14, 1.37] were more likely to receive MDD than those with low decision-making.

CONCLUSIONS

Insufficient dietary diversity is evident among children aged 6-23 months in sub-Saharan Africa. MDD in children is influenced by women's empowerment. Policies and interventions promoting women's empowerment can enhance MDD, especially for vulnerable groups in rural and poorer households. It is crucial to leverage media and poverty reduction strategies to improve MDD among children in sub-Saharan African countries.

Exploring the drinking water supply in Rwanda with panel data analysis

This study in Rwanda offers a comprehensive analysis of water quality, reliability, and cost-effectiveness, departing from previous research by utilizing panel data analysis for a nuanced understanding of spatiotemporal dynamics. Unlike earlier studies focusing on specific aspects, this research adopts a holistic approach, examining factors crucial for water supply, quality, and cost, thus providing an integrated view of Rwanda's water sector. By analyzing data from various sources, including the Water and Sanitation Corporation (WASAC), the study evaluates the reliability, quality, and cost-effectiveness of drinking water. It identifies cost-effective water treatment plants and studies determinants such as production cost, raw water quality, and supply between 2017 and 2022, introducing novel metrics such as performance scores and a drinking water quality index. Despite an increase in lost water, WASAC notably improves water supply, resulting in a higher water access rate by 2022. The study highlights the influence of factors such as performance scores and raw water quality on water supply and quality. It emphasizes continuous monitoring, targeted interventions, and community engagement for sustainable water service delivery. The findings provide actionable insights for policymakers, stakeholders, and practitioners, aiming to enhance water management strategies and improve water access in Rwanda.

Clinical and genetic attributes of congenital anomalies ascertained at a tertiary care hospital in Rawalpindi, Pakistan

Objective

Congenital anomalies (CA) or birth defects cause substantial healthcare burden in developing countries. There are few studies from Pakistan on the prevalence-pattern of CA. The purpose of this study was to determine the prevalence-pattern and genetic attributes of CA at a tertiary care facility in Rawalpindi, Pakistan.

Methods

In a cross-sectional study design, patients with CA were ascertained from Pediatric and Neonatal Section of Holy Family Hospital, Rawalpindi from March-2022 to June-2022. International Classification of Diseases (ICD-10) and Online Mendelian Inheritance in Man (OMIM) databases were utilized for uniformity in classification. The pattern of CA as well as familial/sporadic nature, syndromic/isolated presentations, and prenatal consanguinity were estimated. Descriptive summaries were generated.

Results

A total of 517 independent cases with certain types of CA were recruited. There were eight major and 70 minor categories. Among the major categories, neurological disorders (39.1%) were predominating followed by neuromuscular disorders (21.1%), limb defects (13.5%), musculoskeletal defects (7.4%), blood disorders (4.3%), orofacial defects (3.9%), metabolic disorders (3.7%), and Others (7.1%). The sporadic cases were in majority (72.5%) compared to familial cases (27.5%). Further, 63% patients had syndromic presentations and there were 37% cases with isolated appearances. A total of 70% cases had parental consanguinity.

Conclusion

The majority of anomalies were of preventable nature and certain healthcare measures including antinatal care and counseling can be adopted to minimize their burden. Additionally, there is an urgent need to raise awareness of the negative consequences of consanguineous marriages, which constitute a significant risk factor in cases with inherited CA.

Evidence-Based Design Process for Nutrition-Sensitive Agriculture Interventions: A Case Study of the Advancing Local Dairy Development Programme in Nigeria

BACKGROUND

Nigeria is a significant contributor to the global burden of chronic undernutrition in children under 5 years of age. The undernutrition challenge constrains the productivity of rural households. This study was carried out among beneficiaries of the productivity-enhancing Nigerian Dairy Development Programme (NDDP) to guide incorporation of nutrition into the successor program-Advancing Local Dairy Development in Nigeria (ALDDN). Therefore, this study contributes to the literature about operationalizing nutrition-sensitive agricultural frameworks.

OBJECTIVE

The study sought to determine potential entry points for improving the nutrition of smallholder dairy farmers (≤ 5 milk cows) with a focus on food system entry points.

METHODS

Primary data were collected from 514 smallholder dairy households in Oyo and Kano states of Nigeria. Both quantitative and qualitative data were collected. Quantitative data collected included minimum dietary diversity for women, nutrition status, and socioeconomic characteristics of households. Qualitative data included information about sources of food, markets, and other food system characteristics. Quantitative data were analysed using descriptive statistical tools and correlation analysis, while common themes were identified from qualitative data.

CONCLUSIONS

The study showcased men's important role in food purchase and consumption, particularly in Kano. Increasing opportunities and the ability of women to use nutrition education appeared necessary for translating knowledge into improved practices. The own consumption (i.e., the portion of the milk kept for households' consumption as well as diversification of foods produced for consumption); income; women's empowerment; and environmental sanitation pathways seemed to be the most feasible pathways for improving nutrition within the context of the study population.

The association of intimate Partner violence and decision making power on nutritional status of married women in Ethiopia: a multilevel mixed-effect analysis

BACKGROUND

A growing body of research has established a link between intimate partner violence (IPV) and decision-making autonomy on women's mental, physical, and reproductive health consequences, as well as child nutritional status. However, there is a scarcity of research on the effects of IPV and decision-making autonomy on women's nutritional status. To date, no research has been conducted in Ethiopia to investigate the impact of IPV and decision-making autonomy on women's nutritional status. Therefore, the purpose of this study was to investigate the relationship between IPV and decision-making power at both the individual and community levels on women's nutritional status.

METHODS

We analyzed data from the 2016 Ethiopian demographic and health survey. Our study focused on 3,660 married non-pregnant women of reproductive age. We used the chi-squared test and spearman correlation coefficients for bivariate analysis. The relationship between IPV and decision making power with nutritional status was evaluated using multilevel binary logistic regression models while controlling other determinants.

RESULTS

Around 28% of women reported at least one of the four types of IPV. Approximately 32% of women had no decision-making power at home. About 27.1% of women were underweight (BMI < 18.5), while 10.6% were overweight/obese (BMI ≥ 25). Women who had sexual IPV had a higher chance of being underweight (AOR = 2.97; 95% CI: 2.02-4.38) than women who had no sexual IPV. While women who had decision-making power at home were at lower odds of being underweight (AOR = 0.83; 95% CI: 0.69-0.98) than their counterparts. The findings also revealed a negative relationship between being overweight/obese and community-level women's decision-making autonomy (AOR = 0.75; 95% CI 0.34-0.89).

CONCLUSIONS

Our findings show the presence of a significant association between IPV & decision-making autonomy with women's nutritional status. Therefore, effective policies and programs to end violence against women and encourage women to participate in decision-making are required. This will help to improve the nutritional status of women as well as the nutritional outcomes of their families. This study suggests that efforts to achieve Sustainable Development Goal (SDG5) may have an impact on other SDGs particularly SDG2.

Prevalence of dysmenorrhea and associated risk factors among university students in Zimbabwe

BACKGROUND

Dysmenorrhea is an often incapacitating condition that is characterized by painful menstruation and general body malaise. In Zimbabwe, this condition is understudied, and its associated risk factors are poorly understood.

OBJECTIVES

To investigate the prevalence and associated risk factors of dysmenorrhea among female students at Midlands State University in Zimbabwe.

DESIGN

This is a cross-sectional study that employed simple random sampling technique to obtain data from 382 students using pretested and self-administered questionnaires.

METHODS

Data were analyzed using STATA version 16. Associations between dysmenorrhea, menstrual, sociodemographic, and lifestyle characteristics were measured using chi-square test and logistic regression model.

RESULTS

The prevalence of dysmenorrhea was 75.9%, with 28.6% of sufferers describing their pain as severe. Dysmenorrhea significantly affected the school/daily activities of respondents (χ2 = 18.22, p < 0.001). Family history (χ2 = 4.28, p = 0.04), age of menarche (χ2 = 14.8, p < 0.001), regularity of menstrual cycle (χ2 = 18.1, p < 0.001), and parity (χ2 = 8.8, p = 0.03) were associated with the prevalence of dysmenorrhea. The risk of developing dysmenorrhea almost doubled with positive family history (prevalence odds ratio = 1.68 (95% confidence interval: 1.03 to 2.75, p = 0.040)); increased with decrease in age of menarche (prevalence odds ratio = 0.19 (95% confidence interval: 0.10 to 0.45, p < 0.001)) and decreased with increase in parity (prevalence odds ratio = 0.15 (95% confidence interval: 0.03 to 0.82, p = 0.029)). However, the risk was low among those with irregular menstrual cycles (prevalence odds ratio = 0.14 (95% confidence interval: 0.10 to 0.33, p < 0.001)). Physical exercise, smoking, alcohol, and coffee consumption were not associated with the prevalence of dysmenorrhea (p > 0.05).

CONCLUSION

Dysmenorrhea is common among female students at Midlands State University, and it significantly affects their academic activities. Family history, regular menstrual cycle, nulliparity, and lower age of menarche were risk factors. More awareness is recommended including studies on impact and management strategies.

Multivariate statistics and hydrogeochemistry of deep groundwater at southwestern part of Bangladesh

Multivariate statistics and GIS alone with geochemical modeling were applied to investigate the hydro-geochemical characteristics of groundwater and their spatial distribution in the deep aquifer system of Bagherpara Upazila, Bangladesh. This Upazila consists of an area of 308.3 km² and local people mostly rely on groundwater to meet the drinking water requirements. Water samples from one hundred randomly selected deep tube wells (152–198 m) were collected and analyzed for 14 water quality parameters to characterize the hydro-geochemical properties. The groundwater shows slight alkaline in nature throughout the study area. Most of the water samples were turbid and 68% of them failed to meet the drinking water quality standard prescribed by the World Health Organization (WHO). TDS concentration ranges between 280 mg/L and 1040 mg/L, with a mean value of 446.20 (±122.19) mg/L. The general order of cation and anion along the study area were Ca²⁺>Mg²⁺>Na⁺>K⁺ and HCO₃^->Cl⁻>PO₄^3->SO₄^2->NO₃^- respectively. Carbonate weathering is the dominant process for releasing ions in groundwater. Besides, the ion exchange process is active in the study area, which leads to the reduction of Na⁺ ions. Gibb's plot suggests a rock dominance inheritance controls the dissolution and precipitation of minerals along with the ion-exchange process, and ultimately dictates the groundwater chemistry. Besides, the Piper diagram showed that Ca²⁺-Mg²⁺-SO₄^2- is the dominant water type in 65% of the samples followed by Ca²⁺-Mg²⁺–HCO₃^- water type (35%). The abundance of Ca²⁺ and Mg²⁺ ions and the alkaline nature of groundwater indicate mixed geochemical facies and reverse exchange reactions. The principal component analysis (PCA) reveals that weathering and leaching of host rocks was the main natural source, while municipal solid waste dumping, sewage discharge, and fertilizer application could be other anthropogenic factors that affect the groundwater geochemistry. In fine, the chemical characteristics of groundwater were acquired through rock dissolution, percolation, and reverse exchange process.

Gender and sociocultural factors in animal source foods (ASFs) access and consumption in lower-income households in urban informal settings of Nairobi, Kenya

BACKGROUND

Gender shapes household decision-making and access for nutritious diets, including animal source foods (ASFs) that impact on child health and nutrition status. However, research shows that the poorest households in the urban informal settlements of Nairobi have low ASFs consumption. This study was conducted to explore further from a qualitative perspective the gender, sociocultural factors affecting household ASF consumption this study.

METHODS

To explore further on the topic of study, an exploratory qualitative study was carried out to establish the factors that influence access, allocation and consumption of animal source foods (ASFs) by households in urban informal settings of Nairobi. Nineteen focus group discussions with men and women were conducted to enable in-depth exploration of ASFs consumption.

RESULTS

Gender influences decision-making of household ASFs dietary intake. Gendered power dynamics prevail with men as breadwinners and household heads often determining the food access and consumption of ASFs. Women are increasingly accessing short-term waged-based incomes in urban informal settings and now play a role in food and nutrition security for their households. This enforces the idea that women's decision-making autonomy is an important aspect of women empowerment, as it relates to women's dietary diversity and subsequently, better household nutritional status. As evidenced in this study, if a woman has bargaining power based on accessing incomes to support their household food needs, she will not jeopardize food security. The mobile digital money platform was key in enabling access to resources to access food. Use of trust to access food on credit and purchasing smaller packaged quantities of food were also enablers to access of food/ASFs.

Trends and determinants of minimum acceptable diet intake among infant and young children aged 6-23 months in Ethiopia: a multilevel analysis of Ethiopian demographic and health survey

BACKGROUND

The minimum acceptable diet (MAD) has been used globally as one of the main indicators to assess the adequacy of feeding practices. More than half of the causes of under-five child mortality in developing countries including Ethiopia are attributed to malnutrition. With the exception of anecdotal information on the subject, progress overtime and how it influences the MAD has not been studied or well understood. Thus, this study aimed to determine the trends and determinants of MAD intake among infants and young children aged 6-23 months in Ethiopia.

METHODS

A community-based national survey dataset from the Ethiopian demographic and health survey (EDHS) 2019 were to identify predictors of MAD. In addition, the 2011, 2016, and 2019 EDHS data was used for trend analysis. The World Health Organization indicators were used to measure MAD. A weighted sample of 1457 infants and young children aged 6-23 months. A mixed-effects multi-level logistic regression model was employed using STATA version 16.0.

RESULTS

The proportions of infants and young children who received the MADs in Ethiopia were 4.1%, 7.3%, and 11.3% during the survey periods of 2011, 2016, and 2019, respectively. Having mothers who attended primary education [adjusted odds ratio (aOR) =2.33 (95% C.I 1.25 to 4.35)], secondary education [aOR = 2.49 (95% C.I 1.03 to 6.45)], or higher education [aOR = 4.02 (95% C.I 1.53 to 10.54)] compared to those who never attended formal education. Being in a medium househoold wealth [aOR = 4.06 (95% C.I 1.41 to 11.72)], higher-level wealth [aOR = 4.91 (95% C.I 1.49 to 16.13)] compared to those in the lowest househoold wealth. Being in 12-18 months age group [aOR = 2.12 (95% C.I 1.25 to 3.58)] and in 18-23 months age category [aOR = 2.23 (1.29 to 3.82)] compared to 6-11 months age group; and having postnatal check-ups [aOR = 2.16 (95% C.I 1.31 to 3.55)] compared to their counterparts. Moreover, residing in urban [aOR = 3.40 (95% C.I 1.73 to 6.68)]; living in a communities' where majority had a media exposure [aOR 1.80 (95% C.1.17 to 2.77)] were found to be significantly influenc consumption of the MAD.

CONCLUSIONS

The trends of MAD among children of 6-23 months was steady in Ethiopia. Sociodemographic and socioeconomic factors such as maternal education, child age, household wealth; and health system related factors such as maternal postnatal check-ups had a significant influence on infants' and young children's MAD feeding. Indeed, commnity-level factors such as place of residence, and media exposure affect the MAD of infants and young children. Thus, behavioral change communication interventions are recommended to improve dietary practices in infants and young children.

Dietary Diversity Among Pregnant Women in Gurage Zone, South Central Ethiopia: Assessment Based on Longitudinal Repeated Measurement

Purpose

Dietary diversity is a key proxy indicator of nutrient adequacy; however, limited studies have been done on it among pregnant women in Ethiopia. The study aimed to examine the prevalence of sub-optimal dietary diversity and its associated factors among pregnant women in Gurage zone, South Central Ethiopia.

Materials and Methods

A mixed-method approach, a longitudinal study complemented with an exploratory qualitative study, was conducted. In the longitudinal study, a consecutively included sample of 668 pregnant women was followed in three rounds of survey. Dietary diversity was assessed using the minimum dietary diversity score for women (MDD-W) tool. The average of three dietary diversity scores was used to define overall diversity. Consuming less than 5 of 10 standard food groups was considered as suboptimal dietary diversity. Multivariable logistic regression analysis was used to identify predictors of suboptimal dietary diversity. Qualitative data were analysed using the thematic analysis method.

Results

During the 16 to 20, 28 to 29 and 36 to 37 weeks of gestation surveys, 75.0, 78.7 and 76.5% of the women had sub-optimal dietary diversity. In aggregate, 84.4% (95% CI: 81.6, 87.3) of the women had sub-optimal dietary diversity. Rural residents (AOR: 1.91, 95% CI: 1.01, 3.62), women with no formal education (AOR: 5.51, 95% CI: 1.96, 15.53) and from food insecure households (AOR: 2.44, 95% CI: 1.07, 5.59) had higher odds of suboptimal dietary diversity. Women with higher nutritional knowledge (AOR: 0.92, 95% CI: 0.87, 0.98) were less likely to have suboptimal dietary diversity. Food taboos, poor nutritional literacy and pregnancy complications were also reported as factors affecting dietary diversity.

Conclusion

Majority of pregnant women in the area had sub-optimal dietary diversity. Improving the socio-economic status and promoting nutrition knowledge may improve women's dietary diversity.

A scoping review of research on policies to address child undernutrition in the Millennium Development Goals era

OBJECTIVE

The breadth of research on the impact of nutrition-specific policies to address child undernutrition is not well documented. This review maps the evidence base and identifies gaps on such policies.

DESIGN

We systematically searched Medline, Embase, PAIS Index for public policy, Scopus and Web of Science databases to identify eligible studies. Key study characteristics, including research design, type of policy, time span of policy before impact assessment, child age at outcome assessment and types of outcomes assessed, were abstracted in duplicate.

SETTING

Low-, middle- and high-income countries.

PARTICIPANTS

Studies were eligible for inclusion if they aimed to assess the impact of population-level nutrition-specific policies on undernutrition among children under 10 years of age.

RESULTS

Of the 5646 abstracts screened, eighty-three studies were included. A range of policies to address child undernutrition were evaluated; the majority were related to micronutrient fortification. Most studies were observational, reported on mandatory regional or sub-national polices, were conducted in high-income countries and evaluated policies within 1 year of implementation. A narrow set of health outcomes were evaluated, most commonly iodine deficiency disorders and neural tube defects.

CONCLUSIONS

Nutrition policies were commonly associated with improved child nutritional status and health. However, this evidence is primarily based on limited settings and on a limited number of outcomes. Further research is needed to assess the longer-term impact of a broader range of nutrition policies on child health, particularly in low- and middle-income countries.

Effect of Low Linear Growth and Caregiving with Poor Psychosocial Aspects on Cognitive Development of Toddlers

The purpose of this study was to analyze effect of linear growth and psychosocial aspects of caregiving on cognitive development of toddlers. Methods: Longitudinal studies were carried out from pregnancy to three years old children in Bogor. The collected data included body height, nutritional status based on height by age index, morbidity, aspects of caregiving, and cognitive development of three years old children. Linear growth data is obtained from anthropometric measurements of height at birth, age six months, and twelve months measured using a length measuring instrument body with a precision level of 0.10 cm. Caregiving of psychosocial aspect divided by some characteristics, such as learning stimulation, language stimulation, academic stimulation, modelling, warmth and acceptance, caregiving variation, punishment & acceptance and physical environment. Cognitive development measurement was divided into two categories, namely delay and appropriate to age. Multiple logistic regression was applied to analyze the effects. Toddlers who were born stunted and continued to be stunted until they were three years old had lower cognitive development than stunted newborns that were able to achieve normal height at three years old. In addition, children who experience caregiving with poor psychosocial aspects had lower cognitive development than those with good caregiving. This study highlighted the importance efforts to improve nutritional status of children as well as providing good care for them.

Do cash transfers increase nutritional intakes? Experimental evidence from an unconditional cash transfer in Kenya

Malnutrition due to persistent food insecurity has been a serious public health issue in Kenya. An unconditional cash transfer programme, the Hunger Safety Net Programme (HSNP), was launched in 2009 in northern Kenya to reduce extreme poverty and to mitigate food insecurity. This study investigates the impact of the HSNP, on expenditure on food, types of food consumed and nutritional intake. Focusing on nutritional intake as well as spending and consumption is important because an unconditional cash transfer, which does not specify how the transferred money must be used, does not guarantee nutritional intake improvement. Converting food consumption data to caloric intake and nutrient content using food consumption databases, we calculate the intake of five macro-nutrients, seven vitamins and seven minerals and then estimate the impacts on nutritional intake 12 and 24 months after treatment exposure. This study finds the increased total expenditure on food items. Specifically, the beneficiary households increased their expenditure on milk and milk products and that on sugar after 12 months and expenditure on roots and tubers after 24 months. For consumption amounts, however, the HSNP did not show significant increases in all food categories except sugar. On the other hand, the HSNP improved the nutritional intakes of some macro- and micro-nutrients. The results show that beneficiary households substantially increased their intake of fat by 25.2% after 24 months and their intake of vitamin B12 by 36.6% and calcium by 34.9% after 12 months. The result does not yield sufficiently strong evidence that poorer households significantly enjoy greater improvements than other households.

Calcium Consumption During Pregnancy: A Multicenter Study in a Middle-Income Country in Southeast Asia

Objective

To perform a cross-sectional observational study of calcium consumption among pregnant women from multicenter tertiary care hospitals in the middle-income country in Southeast Asia.

Study Design

A cross-sectional observational study.

Setting

The study was conducted in four geographical regions (northern, northeastern, southern, and central) of Thailand. Five participating hospitals consisted of one university hospital in each region and one additional tertiary care hospital in the central region.

Materials and Methods

A cross-sectional study was performed nationwide from 1st November 2017 to 31st January 2019. All singleton aged 19-40 years were included. Exclusion criteria were any conditions that influenced calcium-containing food consumption. Dietary intake self-records immediately after eating for two working days and one holiday were analyzed via INMUCAL-NV3.0 dietary program.

Results

The 1549 records were obtained. The mean age was 29 ± 5.7 years. Most participants were primigravida (48.6%). The average gestational age was 20.6 ± 8.8 weeks. Mean calcium consumption was 602.4 mg/day (95% CI; 589.2615.6 mg/day) mg/dL. Inadequate calcium consumption prevalence based on the Thai dietary reference intake (less than 800 mg/day) and US Institute of Medicine (less than 1000 mg/day) were 82.0% and 93.4%, respectively.

Conclusion

The mean calcium consumption among pregnant women in the middle-income country in Southeast Asia was 602.4 mg/day (95% CI 589.2-615.6 mg/day). Inadequate calcium consumption of Thai pregnant women prevalence was 82.0% and 93.4% according to Thai dietary reference intake in pregnancy and the US Institute of Medicine.

The impact of conditional cash transfers on nutrition outcomes: Experimental evidence from Mexico

In this paper, we study the effect of Progresa, a conditional cash transfer program in Mexico, on the micronutrient and macronutrient consumption levels of program participants. Overall, we find that Progresa has a complicated effect on nutrition outcomes. We find that treatment households increase their vitamin consumption by 15 percent and mineral consumption by 7 percent. Our results indicate that conditional cash transfers may have important positive effects on vitamin A, iron, and possibly calcium, which are under-consumed by a vast majority of the Mexican population. We also find that Progresa increases consumption of processed carbohydrates by 23 percent and saturated fat by about 5 percent. These findings suggest that Progresa has a dual effect on the nutrition outcomes of Progresa eligible households, likely improving macro- and micronutrient consumption levels, but also increasing the consumption of food categories that likely lead to increased prevalence of overweight and obesity.

[Evolution of social food assistance programs in Mexico through Ensanut MC 2016 data]

OBJECTIVE

To describe the coverage and targeting of Social Food Assistance Programs (SFAP) in Mexico.

MATERIALS AND METHODS

Data were obtained from 9 137 households of the Halfway National Health and Nutrition Survey 2016 (Ensanut MC 2016) who receive SFAP. The distribution of the SFAP by place of residence, index of socioeconomic status and SFAP relevance were analyzed.

RESULTS

44% of households receive some SFAP, with a higher concentration in indigenous households (70%), a very low socioeconomic level (70%), and moderate and severe food insecurity. The SFAP with the greatest coverage were Prospera (21%), Liconsa (9%), School Breakfasts Program (17%) and the Support Program for Older Adults; of these the best-focused program was Prospera.

CONCLUSIONS

It is necessary to review the resources of the programs and direct them to the population with greater deficiencies and greater nutritional vulnerability.