Malnutrition and health in developing countries

Nutrition profiles of farm households across different farming systems in Ethiopia: Unpacking the determinants and implications for nutrition-sensitive interventions

Tackling nutrition insecurity remains a critical challenge in developing countries. In the predominantly rain-fed and smallholder-based farming systems of Ethiopia, production diversity and livelihood strategies of the farm households vary across geographic areas. However, the effects of household socioeconomic characteristics, production diversity, and household incomes on nutrition profiles in distinct settings have been inadequately understood. Therefore, this study was undertaken to examine the association of farming system type, sources of income, and household wealth status with household nutrition profiles in three remote locations such as Mennisa, Welmel Tiqa, and Agam Wuha that represent root crops-based farming, maize-based semi-pastoral farming, and teff-based cereal farming systems, respectively. A combination of qualitative and quantitative data collection techniques was employed. A multistage sampling procedure was used to select a total of 265 smallholder households for the structured survey interviews. Standard statistical tests and Tobit regression analyses were performed after determining the wealth category of each household. Results revealed a diversity of income sources used by each of the farm households with average values of 9 in Mennisa, 10 in Agam Wuha, and 11 in Welmel Tiqa, with the contributions of each income source varying by household wealth category and location. As expected, expenditures on food significantly exceeded those on non-food categories for poor households and vice versa for rich wealth households. The average total food variety score (FVS) for Welmel Tiqa was twice that for Agam Wuha, confirming the need for site-specific nutrition profile assessments. Despite the observed differences in household nutrition profiles among wealth categories and locations, the apparent intakes of vitamin A, vitamin B12, vitamin D, and calcium were consistently below the population-level estimated average requirements across all locations. The number of adequately consumed nutrients by farm households was negatively associated with family size, age of household heads, livestock holdings, wealth categories, and irrigation use, and positively associated with crop production diversity, income diversity, and FVS. The negative association between irrigation use and nutrition security was likely due to the focus on producing crops with a high market value on land under irrigation, coupled with ineffective allocation of generated income for enhancing household nutritional outcomes. Therefore, programs that include irrigated agriculture investments should consider adopting a more integrated nutrition-sensitive interventions, including consideration of locally adapted nutritious crops, such as orange-flesh sweet potato, to address critical deficiency of Vitamin A, nutrition training coupled with development of recipes and cooking demonstrations, and marketing and promotion for nutritious crops.

A modular cell-free protein biosensor platform using split T7 RNA polymerase

Conventional laboratory protein detection techniques are not suitable for point-of-care (POC) use because they require expensive equipment and laborious protocols, and existing POC assays suffer from long development timescales. Here, we describe a modular cell-free biosensing platform for generalizable protein detection that we call TLISA (T7 RNA polymerase-Linked ImmunoSensing Assay), designed for extreme flexibility and equipment-free use. TLISA uses a split T7 RNA polymerase fused to affinity domains against a protein. The target antigen drives polymerase reassembly, inducing reporter expression. We characterize the platform, then demonstrate its modularity by using 16 affinity domains against four different antigens with minimal protocol optimization. We show TLISA is suitable for POC use by sensing human biomarkers in serum and saliva with a colorimetric readout within one hour and by demonstrating functionality after lyophilization. Altogether, this technology could have potentially revolutionary impacts, enabling truly rapid, reconfigurable, equipment-free detection of virtually any protein.

Association among Household Wealth, Maternal Employment, and Undernutrition in Children under Three Years of Age in Pakistan

BACKGROUND

There is an abundance of studies explaining the separate impact of female employment and household wealth status in reducing malnutrition. However, our study has unraveled the combined impact of maternal employment and household wealth on undernutrition among children under three in Pakistan.

METHODS

Using a sample of 1093 children under three years of age from the Pakistan Demographic and Health Survey 2017-2018, a binary logistic model was employed to gauge factors influencing the children's undernutrition.

RESULTS

Our results indicated that children up to a certain age (three years old) with residence in certain regions (Pakistan) and recent episodes of diarrhea had an increased risk of undernutrition. Conversely, secondary and higher maternal education, access to improved water sources, and sanitation facilities lowered the chances of undernutrition in children under three in Pakistan. The interaction between maternal employment and household wealth showed that maternal employment significantly lowered the risk of stunting, being underweight, and wasting among the average, rich, and richest households; however, it did not contribute to child nutrition among the poorer and poor households. Notably, regardless of whether the mother was employed, the wealth status of being rich and richest reduced the risk of stunting, being underweight, and wasting.

CONCLUSIONS

In overcoming undernutrition, maternal employment significantly contributed to middle-income households. However, in the richer and richest households, the wealth status played a more crucial role compared to the maternal employment. This indicates that while employment plays a supportive role in household resources, the wealth status is overall more influential in reducing undernutrition.

The Socio-Environmental Determinants of Childhood Malnutrition: A Spatial and Hierarchical Analysis

Despite a remarkable reduction in global poverty and famines, substantial childhood malnutrition continues to persist. In 2017, over 50 million and 150 million young children suffered from acute malnutrition (wasting) and chronic malnutrition (stunting), respectively. Yet, the measurable impact of determinants is obscure. We evaluate proposed socio-environmental related determinants of stunting and wasting across Kenya and Nigeria and quantify their effectiveness. We combine health and demographic data from Kenya and Nigeria Demographic Health Surveys (2003, 2008-2009, 2013, 2014) with spatially explicit precipitation, temperature, and vegetation data. Geospatial and disaggregated data help to understand better who is at risk and where to target mitigation efforts. We evaluate the responsiveness of malnutrition indicators using a four-level random intercept hierarchical generalized logit model. We find that spatial and hierarchical relationships explain 28% to 36% of malnutrition outcome variation. Temporal variation in precipitation, temperature, and vegetation corresponds with more than a 50% change in malnutrition rates. Wasting is most impacted by mother's education, family wealth, clinical delivery, and vaccinations. Stunting is most impacted by family wealth, mother's education, clinical delivery, vaccinations, and children asymptomatic of fever, cough, or diarrhea. Remotely monitored climatic variables are powerful determinants, however, their effects are inconsistent across different indicators and locations.

Defining a vitamin A5/X specific deficiency - vitamin A5/X as a critical dietary factor for mental health

A healthy and balanced diet is an important factor to assure a good functioning of the central and peripheral nervous system. Retinoid X receptor (RXR)-mediated signaling was identified as an important mechanism of transmitting major diet-dependent physiological and nutritional signaling such as the control of myelination and dopamine signalling. Recently, vitamin A5/X, mainly present in vegetables as provitamin A5/X, was identified as a new concept of a vitamin which functions as the nutritional precursor for enabling RXR-mediated signaling. The active form of vitamin A5/X, 9-cis-13,14-dehydroretinoic acid (9CDHRA), induces RXR-activation, thereby acting as the central switch for enabling various heterodimer-RXR-signaling cascades involving various partner heterodimers like the fatty acid and eicosanoid receptors/peroxisome proliferator-activated receptors (PPARs), the cholesterol receptors/liver X receptors (LXRs), the vitamin D receptor (VDR), and the vitamin A(1) receptors/retinoic acid receptors (RARs). Thus, nutritional supply of vitamin A5/X might be a general nutritional-dependent switch for enabling this large cascade of hormonal signaling pathways and thus appears important to guarantee an overall organism homeostasis. RXR-mediated signaling was shown to be dependent on vitamin A5/X with direct effects for beneficial physiological and neuro-protective functions mediated systemically or directly in the brain. In summary, through control of dopamine signaling, amyloid β-clearance, neuro-protection and neuro-inflammation, the vitamin A5/X - RXR - RAR - vitamin A(1)-signaling might be "one of" or even "the" critical factor(s) necessary for good mental health, healthy brain aging, as well as for preventing drug addiction and prevention of a large array of nervous system diseases. Likewise, vitamin A5/X - RXR - non-RAR-dependent signaling relevant for myelination/re-myelination and phagocytosis/brain cleanup will contribute to such regulations too. In this review we discuss the basic scientific background, logical connections and nutritional/pharmacological expert recommendations for the nervous system especially considering the ageing brain.

Prevalence and Determinants of Stunting-Anemia and Wasting-Anemia Comorbidities and Micronutrient Deficiencies in Children Under 5 in the Least-Developed Countries: A Systematic Review and Meta-analysis

CONTEXT

Despite shifting from addressing isolated forms of malnutrition to recognizing its multifaceted nature, evidence on the prevalence and determinants of micronutrient deficiencies, and their coexistence with undernutrition in children under 5, remains insufficient, unsystematic, and incohesive.

OBJECTIVE

The aim of this systematic review and meta-analysis was to assess the prevalence and determinants of stunting-anemia and wasting-anemia comorbidities and micronutrient deficiencies in children under 5 in the least-developed countries (LDCs).

DATA SOURCES

Electronic searches took place from January 15, 2023, to February 14, 2024, across multiple databases, including PubMed, Embase, Web of Science, SCOPUS, African Index Medicus (AIM), World Health Organization's Institutional Repository for Information Sharing (IRIS), and African Journals Online. The search spanned the years 2000 to 2024, yet it yielded eligible full-text English research articles from only 2005 to 2021 conducted in LDCs. Studies lacking quantitative data on malnutrition types and their determinants were excluded.

DATA EXTRACTION

Two independent authors assessed articles for bias and quality using Hoy et al's 10-item scale and Newcastle-Ottawa Scale (NOS) criteria. Prevalence and other details were extracted using a Joanna Briggs Institute Excel template. Authors extracted adjusted odds ratios (aORs) for determinant factors such as sex and vitamin A and iron supplementation.

DATA ANALYSIS

The search yielded 6248 articles from 46 LDCs. Sixty-nine articles, with a total sample size of 181 605, met inclusion criteria for the final meta-analysis. Vitamin A deficiency affected 16.32% of children, and iodine deficiency affected 43.41% of children. The pooled prevalence of wasting-anemia and stunting-anemia comorbidity was 5.44% and 19.47%, respectively. Stunting was associated with vitamin A deficiency (aOR: 1.54; 95% CI: 1.01-2.37), and not taking vitamin A supplementation was associated with iron-deficiency anemia (aOR: 1.37; 95% CI: 1.21-1.55).

CONCLUSION

A significant proportion of children under 5 in LDCs experienced stunting-anemia and wasting-anemia comorbidities and micronutrient deficiencies. This study underscores the urgent need to address factors driving these burdens.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42023409483.

Another piece of puzzle for the human microbiome: the gut virome under dietary modulation

The virome is the most abundant and highly variable microbial consortium in the gut. Because of difficulties in isolating and culturing gut viruses and the lack of reference genomes, the virome has remained a relatively elusive aspect of the human microbiome. In recent years, studies on the virome have accumulated growing evidence showing that the virome is diet-modulated and widely involved in regulating health. Here, we review the responses of the gut virome to dietary intake and the potential health implications, presenting changes in the gut viral community and preferences of viral members to particular diets. We further discuss how viral-bacterial interactions and phage lifestyle shifts shape the gut microbiota. We also discuss the specific functions conferred by diet on the gut virome and bacterial community in the context of horizontal gene transfer, as well as the import of new viral members along with the diet. Collating these studies will expand our understanding of the dietary regulation of the gut virome and inspire dietary interventions and health maintenance strategies targeting the gut microbiota.

Prevalence and Determinants of Undernutrition in Schoolchildren in the Kilombero District, South-Eastern Tanzania

Childhood undernutrition is a major issue in low- and middle-income countries, affecting the health, well-being, and educational outcomes of schoolchildren. This study aimed to assess the prevalence and associated factors of stunting, wasting, and underweight among schoolchildren in peri-urban areas in the south-eastern part of Tanzania. A cross-sectional study was conducted involving 930 children aged 6-12 years from four primary schools from July to August 2019. The WHO Anthro Survey Analyzer was employed to estimate the prevalence of stunting, wasting, and underweight, while logistic regression analyses examined sociodemographic background, malaria infection, anaemia, anthropometric measures, and dietary diversity score as potential factors. The prevalence of stunting, wasting, underweight, overweight, and obesity was 11.8%, 4.3%, 3.9%, 11.1%, and 2.0%, respectively. Overall, 1.5% of the children had malaria, as determined by rapid diagnostic tests, and 0.4% had severe anaemia. Univariate analysis indicated higher odds of undernutrition among children aged 9-12 compared to their younger peers. Stunting was more common among children with low and medium dietary diversity. Anaemia was found in 11.2% of schoolchildren, and severe anaemia was associated with wasting. Multivariate analysis revealed that age and low dietary diversity were significantly associated with undernutrition. These findings emphasise the need for school-based health and nutrition programmes targeting children beyond the age of 5 to improve their nutritional status and mitigate potential adverse effects on health, cognition, and academic achievement. Regular assessment of the nutritional status of schoolchildren is warranted.

Dietary L-Glu sensing by enteroendocrine cells adjusts food intake via modulating gut PYY/NPF secretion

Amino acid availability is monitored by animals to adapt to their nutritional environment. Beyond gustatory receptors and systemic amino acid sensors, enteroendocrine cells (EECs) are believed to directly percept dietary amino acids and secrete regulatory peptides. However, the cellular machinery underlying amino acid-sensing by EECs and how EEC-derived hormones modulate feeding behavior remain elusive. Here, by developing tools to specifically manipulate EECs, we find that Drosophila neuropeptide F (NPF) from mated female EECs inhibits feeding, similar to human PYY. Mechanistically, dietary L-Glutamate acts through the metabotropic glutamate receptor mGluR to decelerate calcium oscillations in EECs, thereby causing reduced NPF secretion via dense-core vesicles. Furthermore, two dopaminergic enteric neurons expressing NPFR perceive EEC-derived NPF and relay an anorexigenic signal to the brain. Thus, our findings provide mechanistic insights into how EECs assess food quality and identify a conserved mode of action that explains how gut NPF/PYY modulates food intake.

Khat consumption and undernutrition among adult population in Ethiopia: A systematic review and meta-analysis

BACKGROUND

In Ethiopia, malnutrition is a public health threat causing a significant burden of morbidity, mortality, and economic crisis. Simultaneously, khat consumption is alarmingly increasing among adults, yet it might contribute to the existing burden of malnutrition, where the current evidence is inconclusive. Hence, this review was to estimate the association between khat consumption and undernutrition among adults in Ethiopia.

METHODS

A comprehensive search for Google, Google Scholar, and PubMed, coupled with a thorough manual search of the literature, was done up to date, October 18, 2023, using relevant search terms: "impact," "effects," "khat chewing," "khat consumption," "Ethiopia," "nutritional status," and "undernutrition." An updated PRISMA guideline was used to select relevant literature. The extracted data was summarized in narrative summaries, descriptions, and meta-analyses. The risk of bias was assessed. The results are presented in forest plots and funnel plots to assess publication bias. A pooled effect size (odds ratio) with a 95% certainty level was reported.

RESULTS

While a total of 17 articles (n = 45,679) were included in the narrative review, only 15 articles were included in the quantitative meta-analysis. The majority of studies had a low and moderate risk of bias (based on risk of bias assessment tool), mainly due to unclear exposure assessment and high study heterogeneity. A total of 11 studies were cross-sectional studies (71%), three were comparative studies (17.4%), and three were case control studies (17.4%). There is a higher risk of publication bias as evidenced by the funnel plot. Overall, five studies were from the Oromia region, and three studies were conducted at the national level. Overall, chewing had been shown to significantly increase the risk of undernutrition by 53% (pooled OR = 1.53; 95% CI: 1.09-2.16) under a random effect model. Under the fixed effect model, higher weight was given to national-level studies with higher samples, where chewing contributed to a 12% increased risk of undernutrition (AOR = 1.12; 95% CI: 1.01-2.23). Hence, khat chewing could raise the odds of undernutrition by 12-53%.

CONCLUSION

There is evidence of an association between khat chewing and an increased risk of undernutrition among adults in Ethiopia, which highlights the need for public health interventions to address the potential adverse effects of khat chewing on nutritional status.

Caregivers' experiences and practices for malnourished children undergoing tuberculosis treatment in Eswatini

Background

Eswatini is one of the countries affected by malnutrition and tuberculosis (TB) and some cases remained untreated. These two conditions are major public health problems.

Aim

This study aimed to explore and describe caregivers' experiences and practices of children's nutrition during treatment.

Setting

Baylor College of Nursing Children's Foundation - Eswatini (BCMCF-SD).

Methods

A qualitative study following a narrative design used purposive sampling to identify 12 caregivers of malnourished children and informed consent obtained. In-depth interview used semi-structured interview guide and digital voice recorder. Field notes were taken, transcribed, translated and analysed using NVivo version 11.

Results

Two themes emerged as home's nutritional situation and health facility's nutritional support. The study found that most of the caregivers gave children unbalanced diet, while those less than a year were mixed-fed. Some caregivers reported experience of lost breadwinners, unemployment and high number of children than what the family could afford. The caregivers' practices around food by prescription included inadequate supply of the ready-to-use therapeutic food and sharing of prescribed food supplies with other healthy children.

Conclusion

During treatment, children's caregivers need short health education and support. The Ministry of Health in Eswatini should consider using some comic books to guide that. Moreover, upscale vocational training promotes entrepreneurship and agricultural activities.

Contribution

Association of malnutrition and TB outcomes has provided evidence-based information for more comprehensive integration between nutrition programmes and tuberculosis programmes. The study's findings contributed to the growing body of knowledge about the association between malnutrition and diagnosed drug-susceptible TB among children aged from 0 - 15 years.

Long-Term Ovarian Function Assessment After Haematopoietic Stem Cell Transplantation in Female Sickle Cell Anaemia Survivors

BACKGROUND

Haematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for sickle cell anaemia (SCA). While HSCT offers the possibility of disease remission, it can also lead to long-term complications, including gonadal dysfunction and premature menopause.

METHODS

We conducted a retrospective cohort study of female survivors who had hydroxyurea therapy and those who underwent post-HSCT follow-up for SCA at a teaching hospital in Lagos, Nigeria, between January 2019 and December 2022. Participants were eligible if they were at least five years post-HSCT or hydroxyurea treatment and had available serum samples for markers of ovarian function measurement. Demographic and clinical data were collected from the hospital register and patients' medical records. Serum levels of oestradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and anti-Müllerian hormone (AMH) were measured using the Abbott Architect i1000SR chemiluminescent immunoassay analyzer (Abbott Diagnostics, Abbott Park, IL). Descriptive statistics and inferential analyses were used to assess the relationship between markers of ovarian function (FSH and AMH) and clinical parameters.

RESULTS

There were statistically significant differences in the median serum levels of all the assessed endocrine hormones between the HSCT and non-HSCT (hydroxyurea) groups of SCA survivors. Up to 82.6% of the SCA survivors experienced ovarian dysfunction after HSCT treatment. Impaired ovarian function in SCA survivors was associated with a longer median follow-up duration than in SCA survivors who had normal ovarian function (12.0 vs. 7.5 years, p = 0.048). There were higher odds of impaired ovarian function in the SCA survivors who had myeloablative regimens than in those who had reduced intensity conditioning regimens (94.1% vs. 50.0%, p = 0.040).

CONCLUSION

Our study highlights the significant impact of HSCT on long-term ovarian function in female SCA survivors. However, further prospective studies with larger sample sizes and longer follow-up periods are required to confirm our findings and elucidate the factors influencing ovarian function in SCA survivors of HSCT. In addition, studies are also needed to further elucidate the optimal transplant protocols and fertility preservation strategies to minimize gonadal toxicity and preserve reproductive potential in female SCA patients undergoing HSCT.

Nutritional Status Link with Polioseronegativity Among Children from Poliomyelitis Transmission High-Risk Area of the Democratic Republic of the Congo (DRC)

Background

Malnutrition is identified as a risk-factor for insufficient polioseroconversion in the context of a vaccine-derived polio virus (VDPV) outbreak prone region. To assess the prevalence of malnutrition and its link to poliovirus insufficient immunity, a cross-sectional household survey was conducted in the regions of Haut- Lomami and Tanganyika, DRC.

Methods

In March 2018, we included 968 healthy children aged 6 to 59 months from eight out of 27 districts. Selection of study locations within these districts was done using a stratified random sampling method, where villages were chosen based on habitat characteristics identified from satellite images. Consent was obtained verbally in the preferred language of the participant (French or Swahili) by interviewers who received specific training for this task. Furthermore, participants contributed a dried blood spot sample, collected via finger prick. To assess malnutrition, we measured height and weight, applying WHO criteria to determine rates of underweight, wasting, and stunting. The assessment of immunity to poliovirus types 1, 2, and 3 through the detection of neutralizing antibodies was carried out at the CDC in Atlanta, USA.

Results

Of the study population, we found 24.7% underweight, 54.8% stunted, and 15.4% wasted. With IC95%, underweight (OR=1.50; [1.11-2.03]), and the non-administration of vitamin A (OR=1.96; [1.52-2.54]) were significantly associated with seronegativity to polioserotype 1. Underweight (OR=1.64; [1.20-2.24]) and the non-administration of vitamin A (OR=1.55; [1.20-2.01]) were significantly associated with seronegativity to polioserotype 2. Underweight (OR=1.50; [1.11-2.03]), and the non-administration of vitamin A (OR=1.80. [1.38-2.35]) were significantly associated with seronegativity to polioserotype 3. Underweight (OR=1.68; IC95% [1.10-2.57]) and the non-administration of vitamin A (OR=1.82; IC95% [1.30-2.55]) were significantly associated with seronegativity to all polioserotypes.

Conclusion

This study reveals a significant association between underweight and polioseronegativity in children. In order to reduce vaccine failures in high-risk areas, an integrated approach by vaccination and nutrition programs should be adopted.

Stunting and Underweight among Adolescent Girls of Indigenous Communities in Telangana, India: A Cross-Sectional Study

India's indigenous groups remain vulnerable to malnutrition, despite economic progress, reflecting the reliance on traditional agriculture and the problems of poverty and inadequate education and sanitation. This mixed-methods study analyzed the incidence, causes and determinants of chronic malnutrition, measured through stunting, thinness and underweight among adolescent indigenous girls in Telangana. Using 2017 data on 695 girls aged 11-18 years from 2542 households, the analysis showed that 13% had normal nutritional status, while 87% were stunted, underweight or thin. Early adolescents (11-14 years) had higher underweight prevalence (24.4%), while late adolescents (15-18 years) showed greater stunting (30%). Regressions identified key influencing factors. Higher education levels of heads of households and the girls themselves alongside household toilet access significantly improved nutritional status and reduced stunting and underweight. The sociocultural emphasis on starchy staple-based diets and early marriage also impacted outcomes. Tackling this crisis requires mainstreaming nutrition across development agendas via comprehensive policies, education, communication and community participation. Further research can guide context-specific solutions. But, evidence-based investments in indigenous education, livelihoods, sanitation and women's empowerment are the first steps. Nutrition-sensitive development is indispensable for indigenous groups to fully participate in and benefit from India's progress.

[Sociodemographic characteristics associated with underweight and overweight in adults aged 50 years and over (ELSI-Brasil): differences between sexes]

The objective were to describe the prevalence of underweight and overweight, assessed by body mass index (BMI), stratified by sex and age group, and to analyze the sociodemographic characteristics associated with BMI in older women and men. This is a cross-sectional analysis of 8,974 participants aged ≥ 50 years from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brasil, 2015-2016). BMI was classified as underweight, eutrophy, and overweight according to the participant's age. A multinomial logistic regression model was used, considering the sociodemographic characteristics of women and men. The results showed a higher prevalence of overweight in women compared to men (64.1% vs. 57.3%). In both sexes, the prevalence of underweight was higher in the longest-lived individuals, while overweight was lower. In women, the chance of underweight was higher than the chance of eutrophy in those who were single/widowed/divorced (OR = 1.95; 95%CI: 1.42-2.66) and in those living in rural areas (OR = 1.58; 95%CI: 1.01-2.49), while the chance of being overweight was lower than the chance of being eutrophy in those living in rural areas (OR = 0.78; 95%CI: 0.62-0.97) and in all geographic macro-regions related to the South Region. For men, the chance of being overweight was lower than the chance of being eutrophy among single/widowed/divorced individuals (OR = 0.58; 95%CI: 0.48-0.69). The richest had a lower chance of being underweight (OR = 0.59; 95%CI: 0.38-0.90), as well as a higher chance of being overweight (OR = 1.52; 95%CI: 1.20-1.92). In conclusion, the sociodemographic characteristics associated with BMI differed between the sexes.

Comprehensive assessment of nutritional and functional status of patients with ulcerative colitis and their impact on quality of life

INTRODUCTION

Patients with ulcerative colitis (UC) are likely to have poor nutritional intake and increased gut losses. This study was designed to study the prevalence and predictors of nutritional deficiencies in patients with UC and their impact on the quality of life (QOL).

METHODS

A prospective study was conducted among consenting patients with UC (cases) and healthy relatives of the cases (controls) visiting a university teaching hospital. They were assessed for clinical, demographic, endoscopic (Mayo score) and histological profile (Robart's score). They were assessed for the presence of macronutrient and micronutrient deficiency, anthropometry, functional status (muscle strength by dynamometer and sit-to-stand test) and the quality of life (short inflammatory bowel disease questionnaire [SIBDQ]). A SIBDQ score of ≤ 50 was considered poor QOL.

RESULTS

We studied 126 cases and 57 healthy controls (age [mean ± SD] 37.7 ± 13.2 years vs. 34.40 ± 11.05 years; [p = 0.10] females [38.1% vs. 38.7%]; p = 0.94). Cases more often were underweight (28% vs. 3.5%; p < 0.001), had low mid arm circumference (45% vs. 12%; p < 0.0001), lower functional status in the form of weaker hand grip strength (67% vs. 45.6%; p = 0.007) and weaker lower limb strength (80% vs. 42%; p < 0.0001). Cases more often had the evidence of macronutrient deficiencies: total serum protein deficiency (31% vs. 3.5%; p < 0.0001), serum albumin deficiency (25.4% vs. 0.00%; p < 0.0001) and cholesterol deficiency (63% vs. 28%; p < 0.0001). Micronutrient deficiencies were highly prevalent among cases: calcium (44%), phosphate (21%), magnesium (11%), zinc (76%), iron (87%), folate (16%), vitamin B12 (10%) and vitamin D (81%). Most cases had a poor quality of life (85/126; 67.5%). Factors associated with poor QOL were low hemoglobin, serum albumin, zinc and vitamin D levels and histologically active disease. On multi-variate analysis, low vitamin D levels (odds ratio [OR] = 6.1; 95% confidence interval [CI]: 1.9-19.7) and histologically active disease (OR = 4.0; 95% CI: 1.6-9.9) were identified as independent predictors of poor QOL.

CONCLUSIONS

Macronutrient deficiency, micronutrient deficiency, lower functional status and poorer QOL are highly prevalent among patients with UC. The independent predictors of poor QOL were histologically active disease and low serum vitamin D levels. Identifying and correcting the deficiencies may help in improving the QOL of patients with UC.

Prevalence, Incidence, and Reversal Pattern of Childhood Stunting From Birth to Age 2 Years in Ethiopia

Importance

Although there has been a reduction in stunting (low-height-for-age and low-length-for-age), a proxy of malnutrition, the prevalence of malnutrition in Ethiopia is still high. Child growth patterns and estimates of stunting are needed to increase awareness and resources to improve the potential for recovery.

Objective

To estimate the prevalence, incidence, and reversal of stunting among children aged 0 to 24 months.

Design, Setting, and Participants

This population-based cohort study of the Birhan Maternal and Child Health cohort in North Shewa Zone, Amhara, Ethiopia, was conducted between December 2018 and November 2020. Eligible participants included children aged 0 to 24 months who were enrolled during the study period and had their length measured at least once. Data analysis occurred from Month Year to Month Year.

Main Outcomes and Measures

The primary outcome of this study was stunting, defined as length-for-age z score (LAZ) at least 2 SDs below the mean. Z scores were also used to determine the prevalence, incidence, and reversal of stunting at each key time point. Growth velocity was determined in centimeters per month between key time points and compared with global World Health Organization (WHO) standards for the same time periods. Heterogeneity was addressed by excluding outliers in sensitivity analyses using modeled growth trajectories for each child.

Results

A total of 4354 children were enrolled, out of which 3674 (84.4%; 1786 [48.7%] female) had their length measured at least once and were included in this study. The median population-level length was consistently below WHO growth standards from birth to 2 years of age. The observed prevalence of stunting was highest by 2 years of age at 57.4% (95% CI, 54.8%-9 60.0%). Incidence of stunting increased over time and reached 51.0% (95% CI, 45.3%-56.6%) between ages 12 and 24 months. Reversal was 63.5% (95% CI, 54.8%-71.4%) by age 6 months and 45.2% (95% CI, 36.0%-54.8%) by age 2 years. Growth velocity point estimate differences were slowest compared with WHO standards during the neonatal period (-1.4 cm/month for girls and -1.6 cm/month for boys). There was substantial heterogeneity in anthropometric measurements.

Conclusions and Relevance

The evidence from this cohort study highlights a chronically malnourished population with much of the burden associated with growth faltering during the neonatal periods as well as after 6 months of age. To end all forms of malnutrition, growth faltering in populations such as that in young children in Amhara, Ethiopia, needs to be addressed.

Nutritional Status in Leprosy Patients: A Systematic Review and Meta-analysis

BACKGROUND

Leprosy, a chronic mycobacterial disease, is frequently accompanied by malnutrition. However, it is important to regularly assess the nutritional state of leprosy patients in a resource-poor nation like India, where undernutrition is widespread.

OBJECTIVES

This study aimed to compare the nutritional status of leprosy patients to that of normal individuals using the body mass index.

METHODS

The electronic databases PubMed, Google Scholar, and Embase were used to conduct an open literature search. From 1st January 2000 to 31st January 2023, all articles were screened using the following MeSH terms: (nutrition OR body mass index OR body weight) AND (leprosy OR lepra) to find possibly relevant articles.

RESULTS

This meta-analysis includes five research studies with a total of 1173 individuals (363 patients in the leprosy group and 810 patients in the non-leprosy group). The weighted mean difference (WMD) for BMI studies was -17.88 (95% CI -27.65 to -8.12), showing that there was a significant difference in BMI < 18.5 between leprosy patients and non-leprosy patients. There was a significant difference in DDS score and HFIAS score between patients with leprosy and non-leprosy. In a total of 342 leprosy patients, 206 developed deformities.

CONCLUSION

This research increases our understanding of nutrition and leprosy. The results found that people with leprosy are nutritionally at a distinct disadvantage when compared to non-leprosy patients. It emphasises the several ways in which diet may generate circumstances that increase the risk of leprosy.

Mediating effects of women's empowerment on dietary diversity during pregnancy in Central West Ethiopia: A structural equation modelling

BACKGROUND

Considerable proportions of pregnant women consume inadequately diversified diets in Ethiopia. On the other hand, women's empowerment is identified as a means of achieving maternal nutrition improvement. However, evidence on the relationship between multiple dimensions of women's empowerment and dietary diversity during pregnancy is limited in Ethiopia.

OBJECTIVE

This study aimed to assess the mediating effects of women's empowerment in the pathway between women's education and dietary diversity during pregnancy in West Shewa zone, Ethiopia.

METHODS

A health facility-based cross-sectional study was conducted among 1,383 pregnant women in 2021. Dietary diversity was measured using the minimum dietary diversity for women (MDD-W) tool. Exploratory and confirmatory factor analyses were employed to identify and validate women's empowerment dimensions. Structural equation modelling (SEM) was used to examine the pathways linking pregnant women's education and empowerment to dietary diversity during pregnancy.

RESULTS

From the latent dimensions of women's empowerment produced by factor analyses, pregnant women's education was directly associated with household decision-making power, psychological and time dimensions. In turn, household decision-making power, psychological and time dimensions were associated with dietary diversity during pregnancy. The direct relationship between pregnant women's education and dietary diversity was insignificant, but the total indirect effect and total effect were significant. Household decision-making power, psychological and time dimensions were significant mediators in the relationship between pregnant women's education and dietary diversity. However, economic dimension was related to neither pregnant women's education nor dietary diversity.

CONCLUSION

This study highlights pregnant women with better education are more likely to be empowered in household decision-making, psychological and time dimensions; and those empowered pregnant women are more likely to consume more diverse diets, suggesting women's access to higher education could have a positive indirect effect on consumption of more diverse diets during pregnancy by empowering women in the study area.

Prediction Model with Validation for Polioseronegativity in Malnourished Children from Poliomyelitis Transmission High-Risk Area of the Democratic Republic of the Congo (DRC)

Background

Malnutrition is identified as a risk factor for insufficient polio seroconversion in the context of a vaccine-derived poliovirus (VDPV) outbreak-prone region. In the Democratic Republic of Congo (DRC), underweight decreased from 31% (in 2001) to 26% (in 2018). Since 2004, VDPV serotype 2 outbreaks (cVDPV2) have been documented and were geographically limited around the Haut-Lomami and Tanganyika Provinces.

Methods

To develop and validate a predictive model for poliomyelitis vaccine response in malnourished infants, a cross-sectional household study was carried out in the Haut-Lomami and Tanganyika provinces. Healthy children aged 6 to 59 months (n=968) were enrolled from eight health zones (HZ) out of 27, in March 2018. We performed a bivariate and multivariate logistics analysis. Final models were selected using a stepwise Wald method, and variables were selected based on the criterion p < 0.05. The association between nutritional variables, explaining polio seronegativity for the three serotypes, was assessed using the receiver operating characteristic curve (ROC curve).

Results

Factors significantly associated with seronegativity to the three polio serotypes were underweight, non-administration of vitamin A, and the age group of 12 to 59 months. The sensitivity was 10.5%, and its specificity was 96.4% while the positive predictive values (PPV) and negative (PNV) were 62.7% and 65.3%, respectively. We found a convergence of the curves of the initial sample and two split samples. Based on the comparison of the overlapping confidence intervals of the ROC curve, we concluded that our prediction model is valid.

Conclusion

This study proposed the first tool which variables are easy to collect by any health worker in charge of vaccination or in charge of nutrition. It will bring on top, the collaboration between the Immunization and the Nutritional programs in DRC integration policy, and its replicability in other low- and middle-income countries with endemic poliovirus.

Constraints on the functioning of Community-based Health Planning and Services facilities: A qualitative study in the Jirapa Municipality, Ghana

The declaration of the Alma-Alta on primary health care (PHC) in 1978 enjoined nations to make health care accessible, affordable, and situated within their cultural contexts. The Ghana Community-based Health Planning and Services (CHPS), as a strategy to achieve the goal of PHC, has shown significant successes in communities where it has been implemented. However, a number of challenges continue to affect the effective functioning of CHPS. This study explored the community level and health system constraints on the effective functioning of CHPS in the delivering of PHC services in the Jirapa Municipality. A qualitative approach was implemented. A criterion-based purposive sampling technique was employed to recruit 51 managers and health service providers of CHPS for key informant interviews. The respondents included 25 community health management committee members, 25 health officers in charge of CHPS facilities, and one municipal CHPS coordinator. The interviews were held from September 18 to November 23, 2020. All interviews were face-to-face, audio-recorded and transcribed verbatim. Thematic analysis based on the constant comparative method was employed to analyse the data. The results showed that low community involvement in CHPS activities, disputes over the location and naming of CHPS zones, inadequate understanding of the CHPS concept and religious beliefs were the key community level factors which negatively affected the functioning of CHPS. Also, lack of logistics, financial constraints, poor attitude of health workers and inadequate staff motivation were the health sector constraints on the effective functioning of CHPS. In conclusion, concerted efforts are needed to tackle the community level and health system constraints to improve the overall functioning and effectiveness of the CHPS strategy. We recommend the strengthening of community sensitization, timely disbursement of funding, and provision of infrastructure and supplies to improve upon the effective functioning of CHPS as a strategy for delivery PHC in Ghana.

Association of biomarkers of enteric dysfunction, systemic inflammation, and growth hormone resistance with seroconversion to oral rotavirus vaccine: A lasso for inference approach

BACKGROUND

Rotavirus gastroenteritis remains a leading cause of morbidity and mortality despite the introduction of vaccines. Research shows there are several factors contributing to the reduced efficacy of rotavirus vaccines in low- and middle-income settings. Proposed factors include environmental enteric dysfunction (EED), malnutrition, and immune dysfunction. This study aimed to assess the effect of these factors on vaccine responses using a machine learning lasso approach.

METHODS

Serum samples from two rotavirus clinical trials (CVIA 066 n = 99 and CVIA 061 n = 124) were assessed for 11 analytes using the novel Micronutrient and EED Assessment Tool (MEEDAT) multiplex ELISA. Immune responses to oral rotavirus vaccines (Rotarix, Rotavac, and Rotavac 5D) as well as a parenteral rotavirus vaccine (trivalent P2-VP8) were also measured and machine learning using the lasso approach was then applied to investigate any associations between immune responses and environmental enteric dysfunction, systemic inflammation, and growth hormone resistance biomarkers.

RESULTS

Both oral and parenteral rotavirus vaccine responses were negatively associated with retinol binding protein 4 (RBP4), albeit only weakly for oral vaccines. The parenteral vaccine responses were positively associated with thyroglobulin (Tg) and histidine-rich protein 2 (HRP2) for all three serotypes (P8, P6 and P4), whilst intestinal fatty acid binding protein (I-FABP) was negatively associated with P6 and P4, but not P8, and soluble transferrin receptor (sTfR) was positively associated with P6 only.

CONCLUSION

MEEDAT successfully measured biomarkers of growth, systemic inflammation, and EED in infants undergoing vaccination, with RBP4 being the only analyte associated with both oral and parenteral rotavirus vaccine responses. Tg and HRP2 were associated with responses to all three serotypes in the parenteral vaccine, while I-FABP and sTfR results indicated possible strain specific immune responses to parenteral immunization.

Intestinal flora and linear growth in children

The gut microbiota plays a critical role in human growth and development as well as the regulation of human pathophysiological processes. According to research, the gut microbiota controls the host's growth and development in areas such as nutrition, metabolism, endocrine hormones, and immune modulation. The human gut microbiota has an important role in child and adolescent growth, especially when nutritional conditions are poor. In this review, we focus on recent findings about the gut microbiota's influence on child growth, including the relationship between the gut microbiota and linear growth during pregnancy, infancy, childhood, and adolescence. Furthermore, we also review some mechanisms by which intestinal flora influence the host's linear growth. Although the data supports a link between intestinal flora and linear development in children, our review has limitations that prohibit us from fully verifying the causal relationship between gut flora and linear development in children. Improving the gut microbiota, in conjunction with renutrition techniques, has the potential to ameliorate the growth and development impairments currently associated with chronic illness and malnutrition in children.

Socioeconomic, demographic and geographic determinants of food consumption in Mexico

What people eat affects public health and human wellbeing, agricultural production, and environmental sustainability. This paper explores the heterogeneity of food consumption patterns in an ecologically and culturally diverse country. Using a latent class approach (which creates clusters of individuals with homogeneous characteristics), we analyse a food questionnaire (from the National Health and Nutrition Survey) applied across Mexico. We identify four clusters of food consumption (staple, prudent, high meat and low fruit) and find that belonging to these clusters is determined by socioeconomic, demographic (age, sex) and geographic (region, urban/rural) characteristics. Maize and pulses tend to constitute a larger proportion of the diet of poor, rural populations living in the south, while urban populations eat more varied foods, including ingredients whose production systems tend to exert more pressure on natural resources (for instance, meat). Despite the importance given in the literature to the Mexican gastronomy and its diverse traditional regional diets, we find that only 6% of the population adopts a food consumption pattern resembling the traditional Mexican diet. Instead, most of the Mexican population has a food consumption pattern resembling a western diet, which is problematic in terms of public health and environmental sustainability.

Wheat Grains as a Sustainable Source of Protein for Health

Protein deficiency is recognized among the major global health issues with an underestimation of its importance. Genetic biofortification is a cost-effective and sustainable strategy to overcome global protein malnutrition. This study was designed to focus on protein-dense grains of wheat (Triticum aestivum L.) and identify the genes governing grain protein content (GPC) that improve end-use quality and in turn human health. Genome-wide association was applied using the 90k iSELECT Infinium and 35k Affymetrix arrays with GPC quantified by using a proteomic-based technique in 369 wheat genotypes over three field-year trials. The results showed significant natural variation among bread wheat genotypes that led to detecting 54 significant quantitative trait nucleotides (QTNs) surpassing the false discovery rate (FDR) threshold. These QTNs showed contrasting effects on GPC ranging from -0.50 to +0.54% that can be used for protein content improvement. Further bioinformatics analyses reported that these QTNs are genomically linked with 35 candidate genes showing high expression during grain development. The putative candidate genes have functions in the binding, remobilization, or transport of protein. For instance, the promising QTN AX-94727470 on chromosome 6B increases GPC by +0.47% and is physically located inside the gene TraesCS6B02G384500 annotated as Trehalose 6-phosphate phosphatase (T6P), which can be employed to improve grain protein quality. Our findings are valuable for the enhancement of protein content and end-use quality in one of the major daily food resources that ultimately improve human nutrition.

Nutritional Profile Changes in an Insect-Fungus Complex of Antheraea pernyi Pupa Infected by Samsoniella hepiali

Historically, some edible insects have been processed into a complex of insect and fungus, such as Antherea pernyi and Samsoniella hepiali. Until now, the dynamics of the nutritional changes due to this infection were unclear. This study reveals the dynamic changes in nutritional components of Antherea pernyi pupa after infection with Samsoniella hepiali at post-infection time points of 0 d, 10 d, 20 d, and 30 d. The dynamic analysis of the components at different post-infection times showed that the content of polysaccharides and cordycepin increased with time while the content of fats and chitin decreased. The content of proteins showed a trend of decreasing at the beginning and then increasing. The essential amino acids (EAAs) decreased at the beginning and then increased, and non-essential amino acids (NEAA) changed similarly. The essential amino acid index showed a slight continuous decrease. Although the crude fat decreased dramatically due to the infection, from a value of 30.75% to 7.2%, the infection of S. hepiali produced five new fatty acids (14-methyl-pentadecanoic acid, docosanoic acid, succinic acid, arachidonic acid, and myristic acid) while the content of the seven fatty acids was greatly reduced after infection. Therefore, after being infected by S. hepiali and combined with it, the nutritional profile of A pernyi pupa was changed significantly and there were different characteristics at different infection stages. The above findings provide scientifically fundamental data to understand the nutritional value of the insect-fungus complex as human food and animal feed.

A study on the use of sorrel seed flour (Hibiscus sabdariffa) for improving functionality of wheat flour bread

Bread presents one of the easiest opportunities as a food vehicle for delivery of nutritional and health-promoting benefits to large segments of the world population. However, its low nutritional status due to lack of balance of essential amino acids and inadequate macro- and micronutrients has necessitated recent interest in the development of high-protein hybrid breads (HPHB). Sorrel seed, an underutilized, neglected protein-rich seed holds promising nutritional and antioxidant potentials as source of good quality protein, dietary fibre and bioactive compounds. Furthermore, germination of plant seeds increases the bioavailability of these nutritional and bioactive compounds. Hence, this study has investigated the influence of germination time on nutritional, and functional properties of sorrel seed flour. Further, the amino acid profile, dietary fibre and rheological functionality of wheat-germinated defatted sorrel seed bread were assessed. The sorrel seed was germinated for 24-48 h and defatted. Thereafter, the germinated defatted sorrel seed flours were used to partially replace wheat flour using a linear replacement (w/w) of 95-80% wheat (W) and 5-20% germinated defatted sorrel seed (GS) flours to obtain W95:GS5; W90:GS10, W85:GS15 and W80:GS20. These composite flours and 100% wheat flour (control) were used to produce breads using standard recipe and methods. Results showed significant increase (P < 0.05) in crude protein, dietary fibre and mineral contents after 24 and 48 h germination of sorrel seed. While 24 h germination significantly (P < 0.05) increased WAC from 93.75% to 103.13%, further germination (48 h) caused a reduction of 26.67% (from 93.75 to 68.75%). In vitro protein digestibility of wheat flour decreased significantly (P < 0.05) as supplementation of germinated defatted sorrel seed flour increased. Supplementation of wheat flour with germinated defatted sorrel seed flour in bread production resulted in 51.84-121.42% significant (p < 0.05) increase in the protein content of wheat bread. Similarly, total essential amino acids, dietary fibre, mineral, and ash contents followed the same increasing trend. The in-vivo biological value which ranged from 82.10 to 89.40% was significantly higher (p < 0.05) than 58.30% obtained for the control (100% wheat bread) Thus, inclusion of germinated defatted sorrel seed flour in bread production may serve as a low-cost nutritional supplement for enhancing the nutritional profile and functional benefits of wheat bread.

Predicting nutritional status during pregnancy by women's empowerment in West Shewa Zone, Ethiopia

Background

Considerable proportions of pregnant women are affected by poor nutrition outcomes in Ethiopia. Women's empowerment, on the other hand, is highly recognized as a means to achieve better maternal nutrition outcomes. However, the role of pregnant women's empowerment in nutritional status during pregnancy has not been empirically examined in Ethiopia. This study aimed to address this gap.

Objective

To assess the association of individual and composite women's empowerment dimensions with pregnant women's nutrition outcomes in West Shewa Zone, Ethiopia.

Methods

A health facility-based cross-sectional study was performed on 1,453 pregnant women living in West Shewa Zone, Ethiopia, in 2021. Exploratory and confirmatory factor analyses were conducted on half of the samples to identify and validate dimensions of pregnant women's empowerment. The associations between pregnant women's empowerment dimensions and anemia status and mid upper arm circumference levels were examined by logistic regressions.

Results

Composite pregnant women's empowerment was positively associated with both anemia status and mid-upper-arm circumference level. The odds of not being anemic were higher among pregnant women empowered in economic [adjusted odds ratio (AOR) = 1.7, 95% confidence interval (CI): 1.26, 2.22] and assertiveness (AOR = 1.9, 95% CI: 1.46, 2.38) dimensions than those not empowered in these dimensions. Empowered pregnant women in household decision-making (AOR = 1.6, 95% CI: 1.19, 2.22) and psychological (AOR = 1.4, 95% CI: 1.04, 1.85) dimensions had higher odds of having normal mid-upper-arm circumference measures than those not empowered in the respective dimensions. Communication and time dimensions were not significantly associated with any of the nutrition outcomes.

Conclusions

This study suggests that empowered pregnant women are nutritionally better off than their less empowered counterparts. This is also important in child health outcomes. Policies and programs that aim to improve maternal and child health in the study area need to consider interventions that promote the decision-making power, economic, psychological, and assertiveness dimensions of pregnant women.

Socio-demographic and environmental determinants of under-five child mortality in Ethiopia: using Ethiopian demographic and Health 2019 survey

BACKGROUND

The under-five mortality rate is a reliable indicator of a country's general level of development and the wellbeing of its children. Life expectancy is a good indicator of a population's standard of living.

OBJECTIVES

To identify Socio-demographic and Environmental determinants of under-five child mortality in Ethiopia.

METHODS

A national representative cross sectional study and a quantitative study were conducted among 5753 households selected based on 2019 Mini-Ethiopian Demographic and Health Survey (EDHS-2019) data. The analysis was done using STATA version 14 statistical software. Bivariate and multivariate analyses were used. To assess the determinants of under-five child mortality in multivariate analysis, p values less than 0.05 were considered statistically significant, and odds ratios with 95% CI (confidence interval) were used.

RESULTS

A total of 5,753 children were included in the study. Sex of the head of the household being female (AOR = 2:350, 95% CI: 1.310, 4.215), the U5CM for being their mother were currently married (AOR = 2:094, 95% CI: 1.076, 4.072), The odds of U5CM was less by 80% (AOR = 1.797, 95% CI: 1.159-2.782) with the number of under-five children at the household born 2-4th order as compared to those children born on the first order. For the mothers visit anti natal care four and above visit (AOR = 1:803, 95% CI: 1.032, 3.149), for the way of delivery (AOR = 0:478, 95% CI: 0.233, 0.982).

CONCLUSION

Multivariate logistic analysis reflected that way of delivery, mothers had being currently marred, sex of the head of the household and number of antenatal care visit were found to be significant predictors of under-five child mortality. So, government policy, nongovernmental organizations, and all concerned bodies should be focused on the major determinants of under-five child mortality and put in a lot more effort to reduce under-five child mortality.

Breastfeeding and Complementary Feeding Practices among Caregivers at Seshego Zone 4 Clinic in Limpopo Province, South Africa

Breastfeeding and complementary feeding are key components of infant and young child feeding that ensure healthy growth, survival, and development. Initiating breastfeeding within an hour after delivery, exclusively breastfeeding for six months, and introducing complementary feeding at six months while continuing breastfeeding up to 24 months or beyond, helps in the prevention of malnutrition, which is a public health problem. The aim of this study was to determine breastfeeding and complementary feeding practices among caregivers of children under 24 months in Seshego, Limpopo Province. A quantitative and cross-sectional design was applied to collect data from 86 caregivers using convenience sampling. A structured questionnaire was utilised to gather data and analysed through statistical software, using descriptive and inferential statistics. Chi-square tests were used to determine associations at a 95% confidence interval where a p-value of <0.05 was considered statistically significant. The findings show that 55% of participants had good breastfeeding and complementary feeding practices. Moreover, 94.2% of participants breastfeed within an hour after delivery at a healthcare facility. Only 43.6% of children were exclusively breastfed. Most participants (52.3%) gave children food before six months and 45.1% introduced complementary feeding at the appropriate age. Also, 69.7% of children across all age groups were not given infant formula. No statistical association was observed between feeding practices and sociodemographic. Breastfeeding was initiated within an hour after delivery at the healthcare facilities, however, post discharge exclusive breastfeeding maintenance remains a challenge. Few infants were introduced to complementary feeding at the appropriate age. A post discharge intervention to practice exclusive breastfeeding, continued breastfeeding, and introduction of appropriate complementary feeding is recommended.

A systematic review and meta-analysis of the association of dietary diversity with undernutrition in school-aged children

BACKGROUND

Malnutrition in childhood has lasting consequences; its effects not only last a lifetime but are also passed down from generation to generation such as short stature, school-aged children are the most vulnerable section of the population and require special attention, including nutrition.

METHOD

We searched Medline through PubMed, Scopus, and Web of Science to identify all observational studies published before Jun 2022. Observational studies with a pediatric population aged 5-18 years that evaluated risk estimate with 95% confidence intervals the relationship between dietary diversity and undernutrition (wasting, stunting, and thinness) were included. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were followed.

RESULTS

This is a first systematic review and meta-analysis with a total of 20 studies were eligible (n = 18 388). Fourteen data evaluated stunting resulting in a pooled effect size estimated odds ratio of 1.43 (95% CI: 1.08-1.89; p = 0.013). Ten data evaluated Thinness resulting in a pooled effect size estimated odds ratio of 1.10 (95% CI: 0.81-1.49; P = 0.542). Two studies were revealed wasting with a odds ratio of 2.18 (95% CI: 1.41-3.36; p-value < 0.001).

CONCLUSION

According to the conclusions of this meta-analysis of cross-sectional studies, inadequate dietary diversity increases the risk of undernutrition in growth linear but not in thinness in school-aged children. The findings of this analysis suggest that initiatives that support improvements to the diversity of children's diets to reduce the risk of undernutrition may be warranted in LMICs.

Iron deficiency and its epigenetic effects on iron homeostasis

Iron deficiency is a common micronutrient deficiency associated with metabolic changes in the levels of iron regulatory proteins, hepcidin and ferroportin. Studies have associated dysregulation of iron homeostasis to other secondary and life-threatening diseases including anaemia, neurodegeneration and metabolic diseases. Iron deficiency plays a critical role in epigenetic regulation by affecting the Fe²⁺/α-ketoglutarate-dependent demethylating enzymes, Ten Eleven Translocase 1-3 (TET 1-3) and Jumonji-C (JmjC) histone demethylase, which are involved in epigenetic erasure of the methylation marks on both DNA and histone tails, respectively. In this review, studies involving epigenetic effects of iron deficiency associated with dysregulation of TET 1-3 and JmjC histone demethylase enzyme activities on hepcidin/ferroportin axis are discussed.

Soy, Rice and Oat Drinks: Investigating Chemical and Biological Safety in Plant-Based Milk Alternatives

During the last decades, plant-based milk has become very appreciated by consumers, becoming a staple ingredient, especially for alternative breakfasts. Milk contains lactose, which is a sugar hydrolysed by the lactase enzyme. Lactose intolerance and lactose malabsorption are very common food intolerances among individuals. However, a lot of consumers consider themselves as lactose intolerant on the basis of self-reported intolerance and start to avoid dairy products, ignoring that plant-based milk alternatives are not nutritionally comparable to animal milk, especially in terms of protein intake. The aim of this study is to grow folder knowledge of the security of plant-based drinks, helping competent authorities to issue a risk assessment and to apply national plans about consumer safety. Results show that proper sanitary practices, such as pasteurization, are necessary in plant-based milk alternatives as well as in dairy milk. Chemical analysis has highlighted that there are no pesticide risks for consumers.

New Perspectives on the Associations between Blood Fatty Acids, Growth Parameters, and Cognitive Development in Global Child Populations

Malnutrition is prevalent in low-middle-income countries (LMICs), but it is usually clinically diagnosed through abnormal anthropometric parameters characteristic of protein energy malnutrition (PEM). In doing so, other contributors or byproducts of malnutrition, notably essential fatty acid deficiency (EFAD), are overlooked. Previous research performed mainly in high-income countries (HICs) shows that deficiencies in essential fatty acids (EFAs) and their n-3 and n-6 polyunsaturated fatty acid (PUFA) byproducts (also known as highly unsaturated fatty acids or HUFAs) lead to both abnormal linear growth and impaired cognitive development. These adverse developmental outcomes remain an important public health issue in LMICs. To identify EFAD before severe malnutrition develops, clinicians should perform blood fatty acid panels to measure levels of fatty acids associated with EFAD, notably Mead acid and HUFAs. This review demonstrates the importance of measuring endogenous fatty acid levels for measuring fatty acid intake in various child populations in LMICs. Featured topics include a comparison of fatty acid levels between global child populations, the relationships between growth and cognition and PUFAs and the possible mechanisms driving these relationships, and the potential importance of EFAD and HUFA scores as biomarkers of overall health and normal development.

Prevalence, severity, and predictors of malnutrition in Indian children with cerebral palsy and their impact on health-related quality of life

Although several studies have shown that undernutrition is frequent in children with cerebral palsy (CP), studies determining predictors of undernutrition and its impact on health-related quality of life (HRQoL) are scarce. This study aimed to assess the prevalence, severity, and predictors of malnutrition in children with CP and its impact on quality of life. This prospective study was performed between August 2019 and December 2021 in children with a clinical diagnosis of CP aged 2-18 years. We also intended to determine the socio-demographic and clinical predictors of undernutrition in these children and its impact on HRQoL, measured by the cerebral palsy quality of life (CPQoL)-Primary Caregiver reported version. Out of 569 (5.4 ± 2.8 years of age, 74% boys) children with CP, 71%, 44%, and 72% children were underweight, wasted, and stunted respectively, whereas 22%, 11%, and 21% were severely underweight, wasted and stunted respectively. Lower socioeconomic status, higher Gross Motor Function Classification System, and Manual Ability Classification System level were found to be significantly associated with the severity of stunting and underweight (p < 0.05), but not with wasting. CPQoL score in children with CP aged > 4 years was lower in patients with severe wasting, stunting, and underweight, as compared to their rest of the counterparts when adjusted for socio-demographic and other clinical variables (p < 0.05).  Conclusion: Chronic undernutrition is more common than severe acute malnutrition in children with CP. The severity of undernutrition is an important predictor of impaired HRQoL in children with CP. What is Known: • Several studies have shown that undernutrition is frequent in children with cerebral palsy; however, studies determining predictors of undernutrition and its impact on health-related quality of life are scarce. What is New: • Our study identifies that lower socioeconomic status, higher Gross Motor Function Classification System, and Manual Ability Classification System level are significantly associated with the severity of stunting and being underweight. • Chronic undernutrition is more common than severe acute malnutrition in children with cerebral palsy. Its severity is an important predictor of impaired health-related quality of life in children with cerebral palsy.

RuBisCO as a protein source for potential food applications: a review

RuBisCO is a complete protein, widely abundant and recognized as ideal for human consumption. Further, its biochemical composition, organoleptic and physical features mean RuBisCO has potential as a nutritionally beneficial food additive. Nonetheless, despite growing plant-based market trends, there is a lack of information about the applications of this protein. Here, we explored the biochemical features of RuBisCO as a potential food additive and compared it with other plant protein sources currently available. We describe potential advantages, including nutritional content, digestibility, non-allergenicity and, potential bioactivities. Despite the lack of industrial procedures for RuBisCO purification, a growing number of novel methods are emerging, justifying discussion of their feasibilities. Overall, this information can help both researchers and industry to review the use RuBisCO as a sustainable source of protein for plant-based food products or formulation of novel functional foods.

Eating and Lifestyle Habits in Underweight Patients with Insulin Resistance

Background

In recent years, there has been a significant increase in the prevalence of insulin resistance (IR) which has become a global health problem. Obesity is the typical clinical presentation of IR. The connection between underweight and IR is less known.

Objective

The study aimed to investigate the characteristics of eating habits in underweight and obese patients with IR. After the obtained results, propose suitable dietary instructions specific to 2 subject groups. The task was to determine the difference in the nutritional status of underweight and obese patients with proven IR. The questionnaire was designed to collect data on diet and eating habits.

Methods

The research included 60 subjects of both sexes between the ages of 20 and 60. Inclusion criteria for entering the study were: proven obesity (BMI ≥ 30), underweight (BMI≤18,5) and confirmed IR by assessment of the homeostatic model for insulin resistance (HOMA IR-2). BMI, waist-to-hip ratio (WHR), and visceral fat area (VFA) were calculated using the bioelectrical impedance. Data on dietary habits was collected using a questionnaire that included general patient data, physical activity, lifestyle and eating habits. Descriptive statistical methods were used to process and analyse the obtained data.

Results

The average BMI in obese subjects was 34.32 kg/m2, and in underweight subjects, 17.26 kg/m2. There are statistically significant differences between BMI, WHR and VFA. The mean value of HOMA-IR in the obese patients was 2.87 and in the underweight, 2.45. Underweight subjects have a statistically significant (p<0.05) tendency to lose weight, consume milk and milk products, prefer lean meat, and drink more alcohol. Obese subjects are significantly (p<0.05) less physically active, more prone to insomnia, tend to gain weight, enjoy food, consume fewer fruits and vegetables and more carbohydrate food, do not follow clinical nutritional guidelines, and mostly eat in a social setting. Both groups rarely practiced mindful eating. Consumption of highly processed food and sweets is common in both groups.

Conclusion

There are statistically significant differences in the dietary and lifestyle habits of underweight and obese patients diagnosed with IR. It is necessary to educate healthcare workers and the general population about the importance of nutrition for preventing IR, regardless of body weight.

Opportunities to Strengthen Fish Supply Chain Policy to Improve External Food Environments for Nutrition in the Solomon Islands

Malnutrition and food insecurity have significant social and economic impacts in small island developing states, such as the Solomon Islands. Enhancing the domestic supply of fish, the main source of local protein, can contribute to improved nutrition and food security. This research aimed to improve understanding of the policy interface between the fisheries and health sectors and identify opportunities to strengthen fish supply chain policy to improve domestic (particularly urban) access to fish in the Solomon Islands. The study design drew on theories of policy learning and policy change and analysed policies using a consumption-oriented supply chain approach. Interviews were conducted with 12 key informants in the Solomon Islands, and 15 policy documents were analysed. Analysis of policy documents and interview data indicated that there were strengths as well as opportunities in the existing policy context. In particular, community-based fisheries management approaches and explicit recognition of the links between fisheries and nutrition were key strengths. Challenges included gaps in implementation, variations in capacities across government actors and communities, and limited attention to domestic monitoring and enforcement. Improving the effectiveness of resource management efforts may result in sustainable outcomes for both livelihoods and health, which will accomplish priorities at the national and sub-national levels and support the achievement of the Solomon Islands' commitments to the Sustainable Development Goals.

Impact of low birth weight and breastfeeding practices on the nutritional status of children aged 2 to 5 years in the slums

Malnutrition among children in developing countries is a major public health problem, especially in India. Inappropriate feeding practices, in combination with other causes such as infection and food shortage, may be responsible for 1/3rd of malnutrition. Moreover, the risk of mortality is inversely related to children's height-for-age and weight-for-height. The aim: To assess the nutritional status of children aged 2 to 5 years in the urban field practice area of SVIMS-Sri Padmavathi Medical College for Women, Tirupati and to determine the impact of low birth weight, breastfeeding practices and other related factors on the nutritional status of the above study population. Materials and methods: This is a community-based observational cross-sectional study conducted among 282 children aged 2 to 5 years in the urban field practice area of SVIMS-Sri Padmavathi Medical College for Women, Tirupati. Socio-demographic data, Birth history, breastfeeding practices and anthropometric measurements were noted in the study questionnaire. Nutritional status was determined using HAZ, WHZ and WAZ scores of WHO child growth standards. Data was entered and analyzed using IBM SPSS Statistics 26 version to test for association between categorical variables, and a p-value < 0.05 was considered statistically significant. Results: A total of 282 school children with mean age of 39.9 (+10.4) months participated in the study, of which 132 (46.8 %) were boys and 150 (53.2 %) were girls. This study observed exclusive breastfeeding in 193 (68.4 %) children. Prevalence of stunting, wasting and being underweight were 22 %, 12.4 % and 23.8 %, respectively. A statistically significant association was found between stunting (p=0.006) and underweight (p=0.001) with low birth weight children. Conclusions: The present study revealed a high prevalence of malnutrition, especially stunting, a common outcome of long-term malnutrition among young children. Low birth weight and inappropriate breastfeeding practices result in long-term adverse consequences on the nutrition of preschool children, which should be prevented through appropriate strategies.

Bacterial meningitis in adults: a retrospective study among 148 patients in an 8-year period in a university hospital, Finland

BACKGROUND

Bacterial meningitis (BM) causes significant morbidity and mortality. We investigated predisposing factors, clinical characteristics, spectrum of etiological bacteria, and clinical outcome of community-acquired and nosocomial BM.

METHODS

In this retrospective study we analyzed data of 148 adults (age > 16 years) with BM treated in Turku University Hospital, Southwestern Finland, from 2011 to 2018. Besides culture- or polymerase chain reaction (PCR)-positive cases we also included culture-negative cases with laboratory parameters strongly suggestive of BM and those with meningitis-related findings in imaging. We used Glasgow Outcome Scale (GOS) score 1-4 to determine unfavorable outcome.

RESULTS

The median age of patients was 57 years and 48.6% were male. Cerebrospinal fluid (CSF) culture for bacteria showed positivity in 50 (33.8%) cases, although pre-diagnostic antibiotic use was frequent (85, 57.4%). The most common pathogens in CSF culture were Streptococcus pneumoniae (11, 7.4%), Staphylococcus epidermidis (7, 4.7%), Staphylococcus aureus (6, 4.1%) and Neisseria meningitidis (6, 4.1%). Thirty-nine patients (26.4%) presented with the triad of fever, headache, and neck stiffness. A neurosurgical procedure or an acute cerebral incident prior BM was recorded in 74 patients (50%). Most of the patients had nosocomial BM (82, 55.4%) and the rest (66, 44.6%) community-acquired BM. Ceftriaxone and vancomycin were the most used antibiotics. Causative pathogens had resistances against the following antibiotics: cefuroxime with a frequency of 6.8%, ampicillin (6.1%), and tetracycline (6.1%). The case fatality rate was 8.8% and the additional likelihood of unfavorable outcome 40.5%. Headache, decreased general condition, head computed tomography (CT) and magnetic resonance imaging (MRI), hypertension, altered mental status, confusion, operative treatment, neurological symptoms, pre-diagnostic antibiotic use and oral antibiotics on discharge were associated with unfavorable outcome.

CONCLUSIONS

The number of cases with nosocomial BM was surprisingly high and should be further investigated. The usage of pre-diagnostic antibiotics was also quite high. Headache was associated with unfavorable outcome. The frequency of unfavorable outcome of BM was 40.5%, although mortality in our patients was lower than in most previous studies.

Molecular Mapping of Biofortification Traits in Bread Wheat (Triticum aestivum L.) Using a High-Density SNP Based Linkage Map

A set of 188 recombinant inbred lines (RILs) derived from a cross between a high-yielding Indian bread wheat cultivar HD2932 and a synthetic hexaploid wheat (SHW) Synthetic 46 derived from tetraploid Triticum turgidum (AA, BB 2n = 28) and diploid Triticum tauschii (DD, 2n = 14) was used to identify novel genomic regions associated in the expression of grain iron concentration (GFeC), grain zinc concentration (GZnC), grain protein content (GPC) and thousand kernel weight (TKW). The RIL population was genotyped using SNPs from 35K Axiom^® Wheat Breeder's Array and 34 SSRs and phenotyped in two environments. A total of nine QTLs including five for GPC (QGpc.iari_1B, QGpc.iari_4A, QGpc.iari_4B, QGpc.iari_5D, and QGpc.iari_6B), two for GFeC (QGfec.iari_5B and QGfec.iari_6B), and one each for GZnC (QGznc.iari_7A) and TKW (QTkw.iari_4B) were identified. A total of two stable and co-localized QTLs (QGpc.iari_4B and QTkw.iari_4B) were identified on the 4B chromosome between the flanking region of Xgwm149-AX-94559916. In silico analysis revealed that the key putative candidate genes such as P-loop containing nucleoside triphosphatehydrolase, Nodulin-like protein, NAC domain, Purine permease, Zinc-binding ribosomal protein, Cytochrome P450, Protein phosphatase 2A, Zinc finger CCCH-type, and Kinesin motor domain were located within the identified QTL regions and these putative genes are involved in the regulation of iron homeostasis, zinc transportation, Fe, Zn, and protein remobilization to the developing grain, regulation of grain size and shape, and increased nitrogen use efficiency. The identified novel QTLs, particularly stable and co-localized QTLs are useful for subsequent use in marker-assisted selection (MAS).

The nutritional composition of the vegetable soybean (maodou) and its potential in combatting malnutrition

Introduction

Global malnutrition continues to be a canker owing to poor eating habits and over-reliance on the major staple crops. Vegetable soybean (maodou) is gaining popularity globally as an affordable snack and vegetable.

Methods

In this study, we profiled the nutritional composition of 12 soybean cultivars at the vegetable (R6-R7) and mature (R8) stages. We also conducted an RNA-seq analysis during seed development, focusing on key biosynthesis enzymes for quality traits.

Results

The results showed that 100 g of maodou contained 66.54% moisture, 13.49% protein, 7.81% fatty acids, 2.47% soluble sugar, abundant content of minerals, and micronutrients, including folate (462.27 μg FW) and carotenoids (3,935.41 μg FW). Also, the isoflavone content of maodou ranged between 129.26 and 2,359.35 μg/g FW. With regard to the recommended daily allowance, 100 g fresh weight of maodou can contribute 26.98, 115.57, and 11.60% of protein, folate, and zinc, respectively, and significant proportions of other nutrients including linoleic acid (21.16%), linolenic acid (42.96%), zinc (11.60%), and iron (18.01%). On a dry weight basis, maodou has two to six folds higher contents of folate, tocopherol, and carotenoid than the mature soybean. Furthermore, RNA-seq analysis revealed that key biosynthesis enzymes of quality traits are differentially expressed during seed development and may contribute to variations in the content of quality traits at the vegetable and mature stages. Correlation analysis of quality traits at both stages revealed that protein only correlated positively with zinc at the vegetable stage but negatively correlated with total tocopherol and total fatty acid at the mature stage. Complex associations among folates, soluble sugar, and isoflavones were also identified.

Discussion

This study provides insight into the nutritional contents of vegetable soybean and demonstrates that maodou is essential for meeting the nutritional requirements of most countries.

Factors driving underweight, wasting, and stunting among urban school aged children: Evidence from Merawi town, Northwest Ethiopia

Prior research identified malnutrition as one of the most common causes of morbidity and mortality among children globally. Furthermore, research revealed that over two thirds of deaths associated with inappropriate feeding practices occurred during the early years of life. Improper feeding practices impact a child's health in many different ways. However, research on the possible factors driving underweight, wasting, and stunting among school aged children in developing countries is limited, hence warrant further attention. Against this backdrop, this research strives to identify and assess the determinants of underweight, wasting and stunting among school aged children of a developing country-Ethiopia. A community based cross-sectional study was conducted from April 1, 2018 to June 15, 2018 in Merawi town, Ethiopia. An interviewer-administered questionnaire was used to collect data from a sample of 422 children. Binary logistic regression technique was performed to examine the effect of each selected variable on the outcome measure. The prevalence of being underweight, wasting and stunting was found to be 5.7%, 9.8%, 10.4%, respectively. The age of the child [adjusted odds ratio (AOR) = 12.930 (2.350, 71.157)] and the number of children [AOR = 8.155 (1.312, 50.677)] were emerged as the key determinants for underweight, and the gender of the child was significantly associated with wasting [AOR = 0.455 (0.224, 0.927)]. Finally, the age of the child [AOR = 12.369 (2.522, 60.656)] was found to predict the risk of stunting. This study revealed the age, number of children and gender of the child to have a significant association with malnutrition. The findings of this research suggest that in improving the feeding practices of young school-aged children, special attention should be paid to female children and those coming from relatively large families.

Nutraceutical Prospects and Antioxidant Activity of White and Red Water Lily Stem Available in Bangladesh

Generally, the white and red water lily cultivars' stems are consumed as vegetables in Bangladesh. However, data on the nutritional benefits and antioxidant properties of these aquatic plant’s stem are scant. Considering the aforementioned possibilities, the goal of this study was to evaluate the nutritional value, anti-nutritional factors, and antioxidant activity of two common Nymphaea species such as Nymphaea nouchali (white variety), and Nymphaea rubra (red variety) grown in Bangladesh. The proximate analysis and mineral content were determined by following AOAC methods. Crude fiber content was significantly higher in the white lily (19.56±0.68%) compared to the red cultivar (16.24±1.05%). Conversely, the red lily showed a higher value (18.52±1.01%) for ash content than the white species (15.44±0.79%). However, the varieties had no significant differences in moisture, protein, fat, and carbohydrate content. Both stems were rich in essential minerals, whereas Na and Cu were significantly higher in white water lily (WWL); however, the red water lily (RWL) stem possessed significantly copious amounts of K and P. On the other hand, there was no significant difference between two species in the case of Ca, Mg, Fe, and Zn content. The assay showed that the total phenolic contents (mg GAE/g) and total flavonoid contents (mg QE/g) were 16.51±0.05 and 15.48±02, 476±0.1 and 7.846±0.1 in white and red water lily stems respectively. In addition, the anti-nutrient screening revealed that both species were positive for saponin and tannin. Furthermore, the extract of RWL stem showed more antioxidant activity (IC50 value 28.48±0.12µg/ml) against DPPH than WWL (IC50 value 36.67±0.09 µg/ml). Thus, water lily stems can be incorporated into our diet as a potential natural source of antioxidants and vital elements.

A comprehensive intervention package improves the linear growth of children under 2-years-old in rural Bangladesh: a community-based cluster randomized controlled trial

Approximately one-third of children under the age of five are stunted in developing countries and many of them are micronutrient-deficient. We designed a comprehensive intervention package including egg/milk-based snacks to improve linear growth and dietary diversity among 6 to 12-month-old children in rural Bangladesh. In this 1-year community-based cluster randomized controlled longitudinal experiment, 412 mother-infant pairs were randomly assigned to receive either monthly food vouchers (for eggs, milk, semolina, sugar, and oil) to prepare egg and milk-based snacks for their children, along with multiple micronutrient powder (MNP), counseling on child feeding and handwashing, or regular government health communication alone (control; n = 206, treatment; n = 206). The trial was conducted in 12 clusters (small administrative units of sub-district). The primary inclusion criteria were ultra-poor households with limited resources and having children under 2-years-old. The primary and secondary outcomes were differences in children's length gain and dietary diversity. The effect of intervention on child growth was examined using a mixed effect linear regression model. Mean weight and length of the children did not significantly differ between groups at baseline. Around 90% of the children in both groups were breastfed. After receiving intervention for 12 months, LAZ score increased by 0.37 (CI 0.24, 0.51, p < 0.001) and risk of stunting reduced by 73% (OR: 0.27, CI 0.13, 0.58, p = 0.001). This comprehensive intervention package improved the growth and dietary diversity of children in extremely poor Bangladeshi households. A scaling-up of this intervention in contexts with limited resources should be taken into consideration.Trial registration: This trial registered retrospectively at ClinicalTrials.gov as NCT03641001, 21/8/2018.

The relationship between nutrition and the immune system

Nutrition plays an essential role in the regulation of optimal immunological response, by providing adequate nutrients in sufficient concentrations to immune cells. There are a large number of micronutrients, such as minerals, and vitamins, as well as some macronutrients such as some amino acids, cholesterol and fatty acids demonstrated to exert a very important and specific impact on appropriate immune activity. This review aims to summarize at some extent the large amount of data accrued to date related to the modulation of immune function by certain micro and macronutrients and to emphasize their importance in maintaining human health. Thus, among many, some relevant case in point examples are brought and discussed: (1) The role of vitamin A/all-trans-retinoic-acids (ATRA) in acute promyelocytic leukemia, being this vitamin utilized as a very efficient therapeutic agent via effective modulation of the immune function (2) The involvement of vitamin C in the fight against tumor cells via the increase of the number of active NK cells. (3) The stimulation of apoptosis, the suppression of cancer cell proliferation, and delayed tumor development mediated by calcitriol/vitamin D by means of immunity regulation (4) The use of selenium as a cofactor to reach more effective immune response to COVID vaccination (5). The crucial role of cholesterol to regulate the immune function, which is demonstrated to be very sensitive to the variations of this macronutrient concentration. Other important examples are reviewed as well.

Nutritional Composition, Health Benefits, and Application Value of Edible Insects: A Review

For thousands of years, edible insects have been used as food to alleviate hunger and improve malnutrition. Some insects have also been used as medicines because of their therapeutic properties. This is not only due to the high nutritional value of edible insects, but more importantly, the active substances from edible insects have a variety of biofunctional activities. In this paper, we described and summarized the nutritional composition of edible insects and discussed the biological functions of edible insects and their potential benefits for human health. A summary analysis of the findings for each active function confirms that edible insects have the potential to develop functional foods and medicines that are beneficial to humans. In addition, we analyzed the issues that need to be considered in the application of edible insects and the current status of edible insects in food and pharmaceutical applications. We concluded with a discussion of regulations related to edible insects and an outlook on future research and applications of edible insects. By analyzing the current state of research on edible insects, we aim to raise awareness of the use of edible insects to improve human health and thus promote their better use and development.

Undernutrition and its associated factors among children aged 6 to 59 months in Menz Gera Midir district, Northeast Ethiopia: A community-based cross-sectional study

BACKGROUND

Undernutrition can lead to impaired physical growth, restricted intellectual skills, low school performance, reduced working capacity, and rooted disability in adult life. Thus, this study was designed to assess the prevalence and associated factors of undernutrition among children aged 6 to 59 months.

METHODS

A community-based cross-sectional study was conducted among 432 children aged 6 to 59 months in the Menz Gera Midir District. A multi-stage sampling technique was applied to recruit the study participants. Socio-demographic and socio-economic variables were collected by using structured questionnaires. Anthropometric measurements of the children were measured according to the World Health Organization's recommendation. A data collection sheet was used to collect information on the types of foods and number of meals consumed by the child. A bivariable and multivariable logistic regression was performed to identify factors associated with undernutrition.

RESULT

In this study, about 11.3% (95% CI: 8.3-14.3%), 50.2% (95% CI: 45.5-55.0%), and 28% (95% CI: 23.8-32.3%) were wasted, stunted, and underweight, respectively. Children aged 12-23 months (AOR: 1.97; 95% CI: 1.01-3.87), 36-47 months (AOR: 2.05; 95% CI: 1.00-4.19), and being anemic (AOR: 2.92; 95% CI: 1.73-4.92) were found to be an independent predictor of stunting. Moreover, being anemic was found to be significantly associated with wasting (AOR: 6.84; 95% CI: 3.16-14.82).

CONCLUSION

According to the findings of this study, undernutrition was a serious public health issue among 6-59 month old children in the Menz Gera Midir District. Children's age and anemia status were significantly associated with stunting and wasting. Therefore, community-based nutrition programs are vital to reduce childhood undernutrition.

Household decision-making, women's empowerment, and increasing egg consumption in children under five in rural Burkina Faso: Observations from a cluster randomized controlled trial

Malnutrition is one of the most long-suffering problems facing women and children across the world—it is endemic to many low- and low-middle income countries and is a leading comorbidity in CU5 mortality. Malnutrition and food security are gendered issues; not only are boys and girls differently affected by these issues, but societal norms and differing roles of women and men are often drivers of these different outcomes. The United Nations seeks to address both malnutrition and gender inequality by reaching its Sustainable Development Goals by 2030. Researchers have shown that women's empowerment is inextricably linked to the nutritional outcomes of children. As one dimension of women's empowerment, intra-household decision-making is an important determinant of child health and nutrition outcomes, as it can determine how resources are allocated within the household. To better understand how gender inequalities within household decision-making may contribute to child nutrition, this study examines the association between household decision-making and the adoption of behavior change to increase chicken egg consumption among infants and young children in Burkina Faso, and explores the relationship(s) between the Un Oeuf project and women's empowerment. This study analyzes data collected during the Un Oeuf cRCT (July 2018–April 2019) and additional data that were collected in conjunction with the Un Oeuf endline household survey in April 2019. Significant relationships were found between women's household decision-making about eggs and child egg consumption at the end of the project. This was true for women who did not have decision-making power at baseline (p = 0.006, OR 3.822) as well as for women who indicted having had that power and sustaining it through endline (p = 0.013, OR 6.662). Results indicate that the Un Oeuf project significantly increased women's household decision-making (p &gt; 0.005, OR 4.045). Finally, significant relationships were found between a woman's overall level of empowerment and household decision-making power surrounding (1) what is done with household eggs (p &lt; 0.005, OR 2.87) and (2) how foods are portioned (p = 0.012, OR 6.712). These findings illustrate the importance and potential of women's decision-making as a point of entry to improving nutritional outcomes through changes in empowerment.