Plant-Based Dietary Practices and Socioeconomic Factors That Influence Anemia in India

Gen Z's Willingness to Adopt Plant-Based Diets: Empirical Evidence from Greece, India, and the UK

Comprising the largest population cohort on this planet, Gen Z presents a future-oriented consumer segment driven by climate change and food. This study sought to investigate Gen Z's perceptions toward plant-based foods and diets and explore the relationship that attitude components, meal preparation involvement, personal and lifestyle factors, and perceived barriers in adopting a plant-based diet have with willingness to adopt green-eating practices. Using cross-sectional data from university students in Greece, India, and the UK, various tools were employed to determine the factors influencing youths' consumer behavior toward animal-protein substitutes. PCA indicated the underlying dimensions of students' viewpoints on plant-based foods, whereas hierarchical and k-means clustering provided the cluster structure. An ordered probit model was estimated to delineate Gen Z's willingness to adopt plant-based diets and distinguish among mostly unwilling, somewhat willing, and mostly willing youths. Our findings identified two consumer segments, namely proponents and opponents of plant-based foods and diets, with statistically significant differences in the perceived health benefits of plant-based diets, attachment to animal-based proteins, perceived exclusion of animal-based foods, dissatisfaction with plant-based foods' attributes, and demand for ensuring adequate protein intake. The ordered probit model estimates showed that there is a "homogeneity" in the factors influencing youths' intention to adopt plant-based diets, with attitude components, meal preparation indicators, perceived barriers to eating "green", and personal factors, such as self-assessed knowledge of healthy eating and physical activity, being strongly associated with students' willingness to switch to plant-based diets in all three countries. Mapping potential obstacles and enablers in terms of shifting to more green-eating behaviors, our findings could add information to better understand the factors affecting food choice and youths' transition to a more sustainable lifestyle.

An assessment of the impact of traditional rice cooking practice and eating habits on arsenic and iron transfer into the food chain of smallholders of Indo-Gangetic plain of South-Asia: Using AMMI and Monte-Carlo simulation model

The current study was designed to investigate the consequences of rice cooking and soaking of cooked rice (CR) with or without arsenic (As) contaminated water on As and Fe (iron) transfer to the human body along with associated health risk assessment using additive main-effects and multiplicative interaction (AMMI) and Monte Carlo Simulation model. In comparison to raw rice, As content in cooked rice (CR) and soaked cooked rice (SCR) enhanced significantly (at p < 0.05 level), regardless of rice cultivars and locations (at p < 0.05 level) due to the use of As-rich water for cooking and soaking purposes. Whereas As content in CR and SCR was reduced significantly due to the use of As-free water for cooking and soaking purposes. The use of As-free water (AFW) also enhanced the Fe content in CR. The overnight soaking of rice invariably enhanced the Fe content despite the use of As-contaminated water in SCR however, comparatively in lesser amount than As-free rice. In the studied area, due to consumption of As-rich CR and SCR children are more vulnerable to health hazards than adults. Consumption of SCR (prepared with AFW) could be an effective method to minimize As transmission and Fe enrichment among consumers.

Key drivers of reversal of trend in childhood anaemia in India: evidence from Indian demographic and health surveys, 2016-21

AIM

Recent National Family Health Survey results portray striking improvements in most population and health indicators, including fertility, family planning, maternal and child health, gender treatment, household environments, and health insurance coverage of the Pradhan Mantri Jan Arogya Yojana (PM-JAY), with all India resonance. However, the prevalence of any anaemia (< 11 g/dl) among children under age five has exhibited a reversed trajectory in recent years. Therefore, the present study explores key drivers of the reversal of the trend in the prevalence of childhood anaemia between 2015 and2021.

METHODS

Data of four rounds of the National Family Health Survey (NFHS) were used to show the overall trend of anaemia among children. However, for the analysis of key drivers of the reversal trend of childhood anaemia, only the recent two rounds (NFHS-4 & NFHS-5) were used. Descriptive, bivariate multivariable analysis and Fairlie decomposition model were used to explore the drivers of the reversal of the trend in childhood anaemia.

RESULTS

During the past two decades, India has seen a decline in the prevalence of childhood anaemia (NFHS-2 to NFHS-4). However, a reversal of trend was observed recently. The prevalence of anaemia among children aged 6-59 months increased from 59 percent in NFHS-4 to 67 percent in NFHS-5. In addition, the prevalence of mild anaemia increased from 23.3 percent in NFHS-2 to 28.7 percent in NFHS-5. However, the prevalence of moderate and severe anaemia declined considerably from NFHS-2 (40 percent and 4.1 percent) to NFHS-4 (28.7 percent and 1.6 percent), but showed an increase in the prevalence in NFHS-5 (36.3 percent and 2.2 percent). Among others, mothers' educational attainment, anaemia status and socio-economic status emerge as the key drivers of the change in the prevalence of childhood anaemia.

CONCLUSION

These findings may have vital implications for the ongoing Anaemia Mukt Bharat Programme, one of the government's dream projects in India.

Associations of Dietary Patterns and Vitamin D Levels with Iron Status in Pregnant Women: A Cross-Sectional Study in Taiwan

Vitamin D is involved in the pathophysiology of anemia. This cross-sectional study was conducted using the Nationwide Nutrition and Health Survey in Pregnant Women in Taiwan database. We investigated associations among dietary patterns (DPs), vitamin D, and iron-related biomarkers in pregnant women. The principal component analysis revealed four DPs. Linear and logistic regression analyses were performed to investigate the association of DPs with anemia-related biomarkers. Plant-based, carnivore, and dairy and nondairy alternatives DPs were positively associated with serum vitamin D levels. After adjusting covariates, the pregnant women consuming plant-based DPs at the mid-tertile (T2) were associated with reduced risks of low serum folate and vitamin D levels, and those consuming carnivore DPs at higher tertiles (T2 and/or T3) were correlated with an increased risk of low serum iron levels but decreased risks of low serum transferrin saturation, vitamin B₁₂, and vitamin D levels. The pregnant women consuming dairy and nondairy alternatives DPs at the highest tertile (T3) were associated with reduced risks of low serum folate and vitamin B₁₂ levels. However, the processed food DP was not correlated with anemia-related biomarkers. Thus, plant-based, carnivore, and dairy and nondairy alternatives DPs were associated with the risk of low-serum-anemia-related variables.

Assessment of Heme and Non-Heme Iron Intake and Its Dietary Sources among Adults in Armenia

Adequate dietary iron (Fe) intake is crucial for preventing Fe-deficient anemia, a recognized global public health concern which is important in Armenia. This study aimed to analyze the intake of Fe, both heme (from animal tissues) and non-heme (more prevalent, but less efficiently absorbed), as well as the Fe dietary sources, among adults in a representative national sample in Armenia. The study was conducted on 1400 individuals aged 18-80 and above, who were enrolled from all regions of Armenia. The Fe intake was assessed through a 24 h dietary recall survey, while Fe occurrence was determined through atomic absorption spectrophotometry (AAS). The results showed a high proportion of adults with a Fe intake lower than the average requirements set by EFSA (65%, 80% and 85% of males, total females and females at fertile age, respectively). Main Fe sources were bread, fruits and vegetables; heme Fe accounted only for <5% of total Fe intake. Compared to males, females had a lower intake of all forms of Fe (p < 0.05). Significant differences were observed in the intake of different forms of Fe between regions (p < 0.05), while the age-group 36-55 years had higher intakes of total Fe. Our data call for comprehensive nutritional security strategies in order to reduce iron deficiency in Armenia, that represents a public health concern.

Iron from Co-Encapsulation of Defatted Nannochloropsis Oceanica with Inulin Is Highly Bioavailable and Does Not Impact Wheat Flour Shelf Life or Sensorial Attributes

Defatted green microalgae Nannochloropsis oceanica (DGM) is a rich source of bioavailable iron. However, its use in foods results in unacceptable color and taste development. Therefore, the purpose of this study was to investigate strategies to enhance the use of DGM in foods. DGM and inulin were encapsulated (EC) in an oil-in-water emulsion using high-pressure homogenization. To confirm iron bioavailability, C57BL/6 mice were fed an iron-deficient diet (ID) for 2 weeks. The mice were then fed one of the four diets: ID, ID + DGM (DGM), ID + EC (EC50 or EC100) for 4 weeks. To test the stability of DGM as an iron fortificant at two different fortification rates of 17.5 mg Fe/kg (50%) or 35 mg Fe/kg (100%), whole (DGM50/DGM100), encapsulated (EC50/EC100) and color-masked (CM50/CM100) DGM were added to wheat flour (WF) at two different temperatures: 20 °C and 45 °C and were examined for 30 days. Acceptability studies were conducted to determine sensory differences between rotis (Indian flat bread) prepared from WF/EC50/CM50/EC100. The mice consuming EC50/EC100 diets showed comparable iron status to DGM-fed mice, suggesting that encapsulation did not negatively impact iron bioavailability. Addition of EC to wheat flour resulted in the lowest Fe²⁺ oxidation and color change amongst treatments, when stored for 30 days. There were no differences in the overall liking and product acceptance of rotis amongst treatments at both day 0 and day 21 samples. Our results suggest that EC50 can be effectively used as an iron fortificant in WF to deliver highly bioavailable iron without experiencing any stability or sensory defects, at least until 30 days of storage.

Non-linear connections between maternal hemoglobin during the third trimester of pregnancy and birth weight outcomes in full-term newborns: Estimating the breakpoints

Objective

Anemia is still an unfinished global health problem, and adverse birth weight outcomes have everlasting influences on the health of later life. However, the non-linear connections and breakpoints of maternal hemoglobin with birth weight outcomes are still needed to be further elucidated. We aimed to reveal the non-linear connections between maternal hemoglobin during the third trimester of pregnancy and birth weight, low birth weight (LBW), macrosomia, small for gestational age (SGA), and large for gestational age (LGA) in full-term newborns and elucidate the breakpoints of the connections.

Methods

A total of 11,411 singletons, full-term, and live newborns, whose mothers conducted the examination of hemoglobin concentration before delivery, were included in this study. A generalized additive model was used to identify and visualize the non-linear connections between maternal hemoglobin and birth weight outcomes. Piecewise linear regression model was adopted to estimate the breakpoints of the connections and report the non-linear connections in detail.

Results

There were inverted "U"-shaped exposure-response connections between maternal hemoglobin concentration and birth weight and the risk of macrosomia. There was an increasing trend of the risk of LBW and a decreased trend of LGA with the increase in maternal hemoglobin concentration. The breakpoints of maternal hemoglobin for birth weight were 100 and 138 g/L, and those for SGA were 97 and 138 g/L. The breakpoints of maternal hemoglobin were 119 g/L for LBW, 105 g/L for macrosomia, and 106 g/L for LGA. When maternal hemoglobin concentration ranged from 100 to 138 g/L, maternal hemoglobin concentration increased per 1 g/L, and birth weight significantly decreased by 2.58 g (95% CI: -3.33, -1.83). When maternal hemoglobin concentration ranged from 97 to 138 g/L, maternal hemoglobin concentration increased per 1 g/L, and the risk of SGA significantly increased by 2% (95% CI: 1%, 3%). When maternal hemoglobin concentration was equal to or lower than 119 g/L, maternal hemoglobin concentration increased per 1 g/L, and the risk of LBW significantly increased by 3% (95% CI: 0%, 5%). When maternal hemoglobin concentration was higher than the breakpoints, the risks of macrosomia (OR = 0.99, 95% CI: 0.98, 0.99) and LGA (OR = 0.99, 95% CI: 0.98, 1.00) declined as the increase of maternal hemoglobin concentration.

Conclusions

There were non-linear connections between maternal hemoglobin and birth weight outcomes, and there are breakpoints in the connections. Cost-effective interventions targeting pregnant women in the prevention of abnormal maternal hemoglobin concentration should be taken to reduce the incidence of adverse birth weight outcomes.

Sensorially accepted Mangifera indica and Myrciaria dubia yogurts with high ascorbic acid content

Ascorbic acid deficiency has been associated with several health conditions. The objective of this study was to evaluate the content of ascorbic acid and the sensorial qualities of Mangifera indica and Myrciaria dubia yogurts. Four yogurt treatments were elaborated with different concentrations of these fruits (T1: 15% and 5%; T2: 15% and 10%; T3: 20% and 5% and T4: 20% and 10%) respectively, compared with a control treatment (CT: yogurt with 15% of Fragaria vesca). The ascorbic acid contents of the different treatments were determined by spectrophotometry, with values in the following order (T1: 63.2 mg/100 g; T2:114.3 mg/100 g; T3: 57.3 mg/100 g; T4: 115.1 and the control treatment CT:11.5 mg/100 g). The sensorial evaluation consisted of the application of a hedonic scale of 5 points (1: I dislike it very much; 2: I dislike it; 3: I neither like it nor dislike it; 4: I like it; 5: I like it a lot), results show evidence that the acidity level had a significant influence during the sensory evaluation. Treatment (T3) showed the greatest preference. The use of Mangifera indica and Myrciaria dubia in the treatments studied ensured ascorbic acid concentrations compared to the control treatment. This was significantly appreciated by consumers when the percentage of Myrciaria dubia was less than 10% of the total mass of the yogurt.

Iron Deficiency Anemia: Efficacy and Limitations of Nutritional and Comprehensive Mitigation Strategies

Iron deficiency anemia (IDA) has reached epidemic proportions in developing countries and has become a major global public health problem, affecting mainly 0–5-year-old children and young women of childbearing age, especially during pregnancy. Iron deficiency can lead to life-threatening loss of red blood cells, muscle function, and energy production. Therefore, the pathogenic features associated with IDA are weakness and impaired growth, motor, and cognitive performance. IDA affects the well-being of the young generation and the economic advancement of developing countries, such as India. The imbalance between iron intake/absorption/storage and iron utilization/loss culminates into IDA. However, numerous strategic programs aimed to increase iron intake have shown that improvement of iron intake alone has not been sufficient to mitigate IDA. Emerging critical risk factors for IDA include a composition of cultural diets, infections, genetics, inflammatory conditions, metabolic diseases, dysbiosis, and socioeconomic parameters. In this review, we discuss numerous IDA mitigation programs in India and their limitations. The new multifactorial mechanism of IDA pathogenesis opens perspectives for the improvement of mitigation programs and relief of IDA in India and worldwide.