Food and Nutrition Bulletin最新文献

This Nevin S. Scrimshaw Prize Lecture presented in Paris on August 28, 2025, chronicles the scientific journey from Dr. Scrimshaw's vision of "Nutrition for All" to the emerging paradigm of "Precision Nutrition for Everyone," with a focus on Asian metabolic health. The central research question-"Why don't Western nutrition guidelines work optimally for Asian people?"-arose from clinical observations of Korean patients showing suboptimal metabolic outcomes despite adherence to conventional dietary recommendations. By 2024, nearly one in three Korean adults had metabolic disease, with particularly alarming trends among Millennials and Generation Z developing risk factors at earlier ages and lower BMIs than Western populations. Through three distinct research phases spanning 2017-2029, this work demonstrates that population specific precision nutrition requires integration of genomics, metabolomics, and culturally relevant dietary interventions. Phase I (2017-2020) identified obesity-inflammation biomarkers including NK cell activity and lipid mediators (lysoPE/lysoPC) in metabolically unhealthy obese individuals. Phase II (2019-2024) developed predictive models combining Genetic Risk Score and Oxidative Stress Score, achieving 75.1% accuracy for obesity prediction. Korean-specific genetic variants (TMEM182 rs141764639, NPC1L1 rs217434, LP-PLA2 Val279Phe) were identified as strong metabolic disease predictors absent from Western genome-wide studies. Phase III (2024-2029) translated omics findings into actionable dietary recommendations, establishing a fiber threshold of ≥17.28 g/day for maintaining healthy metabolic profiles and demonstrating metabolic benefits of legume-based rice substitution through randomized controlled trials. This journey underscores that precision nutrition must democratize health equity by recognizing genetic diversity as signal rather than noise, ensuring that molecular discoveries translate into accessible public health interventions for all populations.

BackgroundChildhood anaemia is a major global health issue, disproportionately affecting indigenous communities like the Orang Asli in Peninsular Malaysia. Despite its high prevalence, it remains under-researched and overshadowed by other public health priorities.ObjectivesThis study aims to quantify the burden of anaemia and identify its determinants among these vulnerable children.MethodsA cross-sectional study was conducted in four rural districts in Peninsular Malaysia, involving 503 Orang Asli children aged ≤ 5 years. The children were purposively sampled from the mobile clinics. Anthropometry was measured and anaemia was assessed using point-of-care photometry. Data on sociodemographic, childcare practices, home environment, and food insecurity were collected via structured interviews with parents or caregivers. Multivariate logistic regression was used to determine the factors associated with anaemia.ResultsThe prevalence of anaemia was 86.1% (95% CI: 82.8, 89.0); with 19.5% (95% CI: 16.1, 23.2) classified as mild, 52.1% (95% CI:47.6, 56.5) moderate, and 14.5% (95% CI: 11.6, 17.9) severe. Factors associated with anaemia were early initiation of complimentary feeding (aOR: 2.7, 95% CI: 1.0, 7.0) and recent fever or upper respiratory infections (aOR: 2.6, 95% CI: 1.3, 5.3). Geographic variations were observed, with children from Jerantut (aOR: 0.2, 95% CI: 0.1, 0.4) and Lipis (aOR: 0.3, 95% CI: 0.1, 0.9) showing lower odds of anaemia.ConclusionsAnaemia prevalence among Orang Asli children is alarmingly high. Targeted interventions should improve feeding practice and enhance health management. Identifying district-specific lower risk characteristics can guide broader strategies to tackle childhood anaemia among the indigenous Orang Asli children.

BackgroundObesity is a global public health crisis exacerbated by ultra-processed and nutrient-poor foods. Despite policy interventions, progress remains uneven due to socioeconomic, political, and industry barriers.ObjectiveThis review examines global food policies on obesity prevention, highlights implementation gaps, and suggests pathways for more equitable, coordinated action.MethodsA narrative review was conducted using literature from PubMed and Scopus (2017-2025), including peer-reviewed studies, policy documents, and international agency reports. Key search terms included "global food policies," "obesity prevention," "ultra-processed foods," "nutrition labeling," and "sugar taxes." Inclusion criteria encompassed studies on policy strategies for obesity prevention and healthier food environments.ResultsThe review categorized food policy interventions into key thematic areas: fiscal policies, nutrition labeling, marketing restrictions, regulation of ultra-processed foods (UPFs), out-of-home/food-service policies (eg, menu and nutrient labeling, portion-size and sodium limits, healthy defaults, procurement standards), school food policies, and international coordination. Evidence shows that front-of-package labeling and sugar-sweetened beverage levies are effective in some regions. Healthy food subsidies and purchase incentives yield mixed but promising results, especially among low-income groups. However, socioeconomic disparities, industry resistance, weak regulations, and poor multisector and public-private partnerships (PPPs) governance limit their scalability and sustainability.ConclusionsCurrent global food policy efforts are insufficient to curb the escalating obesity epidemic. Transformative, multisectoral, and equity-focused policy frameworks augmented by digital tools for monitoring, enforcement, and targeted health promotion are critical to accelerate progress and reduce inequities. Priority should be given to regulating UPFs, standardizing labels, tightening marketing controls, and integrating obesity prevention into health policies.

BackgroundIndonesia still experiences a high stunting burden. This has both short- and long-term impacts, including higher morbidity and mortality, impaired future growth, increased chronic disease risk, and reduced productivity later in life.ObjectiveThis paper aims to assess the main risk factors associated with stunting in Indonesia and to develop a predictive model to identify stunting risk in childrenMethodsData from the 2018 Indonesian Basic Health Research database were analyzed for children aged under 5 years (n = 13 106) and their mothers. Bivariate analysis was used to select variables significantly associated with stunting risk. A decision tree model was then applied to predict the risk of stunting by age group, and the data were plotted into a receiver operating characteristic (ROC) curve.ResultsThe stunting rate reached 25.8%. Based on the decision tree, age, sex, birth weight, birth length, mother's highest level of education, handwashing habits, and exclusive breastfeeding were found to impact stunting risk. The prediction model demonstrated an accuracy of 73.8% for assessing the risk of stunting. The ROC curve showed an area under the curve of 63.7%, with a sensitivity of 60.1% and specificity of 59.8%.ConclusionsThis prediction model is accurate for assessing the risk of stunting. The decision tree-based prediction model performs reasonably well in differentiating between stunted and non-stunted children across different age groups, as indicated by the ROC curve.

BackgroundIn many low-income settings, pregnant and lactating women (PLW) often have poor dietary diversity, poor nutritional status, and perpetuation of a cycle of malnutrition.ObjectiveThis study aimed to assess the association of Social and Behavioral Change Communication (SBCC) combined with an egg production intervention on the feeding practices of PLW in the Bishoftu and East Shoa Zone, Ethiopia.MethodA four-round repeated cross-sectional survey was conducted, including 459, 494, 425, and 547 PLW in the first, second, third and fourth rounds, respectively. The Market-based Innovation for Nutrition in Ethiopia (MINE) project implemented the egg hub model to increase egg production, and a comprehensive SBCC package was used to promote egg consumption. Dietary diversity was assessed using the Minimum Dietary Diversity for Women (MDD-W) tool, with intake measured through a 24-h recall method. Dietary diversity among PLW was evaluated by comparing data from the first survey round to subsequent rounds. Multivariable logistic regression identified the independent association of the MINE intervention with MDD-W, controlling for confounders.ResultThe proportion of PLW meeting MDD-W increased from 29.9% in the first survey round to 71.3% in the second, 56.7% in the third, and 66.8% in the fourth rounds. Maternal knowledge improved from 52.7% to 78.2%, and favorable attitudes toward feeding recommendations rose from 76.3% to 87.2%.ConclusionThe findings suggest the combined intervention was associated with significant improvements in the dietary diversity, knowledge, and attitudes of PLW, suggesting that it should be scaled up across Ethiopia to evaluate its broader effectiveness.

BackgroundDespite a growing interest in household-level agriculture-nutrition linkage, evidence remains thin in countries like Tajikistan, one of the poorest former socialist countries where food crop production decisions by individual farm households had been significantly regulated by the government until recently.ObjectivesWe narrow this knowledge gap by examining the linkages between households' food production practice as well as their productivity performances and dietary diversity scores (DDS) of both the household and individual women in Tajikistan.MethodsWe use a panel sample of households and individual women of reproductive ages in the Khatlon province of Tajikistan, the poorest province and a major agricultural region of the country. Difference-in-difference propensity score regressions and panel fixed-effects instrumental variable regressions are applied.ResultsHigher overall diversity in food groups (FGs) produced by households, as well as greater overall production per land and per household member at the household level, leads to higher DDS both for the household and for individual women, particularly in areas with poor food market access. FG-specific analyses suggest that for vegetables, fruits, legumes/nuts/seeds, dairy products, and eggs, significant one-on-one linkage exists between own production and consumption for these FGs.ConclusionsResults underscore the importance of supporting household-level agricultural diversification and agricultural productivity growth in Tajikistan to improve dietary diversity, especially in remote areas.

BackgroundIran has developed a comprehensive action plan aimed at reducing premature mortality as a result of noncommunicable diseases (NCDs) by 25% by 2025.ObjectiveThis study aimed to describe and assess current policies and actions that public sectors in Iran are taking to create healthy food environments for prevention and management of obesity, NCDs, and their related inequalities.MethodsThe Healthy Food Environment Policy Index was the principal tool used, and interaction with key stakeholders was the main approach. Available evidence of policy implementation was collated for 47 good practice indicators across 13 policy and infrastructure support domains through searches on institutional websites and verified by government stakeholders. The final evidence report was rated by a national expert panel based on the level of implementation compared to international best practices.ResultsOverall, 89 relevant documents were identified, classified, and analyzed, comprising 5 constitutional laws or general policies, 20 parliamentary mandates, 5 national documents, 22 national regulations, and 37 national programs which were categorized into policy (n = 62) and infrastructure (n = 42) components. Notably, the highest level of evidence was observed in Leadership5 (14 documents), Provision1 (13 documents), and Provision2 (8 documents). No indicator was rated as "high" implementation, while nearly two-thirds of the indicators were rated as low or very low.ConclusionsDespite the Iranian government's broad landscape in supporting policies that help create healthier food environments. The findings also show the need to reform all of their policies and supportive infrastructure in order to achieve significant results.

Background: Campaign-based vitamin A supplementation (VAS) programs are under pressure to reduce costs and increase coverage. Objectives: This study examined coverage, costs, cost-effectiveness, and cost burdens of a campaign-based VAS event (JVA+) in the Yako and Kombissiri health districts of central Burkina Faso. Methods: Data were collected from groups of JVA+ event implementers and caregivers. Post-event coverage surveys measured coverage; spatially scaled primary data provided estimates of costs. Costs of caregiver participation were measured. Data were provided by all actors involved in the design and implementation of the JVA+ event. Results: Overall, 88% of the target age group was covered. Overall coverage did not differ across health districts but was lower in urban areas. Children 6 to 11 months of age had lower coverage, especially in urban areas. The VAS event cost ∼137k USD. Average cost per child reached was 1.34 USD, ranging from 1.19 USD (Yako) to 1.62 USD (Kombissiri). National costs, with international support, covered VA capsules and community health worker salaries. Community stakeholders incurred administrative and transportation/communication costs; regional and district-level stakeholders made small contributions. Caregivers in rural areas contributed significant amounts of time (∼20% of total program costs in some areas). Conclusions: The vast majority of Burkinabe children suffer from vitamin A inadequacy. JVA+ events can be generally effective in distributing twice-annual VAS, but are expensive and heavily reliant on international assistance, and are unsustainable. Young children were consistently under-reached, especially in urban areas. Costs to caregivers were high in rural areas. Evidence-based, area-specific changes in program design could increase coverage and efficiency.