Food and Nutrition Bulletin最新文献

This study aimed to characterize the factors influencing dietary diversity scores (DDS) of infants whose caregivers were classified as doers (those who fed a more diverse diet) and non-doers (those who fed a less diverse diet). This study was conducted using a multiphase study design and guided by a biocultural framework. Phase 1. Interviews with community leaders (n = 13) and direct 6-h household observations (n = 10) were used to formatively explore factors influencing diet. Phase 2. A dietary assessment (n = 81) was used to determine dietary diversity of indexed infants. Phase 3. A biocultural survey and direct 3-h. observations were conducted among indexed infants (6-9 months) (n = 80) to understand the biocultural factors influencing infant DDS. Phase 4. Interviews (n = 34) were conducted among indexed caregivers to understand why and how biocultural factors shape infant DDS. Dietary data were analyzed, and biocultural survey variables were subjected to a forward stepwise linear regression. Textual data were analyzed to identify salient biocultural factors. Findings revealed that infants had an average DDS of 2. Having water access in the household, owning land for homestead food production, and feeding infants the same foods caregivers consume were positively associated with DDS. Conversely, adhering to food proscriptions was negatively associated with DDS. Most caregivers were food insecure and employed both food and non-food-based coping strategies to feed their infants. Decreasing adherence to food rules, promoting homestead food production, and promoting non-food-based coping strategies may improve infant DDS in Guinea.

BackgroundIn response to high rates of undernutrition, Uganda began rolling out the multisectoral Uganda Nutrition Action Plan (UNAP) in 2011, followed by Phase II (UNAP II) in 2020. Uganda has since progressed toward several nutrition targets; however, limitations in nutrition coordination and financing call for continued strengthening of the UNAP II.ObjectivesGiven that monitoring of the UNAP II does not consistently capture district-level outcomes and relies upon quantitative nutrition indicators, this study aims to qualitatively assess nutrition stakeholder and community perspectives at the district level.MethodsFrom June to August in 2022, under an umbrella study utilizing community-based participatory research methods to train youth from Lira District in research, in partnership with the University of Southern California (USC) and community organization Children's Chance International-Uganda, these youth helped carry out an explanatory qualitative assessment consisting of 10 key informant interviews. Responses were compiled, transcribed, and analyzed using the Atlas TI software to code responses for thematic insights.ResultsParticipants highlighted several challenges with the UNAP II implementation at the local level. Mechanisms intended to promote multisectoral collaboration, such as district nutrition coordination committees, have been on hiatus due to limited funding; local governments experience funding disbursement delays and a lack of nutrition prioritization; and nutrition surveillance is limited by tools, training, and human resources.ConclusionsObtaining community perspectives revealed several gaps in local UNAP II implementation and demonstrates the importance of creating mechanisms for communities to continuously provide feedback for national policies like the UNAP II.

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 children.MethodsData 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.

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 1 in 3 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 3 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.

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 4-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.

BackgroundLow- and middle-income countries (LMICs) developing dietary guidelines often face challenges in translating nutrient requirements into practical, culturally acceptable recommendations due to limited data and technical resources. To address this gap, the Food and Agriculture Organization (FAO) developed FAO DietSolve, a user-friendly tool designed to support such efforts through a systematic and evidence-based approach.ObjectiveTo present an overview of the FAO DietSolve methodology, demonstrating its application through a hypothetical example, and highlighting its utility in supporting the development of dietary guidelines in LMICs.MethodsFAO DietSolve uses a mathematical optimization approach using Microsoft Excel's Solver add-in. It combines food groups that meet both nutritional constraints (energy and nutrient requirements) and acceptability constraints (minimum/maximum limits for each food group), while optimizing an objective function. The tool also allows for integration of additional sustainability criteria such as cost, cultural acceptability, and environmental impact into developed dietary patterns. Food groupings are based on representative foods and food consumption data. Objective functions can vary, such as minimizing deviation from observed dietary patterns.ResultsThe tool has been utilized by 8 LMICs in developing their national dietary guidelines. The optimized dietary patterns generated have supported the creation of food selection guides tailored to different population groups and informed food graphics.ConclusionsFAO DietSolve provides LMICs with a practical, data-driven method for developing comprehensive, sustainable, and culturally appropriate dietary patterns. It enables countries to address multiple dimensions of diets and food systems, in line with FAO's new food systems-based dietary guidelines methodology.

BackgroundChildhood anemia 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 anemia and identify its determinants among these vulnerable children.MethodsA cross-sectional study was conducted in 4 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 anemia 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 anemia.ResultsThe prevalence of anemia 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 anemia 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 anemia.ConclusionsAnemia 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 anemia among the indigenous Orang Asli children.