Pub Date : 2022-06-01DOI: 10.1177/03795721211070706
Christina Nyhus Dhillon, Marieke Vossenaar, Bärbel Weiligmann, Neha Sanwal, Eric W Djimeu, Mirjam Kneepkens, Biju Mushahary, Genevieve Stone, Lynnette M Neufeld
Many workers in global supply chains remain nutritionally vulnerable despite the income they earn. The Seeds of Prosperity (SOP) program was implemented in Tamil Nadu and Assam, India, for tea supply chain workers (estate workers, small holder farmers, and farm workers). The aim was to enhance demand for diverse and nutritious foods and improve practices related to handwashing. The program used a behavior change communication approach wherein participants received weekly 1-hour group sessions with messaging on dietary diversity for 5 weeks and handwashing for 4 weeks. An impact evaluation was conducted to estimate changes in reported dietary and hygiene knowledge and behaviors among women. The study used a longitudinal quasi-experimental design in a subsample of program participants at baseline and post-intervention among both intervention and comparison. There was a small but significant increase in mean dietary diversity (DD) for all 4 worker groups (ranging from DD score changes of 0.3 to 0.7; P < .05) and in the proportion of women meeting the minimum dietary diversity in 2 of the 4 groups. Similarly, a significant increase in the mean number of handwashing moments was observed in 2 of the worker groups. An increase in home garden use was observed in 1 of the 4 worker groups. While the SOP program resulted in improvements in dietary diversity, most tea farming women still do not achieve minimum dietary diversity. Nutritious food access may be an important constraint to further improvement.
{"title":"A Nutrition Behavior Change Program Moderately Improves Minimum Diet Diversity and Handwashing Behaviors Among Tea Workers in Assam and Tamil Nadu, India.","authors":"Christina Nyhus Dhillon, Marieke Vossenaar, Bärbel Weiligmann, Neha Sanwal, Eric W Djimeu, Mirjam Kneepkens, Biju Mushahary, Genevieve Stone, Lynnette M Neufeld","doi":"10.1177/03795721211070706","DOIUrl":"https://doi.org/10.1177/03795721211070706","url":null,"abstract":"<p><p>Many workers in global supply chains remain nutritionally vulnerable despite the income they earn. The Seeds of Prosperity (SOP) program was implemented in Tamil Nadu and Assam, India, for tea supply chain workers (estate workers, small holder farmers, and farm workers). The aim was to enhance demand for diverse and nutritious foods and improve practices related to handwashing. The program used a behavior change communication approach wherein participants received weekly 1-hour group sessions with messaging on dietary diversity for 5 weeks and handwashing for 4 weeks. An impact evaluation was conducted to estimate changes in reported dietary and hygiene knowledge and behaviors among women. The study used a longitudinal quasi-experimental design in a subsample of program participants at baseline and post-intervention among both intervention and comparison. There was a small but significant increase in mean dietary diversity (DD) for all 4 worker groups (ranging from DD score changes of 0.3 to 0.7; <i>P</i> < .05) and in the proportion of women meeting the minimum dietary diversity in 2 of the 4 groups. Similarly, a significant increase in the mean number of handwashing moments was observed in 2 of the worker groups. An increase in home garden use was observed in 1 of the 4 worker groups. While the SOP program resulted in improvements in dietary diversity, most tea farming women still do not achieve minimum dietary diversity. Nutritious food access may be an important constraint to further improvement.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/d0/10.1177_03795721211070706.PMC9118494.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10301259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Previous multiple-choice food-based food frequency questionnaires (FFQs) were not validated against weighed dietary records (WDRs) in Iran. This study investigated the validity and reproducibility of a multiple-choice semi-quantitative food frequency questionnaire (SQ-FFQ) in adults living in central Iran. Patients with diabetes and their spouses were asked to complete 3 SQ-FFQs by interview, and nine 3-day WDRs, over 9 months. They provided 2 blood samples to assess serum calcium, magnesium, zinc, and vitamin C levels. The Pearson and intraclass correlation coefficients were calculated to assess reproducibility and validity. The degree of misclassification was explored using a contingency table of quartiles which compare the information between third FFQ and WDRs. The method of triads was incorporated to assess validity coefficients between estimated intakes using third FFQ, WDRs, and biochemical markers and assumed true intakes. A total of 180 participants aged 48.9 ± 8.4 years completed the study. Compared to WDRs, FFQs overestimated all nutrient intakes except for iron. The median intraclass correlation between FFQs was 0.56. The median de-attenuated, age, sex, and education adjusted partial correlation coefficients for validity were 0.17 and 0.26 for FFQ1-WDRs and FFQ3-WDRs, respectively. The FFQ3 validity coefficients for vitamin C, calcium, magnesium, and zinc were 0.13, 0.62, 0.89, and 0.66, respectively, using the triads method. The median exact agreement and complete disagreement between FFQ3 and WDRs were 33% and 6%, respectively. The SQ-FFQ seems to be an acceptable tool to assess the long-term dietary intake for future large-scale studies in this population.
{"title":"Validity and Reproducibility of a Semiquantitative Multiple-Choice Food Frequency Questionnaire in Iranian Adults.","authors":"Alireza Zimorovat, Fatemeh Moghtaderi, Mojgan Amiri, Hamidreza Raeisi-Dehkordi, Matin Mohyadini, Mohammad Mohammadi, Sadegh Zarei, Elham Karimi-Nazari, Masoud Mirzaei, Azadeh Nadjarzadeh, Amin Salehi-Abargouei","doi":"10.1177/03795721221078353","DOIUrl":"https://doi.org/10.1177/03795721221078353","url":null,"abstract":"<p><p>Previous multiple-choice food-based food frequency questionnaires (FFQs) were not validated against weighed dietary records (WDRs) in Iran. This study investigated the validity and reproducibility of a multiple-choice semi-quantitative food frequency questionnaire (SQ-FFQ) in adults living in central Iran. Patients with diabetes and their spouses were asked to complete 3 SQ-FFQs by interview, and nine 3-day WDRs, over 9 months. They provided 2 blood samples to assess serum calcium, magnesium, zinc, and vitamin C levels. The Pearson and intraclass correlation coefficients were calculated to assess reproducibility and validity. The degree of misclassification was explored using a contingency table of quartiles which compare the information between third FFQ and WDRs. The method of triads was incorporated to assess validity coefficients between estimated intakes using third FFQ, WDRs, and biochemical markers and assumed true intakes. A total of 180 participants aged 48.9 ± 8.4 years completed the study. Compared to WDRs, FFQs overestimated all nutrient intakes except for iron. The median intraclass correlation between FFQs was 0.56. The median de-attenuated, age, sex, and education adjusted partial correlation coefficients for validity were 0.17 and 0.26 for FFQ1-WDRs and FFQ3-WDRs, respectively. The FFQ3 validity coefficients for vitamin C, calcium, magnesium, and zinc were 0.13, 0.62, 0.89, and 0.66, respectively, using the triads method. The median exact agreement and complete disagreement between FFQ3 and WDRs were 33% and 6%, respectively. The SQ-FFQ seems to be an acceptable tool to assess the long-term dietary intake for future large-scale studies in this population.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39638828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-01Epub Date: 2022-02-24DOI: 10.1177/03795721221078362
Lesley Macheka, Tatenda Mudiwa, Prosper Chopera, Admire Nyamwanza, Peter Jacobs
Background: The relationship between climate adaptation strategies and nutrition security is poorly understood and often unclear. Although several adaptation strategies have been implemented to mitigate the impact of climate change, there is still a lack of conclusive evidence or studies on the interrelationships between adopted climate change adaptation strategies and nutrition outcomes.
Objective: This study aimed to develop a conceptual framework that links climate change, adaptation strategies and nutrition and to show the indicators that can be used to assess the impact of climate adaptation strategies on nutrition.
Methodology: The proposed conceptual framework was developed through a literature review.
Results: A generic conceptual framework that could be used to assess the impact of adopted climate change adaptation strategies on nutrition outcomes was developed. The framework consists of 5 key elements: agro-food system, context characteristics, adaptation strategies, climatic shocks and stress, and system output. The principles used in designing the conceptual framework include systems approach, contingency theory, and system output.
Conclusion: The developed framework offers a channel to evaluate adopted climate change adaptation strategies and their impact on nutrition outcomes. Such a conceptual framework can also be used in selecting and identifying more suitable climate adaptation strategies given specific contextual environments.
{"title":"Linking Climate Change Adaptation Strategies and Nutrition Outcomes: A Conceptual Framework.","authors":"Lesley Macheka, Tatenda Mudiwa, Prosper Chopera, Admire Nyamwanza, Peter Jacobs","doi":"10.1177/03795721221078362","DOIUrl":"https://doi.org/10.1177/03795721221078362","url":null,"abstract":"<p><strong>Background: </strong>The relationship between climate adaptation strategies and nutrition security is poorly understood and often unclear. Although several adaptation strategies have been implemented to mitigate the impact of climate change, there is still a lack of conclusive evidence or studies on the interrelationships between adopted climate change adaptation strategies and nutrition outcomes.</p><p><strong>Objective: </strong>This study aimed to develop a conceptual framework that links climate change, adaptation strategies and nutrition and to show the indicators that can be used to assess the impact of climate adaptation strategies on nutrition.</p><p><strong>Methodology: </strong>The proposed conceptual framework was developed through a literature review.</p><p><strong>Results: </strong>A generic conceptual framework that could be used to assess the impact of adopted climate change adaptation strategies on nutrition outcomes was developed. The framework consists of 5 key elements: agro-food system, context characteristics, adaptation strategies, climatic shocks and stress, and system output. The principles used in designing the conceptual framework include systems approach, contingency theory, and system output.</p><p><strong>Conclusion: </strong>The developed framework offers a channel to evaluate adopted climate change adaptation strategies and their impact on nutrition outcomes. Such a conceptual framework can also be used in selecting and identifying more suitable climate adaptation strategies given specific contextual environments.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39643517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-08DOI: 10.1177/03795721221078361
S. Puri, T. Rekhi, T. Thomas, Meena Haribhau Jadhav, V. Mannar, L. Diosady
Background: Micronutrient deficiencies are a cause of significant public health burden and loss of gross domestic product, especially in developing countries. Multiple fortified salt can potentially address this challenge at scale and in a cost-effective manner. Objective: This laboratory-based sensory trial evaluated the acceptability of quintuple fortified salt (Q5FS), that is, iodized salt (IS) fortified with additional 4 micronutrients: iron, folic acid, vitamin B12, and zinc. Iodized salt and double fortified salt (DFS), that is, IS fortified with iron, are used for comparison. Methods: Forty-five respondents were recruited by open invitations to the university staff and their families. Each study participant rated 10 food items each in a set of 3 identical preparations differing only in the salt used. A 5-point hedonic scale was used to rate each dish on 6 sensory attributes: appearance, color, aroma, taste, texture, and aftertaste. Finally, the dish was rated on the attribute of overall acceptability—a subjective combined score based on all sensory attributes considered together. Results: Among the 3 salt types, there was no difference in scores for the sensory attributes of appearance, aroma, taste, texture, and aftertaste, and the attribute of overall acceptability. Color in IS scored significantly higher than in Q5FS and DFS, but there was no difference between the scores of DFS and Q5FS. Conclusions: The 3 salts IS, DFS, and Q5FS are comparable to each other in all sensory properties, except for color. This study concludes that Q5FS is organoleptically acceptable under ideal conditions.
{"title":"Sensory Trial of Quintuple Fortified Salt—Salt Fortified With Iodine, Iron, Folic Acid, Vitamin B12, and Zinc—Among Consumers in New Delhi, India","authors":"S. Puri, T. Rekhi, T. Thomas, Meena Haribhau Jadhav, V. Mannar, L. Diosady","doi":"10.1177/03795721221078361","DOIUrl":"https://doi.org/10.1177/03795721221078361","url":null,"abstract":"Background: Micronutrient deficiencies are a cause of significant public health burden and loss of gross domestic product, especially in developing countries. Multiple fortified salt can potentially address this challenge at scale and in a cost-effective manner. Objective: This laboratory-based sensory trial evaluated the acceptability of quintuple fortified salt (Q5FS), that is, iodized salt (IS) fortified with additional 4 micronutrients: iron, folic acid, vitamin B12, and zinc. Iodized salt and double fortified salt (DFS), that is, IS fortified with iron, are used for comparison. Methods: Forty-five respondents were recruited by open invitations to the university staff and their families. Each study participant rated 10 food items each in a set of 3 identical preparations differing only in the salt used. A 5-point hedonic scale was used to rate each dish on 6 sensory attributes: appearance, color, aroma, taste, texture, and aftertaste. Finally, the dish was rated on the attribute of overall acceptability—a subjective combined score based on all sensory attributes considered together. Results: Among the 3 salt types, there was no difference in scores for the sensory attributes of appearance, aroma, taste, texture, and aftertaste, and the attribute of overall acceptability. Color in IS scored significantly higher than in Q5FS and DFS, but there was no difference between the scores of DFS and Q5FS. Conclusions: The 3 salts IS, DFS, and Q5FS are comparable to each other in all sensory properties, except for color. This study concludes that Q5FS is organoleptically acceptable under ideal conditions.","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41299177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-03DOI: 10.1177/03795721221096187
Sayvisene Boulom, Daniëlle M Bon, D. Essink, S. Kounnavong, J. Broerse
Background: Stunting is one of the main contributing factors in the under-five mortality rate worldwide. In Laos, the prevalence of stunting remains high, particularly in mountainous rural areas. To prevent stunting, insight into positive deviant behaviors can help understand how people can cope or adapt in resource-poor settings. Objective: This study aims to analyze the practices and underlying factors that explain discrepancies in nutritional outcomes in children under the age of 5 in remote mountainous areas in Laos. Methods: This mixed-methods study included all children under the age of 5 living in 6 selected villages. Anthropometric measurements were taken, and a Z-score for stunting was calculated to select the positive and negative deviant children. To identify the causes of discrepancies in childhood stunting, household questionnaires, focus group discussions, observations, and individual interviews with family members and health workers were conducted. Results: Fifty-five percent of children were stunted. Inappropriate care and feeding practices were observed such as providing unbalanced diets and not attending health facilities. Positive deviant mothers were less likely to follow inappropriate practices, experienced less food insecurity, and had higher motivation and autonomy, which resulted in prioritizing their children’s health. An active role of fathers seemed to benefit positive practices within households. Conclusions: The combination of many different practices in which positive deviant families are doing slightly better was associated with in less stunting of children. Those practices are related to the household resources, such as access to food and social support; and the mother’s motivation, autonomy, and perspectives on child health.
{"title":"Understanding Discrepancies in Nutritional Outcomes Among Under-Fives in Laos: A Mixed-Methods Study Using the Positive Deviance Approach","authors":"Sayvisene Boulom, Daniëlle M Bon, D. Essink, S. Kounnavong, J. Broerse","doi":"10.1177/03795721221096187","DOIUrl":"https://doi.org/10.1177/03795721221096187","url":null,"abstract":"Background: Stunting is one of the main contributing factors in the under-five mortality rate worldwide. In Laos, the prevalence of stunting remains high, particularly in mountainous rural areas. To prevent stunting, insight into positive deviant behaviors can help understand how people can cope or adapt in resource-poor settings. Objective: This study aims to analyze the practices and underlying factors that explain discrepancies in nutritional outcomes in children under the age of 5 in remote mountainous areas in Laos. Methods: This mixed-methods study included all children under the age of 5 living in 6 selected villages. Anthropometric measurements were taken, and a Z-score for stunting was calculated to select the positive and negative deviant children. To identify the causes of discrepancies in childhood stunting, household questionnaires, focus group discussions, observations, and individual interviews with family members and health workers were conducted. Results: Fifty-five percent of children were stunted. Inappropriate care and feeding practices were observed such as providing unbalanced diets and not attending health facilities. Positive deviant mothers were less likely to follow inappropriate practices, experienced less food insecurity, and had higher motivation and autonomy, which resulted in prioritizing their children’s health. An active role of fathers seemed to benefit positive practices within households. Conclusions: The combination of many different practices in which positive deviant families are doing slightly better was associated with in less stunting of children. Those practices are related to the household resources, such as access to food and social support; and the mother’s motivation, autonomy, and perspectives on child health.","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42286452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-26DOI: 10.1177/03795721221088962
Sabina Di Prima, Dai Nguyen Dinh, Demi Reurings, E. Wright, D. Essink, J. Broerse
Background: Undernutrition threatens the health and future of preschool children in disadvantaged remote communities. Home-grown school feeding (HGSF) in nursery schools could positively impact children’s nutrition while creating multiple benefits for the whole community. However, evidence is lacking on implementation of HGSF within multi-sectoral programs in remote areas. Objective: This study assessed an HGSF pilot intervention, part of a nutrition-sensitive agriculture (NSA) program, in a mountain ethnic minority community in Vietnam. It aimed to identify the changes brought about by the intervention, in particular diversity of children’s food, food sources, barriers and facilitators to change, and future challenges and strategies. Methods: Mixed-methods assessment covered school meal diversity, cost, and food sources but the key focus was on observed changes resulting from the HGSF intervention and perceived barriers and facilitators to its implementation. Data were collected mainly through semi-structured interviews (n = 30) and seven focus group discussions (n = 76). Results: School meals contributed to increasing diversity of food consumed by children. Above 30% of foods used were home-grown. Respondents reported increased school attendance; children’s food preferences and hygiene practices improved as did parents’ caring and feeding practices. Local food systems became less cash-crop-oriented and more self-reliant, contributing to household food security and income generation. Social capital increased. Positive changes were attributed to HGSF and synergy among NSA program components. Poverty and limited resilience to external shocks threatened sustainability. Conclusions: Implementing HGSF within an NSA program in a mountainous ethnic minority area with a high prevalence of undernutrition benefitted children and their communities.
{"title":"Home-Grown School Feeding: Implementation Lessons From a Pilot in a Poor Ethnic Minority Community in Vietnam","authors":"Sabina Di Prima, Dai Nguyen Dinh, Demi Reurings, E. Wright, D. Essink, J. Broerse","doi":"10.1177/03795721221088962","DOIUrl":"https://doi.org/10.1177/03795721221088962","url":null,"abstract":"Background: Undernutrition threatens the health and future of preschool children in disadvantaged remote communities. Home-grown school feeding (HGSF) in nursery schools could positively impact children’s nutrition while creating multiple benefits for the whole community. However, evidence is lacking on implementation of HGSF within multi-sectoral programs in remote areas. Objective: This study assessed an HGSF pilot intervention, part of a nutrition-sensitive agriculture (NSA) program, in a mountain ethnic minority community in Vietnam. It aimed to identify the changes brought about by the intervention, in particular diversity of children’s food, food sources, barriers and facilitators to change, and future challenges and strategies. Methods: Mixed-methods assessment covered school meal diversity, cost, and food sources but the key focus was on observed changes resulting from the HGSF intervention and perceived barriers and facilitators to its implementation. Data were collected mainly through semi-structured interviews (n = 30) and seven focus group discussions (n = 76). Results: School meals contributed to increasing diversity of food consumed by children. Above 30% of foods used were home-grown. Respondents reported increased school attendance; children’s food preferences and hygiene practices improved as did parents’ caring and feeding practices. Local food systems became less cash-crop-oriented and more self-reliant, contributing to household food security and income generation. Social capital increased. Positive changes were attributed to HGSF and synergy among NSA program components. Poverty and limited resilience to external shocks threatened sustainability. Conclusions: Implementing HGSF within an NSA program in a mountainous ethnic minority area with a high prevalence of undernutrition benefitted children and their communities.","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46520177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-19DOI: 10.1177/03795721221090380
L. Bliznashka, Elodie Becquey, M. Ruel, Deanna K. Olney
Background: Little is known about the sustained effects of nutrition- and gender-sensitive agricultural programs (NSAPs) after they end. Objectives: To examine the 4-year effects (2010-2014) of a 2-year NSAP (2010-2012) on women’s outcomes in rural Burkina Faso. Methods: We used baseline (2010) and endline (2012) data from a cluster-randomized controlled trial of Helen Keller International’s Enhanced Homestead Food Production (EHFP) program and baseline (2014) data from a new program. We included 134 women: 82 who participated in the 2-year EHFP program (treatment) and 52 who did not (control). We examined program (2010-2012), post-program (2012-2014), and overall 4-year effects (2010-2014) using difference-in-difference analysis (DID). Results: We found significant positive program effects (2010-2012) on women’s underweight prevalence (DID: 16.44 percentage points [pp]; P = .09) and on women’s knowledge about appropriate age to introduce liquids (DID: 28.40 pp; P = .01). Although there were no significant postprogram effects (2012-2014), differences found in 2012 between the treatment and control group were sustained resulting in an overall 4-year (2010-2014) reduction in women’s underweight prevalence (DID: 18.26 pp; P = .02) and an improvement in women’s knowledge about appropriate age to introduce liquids (DID: 31.29 pp; P = .02). We observed no postprogram or overall 4-year effects on women’s knowledge of child feeding and handwashing practices or women’s empowerment. Conclusions: Nutrition- and gender-sensitive agricultural programs demonstrate potential for sustained improvements in women’s nutritional status and nutritional knowledge. Postprogram assessments of NSAPs should be embedded in program evaluations to help further understand the potential of NSAPs to generate sustainable impacts on women’s outcomes.
{"title":"Four-Year Effects of a 2-Year Nutrition and Gender Sensitive Agricultural Program on Women’s Nutritional Status, Knowledge, and Empowerment in Rural Burkina Faso","authors":"L. Bliznashka, Elodie Becquey, M. Ruel, Deanna K. Olney","doi":"10.1177/03795721221090380","DOIUrl":"https://doi.org/10.1177/03795721221090380","url":null,"abstract":"Background: Little is known about the sustained effects of nutrition- and gender-sensitive agricultural programs (NSAPs) after they end. Objectives: To examine the 4-year effects (2010-2014) of a 2-year NSAP (2010-2012) on women’s outcomes in rural Burkina Faso. Methods: We used baseline (2010) and endline (2012) data from a cluster-randomized controlled trial of Helen Keller International’s Enhanced Homestead Food Production (EHFP) program and baseline (2014) data from a new program. We included 134 women: 82 who participated in the 2-year EHFP program (treatment) and 52 who did not (control). We examined program (2010-2012), post-program (2012-2014), and overall 4-year effects (2010-2014) using difference-in-difference analysis (DID). Results: We found significant positive program effects (2010-2012) on women’s underweight prevalence (DID: 16.44 percentage points [pp]; P = .09) and on women’s knowledge about appropriate age to introduce liquids (DID: 28.40 pp; P = .01). Although there were no significant postprogram effects (2012-2014), differences found in 2012 between the treatment and control group were sustained resulting in an overall 4-year (2010-2014) reduction in women’s underweight prevalence (DID: 18.26 pp; P = .02) and an improvement in women’s knowledge about appropriate age to introduce liquids (DID: 31.29 pp; P = .02). We observed no postprogram or overall 4-year effects on women’s knowledge of child feeding and handwashing practices or women’s empowerment. Conclusions: Nutrition- and gender-sensitive agricultural programs demonstrate potential for sustained improvements in women’s nutritional status and nutritional knowledge. Postprogram assessments of NSAPs should be embedded in program evaluations to help further understand the potential of NSAPs to generate sustainable impacts on women’s outcomes.","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42514325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-13DOI: 10.1177/03795721221078351
Melesse Niguse Kuma, Dessalegn Tamiru, Girma Beressa, T. Belachew
Background: This review aimed at synthesizing evidence on the effectiveness of nutritional interventions that were carried out before and/or during early pregnancy versus the control groups on reducing the risk of low weight at birth in sub-Saharan Africa. Methods: We have searched on MEDLINE, SCOPUS, CINAHL, HINARI, and Cochrane Library of systematic review databases for published articles in English language from 2010 to 2021 years. For unpublished studies, we searched on Google scholar. Randomized controlled trial studies of nutritional interventions carried out before/or during early pregnancy in sub-Saharan Africa to improve low birth weight were considered. The data were extracted and pooled using the Joanna Briggs Institute software. The effect size was calculated using fixed-effect models. Mantel-Haenszel method was used to calculate the relative risk with their respective 95% CI. Heterogeneity was assessed using the standard chi-square and I 2 tests. Results: Seven studies were included in the review with a total of 5934 participants. Three types of nutritional interventions were identified: iron supplementations, lipid-based supplementations, and nutritional education and counseling. We have identified only one intervention started during preconception. The meta-analysis showed that none of the identified nutrition interventions had a statistically significant effect on low birth weight. Conclusions: Based on the review evidence, nutritional interventions before and/or during early pregnancy in sub-Saharan Africa had no significant effect on low birth weight. However, since our evidence was derived from a small number of trials and participants, a large-scale randomized controlled trials review might be required to elucidate the finding.
{"title":"Effect of Nutrition Interventions Before and/or During Early Pregnancy on Low Birth Weight in Sub-Saharan Africa: A Systematic Review and Meta-Analysis","authors":"Melesse Niguse Kuma, Dessalegn Tamiru, Girma Beressa, T. Belachew","doi":"10.1177/03795721221078351","DOIUrl":"https://doi.org/10.1177/03795721221078351","url":null,"abstract":"Background: This review aimed at synthesizing evidence on the effectiveness of nutritional interventions that were carried out before and/or during early pregnancy versus the control groups on reducing the risk of low weight at birth in sub-Saharan Africa. Methods: We have searched on MEDLINE, SCOPUS, CINAHL, HINARI, and Cochrane Library of systematic review databases for published articles in English language from 2010 to 2021 years. For unpublished studies, we searched on Google scholar. Randomized controlled trial studies of nutritional interventions carried out before/or during early pregnancy in sub-Saharan Africa to improve low birth weight were considered. The data were extracted and pooled using the Joanna Briggs Institute software. The effect size was calculated using fixed-effect models. Mantel-Haenszel method was used to calculate the relative risk with their respective 95% CI. Heterogeneity was assessed using the standard chi-square and I 2 tests. Results: Seven studies were included in the review with a total of 5934 participants. Three types of nutritional interventions were identified: iron supplementations, lipid-based supplementations, and nutritional education and counseling. We have identified only one intervention started during preconception. The meta-analysis showed that none of the identified nutrition interventions had a statistically significant effect on low birth weight. Conclusions: Based on the review evidence, nutritional interventions before and/or during early pregnancy in sub-Saharan Africa had no significant effect on low birth weight. However, since our evidence was derived from a small number of trials and participants, a large-scale randomized controlled trials review might be required to elucidate the finding.","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42044339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1177/03795721221088817
Debritu Nane, A. Hatløy, B. Lindtjørn
Background: Management of moderate acute malnutrition (MAM) in children needs to improve to reduce the transition from MAM to severe acute malnutrition (SAM). Objective: This study aimed to assess barriers to management of MAM among children aged 6 to 59 months in Damot Pulassa, Wolaita, South Ethiopia. Method: This descriptive phenomenological design used 6 focus group discussions with mothers or caregivers of children aged 6 to 59 months and 10 in-depth interviews with health service providers. Data were analyzed using Colaizzi’s descriptive phenomenological method. Result: Six themes were identified: Possible reasons for MAM; identification of a child with MAM; management services of MAM; maternal-level barriers; service provider-level barriers; and suggestions to improve the service. Shortage of food and money, selling out of self-produced food without having sufficient reserves at home, large household size, shame from having children with malnutrition, occasional house-to-house screening for MAM, family-initiated screening, leaving the management responsibility of children with MAM to the family, no provision of supplementary food, and lack of repeated follow-up visits were the main obstacles for managing MAM. Conclusion: Maternal-level barriers and service provider-level barriers affect the management of MAM negatively in Damot Pulassa, Wolaita. Children with MAM living in the area ineligible for food supplementation could deteriorate to SAM. The provision of nutrition counseling to the mothers of children with MAM without food supplementation placed children with MAM at increased risk of negative outcomes. Thus, the government should give more attention and facilitation in promoting supplementary food into the existing management of MAM.
{"title":"Barriers to Management of Moderate Acute Malnutrition Among Children Aged 6 to 59 Months in Damot Pulassa, Wolaita, South Ethiopia: A Phenomenological Study of Mothers and Health Service Providers","authors":"Debritu Nane, A. Hatløy, B. Lindtjørn","doi":"10.1177/03795721221088817","DOIUrl":"https://doi.org/10.1177/03795721221088817","url":null,"abstract":"Background: Management of moderate acute malnutrition (MAM) in children needs to improve to reduce the transition from MAM to severe acute malnutrition (SAM). Objective: This study aimed to assess barriers to management of MAM among children aged 6 to 59 months in Damot Pulassa, Wolaita, South Ethiopia. Method: This descriptive phenomenological design used 6 focus group discussions with mothers or caregivers of children aged 6 to 59 months and 10 in-depth interviews with health service providers. Data were analyzed using Colaizzi’s descriptive phenomenological method. Result: Six themes were identified: Possible reasons for MAM; identification of a child with MAM; management services of MAM; maternal-level barriers; service provider-level barriers; and suggestions to improve the service. Shortage of food and money, selling out of self-produced food without having sufficient reserves at home, large household size, shame from having children with malnutrition, occasional house-to-house screening for MAM, family-initiated screening, leaving the management responsibility of children with MAM to the family, no provision of supplementary food, and lack of repeated follow-up visits were the main obstacles for managing MAM. Conclusion: Maternal-level barriers and service provider-level barriers affect the management of MAM negatively in Damot Pulassa, Wolaita. Children with MAM living in the area ineligible for food supplementation could deteriorate to SAM. The provision of nutrition counseling to the mothers of children with MAM without food supplementation placed children with MAM at increased risk of negative outcomes. Thus, the government should give more attention and facilitation in promoting supplementary food into the existing management of MAM.","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45925200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The trend of unhealthy lifestyles is increasing among adolescents and has been associated with the rising burden of noncommunicable diseases (NCDs). However, specific determinants of unhealthy lifestyles among adolescents in low- and middle-income countries remain limited.
Objective: To investigate the relationships of child-, parents-, and environment-associated determinants with diet quality, physical activity, and smoking habits among low-socioeconomic urban adolescents.
Methods: A cross-sectional study involving 238 adolescents aged 11 to 17 years was conducted in Jakarta, Indonesia. Adolescents and their parents were interviewed to assess the determinants of healthy lifestyles that included diet quality, physical activity, and smoking habits. Diet and physical activity were quantified using the Diet Quality Index for Adolescents (DQI-A) and Physical Activity Questionnaire for Older Children (PAQ-C), respectively. Multiple regression was used to determine the β coefficients and odds ratios predictive of healthy lifestyles.
Results: Mean scores of DQI-A and PAQ-C were considered low (33.5% ± 8.9% and 2.1 ± 0.5, respectively). Overall, 17.6% of adolescents were smokers, with 88% of these being males. Predictors of diet quality were child- (age, gender) and environment-associated (house size, access to a computer) determinants with β coefficients of -6.52 to 3.26. The PAQ-C score was associated with child- (female) and environment-associated (living area) determinants with β coefficients of -0.45 and 0.14, respectively. Younger adolescents and females were protective factors for smoking. Parents-associated determinants were not associated with any lifestyle indicators.
Conclusions: Child- and environment-associated determinants were predictors of healthy lifestyles among adolescents. Thus, personal empowerment and environment transformation are needed to facilitate a healthy lifestyle and reduce the burden of NCDs among adolescents.
{"title":"Relationships of Child-, Parents-, and Environment-Associated Determinants with Diet Quality, Physical Activity, and Smoking Habits Among Indonesian Urban Adolescents.","authors":"Rina Agustina, Davrina Rianda, Evania Astella Setiawan","doi":"10.1177/03795721211046145","DOIUrl":"https://doi.org/10.1177/03795721211046145","url":null,"abstract":"<p><strong>Background: </strong>The trend of unhealthy lifestyles is increasing among adolescents and has been associated with the rising burden of noncommunicable diseases (NCDs). However, specific determinants of unhealthy lifestyles among adolescents in low- and middle-income countries remain limited.</p><p><strong>Objective: </strong>To investigate the relationships of child-, parents-, and environment-associated determinants with diet quality, physical activity, and smoking habits among low-socioeconomic urban adolescents.</p><p><strong>Methods: </strong>A cross-sectional study involving 238 adolescents aged 11 to 17 years was conducted in Jakarta, Indonesia. Adolescents and their parents were interviewed to assess the determinants of healthy lifestyles that included diet quality, physical activity, and smoking habits. Diet and physical activity were quantified using the Diet Quality Index for Adolescents (DQI-A) and Physical Activity Questionnaire for Older Children (PAQ-C), respectively. Multiple regression was used to determine the β coefficients and odds ratios predictive of healthy lifestyles.</p><p><strong>Results: </strong>Mean scores of DQI-A and PAQ-C were considered low (33.5% ± 8.9% and 2.1 ± 0.5, respectively). Overall, 17.6% of adolescents were smokers, with 88% of these being males. Predictors of diet quality were child- (age, gender) and environment-associated (house size, access to a computer) determinants with β coefficients of -6.52 to 3.26. The PAQ-C score was associated with child- (female) and environment-associated (living area) determinants with β coefficients of -0.45 and 0.14, respectively. Younger adolescents and females were protective factors for smoking. Parents-associated determinants were not associated with any lifestyle indicators.</p><p><strong>Conclusions: </strong>Child- and environment-associated determinants were predictors of healthy lifestyles among adolescents. Thus, personal empowerment and environment transformation are needed to facilitate a healthy lifestyle and reduce the burden of NCDs among adolescents.</p>","PeriodicalId":12394,"journal":{"name":"Food and Nutrition Bulletin","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39537499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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