Food and Nutrition Bulletin最新文献

Background: An optimal cobalamin status is necessary for normal neurodevelopment.

Objective: To give a description of the epidemiology, pathophysiology and diagnostic challenges related to cobalamin insufficiency in neonates and infants in order to prevent its occurence.

Results: Inadequate cobalamin status is prevalent among neonates and young infants, due to a high prevalence of maternal cobalamin deficiency, exclusive breastfeeding for extended periods and late introduction of animal food. Cobalamin insufficiency is associated with delayed neurodevelopment and subtle clinical symptoms like feeding difficulties, regurgitations and constipation in young infants. Early diagnosis and treatment of impaired cobalamin status is important to prevent neurologic damage.

Conclusion: Clinical suspicion of cobalamin insufficiency in infants should infer immediate biochemical testing and a plasma total homocysteine > 5.0 µmol/L indicate cobalamin insufficiency in need of intramuscular treatment with hydroxycobalamin, followed by introduction of animal food after 4 months of age.

Background: Little attention has been given to prenatal cobalamin insufficiency in settings where dietary cobalamin intake is presumed adequate, such as populations with habitual intake of foods from animal sources.

Results: However, low cobalamin status in women of fertile age has been reported in Europe, United States, and Canada. In India, where cobalamin deficiency is highly prevalent, it has been associated with an increased risk of miscarriage, intrauterine growth retardation, as well as insulin resistance and lower neurodevelopment scores in the offspring. Low cobalamin status in pregnancy has been associated with similar outcomes as those reported in the Indian studies although the evidence is scant and conflicting.

Conclusions: Consideration should be given to maternal cobalamin status in the context of prevention of adverse pregnancy outcomes as well as cobalamin insufficiency both in the mother and the offspring during lactation. Further attention is now justified with the increasing tendency toward plant-based diets. Reference intervals for cobalamin status during each trimester of pregnancy are needed and further investigation of the long-term conse-quences of low cobalamin status during pregnancy for health and development in the offspring is warranted.

Background: Vitamin B12 deficiency is a critical medical condition that, if left untreated, can lead to severe symptoms and potentially serious and life-threatening complications. Clinical guidelines are designed to provide a standardized approach to diagnosis and treatment, aiming for consistency and effectiveness. However, it is well-established that not all patients fit into general guidelines.

Objective: To investigate the clinical relevance of the submitted research to support these protocols for diagnosing and treating a B12 deficiency.

Approach: Conducting a literature review of the references focused and used on diagnosing and treating vitamin B12 deficiency in adults and children.

Results: No robust clinical trial nor RCT has been found to back up the current protocols. The research used is primarily based on assumptions rather than solid clinical evidence.

Conclusion: Existing guidelines for vitamin B12 deficiency need to be significantly revised and improved through clinical research, clinical experience by experts in the field with input from patient groups worldwide.

Background: Governments have a central role to play in creating a food environment that will enable people to have and maintain healthy eating practices.

Objectives: This study analyzes public policies and government actions related to creating healthy food environments in Burkina Faso.

Methods: The Healthy Food Environment Policy Index tool used for this study has 2 components, 13 domains, and 56 indicators of good practice adapted to the Burkina Faso context. Official policy documents collected from data sources such as government and nongovernment websites, and through interviews with government and nongovernment resource persons, provided evidence of considerations of food environment in public policy documents in Burkina Faso.

Results: Policies documents show a lack of revision of old texts and administrative processes for new policies and government practices are very slow. Added to this is the absence of a regulatory document for some implemented actions. The analysis of the documents collected in relation to the indicators of Food-Epi tool shows that there is no evidence of consideration of food environments for the indicators concerning the regulation of nutrition and health claims, labeling, taxes on healthy and unhealthy foods, support systems for training for private structures on healthy diets, implementation of food guidelines, and food trade and investment.

Conclusion: This study permits a review of public policies that take into account food environments through the various indicators and constitutes a starting point from which improvements can be made by the government.

Background: Globally, acute malnutrition threatens the lives of several million children under 5 years of age. Malnutrition affects the social, economic, and medical aspects of all countries. In Ethiopia, acute malnutrition is not decreasing at the intended rate for unclear reasons.

Objective: This study aimed to assess the burden of acute malnutrition and its associated factors among children under 5 years of age in a rural setting of southern Ethiopia.

Methods: A community-based cross-sectional study was conducted from January to March 2022. A multistage sampling technique was used to select 421 children. Mothers/caretakers were interviewed using interviewer-administered questionnaire, while their children's height/length and weight were measured. Logistic regression analyses were used and presented as the crude odds ratio (COR) and adjusted odds ratio (AOR) with their 95% confidence intervals (CI).

Results: The burden of acute malnutrition among children under 5 years of age in the study area was 22.6% (95% CI = 18.5-26.8). Fathers with primary education (AOR = 4.48; 95% CI = 1.93-10.39), households with improper solid waste disposal (AOR = 2.54; 95% CI = 1.11-5.82), not usually sleeping under insecticide-treated bed net (ITN) (AOR = 1.79; 95% CI = 1.01-3.19), unacceptable children dietary diversity score (DDS) (AOR = 2.56; 95% CI = 1.28-5.14), and unacceptable household DDS (AOR = 2.26; 95% CI = 1.02-5.00) were factors associated with acute malnutrition.

Conclusions: The prevalence of acute malnutrition among children was critically high. Upgrading paternal educational status, encouraging safe solid waste disposal, ensuring consistent use of ITN, and improving both child and household DDS should be stressed.

Background: Adequate nutrition has been cited as one of the most critical components for optimal health outcomes during pregnancy. Women in Burkina Faso and Madagascar experience high rates of undernutrition due to lack of knowledge, finances, cultural norms, and autonomy. Therefore, this study aimed (1) to describe typical maternal diets during pregnancy in Burkina Faso and Madagascar, (2) to understand the multilevel factors that influence women's nutrition decision-making, and (3) to explore the extent to which women have nutrition decision-making autonomy during pregnancy.

Methods: This study was conducted between October 2020 and February 2021 in Burkina Faso and Madagascar. Semi-structured interviews, focus group interviews, and free lists were conducted among women of reproductive age and pregnant and lactating women. Textual data from interviews were recorded and translated verbatim from local languages into French. The Food Choice Process Model guided textual content analysis using Dedoose software. Free list data were analyzed using cultural domain analysis approaches.

Results: In Burkina Faso and Madagascar, women primarily consumed staple foods such as rice and tô during pregnancy. Participants cited eating fruits and vegetables when available, while the animal source foods were rarely consumed. Across both contexts, nutrition during pregnancy was influenced by factors that impact food choices, such as social factors, resources, ideals, and personal factors. While women and men in Madagascar had more shared decision-making on critical domains such as finances, men were the primary decision-makers in most areas of inquiry (eg, finances) in Burkina Faso.

Conclusions: The lack of adequate diverse diet consumed during pregnancy is primarily due to important factors including social factors and resources. Understanding the ability for women to consume optimal diets during pregnancy is needed to target behavioral change in maternal nutrition programming.

Background: Malnutrition and anemia are 2 severe public health concerns, predominantly in low-and middle-income nations. Malnutrition is defined as poor nutritional condition that encompasses both under nutrition and over nutrition. The prevalence of overweight or obesity and anemia has increased in India from 2016 to 2021. The study aims to investigate the spatial clustering and factors responsible for underweight, overweight/obesity, and anemia among reproductive women (15-49 years) in India using the data from National Family and Health Survey-5 (2019-2021).

Methods: We conducted hot-spot analysis using Moran's Index (MI) with the help of spatial analysis software (i.e., GeoDa 1.18 and ArcGIS 10.8). It also demonstrates the autocorrelation. Multivariable logistic regression analysis has been performed to examine different determinants and risk associated with underweight, overweight/obesity, and anemia with various dependent variable by using Stata-14 software.

Results: Moran's Index for underweight (MI = 0.68), overweight/obesity (MI = 0.72), and anemia (MI = 0.62) indicates a high level of spatial-autocorrelation (P < .001) exists across the districts in India. As a result, a total of 156, 143, and 126 hot-spot districts are detected for underweight, overweight/obesity, and anemia, respectively. The burden of undernutrition and anemia is higher in rural areas. Risk of under nutrition and anemia are both reduced by media exposure and eating habits. Moreover, low income and low education level raises the risk of anemia and undernutrition, while obesity shows an inverse trend with income and education level.

Conclusion: The study recommends targeting hot-spot districts for malnutrition and anemia, and policy level initiatives by addressing the responsible risk factors.