Food and Nutrition Bulletin最新文献

Background: South Sudan has experienced ongoing civil and environmental problems since gaining independence in 2011 that may influence childhood nutritional status.

Objective: To estimate the prevalence of undernutrition among children in South Sudan in 2018 and 2019 compared to the prevalence in 2010.

Methods: Data on height and weight were collected using a 2-stage stratified sample framework in which households were randomly selected at the county level and nutritional status was calculated for all children under 5 years of age to determine height-for-age, weight-for-height, and weight-for-age Z-scores (HAZ, WHZ, and WAZ) and the prevalence of stunting, wasting, and underweight. Linear and logistic regression analyses were used to determine factors associated with nutritional status and the odds ratio for nutritional outcomes.

Results: In 2010, the mean HAZ, WHZ, and WAZ was -0.78, -0.82, and -1.15, respectively, and the prevalence of stunting, wasting, and underweight was 30%, 23%, and 32%, respectively. In 2018 and 2019, the mean HAZ, WHZ, and WAZ was -0.50, -0.70, -0.77 and -0.53, -0.77, -0.76, respectively. The prevalence of stunting, wasting, and underweight in 2018 and 2019 was 17%, 14%, 15% and 16%, 16%, 17%, respectively. Age was negatively associated with all nutritional indices and girls had higher HAZ, WHZ, and WAZ and a lower mid upper arm circumference (P < .01) compared to boys. The risk of poor nutritional outcomes was associated with vaccine status and varied by state of residence.

Conclusions: Following independence in 2010, the prevalence of undernutrition in South Sudan decreased, but the risk for undernutrition varied by state and efforts to address food security and health need to ensure equitable access for all children in South Sudan.

Background: Fortification of rice with slaked lime is an acceptable and inexpensive way to combat calcium (Ca) deficiency. However, bioavailability of calcium after intake of slaked lime fortified rice is yet to be investigated.

Objective: To measure the fractional absorption of Ca (FAC) from slaked lime fortified cooked rice.

Design: We conducted an experimental study using stable isotopes of Ca to measure FAC during a single morning test meal containing rice fortified with slaked lime. Participants (n = 22) were given slaked lime fortified rice 3 times a day for 4 days. On the morning of the fifth day, the participants were served the same amount of rice as previous the 4 days at the breakfast test meal with an accurately measured amount of ⁴⁴Ca stable isotope oral tracer followed by an intravenous injection of ⁴²Ca. Urine was collected over the next 24 hours in 3 consecutive 8-hour pools. Fractional absorption of Ca was calculated from the measurement of the relative enrichment of the of each administered tracer ⁴⁴Ca and ⁴²Ca using inductively coupled plasma mass spectrometry.

Results: The mean Ca concentration in the test meal was 879.5 ± 152.9 µg/g with a coefficient of variance (CV) of 17.2%. Although Ca absorption efficiency decreases with higher calcium intake, the total amount of calcium absorbed from test meal using FAC = 0.391 calculated from the third 8-hour urine pool was 69.0 (CV of 15.6) mg.

Conclusions: We showed that one-fifth of daily calcium recommendation for women of reproductive age could be met by ingesting ∼200 g cooked slake fortified rice.

Background: Schools can play an important role in promoting healthy child diet and body weight. However, this issue is understudied in Latin American and other populations undergoing nutrition and epidemiologic transition.

Objectives: 2018 Ecuadorian National Health and Nutrition Survey data were used to examine the association of school food sources with healthy and unhealthy food intake and body mass index (BMI) in primary (n = 12632) and secondary students (n = 6617).

Methods: Data on school food environment characteristics were collected by questionnaire, intakes of fruits, vegetables, plain water, sweetened beverages, processed snacks, and fast foods by food frequency questionnaire, and BMI using measured weight and height. Data were analyzed using multivariable methods.

Results: The major school food sources were competitive foods sold by commercial outlets (73%), School Breakfast Program (SBP; 52%), and home-packed items (37%). Most (69%) competitive food outlets sold fruits and vegetables but only 44% offered free clean drinking water and 60% sold prohibited "red traffic light" foods. Primary and secondary students who bought competitive foods consumed sweetened beverages, processed snacks, and fast food more frequently than nonpurchasers (P = .0001). Those who packed home foods had higher fruit and vegetable intakes (P = .0001). Plain water intakes were reduced among all SBP participants (P = .0001). However, primary students in the SBP consumed fast foods less frequently (P = .0001) and had lower average BMI and odds for being obese compared to nonparticipants (P = .0001).

Conclusion: The findings from this nationally representative study underscore the important contribution of the school food environment to child nutrition.

Background: Severe acute malnutrition (SAM) contributes to a substantial number of child deaths globally per year. The mortality rates can be lowered markedly if guideline-based management protocol is properly followed. However, case-fatality rates in resource-poor centers remain high even after introducing the guidelines. Perhaps, the lack of adequate knowledge leading to inappropriate management by the health care providers is responsible for such burden.

Objective: We aimed to evaluate health care providers' knowledge, attitude, and practice regarding the facility-based management of children with SAM in Bangladesh.

Methods: This was a qualitative study where data were collected cross-sectionally from 4 district and 2 tertiary care hospitals. Twenty-six semi-structured in-depth interviews were conducted among the doctors and nurses involved in inpatient care of SAM. Twenty-eight hours of observation were done in each facility to obtain information regarding the management practices.

Results: The doctors had substantial knowledge in managing children with SAM in the facilities. However, knowledge of nurses was found suboptimal when evaluated based on the national guideline. Both doctors and nurses demonstrated favorable attitude toward management of childhood SAM. Identification of SAM at the facilities was poor due to lack of practice in relation to anthropometric measurements. In addition, improper practices related to blood glucose testing, dehydration monitoring, essential micronutrient administration, and follow-up of children with SAM were observed.

Conclusion: The study results underscore the importance of taking appropriate measures to enhance knowledge and ensure proper practice in relation to inpatient care of children with SAM according to the national guideline in Bangladesh.

Background: In homestead food production (HFP) programs, village model farmers (VMFs), after training, implement agriculture and nutrition activities to improve household knowledge and practices. Little evidence exists on what enables VMFs to remain actively engaged and for impacts to be sustained.

Objective: To examine variables explaining active engagement of VMFs, at least 4 years post-training, in an HFP program in Nepal.

Methods: We used cross-sectional data, collected from 2018 to 2019, among 4750 VMFs of Suaahara, a multisectoral nutrition program. We assessed whether respondents registered their HFP group with the local government, conducted regular group meetings, discussed vegetable growing and chicken rearing practices with group members, or engaged in saving and credit activities in their HFP group. Outcome variable was a count of these 4 activities in which the VMF engaged. Socioeconomic, demographic, and programmatic explanatory variables were identified a priori and by bivariate analysis and were adjusted in ordinal regression models accounting for clusters.

Results: On average, VMFs engaged in 1.4 activities. Having attended primary or secondary school (adjusted odds ratios [AOR] = 1.39), being a female community health volunteer (AOR = 1.27), being from an advantaged caste/ethnic group (AOR = 1.34), receiving additional trainings (AOR = 1.56) and inputs (AOR = 1.31) were associated with more active engagement of VMFs.

Conclusion: Village model farmers receiving more training and inputs were more likely to remain actively engaged. Female community health workers, people from higher caste/ethnic groups, and those with primary or secondary education were more likely to remain active VMFs and could be targeted for this role in HFP programs leading to sustained impact.

Background: Ethiopian government was implementing mandatory salt iodization program for the last decade to eliminate iodine deficiency disorders, but several recent studies reported mixed findings.

Objective: This review aimed to assess the difference in implementation of iodized salt program 10 years before and after mandatory salt iodization being implemented in Ethiopia since 2011.

Methods: In Ethiopia, legislation that enforces salt producers to iodize all salts used for human consumption started in February 2011. All studies about iodine deficiency and iodized salt conducted in Ethiopia in the last 2 decades were searched. Searches were performed in PubMed database. Google Scholar, Iodine Global Network, and Ethiopian Public Health Institute websites were also searched.

Results: A total of 235 titles and abstracts were identified. After scanning the abstracts and full papers, 43 articles were remained for final data synthesis. In this review, all studies conducted before 2011 reported a urinary iodine concentration (UIC) value of < 100 μg/L and 66.7% of them reported a goiter prevalence of > 30%. On the other hand, among studies conducted after 2011, 88.9% reported UIC value < 100 μg/L and 73.7% reported goiter prevalence of > 30%. Household availability of adequately iodized salt increased from nearly 20% in pre 2011 to more than 50% in post 2011 period.

Conclusion: Despite the efforts made by the Ethiopian government on mandatory salt iodization for the last decade, iodine deficiency is sustained in the country. Moreover, the goal of universal salt iodization program is offtrack and needs urgent revision.

Registration: Registered on PROSPERO register with reg. no CRD42021251124.

Background: Agroecological methods have the potential to impact nutrition and food security, however, to date there is limited research evaluating this approach.

Objective: A 5-year participatory research project with farming households in north and central Malawi was designed to train farmers on agroecological practices, alongside raising awareness on nutrition and gender equity. This cross-sectional study aimed to explore the relationships between crop diversity, food security at the household level, and individual diversity for women, within the context of an agroecology, nutrition education, and farmer mentoring program.

Methods: Participating farmers were trained in and experimented with different farming methods. These farmers subsequently trained other farmers on these short-term agroecological practices and provided mentorship using community-based educational methods designed to address both household food security and nutrition. In year 4 of the intervention, a cross-sectional survey assessed farm practices, food security, and individual dietary diversity of 851 participating households.

Results: Households with lower crop diversity were significantly less likely to be food secure (odds ratios [OR] = 0.829, P < .001). Women in households with higher crop diversity were more likely to have higher individual dietary diversity (OR = 1.120, P < .01), eat vitamin A rich foods (OR = 1.176, P < .01), and legumes, nuts, and seeds (OR = 1.141, P < .01).

Conclusions: These findings suggest that within a participatory agroecological training combined with community-based nutrition education with a focus on social equity, crop diversity is associated with less household food insecurity and poorer diet quality for rural farming households. Crop diversity may improve dietary diversity by making nutritious foods more available.

Background: In 2016, a Peace Agreement, explicitly addressing the right to food, was signed, marking the end of more than 50 years of armed conflict and the longest war in the Americas. The expectation was that the years to follow would be marked by rapid social and political change, with the potential to improve food security.

Objectives: (i) Ascertain changes in the prevalence of food insecurity in Colombia between 2016 and 2019; (ii) examine which population subgroups (eg, urban women, rural women, urban men, and rural men) were most vulnerable; and (iii) determine significant individual-level factors predicting food insecurity in these 2 years.

Methods: This study used the Gallup World Poll 2016 and 2019 nationally representative samples of Colombian adults aged 15 and older for the analyses (n ≈ 1000 per year). Food insecurity was measured using the Food Insecurity Experience Scale. Descriptive statistics and logistic regression analyses were conducted using IBM SPSS Complex Samples (version 26).

Results: Food insecurity in Colombia increased by 7 percentage points between 2016 and 2019 (from 33% to 40%); women living in rural areas in 2019 reported the highest prevalence (50%). Results from logistic analysis confirm low income, unemployment, and lack of social support were significant predictors of food insecurity in both years. In 2019, gender, low education, and lack of autonomy were also significant predictors. Further research on the determinants of food insecurity is necessary to inform Colombian policies and programs that address food insecurity. The urgency to act is more apparent than ever, given the country's worsening food security profile.

The reasonable strategies of payment for ecosystem services (PES) play a key role in solving the contradiction between ecological protection and economic development in coastal cities. However, at present, the payment efficiency is relatively low and the determination method of PES is lack. Therefore, in this study, the Jimo district of Qingdao city in China, a typical coastal city, was selected as study area, and the equivalent factor method and marine ecological capital assessment method were used to obtain terrestrial and marine ecosystem services value (ESV) and its tempo-spatial variations from 2010 to 2018. Moreover, the payment efficiency of the sea area and 15 towns over 8 years was measured using the Super-efficient SBM-DEA model based on undesired output. ESV presented a clear reduction over 8 years. The marine ecosystem provided the main service value, and waste treatment, water regulation, and soil formation were the top 3 main functions in the land ecosystem. Regulating services provided the highest component among all functions. The high-value areas were mainly distributed in the northeast and northwest regions and the low-value areas were in the south-central regions. The average payment efficiency of the sea area and 15 towns over 8 years shown a stable trend at a low level. On the basis of the evaluation of ESV and efficiency, a new possible payment scheme including payment order and quota was proposed. The total quota of marine ecosystem was 5.226 billion RMB (88% of the total) and of terrestrial ecosystem was 0.713 billion RMB. Tian Heng, Jin Kou, Yi Fengdian, and Ling Shan are the first 4 priority towns, with compensation amounts of 0.205, 0.083, and 0.063 billion RMB respectively, while the last 3 towns are Tong Ji, Huan Xiu, and Chao Hai accounting for 6.02% of the total. The theoretical payment total quota was 5.939 billion RMB, and which accounted for a low proportion of local GDP. The study can provide some recommendations for making the reasonable and feasible payment schemes for ecosystem services in coastal city, and it is feasible in the practice of ecological environment protection and sustainable development.