Journal of Health, Population, and Nutrition最新文献

Climate and conflict crises increasingly occur together, creating compounded risks for household food security. This review synthesizes evidence from 37 quantitative studies published 2020-2025 on how climate crises (such as drought, storms, or floods), violent conflict (such as war and institutional fragility), and their interactions affect household food security. Most studies examine either climate crises (51%) or conflict crises (38%), while only 11% analyze combined crises. Evidence is geographically concentrated in Sub-Saharan Africa (65%) and relies largely on cross-sectional surveys (68%), limiting insight into longer-term trajectories. Climate crises are measured mainly using meteorological or remote-sensing datasets (42%) while conflict exposure relies predominantly on self-reported data (71%). Only a small number of studies integrate geocoded climate or political violence datasets with household surveys, and few studies estimate interaction or spillover effects. Food security measurement is also narrow, with most studies using access and utilization indicators such as the food consumption score (FCS) (43%), household food insecurity access scale (HFIAS) (35%), or household dietary diversity score (HDDS) (19%). Across studies, climate crises, conflict, and their concurrence are associated with reduced consumption, lower dietary diversity, and greater coping burdens. Impacts vary by household assets, agroecology, and institutional or humanitarian support, highlighting the need for longitudinal and spatially or contextually explicit evidence measuring productive resilience rather than only short-term consumption smoothing.

Background: Successful aging (SA) is a key focus in gerontological research, highlighting the importance of maintaining physical, cognitive, and social well-being. Nutrition is a critical determinant of health in older adults, and sustainable healthy eating behaviors are increasingly recognized for their role in promoting SA and longevity. However, evidence examining this relationship within the Saudi context remains limited.

Aim: This study investigated the relationship between sustainable healthy eating behaviors and successful aging among community-dwelling older adults.

Methods: A cross-sectional study was conducted among 400 community-dwelling older adults aged 60 years and above, recruited from primary health care centers in the Abha district of Saudi Arabia. Data were collected using the Successful Aging Scale (SAS) and the Sustainable and Healthy Eating Behaviors Scale (SHEBS). Spearman's rho correlation and a multivariate general linear model were applied to assess associations and predictors.

Results: The findings showed that sustainable, healthy eating behaviors (SHEB) and SA scores were both relatively high among participants. Primary education, sufficient income, normal BMI, and favorable lifestyle factors emerged as significant predictors for both SHEB and SA.

Conclusion: The study shows that SHEB emerged as a significant predictor of SA. In addition to dietary practices, sociodemographic factors, physical activity, and sleep quality contributed significantly to SA outcomes. These findings underscore the need for culturally tailored strategies that support sustainable nutrition and promote healthy lifestyle behaviors among older adults in Saudi Arabia, thereby supporting SA.

Background: Extension of healthy longevity is an important health program in long-lived countries like Japan. The Dietary Reference Intakes for Japanese 2025 established tentative dietary goals for the prevention of lifestyle-related diseases; however, the adequate macronutrient energy ratios in a diet to support longevity remain unclear, particularly for the protein content. This study aimed to evaluate the associations between protein or amino acid intakes and healthy aging in the Japanese population.

Methods: Global Burden of Disease Study data and de-identified individual records in the National Health and Nutrition Survey Japan from 2001 to 2019 for subjects aged ≥ 20 years were used. Multiple regression analyses were conducted to assess the relationships between all-cause disability-adjusted life years (DALYs) as an index for healthy aging and protein or amino acid intakes, with adjustment for lifestyle factors and sociodemographic index as confounding factors.

Results: The mean DALYs (per 100,000 people) were 10287.91 for women and 12566.85 for men. Women exhibited no significant correlations between protein or amino acid intakes and DALYs. In men, significant negative correlations were observed for plant protein (partial regression coefficient [Coeff.] - 6063.267; p = 0.010), cysteine (Coeff. -127.575; p = 0.044), phenylalanine (Coeff. -38.506; p = 0.048), glutamic acid (Coeff. -12.184; p = 0.006), and proline (Coeff. -31.499; p = 0.010) intakes with DALYs after adjustment for sociodemographic index, drinking habit, smoking habit, and exercise habit.

Conclusions: Higher intakes of plant protein, cysteine, phenylalanine, glutamic acid, and proline were correlated with lower DALYs in men only. Adequate plant protein and specific amino acid intakes may be related to the extension of healthy life expectancy.

Background: Home gardens are promoted as a strategy for climate change adaptation in SSA. Here, we determined the lived experiences, the perceived knowledge gain and practice change, and the suggested strategies for maintenance, spread and scaling among beneficiaries, implementers and stakeholders of a home gardening intervention in rural Kenya.

Methods: For this explanatory qualitative study, we conducted two focus group discussions (FGDs) with stakeholders (n = 5) and implementers (n = 8), and 30 in-depth interviews (IDIs) with male (n = 5) and female (n = 25) beneficiaries living in Siaya county, from September to November 2023. We used purposive sampling and employed semi-structured interview guides. The data were translated into English, transcribed verbatim, and analyzed using inductive content analysis; we mapped the findings along the proposed impact pathways.

Results: The participants articulated good understanding of the trainings and valued them as an occasion for knowledge exchange. The adoption of tailored garden structures, organic gardening, and food preservation created feelings of fulfillment, women empowerment, and family peace. Experienced challenges included water scarcity, ineffective pesticides, and long distances between the beneficiary households. Perceived benefits were increased income, cost savings, and increased dietary diversity. For maintenance, spread and scale, the participants suggested agri-business, local partnerships, and the integration of home gardens into the county's political agenda.

Conclusions: This project seems to have followed its planned pathways to improved child nutritional status. The organic gardening approach offers solutions in low-resource settings but creates challenges for maintenance, spread and scale of home gardens in Siaya county, Kenya.

Background: Breastfeeding is known to have positive effects on child health outcomes. However, little is known about its effects on physical health outcomes for mothers. Given that hypertension remains a significant public health concern in Kenya, it is imperative to understand whether breastfeeding has some protective effects for mothers. This study investigates the association between breastfeeding duration and hypertension risk while considering the moderating effects of overweight/obesity and alcohol consumption.

Methods: We relied on 2022 Kenya demographic and health survey data. A total sample of 5314 was analyzed. Prevalence rates of hypertension were assessed across different breastfeeding durations, and both unadjusted and adjusted odds ratios were calculated to evaluate the risk of hypertension. Interaction effects between breastfeeding duration, overweight/obesity status, and alcohol consumption were also analyzed with predictive margins.

Results: Overall, the prevalence of hypertension in the sample was 8.7% (95% CI: 7.7-9.9). After adjusting for confounders, women who breastfed for 12-24 months (AOR = 0.60, 95%CI: 0.43-0.84) and for more than 24 months (AOR = 0.60, 95%CI: 0.45-0.80) were at lower odds of being hypertensive. Despite the increased risk of hypertension among overweight or obese women and those who consumed alcohol, the predictive margins did not show a significant moderating effect of these factors on the association between breastfeeding duration and hypertension in this study.

Conclusion: Our study suggests that prolonged breastfeeding may have a protective effect against hypertension among parous women. This protective effect of longer breastfeeding durations remains relatively stable across different obesity and alcohol consumption statuses. It is essential for the Kenyan Ministry of Health to intensify its breastfeeding awareness. Health providers at antenatal and postnatal care centers must emphasize the protective effects of prolonged breastfeeding on physical health outcomes.

Background: Globally, undernutrition is responsible for over 3.5 million deaths among children under the age of 5. In Mozambique, it remains a major contributing factor to the high rates of child mortality and illness. Essential micronutrients like zinc, iron, and calcium play a vital role in healthy growth and development. However, their absorption is hindered by anti-nutrients such as phytates, which chelate these minerals and reduce their bioavailability. The extent of this inhibitory effect largely depends on the molar ratios of phytate to the respective minerals.

Objective: To assess the dietary patterns and quality of diets consumed by young children; with a primary focus on micronutrients adequacy, phytate intake and the implications on mineral bioavailability.

Methods: Anthropometric measurements and dietary assessment of 47 children, aged 2 to 5 years, accompanied by their mothers. The method Food Photography 24-h Recall (FP24hR) was used for three consecutive days to evaluate their nutrient intake, which included macronutrients, 15 micronutrients and phytate intake. The estimated mineral bioavailability of the diets was determined based on the phytate-to-mineral molar ratios.

Results: Stunting was found in 32% of children and waste in 6% of them, 2% of children were underweight, and 13% were overweight. Children were found to be at risk of calcium, zinc, vitamins A, E, B12 and folate deficiencies. The molar ratio phytate-to-Zinc (phy:Zn) was between 22.3 and 31.2; phytate-to-Iron (phy:Fe) was between 7.2 and 16.3 and phytate-to-Calcium (phy:Ca) was between 0.34 and 0.53. All the ratios exceeded the recommended values phy:Zn < 15, phy:Fe < 1, and phy:Ca < 0.24, which indicates that phytate in the children's diet can negatively affect the bioavailability of zinc, iron and calcium.

Conclusion: The high prevalence of stunting among children in this study highlights a persistent issue of chronic undernutrition in the region. The elevated phytate-to-mineral molar ratios suggest a reduced mineral absorption, which is a contributing factor to growth failure in children. These findings underscore the urgent need for targeted nutrition policies in Mozambique to address both dietary quality and phytate content.

Background: Many randomized controlled trials (RCTs) have revealed the benefits of caffeic acid tablets on leukopenia and thrombocytopenia, but the results are inconclusive. This meta-analysis of RCTs aimed to assess the effects of caffeic acid tablet supplementation on treating leukopenia.

Methods: A systematic review of PubMed, Scopus, Embase, Cochrane library, China Knowledge Network, China Biomedical Literature Database, Wipu.com and Wanfang Data were conducted, and the search time frame was from the establishment of the database up to May 2025. Data were pooled using a random-effects model to calculate standardized mean differences (SMDs) and 95% confidence intervals (CIs).

Results: Thirty-three studies with 2,483 patients were included. Meta-analysis results indicated that the clinical effectiveness of caffeic acid tablets for leukopenia was significantly different from that of the control group (RR: 1.44; 95% CI: 1.31, 1.58, p < 0.01; I² = 67.0%, p < 0.01), and significantly increased white blood cell count (SMD: 1.39, 95% CI: 1.09, 1.70, p < 0.001; I² = 85.4%, p < 0.001), platelet count (SMD: 1.18, 95% CI: 0.46, 1.89, p < 0.001; I² = 94.4%, p < 0.001), and neutrophil count (SMD:0.88, 95% CI: 0.60, 1.16, p < 0.001; I² = 49.0%, p = 0.081). Caffeic acid tablets can reduce bone marrow suppression (RR: 0.34; 95% CI: 0.22, 0.54, p < 0.001; I² = 0.0%, p = 0.685), incidence of infection (RR: 0.50; 95% CI: 0.38, 0.64, p < 0.001; I² = 0.0%, p = 0.833) was significantly lower than that of the control group.

Conclusion: Caffeic acid may be a promising management for the treatment of leukopenia. The findings should be interpreted with caution due to the high risk of bias in many included trials and the limited generalizability, as all studies were conducted in China.

Background: School-based interventions are effective in improving physical activity and healthy eating in adolescents. However, there has been limited research into how bundled school-based programs, and their components, may improve adolescents' metabolic health. The purpose of this study is to evaluate the effectiveness of the Healthy School Recognized Campus (HSRC) - a bundled school-based health initiative - and two HSRC components on metabolic syndrome (MetS) and other obesity-related risk factors.

Methods: A 2 × 2 cluster randomized factorial trial was conducted in eight HSRC middle schools (n = 107 students) to pilot test a novel program's (Strong Teens for Healthy Schools [STHS]) and implementation strategy's (mentoring program) preliminary effects on MetS z-scores, obesity-related risk factors (e.g., BMI z-scores), and behavioral risk factors (e.g., physical activity, healthy eating). General linear model frameworks were used to estimate the main and interaction effects on outcomes. Additionally, bivariate tests were run to determine if students had a significant change in outcomes over the year-long HSRC intervention.

Results: Across all schools, students involved in the HSRC program decreased BMI z-scores (mean difference [MD]=-0.12 ± 0.33, p=.003); whereas students increased glucose levels (MD = 6.29 ± 18.34, p=.003), total MetS factors (MD = 0.23 ± 0.83, p=.015), and fruit and vegetable consumption (MD = 34.47 ± 92.33, p = < 0.001). The STHS intervention was associated with an increase in waist circumference (β = 5.55, 95%CI: 0.14, 10.96, p=.044). The mentoring program was associated with a reduction in systolic blood pressure (β=-6.32, 95%CI: -12.13, -0.51, p=.033) and increase in dermal carotenoids (β = 65.50, 95%CI: 18.11, 112.89, p=.007).

Conclusions: HSRC improved some obesity-related risk factors, but not MetS severity. The STHS intervention independently increased waist circumference, and the mentoring program independently improved dermal carotenoid levels and systolic blood pressure. Results suggest that complex interaction effects exist in bundled interventions within school settings; however, bundled EBPs may be effective in reducing some obesity-related outcomes (e.g., BMI z-scores) over a one-year duration for adolescents in East Texas.

Background: Access to safe drinking water remains a major challenge in sub-Saharan Africa, where reliance on unimproved water sources exposes millions to waterborne diseases and undermines progress toward Sustainable Development Goal 6 (SDG 6). Understanding spatial patterns and determinants of unimproved water use is essential for targeting WASH interventions.

Method: We analyzed data from 500,845 households across 20,492 clusters in 34 sub-Saharan African countries using Demographic and Health Surveys (2012-2024). Data was processed using Microsoft Excel and STATA version 17. Prevalence estimates accounted for the DHS complex sampling design. Spatial analyses (Global Moran's I, Getis-Ord Gi*, SaTScan™, Anselin Local Moran's I) and Geographically Weighted Regression (GWR) were conducted to identify clusters and key predictors.

Result: Overall, 58% (95% CI: 51%-65%) of households relied on unimproved drinking water sources. This indicates that approximately three in five households utilize unimproved water source. Significant spatial clustering was detected (Global Moran's I = 0.2415, p < 0.001), with major hotspots in Madagascar, Uganda, Rwanda, Mozambique, Malawi, Chad, Nigeria, Togo, Burkina Faso, Liberia, Sierra Leone, Mali, Ethiopia, parts of Angola, the Congo Republic, Zambia, and Zimbabwe. SaTScan™ identified 109 significant clusters, and Local Moran's I revealed mixed high- and low-risk zones. GWR (adjusted R² = 0.917) highlighted key predictors: rural residence, female-headed households, older household heads (50 + years), poverty, limited media exposure, lack of electricity, and poor water access.

Conclusion: Unimproved water use remains widespread and spatially concentrated across sub-Saharan Africa. The determinants identified by GWR poverty, rural residence, limited infrastructure access, and low household media exposure highlight critical inequities driving this burden. Addressing these disparities requires localized, data-driven WASH planning that prioritizes hotspot regions, expands access to affordable improved water systems, strengthens electricity and media outreach infrastructure, and supports vulnerable households. Implementing these targeted and multi-sectoral strategies is essential for accelerating equitable progress toward SDG 6 and improving public health resilience across the region.

Introduction: The rising consumption of unhealthy foods, characterized by high levels of sugar, salt, and unhealthy fats, poses significant health risks to women. Urbanization and globalization have shifted dietary patterns, leading many people to opt for processed and fast foods over traditional, nutrient-rich meals. This trend contributes to increased rates of non-communicable diseases, such as diabetes, and cardiovascular conditions, particularly among women of reproductive age.

Objective: To determine the socio-demographic and economic factors associated with unhealthy food consumption among women of reproductive age in Tanzania.

Methods: The study analyzed secondary data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey. The study included a weighted sample of 15,254 women of reproductive age. The "svy" command in Stata was used to assign the sample weight. Multivariable logistic regression was employed to identify significant factors associated with unhealthy food consumption, with significance set at a 5% level.

Results: The overall unhealthy food consumption among women of reproductive was 14% (95% CI: 12.9, 15.2). The study found that women residing in urban areas (AOR = 1.37, 95% CI = 1.17, 1.61), women with secondary education (AOR = 1.72, 95% CI = 1.36, 2.17), higher education (AOR = 2.39, 95% CI = 1.73, 3.31), women from middle quintile (AOR = 1.35, 95% CI = 1.06, 1.73), and rich quintile (AOR = 2.42, 95% CI = 1.92, 3.05), married women (AOR = 0.87, 95% CI = 0.75, 1.00), women who listened to radio (AOR = 1.18, 95% CI = 1.04, 1.34), watching television (AOR = 1.23, 95% CI = 1.08, 1.40), having 0-2 children (AOR = 1.30, 95% CI = 1.06, 1.58) were significantly associated with unhealthy food consumption.

Conclusion: The study found that overall unhealthy food consumption among women of reproductive age was 14%. This was associated with place of residence, education level, wealth status, listening to radio, watching television and number of children. The study recommends implementation of community-based nutritional education programs focusing on healthy eating habits, particularly targeting urban areas where unhealthy food consumption is higher as well as utilize mass media platforms to disseminate information about healthy dietary habits.