Journal of Health, Population, and Nutrition最新文献

Background: Despite global efforts to improve maternal health outcomes, many regions, including Uganda, continue to face challenges in achieving optimal maternal healthcare utilization. This study aims to investigate how restricted autonomy in household decision-making by significant others affects inadequate use of maternal healthcare services among married women in Uganda. Inadequate use of maternal healthcare services refers to not meeting all four WHO-recommended standards for ANC timing, ANC visits, place of delivery, and PNC timing.

Methods: Secondary data from the latest 2016 Uganda Demographic and Health Survey (UDHS 2016) were used for this study. Data from 7906 married women of childbearing age were analyzed using a multilevel binary logistic regression approach.

Results: The inadequate use of maternal healthcare services was estimated to be 39.1%. The odds of inadequate use were 17% higher among women with moderate restricted autonomy in household decision-making by significant others compared to women with low restrictions [Adjusted Odds Ratio (AOR) = 1.17, 95% Confidence Interval (CI) = 1.02-1.34]. Inadequate use of MHCS decreases with an increase in the household wealth index. Women from the richest household [(AOR) = 0.52, 95% CI = 0.39,0.70] were less likely to report Inadequate use of maternal healthcare services compared to the poorest. Employed women were less likely [AOR = 0.73, 95% CI = 0.62-0.84] to report inadequate use of maternal healthcare services. Women who reside in the northern region of Uganda were significantly less likely [AOR = 0.72, 95% CI = 0.52-0.99] to report inadequate use of maternal healthcare services compared to those who reside in the central region.

Conclusion: The study concluded that the restricted autonomy in household decision-making by significant others plays a crucial role in the use of maternal healthcare services among married women in Uganda. Factors such as maternal age, household wealth index, employment status, and region of residence were also associated with inadequate use of maternal healthcare services. Therefore, to achieve Sustainable Development Goal (SDG) 3.1, the government and policymakers should engage significant others in maternal health programs, promote regional equity, female labor force participation, education, and autonomy in health decision-making.

Background: Despite advancements in the use of maternity care services, certain nations in sub-Saharan Africa continue to record unacceptable rates of maternal and perinatal morbidity and mortality, particularly in the postnatal period. This study aimed to assess the level of postnatal care service utilisation and associated factors among multiparous women in Buyamba County, Rakai District, Uganda.

Method: A community-based cross-sectional study involving women who had two or more children was conducted in four sub-counties of Buyamba County. Study participants were recruited using a systematic sampling technique. A structured and pre-tested questionnaire was used to gather data. Descriptive, bivariate and modified poisson regressions were computed using STATA version 14. Statistical significance was considered at p < 0.05 and the strength of statistical association was assessed by prevalence ratios with 95% confidence intervals.

Result: Out of 321 women who participated in the study, (81.9%) were married, (30.8%) were aged 35-44 years, (71.0%) attended antenatal care (ANC) during their previous pregnancy, (94.7%) delivered normally, and (94.4%) utilised postnatal care (PNC) services of which (67.2%) received immunisation for the children, (26.2%) acquired family planning counseling and (70.3%) had four or more PNC visits. Attending antenatal care (aPR = 1.750; 95% CI: 1.029-2.981), being aware of PNC services (aPR = 1.380; 95% CI: 1.016-1.875), receiving PNC education (aPR = 1.421; 95% CI: 1.048-1.923), having a normal delivery (aPR = 1.538; 95% CI: 1.055-2.241), and residing within 5 km of a health facility (aPR = 1.282; 95% CI: 1.006-1.632) were significantly associated with a higher likelihood of utilising postnatal care services. In contrast, being younger in age (aPR = 0.511; 95% CI: 0.347-0.752) and having a husband without formal education (aPR = 0.622; 95% CI: 0.454-0.853) were significantly associated with a lower likelihood of postnatal care services utilisation.

Conclusion: The study identified several maternal, spousal, and accessibility factors influencing postnatal care utilisation. Enhancing maternal health education, improving facility access, involving partners, and strengthening antenatal counseling and community sensitisation can increase PNC utilisation and improve maternal and neonatal health outcomes.

Aim: A community-based cross-sectional study was conducted to explore the association between Ultra-Processed Foods (UPFs) intake and the risk of frailty among community-dwelling older adults.

Methods: The current study was conducted on 368 community-dwelling older adults (with a mean age of 67.11 ± 6.21 years, of whom 55.2% were women) at health centers of Maragheh city in Iran. Body composition was measured by a body composition analyzer and physical activity by the short-form physical activity questionnaire. The UPFs intake were determined using NOVA classification, based on a self-administered 147-item semi-quantitative FFQ. Blood samples were derived for the evaluation of blood parameters. Raw and adjusted logistic regression models were used to examine the relationship between UPFs intake tertiles and the risk of frailty.

Results: Outcomes showed that the overall prevalence of frailty was 96 (26.1%). Results from the multivariable adjusted logistic regression model indicated that higher UPFs intake was significantly associated with higher odds of frailty (OR = 2.15, 95% CI: 1.13-4.09, P = 0.019). Subgroup analysis also indicated that among men, higher UPF intake was significantly related to higher odds of frailty (OR = 3.55, 95% CI: 1.20-10.51, P = 0.022), but not for women (P > 0.05). Additionally, the results revealed that higher UPF intake was significantly associated with the risk of exhaustion (OR = 3.97, 95% CI: 1.89-8.34, P < 0.001), especially among men (OR = 9.89, 95% CI: 3.10-31.60, P < 0.001), unlike women (P > 0.05). However, there were no significant associations between UPFs intake and other components of frailty, including the risk of weight loss, slowness, dominant hand grip strength and low physical activity.

Conclusions: The results highlighted that higher UPFs intake was significantly associated with the risk of frailty and exhaustion among community-dwelling older adults, especially for men. Future large-scale prospective and interventional studies are warranted to validate these associations and elucidate underlying biological mechanisms.

Malnutrition is a significant public health concern affecting many populations, particularly in developing countries such as India and its neighboring economies. It can lead to adverse health outcomes, including stunted growth, impaired cognition, and increased susceptibility to disease. This review attempts to summarize the problems associated with malnutrition in different age groups in India and its neighboring countries, and the accompanying factors contributing to it. We also summarize the different biofortification techniques, which, when appropriately implemented, can alleviate these problems and potentially increase the availability and accessibility of crucial micronutrients such as vitamins and minerals in the diets of vulnerable populations. Government schemes and policies for scaling up biofortification interventions, as well as increasing public awareness and acceptance of biofortified crops, have also been delineated. In conclusion, while significant challenges remain, biofortification represents a promising approach for combating malnutrition, although further research and evaluations are needed to realize its potential impact fully.

Background: Multivitamin and mineral (MVM) supplements have been shown to provide various health benefits, including enhanced energy, skin health, metabolism, and immune function. This study explored the impact of MVM supplements based on users' experience in Taiwan.

Methods: This retrospective, real-world, cross-sectional study included 400 respondents, aged 35-60 years, residing in Taiwan. Data were collected via an online survey. Respondents self-reported perceived benefits across six youthful vitality benefits: energy, metabolism, sleep, mental alertness, skin health and complexion, and spirit. Additional assessments covered perceived immunity, general health, quality-of-life (QoL), well-being, user attitude and perception. Subgroup analyses was performed post hoc based on gender (male vs. female), age (< 50 vs. ≥50 years) and frequency of use (daily vs. occasional) to explore potential subgroup differences in perceived benefits.

Results: A total of 93% of users agreed that MVM supplements support at least one out of six youthful vitality benefits. Users reported several perceived benefits: energy support (59.00%), improved metabolism (59.75%), improved complexion (53.25%), normal immune functioning (66.25%), confident in maintaining overall health (63.25%). Satisfaction levels were notably high, with 74.50% expressing satisfaction with product use, 72.50% trusting the product, and 79.00% showed willingness to repurchase. Subgroup analyses suggested that males, daily users, and users aged ≥ 50 years experienced more favorable outcomes across several parameters as compared to their respective counterparts.

Conclusion: This study provides real-world evidence that MVM supplements are widely perceived to support youthful vitality, immunity, general health, and QoL. These user-reported outcomes complement existing clinical research by highlighting benefits experienced in everyday settings, especially among daily users and those aged 50 and above. The high satisfaction and trust levels observed further reinforce the relevance of MVM supplements as a self-care strategy. By bridging the gap between controlled trials and consumer experience, this study adds valuable context to the science and recommendation of micronutrient supplementation.

Background: Sustainable food literacy, healthy life awareness, and adherence to sustainable dietary models such as the Mediterranean diet are critical for promoting both public health and environmental well-being. While sociodemographic influences have been examined in previous research, the potential role of social media addiction as a behavioral factor in shaping sustainable dietary practices remains underexplored.

Objectives: This study aimed to investigate how sustainable food literacy, healthy life awareness, and social media addiction relate to Mediterranean diet adherence and nutritional sustainability in adults, while also accounting for key sociodemographic characteristics.

Methods: This cross-sectional online study included 2,263 adults (60.5% female; mean age, 29.4 ± 11.7 years; mean BMI, 24.54 ± 6.8 kg/m²). Data were collected using the Sustainable Food Literacy Scale (SFLS), Social Media Addiction Scale (SMAS), Adherence to the Mediterranean Diet and Nutritional Sustainability Questionnaire Turkish Version (MedQ-Sus-Tr), and Healthy Life Awareness Scale (HLAS). Pearson correlation and multiple linear regression analyses were performed.

Results: Based on the MedQ-Sus-Tr, 91.0% of participants were classified as having low adherence to the Mediterranean diet, and 70.1% were classified as having low nutritional sustainability. Mediterranean diet adherence showed the strongest correlation with nutritional sustainability (r = 0.728, p < 0.001). Predictors of Mediterranean diet adherence included marital status, income, SFLS, and HLAS (R² = 0.365), while nutritional sustainability was predicted by marital status, income, SFLS, and HLAS (R² = 0.301). SFLS was associated with sex, education level, marital status, income, social media addiction, HLAS, Mediterranean diet adherence, and nutritional sustainability (R² = 0.704). HLAS was predicted by sex, age, SFLS, social media addiction, Mediterranean diet adherence, and nutritional sustainability (R² = 0.696).

Conclusions: Our findings highlight that higher sustainable food literacy and healthy life awareness significantly predict greater adherence to the Mediterranean diet and improved nutritional sustainability, regardless of sociodemographic characteristics. Social media addiction was positively associated with both literacy and awareness, though it did not directly predict dietary adherence or sustainability. These results suggest that while social media use may enhance exposure to nutrition-related information, its impact on actual dietary behaviors is less direct. Targeted interventions should therefore leverage the informational potential of digital platforms, while also fostering translation of awareness into healthier and more sustainable eating practices.

Objective: This study aimed to investigate the effect of gestational diabetes mellitus (GDM) on maternal serum uric acid (SUA) levels.

Methods: We searched PubMed, Embase, Web of Science, Scopus and the Cochrane Library from inception to 31 January 2025. Cohort and case-control studies reporting SUA at or before 28 weeks' gestation and subsequent GDM were eligible. Random effects meta analyses with Hartung-Knapp adjustment synthesised.

Results: Sixteen studies (19 reports) encompassing 25 212 GDM cases and 148 519 normoglycaemic controls met all criteria. In eight studies with continuous data (2 690 GDM vs. 6 250 controls), women who developed GDM had an average first trimester SUA 44.3 µmol L⁻¹ higher than controls (95% CI 10.3-78.3; I²=96.9%). Ten studies providing categorical estimates yielded a pooled adjusted OR of 2.35 (95% CI 1.54-3.58; I² = 98.7%), indicating a > two fold risk of GDM with elevated SUA. However, substantial heterogeneity was observed across studies (I² >95%). Sequential omission of individual studies, alternative τ² estimators and restriction to high quality cohorts all preserved statistical significance. Funnel plot asymmetry suggested mild small study effects for categorical data but trim and fill adjustment changed the OR by < 10%.

Conclusions: Elevated SUA measured as early as the periconceptional period is consistently associated with an approximately two fold increase in GDM risk. Given its low cost and routine availability, first trimester SUA may hold promise as an adjunctive early pregnancy risk stratification tool, though further validation studies are needed to confirm its clinical utility.

Background: Exposure to metals from the combustion of biomass via inhalation may result in negative health outcomes affecting a variety of organs and systems. Pregnant women cooking with biomass fuels may be exposed to metals, such as lead (Pb) and cadmium (Cd), and have unique risks for adverse health effects with potential impacts on the growing fetus. We assessed the associations between household air pollution and metals detected in dried blood spots from pregnant women at baseline in Rwanda.

Methods: We analyzed data from 781 pregnant women aged 18-35 years who resided in rural households using biomass fuel and who were enrolled in the Household Air Pollution Intervention Network (HAPIN) Trial in Rwanda. We explored associations between 24-h average natural log-transformed personal exposures to fine particulate matter (PM_2.5), black carbon (BC), and carbon monoxide (CO) and K + standardized Pb and Cd concentrations using linear regression models adjusted for potential confounders (i.e., age, body mass index, bicycle ownership, fish consumption, and food insecurity).

Results: The adjusted models showed positive but non-significant associations between air pollutant concentrations and metals detected in blood: PM₂.₅ and Pb (β coefficient: 0.06; 95% CI - 0.03-0.15), BC and Pb (0.11; 95% CI - 0.01-0.24), PM₂.₅ and Cd (0.04; 95% CI - 0.02-0.09), and BC with Cd (0.02; 95% CI - 0.05-0.09).

Conclusions: While associations were not statistically significant, the directionally consistent increases in blood Pb and Cd with increased PM₂.₅ and BC exposures align with existing evidence and underscore the need for continued research and policy action to reduce household air pollution exposures and protect maternal and fetal health.

Background: It is estimated that approximately 80% of childhood cancer cases occur in resource-limited settings and that most unvaccinated children live in middle-income countries. This creates an overlap of burdens for children with cancer, who are especially vulnerable to vaccine-preventable infections such as influenza and invasive pneumococcal disease. Given the complexity of vaccinating children with cancer because of the multidisciplinary care they require, it is unclear how such vaccination is achieved in these settings.

Methods: A self-administered, anonymized, cross-sectional survey was distributed to providers of healthcare for children with cancer in Latin America and the Caribbean through a contact list of 3236 email addresses. A total of 378 participant responses were included in the final analysis. This study used the Consolidated Framework for Implementation Research to understand the implementation factors influencing the vaccination of children with cancer in Latin America and the Caribbean.

Results: Most respondents (n = 246, 65.3%) reported that vaccines were always, almost always, or often available for administration at their institution - and were willing to recommend children with cancer for vaccination. Most respondents reported receiving no training or education on immunizing children with cancer at their current institution (n = 297, 78.6%) or before joining it (n = 242, 64.0%). Furthermore, only a small minority reported working in institutions with written policies on vaccinating children with cancer (n = 53, 14.0%) or clinical guidelines (n = 97, 25.7%) for vaccinating these patients. Respondents estimated that most pediatric patients with cancer at their hospital were not up to date on childhood immunizations and did not receive the annual influenza vaccine. Although most respondents (n = 345, 91.3%) reported that their government provides funding for childhood vaccinations, fewer than half (n = 183, 48.5%) reported that government funding was available for re-immunizing children with cancer.

Conclusions: We found a clear willingness to recommend vaccines for children with cancer in Latin America and the Caribbean, a trend not found in similar studies in the literature. Our findings support the notion that interventions to improve vaccination for children with cancer should gear their efforts towards building an institutional culture that prioritizes immunization for both patients and staff and that supports providers in their already established practice of recommending vaccines to their patients.