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Stunting in Developing Countries. 发展中国家的发育迟缓问题。
4区 医学 Pub Date : 2024-01-01 Epub Date: 2024-02-01 DOI: 10.1159/000534911
Janet Tapkigen, Joycelyn Kathembe, Helen M Nabwera, Andrew M Prentice, Martha K Mwangome
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引用次数: 0
The trends and effects of food price inflation on the cost and affordability of nutritionally adequate diets in Malawi 粮食价格通货膨胀的趋势和对马拉维营养充足饮食的成本和负担能力的影响
4区 医学 Pub Date : 2023-09-30 DOI: 10.26596/wn.20231433-13
Md Masud Rana, Natalie Roschnik, Olusegun Caleb Taiwo, Anthony Kulemba, Deusdedit Dambuleni, Brenda Phiri
Background Global challenges of hunger, food insecurity, and malnutrition persist, with nearly one in three people lacking sufficient food access. The COVID-19 pandemic exacerbated these issues, particularly in Africa, where 59.6% of the population grapples with food insecurity. Malawi faces high stunting and anaemia rates in children, driven by poverty, inadequate health services, and improper diet. Despite progress, the prevalence remains above regional averages. Research reveals imbalanced diets in Malawi, primarily reliant on maize, risking micronutrient deficiencies. This study examines diet affordability in the context of rising costs and low incomes, aiming to influence policy in addressing undernutrition in Malawi and highlighting the overlooked role of affordability in nutrition access. Objectives This assessment aimed to estimate the minimum cost of a nutritious diet using locally available and culturally acceptable food items in Malawi. The objective was to explore how economic constraints affect Malawian households, particularly the poor and ultra-poor, in accessing such diets. Additionally, it sought answers to questions about cost changes over 12 months and affordability among different wealth groups in the country. Methods This study involved secondary data analysis by employing the Cost of the Diet (CotD) research method and software. The World Food Programme’s Minimum Expenditure Basket (MEB) provided monthly food prices for 28 items from April 2021 to March 2022. Comparing the cost of a nutritious diet with per capita income from the Malawi Poverty Report, we estimated the affordability gap. Food price data was from 77 markets in 25 districts, ensuring national representation. Results The annual cost of a culturally acceptable nutritious diet for a five-person household from April 2021 to March 2022 was MWK 84,658/month (≈$103). The diet’s cost increased by 25% during the period, from MWK 2,519 to MWK 3,140 per day. Only average urban households had sufficient income to afford the diet, with a 9.7% surplus. Ultra-poor, poor, rural, and average Malawian households faced affordability gaps of 139.5%, 61.4%, 48.5%, and 32%, respectively. Closing the affordability gap would require additional monthly income of 29,134 kwacha (≈$35.5) for an average Malawian household, 37,481 kwacha for a typical rural household, 42,452 kwacha for a poor household, and 58,885 kwacha for an ultra-poor household. Conclusion The CotD assessment revealed a significant increase in the cost of a nutritious diet over the past 12 months. Most of the population cannot afford the cheapest nutritious diet. The recent currency devaluation may worsen the situation. Cash, voucher or food distribution could help close the affordability gap for poor and ultra-poor households. Regular monitoring and ongoing updates of the CotD results are necessary for informed decision-making.
饥饿、粮食不安全和营养不良等全球挑战持续存在,近三分之一的人缺乏足够的粮食。2019冠状病毒病大流行加剧了这些问题,特别是在非洲,59.6%的人口面临粮食不安全问题。由于贫穷、保健服务不足和饮食不当,马拉维儿童发育迟缓和贫血率很高。尽管取得了进展,但患病率仍高于区域平均水平。研究表明,马拉维的饮食不平衡,主要依赖玉米,有微量营养素缺乏的风险。本研究考察了成本上升和低收入背景下的饮食可负担性,旨在影响马拉维解决营养不良问题的政策,并强调可负担性在营养获取中被忽视的作用。本评估旨在估计马拉维使用当地可获得和文化上可接受的食物的营养饮食的最低成本。目的是探讨经济限制如何影响马拉维家庭,特别是穷人和超穷人获得这种饮食。此外,它还寻求有关12个月内成本变化以及该国不同财富群体负担能力的问题的答案。方法采用饮食成本(Cost of the Diet, CotD)研究方法和软件进行二次资料分析。世界粮食计划署的最低支出篮子(MEB)提供了2021年4月至2022年3月期间28种食品的每月价格。通过比较营养饮食的成本与马拉维贫困报告的人均收入,我们估计了可负担性差距。粮食价格数据来自25个地区的77个市场,确保具有全国代表性。结果从2021年4月至2022年3月,一个五口之家在文化上可接受的营养饮食方面的年成本为84,658元/月(≈103美元)。在此期间,这种饮食的成本增加了25%,从每天2519英镑增加到3140英镑。只有普通城市家庭有足够的收入来支付这种饮食,有9.7%的盈余。极度贫困、贫困、农村和普通马拉维家庭的负担能力差距分别为139.5%、61.4%、48.5%和32%。要缩小支付能力差距,马拉维的普通家庭需要额外的月收入29134克瓦查(约35.5美元),典型农村家庭需要额外的月收入37481克瓦查,贫困家庭需要额外的月收入42452克瓦查,超贫困家庭需要额外的月收入58885克瓦查。CotD评估显示,在过去12个月中,营养饮食的成本显著增加。大多数人负担不起最便宜的营养饮食。最近的货币贬值可能会使情况恶化。现金、代金券或食品分发可以帮助缩小贫困和超贫困家庭的负担能力差距。定期监测和不断更新禁毒署的结果对于知情决策是必要的。
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引用次数: 0
Introduction to the third issue of World Nutrition for 2023 《世界营养》2023年第三期导言
4区 医学 Pub Date : 2023-09-30 DOI: 10.26596/wn.20231431-2
Ted Greiner
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引用次数: 0
Nourishment or Punishment: Nutrition support towards the end of life 营养或惩罚:生命结束时的营养支持
4区 医学 Pub Date : 2023-09-30 DOI: 10.26596/wn.202314374-78
Madrika Mirza Kanjiani, Amber Qasim
Artificial nutrition support during the end-of-life is deemed non-beneficial. Withholding nutrition when the patient is near death is a controversial and ethical dilemma that families and healthcare workers face. For family, feeding is a source of showing love and affection to loved ones and it is distressing for them to see their loved one die painfully with hunger and thirst. Therefore, healthcare workers need to counsel families regarding the benefits and drawbacks of artificial nutrition toward the end of life. The family must be taught about alternative means of comfort for patients like mouth care, offering back massage, or moistening lips to interact with patients during end-of-life.
生命末期的人工营养支持被认为是无益的。当病人濒临死亡时,拒绝营养是家庭和医护人员面临的一个有争议和道德困境。对家人来说,喂食是向亲人表达爱和感情的一种方式,看到亲人因饥饿和干渴而痛苦地死去,对他们来说是很痛苦的。因此,卫生保健工作者需要就人工营养在生命末期的利弊向家庭提供咨询。家属必须被告知病人的其他舒适方式,如口腔护理,提供背部按摩,或在临终时与病人互动的嘴唇湿润。
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引用次数: 0
“Because of mchango, I give my baby gripe water so he sleeps and stops crying”: Exclusive breastfeeding and parents’ concerns about colic-like symptoms in infants under 6 months in Lake Zone, Tanzania “因为mchango,我给我的宝宝喝洗手水,这样他就能睡觉,不再哭泣”:坦桑尼亚湖区6个月以下婴儿的纯母乳喂养和父母对绞痛样症状的担忧
4区 医学 Pub Date : 2023-09-30 DOI: 10.26596/wn.202314348-59
Hope C. Craig, Cynthia R. Matare, Stephanie L. Martin, Rosemary A. Kayanda, Gina C. Klemm, Rachel Bezner Kerr, Kirk A. Dearden, Luitfrid P. Nnally, Katherine L. Dickin
BackgroundEffective social and behavior change strategies for exclusive breastfeeding (EBF) rely on understanding how families interpret infant behavior and provide care. Little research thoroughly explores household use of non-prescribed medicine for infants under 6 months in rural Tanzania, which can interrupt EBF and may have other harmful unintended effects. AimTo explore parents’ use of non-prescribed medicine in response to infants’ colic-like symptoms during the EBF period. MethodsWe conducted thematic analysis of a series of qualitative, semi-structured interviews with 36 mothers and 30 fathers of infants 0-6 months in Lake Zone, Tanzania. Here, we focus on emergent themes related to concerns about colic-like symptoms and global implications for public health practitioners. ResultsParents reported concerns about excessive crying and perceived infant abdominal pain, attributed to a potentially serious disease state locally known as mchango. Most parents gave non-prescribed medicines (e.g. gripe water, oral traditional medicine, and/or other commercial medicines) to treat or prevent mchango and associated symptoms, often including infant crying. After receiving supportive counselling on soothing techniques, most were willing to avoid giving non-prescribed medicines. Some reported continued challenges attributed to mchango symptoms, namely inconsolable crying. ConclusionWhile symptoms of mchango reported in this study overlapped with colic symptoms, literature in Tanzania suggests, in some cases, mchango is perceived to have spiritual origins and potentially be dangerous if left untreated. Empathetic counseling can offer parents knowledge and skills to manage colic-like symptoms without using non-prescribed medicines. Health workers need clear messages and training on risks of non-prescribed medicines and Tanzanian legislation banning its promotion and distribution.
背景:纯母乳喂养(EBF)的有效社会和行为改变策略依赖于了解家庭如何解释婴儿行为并提供护理。很少有研究深入探讨坦桑尼亚农村6个月以下婴儿家庭使用非处方药的情况,这可能会中断EBF,并可能产生其他有害的意想不到的影响。目的探讨父母使用非处方药物应对EBF期婴儿肠绞痛样症状的情况。 方法对坦桑尼亚湖区36名0-6个月婴儿的母亲和30名婴儿的父亲进行了一系列定性、半结构化访谈,并进行了主题分析。在这里,我们关注与关注肠绞痛样症状和对公共卫生从业人员的全球影响相关的新兴主题。 结果家长报告了对过度哭闹和婴儿腹痛的担忧,这是一种潜在的严重疾病状态,在当地被称为mchango。大多数家长给予非处方药物(如漱口水、口服传统药物和/或其他商业药物)来治疗或预防mchango及相关症状,通常包括婴儿哭闹。在接受了关于安抚技巧的支持性咨询后,大多数人愿意避免服用非处方药。一些人报告说,持续的挑战归因于mchango症状,即无法安慰的哭泣。结论虽然本研究中报告的mchango症状与绞痛症状重叠,但坦桑尼亚的文献表明,在某些情况下,mchango被认为具有精神根源,如果不及时治疗,可能会有危险。移情咨询可以为父母提供知识和技能,在不使用非处方药的情况下管理类似绞痛的症状。卫生工作者需要关于非处方药风险的明确信息和培训,以及坦桑尼亚立法禁止推广和分发非处方药。
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 AimTo explore parents’ use of non-prescribed medicine in response to infants’ colic-like symptoms during the EBF period.
 MethodsWe conducted thematic analysis of a series of qualitative, semi-structured interviews with 36 mothers and 30 fathers of infants 0-6 months in Lake Zone, Tanzania. Here, we focus on emergent themes related to concerns about colic-like symptoms and global implications for public health practitioners.
 ResultsParents reported concerns about excessive crying and perceived infant abdominal pain, attributed to a potentially serious disease state locally known as mchango. Most parents gave non-prescribed medicines (e.g. gripe water, oral traditional medicine, and/or other commercial medicines) to treat or prevent mchango and associated symptoms, often including infant crying. After receiving supportive counselling on soothing techniques, most were willing to avoid giving non-prescribed medicines. Some reported continued challenges attributed to mchango symptoms, namely inconsolable crying.
 ConclusionWhile symptoms of mchango reported in this study overlapped with colic symptoms, literature in Tanzania suggests, in some cases, mchango is perceived to have spiritual origins and potentially be dangerous if left untreated. Empathetic counseling can offer parents knowledge and skills to manage colic-like symptoms without using non-prescribed medicines. Health workers need clear messages and training on risks of non-prescribed medicines and Tanzanian legislation banning its promotion and distribution.","PeriodicalId":23779,"journal":{"name":"World review of nutrition and dietetics","volume":"160 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136279749","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}
引用次数: 0
The UN Committee on World Food Security: An opportunity to counter the ongoing corporate capture of FAO 联合国世界粮食安全委员会:应对粮农组织持续的集体俘获的机会
4区 医学 Pub Date : 2023-09-30 DOI: 10.26596/wn.202314379-82
Magdalena Ackermann Aredes
In this letter to the editor, I suggest how the UN Committee on World Food Security (CFS) is a good example within the United Nations (UN) of how to continue urging for human rights based and multilateral decision making in global food governance, especially now when 134 million more people, compared to 2019, cannot access a healthy diet1. Contrary to what the recent article entitled “Is the Committee on World Food Security fit for purpose?”2 , published by Devex, which seems bent towards only pointing out the failures of the Committee, I rather suggest making a case for how the CFS ought to succeed.
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引用次数: 0
Book Review of George Kent’s “Caring About Hunger” 乔治·肯特《关心饥饿》书评
4区 医学 Pub Date : 2023-09-30 DOI: 10.26596/wn.202314383-85
Joseph Ben-Dak
Reading George Kent's 2016 book, “Caring about Hunger” (Kent 2016) is refreshing and helpful, as it is a reflective essay on the interrelations between and among the various facets and factors that produce hunger. At the same time, it is an attempt to produce a conceptual and informative foundation as to how to reconstruct a response to the problem at all relevant levels, i.e., international and global institutions, the government, local, and the personal, emphasizing the care for children. The fact that the book was completed in 2016 and is even more pertinent today, in 2023, shows the continuities and worsening of trends such as caring, but not caring enough, in terms of both first and second-order consequences of the quality and mixing of, for example, industry made milk for babies and the highly preferred mother's milk. The many and manifold exposures George had to virtually each of the less than fully caring institutions that created worsening realities in the food production, distribution, and trade were in geographies of the advanced countries and the less developed and in virtually all levels of hunger, where food production did not accord with actual supply at household level. His dealing with fisheries, for example, started with Hawaii Coastal Zone Management (1975), then he got a sabbatical to study fisheries as a model for global resource management (1977-1978), and later continued to the nutrition objectives that were to be achieved in fisheries’ policies (1985) in Thailand and Indonesia. He then continued with UNFAO in the very same area of concern. Thus, he was able to view hunger creation and response at all relevant levels. He has devoted more than 40 years to developing the conclusions and insights he reviews in 8 chapters of key concerns in this book. He took the same type of gradual collection on the spot of lessons re fisheries into the other key components of the food machinery globally and within many countries. In the early parts of the book, terms like holocaust and genocide are used to define the magnitude, de facto, of hunger’s disastrous reality, even when it is not caused by
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引用次数: 0
Perception and practice of junk food consumption among undergraduate students in a medical university in Chengalpattu District” 成都市某医科大学大学生垃圾食品消费认知与行为研究
4区 医学 Pub Date : 2023-09-30 DOI: 10.26596/wn.202314327-35
Gunaseelan Latha Kokilaa, Ravichandhiran Gowthamkarthic, Abhinandan Wali, Soumya Agadi
IntroductionJunk foods are defined as processed foods with negligible nutrient value and are often high in salt, sugar, and fat. Junk foods with high sugar content deplete energy levels and the ability to concentrate for extended periods, especially for college students who are forced to consume junk food to curb their hunger as it gives them a sense of pleasure. Due to low prices and affordability, they consume junk food as an alternative to home food. MethodologyThis was a cross-sectional study carried out among undergraduate medical college students in the Chengalpattu district by systematic random sampling. A semi-structured questionnaire which was framed after reviewing similar works of literature was used to assess the knowledge, attitude, and practice regarding junk food consumption. The collected data were entered into MS Excel and analyzed using SPSS version 21. P value <0.05 was considered significant. ResultsOf the 260 participants, 51% were males and 49% were females with a mean age of 20±2.0 years. 65% of the respondents had adequate knowledge regarding the harmful effects of junk food consumption and their BMI scores tended to be in the normal range. 45% of participants felt lethargic after consuming junk food. Chi-square revealed a statistically significant association between the student’s year of study (0.004) and their knowledge score, suggesting that the knowledge level was higher for interns. ConclusionThe present study concludes that most participants had adequate knowledge of junk food consumption patterns. Nutrition counseling regarding a balanced diet and the harmful effects of junk foods may help to curb junk food addiction.
垃圾食品被定义为营养价值可忽略不计的加工食品,通常含有高盐、高糖和高脂肪。高含糖量的垃圾食品会消耗能量水平和长时间集中注意力的能力,尤其是对那些被迫吃垃圾食品来抑制饥饿感的大学生来说,因为它能给他们一种快感。由于价格低廉,负担得起,他们消费垃圾食品作为家庭食品的替代品。 方法采用横断面研究方法,采用系统随机抽样的方法对成都地区医学本科院校学生进行调查。在查阅了类似的文献后,我们编制了一份半结构化的调查问卷来评估人们对垃圾食品消费的认识、态度和行为。将收集到的数据输入MS Excel中,并使用SPSS version 21进行分析。P值<0.05被认为是显著的. 结果260例患者中男性占51%,女性占49%,平均年龄20±2.0岁。65%的受访者对垃圾食品的危害有足够的认识,他们的身体质量指数在正常范围内。45%的参与者在食用垃圾食品后感到昏昏欲睡。卡方分析显示,学生的学习年份与他们的知识得分之间存在显著的统计学相关性(0.004),表明实习生的知识水平更高。 结论本研究的结论是,大多数参与者对垃圾食品的消费模式有足够的了解。关于均衡饮食和垃圾食品有害影响的营养咨询可能有助于抑制垃圾食品成瘾。
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引用次数: 0
SHIFTING MINDSETS: Views of seasoned experts on changes most needed now in global nutrition work 转变心态:经验丰富的专家对目前全球营养工作中最需要的变化的看法
4区 医学 Pub Date : 2023-09-30 DOI: 10.26596/wn.202314360-74
Ted Greiner
In preparation for a talk Alan Berg was asked to give at an American Society for Nutrition meeting honoring him and celebrating his 90th birthday, as well as the 50th anniversery of the publication of his book The Nutrition Factor, he asked 11 “nutrition engineers” (experts in public health nutrition, specializing in low-income settings) 3 questions. These are their responses.
艾伦·伯格受邀在美国营养学会的一次会议上发表演讲,以纪念他的90岁生日,以及他的书《营养因素》出版50周年。在准备演讲时,他问了11位“营养工程师”(公共卫生营养专家,专门研究低收入环境)3个问题。这些是他们的回应。
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引用次数: 0
Opposite ends of the spectrum: Does emotional eating present more barriers to applying mindful eating and intuitive eating strategies for females? 与之相反的是:情绪化进食是否会给女性应用正念进食和直觉饮食策略带来更多障碍?
4区 医学 Pub Date : 2023-09-30 DOI: 10.26596/wn.202314314-26
Meryem KAHRIMAN, Nese KAYA
Objective We aimed to evaluate the relationship between intuitive eating, mindful eating, emotional eating and dietary restraint behaviors and the role of gender in these relationships. Material and Method This study was conducted with 522 participants aged 18-65. Questionnaire about sociodemographic characteristics and general eating habits, Intuitive Eating Scale-2 (IES-2), Mindful Eating Questionnaire-30 (MEQ-30), and Emotional Eating and Restraint Eating Subscale of Dutch Eating Behavior Questionnaire (DEBQ) were administered to the participants. Results DEBQ Restraint Eating, and Emotional Eating subscale scores were found to be higher in women. The total scores of IES-2 and MEQ-30 were found to be higher in the group with Body Mass Index (BMI)<25, and the DEBQ Emotional Eating subscale score was found to be higher in the group with BMI≥25. The negative correlation between DEBQ Emotional Eating subscale score and IES-2 total score was weak in men and strong in women. The negative relationship between MEQ-30 total score and DEBQ Emotional Eating subscale score was moderate in men and strong in women. We found that gender had a moderator role between IES-2 and MEQ-30 total scores and between MEQ-30 total score and DEBQ Emotional Eating score. Conclusion Overweight and obese participants had lower levels of intuitive eating and mindful eating, while emotional eating levels were higher. Mindful eating and intuitive eating strategies may be concepts that represent two opposite ends of a spectrum with emotional eating, and emotional eating can be an obstacle when these strategies are administered, especially in women.
目的探讨直觉性饮食、正念性饮食、情绪性饮食与饮食限制行为的关系及性别在这些关系中的作用。 本研究共纳入522名年龄在18-65岁之间的参与者。采用社会人口学特征和一般饮食习惯问卷、直觉性饮食量表-2 (IES-2)、正念性饮食量表-30 (MEQ-30)和荷兰式饮食行为问卷(DEBQ)情绪性饮食和克制性饮食子量表对被试进行调查。 结果DEBQ自制进食和情绪性进食分量表得分在女性中较高。体重指数(BMI)≥25组的IES-2和MEQ-30总分较高,BMI≥25组的DEBQ情绪饮食分量表总分较高。DEBQ情绪饮食分量表得分与IES-2总分的负相关男性较弱,女性较强。MEQ-30总分与DEBQ情绪饮食分量表得分的负相关关系在男性中为中等,在女性中为较强。我们发现性别在IES-2和MEQ-30总分、MEQ-30总分和DEBQ情绪饮食总分之间具有调节作用。结论超重和肥胖参与者的直觉性饮食和正念性饮食水平较低,而情绪化饮食水平较高。正念饮食和直觉饮食策略可能是两个概念,代表了情绪饮食的两个相反的极端,当这些策略被执行时,情绪饮食可能是一个障碍,尤其是对女性来说。
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引用次数: 0
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World review of nutrition and dietetics
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