Studies on the nutritional status of children aged 0-5 years in a drought-affected desert area of western Rajasthan, India

OBJECTIVE: The present study was undertaken to assess the impact of drought on the nutritional status of pre-school children aged 0-5 years from a rural population in a desert area facing drought conditions very frequently. DESIGN: The sampling design for assessment was the three-stage sampling technique. SETTING: The study was carried out in 24 villages belonging to six tehsils (sub-units of district) of Jodhpur District, a drought-affected desert district of western Rajasthan, during a drought in 2003. SUBJECTS: A total of 914 children were examined at household level, with nutritional status assessed by anthropometry, dietary intake and clinical signs of nutritional deficiency. RESULTS: The results revealed growth retardation. Stunting (malnutrition of long duration) was observed in 53% of children and underweight in 60%. Wasting, an indicator of short-duration malnutrition, was present in 28% of children. The extent of malnutrition was significantly higher in girls than boys (P<0.05). Vitamin A and B complex deficiencies were found in 0.7 and 3.0% of children, respectively. Prevalence of marasmus (protein-energy malnutrition, PEM) was 1.7% (2.3% in boys and 1.1% in girls). Overall deficits in mean energy and protein intakes were very high (76 and 54%, respectively). Comparison of the present drought results with earlier studies in desert normal and desert drought conditions showed higher prevalence of PEM and higher dietary energy and protein deficiencies. CONCLUSIONS: The prevalence of wasting was high, greater than the cut-off point of 15% stated by the World Health Organization to indicate that the severity of malnutrition is critical. PEM, vitamin A and B complex deficiencies and anaemia, along with dietary deficits of energy and protein, were observed to be higher than in non-desert areas. This may be due to the harsh environmental conditions in desert areas where drought occurs quite frequently and adversely affects the economy, largely by eroding the coping capacity and economic potential of the people as a result of heavy livestock losses and reduced harvests, leading to increased poverty and poor food intake of the inhabitants. Due to inadequate consumption of daily food the children were suffering from wasting and PEM. Efforts should be made to incorporate measures, such as ensuring the supply of adequate energy and protein to all age groups and especially pre-school children, into ongoing nutrition programmes in order to improve the food security of local inhabitants in this area.     

Development of a novel nutrition screening tool for use in elderly South Africans

OBJECTIVE: To develop a nutrition screening tool for use in older South Africans. DESIGN: A cross-sectional validation study in 283 free-living and institutionalised black South Africans (60+ years). METHODS: Trained field-workers administered a 24-hour recall and the Mini Nutritional Assessment (MNA) screening tool, and performed anthropometric measurements and physical function tests. Cognitive function was assessed using a validated version of the Six-Item Cognitive Impairment Test. Biochemical indicators assessed included serum albumin, haemoglobin, ferritin, vitamin B12, red-blood-cell folate, cholesterol and vitamin C. The MNA was used as the gold standard against which a novel screening tool was developed using a six-step systematic approach, namely: correspondence analysis; identification of key questions; determination of internal consistency; correlational analyses with objective measures; determination of reference cut-off values for categories of nutritional risk; and determination of sensitivity and specificity. RESULTS: The new screening tool includes nine separate concepts, comprising a total of 14 questions, as well as measurement of mid-upper arm circumference. The new tool score was positively associated with level of independence in either basic activities of daily living (r = 0.472) or the more complex instrumental activities of daily living (r = 0.233). A three-category scoring system of nutritional risk was developed and shown to significantly characterise subjects according to physical function tests, level of independence and cognitive function. The new tool has good sensitivity (87.5%) and specificity (95.0%) compared with the MNA scoring system. It has a very high negative predictive value (99.5%), which means that the tool is unlikely to falsely classify subjects as well nourished/at risk when they are in fact malnourished. CONCLUSION: A novel screening tool has been shown to have content-, construct- and criterion-related validity, and the individual items have been shown to have good internal consistency. Further validation of the tool in a new population of elderly Africans is warranted.     

基于Web of Science文献计量学分析的全球老年食品研究进展

为深入了解国内外老年食品的研究现状和研究热点,该研究基于Web of Science核心合集(SCI-E)数据库,采用文献计量学理论和可视化分析技术,对1990～2020年全球老年食品研究文献进行分析,以为中国老年食品的研究和开发提供参考。全球有64个国家/地区、852个研究机构,236种期刊开展了老年食品研究,跨区域合作、多学科交叉融合频繁,美国、日本、法国、加拿大、中国等国家均表现出较大的研究体量和较强的合作关系,美国、荷兰老年食品研究的总体质量较高,优势研究机构大多位于欧美等发达国家,研究领域主要集中于营养学、食品科学技术、老年医学等,重点关注膳食补充、健康状况和相关风险。研究前沿有粮食不安全(food insecurity)、健康状况(health status)、生活质量(quality of life)、康复(rehabilitation)、超重(overweight)、有效性(validity)、吞咽困难(dysphagia)、滋味(taste)等。中国老年食品以糊粉类为主,分类混乱、结构单一、科技含量低,与美国、日本、荷兰等国相比还有较大的差距。中国作为世界上人口最多的国家,在人口老龄化加速发展的关键时期,老年食品的研发显得尤为迫切和重要。因此,未来老年食品研究应以老年医学和营养学理论为基础,重点开发营养强化食品和功能性食品,加强食品的感官修饰研究力度,以满足老年人营养和健康的多元化需求,积极应对全球人口老龄化问题。     

Do childhood growth indicators in developing countries cluster? Implications for intervention strategies

OBJECTIVE: The effectiveness of geographic targeting in nutrition programmes depends largely on the degree to which malnutrition clusters within particular areas. This study investigates the extent to which the childhood nutrition indicators, stunting (height-for-age Z-score <-2) and wasting (weight-for-height Z-score <-2), are spatially clustered; this information is used to determine the implications of spatial clustering for the effectiveness of geographic targeting. DESIGN: Analysis of data from Demographic and Health Survey (DHS) results. Clustering is assessed by calculating intra-cluster correlation coefficients (ICCs). Estimating the proportion of malnourished children covered by a programme successfully targeting 10% of clusters with the highest malnutrition prevalences allows an assessment of the effectiveness of geographic targeting. SETTING: Fifty-eight DHS III (1992-1997) and DHS IV (1998-2001) reports from 46 developing countries. SUBJECTS: Pre-school children of mothers interviewed by DHS. MAIN RESULTS: The extent of clustering of nutritional status was surprisingly low (median ICC for national samples: stunting=0.054, wasting=0.032) and most countries were characterised by having an ICC <0.1--i.e. low clustering--for childhood undernutrition (91% of countries for wasting and 78% for stunting). Our assessment of the effectiveness of geographic targeting showed that coverage was better for wasting than for stunting; for wasting, 23% of countries would achieve less than 20% coverage, compared with 76% of countries achieving less than 20% coverage for stunting. Coverage is dependent on the overall prevalence of malnutrition and the ICC. CONCLUSIONS: Childhood nutritional status is determined at the household, or even individual, level; nutrition programmes that are geographically targeted may result in high levels of under-coverage and leakage, thereby compromising their cost-effectiveness; the lack of clustering questions the appropriateness of current nutrition interventions.     

Evaluation of health, nutrition and food security programmes in a complex emergency: the case of Congo as an example of a chronic post-conflict situation

OBJECTIVE: To describe the case of Congo as an example of the assessment and appropriateness of donor operational and sectoral strategies in a complex emergency. DESIGN AND SETTING: The paper reports the findings of an external evaluation of operations financed by the European Commission Humanitarian Office in the Democratic Republic of Congo (DRC). RESULTS: The Congolese health system is suffering from severe deterioration. What is functioning in the public health context is donor-dependent with high costs and limited coverage. Despite a relatively favourable agro-climatic situation, food shortage and famine severely affect the nutritional status of large population groups. In this context, humanitarian programmes have generally improved access to health care and the nutritional status of beneficiaries. The reduction of malnutrition in project areas is often demonstrated even though the context did not permit consolidation of these results. Malnutrition continues to claim a massive cost of lives owing to the effect of widespread food insecurity that follows a circular cause-and-effect pattern of very low food production and extreme poverty. CONCLUSIONS: The current context in DRC does not correspond yet to 'post-crisis': neither at population level with regard to indicators of poverty, malnutrition, disease and death, nor at institutional level, with regard to state support to institutions. In these situations, the international community is often called upon to replace the state as service provider. Integrated humanitarian actions should be the future of relief projects in DRC. Health, nutrition and food security components should be considered a standard public health intervention strategy representing the most sensible approach to address the needs of the affected population.     

Malnutrition and high childhood mortality among the Onge tribe of the Andaman and Nicobar Islands

OBJECTIVES: A study was conducted among the Onge tribe of the Andaman and Nicobar Islands with the objectives of identifying demographic factors responsible for the decline in their population and assessing their nutritional status, which is an important determinant of child survival. STUDY DESIGN AND SUBJECTS: The study included estimation of indices of fertility and child mortality, and assessment of nutritional status. All individuals of the Onge community settled on Little Andaman Island were included. RESULTS: The mean total marital fertility rate was estimated to be 5.15 live births per woman and the general fertility rate was 200 live births per 1000 married-woman-years. Although the gross reproduction rate was estimated to be 2.2 female children per married woman, the net reproduction rate was only 0.9 surviving female child per married woman. The mean infant mortality rate during the past 30 years was 192.7 per 1000 live births, and the child survival rate was found to be only 53.2%. A mild to moderate degree of malnutrition was found in 85% of children of pre-school age and severe malnutrition in 10%. The Onges had low intakes of iron, vitamin A and vitamin C. All the screened Onges were found to be infested with one or more intestinal parasites. CONCLUSIONS: High childhood mortality appears to be the predominant demographic factor responsible for the decline in the Onge population. The high prevalence of undernutrition and micronutrient deficiency disorders could be important factors contributing to the high childhood mortality.     

AIDS, drought, and child malnutrition in southern Africa

OBJECTIVE: To investigate trends in child malnutrition in six countries in southern Africa, in relation to the HIV epidemic and drought in crop years 2001/2 and 2002/3. DESIGN: Epidemiological analysis of sub-national and national surveys with related data.Setting: Data from Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe, compiled and analysed under UNICEF auspices. SUBJECTS: Secondary data: children 0-5 years for weight-for-age; HIV prevalence data from various sources especially antenatal clinic surveillance. RESULTS: Child nutritional status as measured by prevalence of underweight deteriorated from 2001 onwards in all countries except Lesotho, with very substantial increases in some provinces/districts (e.g. from 5 to 20% in Maputo (Mozambique, 1997-2002), 17 to 32% in Copperbelt (Zambia, 1999-2001/2) and 11 to 26% in Midlands province (Zimbabwe, 1999-2002)). Greater deterioration in underweight occurred in better-off areas. Areas with higher HIV/AIDS prevalences had (so far) lower malnutrition rates (and infant mortality rates), presumably because more modern areas--with greater reliance on trade and wage employment--have more HIV/AIDS. Areas with higher HIV/AIDS showed more deterioration in child nutrition. A significant area-level interaction was found of HIV/AIDS with the drought period, associated with particularly rapid deterioration in nutritional status. CONCLUSIONS: First, the most vulnerable may be households in more modern areas, nearer towns, to whom resources need to be directed. Second, the causes of this vulnerability need to be investigated. Third, HIV/AIDS amplifies the effect of drought on nutrition, so rapid and effective response will be crucial if drought strikes again. Fourth, expanded nutritional surveillance is now needed to monitor and respond to deteriorating trends. Finally, with or without drought, new means are needed of bringing help, comfort and assistance to the child population.     

Strategies to promote healthier food purchases: a pilot supermarket intervention study

OBJECTIVE: To pilot the design and methodology for a large randomised controlled trial (RCT) of two interventions to promote healthier food purchasing: culturally appropriate nutrition education and price discounts. DESIGN: A 12-week, single-blind, pilot RCT. Effects on food purchases were measured using individualised electronic shopping data ('Shop 'N Go' system). Partial data were also collected on food expenditure at other (non-supermarket) retail outlets. SETTING: A supermarket in Wellington, New Zealand. PARTICIPANTS: Eligible customers were those who were the main household shoppers, shopped mainly at the participating store, and were registered to use the Shop 'N Go system. Ninety-seven supermarket customers (72% women; age 40 +/- 9.6 years, mean +/- standard deviation) were randomised to one of four intervention groups: price discounts, nutrition education, a combination of price discounts and nutrition education, or control (no intervention). RESULTS: There was a 98% follow-up rate of participants, with 85% of all reported supermarket purchases being captured via the electronic data collection system. The pilot did, however, demonstrate difficulty recruiting Maori, Pacific and low-income shoppers using the electronic register and mail-out. CONCLUSIONS: This pilot study showed that electronic sales data capture is a viable way to measure effects of study interventions on food purchases in supermarkets, and points to the feasibility of conducting a large-scale RCT to evaluate the effectiveness of price discounts and nutrition education. Recruitment strategies will, however, need to be modified for the main trial in order to ensure inclusion of all ethnic and socio-economic groups.     

Hunger in young children of Mexican immigrant families

OBJECTIVE: To measure rates of hunger and food insecurity among young US-born Latino children with Mexican immigrant parents (Latinos) compared with a non-immigrant non-Latino population (non-Latinos) in a low-income clinic population. DESIGN, SETTING AND SUBJECTS: A repeated cross-sectional survey of 4278 caregivers of children < 3 years of age in the paediatric clinic of an urban county hospital for a 5-year period from 1998 to 2003. A total of 1310 respondents had a US-born child with at least one parent born in Mexico. They were compared with a reference group comprised of non-Latino US-born participants (n = 1805). Child hunger and household food insecurity were determined with the US Household Food Security Scale. RESULTS: Young Latino children had much higher rates of child hunger than non-Latinos, 6.8 versus 0.5%. Latino families also had higher rates of household food insecurity than non-Latinos, 53.1 versus 15.6%. Latino children remained much more likely to be hungry (odds ratio (OR) = 13.0, 95% confidence interval (CI) = 5.9-28.7, P < 0.01) and in household food-insecure households (OR = 6.6, 95% CI = 5.2-8.3, P < 0.01) than non-Latinos after controlling for the following variables in multivariate analysis: child's age, sex, maternal education level, single-headed household status, family size, young maternal age ( < 21 years), food stamp programme participation, TANF (Temporary Assistance to Needy Families, or 'welfare') programme participation and WIC (Women, Infants, and Children) usage, and reason for clinic visit (sick visit versus well-child). CONCLUSION: Young children in Mexican immigrant families are at especially high risk for hunger and household food insecurity compared with non-immigrant, non-Latino patients in a low-income paediatric clinic.     

Salt stress and mungbean [Vigna radiata (L.) Wilczek]: effects,physiological perspective and management practices for alleviating salinity

Mungbean is an important food grain legume with high economic status. It has an excellent source of dietary protein and nutritional health benefits, particularly for the vegetarians. It increases soil fertility and also plays an imperative role in major cropping systems due to its short life span. Production of mungbean is still decreasing due to its susceptibility towards various environmental stress factors. Salt stress is one of the most prevailing abiotic stress imposing threats for agriculture food crops along with increasing world population and limited natural resources. Fewer efforts have been made to develop an improved variety of mungbean. The present review summarizes the adverse effects of salt stress and mungbean response at the physiological and molecular level. It covers recent studies on introgression of useful traits in mungbean for its better adaptability and survival under stressed conditions. Modern biotechnological approaches and traditional breeding methods may assist the development of salt-tolerant cultivars of mungbean for salinity-affected area in arid and semi-arid regions. Researchers involved in this area should keep this goal on priority for sustainable mungbean production. Availability of protein-rich food may help to reduce the problem of malnutrition in poor families and national food security issue for a continuous rising population.     

The humanitarian emergency in Burundi: evaluation of the operational strategy for management of nutritional crisis

OBJECTIVE: To evaluate the impact and appropriateness of programmes for the management and treatment of severe malnutrition in emergency situations. DESIGN: A central unified database was set up with all data and statistics provided by nutritional centres (NC) active in Burundi. SETTING: The paper describes the case of Burundi as an example of the response of the humanitarian community to nutritional crisis. SUBJECTS: Since 1999, more than one million (1,054,210) severely malnourished patients were treated in NC established in Burundi. RESULTS: Peaks of beneficiaries were registered in 2000 and 2001; the admission rate started to decrease in 2002. In 2004, twenty therapeutic feeding centres (TFC) and 224 supplementary feeding centres (SFC) were active for the treatment of 127,420 beneficiaries. Nutritional programmes were present in every province with a coverage rate of 55%. The most convincing impact of the nutritional programme in Burundi was the reduction of mortality rate in children under 5 years of age; an impact on the prevalence of acute malnutrition could not be demonstrated. Children under 5 years old accounted for 62% of beneficiaries in TFC and 76% in SFC. TFC performance indicators fulfilled the minimum standards in disaster response; the performance of SFC was not so optimal with a low recovery rate (69% v. >80%) and a high non-respondent rate (16% v. <5%). With the combination of coverage and cure rate, the programme met 44% of the assessed needs in 2004. CONCLUSIONS: In Burundi the stabilisation of security conditions permitted a combination of humanitarian responses ranging from emergency activities to strengthening of community-based initiatives that could correct the coverage and impact limitations.     

Use of national food balance data to estimate the adequacy of zinc in national food supplies: methodology and regional estimates

OBJECTIVES: Adequate zinc nutriture is critically important for human health, but the development of programmes to control zinc deficiency is limited by the lack of reliable information on population zinc status. The present analyses were conducted to: (1) estimate the absorbable zinc content of national food supplies; (2) compare this information with theoretical population requirements for zinc; and (3) use these results to predict national risks of inadequate zinc intake. SETTING AND DESIGN: National food balance data were obtained for 176 countries from the Food and Agriculture Organization of the United Nations. The amount of absorbable zinc in these foods was estimated from food composition data, and zinc absorption was predicted using a model developed by the International Zinc Nutrition Consultative Group (IZiNCG). Demographic data were obtained from United Nations estimates, and age- and sex-specific physiological requirements for absorbable zinc were estimated using IZiNCG recommendations. RESULTS AND CONCLUSIONS: The mean per capita absorbable zinc content of national food supplies ranged from 2.98-3.01 mg day(-1) in Western Europe and USA & Canada to 2.09 mg day(-1) in Southeast Asia. The estimated percentage of individuals at risk of inadequate zinc intake ranged from 9.3-9.5% in the regions of North Africa & Eastern Mediterranean and USA & Canada to 33.1% in Southeast Asia. Overall, approximately 20.5% of the world's population is estimated to be at risk of inadequate zinc intake. Data on the absorbable zinc content of national food supplies can be used to determine whether further assessments of population zinc status and development of intervention programmes are warranted.     

Mediterranean Adequacy Index of Italian diets

OBJECTIVE: To assess, particularly in longitudinal studies, how close or far the food intakes of population groups are from a reference dietary pattern. DESIGN: Computation of an index, called the Mediterranean Adequacy Index (MAI), by dividing the sum of the percentage of total energy from typical Mediterranean food groups by the sum of the percentage of total energy from non-typical Mediterranean food groups. The reference Italian-Mediterranean diet utilised was that of subjects from Nicotera in 1960. SETTING: Different areas in Italy. SUBJECTS: Men aged 45-65 years at the start of the study from rural areas of Italy in the Seven Countries Study followed for 26 years (Crevalcore and Montegiorgio), elderly men and women from Perugia followed for 11 years, men and women from Pollica (Salerno) followed for 32 years, and families from Rofrano (Salerno) followed for 41 years. RESULTS: The median value of MAI among 40-59-year-old men from Nicotera in 1960 was 7.2; in Crevalcore it was 2.9 in 1965 and 2.2 in 1991; and in Montegiorgio, 5.6 in 1965 and 3.9 in 1991. In Pollica, the values in men ranged from 5.6 to 6.3 in 1967 and from 2.4 to 4.5 in 1999; for women, the corresponding ranges were 4.2-7.2 and 2.7-4.1. In elderly men of Perugia, median MAI value was 4.9 in 1976 and 3.2 in 1987; for women, the corresponding values were 3.1 and 2.6. CONCLUSIONS: The diet of these Italian population groups has changed over the last four decades, progressively abandoning the nutritional characteristics of the reference Italian-Mediterranean diet. The MAI proposed is simple to compute; it has satisfactory discriminating power particularly for longitudinal dietary data with only a few limitations.     

Food insecurity, malnutrition and mortality in Maewo and Ambae Islands, Vanuatu

CONTEXT: This paper reports on findings from the ex-post evaluation of the Maewo Capacity Building project in Maewo Island, Vanuatu, which was funded by World Vision Australia. OBJECTIVES: To examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security and health and nutritional outcomes in Maewo Island, using Ambae Island as a comparator. SETTING: Two-stage cluster survey conducted from 6 to 20 July 2004, which included anthropometric measures and 4.5-year retrospective mortality data collection. PARTICIPANTS: A total of 406 households in Maewo comprising 1623 people and 411 households in Ambae comprising 1799 people. MAIN OUTCOME MEASURES: Household food insecurity, crude mortality rate (CMR), under-five mortality rate (U5MR) and malnutrition prevalence among children. RESULTS: The prevalence of food insecurity without hunger was estimated at 15.3% (95% confidence interval (CI): 12.1, 19.2%) in Maewo versus 38.2% (95% CI: 33.6, 43.0%) in Ambae, while food insecurity with hunger in children did not vary by location. After controlling for the child's age and gender, children in Maewo had higher weight-for-age and height-for-age Z-scores than children of the same age in Ambae. The CMR was lower in Maewo (CMR = 0.47/10 000 per day, 95% CI: 0.39, 0.55) than in Ambae (CMR=0.59/10 000 per day, 95% CI: 0.51, 0.67) but no difference existed in U5MR. The major causes of death were similar in both locations, with frequently reported causes being malaria, acute respiratory infection and diarrhoeal disease. CONCLUSIONS: Project initiatives in Maewo Island have reduced the risks of mortality and malnutrition. Using a cross-sectional 'external control group' design, this paper demonstrates that it is possible to draw conclusions about project effectiveness where baseline data are incomplete or absent. Shifting from donor-driven evaluations to impact evaluations has greater learning value for the organisation, and greater value when reporting back to the beneficiaries about project impact and transformational development in their community. Public health nutritionists working in the field are well versed in the collection and interpretation of anthropometric data for evaluation of nutritional interventions such as emergency feeding programmes. These same skills can be used to conduct impact evaluations, even some time after project completion, and elucidate lessons to be learned and shared. These skills can also be applied more widely to projects which impact on the longer-term nutritional status of communities and their food security.     

Nutritional status of the Andean population of Puna and Quebrada of Humahuaca, Jujuy, Argentina

OBJECTIVE: To assess the nutritional status of the Andean population of Puna and Quebrada of Humahuaca, Jujuy, using anthropometric measurements. DESIGN AND SUBJECTS: A cross-sectional nutritional survey was carried out in a representative sample (n = 1236) of individuals from these regions. Children aged 2-9 years, adolescents (10-17 years) and adults (>or=18 years; pregnant and lactating women excluded) were considered. Height-for-age, weight-for-height and body mass index (BMI) were calculated in children and adolescents and compared with World Health Organization/National Center for Health Statistics/Centers for Disease Control and Prevention reference standards using Z-scores or percentiles, in order to assess the prevalence of stunting, wasting/thinness and excess weight. In adults, BMI, waist circumference (WC) and waist-to-hip (WHR) ratio were used to identify obesity and central adiposity. RESULTS: Stunting (height-for-age Z-score <-2 standard deviations) and obesity (BMI >or= 95th percentile) were found to be major nutritional problems in children and adolescents. Stunting was prevalent in 10.7% of children and 12.4% of adolescents; 8.2% of children and 3.5% of adolescents were obese. Adults were short (mean: 155.8 cm) and values of overweight (32.3%), obesity (18.3%) and central adiposity (mean WC: 86.5 cm) were high. Older adults and those with higher economic development showed higher prevalence of obesity and central adiposity. CONCLUSIONS: The present population may be at the early stages of nutritional transition as symptoms of undernutrition and overnutrition coexist at the population level. These results suggest that rates of growth retardation may be decreasing owing to improved nutritional conditions; however, this could be accompanied by a sharp increase in the prevalence of other diet-related chronic diseases.     

Food supplementation, nutritional intake of recipients and operational aspects: an integrated pilot nutrition initiative of BRAC

OBJECTIVES: To explore the nutritional quality of supplementary foods and additional energy consumption by the recipients in a pilot nutrition initiative of BRAC. DESIGN: In-depth interviews, observations during feeding at feeding centres, and laboratory analyses of supplementary foods for nutrient contents performed at the Institute of Nutrition and Food Science, University of Dhaka, Bangladesh. SETTING: Muktagacha thana (sub-district) in Mymensingh district, a rural area of Bangladesh. SUBJECTS: Pregnant and lactating mothers and children below 2 years of age. RESULTS: Analysis revealed that supplementary food, if taken completely, could provide daily energy equivalent to 752 kcal to a mother and 212 kcal to a child below 2 years of age. Mothers consumed about 75% of the food provided (approximately 564 kcal day(-1)). The food was shared mostly with young children and husbands. In-depth interview with mothers also suggested that they usually skipped breakfast if the food was given in the morning. The children liked the taste of food, and unless the child was sick or had some food before coming to the centre, she/he ate all the food provided. Although the main purpose of the project was to provide nutrition education, it was observed that activities at feeding centres were limited to food distribution with little time devoted to the communication of nutritional messages. CONCLUSIONS: Training should be given to service providers to communicate nutritional messages effectively as part of understanding the goal of the initiative. It is important to explore whether the regular diets of the recipients are replaced by the food supplementation or not.     

Concurrent comparison of energy intake and expenditure among adults in Butajira District, Ethiopia

OBJECTIVE: To estimate and compare dietary energy intake (DEI) and total energy expenditure (TEE) among adults, using questionnaires. DESIGN: Comparative, cross-sectional study. SETTING: Community-based, at the demographic surveillance site (DSS) in Butajira District of Ethiopia. SUBJECTS: A total of 619 adults, 18-64 years of age, were randomly selected from among the urban and rural population of Butajira using the DSS sampling frame. Habitual dietary intake and physical activity were assessed using questionnaires. BMR was estimated using a regression equation, and TEE was calculated from BMR and the metabolic energy equivalent task (MET) and duration of reported activities. Physical activity level (PAL) was calculated as TEE/BMR, while food intake level (FIL) was calculated as DEI/BMR. The mean DEI:TEE ratio was used to evaluate reported DEI at the population level, while individual misreporters were identified by applying the Goldberg cut-off points at three levels of PAL. RESULTS: Based on the Goldberg method, 57% of the study participants were identified as acceptable reporters of DEI, among whom mean TEE was 8.21 (95% CI 8.01, 8.42) MJ (1963 (95% CI 1914, 2012) kcal), mean DEI was 8.13 (95% CI 7.93, 8.34) MJ (1944 (95% CI 1895, 1993) kcal) and mean DEI:TEE was 1.01 (95% CI 0.99, 1.04). CONCLUSION: The dietary history and physical activity questionnaires provide comparable estimates of mean energy intake and expenditure at a population level. Acceptable reporters have to be identified in order to obtain better estimates. Questionnaire-based estimates of energy intake should not be interpreted without an inherent system of comparison or validation.     

REVIEW: Biofortification of Durum Wheat with Zinc and Iron

Micronutrient malnutrition affects over 2 billion people in the developing world. Iron (Fe) deficiency alone affects >47% of all preschool aged children globally, often leading to impaired physical growth, mental development, and learning capacity. Zinc (Zn) deficiency, like iron, is thought to affect billions of people, hampering growth and development, and destroying immune systems. In many micronutrient‐deficient regions, wheat is the dominant staple food making up >50% of the diet. Biofortification, or harnessing the powers of plant breeding to improve the nutritional quality of foods, is a new approach being used to improve the nutrient content of a variety of staple crops. Durum wheat in particular has been quite responsive to breeding for nutritional quality by making full use of the genetic diversity of Fe and Zn concentrations in wild and synthetic parents. Micronutrient concentration and genetic diversity has been well explored under the HarvestPlus biofortification research program, and very positive associations have been confirmed between grain concentrations of protein, Zn, and Fe. Yet some work remains to adequately explain genetic control and molecular mechanisms affecting the accumulation of Zn and Fe in grain. Further, evidence suggests that nitrogen (N) nutritional status of plants can have a positive impact on root uptake and the deposition of micronutrients in seed. Extensive research has been completed on the role of Zn fertilizers in increasing the Zn density of grain, suggesting that where fertilizers are available, making full use of Zn fertilizers can provide an immediate and effective option to increase grain Zn concentration, and productivity in particular, under soil conditions with severe Zn deficiency.     

Anaemia and vitamin A status among adolescent schoolboys in Dhaka City, Bangladesh

OBJECTIVES: To investigate the prevalence of anaemia and subclinical vitamin A deficiency among adolescent schoolboys in Dhaka City, Bangladesh, and to identify factors related to anaemia and vitamin A status.DESIGN: A cross-sectional study.SETTING: Government high schools in Dhaka City, Bangladesh.SUBJECTS AND METHODS: A total of 381 boys, aged 11-16 years, from 10 schools in Dhaka City participated in the study. Socio-economic, anthropometric and dietary data were collected. Haemoglobin and serum retinol (vitamin A) concentrations were determined.RESULTS: Seven per cent of the boys were anaemic and 22% had serum vitamin A levels below the adequate level of 1.05 micromol l(-1), with only 1.5% having subclinical vitamin A deficiency (<0.70 micromol l(-1)). Food frequency data revealed poor dietary habits. Multiple regression analysis showed that age, body mass index (BMI), parents' occupation, serum vitamin A level and frequency of intakes of meat and fruit were significantly independently related to haemoglobin level. The overall F-ratio (13.1) was highly significant (P<0.000) and the adjusted R(2) was 0.192. For serum vitamin A, BMI, father's education, per capita expenditure on food, haemoglobin concentration and frequency of intake of vitamin A-rich fruit were found to be significantly independently related. The overall F-ratio (14.5) was highly significant (P<0.000) and the adjusted R(2) was 0.186.CONCLUSION: The data show that adolescent schoolboys in Dhaka City have anaemia and inadequate vitamin A status, although the extent of the problems is lower than in other population groups in the country. Sociodemographic and dietary factors appear to have important relationships with anaemia and vitamin A status of these boys.     

Measuring dietary diversity in rural Burkina Faso: comparison of a 1-day and a 3-day dietary recall

OBJECTIVES: To compare dietary diversity scores measured over a 1-day and a 3-day period, and to assess their relationships with socio-economic characteristics and the nutritional status of rural African women. DESIGN: A qualitative dietary recall allowed calculation of a dietary diversity score (DDS; number of food groups consumed out of a total of nine). Body mass index (BMI) and body fat percentage (BFP) were used to assess the nutritional status of women. SETTING AND SUBJECTS: A representative sample of 550 mothers in north-east Burkina Faso. RESULTS: The DDS increased from 3.5 to 4.4 when calculated from a 1-day or a 3-day recall (P < 0.0001), although for the latter the DDS was affected by memory bias. The DDS calculated from a 1-day recall was higher when a market day occurred during the recall period. Both scores were linked to the sociodemographic and economic characteristics of the women. Women in the lowest DDS tertile calculated from the 1-day recall had a mean BMI of 20.5 kg m-(2) and 17.7% of them were underweight, versus 21.6 kg m (-2) and 3.5% for those in the highest tertile (P = 0.0003 and 0.0007, respectively). The DDS calculated from the 1-day recall was also linked to mean BFP; all these links remained significant after adjustment for confounders. For the 3-day period, no such relationships were found to be significant after adjustment. CONCLUSION: The DDS calculated from a 1-day dietary recall was sufficient to predict the women's nutritional status. In such a context attention should be paid to market days.