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Authors:Olutayo Adeyemi, Victor Adejoh, Olufolakemi Anjorin, Oluwaseun Ariyo, Babatunde Makanjuola, Mawuli Sablah, Adeyinka Onabolu Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Achieving meaningful malnutrition reductions in Nigeria and other high-burden countries requires sustained improvements in diets, mediated through nutrition-sensitive agriculture and food systems. Yet, the capacity to design, plan, implement, and monitor such nutrition-sensitive systems is very limited, including within agricultural extension services delivery. Understanding existing capacity of actors required to implement nutrition change is crucial for effective capacity development.Objective:This study assessed the nutrition capacity of agriculture extension agents (AEAs) in Nigeria and the capacity of their organizations and the institutions within which they operate.Methods:The study assessed 31 extension training materials for inclusion of recommendations for nutrition-sensitive agriculture. Structured interviews and focus group discussions were conducted with 23 extension agents and were coded and analyzed for major themes.Results:Training materials hardly included nutrition objectives and or nutrition-related services to be delivered. Some nutrition-related services were being delivered, including promotion of biofortified crops and nutrient-dense crops and animals, home gardening, food safety, and dietary diversification. However, these services were limited, and service delivery was unstructured, nonuniform, and inconsistent. Numbers of AEAs are quite inadequate while available AEAs had high workloads, are poorly motivated, and had limited funding, supervision, and logistics capacity to perform roles. Physical security was also a challenge for service delivery. Further, complementary activities in other sectors that were necessary for adequate delivery of nutrition-sensitive agriculture did not always exist.Conclusion:Extensive development of nutrition capacities of extension agents appears unlikely to achieve nutrition-related changes if limiting institutional and organizational capacity deficits are not addressed.Plain Language Title:Capacity of Agriculture Extension Agents in Nigeria to Deliver Nutrition Services.Plain Language Summary:Reducing the significant burden of malnutrition in Nigeria requires increased availability and consumption of foods that are nutritious and free from harmful substances. To produce such foods, farmers need adequate nutrition and food safety knowledge and skills. The production of such food will also need to support nutrition in other ways, including increased women’s empowerment. Extension agents traditionally support farmers to adopt new methods of food production and/or processing that support increased food yields. These agents can also be used to deliver services that will address nutrition if they have the necessary knowledge and skills. This study assessed the capacity of agriculture extension agents in Nigeria to deliver nutrition services, in order to determine how to increase their capacity to deliver these services. The results from the study are that the extension agents do not have sufficient knowledge and skills to deliver nutrition services, and that their organizations and the wider context in which they work do not have the capacity to enable them to deliver nutrition services effectively. For instance, the organizations do not have sufficient numbers of staff and do not provide current staff with adequate means of transportation to visit farmers. Insecurity is high and so extension agents are unable to visit farmers frequently because of the potential threats to their lives. The study concludes that effectively using extension agents to deliver nutrition services will require not just training of the extension agents but also improvements in organizational capacity and contextual factors. Citation: Food and Nutrition Bulletin PubDate: 2023-03-22T10:20:08Z DOI: 10.1177/03795721231158417
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Abstract: Food and Nutrition Bulletin, Ahead of Print.
Citation: Food and Nutrition Bulletin PubDate: 2023-02-28T07:24:10Z DOI: 10.1177/03795721231161901
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Authors:Fikrewold H. Bitew, Corey S. Sparks, Samuel H. Nyarko, Lauren Apgar Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Stunting has been a major concern in sub-Saharan Africa. However, little evidence exists on the spatiotemporal variations in under-five stunting within a national context.Objective:This paper examines the spatiotemporal variations in under-five stunting and determinants using data from the Ethiopia Demographic and Health Surveys (2000-2016).Methods:Spatial autocorrelation and multilevel logistic regression models were used to conduct the analyses.Results:The stunting prevalence has decreased from 51% to 37%, while the prevalence of severe stunting has decreased by more than half (from 28% to 12%). Wide regional variations in stunting have been consistently observed over the years, which exhibited a higher level of stunting in Tigray (48%), Afar (42%), and Amhara (42%). The results show considerable local and regional variations in under-five stunting levels with diverse patterns of improvements in regional stunting levels over time. Stunting levels were associated with child-level factors such as the sex of a child, birth size, age of a child, birth order, preceding birth interval, and place of birth. Maternal educational attainment, nutritional status, household wealth, toilet facility type, and place of residence were linked to under-five stunting. The regional-level infant mortality rate was associated with under-five stunting.Conclusions:Specially tailored policies and interventions should be devised to address persistent spatial inequalities in stunting by focusing on higher risk populations. Citation: Food and Nutrition Bulletin PubDate: 2023-02-24T07:05:04Z DOI: 10.1177/03795721231158503
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Authors:Celia Basurko, Ophélie Dupart, Mathilde Savy, Camille Obert-Marby, Alexandra Mvogo, Adriana Gonzalez, Aude Trepont, Lisa Cann, Claire Boceno, Lindsay Osei, Pierre-Marie Creton, Valentin Dufit, Liliane Thelusme, Antoine Adenis, Astrid Van-Melle, Florence Huber, Mathieu Nacher Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:In French Guiana, restrictions to control the spread of SARS-CoV-2 were put in place between March 2020 and March 2022. In vulnerable urban neighborhoods, during this period, requests for food assistance increased and fear of hunger overtook fear of being affected by COVID-19.Objective:The objective of this survey was to describe food security during the COVID-19 pandemic in French Guiana and to study the relationship between the socioeconomic conditions of the study households and household hunger.Methods:A multicenter survey was therefore conducted in mobile clinics and fixed structures providing care to at-risk urban populations. In a face-to-face interview, a community health worker asked participants questions about the sociodemographic and economic profile of the household, and about household food security (food consumption score, coping strategies in the face of food shortages, and household hunger index). Two hundred and seventy-seven households were recruited in February 2021.Results:According to the household hunger scale, 42.6% of households experienced moderate hunger and 23.8% of households experienced severe hunger in the month preceding the survey. Lack of residence permit, lack of social support, water insecurity, small housing, and lack of access to an urban garden were determinants related to the risk of household hunger.Conclusions:Food insecurity have affected a large majority of the households in this survey, and the immediate consequences for children’s health were already apparent. These results draw attention to a neglected health problem in a socioeconomically vulnerable population during the COVID-19 pandemic. Citation: Food and Nutrition Bulletin PubDate: 2023-02-24T07:03:02Z DOI: 10.1177/03795721231156641
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Authors:Reshma P. Roshania, Amy Webb-Girard, Aritra Das, Rakesh Giri, G. Sai Mala, Sridhar Srikantiah, Melissa F. Young, Tanmay Mahapatra, Usha Ramakrishnan Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Circular migration is the dominant pattern of movement in India and is a livelihood strategy used by many food insecure rural households. Repeated shifts in food environments have important implications on household food security and dietary patterns but have not been studied.Objective:To explore differences in the food environment, food security, and food availability between home and destination spaces.Methods:Mixed-methods research was conducted among circular migrant families working and residing on brick kilns in the state of Bihar. Utilizing stratified cluster sampling, 2 rounds of cross-sectional data were collected from 2564 families. Additionally, 25 in-depth interviews were conducted with circular migrant parents, kiln owners, and labor contractors. The Food Insecurity Experience Scale was validated for use in our study population. Bivariate analyses were conducted to estimate the association of food insecurity with sociodemographic variables. Qualitative data were analyzed using descriptive thematic methods.Results:Seventy percent of respondents utilized at least one nonmarket source of food at the origin; at the destination, sources of food were limited to the private market. Despite higher food prices at the destination, perceived food affordability was higher during periods of migration, resulting in improved food security. Tubers, rice, and wheat were typically available in the household daily, whereas fruits, eggs, and dairy were typically unavailable during the week.Conclusions:Circular migration can enable short-term food security by improving food affordability. Policy frameworks must address the root causes of chronic food insecurity, especially among rural-to-rural circular migrant families. Citation: Food and Nutrition Bulletin PubDate: 2023-02-17T04:44:10Z DOI: 10.1177/03795721231152057
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Authors:Camila Elizandra Rossi, Maria Gabriela M. Pinho, Elizabeth Nappi Corrêa, Ângelo Horta de Abreu, Cassiano Ricardo Rech, Jorge Ricardo da Costa Ferreira, Francisco de Assis Guedes de Vasconcelos Abstract: Food and Nutrition Bulletin, Ahead of Print. Objective:To evaluate the association of a combined measure of availability and use of facilities from the food environment and overweight (including obesity) among schoolchildren, while taking into account the physical activity and social-assistance environments.Methods:Cross-sectional study with a probabilistic sample of schoolchildren aged 7 to 14 years living in a southern Brazilian city (n = 2026). Multilevel analyses were performed with overweight as outcome and the food environment as main exposure. Models were adjusted for the physical activity and social-assistance environments, as well as individual and other residential neighborhood characteristics.Results:Greater availability of restaurants around the home was associated with higher odds of overweight (odds ratio [OR] = 1.40; 95% CI = 1.06-1.85). Stronger associations were found for schoolchildren reporting to use restaurants (OR = 1.48; 95% CI = 1.15-1.90). This association remained significant after adjusting for the presence of other food retailers. Schoolchildren who had social-assistance facilities around their homes, but reported not to use them, showed consistently higher odds of being overweight (OR = 1.34; 95% CI = 1.01-1.78) as compared to schoolchildren who had these facilities near home and used them. The physical activity environment was not associated with the outcome.Conclusions:Availability and use of the food and social-assistance environments were significantly associated with overweight (including obesity) among the schoolchildren. Future research should consider the use of environmental facilities in combination to their geographical availability. Our results highlight the need for policies that limit the access to obesogenic food outlets by children and adolescents. Citation: Food and Nutrition Bulletin PubDate: 2023-01-05T07:28:58Z DOI: 10.1177/03795721221146215
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Authors:Corey O’Hara, Irwin H. Rosenberg, Barbara Bowman, Daniel Hoffman, Beatrice Lorge Rogers Pages: 379 - 380 Abstract: Food and Nutrition Bulletin, Volume 43, Issue 4, Page 379-380, December 2022.
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Authors:Ayodeji Ojo, Olutayo Adeyemi, Fisayomi Kayode, Olumide Oyebamiji, Adeyinka Onabolu, Audu Grema, Kristen MacNaughtan, Victor Ajierou Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Nigeria is a significant contributor to the global burden of chronic undernutrition in children under 5 years of age. The undernutrition challenge constrains the productivity of rural households. This study was carried out among beneficiaries of the productivity-enhancing Nigerian Dairy Development Programme (NDDP) to guide incorporation of nutrition into the successor program—Advancing Local Dairy Development in Nigeria (ALDDN). Therefore, this study contributes to the literature about operationalizing nutrition-sensitive agricultural frameworks.Objective:The study sought to determine potential entry points for improving the nutrition of smallholder dairy farmers (≤=5 milk cows) with a focus on food system entry points.Methods:Primary data were collected from 514 smallholder dairy households in Oyo and Kano states of Nigeria. Both quantitative and qualitative data were collected. Quantitative data collected included minimum dietary diversity for women, nutrition status, and socioeconomic characteristics of households. Qualitative data included information about sources of food, markets, and other food system characteristics. Quantitative data were analysed using descriptive statistical tools and correlation analysis, while common themes were identified from qualitative data.Conclusions:The study showcased men’s important role in food purchase and consumption, particularly in Kano. Increasing opportunities and the ability of women to use nutrition education appeared necessary for translating knowledge into improved practices. The own consumption (i.e., the portion of the milk kept for households’ consumption as well as diversification of foods produced for consumption); income; women’s empowerment; and environmental sanitation pathways seemed to be the most feasible pathways for improving nutrition within the context of the study population. Citation: Food and Nutrition Bulletin PubDate: 2022-12-06T08:45:33Z DOI: 10.1177/03795721221138396
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Authors:Jahdiel Kossou, Halimatou Alaofè, Waliou Amoussa Hounkpatin, Jaurès Lokonon Abstract: Food and Nutrition Bulletin, Ahead of Print. Background and Objective:The obesity epidemic among women in Africa is a health problem, and many studies attribute it to childbearing. However, most studies of postpartum weight retention (PPWR) occur in high-income countries. Therefore, this review sought to identify the potential factors affecting PPWR among African women.Methods:Four databases were searched from January 2000 to December 2020: Medline/PubMed, Google scholar, Ajol research, FreeFullPDF. The quality of included studies was assessed using the Newcastle Ottawa Scale.Results:Fifteen studies (5 from west, 4 from south, 3 from east, 2 from central, and 1 from north) were included: 8 cohort and 7 prospective cohort studies. Two studies examined the effect of obesity and weight gain during pregnancy on PPWR, 3 studies assessed the effect of childbirth, 4 examined the effect of breastfeeding, 4 assessed the impact of morbidities such as HIV, and 2 looked at food insecurity. Five studies demonstrated that postpartum weight is due to residual pregnancy weight gain and childbirth weight gain and is accentuated as parity increases (n = 2). Breastfeeding has a controversial effect, while morbidity (n = 4) and food insecurity (n = 4) contributed to weight loss. The variation in weight was also influenced by cultural practices (n = 1), prepregnancy weight (n = 1), and socioeconomic status (n = 1). On all domains, only 3 included studies were of good quality.Conclusions:Pregnancy weight gain, childbirth, breastfeeding, morbidity, and food insecurity were associated with PPWR. However, preexisting factors must be considered when developing PPWR modification strategies. In addition, due to the limited number of studies included, robust conclusions cannot be drawn. Citation: Food and Nutrition Bulletin PubDate: 2022-11-23T07:00:29Z DOI: 10.1177/03795721221134566
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Authors:Tobi Durotoye, Ike Ilegbune, Dominic Schofield, Victor Ajieroh, Oluchi Ezekannagha Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Sustaining large-scale and good-quality food fortification requires strategies that incentivize food processors to invest in and consistently meet national food fortification standards where they exist. A standardized Micronutrient Fortification Index (MFI) piloted in Nigeria has provided a ranking of fortified branded products for each participating company based on a score aggregating the effectiveness and efficiency of the company’s systems and levels of product fortification. The MFI has demonstrated the significance of brands as a focal point for investment and industry accountability in food fortification and the power of harnessing the competitive nature of businesses to drive their food fortification performance.Results:The initiative started with a pilot consisting of well-known brands of 4 companies and has since expanded participation to 15 companies, representing 31 brands, having completed the first entire ranking cycle. The publicly listed brands on the Index now cover approximately 80% of the flour milling market, 40% of the edible oils market, and 88% of the sugar market in Nigeria, reaching over an estimated 134 million people in the country in 2022 (Based on analysis by TechnoServe Supporting African Processors of Fortified Foods [SAPFF] program in Nigeria. Underlying information as supplied by industry participants.). The data inputs are made through company-owned digital portals, and the results are published on a secure, web-based public portal which also serves as a gateway for stakeholders to access related information on micronutrient fortification and food quality (https://technoserve-mfi.web.app/). The ultimate aim of the MFI is to serve as a leverage for private sector efforts to both digitalize quality assurance and business processes linked to industrial automation and to harness their competitiveness through voluntary participation in the Index to drive improved food fortification performance based on industry best practices and quality benchmarks. Citation: Food and Nutrition Bulletin PubDate: 2022-11-09T11:30:56Z DOI: 10.1177/03795721221132610
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Authors:Tobi Durotoye, Rizwan Yusufali, Victor Ajieroh, Oluchi Ezekannagha Abstract: Food and Nutrition Bulletin, Ahead of Print. The private sector is a critical partner in achieving the universally adopted Sustainable Development Goals (SDGs)—UNDP 2022. As part of a national strategy to address malnutrition (SDG2), Large-Scale Food Fortification of commonly consumed staple foods and condiments with vitamins and minerals is a proven intervention that requires the concerted engagement of multiple actors in a country’s agri-food and public health ecosystems. Lessons from TechnoServe’s Strengthening African Processors of Fortified Foods (SAPFF) Program, implemented from 2016 to 2022 in Kenya, Nigeria, and Tanzania with support from the Bill and Melinda Gates Foundation, provide essential learnings about how to effectively engage, motivate, and improve the food fortification performance of the industry in compliance with national standards, through capacity building, responsive technical assistance, and multistakeholder engagement that builds trust and accountability of industry in the fight against malnutrition. Citation: Food and Nutrition Bulletin PubDate: 2022-10-12T05:09:12Z DOI: 10.1177/03795721221123699
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Authors:Olutayo Adeyemi, Olapeju Phorbee, Folake Samuel, Rasaki Sanusi, Wasiu Afolabi, Namukolo Covic, Adeyinka Onabolu, Victor Ajieroh Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:In response to calls to increase nutrition-sensitive agriculture (NSA), the Federal Ministry of Agriculture and Rural Development developed the Nigeria Agricultural Sector Food Security and Nutrition Strategy 2016-2025 (AFSNS). Capacity development activities to facilitate the AFSNS implementation subsequently commenced.Objective:This study analyzed the processes and outputs of initial capacity development efforts, examined findings from the analysis using existing literature, and identified critical next steps for nutrition capacity development in the Nigerian agriculture sector.Methods:The study reviewed documents including a proposal for nutrition training of agriculture sector actors, reports of meetings held among 6 resource persons who designed and/or delivered training, training reports, participants’ pre- and posttraining assessments, and participants’ training evaluation. Interviews were conducted with 2 resource persons involved in training design and delivery. Documents and interviews were coded and analyzed to identify emergent themes. Participants’ pre- and posttests results were compared using paired t test in Stata 12.0.Results:Knowledge and practice gaps were more extensive than had been anticipated. Training had some but limited effects on knowledge scores at the federal level. Modules addressing implementation practices had to be scaled down for participants to keep up with the learning pace. Existing literature indicates that such training would have been better planned as part of a broader sectoral nutrition workforce strategy, to facilitate greater tailoring of training to participants’ job roles.Conclusion:Effective AFSNS implementation requires developing and operationalizing a comprehensive short-, medium- and long-term Agriculture Sector Nutrition Capacity Development Strategy for Nigeria. Citation: Food and Nutrition Bulletin PubDate: 2022-09-21T04:48:56Z DOI: 10.1177/03795721221123870
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Authors:Olutayo Adeyemi, Victor Ajieroh, Larry Umunna, Francis Aminu, Adeyinka Onabolu Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Renewed efforts by the Nigerian government to address malnutrition have led to nutrition actions by several sectors, including the agriculture sector. However, the success of these actions depends on the characteristics of the stakeholders involved, including their relationships and coordination.Objective:This article reports a 2015 study of nutrition-sensitive agricultural stakeholders in Nigeria that assessed what the stakeholders do, where they work and how they are organized to improve nutrition. The study provides a baseline for assessing progress and measuring stakeholder and coordination changes in the Nigerian nutrition-sensitive agriculture landscape.Methods:Semi-structured interviews (n = 17) and focus group discussions (n = 2) were held with federal, state, and local government level stakeholders; reviews of stakeholder program documents were also conducted.Results:The study identified 7 groups of nutrition-sensitive agriculture stakeholders and several coordination challenges. Political leadership, advocacy and provision of material and human resource support by nongovernmental organizations, and donor interest and funding have been vital for mobilizing nutrition-sensitive agriculture. Still, although stakeholders frequently highlighted that nutrition was an important consideration in their interventions, nutrition goals and activities and/or indicators to measure outcomes were not regularly communicated. Also, while coordination mechanisms existed, there appeared to be minimal actual cross-sectoral partnerships because of inadequate trust, competition, and conflicts over institutional turf and mandates.Conclusions:Needed enablers for improving nutrition-sensitive agriculture in Nigeria included improved stakeholder nutrition literacy, as well as enhanced stakeholder engagement facilitated by role definition, clarification, and consensus. Exploring different approaches to coordination may also be necessary. Citation: Food and Nutrition Bulletin PubDate: 2022-09-01T07:00:45Z DOI: 10.1177/03795721221119249
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Authors:Ekin Birol, Jennifer Foley, Caitlin Herrington, Rewa Misra, Bho Mudyahoto, Wolfgang Pfeiffer, Michael Tedla Diressie, Paul Ilona Abstract: Food and Nutrition Bulletin, Ahead of Print. This article presents the evolution of the biofortification program in Nigeria over the last decade and the role of interdisciplinary research in informing cost-effective, efficient, and inclusive development; implementation; and scaling of this program. Launched in 2011 to improve Nigeria’s food systems to deliver accessible and affordable nutrients through commonly consumed staples, the Nigeria biofortification program was implemented through an effective partnership between the CGIAR and public, private, and civil society sectors at federal, state, and local levels. By the end of 2021, several biofortified varieties of Nigeria’s 2 main staples, namely cassava and maize, were officially released for production by smallholders, with several biofortified varieties of other key staples (including pearl millet, rice, and sorghum) either under testing or in the release pipeline. In 2021, the program was estimated to benefit 13 million Nigerians consuming biofortified cassava and maize varieties. The evidence on the nutritional impact, consumer and farmer acceptance, and cost-effective scalability of biofortified crops documented by the program resulted in the integration of biofortified crops in several key national public policies and social protection programs; private seed and food company products/investments, as well as in humanitarian aid. Citation: Food and Nutrition Bulletin PubDate: 2022-08-26T05:20:26Z DOI: 10.1177/03795721221117361
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Authors:Daniel J. Hoffman, Ismail Kassim, Biram Ndiaye, Mark E. McGovern, Huyen Le, Kiross Tefera Abebe, Mohamed Ag Ayoya First page: 381 Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:South Sudan has experienced ongoing civil and environmental problems since gaining independence in 2011 that may influence childhood nutritional status.Objective:To estimate the prevalence of undernutrition among children in South Sudan in 2018 and 2019 compared to the prevalence in 2010.Methods:Data on height and weight were collected using a 2-stage stratified sample framework in which households were randomly selected at the county level and nutritional status was calculated for all children under 5 years of age to determine height-for-age, weight-for-height, and weight-for-age Z-scores (HAZ, WHZ, and WAZ) and the prevalence of stunting, wasting, and underweight. Linear and logistic regression analyses were used to determine factors associated with nutritional status and the odds ratio for nutritional outcomes.Results:In 2010, the mean HAZ, WHZ, and WAZ was −0.78, −0.82, and −1.15, respectively, and the prevalence of stunting, wasting, and underweight was 30%, 23%, and 32%, respectively. In 2018 and 2019, the mean HAZ, WHZ, and WAZ was −0.50, −0.70, −0.77 and −0.53, −0.77, −0.76, respectively. The prevalence of stunting, wasting, and underweight in 2018 and 2019 was 17%, 14%, 15% and 16%, 16%, 17%, respectively. Age was negatively associated with all nutritional indices and girls had higher HAZ, WHZ, and WAZ and a lower mid upper arm circumference (P < .01) compared to boys. The risk of poor nutritional outcomes was associated with vaccine status and varied by state of residence.Conclusions:Following independence in 2010, the prevalence of undernutrition in South Sudan decreased, but the risk for undernutrition varied by state and efforts to address food security and health need to ensure equitable access for all children in South Sudan. Citation: Food and Nutrition Bulletin PubDate: 2022-10-17T07:54:51Z DOI: 10.1177/03795721221128126
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Authors:Ibukun Owoputi, Nola Booth, Isaac Luginaah, Hanson Nyantakyi-Frimpong, Lizzie Shumba, Laifolo Dakishoni, Esther Lupafya, Catherine Hickey, Rachel Bezner Kerr First page: 395 Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Agroecological methods have the potential to impact nutrition and food security, however, to date there is limited research evaluating this approach.Objective:A 5-year participatory research project with farming households in north and central Malawi was designed to train farmers on agroecological practices, alongside raising awareness on nutrition and gender equity. This cross-sectional study aimed to explore the relationships between crop diversity, food security at the household level, and individual diversity for women, within the context of an agroecology, nutrition education, and farmer mentoring program.Methods:Participating farmers were trained in and experimented with different farming methods. These farmers subsequently trained other farmers on these short-term agroecological practices and provided mentorship using community-based educational methods designed to address both household food security and nutrition. In year 4 of the intervention, a cross-sectional survey assessed farm practices, food security, and individual dietary diversity of 851 participating households.Results:Households with lower crop diversity were significantly less likely to be food secure (odds ratios [OR] = 0.829, P < .001). Women in households with higher crop diversity were more likely to have higher individual dietary diversity (OR = 1.120, P < .01), eat vitamin A rich foods (OR = 1.176, P < .01), and legumes, nuts, and seeds (OR = 1.141, P < .01).Conclusions:These findings suggest that within a participatory agroecological training combined with community-based nutrition education with a focus on social equity, crop diversity is associated with less household food insecurity and poorer diet quality for rural farming households. Crop diversity may improve dietary diversity by making nutritious foods more available. Citation: Food and Nutrition Bulletin PubDate: 2022-09-28T12:07:39Z DOI: 10.1177/03795721221126787
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Authors:Shiva Bhandari, Edward A. Frongillo, Rojee Suwal, Pepijn Schreinemachers, Aman Sen Gupta, Christine E. Blake, Narayan Prasad Tiwari, Kenda Cunningham First page: 412 Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:In homestead food production (HFP) programs, village model farmers (VMFs), after training, implement agriculture and nutrition activities to improve household knowledge and practices. Little evidence exists on what enables VMFs to remain actively engaged and for impacts to be sustained.Objective:To examine variables explaining active engagement of VMFs, at least 4 years post-training, in an HFP program in Nepal.Methods:We used cross-sectional data, collected from 2018 to 2019, among 4750 VMFs of Suaahara, a multisectoral nutrition program. We assessed whether respondents registered their HFP group with the local government, conducted regular group meetings, discussed vegetable growing and chicken rearing practices with group members, or engaged in saving and credit activities in their HFP group. Outcome variable was a count of these 4 activities in which the VMF engaged. Socioeconomic, demographic, and programmatic explanatory variables were identified a priori and by bivariate analysis and were adjusted in ordinal regression models accounting for clusters.Results:On average, VMFs engaged in 1.4 activities. Having attended primary or secondary school (adjusted odds ratios [AOR] = 1.39), being a female community health volunteer (AOR = 1.27), being from an advantaged caste/ethnic group (AOR = 1.34), receiving additional trainings (AOR = 1.56) and inputs (AOR = 1.31) were associated with more active engagement of VMFs.Conclusion:Village model farmers receiving more training and inputs were more likely to remain actively engaged. Female community health workers, people from higher caste/ethnic groups, and those with primary or secondary education were more likely to remain active VMFs and could be targeted for this role in HFP programs leading to sustained impact. Citation: Food and Nutrition Bulletin PubDate: 2022-06-21T05:40:16Z DOI: 10.1177/03795721221106588
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Authors:Nurun Nahar Naila, Subhasish Das, Afsana Mim Khandaker, Rahvia Alam, Jamie Westcott, Julie Long, Nancy F. Krebs, M. Munirul Islam, Tahmeed Ahmed First page: 429 Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Fortification of rice with slaked lime is an acceptable and inexpensive way to combat calcium (Ca) deficiency. However, bioavailability of calcium after intake of slaked lime fortified rice is yet to be investigated.Objective:To measure the fractional absorption of Ca (FAC) from slaked lime fortified cooked rice.Design:We conducted an experimental study using stable isotopes of Ca to measure FAC during a single morning test meal containing rice fortified with slaked lime. Participants (n = 22) were given slaked lime fortified rice 3 times a day for 4 days. On the morning of the fifth day, the participants were served the same amount of rice as previous the 4 days at the breakfast test meal with an accurately measured amount of 44Ca stable isotope oral tracer followed by an intravenous injection of 42Ca. Urine was collected over the next 24 hours in 3 consecutive 8-hour pools. Fractional absorption of Ca was calculated from the measurement of the relative enrichment of the of each administered tracer 44Ca and 42Ca using inductively coupled plasma mass spectrometry.Results:The mean Ca concentration in the test meal was 879.5 ± 152.9 µg/g with a coefficient of variance (CV) of 17.2%. Although Ca absorption efficiency decreases with higher calcium intake, the total amount of calcium absorbed from test meal using FAC = 0.391 calculated from the third 8-hour urine pool was 69.0 (CV of 15.6) mg.Conclusions:We showed that one-fifth of daily calcium recommendation for women of reproductive age could be met by ingesting ∼200 g cooked slake fortified rice. Citation: Food and Nutrition Bulletin PubDate: 2022-09-28T07:09:09Z DOI: 10.1177/03795721221117624
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Authors:M. Margaret Weigel, Rodrigo X. Armijos First page: 439 Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Schools can play an important role in promoting healthy child diet and body weight. However, this issue is understudied in Latin American and other populations undergoing nutrition and epidemiologic transition.Objectives:2018 Ecuadorian National Health and Nutrition Survey data were used to examine the association of school food sources with healthy and unhealthy food intake and body mass index (BMI) in primary (n = 12,632) and secondary students (n = 6617).Methods:Data on school food environment characteristics were collected by questionnaire, intakes of fruits, vegetables, plain water, sweetened beverages, processed snacks, and fast foods by food frequency questionnaire, and BMI using measured weight and height. Data were analyzed using multivariable methods.Results:The major school food sources were competitive foods sold by commercial outlets (73%), School Breakfast Program (SBP; 52%), and home-packed items (37%). Most (69%) competitive food outlets sold fruits and vegetables but only 44% offered free clean drinking water and 60% sold prohibited “red traffic light” foods. Primary and secondary students who bought competitive foods consumed sweetened beverages, processed snacks, and fast food more frequently than nonpurchasers (P = .0001). Those who packed home foods had higher fruit and vegetable intakes (P = .0001). Plain water intakes were reduced among all SBP participants (P = .0001). However, primary students in the SBP consumed fast foods less frequently (P = .0001) and had lower average BMI and odds for being obese compared to nonparticipants (P = .0001).Conclusion:The findings from this nationally representative study underscore the important contribution of the school food environment to child nutrition. Citation: Food and Nutrition Bulletin PubDate: 2022-08-22T05:16:35Z DOI: 10.1177/03795721221116447
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Authors:Md Ridwan Islam, Shah Mohammad Fahim, Md. Golam Rasul, Mohammad Jyoti Raihan, Nafi Mohammad Ali, Md Mofijul Islam Bulbul, Tahmeed Ahmed First page: 465 Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Severe acute malnutrition (SAM) contributes to a substantial number of child deaths globally per year. The mortality rates can be lowered markedly if guideline-based management protocol is properly followed. However, case-fatality rates in resource-poor centers remain high even after introducing the guidelines. Perhaps, the lack of adequate knowledge leading to inappropriate management by the health care providers is responsible for such burden.Objective:We aimed to evaluate health care providers’ knowledge, attitude, and practice regarding the facility-based management of children with SAM in Bangladesh.Methods:This was a qualitative study where data were collected cross-sectionally from 4 district and 2 tertiary care hospitals. Twenty-six semi-structured in-depth interviews were conducted among the doctors and nurses involved in inpatient care of SAM. Twenty-eight hours of observation were done in each facility to obtain information regarding the management practices.Results:The doctors had substantial knowledge in managing children with SAM in the facilities. However, knowledge of nurses was found suboptimal when evaluated based on the national guideline. Both doctors and nurses demonstrated favorable attitude toward management of childhood SAM. Identification of SAM at the facilities was poor due to lack of practice in relation to anthropometric measurements. In addition, improper practices related to blood glucose testing, dehydration monitoring, essential micronutrient administration, and follow-up of children with SAM were observed.Conclusion:The study results underscore the importance of taking appropriate measures to enhance knowledge and ensure proper practice in relation to inpatient care of children with SAM according to the national guideline in Bangladesh. Citation: Food and Nutrition Bulletin PubDate: 2022-08-19T05:51:22Z DOI: 10.1177/03795721221116710
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Authors:Astrid Mathiassen, Margarita Lovon, Barbara Baille, Kathryn Ogden, Susanna Sandström First page: 479 Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Information on food consumption, dietary diversity, and nutrient inadequacies are key for informing food security and nutrition programming. Household- and individual-level data together provide the most complete information, but individual dietary modules are not always feasible in humanitarian contexts due to cost and time constraints.Objective:This article asks to what extent it is possible to use food consumption data which is commonly collected at household level through food security and vulnerability surveys, to assess the household’s access to vitamin A and iron.Methods:The validation analysis uses household food consumption and expenditure surveys from Guatemala, Honduras, Nepal, and Uganda and the adult male equivalent approach for calculating nutrient access.Results:The results show a positive significant correlation between the frequency of consumption and adequacy as estimated from comprehensive household food consumption modules, with correlation in the range of 0.4 to 0.7. Frequency thresholds for distinguishing between adequate and inadequate nutrient access, based on how often foods rich in the relevant nutrient are eaten during 1 week, mostly fulfill standard sensitivity and specificity criteria.Conclusions:The article concludes that in humanitarian contexts, a frequency-based proxy for nutrient access based on household data commonly collected in emergency assessments and through monitoring systems can be used and can support this particular data gap. As a rule of thumb, a frequency threshold of 7 should be used for vitamin A and of 12 for iron. Citation: Food and Nutrition Bulletin PubDate: 2022-10-12T05:12:33Z DOI: 10.1177/0379572121989219
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Authors:Agize Asfaw, Dessalegn Tamiru, Tefera Belachew First page: 500 Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Ethiopian government was implementing mandatory salt iodization program for the last decade to eliminate iodine deficiency disorders, but several recent studies reported a mixed findings.Objective:This review aimed to assess the difference in implementation of iodized salt program 10 years before and after mandatory salt iodization being implemented in Ethiopia since 2011.Methods:In Ethiopia, legislation that enforces salt producers to iodize all salts used for human consumption started in February, 2011. All studies about iodine deficiency and iodized salt conducted in Ethiopia in the last 2 decades were searched. Searches were performed in PubMed database. Google Scholar, Iodine Global Network, and Ethiopian Public Health Institute websites were also searched.Results:A total of 235 titles and abstracts were identified. After scanning the abstracts and full papers, 43 articles were remained for final data synthesis. In this review, all studies conducted before 2011 reported a urinary iodine concentration (UIC) value of 30%. On the other hand, among studies conducted after 2011, 88.9% reported UIC value 30%. Household availability of adequately iodized salt increased from nearly 20% in pre 2011 to more than 50% in post 2011 period.Conclusion:Despite the efforts made by the Ethiopian government on mandatory salt iodization for the last decade, iodine deficiency is sustained in the country. Moreover, the goal of universal salt iodization program is offtrack and needs urgent revision.Registration:Registered on PROSPERO register with reg. no CRD42021251124. Citation: Food and Nutrition Bulletin PubDate: 2022-07-29T07:00:49Z DOI: 10.1177/03795721221114523
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