Authors:Kang Y; Kim H, Hossain M, et al. Abstract: ABSTRACTBackgroundReduced health and nutrition services as a result of coronavirus disease 2019 (COVID-19) measures endanger children's well-being. The Bangladesh Rajshahi Division of Maternal and Child Nutrition (BRDMCN; 2018–2020) involving social behavior change communication (SBCC) and an economic development (ED) of asset transfer was implemented.ObjectivesThis study describes how the implementation modality of the BRDMCN was adapted, and changes in the program's short/intermediate-term outcomes during the COVID-19 pandemic compared with pre-pandemic.MethodsThe following evaluation components were assessed: 1) program fidelity, 2) program reach, 3) program acceptance, 4) perceived influence of COVID-19, and 5) short-term outcomes over the 3 y. We compared the first 2 y (“pre–COVID-19,” from April 2018 through December 2019) and the final year (“during COVID-19,” from January to December 2020) for all components except for (3) and (4). Data were collected through multiple sources: reviews of program annual progress reports, monitoring records of SBCC and ED programs, and cohort surveys (n = 1094).ResultsThe percentage dose delivery of activities decreased from 66.7–118% at pre–COVID-19 to 0–90% during COVID-19. The SBCC programs were altered to reduce the frequency of activities as well as the number of participants per session. The ED program involving large group meetings was modified to include within-member meetings, individual visits of community facilitators, or virtual discussions. Production activity using received assets continued during the pandemic, with no significant reduction compared with pre–COVID-19. The percentage of children recovering from underweight after 30 d of a Positive deviance/Hearth (PD/Hearth) session, a component of the SBCC program, remained constant at 16.5–20.3 percentage points before and during the COVID-19 pandemic.ConclusionsProgram activities were scaled back and changed due to the pandemic. The BRDMCN maintained asset management and the degree of short-term outcomes over the course of a 3-y project. Further study is required to determine whether adaptive program management would achieve the long-term expected impact at a population level. PubDate: Fri, 13 May 2022 00:00:00 GMT DOI: 10.1093/cdn/nzac041 Issue No:Vol. 6, No. 5 (2022)
Authors:Popp C; Zhou B, Manigrasso M, et al. Abstract: AbstractBackgroundAccruing evidence indicates that accumulation of advanced glycation end products (AGEs) and activation of the receptor for AGEs (RAGE) play a significant role in obesity and type 2 diabetes. The concentrations of circulating RAGE isoforms, such as soluble RAGE (sRAGE), cleaved RAGE (cRAGE), and endogenous secretory RAGE (esRAGE), collectively sRAGE isoforms, may be implicit in weight loss and energy compensation resulting from caloric restriction.ObjectivesWe aimed to evaluate whether baseline concentrations of sRAGE isoforms predicted changes (∆) in body composition [fat mass (FM), fat-free mass (FFM)], resting energy expenditure (REE), and adaptive thermogenesis (AT) during weight loss.MethodsData were collected during a behavioral weight loss intervention in adults with obesity. At baseline and 3 mo, participants were assessed for body composition (bioelectrical impedance analysis) and REE (indirect calorimetry), and plasma was assayed for concentrations of sRAGE isoforms (sRAGE, esRAGE, cRAGE). AT was calculated using various mathematical models that included measured and predicted REE. A linear regression model that adjusted for age, sex, glycated hemoglobin (HbA1c), and randomization arm was used to test the associations between sRAGE isoforms and metabolic outcomes.ResultsParticipants (n = 41; 70% female; mean ± SD age: 57 ± 11 y; BMI: 38.7 ± 3.4 kg/m2) experienced modest and variable weight loss over 3 mo. Although baseline sRAGE isoforms did not predict changes in ∆FM or ∆FFM, all baseline sRAGE isoforms were positively associated with ∆REE at 3 mo. Baseline esRAGE was positively associated with AT in some, but not all, AT models. The association between sRAGE isoforms and energy expenditure was independent of HbA1c, suggesting that the relation was unrelated to glycemia.ConclusionsThis study demonstrates a novel link between RAGE and energy expenditure in human participants undergoing weight loss.This trial was registered at clinicaltrials.gov as NCT03336411. PubDate: Tue, 29 Mar 2022 00:00:00 GMT DOI: 10.1093/cdn/nzac046 Issue No:Vol. 6, No. 5 (2022)
Authors:Zivkovic A; Merchant E, Nyawir T, et al. Abstract: AbstractBackgroundOver 85% of Kibera's population, an informal settlement in Nairobi, Kenya, is food insecure. Nutrition-sensitive agriculture interventions, such as sack gardens, have the potential to diversify diets—in turn, improving household food security and diet quality. Furthermore, the sale of extra vegetables may provide an income for program participants.ObjectivesThe aim of this paper was to conduct a feasibility assessment and preliminary impact assessment of a nutrition-sensitive urban agriculture intervention that used sack gardens for women in Kibera.MethodsWomen, from a women's empowerment program, in Kibera (n = 36; n = 21 full program participants, n = 11 withdrawn, n = 4 new members) were engaged in a sack garden intervention in June 2018. A mixed-method approach was used to assess the feasibility and preliminary impact of the program. Qualitative semi-structured interviews (n = 25; n = 18 full program participants, n = 5 withdrawn, n = 2 new members), administered at the end of the pilot phase (March 2019), identified barriers and facilitators (e.g., preferences, inputs, group dynamics) to the production, consumption, and sale of self-produced vegetables. Quantitative surveys (n = 21 full program participants), administered in June 2018 and March 2019, were conducted to evaluate preliminary intervention impact on food security and diet quality through analysis of the Household Hunger Scale (HHS) and Minimum Dietary Diversity for Women (MDD-W).ResultsKey barriers included insufficient inputs and group work difficulties, particularly around communication. Facilitators included positive intervention feedback, social bonds and teamwork, participants’ self-sufficiency, and preference for sack garden vegetables over market vegetables. Post-intervention, participants reported reduced household food insecurity. Recommendations for program scale-up include investment in additional inputs, a water-collection/irrigation system, additional training, and placing sack gardens closer to women's homes to reduce time constraints.ConclusionsThis study suggests that sack gardens may provide partial solutions to improve diet quality; however, further research is needed to assess any impact on household income. PubDate: Tue, 29 Mar 2022 00:00:00 GMT DOI: 10.1093/cdn/nzac036 Issue No:Vol. 6, No. 5 (2022)
Authors:Manandhar S; Adhikari R, Acharya A, et al. Abstract: AbstractBackgroundNepal's female community health volunteers (FCHVs) each lead a monthly health mothers’ group (HMG) to share health-related information and engage communities in the health system. Suaahara II (SII), a US Agency for International Development–funded multisectoral nutrition program, uses social and behavior change interventions to promote HMG participation and uses its health systems interventions to strengthen HMG quality.ObjectivesThis study aimed to explore HMG functionality and variation across Nepal, including barriers and facilitators to attending HMG meetings.MethodsSII's cross-sectional annual survey data from 16 districts (n = 192 FCHVs and 1850 mothers with children <2 y) were used. Descriptive and logistic regression analyses were conducted where the outcome variable was whether mothers were active HMG members or not, with FCHV and maternal characteristics as explanatory variables. Qualitative data were obtained from 3 of 16 survey districts (n = 30 observations, n = 30 in-depth interviews with mothers, and n = 16 focus group discussions with mothers, family members, FCHVs, health workers, and SII staff).ResultsAmong FCHVs, 90% reported facilitating HMG meetings, whereas 64% of mothers reported HMG availability, and only 25% reported participating actively in meetings. Household head sex, maternal age, maternal education, maternal self-efficacy, and engagement with an FCHV and SII were associated with whether mothers were active participants in HMG meetings. Qualitative findings highlighted systems-level barriers, including lack of FCHV skills, demotivation, and heavy workload. Mothers noted time as the major constraint and family support, the HMG's savings component, and active FCHVs as facilitators to participation.ConclusionsFindings suggest that both supply- and demand-side solutions are needed to improve HMG performance and uptake in Nepal. These solutions need to include improving FCHV skills and motivating them to provide high-quality HMG services, as well as encouraging family members to support women so that they have time to participate in the HMGs. PubDate: Tue, 22 Mar 2022 00:00:00 GMT DOI: 10.1093/cdn/nzac039 Issue No:Vol. 6, No. 5 (2022)
Authors:Hoy M; Murayi T, Moshfegh A. Abstract: AbstractBackgroundDietary recommendations encourage consuming protein from a variety of plant and animal sources. Evaluating the diet of US adults by level of animal protein (AP) intake can inform dietary assessment and nutrition education.ObjectivesThe objective of this cross-sectional study was to estimate percentage of total protein intake from animal sources by US adults to compare diet quality, and intake from USDA Food Patterns (FP) groups by quintiles of AP.MethodsOne day dietary intake data from adults 20+ y (N = 9566) in What We Eat in America (WWEIA), NHANES 2015–2018 were used. Proportions of total protein intake from animal and plant sources and the USDA FP groups were estimated from the ingredients in the Food and Nutrient Database for Dietary Studies 2015–2018, then applied to the dietary intakes. The 2015 Healthy Eating Index (HEI) was used as an indicator of diet quality. The USDA FP groups were used to describe the contribution of animal and plant foods to total protein intake. Data were analyzed by quintile (Q) of AP protein intake; comparisons were made using pairwise t-tests with adjustments for covariates using survey sample weights. Results were considered significant at P <0.001.ResultsTotal mean protein intakes ranged from 62 (Q1) to 104 g (Q5) (all comparisons P <0.001). Total HEI score (possible 100) of Q1 was slightly higher (54.2) (P <0.001) compared with Q1–Q4 (range: 48.0–50.3), which did not differ significantly from each other. Contributions of plant FP components to total protein intake of Q1 to Q5, respectively, were 15% to 1% from nuts/seeds, legumes, and soy products combined; 35 to 10% from grains. The contribution of animal FP components were 19–66% from meat/poultry/seafood, 14–19% dairy, and 3–5% eggs.ConclusionsThe intake of foods considered to be good sources of plant protein was low. The overall diet quality of all adults was suboptimal regardless of plant protein intake. PubDate: Thu, 17 Mar 2022 00:00:00 GMT DOI: 10.1093/cdn/nzac035 Issue No:Vol. 6, No. 5 (2022)
Authors:Fahmida U; Pramesthi I, Kusuma S, et al. Abstract: AbstractBackgroundStunting and anemia in pregnant women and under-five children remain a challenge in developing countries, including Indonesia. One of the significant contributors to these problems is inadequate nutrient intake.ObjectivesThe aim of the study was to identify, using a linear programming (LP) approach, problem nutrients and optimized food-based recommendations for under-five children and pregnant women in 10 stunting-prioritized districts in Indonesia.MethodsLP analysis was done using the Optifood tool on dietary data collected using single 24-h dietary recall in the National Monitoring of Nutrient Consumption (Pemantauan Konsumsi Gizi), conducted by the Ministry of Health from 10 stunting-prioritized districts in Indonesia. Problem nutrients and nutrient-dense foods were identified, and all alternative food-based recommendations or complementary feeding recommendations were compared to identify which recommendation will best contribute to fulfill dietary adequacy.ResultsThe number of problem nutrients in each district ranged from 0 to 7 nutrients for under-five children and 1 to 6 nutrients for pregnant women. The top 3 problem nutrients were: iron, zinc, and folate (for children aged 6–11 mo); zinc, folate, and calcium (for 12–23-mo-olds and 24–35-mo-olds); folate, zinc, and vitamin C/riboflavin (for 36–59-mo-olds); and iron, folate, and calcium (for pregnant women). The findings showed that problem nutrients identified using LP were in line with nutritional problems in under-five children (stunting and anemia) and pregnant women (anemia). Food-based recommendations (FBRs)/complementary feeding recommendations were developed that best meet dietary adequacy for the nutrients.ConclusionsDespite the similarity in stunting prevalence across the districts, there was variation in number and types of problem nutrients. The developed FBRs that promoted nutrient-dense foods suited to the problem nutrients in each area need to be promoted to improve nutrient intakes of under-five children and pregnant women in these areas with high stunting prevalence. PubDate: Tue, 08 Mar 2022 00:00:00 GMT DOI: 10.1093/cdn/nzac028 Issue No:Vol. 6, No. 5 (2022)
Authors:Van Elswyk M; Teo L, Lau C, et al. Abstract: ABSTRACTThe purpose of this systematic review is to examine the relationship between dietary patterns and sarcopenia using a protocol developed for use by the 2020 Dietary Guidelines Advisory Committee, and to conduct a meta-analysis to summarize the evidence. Multiple electronic databases were searched for studies investigating sarcopenia risk factors or risk of sarcopenia and dietary patterns. Eligible studies were 1) peer-reviewed controlled trials or observational trials, 2) involving adult or older-adult human subjects who were healthy and/or at risk for chronic disease, 3) comparing the effect of consumption or adherence to dietary patterns (measured as an index/score, factor or cluster analysis; reduced rank regression; or a macronutrient distribution), and 4) reported on measures of skeletal muscle mass, muscle strength, muscle performance, and/or risk of sarcopenia. Thirty-eight publications met all inclusion criteria for qualitative synthesis. Thirteen observational studies met inclusion criteria for meta-analysis. Higher adherence to a healthy dietary pattern was associated with a decreased risk of gait speed reduction (OR = 0.58; 95% CI: 0.18, 0.97). The association between healthy dietary pattern adherence and other intermediate markers or risk of sarcopenia was not statistically significant. The majority of individual studies were judged as “serious” risk of bias and analysis of the collective evidence base was suggestive of publication bias. Studies suggest a significant association between healthy dietary patterns and maintenance of gait speed with age, an intermediate marker of sarcopenia risk, but the evidence base is limited by serious risk of bias, within and between studies. Further research is needed to understand the association between healthy dietary patterns and risk of sarcopenia. PubDate: Fri, 14 Jan 2022 00:00:00 GMT DOI: 10.1093/cdn/nzac001 Issue No:Vol. 6, No. 5 (2022)
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