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  • Association between delivery methods for enteral nutrition and physical status among older adults
    BMC Nutr. (IF 0) Pub Date : 2020-01-14
    Tetsuro Hayashi; Masato Matsushima; Hidetaka Wakabayashi; Seiji Bito

    The physical status of patients who received enteral nutrition is still unclear. We aimed to compare the physical functional status among older adult patients who underwent percutaneous endoscopic gastrostomy (PEG) and those with nasogastric feeding. We conducted a retrospective cohort study in an acute care hospital from August 1, 2009 to March 31, 2015. We included older adult patients (age ≥ 65 years) who were administered PEG or nasogastric feeding during hospitalization and received enteral nutrition for ≥14 days. We excluded patients who were completely bedridden at the administration of enteral nutrition. The primary outcome was death or becoming bedridden at discharge. The incidence of being bedridden among the patients who survived and received enteral nutrition at discharge was also compared according to the enteral nutrition method used. Among the 181 patients who were administered enteral nutrition during hospitalization, 40 patients (22%) died and 66 patients (36%) were bedridden at discharge. The proportions of patients who fully resumed oral intake were 30% in the nasogastric group and 2.3% in the PEG group. The adjusted odds ratios comparing PEG feeding to nasogastric feeding were 0.38 (95% CI, 0.16–0.93) for death or being bedridden and 0.09 (95% CI, 0.02–0.40) for being bedridden among the patients who were receiving enteral nutrition at discharge. Among older adult patients who were administered enteral nutrition, more than half of these patients died or became bedridden. PEG feeding could be associated with a lower risk of becoming bedridden or death in comparison with nasogastric feeding, although PEG feeding may be offered to the most mobile/ambulatory patients within clinical decision-making. Clinicians should carefully consider the administration and choice of enteral nutrition methods, when considering the prognosis of the patients.

    更新日期:2020-01-14
  • Breakfast consumption habits of Australian men participating in the “Typical Aussie Bloke” study
    BMC Nutr. (IF 0) Pub Date : 2020-01-07
    Angelica Quatela; Amanda Patterson; Robin Callister; Lesley MacDonald-Wicks

    Breakfast is often regarded as “the most important meal of the day” but there is limited reporting of the foods/beverages currently constituting a typical breakfast. This study investigated current breakfast habits of Australian men. Men aged 18-44y were recruited from metropolitan and regional NSW Australia and completed an online survey investigating breakfast consumption habits and other lifestyle parameters including demographic characteristics and waking habits. 112 men participated. Most (83.5%) ate breakfast ≥5 times/week and consumed this meal before 8 am (84.0%). Breakfast for habitual breakfast eaters consisted of one or more of the following foods or beverages eaten ≥5 times/week: breakfast cereal (50.0%), milk for cereal (51.1%), fruit (28.7%), toast (13.8%), spreads (11.7%), yogurt (12.8%), and/or coffee (40.4%). Breakfast may also include the following foods 1–4 times/week: eggs (58.5%), bacon (30.9%), juice (19.1%), and/or tea (17.0%). A majority of Australian men younger than 45 years old were found to eat breakfast most days of the week. Cereal, milk and fruit were the most common foods consumed for breakfast. Breakfast is considered to be an important meal among health professionals and we found a majority of Australian men do eat breakfast regularly. Approximately half of the young men in the study reported consuming cereal and milk for breakfast most of the time, a breakfast option that is linked to higher daily wholegrain, fibre and micro-nutrient intakes.

    更新日期:2020-01-07
  • Relationship between ethanol consumption and TBL2 rs17145738 on LDL-C concentration in Japanese adults: a four season 3-day weighed diet record study
    BMC Nutr. (IF 0) Pub Date : 2019-12-19
    S. Akimoto; C. Goto; K. Kuriki

    LDL cholesterol (LDL-C) concentration is modified by dietary and genetic factors; however, little is known about the details of this relationship. Our aim was to investigate the associations taking into account dietary assessment methods, seasonal effects and missing values. Study subjects completed food frequency questionnaires (FFQ) and supplied 3-day weighed dietary records (WDRs) and blood samples in four seasons. Approximately 660,000 single nucleotide polymorphisms (SNPs) were measured. Candidate SNPs related to LDL-C concentration were systematically selected. Multiple imputation was applied for missing values. A total of 312 repeated measures data were used for analyses. After adjusting for season and subjects as fixed and random effects, effects of nutrient intake and SNPs on LDL-C concentration were assessed according to three dietary assessment methods: the FFQ and first and four season 3-day WDRs (4 s-3d WDRs). For LDL-C concentration, ethanol consumption derived from all three dietary assessment methods was consistently associated (P < 0.09 for all). Positive and negative relationships were consistently shown with rs651007 and rs1160985 in the first and four seasons; but the latter remained after adjusting for total dietary fiber intake derived from the FFQ and 4 s-3d WDRs (P < 0.05, excepting the first 3-day WDRs). rs599839 was negatively associated after cholesterol intakes derived from the first and 4 s-3d WDRs were considered (P < 0.05 and 0.07, respectively). Each rs17145738 and ethanol consumption based on the 4 s-3d WDRs was related to LDL-C concentration (P < 0.05). Seasonal variations of LDL-C concentration were observed only in summer. In contrast to nutrient intake, ethanol consumption was shown to be comprehensively related to LDL-C concentration, regardless of dietary assessment methods. Taking into account seasonal effects, critical relationships with LDL-C concentration for some SNPs, after adjustment for specific nutrients, were revealed. Our findings can be used to help to interpret the relationships between dietary and genetic factors on LDL-C concentration in large-scale epidemiological studies. (10/10 keywords)

    更新日期:2019-12-19
  • Mixed methods evaluation of an employer-led, free lunch initiative in Northern Ireland
    BMC Nutr. (IF 0) Pub Date : 2019-12-18
    Désirée Schliemann; Michelle C. McKinley; Jayne V. Woodside

    The objective of this study was to evaluate the acceptance of an employer-led free lunch initiative and its effect on health, diet, and attitudes towards health and diet amongst employees in a small workplace in Northern Ireland. This was a controlled, employer-led pilot intervention, which was evaluated through a mixed methods approach. Seventeen participants from the intervention site and 14 participants from the control site completed all assessments. Post-intervention, there was no difference in change in dietary measures between the sites, except for saturated fat intake during weekdays (IS: − 1.3% of calories, SD: 4.3; CS: 2.8% of calories, SD: 6.6; P-value < 0.05). Qualitative information was summarised to highlight employees’ expectations and experiences with the intervention. This study highlights the challenges that need to be considered when implementing a free lunch initiative for staff.

    更新日期:2019-12-18
  • Rationale, design, and methodology for the healthy mothers-healthy children study: a randomized controlled trial
    BMC Nutr. (IF 0) Pub Date : 2019-12-16
    Diane C. Berry; Cecilia Gonzales; Nilda Peragallo Montano; Krista M. Perreira; Alice S. Ammerman; Jaime Crandell; Kelly R. Evenson; Myles S. Faith; Hugh Waters; Crystal Linares; Yamnia I. Cόrtes; Eliana M. Perrin

    Hispanic women and children who become overweight or obese are at risk for developing prediabetes, type 2 diabetes, and cardiovascular disease later in life. Interdisciplinary interventions which target Hispanic women and their 3–5-year old children to improve nutrition and physical activity behaviors, manage adiposity and weight in mothers, and prevent excessive adiposity and weight gain trajectory in their children offer promise to break the intergenerational cycle. Using a randomized two-group, repeated measures experimental design, the goal of the proposed study is to investigate the efficacy of a 12-week nutrition and physical activity program including education, coping skills training, and home-based intervention in Hispanic women and their 3–5-year old children. The program includes 6 months of continued monthly contact to help overweight and obese Hispanic mothers and their children improve adiposity, weight (trajectory for children), health behaviors (nutrition and physical activity), and self-efficacy We will partner with two federally qualified health departments in Durham and Chatham counties, North Carolina to enroll participants. We will partner with community centers to deliver the intervention. A total of 294 Hispanic women with a BMI ≥ 25 kg/m2 and 294 Hispanic 3–5-year old children with a ≥ 25th BMI percentile will be enrolled over 4 years and randomized to the experimental or equal attention control group. Data will be collected at Time 1 (0 months [baseline]) to Time 2 (9 months [completion of the intervention]) and Time 1 to Time 3 (15 months [after 6 months with no contact from the study staff]). Data collected will include adiposity and weight in mothers and children (primary outcomes). Secondary outcomes will include health behaviors and self-efficacy in the mothers and in the children. We will also evaluate the cost of delivering the program for public health departments. We will use general linear mixed models to test the hypotheses. Decreasing overweight and obesity in Hispanic women and slowing adiposity and weight gain trajectory in young Hispanic children is urgently needed to decrease morbidity, mortality, and future health care costs. NCT03866902. (March 7, 2019).

    更新日期:2019-12-17
  • Infant and young child nutritional status and their caregivers’ feeding knowledge and hygiene practices in internally displaced person camps, Somalia
    BMC Nutr. (IF 0) Pub Date : 2019-12-17
    Mohamed Kalid; Fatumo Osman; Munshi Sulaiman; Fiona Dykes; Kerstin Erlandsson

    In an attempt to design an educational programme targeting caregivers of children aged 6 to 59 months in internally displaced persons camps in Somalia, the objective of this study was twofold. First, to explore the nutritional situation of all children aged 6–59 months enrolled in a nutrition programme provided by Save the Children in 2017 in internally displaced persons camps. Second, to identify gaps in the caregivers’ hygiene and feeding practices. In a study of 1655 households, 1655 caregivers for 2370 children aged 6 to 59 months enrolled in a nutrition programme provided by Save the Children answered an adapted questionnaire on hygiene and feeding practices. At the same time, based on standard criteria in the questionnaire, naturalistic observations of caregivers’ hygiene practices were conducted. Every child in the study was measured with anthropometric Mid-Upper-Arm Circumference measurements for the classification of Moderate Acute Malnutrition, Severe Acute Malnutrition and Global Acute Malnutrition. Descriptive statistics were used for analysis. 1) There was Severe (12.1%) and Global Acute (19.9%) Malnutrition among children included in the nutrition programme, more frequently in the 6–24 month age group compared to the 25–59 month age group (p < 0.01). 2). The practices in the households were below what could generally be considered hygienic. 3) There was poor caregivers’ knowledge of breastfeeding benefits and complementary foods. Child malnutrition might derive from gaps in the caregiver’s knowledge, attitudes, and practices regarding hygiene and infant feeding. An awareness of these gaps can be helpful in designing future educational programmes that target caregivers, particularly in at-risk population groups.

    更新日期:2019-12-17
  • Prevalence and associated factors of adolescent undernutrition in Ethiopia: a systematic review and meta-analysis
    BMC Nutr. (IF 0) Pub Date : 2019-12-09
    Kidanemaryam Berhe; Abadi Kidanemariam; Gebrehiwot Gebremariam; Alem Gebremariam

    In Ethiopia, there are different pocket studies that assessed adolescent undernutrition which came up with inconsistent and inconclusive findings. Therefore, estimating the pooled prevalence and associated factors of the adolescent undernutrition using meta-analysis is crucial in Ethiopia. A systematic review of eligible articles was conducted using preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A comprehensive searching of the literature was made in Pub Med, Scopus, Google, Google Scholar, Cochrane Library and CINAHL. The quality of the articles included in the review was assessed using the Newcastle-Ottawa Scale (NOS) for non-randomized studies in meta-analyses. The pooled prevalence and odds ratio of the associated factors with their 95% confidence interval was computed using STATA version 14 software. Twenty-two studies were included in the meta-analysis with a total of 17,854 adolescents. Using the random-effects model analysis, the pooled prevalence of stunting and underweight was 20.7% (95% CI: 16.08, 25.33) and 27.5% (95% CI: 17.9, 57.14), respectively. Rural residence, having family size≥5, households with an unprotected water source for drinking and food-insecure household were significant associated factors for adolescent stunting. Early adolescent age (10–14 years), family size≥5, food-insecure household, lack of latrine, WHO diet diversity score < 4, mother educational status (with no formal education) were significant associated factors for adolescent underweight. Adolescent undernutrition remains one of the most important public health problems in Ethiopia. Almost a quarter of Ethiopian adolescents were affected by stunting and underweight. Large family size, rural residence and unprotected source of drinking water were the associated factors for adolescent stunting. Similarly, large family size, early age of adolescent, lack of latrine, low dietary diversity score, mother illiteracy, and food insecure household were the associated factors for adolescent underweight. It would be good to give high emphasis on adolescent undernutrition and it is important to address the above mentioned associated factors during adolescent nutritional interventions in Ethiopia.

    更新日期:2019-12-09
  • Diet quality is associated with malnutrition and low calf circumference in Canadian long-term care residents
    BMC Nutr. (IF 0) Pub Date : 2019-12-09
    Natalie Carrier; Lita Villalon; Christina Lengyel; Susan E. Slaughter; Lisa Duizer; Jill Morrison-Koechl; Heather Keller

    Older adults living in long-term care (LTC) are nutritionally vulnerable. The purpose of this study was to determine diet quality of Canadian LTC residents and its association with malnutrition and low calf circumference. A cross-sectional study was undertaken in 32 LTC homes across four Canadian provinces. Nutrient adequacy ratios (NARs) were calculated for seventeen nutrients; mean adequacy ratio (MAR) was calculated to describe overall diet quality. Malnutrition risk was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF) and diagnosis of protein/energy malnutrition with the Patient-Generated Subjective Global Assessment (PG-SGA). Calf circumference (CC) was also assessed. Linear and logistic regressions for these outcomes with diet quality as the predictor were conducted adjusting for covariates. Average MNA-SF score was 10.7 ± 2.5. Residents (43.5%) had mild/moderate to severe malnutrition based on the PG-SGA and 32.6% had a CC of < 31 cm. Mean MAR score was 0.79 ± 0.09 with significant differences between those requiring eating assistance (0.77 ± 0.11) and those that did not require assistance (0.80 ± 0.07) (p < .05). MAR score was significantly associated with malnutrition in fully adjusted models: MNA-SF scores [β = 5.34, 95% Confidence interval (CI) (2.81, 7.85)] and PG-SGA [Odds ratio (OR) = 0.49, 95% CI (0.38, 0.64)]. Those who had better diet quality were more likely to be well nourished or not at risk. Although several individual nutrients were associated with low CC (< 31 cm), there was no association between overall diet quality (MAR) and low CC. Diet quality is associated with malnutrition and individual nutrients (NARs) with a low CC. In addition to calories and protein, nutrient dense diets that promote adequate micronutrient intake are required in LTC.

    更新日期:2019-12-09
  • Characterization, dietary habits and nutritional intake of omnivorous, lacto-ovo vegetarian and vegan runners – a pilot study
    BMC Nutr. (IF 0) Pub Date : 2019-12-03
    Josefine Nebl; Jan Philipp Schuchardt; Paulina Wasserfurth; Sven Haufe; Julian Eigendorf; Uwe Tegtbur; Andreas Hahn

    The number of people preferring plant-based nutrition is growing continuously in the western world. Vegetarianism and veganism are also becoming increasingly popular among individuals participating in sport. However, whether recreationally active vegetarian and vegan populations can meet their nutritional needs is not clear. The purpose of this cross-sectional study was to compare the nutrient intake of omnivorous (OMN, n = 27), lacto-ovo vegetarian (LOV, n = 25) and vegan (VEG, n = 27) recreational runners (two to five training sessions per week) with intake recommendations of the German, Austrian and Swiss Nutrition Societies (Deutsche, Österreichische und Schweizerische Gesellschaften für Ernährung, D-A-CH) for the general population. Lifestyle factors and supplement intake were examined via questionnaires; dietary habits and nutrient intake were determined based on 3-day dietary records. More than half of each group did not reach the recommended energy intake (OMN: 10.4, 8.70–12.1; LOV: 9.67, 8.55–10.8; VEG: 10.2, 9.12–11.3 MJ). Carbohydrate intake was slightly below the recommendations of > 50 EN% in OMN (46.7, 43.6–49.8 EN%), while LOV (49.4, 45.5–53.3 EN%) and VEG (55.2, 51.4–59.0 EN%) consumed adequate amounts (p = 0.003). The recommended protein intake of 0.8 g/kg body weight (D-A-CH) was exceeded in all three groups (OMN: 1.50, 1.27–1.66; LOV: 1.34, 1.09–1.56; VEG: 1.25; 1.07–1.42 g/kg BW; p = 0.047). Only VEG (26.3, 22.7–29.8 EN%) did not achieve the recommended fat intake of 30 EN%. The supply of micronutrients, such as vitamin D and cobalamin, was dependent on supplement intake. Additionally, female OMN and LOV achieved the recommended daily intake of 15 mg iron only after supplementation, while VEG consumed adequate amounts solely via food. All three groups were sufficiently supplied with most nutrients despite the exceptions mentioned above. The VEG group even showed advantages in nutrient intake (e.g. carbohydrates, fiber and iron) in comparison to the other groups. However, the demand for energy and several macro- and micronutrients might be higher for athletes. Thus, it is also necessary to analyze the endogenous status of nutrients to evaluate the influence of a vegetarian and vegan diet on the nutrient supply of athletes. German Clinical Trial Register (DRKS00012377), registered on April 28, 2017.

    更新日期:2019-12-03
  • Nutritional status and Cardiometabolic health among adolescents; findings from southwestern Nigeria
    BMC Nutr. (IF 0) Pub Date : 2019-12-02
    Adeleye Abiodun Adeomi; Iyanuoluwa Odunayo Adelusi; Praise Oluwatooni Adedeji; Adedoyin Esther Awofeso; Olajumoke Omotoyosi Oroleye; Doyinfunmi Lydia Gbadegesin

    Obesity has been associated with an increased risk for cardio-metabolic diseases. The prevalence of obesity among adolescents is increasing worldwide, including Nigeria, but only little data exist on the relationship of nutritional status with cardio-metabolic health among adolescents in Nigeria. This study therefore investigated the relationship of nutrition status, raised blood pressure, glucose intolerance and risk for metabolic diseases among adolescents in southwestern Nigeria. This was a cross-sectional study conducted among 313 in-school adolescents in Ile-Ife, southwestern Nigeria. The respondents were selected using multi-stage sampling technique, and data were collected using pre-tested structured questionnaires. Anthropometric, blood pressure and random blood glucose measurements were done using standard protocols. Nutritional assessment was done using the World Health Organization (WHO) 2007 reference. Pre-hypertension and hypertension were measured using percentiles for gender, age and height. Analysis was done using IBM SPSS and the level of significance was set at p ≤ 0.05. The mean age of the respondents was 14.4 ± 2.0 years. The prevalence of overweight and obesity was 10.2%, and it was significantly higher among females (12.5%) than males (7.0%). The prevalence of systolic and diastolic pre-hypertension was 10.9 and 11.5% respectively, while the prevalence for systolic and diastolic hypertension were 14.4 and 8.6% respectively. Using WHtR to assess cardio-metabolic risk, 7.3% of the respondents were at risk. There were statistically significant relationships between BMI, WHtR and blood pressure levels (< 0.05). The prevalence of overweight/obesity among the adolescents was relatively high, and this was significantly associated with elevated blood pressure and increased risk for cardio-metabolic diseases. There is need for more interest and intervention by stakeholders into the cardio-metabolic health of adolescents in Nigeria.

    更新日期:2019-12-02
  • A survey identifying nutritional needs in a contemporary adult cystic fibrosis cohort
    BMC Nutr. (IF 0) Pub Date : 2019-01-07
    Siddhartha G. Kapnadak; Kathleen J. Ramos; Andrea M. Lopriore; Christopher H. Goss; Moira L. Aitken

    Cystic fibrosis (CF) is a disease in which nutritional barriers are diverse and common, with malnutrition greatly influencing pulmonary trajectory and overall outcomes. Despite this, the most effective methods to optimize CF nutrition are unknown, and literature describing patients’ perspectives on their specific nutritional needs is lacking, particularly in the modern era of CF care. This study aimed to identify the most important nutritional needs and desired health-improvement resources in a contemporary adult CF cohort. A 14-question investigator-designed survey addressing nutrition concerns, preferred health-improvement resources, and dietary/exercise routines was administered to CF adults. Clinical characteristics and survey responses are presented with descriptive statistics, and responses compared by body mass index (BMI) category (< 18.5 kg/m2; 18.5–24.99 kg/m2; 25–29.99 kg/m2; ≥30 kg/m2), gender, and socioeconomic status using Chi square or Fisher’s Exact testing. Of 66 total patients, nine (13.6%) were underweight (BMI < 18.5 kg/m2), while 19 (28.8%) were overweight or obese (BMI ≥ 25 kg/m2). In the overall cohort, the most common primary concern was preventing weight loss [in 20/66 patients (30.3%)], but there were significant differences by BMI (p < 0.001), with the most common concern in the overweight subgroup being preventing weight gain. Fifteen (46.9%) men (BMI mean 20.7, range 16.4–29.2 kg/m2) listed preventing weight loss as the primary concern, compared to only 5 (14.7%) women (BMI mean 18.4, range 16.2–19.9 kg/m2), representing a trend toward a difference in primary concerns by gender (p = 0.066). The most commonly desired health-improvement resource was online CF nutrition and fitness information, found in 26 patients (39.4%) in the overall cohort, without significant differences by BMI (p = 0.814) or gender (p = 0.199). Financial assistance was the preferred resource in 17 (26.2%), without differences by socioeconomic status (p = 0.367). We identified a wide variety of nutritional needs in CF adults, including a high prevalence of overweight status, many patients desiring weight loss, and many seeking financial resources. Our findings support the individualization of modern-day CF nutrition programs and development of online resources, in an effort to address the heterogeneous barriers that exist in the contemporary CF population and improve outcomes in patients with the disease.

    更新日期:2019-11-28
  • Maternal knowledge and attitudes towards complementary feeding in relation to timing of its initiation in rural Bangladesh
    BMC Nutr. (IF 0) Pub Date : 2019-01-30
    Aatekah Owais; Parminder S. Suchdev; Benjamin Schwartz; David G. Kleinbaum; A. S. G. Faruque; Sumon K. Das; Aryeh D. Stein

    Initiation of complementary feeding is often delayed in Bangladesh and likely contributes to the high burden of infant undernutrition in the country. Pregnant women at 28–32 weeks’ gestation were recruited for a cohort-based evaluation of a community-based nutrition education program. To identify predictors of the timing of introduction of solid/semi-solid/soft foods (complementary feeding initiation), we prospectively interviewed 2078women (1042 from intervention area, 1036 from control area) at time of recruitment and at child age 3 and 9 mo. Maternal knowledge and attitudes towards complementary feeding, nutritional importance and cost of complementary foods were assessed at child age 3 months. Two scales were created from the sum of correct responses. Tertiles were created for analysis (Knowledge: 0–7, 8–9, 10–15; Attitudes: 18–25, 26, 27–34). Infant age at complementary feeding initiation was characterized as early (≤4 months), timely (5–6 months) or late (≥7 months), based on maternal recall at child age 9 mo. We used stratified polytomous logistic regression, adjusted for socioeconomic status, infant gender, maternal age, literacy and parity to identify predictors of early or late vs. timely complementary feeding initiation. Complementary feeding initiation was early for 7%, timely for 49%, and late for 44% of infants. Only 19% of mothers knew the WHO recommended age for complementary feeding initiation. The knowledge score was not associated with timely complementary feeding initiation. Mothers with the most favorable attitudes (highest attitudes score tertile) were more likely to initiate late complementary feeding compared to those with the lowest attitudes score tertile (adjusted OR = 2.2, 95% CI: 1.1–4.4). Late introduction of complementary foods is still widely prevalent in Bangladesh. Improved maternal knowledge or favorable attitudes towards complementary feeding were not associated with timely introduction of complementary foods, indicating other factors likely determine timing of complementary feeding initiation. This presents an avenue for future research.

    更新日期:2019-11-28
  • Prevalence of goiter and its associated factors among primary school children in Chole District, Arsi Zone, Ethiopia: a cross- sectional study
    BMC Nutr. (IF 0) Pub Date : 2019-02-01
    Abera Bekele; Takele Menna Adilo

    Goiter remains one of the major public health problems particularly among young children in economically disadvantaged countries like Ethiopia. The aim of the study was to assess the prevalence of goiter and its associated factors among children aged 6–12 years in Chole district, Arsi Zone, Eastern Ethiopia. A school based cross-sectional study was conducted in February, 2017 among 422 primary school children in Chole district, eastern Ethiopia. The schools and study subjects were randomly selected. A structured, pretested and interviewer- administered questionnaire was used to collect the required data. It was conducted after getting due consents from the school administration and assent from caregiver/parent. Spot testing kits were used to estimate the level of iodine in salts. Descriptive statistics, cross-tabulations for chi-square test, and bivariate and multivariate logistic regression models were used to show the magnitude of goiter and its associated factors. Odds ratios with 95% confidence intervals were computed to determine the presence and strengths of associations. From the 422 study participants, 407 (96.4%) completed the questionnaire. Of these 205(50.3%) were female. The mean age of participant school children was 9.87(SD ± 1.6) years. The prevalence of goiter among study subjects was 36.6% (95% CI, 31.6–40.8%). History of goiter in the family (AOR = 6.80; 95% CI: 3.34–13.84), cabbage consumption (AOR = 2.52; 95% CI: 1.38–4.60) and living with family in a single room (AOR = 2.30; 95% CI: 1.13–4.67) were positively associated with the development of goiter among primary school children in Chole district, eastern Ethiopia. But consuming milk (AOR =0.37; 95% CI: 0.23–0.59) was found to be negatively associated or protective against the development of goiter among the study subjects. Iodine deficiency was found to be significant public health problem in the study area. Consuming milk was found to be protective, whereas consuming goitrogenic foods like cabbage were found to be the risk factors for the development of goiter among school -aged children. Thus, ensuring the consumption of iodized salt and promoting iodine rich food items among the community in Chole district and other similar settings in Ethiopia are strongly recommended.

    更新日期:2019-11-28
  • Correction to: The impact of food reformulation on nutrient intakes and health, a systematic review of modelling studies
    BMC Nutr. (IF 0) Pub Date : 2019-02-04
    Carlo Federici; Patrick Detzel; Francesco Petracca; Livia Dainelli; Giovanni Fattore

    Abstract Following publication of the original article [1], the authors reported an error in Table 1.

    更新日期:2019-11-28
  • Correlation between physical activity, eating behavior and obesity among Sudanese medical students Sudan
    BMC Nutr. (IF 0) Pub Date : 2019-02-06
    Marwa Mohammed Yousif; Lamis AbdelGadir Kaddam; Humeda Suekit Humeda

    Obesity has emerged as a major health problem. Prevalence is increasing hugely. Various etiological factors had been identified as potential causes of obesity. There is an increasing need to study different determinants of obesity especially the physical activity and eating habits. Future doctors considered as role models in community. Doctor wellbeing’s does not just affect them it has robust impact on their surroundings. More knowledge about determinants of obesity among medical students may shed light concerning obesity prevention and control. Therefore, the aim of this study was to determine the relationships between physical activity, eating patterns, and obesity among medical students. This was a cross sectional study conducted among 216 medical students at Al-Neelain University selected by stratified random sampling. Data were collected by self-administered questionnaire, which included background data. International physical activity questionnaire (IPAQ) was used to determine physical activity level and the three factors eating questionnaire Revised 18 (TFEQ-r18) was used to determine eating behavior. Also, anthropometric measurements were performed for each participant. Data were analyzed using SPSS version 23 program. Descriptive data were presented as means ± SD and percentages. The relationships between BMI and physical activity levels and between BMI and eating pattern were analysed using non parametric test. P value < 0.05 was considered significant. . The prevalence of obesity among students was 6.5% and overweight was 22.2%. The study showed that 44.9% of medical students had low activity level while 32% of students had moderate activity level and 23.1% had high physical activity level. There was no significant relationship between physical activity and body mass index (BMI) in this study. The common eating pattern among students was controlled eating (45.8%). There was significant relationship between eating behaviors and BMI (P = 0.01). The study revealed eating habits has stronger impact on BMI than physical activity. Disturbing figures regarding overweight and low physical activity among medical students, identified in this study, encourages implementation of health programs. Emphasize on importance and benefits of physical activity and eating habits in medical curricula.

    更新日期:2019-11-28
  • Maternal nutritional supplement delivery in developing countries: a scoping review
    BMC Nutr. (IF 0) Pub Date : 2019-02-11
    L. McKerricher; P. Petrucka

    Maternal under-nutrition in low-income countries has been inextricably linked to negative child outcomes. Developing countries lack policies for monitoring and evaluating maternal nutritional programs, which has led to a gap in data collection regarding the effectiveness of prenatal supplement delivery methods. The objective of this scoping review is to examine and determine the delivery methods of maternal nutritional supplements in developing countries. Scoping review of maternal supplement programs delivery methods in low-income countries including Bangladesh, Ethiopia, India, Kenya, and Nepal are examined. A systematic search was performed in six databases; CINAHL (Cumulative Index to Nursing & Allied Health), MEDLINE, Web of Science, PubMed, Scopus, and FSTA (Food Science and Technology Abstracts). A systematic search performed in six databases yielded a total of 510 un-duplicated results; (CINAHL: 42, Medline: 112, Web of Science: 77, PubMed: 46, Scopus: 179, FSTA: 38, and additional records: 16). Results after duplicates were removed (n = 308), these results were screened, and relevant studies based on the research question identified and selected (n = 12). The 12 full-text articles were assessed for eligibility and 8 of these studies were excluded for not meeting the scoping review criteria. Data was extracted and charted from the four remaining studies. The findings were collated and summarized. Three modes of delivery were identified: 1. Volunteer maternal nutrition educator delivered supplements to the pregnant woman’s home; 2. The pregnant woman received a maternal supplements from school, health/local center, or village market; and 3. The pregnant woman received a ration card for subsidized food. Barriers in delivering maternal supplements included lack of trained professional volunteers, limited support and guidance provided to volunteers, and a high cost of equipment, supplies, and buildings. Pregnant women in developing countries faced many obstacles in accessing maternal supplement programs including poverty, rural isolation, limited transportation, low social status, traditional, cultural, and religious practices. Strategies required to improve program delivery involved an earlier invitation to prenatal supplements, increase in partnerships, a focus on adolescent girls’ health, paid maternal leave, increase in training and incentives for volunteers, and self-help groups focused on prenatal education and counseling services.

    更新日期:2019-11-28
  • Nutritional status of children 7–36 months old from millet consuming communities of Masindi District, Western Uganda
    BMC Nutr. (IF 0) Pub Date : 2019-02-11
    Barugahara Evyline Isingoma; Samuel Kuria Mbugua; Edward Gichohi Karuri

    Several national reports have indicated poor nutritional status among children from Western Uganda where millet porridge is a predominant complementary food. However, little is known about the nutritional status of 7–36 months old children from millet consuming communities of Western Uganda. A cross-sectional study was conducted in Bujenje County of Masindi District. A total of 636 children from 23 villages within Bwijanga and Budongo sub counties were randomly selected. Anthropometric measurements of children were taken. Data on demographic and socioeconomic characteristics of children’s households, their dietary practices and morbidity patterns was collected using a self-administered questionnaire. A statistical Package for the Social Sciences (SPSS) version 20 and Emergency Nutritional Assessment (ENA) Software Version 2010 were used for analysing data. The relationship between demographic and socioeconomic characteristics of households and children’s nutritional status was determined using Chi-square tests. Pearson’s correlation coefficient was used to determine the association between children’s nutritional status and the amount of millet porridge consumed. A p-value of < 0.05 indicated statistical significance. A proportion of 30.5% children were stunted, 11.6% underweight and 7.4% wasted. Underweight and wasting were significantly high in Budongo sub county at p = 0.044 and p = 0.005 respectively. Stunting and underweight were highest between 12 and 23 months at p = 0.005 and 0.020 respectively. Although millet porridges formed the bulk of children’s meals, they could only cater for < 60% of the recommended daily nutrient intake. Children with diarrhoea were 1.4 and 2 times likely to become stunted and underweight at p = 0.025 and 0.007 respectively. Feeding practices for children with diarrhoea were contrary to World Health Organisation’s recommendations in more than 50% of the studied children. There was a significant association between Height-for-Age Z scores, Weight-for-Height Z scores and the amount of millet porridge consumed by children (r = − 0.20, p < 0.001 and r = 0.14, p < 0.001 respectively). Results showed slightly higher percentages of stunted, underweight and wasted children compared to national figures. This was attributed to high incidences of diarrhoea and inadequate feeding practices especially for children 12–36 months old.

    更新日期:2019-11-28
  • Current status of education and research on public health nutrition in Japan: comparison with South Korea, Taiwan, and mainland China
    BMC Nutr. (IF 0) Pub Date : 2019-02-12
    Nana Shinozaki; Han-Chieh Wang; Xiaoyi Yuan; Tianyu Li; Kana Asano; Satomi Kobayashi; Satoshi Sasaki

    Although the importance of capacity building for public health nutrition (PHN) has been increasing globally, reports on the current status of training programs for PHN in East-Asia including Japan are limited. The aim of this study was to compare the current status of education and research activities in the field of PHN in Japan with those in South Korea, Taiwan, and mainland China. Necessary information was collected by internet search and telephone inquiry. Collection focused on the number of departments in colleges and universities with PHN as a compulsory subject in the 2016 academic year, and the number of articles and information related to these articles published in the journal Public Health Nutrition between 2007 and 2016. The number of departments with PHN as a compulsory subject was the highest in Japan (n = 137), followed by mainland China (n = 32), Taiwan (n = 18) and South Korea (n = 7). Using the classification list of education in each country and region, the majority of these departments were classified as home economics, natural science, health and welfare, and medical science in Japan, South Korea, Taiwan, and mainland China, respectively. Regarding publications, most of the articles were written in colleges and universities not having PHN as a compulsory subject in Japan, South Korea, and Taiwan. The number of articles per department among departments with compulsory PHN education was lowest in Japan (n = 0.3) compared to Taiwan, mainland China, and South Korea (n = 1.2, 2.7, and 3.7, respectively). Japan has a much higher number of departments with PHN as a compulsory subject than neighboring East Asian states and relatively low research activities in the field of PHN. This suggests that current university education may not lead to active PHN research in Japan. Further studies are warranted to explore the reasons for this.

    更新日期:2019-11-28
  • Dietary intake in undernourished adults living in Guinea-Bissau; a cross-sectional study
    BMC Nutr. (IF 0) Pub Date : 2019-02-15
    Cecilie Blenstrup Patsche; Frauke Rudolf; Antonio Mateus da Silva Mendes; Idalina da Cunha; Victor Francisco Gomes; Christian Wejse; Charlotte Jeppesen

    Data on dietary intake in Guinea-Bissau is limited. The main purpose of this study was to compare mean daily energy intake (EI) with mean daily energy expenditure (EE) for a moderately active lifestyle in health-seeking individuals with a body mass index < 20.0 kg/m2. Furthermore, dietary composition was evaluated by estimates of macronutrient energy distribution, individual dietary diversity scores, and the identification of frequently consumed food items, stratified by sex. A cross-sectional dietary survey was conducted at the suburban health- and demographic surveillance site in Guinea-Bissau, West Africa, from May 2014–February 2015. Each participant answered one interviewer-administered 24-h dietary recall at baseline, from which dietary intake was assessed. Differences in dietary intake between men and women were analysed using the X2 test or Fisher’s Exact test for categorical outcomes, and the Student’s t-test for continuous variables. Forty-three men and forty-eight women were included. Mean EI for men was 6326 kJ/d (sd 2104) and for women 6822 kJ/d (sd 2210). Mean EE for a moderately active lifestyle with a physical activity level of 1.75 was 10,479 kJ/d (sd 658) for men and 8729 kJ/d (sd 731) for women. Both men and women had a significantly lower mean EI compared with mean EE (p-values both < 0.001). Dietary diversity was low with a score of 3.5 (sd 1.0) for men and 4.0 (sd 1.3) for women, p-value 0.046. Macronutrient energy was distributed as 66% (sd 11) carbohydrate, 15% (sd 5) protein, and 19% (sd 9) fat, with no significant difference in distribution between men and women. Consumption of starchy and sugary carbohydrates accounted for two thirds of mean EI. Cereals were the main source of protein, in place of animal protein. Both men and women in this study had low mean EI compared with mean EE for a moderately active lifestyle. Dietary intake was characterized by a seemingly low dietary diversity and imbalanced macronutrient energy distribution, comprising insufficient fat intake and excess carbohydrate intake. Cereals were the main source of protein. PACTR2009110001673419 . Registered 22 Oct 2009.

    更新日期:2019-11-28
  • Factors associated with prelacteal feeding practices in Debre Berhan district, North Shoa, Central Ethiopia: a cross-sectional, community-based study
    BMC Nutr. (IF 0) Pub Date : 2019-02-15
    Mesele Damte Argaw; Maeza Mitiku Asfaw; Mekonen Birhane Ayalew; Binyam Fekadu Desta; Thandisizwe Redford Mavundla; Kassa Daka Gidebo; Aynalem Hailemichael Frew; Aychiluhim Damtew Mitiku; Alebel Yaregal Desale

    Prelacteal feeding is one of the major harmful newborn feeding practices and is top on the list of global public health concerns. The practice deprives newborns of valuable nutrients and protection of colostrum and exposes them to preventable morbidity and mortality. Studying the prevalence and factors influencing the prelacteal feeding practice of mothers will help program managers and implementers to properly address broad major public health problems. Therefore, this study aims to investigate the prevalence of prelacteal feeding practices and its associated factors among mother-infant dyads in the Debre Berhan district of North Shoa administrative zone, central Ethiopia. A community-based cross-sectional study design was conducted from January through to April 2014 among 634 mother-infant dyads. The data were entered into EPI Info version 3.5.1. (CDC, Atlanta, Georgia). All statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) research IBM version 20.0. The prevalence of prelacteal feeding was determined using the ‘recall since birth’ method. Multi-variable logistic regression analysis was employed to control confounders in determining the association between prelacteal feeding practices and selected independent variables. Adjusted Odds Ratio (AOR), with 95% Confidence Interval (CI) and P < 0.05 was used to claim statistical significance. The prevalence of prelacteal feeding practice was 14.2% (95% CI: 11.00–17.00%). Slightly greater than half, 48 (53.3%) of prelacteal fed newborns were given butter. Home delivery was a major risk factor for practicing prelacteal feeding. Mothers who delivered their indexed infant at home practiced prelacteal feeding over four folds more than mothers who delivered in a health institution (Adjusted Odds Ratio (AOR) 4.70; 95% CI: 2.56–8.60, p-value = 0.001). Mothers who did not initiate breastfeeding within an hour were six times more likely to practice prelacteal feeding (AOR 5.58; 3.21–9.46, p-value = 0.001). Similarly, with regards to the occupation of mothers, farmers practiced prelacteal feedings (AOR 4.33; 95% CI: 1.73–10.81, p-value = 0.002) up to four folds more than their counterpart housewives. Mothers who can read and write are 54% less likely to practice prelacteal feeding than their counterpart, illiterate mothers, with (AOR 0.46; 95% CI: 0.22–0.98, p-value = 0.044). In the Debre Berhan town of North Shoa administrative zone, central Ethiopia, almost one-sixth of mothers practiced prelacteal feeding. Therefore, improving access to information about appropriate newborn feeding practices, encouraging mothers to deliver their babies in health institutions and inspiring them to initiate breastfeeding within an hour of birth is recommended.

    更新日期:2019-11-28
  • Insulin resistance (HOMA-IR) and body fat (%) are associated to low intake of fruit and vegetables in Swedish, young adults: the cross-sectional lifestyle, biomarkers and atherosclerosis study
    BMC Nutr. (IF 0) Pub Date : 2019-02-20
    Maria Fernström; Ulrika Fernberg; Anita Hurtig-Wennlöf

    In the cross-sectional Lifestyle, Biomarkers, and Atherosclerosis study (LBA study) we have previously reported a high prevalence (15%) of homeostasis model assessment of insulin resistance (HOMA-IR) in Swedish, young adults. The aim of the present study was to report the dietary habits of subjects 18.0–25.9 years, and to associate dietary habits to body composition measures; body mass index (BMI), body fat (%), waist circumference and to HOMA-IR, a risk marker for diabetes. The subjects (577 women and 257 men) filled in a validated computerized food frequency questionnaire. The questionnaire was based on recommendations from the Swedish national food administration. To associate the dietary habits to BMI, body fat (%), waist circumference and to HOMA-IR the subjects were divided in two groups. Subjects “eating as recommended” and subjects “eating less/more than recommended”. Recommended intake of fish and seafood (P < 0.05), fruit and vegetables (P < 0.001), and sweets (P < 0.05) were associated to lower HOMA-IR values compared to subjects not eating as recommended. When split by sex no difference in HOMA-IR was detected with recommended intake of fish and seafood, but women eating fish and seafood as recommended had less body fat (%) (P < 0.05) compared to women not eating fish and seafood as recommended. Recommended intake of fruit and vegetables was associated to lower HOMA-IR in women (P < 0.01), and in women and men to less body fat (%) (P < 0.05) compared to subjects not eating the recommended 500 g of fruit and vegetables per day. Both women and men with higher consumption of sweets than recommended had higher HOMA-IR (P < 0.05), but no difference in the body composition measures BMI, body fat (%) or waist circumference compared to subjects eating sweets as recommended. The results highlight the importance of reducing a high intake of sweets and to increase the intake of fish, fruit and vegetables, in young adults, to reduce the risk of future diabetes.

    更新日期:2019-11-28
  • Identifying perceived barriers and enablers of healthy eating in college students in Hawai’i: a qualitative study using focus groups
    BMC Nutr. (IF 0) Pub Date : 2019-02-22
    Lucia Amore; Opal Vanessa Buchthal; Jinan C. Banna

    To design effective nutrition education interventions for college students, research is needed to determine the factors influencing food choices. The purpose of this study was to identify perceived barriers and enablers of healthy eating in college students ages 18–24 at the University of Hawai’i at Mānoa. Prior to conducting focus groups, an interview guide was developed based on a literature review of relevant studies. The interview guide was successfully tested in the first focus group and used in the rest of the focus groups. Eleven focus groups with group sizes of two to six were conducted (n = 44). Focus groups were audio-recorded and transcribed. Transcripts were coded in NVIVO11 using content analysis, and additional codes were added to the codebook based on emergent ideas from the transcripts. After completion of the final codebook, transcripts were recoded with the new codebook. Final code counts were used to identify overarching ideas based on the socio-ecological model of health, consisting of four levels of influence: individual (intrapersonal), social environmental (interpersonal), physical environmental (community settings), and macrosystem (societal). The largest barriers according to level of influence in the socio-ecological model were nutrition knowledge deficit (individual), peer pressure (social environmental), unsupportive institutional environment (physical environmental), and cost (macrosystem). The largest enablers were nutrition knowledge (individual), parental influence (social environmental), an institutional environment with consistent healthy offerings (physical environmental), and social media (macrosystem). Some factors served as barriers for some participants and enablers for others, such as parental influence. Factors such as individual knowledge and parental support were cited as having a positive influence in promoting healthy eating, while factors such as the cost of living and food availability at college serve as barriers even for motivated students. Results from this study identify potential areas of intervention, such as improving nutrition knowledge (individual), offering more healthy options (physical environmental), or reducing cost of food (macrosystem). However, more research is needed to identify which level of intervention may be most effective in changing food habits, and which barriers or enablers are deciding factors in determining this population’s food choices.

    更新日期:2019-11-28
  • Uptake of minimum acceptable diet among children aged 6–23 months in orthodox religion followers during fasting season in rural area, DEMBECHA, north West Ethiopia
    BMC Nutr. (IF 0) Pub Date : 2019-02-27
    Efram Mulat; Girma Alem; Wubetu Woyraw; Habtamu Temesgen

    Under-nutrition is the cause for poor physical and mental development and has more burden among infants and young children aged between 6 and 23 months. Cultural practices like not providing animal source foods for infants and young child aged between 6 and 23 months were barrier for practicing proper children feeding. The aim of this study was to assess minimum acceptable diet and associated factors among children aged between 6 and 23 months in Orthodox religion during fasting season in rural area, Dembecha, Ethiopia. A community-based cross-sectional study was conducted to assess Minimum Acceptable diet. Random sampling technique was applied to select 506 study participants. Interview was used to collect data on Practice of minimum acceptable diet, minimum dietary diversity, minimum meal frequency and related factors among children aged between 6 and 23 months from mothers / caregivers. About 8.6% of infants and young children aged between 6 and 23 months received minimum acceptable diet. Education status of mother(AOR = 0.22,95%CI:0.1, 0.48), involvement of mother in decision making (AOR = 0.22,95%CI:0.10,0.48), birth order of index children (AOR = 0.36,95%CI:0.14,0. 94), knowledge on feeding frequency (AOR = 0.3,95% CI:0.16,0.58), and institutional delivery (AOR = 5.13, 95%CI: 1.26, 20.80) were significantly associated with minimum acceptable diet. Minimum acceptable diet practice was low. Educational status of mother, involvement of mother in decision making, knowledge on feeding frequency and institutional delivery were significantly associated with minimum acceptable diet. This indicates that nutrition education and counseling related to infant and young child feeding practice is not addressed for all mothers. Strengthening mothers’ education on acceptable child feed practice, and working with religion leaders to increase knowledge of mothers on child feed practice are recommended.

    更新日期:2019-11-28
  • Maternal undernutrition as proxy indicators of their offspring’s undernutrition: evidence from 2011 Ethiopia demographic and health survey
    BMC Nutr. (IF 0) Pub Date : 2019-03-01
    Alinoor Mohamed Farah; Bilal Shikur Endris; Seifu Hagos Gebreyesus

    The intergenerational continuity of undernutrition is influenced by shared genetic, household socio-economic and cultural resources which will be associated with the mother and the child nutritional status, possibly to the same degree. Provided that this assumption is valid, maternal height and BMI could be a simple way of measuring nutritional status of their children. Data were obtained from the 2011 Ethiopia Demographic and Health Survey (EDHS 2011). An analytical sample of 8, 505 children whose mothers are not pregnant and live with their biological mothers was included. The bivariate associations between nutritional indices of the mother and the children were analyzed with Pearson correlation coefficients. The sensitivity, specificity, predictive values and area under Roc curves were calculated. Logistics regression for binary outcomes was also used to evaluate the predictors of child undernutrition. Children who experienced stunting, underweight or wasting had mothers with lower mean BMI than those who did not (p < 0.001). Maternal and child nutritional status were positively correlated. The sensitivity of maternal underweight (defined by BMI < 18.5 kg/m2) as a predictor of child’s nutritional status (<− 2 z-scores) is low, failing to reach 50% for any of the child nutrition indices. In logistics regression, maternal BMI was associated with stunting, underweight and wasting (p < 0.001) while maternal height was only associated with stunting and underweight (p < 0.001). The sensitivity and specificity of maternal anthropometric indicators to identify growth deficits among children were too low to justify using maternal indicators as a replacement for child growth measurements.

    更新日期:2019-11-28
  • Determinants of undernutrition among adult patients receiving antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: a case-control study design
    BMC Nutr. (IF 0) Pub Date : 2019-03-01
    Ayenew Negessie; Dube Jara; Mekaunint Taddele; Sahai Burrowes

    A complex and negatively reinforcing relationship exists between infection with Human Immune Deficiency Virus (HIV) and malnutrition. HIV-induced immune impairment and its resulting opportunistic infections (OIs) can lead to malnutrition and nutritional deficits, can, in turn, hasten the progression of HIV infection and reduce chances of survival. The determinants of undernutrition among patients receiving antiretroviral therapy (ART) is poorly understood in Ethiopia, despite a high prevalence of food-insecurity that overlaps with a generalized HIV/AIDS epidemic. Therefore, this study aimed to assess determinants of undernutrition among adult patients receiving antiretroviral therapy at Debre Markos Referral Hospital in Northwest Ethiopia. We conducted an institution-based, unmatched, case-control study with 636 adult patients receiving antiretroviral therapy. We randomly selected 212 patients with poor nutritional outcomes (cases) and 424 without undernutrition (controls) and then conducted a chart review to collect information on their treatment, socio-economic, and demographic background. Data were analyzed using bivariable and multivariable logistic regression to identify factors associated with under nutrition. We found that greater age (AOR = 1.02, 95% CI: 1.01,1.05), fair or poor adherence (AOR = 2.77, 95% CI: 1.40, 5.50 and AOR = 4.72, 95% CI: 1.92, 11.6), and the presence of OIs (AOR = 1.70, 95% CI: 1.12, 2.52), anemia (AOR = 1.81, 95% CI: 1.07, 3.07), or eating problems (AOR = 3.40, 95% CI: 2.27, 5.10), were all independently and positively associated with under nutrition. Starting treatment with a medium or low CD4 count was protective (AOR = 0.61, 95% CI: 0.39, 0.96 and AOR = 0.49, 95% CI: 0.27, 0.88). Having social support (AOR = 0.64, 95% CI: 0.43, 0.95), and having a source of informal care-giving (AOR = 0.48, 95% CI: 0.27, 0.84), reduced the odds of undernutrition. Our findings support calls for treating HIV infection early and aggressively, while closely monitoring patients for opportunistic infections that might affect eating and drug side effects that may affect appetite. The role of disclosure, peer-caregivers and age in preventing undernutrition should be explored in future research.

    更新日期:2019-11-28
  • Child assessments of vegetable preferences and cooking self-efficacy show predictive validity with targeted diet quality measures
    BMC Nutr. (IF 0) Pub Date : 2019-03-02
    Melissa Pflugh Prescott; Barbara Lohse; Diane C. Mitchell; Leslie Cunningham-Sabo

    Cooking interventions have the potential to improve child diet quality because cooking involvement is associated with positive changes in dietary behavior. Valid and reliable instruments that are low-cost and convenient to administer are needed to feasibly assess the impact of cooking interventions on dietary behavior. The purpose of the current research is to examine the validity of fruit and vegetable preferences, cooking attitudes and self-efficacy assessments to predict targeted Healthy Eating Index-2010 (HEI) scores among 4th-grade youth. Child fruit and vegetable preferences, cooking attitudes, self-efficacy, age, sex and race/ethnicity were collected with the Fuel for Fun survey in classroom settings using a standardized administration protocol. Child dietary assessment data consisted of three 24-h dietary recalls collected by telephone over a 2–4 week period by trained interviewers using a standard protocol. Bootstrapped linear regressions examined the predictive validity of fruit and vegetable preference, cooking attitudes and cooking self-efficacy for the Total and 4 targeted HEI components: whole fruit, total vegetables, green vegetables and beans, and empty calories. Logistic regressions were used to confirm the relationships between Fuel for Fun survey items and HEI components. Sex and a categorical variable for race/ethnicity were included as a priori controls in each regression model. Vegetable preference predicted positive associations with HEI Total Score, Total Vegetables, and Green Vegetables and Beans (p < 0.05) Each additional 2 point increase in cooking self-efficacy was associated with a 1.33 point HEI Score increase, even after including BMI z-score as a control (b = 0.667, p = 0.003). Fruit preference and cooking attitudes did not significantly predict HEI total or component scores. This study provides evidence that low-cost, validated measures of vegetable preferences and cooking self-efficacy predict diet quality in 4th grade children. These results also reinforce the relationship between cooking and healthful dietary behavior.

    更新日期:2019-11-28
  • Trends and inequalities in stunting in Nepal: a secondary data analysis of four Nepal demographic health surveys from 2001 to 2016
    BMC Nutr. (IF 0) Pub Date : 2019-03-04
    Sajama Nepali; Padam Simkhada; Ian Davies

    The rate of stunting in Nepal is among the highest in the world, which is a major public health problem. The objective of this study was to present data on stunting prevalence according to socio-demographic and geographical circumstances and to determine the impact of those circumstances on the risk of stunting. Data from Nepal Demographic and Health Surveys were used with the study population of children under 5 years old. The prevalence of stunting was determined by descriptive analysis and logistic regression analysis was used to determine risk factors for stunting. The prevalence of stunting has declined in overall as well as in all groups and subgroups analysed. The percentage of stunted children from 2001 to 2016 decreased by 18 and 10.7% in the rural and urban areas respectively. The unadjusted analysis depicted association between stunting and children living in rural areas since children living in rural areas had higher odds of being stunted compared to their urban counterparts. However, the association was no longer observed when adjusted for other variables included in this study. Children born to mothers without any education had 2.27 (95% CI 1.70–3.05), 5.222 (95% CI 2.54–10.74), 1.81 (95% CI 0.92–3.55) and 1.92 (95% CI 1.28–2.89) odds of being stunted than those born to mothers with higher education for the year 2001, 2006, 2011 and 2016 respectively in the adjusted analysis. Similarly, children belonging to the poorest wealth quintile had 1.90 (95% CI 1.55–2.33), 1.87 (95% CI 1.36–2.58), 2.47 (95% CI 1.51–4.02) and 4.18 (95% CI 2.60–6.71) odds of being stunted than those belonging to the richest quintile in 2001, 2006, 2011 and 2016 respectively. The association between stunting and wealth quintile depicting children belonging to the poorest and poorer wealth quintile having higher odds of being stunted remain the same in both unadjusted and adjusted analysis. At national level, stunting is decreasing in Nepal; however, the prevalence of stunting is different between groups and subgroups analysed. The substantial inequalities in stunting have been preserved. Therefore, special emphasis should be given to vulnerable groups such as children belonging to the poorest and poorer wealth quintile instead of using blanket approach for delivering nutrition interventions. A balanced approach to nutritional inequalities prevalent across different regions and subgroups is required.

    更新日期:2019-11-28
  • Addressing malnutrition among children in routine care: how is the Integrated Management of Childhood Illnesses strategy implemented at health centre level in Burundi?
    BMC Nutr. (IF 0) Pub Date : 2019-03-05
    Manassé Nimpagaritse; Catherine Korachais; Georges Nsengiyumva; Jean Macq; Bruno Meessen

    The Integrated Management of Childhood Illness (IMCI) strategy was adopted in Burundi in 2003. Our aim was to evaluate to what extent the malnutrition component of the IMCI guidelines is implemented at health facilities level. We carried out direct observations of curative outpatient consultations for children aged 6–59 months in 90 health centres selected randomly. We considered both the child and the health worker (HW) as units of analysis and used bivariate analysis to explore characteristics of HWs associated with tasks systematically or never performed. A total of 514 consultations carried out by 145 HWs were observed. Among the 250 children under two years, less than 30% were asked questions on breastfeeding. None of them had all seven nutrition-related questions asked to their caregivers and none of the 200 children over the age of two years had all five nutrition-related questions asked to their caregivers. Only 13 cases (3%) had all of the six examinations/tasks (weight, height/length, mid-upper arm circumference, oedema, filling in and discussing the growth curve and calculating the weight for height z-score) performed as part of their care. 393 cases (76%) reported that they had not being given any nutrition advice. With regards to HWs, among 99 of them who had received children under two, only 21 (21.2%)[14.2–30.5%) systematically asked the question regarding ‘ongoing breastfeeding’. Only 56 (38.6%)[31–46.9%] weighed or discussed the weight taken prior the consultation for each child they reviewed, only 38 (26.2%)[19.6–34.1%] measured the height/length or discussed it for each child reviewed and 23 (15.9%)[10.7–22.8%] performed (systematically?) the WHZ-score. More than 50% never gave nutrition advices to any child reviewed. HWs who daily manage severe acute malnutrition were the most likely to systematically ask the question regarding ‘ongoing breastfeeding’ and to perform a ‘weight examination’. Those who had not received supervision visit on the topic of malnutrition predominantly never performed a ‘weight examination’. The ‘height/length’ examination’ was predominantly performed by female HWs and those who have ‘contract with the government. This study has found poor compliance by HWs to IMCI in Burundi. This indicates that a substantial proportion of children do not receive early and appropriate care, especially that pertaining to malnutrition. This alarming situation calls for strong action by actors committed to child health in the country. Clinical Trials.gov Identifier: NCT02721160; March 2016 (retrospectively registered).

    更新日期:2019-11-28
  • Randomised clinical trial: effect of low-FODMAP rye bread versus regular rye bread on the intestinal microbiota of irritable bowel syndrome patients: association with individual symptom variation
    BMC Nutr. (IF 0) Pub Date : 2019-03-06
    Reijo Laatikainen; Jonna Jalanka; Jussi Loponen; Sanna-Maria Hongisto; Markku Hillilä; Jari Koskenpato; Riitta Korpela; Anne Salonen

    A low intake of Fermentable, Oligo-, Di-, Mono-saccharides and Polyols (FODMAPs) is effective in the symptom control of irritable bowel syndrome (IBS) patients but may exert negative effects on the intestinal microbiota. The microbial effects of increasing regular or non-FODMAP fibre sources are largely unknown. Furthermore, it is not known if the baseline microbiota composition is associated with individual symptom control during the consumption of different rye products in IBS patients. Our objective was to evaluate whether increased consumption of low-FODMAP rye bread or regular rye bread for 4 weeks would alter the intestinal microbiota composition of IBS patients following their habitual diet, and whether these changes associate to symptoms and/or the baseline microbiota. The study was conducted as a randomized double blind controlled cross-over study (n = 50). Microbiota was analysed by 16S rRNA gene sequencing and associated with gastrointestinal symptoms. Both microbial changes and their associations to symptoms were secondary outcomes. The consumption of the test breads did not alter microbiota diversity. Compared to baseline, consumption of the low FODMAP rye bread decreased the abundance of Bacteroides, Flavonifractor, Holdemania, Parasutterella and Klebsiella and showed a trend towards increased bifidobacteria, whereas the regular rye bread decreased the abundance of Flavonifractor. When comparing between the two test breads, Klebsiella was decreased after low-FODMAP rye bread intake. Patients whose symptoms decreased during the low-FODMAP rye bread displayed more Blautia and less Barnesiella at baseline. Consumption of low-FODMAP rye bread had modest, potentially beneficial effects on patients’ microbiota while increasing their intake of fibre substantially. The baseline microbiota composition was associated with the variable degrees of symptom relief experienced by the patients. Consumption of a low-FODMAP rye bread might be one way to increase dietary fibre intake and improve the mild dysbiosis often observed among patients with IBS. ClinicalTrials.gov: NCT02161120 . Retrospectively registered 11 June 2014.

    更新日期:2019-11-28
  • Predictors of stunting among children 6–59 months of age in Sodo Zuria District, South Ethiopia: a community based cross-sectional study
    BMC Nutr. (IF 0) Pub Date : 2019-03-11
    Samson Kastro Dake; Fithamlak Bisetegen Solomon; Tesfahun Molla Bobe; Habtamu Azene Tekle; Efrata Girma Tufa

    Despite the decline in the rate of stunting in Ethiopia, the prevalence is still high and needs immense efforts to achieve the target set to reduce the prevalence. It varies between localities due to individual level factors and dominant livelihood practice in the community. Thus, the aim of this study was to determine the prevalence of stunting and identify factors associated with it in Sodo Zuria district in South Ethiopia. A community based cross sectional study was conducted among 342 children aged 6–59 months paired with mothers/caretakers. Households were selected using systematic sampling. Structured questionnaire was used and mothers/caregivers were interviewed face to face. Standardized anthropometric measurements were used to measure length, and weight and height of a child. Data were entered into Epi Info software version 3.5.1 and exported to SPSS version 20 for analysis. Height for age Z score data were analyzed using WHO Anthro software. Multivariate logistic regression analysis was conducted to identify predictor variables. Statistical significance was considered at p < 0.05. The prevalence of stunting in this study was 24.9% with 7.9% being severely stunted. Being female (AOR = 2.8; 95% CI: 1.5, 5.3), children aged 12–23 months (AOR = 7.1; 95% CI: 2.3, 21.9), mother’s who do not use family planning (AOR = 2.5; 95% CI: 1.1,5.7), children with diarrheal morbidity (AOR = 2.5; 95% CI: 1.2,5.3), income of 750–1500 ETB and > 1500, and children who received pre-lacteal feeding (AOR = 3.8; 95% CI: 1.2–12.2) became predictors for stunting. Significant proportion of stunting was found where one third of them were severely stunted. Being female, children aged 12–23 months, using family planning, children with diarrheal morbidity, income and pre-lacteal feeding became predictors for stunting. So Gender-based policies should be enacted in child feeding practice, interventions should focus on the utilization of family planning and appropriate child caring and feeding practices. Water, sanitation and hygiene interventions need to be strengthened.

    更新日期:2019-11-28
  • Knowledge about iodine requirements during pregnancy and breastfeeding among pregnant women living in Northern Ireland
    BMC Nutr. (IF 0) Pub Date : 2019-03-12
    Paul McMullan; Alyson Hunter; David McCance; Jayne V. Woodside; Karen Mullan

    Iodine is an essential micronutrient important for foetal nerve and brain development, especially in the early stages of pregnancy. The re-emergence of mild to moderate iodine deficiency has recently been reported in the United Kingdom (UK). The level of knowledge amongst pregnant women regarding iodine nutrition is poorly understood. The aim of this study was to determine the level of knowledge about iodine nutrition during pregnancy among pregnant women living in Northern Ireland (NI). A cross-sectional study in pregnant women was carried out in Royal Jubilee Maternity Hospital Belfast, from March to June 2015. Two hundred pregnant women were provided with a short questionnaire on iodine knowledge during routine clinic visits and comparisons were made across trimester and parity. Only 20% of women were aware of the potentially increased iodine requirements during pregnancy and breast feeding; 45% were unable to identify any foods they thought would be iodine rich. The three main sources of dietary iodine in the UK are fish, dairy and eggs and 30, 9 and 15% correctly identified these as good sources respectively. When asked about whether they felt they had been given sufficient advice about folic acid and iodine in pregnancy, 90% felt this was so for folic acid, but only 5% for iodine. This study suggests that iodine knowledge among pregnant women living in NI is poor. In the absence of any iodine fortification programme, women in the UK may be vulnerable to iodine deficiency in pregnancy. At present they are poorly equipped to make positive dietary changes to meet their increasing iodine requirements during pregnancy and breastfeeding. Public health strategies should be considered to target this population group.

    更新日期:2019-11-28
  • Diet satisfaction and associated factors among adult surgical orthopaedic inpatients at a teaching hospital in Lusaka province, Zambia; a hospital-based cross-sectional study
    BMC Nutr. (IF 0) Pub Date : 2019-04-01
    Nixon Miyoba; Irene Ogada

    Poor quality of food services in hospital contributes to low diet satisfaction among inpatients in both developed and developing countries. However, there is paucity of literature on diet satisfaction in health care facilities in the sub-Saharan region and in particular Zambia. Therefore, this study sought to assess levels of diet satisfaction among adult surgical orthopaedic inpatients at a teaching hospital in Lusaka province, Zambia. A hospital-based cross-sectional study was conducted over a period of three months. Comprehensive sampling was used to select 98 study participants. A researcher-administered questionnaire adapted from a similar study was used to collect data. The instrument used in this study had 9 aspects of satisfaction. Descriptive statistics such as frequencies, percentages, means and standard deviations were used to analyze the data. Chi-square test was used to test for associations between categorical data. A p-value of less than 0.05 was considered to be statistically significant. In this study, 64.3% of surgical orthopaedic inpatients were not satisfied with overall quality of hospital food. In addition, 76.5, 96.9, 65.3 and 71.4% of the patients were not satisfied with type, variety, appearance and taste of hospital food respectively. However, patients who were satisfied with portion size, temperature and time of meal distribution were 67.3, 94.9 and 56.1% respectively. There was no significant association between variables of age, sex, education level, marital status, monthly income, days in hospital and overall satisfaction (p > 0.05). Low diet satisfaction is a global problem associated with poor quality of hospital meals. Although the majority of surgical orthopaedic inpatients were not satisfied with more than half of the dimensions of diet satisfaction, they were satisfied with aspects of portion size, temperature and time of meal distribution. Therefore, an assessment of diet satisfaction can inform hospital administrators and policy makers on the deficiencies in hospital diets and thereby help improve quality of meals.

    更新日期:2019-11-28
  • Impact of fruits and vegetables vouchers on food insecurity in disadvantaged families from a Paris suburb
    BMC Nutr. (IF 0) Pub Date : 2019-04-04
    Camille Buscail; Judith Gendreau; Paul Daval; Pierre Lombrail; Serge Hercberg; Paule Latino-Martel; Chantal Julia

    Social inequalities in nutrition lead a high number of families to struggle with food insecurity, even in developed countries. We aimed to assess the impact of fruits and vegetables vouchers on food security among disadvantaged households from a Paris suburb. We used a pre-post assessment design. Families answered face-to-face questionnaires on food consumption and food security status before and after a randomly assigned intervention. Households in the intervention group received vouchers to buy exclusively fruits and vegetables over one year. Both intervention and control groups benefitted from nutritional education through workshops performed by dieticians during the study period. The Household Food Security Module (HFSM) was used to assess food security status of households at inclusion. Food Insufficiency Indicator (FSI) was used to assess food security at inclusion and follow-up. Evolution of FSI on both groups was evaluated using McNemar test. Among the 91 families included between May 2015 and May 2016, 64 completed the post assessment questionnaire. At inclusion, 68.3% of families were experiencing food insecurity and 78.1% were experiencing food insufficiency. No association was found between food consumptions and food security status. After one-year follow-up, the prevalence of food insufficiency was significantly decreased in the intervention group (61.8%, with p value = 0.03), and unchanged in the control group. In this pilot study, food insufficiency was significantly decreased in families receiving vouchers for fruits and vegetables over a one-year period. NCT02461238 , registered 3 June 2015 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02461238

    更新日期:2019-11-28
  • Prevalence and associated factors of undernutrition among under-five children from model and non-model households in east Gojjam zone, Northwest Ethiopia: a comparative cross-sectional study
    BMC Nutr. (IF 0) Pub Date : 2019-04-08
    Abrehet Zeray; Getiye Dejenu Kibret; Cheru Tesema Leshargie

    Developing countries, undernutrition remains significant public health attention, as it was a combined consequence of poor dietary consumption and recurrent infectious illness especially in countries same Ethiopia. Undernutrition is associated with morbidity and mortality among children. This study, therefore, was conducted to assess the prevalence and associated factors of undernutrition among under-five children from the model and non-model households at Eastern Gojjam administrative Zone, northwest Ethiopia. A community-based comparative cross-sectional study was conducted from 1st July 2015 to 30th August 2015 in East Gojjam Zone among 507 households (170 from model-household and 337 from non-model household) selected using a multistage sampling technique. Data were collected using questionnaire and nutritional anthropometric measurement. The Emergency Nutrition Assessment for Standardized Monitoring and Assessment of Relief and Transition was used to convert raw anthropometric data into Z-scores. The collected data were entered into EpiData, and analysis was conducted using Statistical Package for Social Sciences (SPSS) version 22. The Emergency Nutrition Assessment for Standardized Monitoring and Assessment of Relief and Transition was used to convert raw anthropometric data into Z scores. Descriptive statistics were used to report the prevalence of outcome variable, undernutrition (intermesh of underweight, stunting, and wasting). In addition, results were presented using narration, tables, and figures including frequency and percentage. Adjusted Odds Ratio (AOR) with its 95% Confidence Interval (CI) was computed. Univariate and multivariate logistic regression analyses were done. A p-value less than 0.05 of was considered to declare a result as statistically significant. This study found that the prevalence of undernutrition explained by stunting (height-for-age Z-score (HAZ) < − 2), underweight (weight-for-age Z-score (WAZ) < − 2) and wasting (weight-for-height Z-score (WHZ) < − 2) were 44.7% [95%CI 41.11, 48.29%]c, 15.3% [95%CI: 12.17, 18.43%] and 10% [95% CI 8.0, 12.0%], and 52.5% [95% CI: 48.62, 56.98%], 24.3% [95% CI: 20.22, 28.38%] and 11.3% [95% CI: 8.45, 14.15%] in under-five children among model household and non-model respectively. Protected water (AOR = 0.08, 95% CI: 0.03, 0.18) and less than three times daily intake of food (AOR = 4.06, 95% CI: 1.53, 10.82) were predictors for undernutrition among under-five model household. Protected source of drinking water (AOR = 0.07, 95% CI: 0.03, 0.13), households that ever-had education on complementary feeding (AOR = 0.19, 95% CI: 0.09, 0.25) and starting complementary feeding on 6 month after birth (AOR = 0.19, 95% CI: 0.09, 0.25) were significant predictors for under-five undernutrition among non-model households. The prevalence of undernutrition explained by stunting, underweight and wasting among under-five children in both model and non-model households were high. The prevalence of all the three parameters (stunting, underweight and wasting) was higher among the non-model households compared to the models, even if the differences were not statistically significant. Use of an unprotected source of drinking water and less than three times daily intake of food were found to be associated with undernutrition among under-five children in the model households. On the other hand, having educational exposure on complementary feeding, using drinking water from protected sources and initiation of complementary feedings at age of 6 months were found to be associated with undernutrition among children in the non-model households. Therefore, the concerned bodies must access safe and adequate water supply, works on information dissemination using mass media on timely initiation of complementary feeding, save water and on meal frequency should be strengthened.

    更新日期:2019-11-28
  • Iodine level concentration, coverage of adequately iodized salt consumption and factors affecting proper iodized salt utilization among households in North Ethiopia: a community based cross sectional study
    BMC Nutr. (IF 0) Pub Date : 2019-04-18
    Abraham Aregay Desta; Usha Kulkarni; Kidan Abraha; Solomon Worku; Berhe Woldearegay Sahle

    Adequate iodine fortified salt is the most common and effective method of preventing iodine deficiency. Studies showed households using iodized salt (15 Parts Per Million (PPM) to 80 PPM) of iodine at household level were low in Tigray region and other regions of Ethiopia. Limited studies have conducted on utilization of iodized salt at the household level and none of them did not addressed on factors affecting to proper iodized salt utilization. The aim of this study was to determine the iodine concentration in the collected salt samples, adequately iodized salt consumption coverage and identify factors affecting to proper iodized salt utilization amongst the households of Northern Ethiopia. Community based cross-sectional designs on selected 318 household food caterers were interviewed and salt samples were accordingly collected. Data was analyzed by the SAS-9.2 statistical software package. The iodine concentrations of the salt samples were determined by using the golden standard iodometric titration technique. Logistic Generalized Estimating Equation (GEE) statistical analysis method was used to assess factors affecting proper iodized salt utilization at household level. Adequately iodized salt coverage among the households was only 51 (17.5%). About 42 (14.38%) had 15 ppm (ppm) – 80 ppm, 9 (3.08%) had > 80 ppm, 188 (64.4%) had 1.1 ppm to 14.9 ppm and 53 (18.2%) had no iodine in the salt (0 ppm). Only 26 (8.9%) of the households had used iodized salt properly. Family size with Adjusted Odds Ratio (AOR) (0.82) and 95%CI [0.67, 0.92], residency of the household with AOR (2.83) and 95%CI [1.48, 5.40], the availability of iodized salt with AOR (3.90) and 95% CI [1.74, 8.7] and affordability to iodized salt with AOR (3.33) and 95% CI [1.41, 7.34] was strong predictors to proper iodized salt utilization. Coverage of adequately iodized salt was low. Family size, residency, availability and affordability of iodized salt were the predictors of proper iodized salt utilization. To enhance USI utilization effective inspection and regulatory measures should be taken to prevent the production and distribution of under/ over iodized salt in the market.

    更新日期:2019-11-28
  • The effect of culinary interventions (cooking classes) on dietary intake and behavioral change: a systematic review and evidence map
    BMC Nutr. (IF 0) Pub Date : 2019-05-10
    Bashar Hasan; Warren G. Thompson; Jehad Almasri; Zhen Wang; Sumaya Lakis; Larry J. Prokop; Donald D. Hensrud; Kristen S. Frie; Mary J. Wirtz; Angela L. Murad; Jason S. Ewoldt; M. Hassan Murad

    Culinary interventions (cooking classes) have been used to improve the quality of dietary intake and change behavior. The aim of this systematic review is to investigate the effects of culinary interventions on dietary intake and behavioral and cardiometabolic outcomes. We conducted a systematic review of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus for comparative studies that evaluated culinary interventions to a control group or baseline values. The intervention was defined as a cooking class regardless of its length or delivery approach. Studies included populations of children, healthy adults or adults with morbidities. The risk of bias was assessed using the Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale. Outcomes were pooled using the random-effects model and descriptive statistics and depicted in an evidence map. Simple logistic regression was used to evaluate factors associated with intervention success. We included 30 studies (6 were randomized, 7381 patients, average follow up 25 weeks). Culinary interventions were not associated with a significant change in body mass index (− 0.07 kg/m2, 95% CI: -1.53, 1.40), systolic (− 5.31 mmHg, 95% CI: -34.2, 23.58) or diastolic blood pressure (− 3.1 mmHg, 95% CI: -23.82, 17.62) or LDL cholesterol (− 8.09 mg/dL, 95% CI: -84.43, 68.25). Culinary interventions were associated with improved attitudes, self-efficacy and healthy dietary intake in adults and children. We were unable to demonstrate whether the effect of a culinary intervention was modified by various characteristics of the intervention such as its delivery or intensity. Interventions with additional components such as education on nutrition, physical activity or gardening were particularly effective. Culinary interventions were not associated with a significant change in cardiometabolic risk factors, but were associated with improved attitudes, self-efficacy and a healthier dietary intake in adults and children.

    更新日期:2019-11-28
  • Potential impact of restricted caribou (Rangifer tarandus) consumption on anemia prevalence among Inuit adults in northern Canada
    BMC Nutr. (IF 0) Pub Date : 2019-05-16
    Tiff-Annie Kenny; Xue Feng Hu; Jennifer A. Jamieson; Harriet V. Kuhnlein; Sonia D. Wesche; Hing Man Chan

    Caribou (Rangifer tarandus) is the top dietary source of iron and several micronutrients necessary for red blood cell production (erythropoiesis) in the contemporary diet of Inuit adults across Canada. Many caribou populations across the circumpolar north, however, have experienced dramatic declines in recent decades. Restricted access to caribou may negatively impact the nutrition and health of Inuit communities. We used data from the Inuit Health Survey, a cross-sectional survey of 2550 Inuit adults in thirty-six communities across northern Canada (conducted in 2007–2008) to examine the relationship between caribou consumption, hemoglobin (Hb), and blood biomarkers of nutrient intake and contaminant exposure. Multivariable linear regression was used to investigate the potential public health impact of a theoretical restriction in caribou consumption, by estimating the response of Hb concentrations (and the attendant change in anemia prevalence), to theoretical changes in caribou consumption (with and without substitution of caribou with other country food meat). Mean (95% CI) daily caribou meat consumption differed by an order of magnitude 4.3 (3.9–4.7), 51.1 (48.5-53.8), and 236.7 (224.7–248.7) grams/day between tertiles of caribou consumption. Mean (95% CI) hemoglobin levels increased from 129.1 (128.1–130.2) g/L to 132.5 (131.3–133.7) g/L between the highest and lowest tertiles of caribou consumption. In multivariable regression analyses, average daily caribou meat consumption was positively associated (P< 0.001) with hemoglobin levels. This relationship translated into approximately 4 g/L hemoglobin increase in participants in the third tertile of caribou consumption. The overall prevalence of anemia observed in the study population was 26.5% (24.5 – 28.3%) and a modelled restriction in caribou consumption (i.e. caribou = 0) increased the overall prevalence of anemia by approximately 6%. The maximum negative effect of caribou restrictions was related to a complete restriction on caribou consumption, coupled with the substitution of caribou with other country food meat (35.4% prevalence). Given the importance of caribou to Inuit culture, health and wellbeing, and the high price of healthful market foods in remote northern communities, strategies to promote the sustainable harvest of country foods are urgently required to ensure the health and nutrition security of the Inuit, in the context of rapidly changing Arctic environments and ecosystems.

    更新日期:2019-11-28
  • Prevalence of vitamin D deficiency in pregnant women and their babies in Bhaktapur, Nepal
    BMC Nutr. (IF 0) Pub Date : 2019-05-29
    Dhruba Shrestha; Saraswati Budhathoki; Sabi Pokhrel; Ashok Kumar Sah; Raj Kumar Shrestha; Ganendra Bhakta Raya; Reena Shrestha; Rasila Pasakhala; Christopher Smith; Bhim Gopal Dhoubhadel

    Vitamin D deficiency has been observed worldwide in pregnant women and their newborns. Maternal vitamin D deficiency can lead to deficiency in their newborn baby and has been linked with various complications during pregnancy and delivery. There is risk of premature delivery and it is associated with high neonatal mortality. Seventy-nine pregnant women who were admitted to the Siddhi Memorial Hospital for delivery and their newborn babies were enrolled in the study. Maternal blood samples were taken before delivery while umbilical cord blood samples of their babies were taken after delivery. Serum vitamin D level and calcium level were assessed by fluorescence immunoassay using Ichromax vitamin D kit and endpoint method, respectively in the Siddhi Memorial Hospital laboratory. Mean +/− SD serum vitamin D and calcium levels in pregnant mother before delivery were 14.6 +/− 8.5 ng/ml and 8.0 +/− 0.5 mg/dl, respectively, and in the cord blood were 25.7 +/− 11.2 ng/ml and 8.6 +/− 0.9 mg/dl, respectively. Eighty-one percent of the mothers and 35.8% of their babies were found to have vitamin D deficiency. Although 97.5% of the pregnant women were taking calcium supplementation, serum calcium was found lower than the normal reference value in 67% of the pregnant women and 64.2% of their babies. There were a linear relationship between the maternal and baby’s serum vitamin D (P < 0.001) and calcium (P < 0.001) levels. There is high prevalence of vitamin D and calcium deficiency in pregnant mothers and newborn babies in Bhaktapur, Nepal. Pregnant women need to be supplemented with adequate amounts of these nutrients.

    更新日期:2019-11-28
  • A space-time analysis of recurrent malnutrition-related hospitalisations in Kilifi, Kenya for children under-5 years
    BMC Nutr. (IF 0) Pub Date : 2019-06-04
    Kennedy Mwai Wambui; Eustasius Musenge

    Globally, malnutrition underlies 45% of under-5 s mortality, mainly from potentiating common infections such as diarrhoea and pneumonia. Malnutrition as a public health problem is not evenly disbursed because of disparities in food insecurity and health, and children commonly suffer recurrent episodes of opportunistic infections. We aimed to understand better the spatial and temporal structure of multiple paediatric hospital admissions associated with malnutrition-related illnesses. This paper aimed to investigate the spatial-temporal variations in malnutrition-related recurrent morbidity of children under-5 years from the Kilifi County in Kenya between 2002 and 2015. The study included data from children under-5 years old who had more than one admission to a rural district hospital in Kenya within the Kilifi Health and Demographic Surveillance System (KHDSS). The primary outcome was a malnutrition-related admission, based on wasting (WHZ < -2) or nutritional oedema. Individual, household and environmental level covariates were examined as exposures. We first fitted a SARIMA model for the temporality, and the Moran’s Index affirmed spatial clustering in malnutrition admissions. Kulldorf Statistics using SaTScan were applied to detect hotspots. Then, bivariate analysis was done using repeated values tabulation and analysis of covariance (ANCOVA). Inferential analysis was done using a mixed effect multivariable negative-binomial regression model, adjusting for spatiotemporal random effects. A total of 2821 children were admitted more than once, giving a total of 6375 admissions. Of these 6375 admissions, 1866 were malnutrition-related, and 3.9% (109/2821) of the children with repeat admissions died. There was a seasonal pattern of re-admissions, peaking from May to July over the years. Hotspots were found in both the Northern and Southern areas of the KHDSS, while the areas near Kilifi Town were least affected. We found that disease severity was most likely associated with a malnutrition re-admission to the hospital. Disease severity was strongly associated with admission with malnutrition but its effect reduced after adjusting for the spatial and temporal random effects. Adjusting for clustering in space and in time (spatial-temporal) in models helps to improve the understanding of recurrent hospitalisations involving malnutrition.

    更新日期:2019-11-28
  • Magnitude and associated factors of wasting among under five orphans in Dilla town, southern Ethiopia: 2018: a cross-sectional study
    BMC Nutr. (IF 0) Pub Date : 2019-06-20
    Andnet Tadesse Wete; Tadesse Alemu Zerfu; Adane Tesfaye Anbese

    About 24 million children across the world live without their parents. In resource-limited countries like Ethiopia, childhood malnutrition is common and intertwined with poverty. It is a leading cause of death for children contributing over half of child mortality in sub-Saharan Africa. Nevertheless; little is known about the prevalence of malnutrition and associated factors among under five age orphans, as most of the variable studies were geared towards under five children as wholesome. A community based cross-sectional study design complemented with qualitative methods was conducted collecting data from mothers/caretakers of 367 orphans in Dilla town, Southern Ethiopia from 5, Dec.2017–18, Jan. 2018. Systematic random sampling technique was used, A structured pretested interviewer administered questionnaire complemented by focus group discussions and key informant in-depth interviews" was used. Anthropometric measurements were also carried. Data were entered in to EPi-info version 3.5.4 software and exported to SPSS version 20 for analysis. The prevalence of wasting among Orphans was assessed by calculating the percentages using ENA for SMART 2012 software and analysis was made using WHO Standard cut off point below- 2 S. D using z-scores. All variables with p value of < 0.25 during bivariate logistic regression analysis were entered to a multivariate analysis to identify variables independently associated with the outcome variable at p value 0.05 with 95% CI. For qualitative aspect, thematic framework analysis was employed. 11.1% orphans were wasted from which 3.3 are severely wasted. The main associated factors of wasting were found to be number of under-five orphans at home (AOR 1.420; 95% CI 1.094–3.086), duration of breast feeding (AOR 2.039; 95% CI 1.027–4.048), marital status of care givers (AOR 1.482; 95% CI 1.692–3.377), age when complementary meal started (AOR 2.023; 95% CI 1.028–3.980), wealth index (AOR 2.558; 95% CI 1.074–3.515) and access to balanced diet (AOR 2.022; 95% CI 1.026–3.889) The prevalence of wasting is high among under-five orphans; therefore, all concerned bodies should pay a great attention for proposed interventions like Strengthen the social interactions and indigenous institutions to maximize social care for under five orphans and Integrating locally available nutrition support programs to reach under 5 yrs orphans.

    更新日期:2019-11-28
  • Acceptability and utilization of a lipid-based nutrient supplement formulated for pregnant women in rural Niger: a multi-methods study
    BMC Nutr. (IF 0) Pub Date : 2019-07-01
    Sheila Isanaka; Stephen R. Kodish; Abdoul Aziz Mamaty; Ousmane Guindo; Mamane Zeilani; Rebecca F. Grais

    In food insecure settings, it may be difficult for pregnant women to meet increased nutritional needs through traditional diets. A promising new strategy to fill nutrient gaps in pregnancy involves the provision of lipid-based nutrient supplements (LNS). We aimed to assess the acceptability and utilization of a 40 g LNS formulation (Epi-E) with increased micronutrient content relative to the recommended daily allowance among pregnant women in rural Niger. We conducted a two-part, multi-methods study among pregnant women presenting to antenatal care in Madarounfa, Niger during two periods (Ramadan and non-Ramadan). Part 1 included two LNS test meals provided at the health center, and Part 2 included a 14-day home trial to simulate more realistic conditions outside of the health center. Open- and closed-ended questions were used to assess organoleptic properties of Epi-E using a 5-point hedonic scale after the test meals, as well as utilization and willingness to pay for Epi-E after the 14-day home trial. Participants consumed more than 90% of the test meal in both periods. Epi-E was rated highly in terms of overall liking, color, taste and smell during test meals in both periods (median 5/5 for all); only time, mode and frequency of consumption varied between Ramadan and non-Ramadan periods in observance of daily fasting during the holy month. Epi- E, a 40 g LNS formulation with increased micronutrient content, was highly acceptable among pregnant women in rural Niger, and utilization was guided by household and individual considerations that varied by time period. This formulation can be further tested as a potential strategy to improve the nutritional status of pregnant women in this context. ClinicalTrials.gov Identifier: NCT02145000 . Registered 22 May 2014.

    更新日期:2019-11-28
  • Malnutrition in Chakradharpur, Jharkhand: an anthropological study of perceptions and care practices from India
    BMC Nutr. (IF 0) Pub Date : 2019-07-02
    Ipsha Chaand; Minashree Horo; Mohit Nair; Amit Harshana; Raman Mahajan; Vivek Kashyap; Fernanda Falero; Montse Escruela; Sakib Burza; Rajib Dasgupta

    This study aims to investigate the knowledge, perception and practices related to health, nutrition, care practices, and their effect on nutrition health-seeking behaviour. In order to have maximum representation, we divided Chakradharpur block in Jharkhand state into three zones (north, south and centre regions) and purposively selected 2 Ambulatory Therapeutic Feeding Centre (ATFC) clusters from each zone, along with 2 villages per ATFC (12 villages from 6 ATFCs in total). In-depth interviews and natural group discussions were conducted with mothers/caregivers, frontline health workers (FHWs), Medicins Sans Frontieres (MSF) staff, community representatives, and social leaders from selected villages. We found that the community demonstrates a strong dependence on traditional and cultural practices for health care and nutrition for newborns, infants and young children. Furthermore, the community relies on alternative systems of medicine for treatment of childhood illnesses such as malnutrition. The study indicated that there was limited access to and utilization of local health services by the community. Lack of adequate social safety nets, limited livelihood opportunities, inadequate child care support and care, and seasonal male migration leave mothers and caregivers vulnerable and limit proper child care and feeding practices. With respect to continuum of care, services linking care across households to facilities are fragmented. Limited knowledge of child nutrition amongst mothers and caregivers as well as fragmented service provision contribute to the limited utilization of local health services. Government FHWs and MSF field staff do not have a robust understanding of screening methods, referral pathways, and counselling. Additionally, collaboration between MSF and FHWs regarding cases treated at the ATFC is lacking, disrupting the follow up process with discharged cases in the community. For caregivers, there is a need to focus on capacity building in the area of child nutrition and health care provision post-discharge. It is also recommended that children identified as having moderate acute malnutrition be supported to prevent them from slipping into severe acute malnutrition, even if they do not qualify for admission at ATFCs. Community education and engagement are critical components of a successful CMAM program.

    更新日期:2019-11-28
  • Impact of lunch provision on anthropometry, hemoglobin, and micronutrient status of female Cambodian garment workers: exploratory randomized controlled trial
    BMC Nutr. (IF 0) Pub Date : 2019-07-08
    Jan Makurat; Natalie Becker; Frank T. Wieringa; Chhoun Chamnan; Michael B. Krawinkel

    Lunch provision is expected to improve the nutritional status of Cambodian garment workers. The objective of this study is to evaluate the effects of a model lunch provision through a canteen on anthropometry, hemoglobin, and micronutrient status in female garment workers in Cambodia. This exploratory randomized controlled trial was implemented at a garment factory in Phnom Penh, Cambodia. Female workers (nulliparous, non-pregnant) were recruited and randomly allocated into an intervention arm (workday’s lunch provision) and a control arm. Served lunch sets (~ 700 kcal on average) included diverse local dishes. Anthropometry (body mass index, weight, triceps skinfold thickness, and mid-upper arm muscle circumference), as well as hemoglobin, serum ferritin and soluble transferrin receptor, serum retinol binding protein, and serum folate concentrations were assessed at baseline and after 5 months of lunch provision. A general linear model with adjustments for baseline values was used to estimate intervention effects for each outcome variable. Two hundred twenty-three women were recruited (n = 112 control and n = 111 intervention). 172 (n = 86 in each arm) completed the study. Baseline prevalence of underweight, anemia, depleted iron stores, and marginal iron stores, were 31, 24, 21, and 50%, respectively. Subjects were not affected by frank vitamin A or folate deficiency, whereas 30% showed a marginal folate status. Overall, mean changes in anthropometric variables, hemoglobin, and retinol binding protein were marginal and not significant among intervention subjects. Mean folate concentration increased insignificantly by + 1.1 ng/mL (− 0.02, 2.2) (p = 0.054). On the other hand, mean ferritin decreased by − 6.6 μg/L (− 11.9, − 1.3) (p = 0.015). Subgroup analysis prompts that effects are differently pronounced according to the baseline status of workers. Findings indicate that model lunch sets provided a beneficial amount of dietary folate, but need to be revisited for iron content and/or iron bioavailability. It is believed that distinct positive effects on anthropometry, hemoglobin, and micronutrient status can solely be expected in malnourished individuals. The authors suggest that similar larger trials, which include sets adapted to the concrete needs of workers affected by underweight, anemia and/or definite micronutrient deficiencies, should be performed. The trial was registered at the German Clinical Trials Register (9 January 2015, Identifier: DRKS00007666 ).

    更新日期:2019-11-28
  • Determinants of stunting among children aged 0–59 months in Nepal: findings from Nepal Demographic and health Survey, 2006, 2011, and 2016
    BMC Nutr. (IF 0) Pub Date : 2019-08-05
    Ramesh P. Adhikari; Manisha Laxmi Shrestha; Ajay Acharya; Nawaraj Upadhaya

    Stunting is one of the most commonly used indicators of child nutrition and health status. Despite significant efforts by the government and external development partners to improve maternal and child health and nutrition, stunting is consistently high in Nepal. This paper assesses the potential determinants of stunting among children aged 0–59 months using the last three successive Nepal Demographic and Health Surveys (NDHS). We used three nationally representative cross-sectional household surveys, known as the NDHS- 2006, 2011 and 2016. Logistic regression was used to identify the potential determinants of stunting. The sub sample for this study includes n = 5083 in 2006, n = 2485 in 2011, and n = 2421 in 2016. Rates of stunting decreased from nearly 50% in 2006 to about 36% in 2016. The prevalence of stunting was higher among children from larger families (51.0% in 2006, 41.1% in 2011, 38.7% in 2016), poor wealth quintile households (61.2% in 2006, 56.0% in 2011, 49.2% in 2016), and severely food insecure households (49.0% in 2011, 46.5% in 2016). For child stunting, the common determinants in all three surveys included: being from the highest equity quintile (OR: 0.58 in 2006, 0.26 in 2011, 0.28 in 2016), being older (OR: 2.24 in 2006, 2.58 in 2011, 1.58 in 2016), being below average size at time of birth (OR: 1.64 in 2006, 1.55 in 2011, 1.60 in 2016), and being affected by anemia (OR: 1.32 in 2006, 1.59 in 2011, 1.40 in 2016). This study found that household wealth status, age of child, size of child at time of birth, and child anemia comprised the common determinants of stunting in all three surveys in Nepal. Study findings underscore the need for effective implementation of evidence-based nutrition interventions in health and non-health sectors to reduce the high rates of child stunting in Nepal.

    更新日期:2019-11-28
  • Concordance between estimates of acute malnutrition measured by weight-for-height and by mid-upper arm circumference after age adjustment: population-representative surveys from humanitarian settings
    BMC Nutr. (IF 0) Pub Date : 2019-08-19
    Eva Leidman; Alexia Couture; Erin Hulland; Oleg Bilukha

    Mid-upper arm circumference (MUAC) and weight-for-height (WHZ) are commonly used indicators to identify acute malnutrition. However, MUAC and WHZ diagnose different children, and produce prevalence estimates that are meaningfully different. Previous research in Somalia has suggested improved concordance using MUAC-for-age (MUACZ) rather than MUAC. We further evaluate the relationship between MUACZ, MUAC, and WHZ using surveys conducted globally. We analyzed 882 population representative surveys from 41 countries. Children ages 6–59 months were classified as acutely malnourished using three independent criteria: WHZ < − 2 (WHZ2), MUAC< 125 mm (MUAC125), MUACZ < − 2 (MUACZ2). Population prevalence using each of the three criteria are presented by country and region. Correlations of survey prevalence for each indicator pair were assessed. Multivariable regression models of MUACZ and MUAC125 adjusted for WHZ2, stunting prevalence, age, and sex. To evaluate individual level diagnostic concordance, we compared the proportion of children identified by each of the three criteria. Median prevalence of acute malnutrition overall was highest for MUACZ2 (14.0%) followed by WHZ2 (10.6%), and lowest for MUAC125 (7.3%). The absolute difference in prevalence between MUACZ2 and WHZ2 was smaller than the difference between MUAC125 and WHZ2 for 51.3% of surveys. The correlations of WHZ2 with both MUACZ2 as well as with MUAC125 were weak, positive associations (Pearson’s r = 0.5757 and 0.4943, respectively), but MUAC125 and MUACZ2 had a strong, linear relationship (Pearson’s r = 0.9265). The adjusted regression model for MUACZ2 had greater fit (R2 = 0.50) relative to the adjusted model for MUAC125 (R2 = 0.43). The proportion of children identified by both MUAC125 and WHZ2 was 25.5%, smaller than the proportion identified by both MUACZ2 and WHZ2 (30.6%). MUACZ identified more children as malnourished than MUAC, resulting in a higher prevalence of acute malnutrition in nearly all settings. Prevalence by MUACZ was not consistently more similar to WHZ than that estimated by MUAC, and correlations with WHZ were only slightly improved relative to MUAC. Consequently, programmatic use of MUACZ cannot be justified based on improved concordance with WHZ. Further research on morbidity and mortality of children with low MUACZ only are needed before recommending MUACZ for wider use.

    更新日期:2019-11-28
  • Baseline diet quality of predominantly minority children and adolescents from households characterized by low socioeconomic status in the Childhood Obesity Prevention and Treatment Research (COPTR) Consortium
    BMC Nutr. (IF 0) Pub Date : 2019-09-09
    Kimberly P. Truesdale; Donna M. Matheson; Meghan M. JaKa; Sarah McAleer; Evan C. Sommer; Charlotte A. Pratt

    The Healthy Eating Index (HEI-2010) is a measure of diet quality that examines conformance with the Dietary Guidelines for Americans. The objectives of this study were to estimate baseline diet quality of predominantly low-income minority children using the HEI-2010 and to identify the most important HEI components to target for dietary intervention. Two or three baseline 24 h dietary recalls were collected in-person or over telephone between May 2012 and June 2014 from 1,745 children and adolescents from four randomized clinical trials in the Childhood Obesity Prevention and Treatment Research (COPTR) Consortium. Nine adequacy and three moderation food components were calculated and averaged to determine overall HEI scores. The overall HEI-2010 scores were categorized as ≥81, 51–80, or ≤ 50 based on the HEI-2005 classification. For each study, mean overall and component HEI scores were estimated using linear regression models. Mean (95% CI) overall HEI scores ranged from 47.9 (46.8, 49.0) to 64.5 (63.6, 65.4). Only 0.3 to 8.1% of children and adolescents had HEI-2010 score ≥ 81. The average component score for green and beans was less than 30% of maximum score for all trials. In contrast, the average component score for protein, dairy (except for IMPACT), and empty calories (except forIMPACT) was more than 80% of maximum score. Based on HEI-2010 scores, few children and adolescents consumed high quality diets. Dietary interventions for children and adolescents should focus on improving intakes of green vegetables and beans. GROW study (clinical trial # NCT01316653); NET-Works study (clinical trial #NCT01606891); Stanford Goals (clinical trial #NCT01642836); IMPACT (clinical trial # NCT01514279).

    更新日期:2019-11-28
  • Prevalence and associated risk factors of anaemia among women attending antenatal and post-natal clinics at a public health facility in Ghana
    BMC Nutr. (IF 0) Pub Date : 2019-09-23
    Philip Kofie; Elvis E. Tarkang; Emmanuel Manu; Hubert Amu; Martin Amogre Ayanore; Fortress Yayra Aku; Joyce Komesuor; Martin Adjuik; Fred Binka; Margaret Kweku

    Anaemia among pregnant women and post-partum mothers is a public health challenge in Ghana, especially in the Volta Region. While literature abounds on anaemia among pregnant women, the same cannot be said for anaemia among post-partum mothers in the region. This study, therefore, examined the prevalence and associated risk factors of anaemia among women attending antenatal care and post-natal care. This descriptive cross-sectional survey recruited 409 pregnant women and 194 post-natal mothers attending antenatal and post-natal care, at the Hohoe Municipal Hospital. Background characteristics were collected using a semi-structured questionnaire, blood samples were analysed for the presence of anaemia and malaria parasitaemia and folders were reviewed for estimated blood loss. We found the prevalence of anaemia among pregnant women and post-partum mothers to be 33 and 16% respectively. Higher malaria parasitaemia (2%) was found in pregnant women compared with postpartum mothers (1%). We found that 4% of post-partum mothers had abnormal blood loss (301mls-500mls) whereas 5% of them had postpartum haemorrhage (>500mls) during child birth. A univariate logistics regression of anaemia status on some risk factors in pregnant women showed no significant association between anaemia and any of the risk factors. Among post-partum mothers, only mothers’ age was statistically significant in the univariate analysis [COR = 0.27 (95% CI:0.103, 0.72);0.008]. Mothers aged 20–29 were 73% less likely to be anaemic. The prevalence of anaemia among pregnant women found in this study points to a situation of moderate public health problem according to WHO cut-off values for the public health significance of anaemia. Strategies should therefore be put in place to encourage thorough health education and promotion programmes among both pregnant and post-partum women.

    更新日期:2019-11-28
  • Correlates of stunting among under-five children in Bangladesh: a multilevel approach
    BMC Nutr. (IF 0) Pub Date : 2019-10-07
    Papia Sultana; Md. Mahfuzur Rahman; Jahanara Akter

    Child malnutrition still remains a major cause of childhood morbidity and mortality in Bangladesh. This study aims to determine the prevalence and identify the associated risk factors of child malnutrition in Bangladesh using multilevel logistic regression model on data from the Bangladesh Demographic and Health Survey (BDHS), 2014. A total sample of 6965 children aged 0–59 months was extracted from BDHS 2014. We performed descriptive analysis and multilevel generalized linear regression analysis with clustered data structure. Our findings show that among children the prevalence of moderate and severe values was respectively: 25 and 12% for stunting; 11 and 3.1% for wasting; 25 and 7.9% for underweight. The probability of stunting increased with age, with highest rate among children aged 36–47 months, which was significantly higher than children aged less than 6 months (OR = 6.71, 95% CI = 4.46, 10.10). Female children are found to be 11% less likely to be stunted than male children (OR = 0.89, 95% CI = 0.78, 1.02). Children with birth interval less than 24 months were significantly more likely to be stunted than children of first birth by 36% (OR = 1.36, 95% CI = 1.11, 1.67). Mothers with a normal BMI were 16% less likely to have children with stunting compared to mothers who are underweight (OR = 0.84, 95% CI = 0.76, 0.93). Other factors which were associated with a higher risk of stunting included parents with lower educational levels, children from the poorest wealth index, and mothers aged less than 20 years as first birth. Government and non-government organization should generate effective program to aware women of reproductive age about adverse effect of short birth interval, and to aware parents about standard height and weight according to age and gender of children. Overall, necessary steps may be taken to make people educated and to reduce household wealth inequality to improve nutritional status of children.

    更新日期:2019-11-28
  • The effect of vitamin D supplementation on the glycemic control of pre-diabetic Qatari patients in a randomized control trial
    BMC Nutr. (IF 0) Pub Date : 2019-10-10
    Mohammed Al Thani; Eman Sadoun; Angeliki Sofroniou; Amin Jayyousi; Khaled Ahmed Mohamed Baagar; Abdulla Al Hammaq; Benjamin Vinodson; Hammad Akram; Zaid Shakoor Bhatti; Heba Samir Nasser; Vasiliki Leventakou

    Vitamin D deficiency is associated with indicators of pre-diabetes including, insulin resistance, β-cell dysfunction and elevated plasma glucose with controversial findings from current trials. This study aims to investigate the long-term effect of vitamin D on glucose metabolism and insulin sensitivity in pre-diabetic and highly vitamin-deficient subjects. One hundred thirty-two participants were randomized to 30,000 IU vitamin D weekly for 6 months. Participants underwent oral glucose tolerance test (OGTT) at 3-month intervals to determine the change in plasma glucose concentration at 2 h after 75 g OGTT (2hPCG). Secondary measurements included glycated hemoglobin, fasting plasma glucose and insulin, post-prandial insulin, indices of insulin sensitivity (HOMA-IR, Matsuda Index), β-cell function (HOMA-β, glucose and insulin area under the curve (AUC), disposition and insulinogenic indices), and lipid profile. A total of 57 (vitamin D) and 75 (placebo) subjects completed the study. Mean baseline serum 25(OH) D levels were 17.0 ng/ml and 14.9 ng/ml for placebo and vitamin D group, respectively. No significant differences were observed for 2hPC glucose or insulin sensitivity indices between groups. HOMA-β significantly decreased in the vitamin D group, while area under curve for glucose and insulin showed a significant reduction in β-cell function in both groups. Additionally, HOMA-β was found to be significantly different between control and treatment group and significance persisted after adjusting for confounding factors. Vitamin D supplementation in a pre-diabetic and severely vitamin-deficient population had no effect on glucose tolerance or insulin sensitivity. The observed reduction in β-cell function in both placebo and vitamin D groups could be attributed to factors other than supplementation. NCT02098980 , 28/03/2014 ( www.clinicaltrials.gov ).

    更新日期:2019-11-28
  • Association of nutritional support programs with zinc deficiency in Colombian children: a cross-sectional study
    BMC Nutr. (IF 0) Pub Date : 2019-10-21
    Ángela María Pinzón-Rondón; Alfonso Hoyos-Martínez; Daniela Parra-Correa; Ana María Pedraza-Flechas; Ángela María Ruiz-Sternberg

    Zinc is an essential trace element that plays a key role in the immune, gastrointestinal, respiratory and nervous systems. In Colombia, a vast percentage of children live in low-income households with food insecurity and nutritional deficiencies, including zinc. In an effort to improve children’s well-being, public health measures such as nutritional support programs that provide meals have targeted the poorest populations. The aim of the present study was to assess the role of nutritional support programs on zinc deficiency in Colombian children, while considering their wealth and food security. Cross-sectional study using data from the 2010 Colombian National Nutrition Survey, a population-based study representative of Colombia. A total of 4275 children between 12 and 59 months of age were included in the study. Stepwise logistic regressions were modelled with SPSS, first for zinc deficiency on wealth and food security, then adding enrolment in a nutritional support program, and finally, adjusting for socio-demographic variables. A zinc deficiency prevalence of 49% was found. The adjusted models showed an association of wealth quintiles: very poor (OR = 1.48) and poor (OR = 1.39), food security (OR = 0.75) and enrolment in a nutritional support program (OR = 0.76) with zinc deficiency. Enrolment in nutritional programs did not modify the relationship of wealth and food security to zinc deficiency. Zinc deficiency is associated with wealth, food security and enrolment in nutritional support programs. Nutritional programs may be a good alternative against zinc deficiency, if they focus appropriately on the needs of children according to their wealth and food security.

    更新日期:2019-11-28
  • Nutritional status and associated factors among high school adolescents in Debre Tabor Town, South Gondar Zone, Northcentral Ethiopia
    BMC Nutr. (IF 0) Pub Date : 2019-11-04
    Melkamu Aderajew Zemene; Melaku Tadege Engidaw; Alemayehu Digssie Gebremariam; Desalegn Tesfa Asnakew; Sofonyas Abebaw Tiruneh

    Adolescents are among the nutritionally vulnerable group due to their nutritional demand for pubertal spurt. At this age, adequate nutrition, nutritional education, and counseling are very important to halt the consequence and its impact on this segment of the population. So, the aim of this study was to assess the prevalence and its associated factors of nutritional status among high school adolescents aged 10–19 years in Debre Tabor Town, South Gondar Zone, and North central Ethiopia. A cross-sectional study was conducted from September to October 2017. A total of 349 high school adolescents were selected by using simple random sampling. Data were collected through face to face interview and physical measurement. The data were entered into Epi info version 7 software and then exported into SPSS version 20 software for further analysis. A p-value < 0.2 was used to select independent variables for multivariable logistic regression. A p-value ≤0.05 was used to declare the statistical significance. Also, odd ratios were calculated with a 95% of the confidence interval to check the existence of the association. A total of 327 adolescents participated in this study with the overall response rate of 93.69%. The magnitude of stunting and thinness was 15% (95% CI: 11, 19) and 4.9% (95% CI: 2.4, 7.4) respectively. Sex (AOR: 2.24, 95% CI: 1.15, 4.36), residency (AOR: 2.48, 95% CI: 1.28, 4.82), and family size (AOR: 3.41, 95% CI: 1.65, 7.05) were the associated factors for stunting. Residence (AOR: 3.67, 95% CI: 1.16, 11.56), and living away from the family (AOR: 4.37, 95% CI: 1.20, 15.95) were the associated factors for the development of thinness. Stunting is a mild public health problem but not thinness. Sociodemographic variables were the determinant factors for the development of stunting and thinness. To halt this, integrated adolescent related school and nutrition services is very important with adequate and quality food access to adolescents. In addition to this the government shall have to increase the access of education.

    更新日期:2019-11-28
  • Socio-demographic and facility-based determinants of perceived quality of nutrition Services of Pregnant and Lactating Adolescent Girls in Trans-Mara east Sub-County, Narok County, Kenya
    BMC Nutr. (IF 0) Pub Date : 2019-11-06
    David Omondi Okeyo; Sussy Gumo; Elly O. Munde; Charles O. Opiyo; Zablon O. Omungo; Maureen Olyaro; Rachel K. Ndirangu; Nanlop Ogbureke; Sophie Efange; Collins Ouma

    It has been established that use and utilization of nutrition services among adolescents are highly linked to availability, access, cost and quality of care. The main objective of this study was to assess the socio-demographic and facility-based factors as proxies to access to perceived quality of nutrition-specific and nutrition-sensitive services among adolescents in Trans-Mara East Sub-County, Narok County. The study adopted a cross-sectional approach that employed mixed methods on 291 households. Probability proportionate to size sampling techniques using cluster and simple random methods were used to practically access adolescents who are pregnant or lactating. Data were collected using questionnaires, in-depth interview and Focus Group Discussion. Quantitative data was analyzed descriptively using frequencies and inferentially using odds ratio and Z-test. Framework analysis was employed to analyze qualitative data. A nutritionist was more likely to increase overall utilization (considered as a proxy index to access quality nutrition-sensitive and -specific services) by 3.18 times (OR = 3.18, 95% CI = 1.50–6.60, P = 0.002) and nurses 2.7 times (OR = 2.70, 95% CI = 1.40–5.30, P = 0.005). Generally, 80.7 and 69.4% attached positive value to environmental and basic personal hygiene, respectively, as being areas of nutrition-sensitive service delivery with a significant number higher than expected frequency of 50% (P < 0.05). An assessment of facility networks isolated only public health center as the key determinant of overall utilization. Public health centers among other health facilities were more likely to increase utilization (OR = 4.52, 95% CI = 1.50–13.50, P = 0.007). Assessment of distance to facility identified both distances as key determinants of overall utilization as those resident < 1 km from the facilities were 2.4 times more likely to utilize the facilities (OR = 2.42, 95% CI = 1.20–4.80, P = 0.012) while those resident 1-5 km were 5.3 times more likely to utilize the services (OR = 5.34, 95% CI = 1.90–15.10, P = 0.002) relative to longer distances. Finally, on methods of conveying messages, those who received messages through Information Education and Communication (IEC) materials were 7.8 times (OR = 7.85, 95% CI = 1.50–40.50, P = 0.014) and through face-to-face were 3.9 times more likely to utilize the services (OR = 3.91, 95% CI = 1.30–11.90, P = 0.016). Critical facility-based determinants of utilization of nutrition services include personnel (mainly nutritionist and nurse), distance and IEC materials.

    更新日期:2019-11-28
  • Reproducibility and relative validity of a newly developed web-based food-frequency questionnaire for assessment of preconception diet
    BMC Nutr. (IF 0) Pub Date : 2019-11-07
    L. Salvesen; E. R. Hillesund; F. N. Vik; A. L. Brantsæter; N. C. Øverby

    The importance of diet and nutrition during preconception age is a window of opportunity to promote future parental and transgenerational health. As a sub-study to a large Norwegian study, ‘Diet today – health of tomorrow’, a food-frequency questionnaire (FFQ) was developed to assess diet during the preconception phase in young adults aged 20 – 30 years and in this paper we report the reproducibility and relative validity of this questionnaire. The FFQ was developed from an existing FFQ validated in adolescents. Participants were recruited on social media and at a university. Reproducibility was assessed by comparing the test and retest of the FFQ. Relative validity was assessed by comparing intake measured by the FFQ with a 7-day weighed food record. Energy, nutrients and food intake were used to assess the reproducibility and relative validity of the FFQ. The study applied the Spearman’s rank correlation coefficient, percentage of agreement and Cohen’s Kappa to assess reproducibility and validity. There were 32 participants recruited to the study, of which 21 participants completed both the test-retest reproducibility and the relative validation. The test-retest reproducibility had a median correlation coefficient of 0.85 for energy and nutrients, a median Spearman’s rank correlation coefficient of 0.75 and a median Cohen’s Kappa of 0.51 for food groups. The relative validity of the FFQ had a median correlation coefficient of 0.59 for energy and nutrients, a median Spearman’s rank correlation coefficient of 0.54 and a median Cohen’s Kappa of 0.28 for food groups. This newly developed FFQ for preconception diet in young adults had a satisfactory test-retest reproducibility and fair relative validity.

    更新日期:2019-11-28
  • Predictors of undernutrition among the elderly in Sodo zuriya district Wolaita zone, Ethiopia
    BMC Nutr. (IF 0) Pub Date : 2019-11-08
    Kidest Wondiye; Netsanet Abera Asseffa; Tsegaye Demisse Gemebo; Feleke Hailemichael Astawesegn

    In any society, the elderly are among the vulnerable and high risk groups with regard to health status. In persons over the age of 60 years, nutrition is among the important determinants of health. However, undernutrition among the elderly is often under diagnosed and/or neglected. Hence, in this study, we looked at prevalence and factors associated with undernutrition among the elderly. A community based cross-sectional study was conducted at Sodo Zuriya district. Multi-stage systematic sampling method was used to select 578 elderly. A structured questionnaire was used to collect data on socio-demographics, dietary diversity, and health status of the elderly. Measurements of weight and height were taken using digital weighing scale and stadio-meter, respectively. Data was entered and cleaned in Epi-Data version3.1and exported to SPSS version 20 for analysis. Binary and multivariate logistic regressions were done and odds ratios with 95% confidence intervals were calculated. The overall prevalence of undernutrition was 17.1%. On multivariate logistic regression, being unable to read and write (AOR = 2.09), not being married (AOR = 2.02), history of decline in food intake (AOR = 2.1), smoking (AOR = 4.9) and monthly income <$20 (AOR = 7.5) were factors positively associated with undernutrition. The study revealed that prevalence of undernutrition in the district was relatively high. Hence, it is among the major public health burdens in the district. Hence, to improve nutritional status of elderly the district health office and health professionals should consider behavioral support interventions to assist in cessation of smoking. There is also a need to financially empower the elderly in the district.

    更新日期:2019-11-28
  • Clinical application of invalid foods using mealworms and evaluation of nutrition status and immune function: a study protocol for a randomized, double blind, placebo-controlled trial
    BMC Nutr. (IF 0) Pub Date : 2019-11-18
    Hyung Sun Kim; Yun Sun Lee; Soo Yun Jang; So Young Jun; Jin Hong Lim; Im Kyung Kim; Hyung Mi Kim; Joon Seong Park

    Protein intake is important for the recovery of the immune system, physical strength, and wound healing after surgery. Sarcopenia is associated with a poor prognosis when compared to patients without sarcopenia in cancer patients. Recently, edible insects, such as mealworms, have been recognized as having a high protein content. In this study, we will evaluate the effect of nutritional status and immune function change based on a patient’s ingestion of mealworms after hepatobiliary pancreatic surgery. This is a prospective, two-armed, phase III study investigating the effect of mealworm improving nutrition and immune status in patients after hepatobiliary pancreatic surgery. In the trial group, the patients will be provided with mealworms for 2 months after surgery. In the control group, patients will be provided with grain powder for 2 months after surgery. The target for accrual is 168 patients. We divided in to three groups according to the type of surgery. The primary endpoint is to evaluate body cell mass index 2 months postoperatively. Secondary endpoints include other body composition changes as well as nutrition index and immune function change. We expect that ingestion of mealworms can effectively improve the nutritional status and enhance the immune function. Mealworm can be used effectively for nutritional management of patients after surgery. Clinicaltrials.gov NCT03201926 Registered June 28, 2017, retrospectively registered.

    更新日期:2019-11-28
  • Nutrition education and cooking workshops for families of children with cancer: a feasibility study
    BMC Nutr. (IF 0) Pub Date : 2019-11-19
    S. Beaulieu-Gagnon; V. Bélanger; C. Meloche; D. Curnier; S. Sultan; C. Laverdière; D. Sinnett; V. Marcil

    Changes in food intake are common in children with cancer and are often caused by nausea and perturbations in sense of taste. The VIE (Valorization, Implication, Education) study proposes family-based nutrition and cooking education workshops during childhood cancer treatments. Process evaluation during implementation allows to assess if the intervention was delivered as planned and to determine its barriers and facilitators. The study objective was to describe the implementation process of a nutrition education and cooking workshop program for families of children actively treated for cancer in a non-randomized non-controlled feasibility study. Six open-to-all in-hospital workshops were offered on a weekly basis during a one-year implementation phase. We collected qualitative and quantitative data using field notes and activity reports completed by the registered dietician facilitator; surveys and questionnaires fulfilled by the workshop participants and by the families enrolled in the VIE study. Field notes were used to collect only qualitative data. Survey respondents (n = 26) were mostly mothers (n = 19, 73%). Children’s mean age was 7.80 (± 4.99) years and the mean time since diagnosis was 7.98 (± 0.81) months. Qualitative data were codified using hybrid content analysis. The first deductive analysis was based on the Steckler & Linnan concepts. Subthemes were then identified inductively. Quantitative data were presented with descriptive statistics. Workshop attendance was low (17 participants over 1 year) and 71% of the planned workshops were cancelled due to lack of participants. The principal barriers to participation referred the child’s medical condition, parental presence required at the child’s bedside and challenges related to logistics and time management. The level of interest in the topics addressed was found high or very high for 92% of the participants. The themes that were perceived as the most useful by parents were related to the child’s specific medical condition. Despite high interest, workshops delivered in a face-to-face format were poorly feasible in our sample population. This supports the need to develop educational programs in pediatric oncology using strategies and delivery formats that address the major barriers for participation encountered by families.

    更新日期:2019-11-28
  • Performance of an adapted household food insecurity access scale in measuring seasonality in household food insecurity in rural Ethiopia: a cohort analysis
    BMC Nutr. (IF 0) Pub Date : 2019-11-20
    Bereket Yohannes Kabalo; Seifu Hagos Gebreyesus; Eskindir Loha; Bernt Lindtjørn

    Seasonality poses a considerable food security challenge in Ethiopia. Yet, measuring seasonal variations in food insecurity, particularly the dimension of food access, lacks an adequately validated tool. We therefore evaluated the performance of an adapted Household Food Insecurity Access Scale (HFIAS) to estimate seasonal variations in food insecurity (FI) among subsistence villagers in Ethiopia. We employed a cohort study design using a panel of four repeated measurements taken in June, September, and December in the year 2017, and in March 2018. The study recruited 473 villagers from the drought-affected Wolaita area in southwest Ethiopia. The performance of the HFIAS was evaluated via internal consistency (Chronbach’s alpha values) and criterion validation techniques. The set of criteria include: parallelism between affirmative responses to FI questions and wealth strata; dose-response relationship between FI and dietary intake; and also FI severity and household wealth status. This study revealed that the HFIAS had satisfactory performance in four repeated measurements. The likelihood of affirmative responses to questions about FI decreased with ascending wealth quintiles. We observed an inverse dose-response relationship between FI and wealth status, and between FI and household dietary diversity. The HFIAS showed an acceptable potential for measuring seasonal variations in FI in the study area. Our findings complement efforts to evaluate the scale’s applicability in various settings, in order to promote cross-culture monitoring and comparisons. However, it required a careful adaption for contextual and cultural sensitivities.

    更新日期:2019-11-28
  • Measuring energy, macro and micronutrient intake in UK children and adolescents: a comparison of validated dietary assessment tools
    BMC Nutr. (IF 0) Pub Date : 2019-11-21
    Linda A. Bush; Jayne Hutchinson; Jozef Hooson; Marisol Warthon-Medina; Neil Hancock; Katharine Greathead; Bethany Knowles; Elisa J. Vargas-Garcia; Lauren E. Gibson; Barrie Margetts; Sian Robinson; Andy Ness; Nisreen A. Alwan; Petra A. Wark; Mark Roe; Paul Finglas; Toni Steer; Polly Page; Laura Johnson; Katharine Roberts; Birdem Amoutzopoulos; Darren C. Greenwood; Janet E. Cade

    Measuring dietary intake in children and adolescents can be challenging due to misreporting, difficulties in establishing portion size and reliance on recording dietary data via proxy reporters. The aim of this review was to present results from a recent systematic review of reviews reporting and comparing validated dietary assessment tools used in younger populations in the UK. Validation data for dietary assessment tools used in younger populations (≤18 years) were extracted and summarised using results from a systematic review of reviews of validated dietary assessment tools. Mean differences and Bland-Altman limits of agreement (LOA) between the test and reference tool were extracted or calculated and compared for energy, macronutrients and micronutrients. Seventeen studies which reported validation of 14 dietary assessment tools (DATs) were identified with relevant nutrition information. The most commonly validated nutrients were energy, carbohydrate, protein, fat, calcium, iron, folate and vitamin C. There were no validated DATs reporting assessment of zinc, iodine or selenium intake. The most frequently used reference method was the weighed food diary, followed by doubly labelled water and 24 h recall. Summary plots were created to facilitate comparison between tools. On average, the test tools reported higher mean intakes than the reference methods with some studies consistently reporting wide LOA. Out of the 14 DATs, absolute values for LOA and mean difference were obtained for 11 DATs for EI. From the 24 validation results assessing EI, 16 (67%) reported higher mean intakes than the reference. Of the seven (29%) validation studies using doubly labelled water (DLW) as the reference, results for the test DATs were not substantially better or worse than those using other reference measures. Further information on the studies from this review is available on the www.nutritools.org website. Validated dietary assessment tools for use with children and adolescents in the UK have been identified and compared. Whilst tools are generally validated for macronutrient intakes, micronutrients are poorly evaluated. Validation studies that include estimates of zinc, selenium, dietary fibre, sugars and sodium are needed.

    更新日期:2019-11-28
  • Awareness and factors associated with reported intake of folic acid-fortified flour among women of reproductive age in Ifakara, Morogoro region, Tanzania: a cross-sectional study
    BMC Nutr. (IF 0) Pub Date : 2019-11-25
    Ipyana Frank Mwandelile; Rose Mpembeni; Ahmed Abade; Susan F. Rumisha; Julius J. Massaga; Rogath Kishimba

    Folic acid fortification of staple foods has been in place in many countries for over two decades. Studies have shown that folic acid fortification can significantly reduce incidence of neural tube defects. Tanzania adopted a mandatory fortification policy for commercially-produced wheat and maize flour in 2011. We determined factors influencing intake of folic acid-fortified flour among women of reproductive age (WRA). We conducted a cross-sectional study among WRA during March–April 2017 in Ifakara Town Council, Morogoro region. Multistage cluster sampling was used to select study participants. We used a questionnaire to capture information on demographics, awareness of folic acid, awareness of existence of folic acid fortified flour in community and intake of folic acid fortified flour. Intake was defined as reported consumption of folic acid fortified flour products at least once within 7 days before interview. Univariate, bivariate, and multivariable logistic analyses were done to evaluate factors associated with intake of folic acid fortified flour. The median age of the 698 participating WRA was 30 years (range: 18–49). Awareness of folic acid and folic acid fortified flour was 6.9% (95% CI: 5.2–9.0%) and 7.5% (95% CI: 5.7–9.6%), respectively. Consumption of folic acid fortified flour was 63.3% (95% CI: 59.7–66.8%). Independent factors associated with intake included being employed (aOR = 1.91; 95% CI: 1.19–3.06), having no children (nulliparity) (aOR = 2.59; 95% CI: 1.36–4.95) or having 1–4 children (aOR = 1.98; 95% CI: 1.17–3.33) (vs. 5 or more children), and folic acid awareness (aOR = 2.53; 95% CI: 1.30–4.92). Folic acid fortified flour was used by most respondents in our study despite low awareness of existence of folic acid fortified flour in the community. Being employed, having fewer than five children, and folic acid awareness were independent factors associated with intake. We recommend scaling up of mandatory flour fortification program and doing further studies on blood folate level among women of reproductive age in Ifakara to assess fortification program effectiveness.

    更新日期:2019-11-28
  • Food choice patterns of long-haul truck drivers driving through Germany, a cross sectional study
    BMC Nutr. (IF 0) Pub Date : 2019-11-26
    Andreas Bschaden; Siegfried Rothe; Anja Schöner; Nina Pijahn; Nanette Stroebele-Benschop

    Long-haul truck drivers are exposed to unfavorable working conditions affecting their health but information on truck drivers travelling through Europe is missing. The study aimed to describe the populations’ characteristics and food choice patterns while working compared with eating patterns at home, taking weight status into account. A cross-sectional survey using questionnaires in 12 languages conducted at two truck stops in Germany. Among 404 truck drivers of 24 nationalities, only 24% were normal weight while 46% were considered overweight and 30% obese. In regards to their health, more than half reported that they smoked and 32% reported at least one chronic disease. 37% ate their meals often or always at truck stops, while 6% never did so. The most common food items brought from home were fruits (62%) followed by sausages (50.6%), sandwiches (38.7%), self-cooked meals (37%), sweets (35.4%), and raw vegetables (31%). Bivariate analyses revealed differences in food choices during work and at home with more sausages, energy drinks and soft drinks, and canned foods eaten during trips. Fresh vegetables, legumes and fish were more often chosen at home. Available food appliances in trucks appeared to be associated with food choice patterns. Interestingly, food choice patterns and food preparation did not differ significantly across weight categories. The working conditions of professional truck drivers make a healthy lifestyle difficult to follow and appear to influence food choices while working. Particular effort should be taken to improve food choice patterns, food preparation and purchasing possibilities during trips.

    更新日期:2019-11-28
Contents have been reproduced by permission of the publishers.
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