Effectiveness of provision of animal-source foods for supporting optimal growth and development in children 6 to 59 months of age (Review)

Abstract. Anemia diminishes oxygen transport in the body, resulting in potentially irreversible growth and developmental consequences for children. Limited evidence for determinants of anemia exists for school-aged children. We conducted a cluster randomized controlled trial in Haiti from 2012 to 2013 to test the efficacy of a fortified school snack. Children (N = 1,047) aged 3-13 years were followed longitudinally at three time points for hemoglobin (Hb) concentrations, anthropometry, and bioelectrical impedance measures. Dietary intakes, infectious disease morbidities, and socioeconomic and demographic factors were collected at baseline and endline. Longitudinal regression modeling with generalized least squares and logit models with random effects identified anemia risk factors beyond the intervention effect. At baseline, 70.6% of children were anemic and 2.6% were severely anemic. Stunting increased the odds of developing anemia (adjusted odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.05-2.08) and severe anemia (adjusted OR: 2.47, 95% CI: 1.30-4.71). Parent-reported vitamin A supplementation and deworming were positively associated with Hb concentrations, whereas fever and poultry ownership showed a negative relationship with Hb concentration and increased odds of severe anemia, respectively. Further research should explore the full spectrum of anemia etiologies in school children, including genetic causes.

Recent events in Ferguson underscore the need to better understand the unique challenges, stressors, and coping mechanisms of African American men. To this end, a focus group study was conducted in Saint Louis, a few miles from Ferguson. Although numerous stress-related themes were discussed, racial discrimination and structural racism emerged as pervasive stressors among these men. Participants described experiences of discrimination in multiple settings including workplace, school, and residential, and within the criminal justice system. Coping strategies included not only drinking and smoking but also religiosity and familial support. Men also mentioned that they found relief in simply discussing their stressors in a group setting. One implication of this study is to develop and implement group support models for this population. Keywords racial discrimination, coping, African American men Recent events in Ferguson, a small northern suburb of St. Louis, underscore the need to better understand the challenges, stressors, and coping mechanisms of African American men. African American men have the lowest life expectancy (72.3 years) of

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BackgroundNutrition in the school-aged child matters for brain development and public policy investments globally. Our group previously conducted a trial in urban schools of Haiti to examine the effects of a fortified peanut butter snack, Vita Mamba, with limited findings for anemia.ObjectiveWe aimed to test the hypothesis that Vita Mamba, with systematic deworming in both study arms, would significantly reduce anemia among rural, school-aged children.MethodsA cluster, randomized longitudinal study was conducted in two rural communities of the North-East Department of Haiti, 2014–2015. Healthy children ages 3–16 years were enrolled (n = 321) and assigned by school to intervention (Vita Mamba and deworming) and control (deworming). Vita Mamba contains 260 kcal and meets >75% of the Recommended Dietary Allowance for critical micronutrients. Multivariate regression analyses including propensity score matching techniques to correct for potential group imbalance (Kernel-based Matching and Propensity Score Weighting) were applied to examine difference-in-difference intervention effects.ResultsAt baseline, 51% of the children were anemic with no significant differences between study groups. Vita Mamba supplementation showed a consistent, positive effect across regression models on increasing Hb concentration and reducing the odds of anemia compared to the control group after adjusting for child age, vitamin A supplementation, milk consumption, and height-for-age z score. The average treatment effect for the treated in the Propensity Score Weighting models was 0.62±0.27 grams per 100 milliliters (g/dL) for Hb concentration (F = 4.64, P = 0.001), and the odds of anemia were reduced by 88% (Wald χ² = 9.77, P = 0.02). No differences in change in anthropometric markers were evident.ConclusionsSchool feeding programs that integrate fortified foods with deworming could reduce anemia burden with important implications for learning, health, and well-being. The rural-urban differences in anemia require further study.

Humans adapted over a period of 2.3 million years to a diet high in quality and diversity. Genome–nutrition divergence describes the misalignment between modern global diets and the genome formed through evolution. A survey of hominin diets over time shows that humans have thrived on a broad range of foods. Earlier diets were highly diverse and nutrient dense, in contrast to modern food systems in which monotonous diets of staple cereals and ultraprocessed foods play a more prominent role. Applying the lens of genome–nutrition divergence to malnutrition reveals shared risk factors for undernutrition and overnutrition at nutrient, food, and environmental levels. Mechanisms for food system shifts, such as crop-neutral agricultural policy, agroecology, and social policy, are explored as a means to realign modern diets with the nutritional patterns to which humans may be better adapted to thrive.

Objectives Ultra-processed foods (UPF) and sugar-sweetened beverages (SSB) comprise over 50% of energy intake in most upper-middle and high-income contexts. Higher intake of UPF and SSB is associated with an increased prevalence of overweight and obesity at the individual level, but few studies have examined the association between UPF, SSB, and BMI at the country level. The objective of this study was to evaluate global trends in UPF and SSB sales and associations with trajectories of change in BMI and prevalence of overweight, and obesity. Methods Data on UPF and SSB sales was collected from EuroMonitor International; BMI, overweight, and obesity prevalence from the NCD Risk Factor Collaboration; and potential confounders from the World Health Organization Global Health Observatory. Longitudinal multi-level models were used to estimate the relationship between country-level UPF/SSB sales and weight trajectories for adults and children and adolescents less than 19 years, for both general population and sex disaggregated. Results UPF sales grew 2.7% between 2005 and 2018. Sales were highest in high income contexts of North America (139.3 kg/person/year) and Europe (117.3 kg/p/y) but grew most rapidly in low and lower-middle income countries, particularly South Asia and Sub-Saharan Africa. SSB sales grew 1.9% but ranged from −22.4% in North America (120.3 liters/person/year in 2018) to 144.7% in South Asia (7.3 liters/p/year). Both UPF and SSB were significant and positive predictors of BMI; 1 SD increases in sales predicted mean population BMI increases between 0.2 kg/m² and 0.5 kg/m². Neither UPF nor SSB predicted obesity, but both were significantly associated with overweight prevalence trajectories for the adult general population and for males. Associations remained controlling for both country calorie supply and physical inactivity prevalence. In children and adolescents (5–19 years), SSBs significantly predicted BMI levels and obesity prevalence, while only UPF was associated with overweight. Conclusions UPF and SSB sales have a significant impact on country-level BMI trajectories. At current rates, upper-middle income countries will soon equal high-income contexts in UPF/SSB consumption and BMI trajectories. Findings suggest the need for global level action to limit UPF and SSB consumption. Funding Sources No funding sources declared.

Background: In rural Tanzania, women and girls disproportionately bear the burden of water scarcity. Gendered social norms on the acceptability of women’s participation in the public sphere limit their decision-making power within local water governance structures. The UPWARD (Uplifting Women’s Participation in Water-Related Decision-Making) intervention sought to understand how a community-based gendered social norms approach using organized diffusion can lead to changes in the gendered social norms impacting women's participation in water-related governance structures.Methods: As part of WARIDI, a 5-years integrated water resource management (IWRM) program, a gendered-social norms change (GSNC) activity (UPWARD: Uplifting Women’s Participation in Water-Related Decision-Making) was implemented in two villages in Iringa and Kilombero districts. Encouraging organized diffusion, UPWARD promoted gender-equitable norms among a critical mass of community members. WARIDI identified and trained a Community Facilitation Team (CFT) of three women and men to lead a series of education and empowerment sessions in two communities. The intervention reached >300 individuals directly (∼10% of total village population). Changes in social norms were assessed through social norms analysis plots (SNAP) delivered in focus group discussions (FGDs) of 8–12 participants.Results: At baseline, most participants reported that women’s involvement in water-related decision-making was restricted to household decisions. Men viewed themselves as primary decision-makers in water governance. Women who spoke in village meetings experienced sanctions for disrespect and outspokenness; their husbands were teased for being “controlled.” At endline, participants reported fewer instances of ridicule towards women’s participation. Women expressed a greater sense of solidarity with each other; men reported greater respect for men whose wives contribute. The intervention’s effects appeared more pronounced in areas with greater cultural heterogeneity, suggesting norm change may be harder to affect where norms are tighter.Conclusion: UPWARD provides evidence that gendered social norms change programs can have identifiable impacts on women’s participation in water-related decision-making over a short time. While other interventions have used larger, multi-level strategies to affect gender norms, UPWARD has shown that community mobilization with brief (∼4 months) but concentrated engagement with communities can promote changes in social norms that persist at least 6 months after intervention’s end.