Ensuring diets of children aged 6-23 months meet recommended guidance is crucial for growth and development and for the prevention of malnutrition including stunting, wasting and micronutrient deficiencies. Despite some improvement, indicators related to undernutrition and overnutrition fall short of global targets in the Middle East and North Africa (MENA) region that consist of low-and middle-income countries witnessing political and social changes and a nutrition transition. This research aims at reviewing the situation related to the diets of children aged 6-23 months in five selected countries in the MENA region, examining factors affecting complementary feeding and providing recommendations for guiding effective strategies to improve it. The study triangulated data on complementary feeding status and predictors from semistructured interviews with 30 key informants, and multivariable analysis of household surveys in Egypt, Jordan, Lebanon, State of Palestine and Sudan including data on refugees in Lebanon and Jordan. There remain considerable gaps in complementary feeding differing noticeably among geographic areas. Findings from qualitative and quantitative analyses showed that maternal factors, including maternal education and age, household level factors such as paternal education and wealth, community-level factors (culture and geographic location), and utilization of health services, were associated with minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD) at varied levels in the five countries. Interventions to improve complementary feeding practices should include actions tailored to the needs of the population at multiple levels including at the caregiver's level, household, service use, community and policy level.

Data on the nutritional situation and prevalence of micronutrient deficiencies in Azerbaijan are scarce, and knowledge about anemia risk factors is needed for national and regional policymakers. A nationally representative cross-sectional survey was conducted to assess the prevalence of micronutrient deficiencies, over- and undernutrition, and to disentangle determinants of anemia in children and women in Azerbaijan. The survey generated estimates of micronutrient deficiency and growth indicators for children aged 0–59 months of age (6–59 months for blood biomarkers) and non-pregnant women 15–49 years of age. Questionnaire data, anthropometric measurements, and blood samples were collected to assess the prevalence of under- and over-nutrition, anemia, iron deficiency, and iron deficiency anemia, in both groups. In children only, vitamin A deficiency and zinc deficiency were also assessed. In women only, folate and vitamin B12 deficiencies and vitamin A insufficiency were assessed. In total, 3926 household interviews were successfully completed with a response rate of 80.6%. In the 1455 children, infant and young child feeding practices were relatively poor overall; the prevalence of wasting and stunting were 3.1% and 18.0%, respectively; and 14.1% of children were overweight or obese. The prevalence of anemia was 24.2% in 6–59 months old children, the prevalence of iron deficiency was 15.0% in this age group, and the prevalence of iron deficiency anemia was 6.5%. Vitamin A deficiency was found in 8.0% of children, and zinc deficiency was found in 10.7%. Data from 3089 non-pregnant women 15–49 years of age showed that while undernutrition was scarce, 53% were overweight or obese, with increasing prevalence with increasing age. Anemia affected 38.2% of the women, iron deficiency 34.1% and iron deficiency anemia 23.8%. Vitamin A insufficiency was found in 10.5% of women. Folate and vitamin B12 deficiency were somewhat more common, with prevalence rates of 35.0% and 19.7%, respectively. The main risk factors for anemia in children were recent lower respiratory infection, inflammation and iron deficiency. In women, the main risk factors for anemia were iron deficiency and vitamin A insufficiency. Anemia is a public health problem in Azerbaijani children and women, and additional efforts are needed to reduce anemia in both groups.

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Neural tube defects (NTDs) annually affect an estimated 320 000 newborns worldwide. Folic acid (FA), provided through supplementation and fortification, is an effective primary-prevention strategy for NTDs if consumed in the periconceptional period. However, the potential impact of FA supplementation is tempered by low compliance. Countries that mandate FA fortification of wheat flour report an average reduction of 46% in NTD birth prevalence and favourable benefit : cost ratios of 12-48:1. Despite the well-documented benefits of fortification and the new evidence that provides a better understanding of purported risks associated with FA, European countries have yet to embrace this public health initiative. Viable primary-prevention strategies are needed given that an estimated 4500 NTDs occur in the 27 countries of the European Union annually, of which 72% end in terminations. Many existing factors will facilitate the success of FA flour fortification programs in the region: widespread consumption of wheat-based products, a technologically advanced milling industry, experience adhering to and monitoring food safety measures, and familiarity with mandatory food fortification.

A national cross-sectional survey was conducted to estimate the prevalence of anaemia, micronutrient deficiencies, haemoglobin disorders and over- and undernutrition in children and women of reproductive age in Oman. Wasting and stunting were found in 9.3% and 11.4% of children aged 0–59 months, respectively, while 4.2% were overweight or obese. In addition, 23.8% were anaemic and 10.2%, 9.5% and 10.6% had iron, vitamin A and vitamin D deficiencies, respectively. Sickle cell and β-thalassaemia genetic traits were present in 5.3% and 4.2% of children and 4.7% and 2.8% of women, respectively. Overall, 9.1% of Omani women were underweight and 59.2% were overweight or obese. The prevalence of anaemia was 27.8%, while iron, folate, vitamin B12 and vitamin D deficiencies affected 24.8%, 11.6%, 8.9% and 16.2%, respectively. Anaemia among both children and women and the prevalence of overweight and obesity in women are the most concerning nutritional problems in Oman.Keywords: Nutrition Disorders; Malnutrition; Micronutrients; Iron-Deficiency Anemia; Avitaminosis; Vitamin D Deficiency; Vitamin B 12 Deficiency; Oman.