搜索结果：Food and nutrition bulletin

BackgroundIn response to high rates of undernutrition, Uganda began rolling out the multisectoral Uganda Nutrition Action Plan (UNAP) in 2011, followed by Phase II (UNAP II) in 2020. Uganda has since progressed toward several nutrition targets; however, limitations in nutrition coordination and financing call for continued strengthening of the UNAP II.ObjectivesGiven that monitoring of the UNAP II does not consistently capture district-level outcomes and relies upon quantitative nutrition indicators, this study aims to qualitatively assess nutrition stakeholder and community perspectives at the district level.MethodsFrom June to August in 2022, under an umbrella study utilizing community-based participatory research methods to train youth from Lira District in research, in partnership with the University of Southern California (USC) and community organization Children's Chance International-Uganda, these youth helped carry out an explanatory qualitative assessment consisting of 10 key informant interviews. Responses were compiled, transcribed, and analyzed using the Atlas TI software to code responses for thematic insights.ResultsParticipants highlighted several challenges with the UNAP II implementation at the local level. Mechanisms intended to promote multisectoral collaboration, such as district nutrition coordination committees, have been on hiatus due to limited funding; local governments experience funding disbursement delays and a lack of nutrition prioritization; and nutrition surveillance is limited by tools, training, and human resources.ConclusionsObtaining community perspectives revealed several gaps in local UNAP II implementation and demonstrates the importance of creating mechanisms for communities to continuously provide feedback for national policies like the UNAP II. Uganda implemented its first multisectoral nutrition strategy, called the Uganda Nutrition Action Plan, in 2011, followed by Phase II in 2020. The Uganda Nutrition Action Plan does not currently have its own mechanism of monitoring and evaluation. Instead, it relies on quantitative data from national health surveys to track levels of undernutrition. These data are not specific to each district and provide a helpful but incomplete picture of nutrition progress in the country. In order to gather local stakeholder perspectives of the Uganda Nutrition Action Plan, our research team facilitated interviews with key nutrition stakeholders in Lira District between June and August, 2022. We sought to understand how the Uganda Nutrition Action Plan's implementation has fared in 3 ways: multisectoral collaboration, funding, and surveillance of nutrition.Overall, participants described the Uganda Nutrition Action Plan's limited success at the district level. Mechanisms intended to promote multisectoral collaboration, such as district nutrition coordination committees, have been on hiatus due to limited funding. Furthermore, the local government frequently does not have enough nutrition funding due to disbursement delays and the nutrition budget being integrated into the budgets of other sectors. Finally, the district struggles to produce accurate and consistent nutrition monitoring due to inadequate surveillance tools, training, and human resources. Local perspectives in Lira District have uncovered several gaps in the implementation of the Uganda Nutrition Action Plan, and they highlight key recommendations moving forward. This study demonstrates the value of community-level insights on the implementation of national policies like the Uganda Nutrition Action Plan to promote measures that are effective, relevant, and made in partnership with the community.

BackgroundEdible residues from Hindu offerings (lungsuran) may enter mixed waste streams despite retaining nutritional value. Although food rescue research has focused on household leftovers and supply-chain loss, less is known about how culturally governed norms and changing ritual economies shape post-ritual handling of edible offerings.ObjectiveTo examine how socio-religious norms, authority structures, and changing ritual economies shape lungsuran handling in urban Bali and identify culturally legitimate pathways for nutrition-sensitive recovery.MethodsWe conducted a qualitative study in Denpasar, Indonesia, from September to November 2025 using 20 in-depth interviews with key informants, 4 focus group discussions involving 40 participants, and structured observations across 8 household and temple ritual settings. Data were transcribed, coded, and analyzed thematically.ResultsParticipants described lungsuran as edible and blessed, yet discard occurred in both household and temple settings, especially after large or frequent ceremonies. Post-ritual handling was shaped by four interrelated mechanisms: ritual-temporal suitability, authority and ownership, social permission and hierarchy, and marketization with devotional abundance. Reuse was more likely when decision rights were clear, social permission was explicit, and sorting occurred within an acceptable safety window. In pooled temple settings, ownership ambiguity, reluctance to be seen taking food, and reliance on purchased offerings increased discard. Across settings, time, labor, containers, storage, and transport affected recovery.ConclusionsLungsuran is not ordinary leftover food but a culturally governed edible flow. Nutrition-sensitive recovery is more likely when it aligns with ritual timing, clarifies authority, reduces social hesitation, and integrates food safety into community governance. In Balinese Hindu ceremonies, people prepare offerings that often include fruit, cakes, rice-based foods, and other items. After prayers, some of this food becomes lungsuran—food that has been offered and is believed to carry blessings. Many people feel it is not right to throw away blessed food. Yet, in daily practice, much lungsuran is still left unused and ends up in the trash.This study explored why this happens in an urban setting in Bali. We found that lungsuran is often not taken or used because it may remain exposed for a long time during ceremonies, so people later worry it is no longer clean or safe to eat. In temples and shared spaces, it is also not always clear who has the right to take the remaining food. Some people feel embarrassed to be seen taking food or worry others will judge them. Some families also leave offerings behind, especially when they buy ready-made offerings, because they feel their religious duty is complete once they have prayed, even if the food is still edible.These findings suggest practical ways to reduce waste while respecting tradition: preparing amounts that match actual needs, sorting edible items soon after ceremonies, using simple safe-handling practice such as clean surfaces and covered containers, and clearly announcing who may take remaining food and when. Importantly, rules should be supported by religious and community leaders, and the process should avoid selling blessed food.

Water and food security in Israel and the Palestinian Authority are deeply interconnected due to the region's arid climate and water scarcity, shared water resources, and interrelated agricultural sectors. Therefore, jointly addressing water reuse is vital to supporting sustainable agricultural production and ensuring food safety. This paper examines the food safety implications of the cross-border trade of fresh fruits and vegetables between the Palestinian Authority and Israel, with an emphasis on the influence of, water technologies, agricultural practices, and environmental health. This paper provides a comprehensive review of existing data to assess water irrigation quality, food safety, and water reuse regulations in the Palestinian Authority and Israel. Significant discrepancies in food safety, food quality, and exposure to contaminants from fresh produce result from different water reuse regulations, practices, and socioeconomic conditions. Given the volume of trade, consumer mobility, and environmental sustainability, coupled with geopolitical limitations between the Palestinian Authority and Israel, there is an urgent need for a unified regulatory strategy for wastewater reuse ensuring food safety and security. We propose a single, coordinated approach to overseeing wastewater reuse to enhance public health and address contaminants of emerging concern that are not currently regulated. Navigating the political and legislative complexities in a proactive stance requires both Israeli and Palestinian decision-makers to address the matter conscientiously. Existing data and the precautionary principle are sufficient to propose an interim prohibition on treated wastewater irrigation for leafy vegetables to mitigate pollution risks and act as a catalyst for improving irrigation water quality. Our proposed strategy for a unified water reuse regulation emphasizes the necessary steps for its implementation and addresses potential obstacles. This strategy underscores the importance of responsible wastewater management in advancing common goals of environmental sustainability, food safety, and human health. We propose a coordinated Israeli-Palestinian approach to wastewater reuse to ensure food safety based on shared environmental and health concerns, economic considerations, and the precautionary principle. A Call for Joint Israeli-Palestinian Guidelines for Water Recycling to Improve Food Security and Safety. The Palestinian Authority and Israel share a common ecosystem and closely interrelated water supply, agriculture, and food markets. Differences in economic conditions, water use, and farming methods in each society affect the safety and quality of traded food. Because of varying regulations on how wastewater is reused for irrigation, there are noticeable differences in the food safety, exposing both populations to harmful contaminants. To address this concern, there is a pressing need to unify the regulation of wastewater reuse. We suggest that both Israeli and Palestinian authorities should work together on a coordinated plan to oversee wastewater reuse, which would improve public and environmental health and address contaminants that are not currently regulated. In the interim, an immediate temporary ban on using treated wastewater for irrigating leafy vegetables could reduce pollution risks, and encourage improvements in the quality of water used for irrigation. The responsible management of wastewater is a common Palestinian and Israeli interest for sustaining water and food security, to protect both the environment and the health of all people in the region.

BackgroundTo prevent micronutrient deficiencies and address the double burden of malnutrition, Benin has implemented Infant and Young Child Feeding (IYCF) and food fortification policies for several years. Despite these efforts, significant micronutrient deficiencies persist, posing a public health problem.ObjectiveThis study aims to identify barriers and facilitators to the implementation of government policies on IYCF and food fortification in Benin.MethodsWe conducted in-depth individual interviews with 23 key national and local stakeholders involved in implementing these policies. The interviews were recorded, transcribed, and analyzed through a deductive and iterative process based on the study's objective.ResultsStakeholders identified several barriers to policy implementation, including low staff motivation, exacerbated by poor personnel management and lack of recognition. Financial resources are insufficient despite organizational support. Training and awareness among health workers and producers are limited outside UNICEF's intervention areas. Traditional eating habits and cultural resistance impede the adoption of new practices. The monitoring system is complex and ill-equipped, hindering quality control of fortified foods. Facilitators include strong political commitment, partnerships with international nongovernmental organizations, and effective intersectoral collaboration. These partnerships have improved training and community awareness, though gaps remain. The involvement of local producers and professional associations also supports food fortification initiatives.ConclusionNutrition policies in Benin face challenges such as low staff motivation and lack of resources. However, strong political commitment and international partnerships present opportunities to overcome these barriers.Plain language titleStudy of Challenges and Solutions to Improve Food Policies for Babies and Children in Benin. Benin is implementing policies to improve the nutrition of babies and young children and to fortify foods to prevent vitamin and mineral deficiencies. However, the country continues to suffer from these deficiencies, posing a serious health problem. The study seeks to understand why these policies are not working as well as expected, and to identify what could improve them. The researchers interviewed the key people involved in these policies, recording, and analyzing their responses to identify the main problems and positive points. The interviews revealed several problems, notably that health workers are demotivated due to poor management and lack of recognition. Financial resources are insufficient, even with the help of international organizations. Training and awareness-raising are limited, especially outside UNICEF-supported areas. In addition, traditional eating habits and cultural resistance make the adoption of new practices difficult. However, some positive elements have been identified, including: strong political support, effective partnerships with international nongovernmental organizations, successful collaboration between different sectors and the involvement of local producers and professional associations. At the end of this study, we can conclude that nutrition policies in Benin face difficulties such as the lack of motivation of agents and the lack of resources. But, with strong political support and international partnerships, there is a good chance of overcoming these challenges.

IntroductionUndernutrition continues to be a significant public health concern, particularly among children under 5 years.ObjectivesThis study evaluated the efficacy of an additional nutritional intervention in improving growth parameters, dietary diversity and hemoglobin levels in children aged 6 to 59 months with moderate acute malnutrition (MAM) during the 2023 economic crisis in Sri Lanka.MethodsThis was a randomized-controlled trial, and children with MAM were randomly allocated to either the intervention group, receiving additional food transfers and nutrition education, or the control group, receiving standard care. The outcomes were improvement in growth parameters, dietary diversity, and hemoglobin levels. Regression analysis was used to adjust for potential confounding variables. A total of 510 children were enrolled and followed for 6 months. The intervention group showed a significant proportion of children improving to normal weight-for-height Z-scores than the control group in addition to the improvement in dietary diversity. However, the 2 groups had no significant difference in stunting and underweight.ConclusionsThe nutritional intervention improved weight for height z-scores and dietary diversity in this cohort of children with MAM. The study highlights the importance of targeted nutrient-adequate food security interventions in undernourished children during crises to support their nutrition rehabilitation effectively. Undernutrition continues to be a significant public health concern in Sri Lanka despite the considerable progress the country has made in reducing maternal and child mortality. Compared to 2021, by 2023, the proportion of children under 5 with growth faltering, underweight, wasting and stunting has increased. This study focused on young children, aged 6 to 59 months, who were moderately undernourished. The main aim was to evaluate the efficacy of food-in-kind assistance and nutrition education to reach a healthier weight and height over a period of 6 months during the economic crisis in Sri Lanka in 2023. The study involved comparing 2 groups of malnourished children. The control group received standard care, which included food assistance and monthly educational sessions on topics like breastfeeding and child development. The experimental group received the same standard care plus additional support. This extra support included a food basket every 2 weeks, a recipe booklet, and cooking demonstrations to help parents prepare nutritious meals at home. We measured changes in weight, height, and various nutritional and health scores, such as weight-for-age, height-for-age, and weight-for-height ratios. Additionally, it assessed improvements in dietary diversity, which is an indicator of household food security. In total, 510 children participated and were followed for 6 months. The intervention group showed a significant improvement in weight-for-height and dietary diversity compared to the control group. However, there was no significant difference in stunting and underweight between the 2 groups. The study highlights the importance of targeted food security interventions during crises to help undernourished children recover effectively.

BackgroundAdequate fruit and vegetable (F&V) intake is important for health, yet populations globally are failing to meet recommendations.ObjectiveA scoping review to summarize available evidence of evaluations of interventions to increase F&V intake globally, focusing on target populations, intervention strategies, research methods, and summarizing their evaluated impacts.MethodsWe searched PubMed and Web of Science in February 2023 for intervention studies in which dietary intake of fruit and/or vegetables were documented. Eligible studies included all age groups, excluding those targeting populations with specific disease-related conditions, such as cancer patients/survivors. Only articles published in English since 2012 were included in the review.ResultsWe identified 6338 articles, with 226 meeting inclusion criteria, comprising 223 unique studies and 284 intervention comparisons. Most comparisons occurred in high-income countries (n = 192) compared to low- and middle-income countries (n = 92). Randomized controlled trials (RCTs; 37.3%) and cluster RCTs (52.5%) were predominant. Interventions primarily targeted adults (31.7%), school-aged children (18.0%), children under-five (14.4%), and adolescents (13.7%), lasting an average of 24 weeks (range: 2 weeks to 20 years). Food-frequency questionnaires (59.2%) and 24-h recalls (26.8%) were the most used dietary assessment method. Health and nutrition communication (75.9%) was the most common intervention, utilizing interpersonal communication, mass media, and information-communication technology, often in combinations. Positive impacts on fruit (43.9%), vegetable (40.2%), and combined F&V intake (53.0%) were observed in nearly half the intervention comparisons.ConclusionsThese findings highlight the predominance of health and nutrition communication interventions, predominantly in high-income countries, showing mixed success in improving F&V intake, emphasizing the need for context-specific strategies and standardized methodologies to design sustainable, cost-effective interventions for better diet quality and health outcomes.Plain language titleA literature review assessing what we know and do not know about efforts to improve fruit and vegetable intake across the world. Eating enough fruit and vegetables is important to stay healthy, but most people do not eat enough diverse fruits and vegetables. Various strategies have been tried to increase fruit and vegetable intake; however, what worked, for whom, and in which context is not well understood. In this paper, we summarize the intervention strategies that have been implemented and their impact across different countries and age groups. Of the 226 published articles comprising 284 intervention comparisons included in this review, most intervention comparisons were from high-income countries (67.6%). Most intervention comparisons in which dietary intake of fruit and/or vegetables was documented focused on adults (31.7%), followed by school-aged children (5-9.9 years of age; 18.0%) and children under 5 years of age (14.4%). The interventions lasted an average of 24 weeks. Health and nutrition communication was the most commonly used component to encourage study participants to eat more fruit and vegetables. Different approaches were used, like talking to people in group settings and using mass media or technology. About one-half of studies found a positive impact on fruit intake, vegetable intake, and/or the intake of total fruit and vegetables. Few interventions have been implemented in low- and middle-income countries. The findings highlight the dominance of health and nutrition communication interventions, mainly in high-income countries, with mixed success in improving fruit and vegetable intake. Tailored, context-specific strategies are needed to enhance the intake of fruit and vegetables worldwide. Additionally, harmonizing study designs and methods is crucial for accurately evaluating intervention impact and strategies used. More research is needed to better understand how to improve fruit and vegetable intake in low- and middle-income countries and across different age groups.

BackgroundObesity is a global public health crisis exacerbated by ultra-processed and nutrient-poor foods. Despite policy interventions, progress remains uneven due to socioeconomic, political, and industry barriers.ObjectiveThis review examines global food policies on obesity prevention, highlights implementation gaps, and suggests pathways for more equitable, coordinated action.MethodsA narrative review was conducted using literature from PubMed and Scopus (2017-2025), including peer-reviewed studies, policy documents, and international agency reports. Key search terms included "global food policies," "obesity prevention," "ultra-processed foods," "nutrition labeling," and "sugar taxes." Inclusion criteria encompassed studies on policy strategies for obesity prevention and healthier food environments.ResultsThe review categorized food policy interventions into key thematic areas: fiscal policies, nutrition labeling, marketing restrictions, regulation of ultra-processed foods (UPFs), out-of-home/food-service policies (eg, menu and nutrient labeling, portion-size and sodium limits, healthy defaults, procurement standards), school food policies, and international coordination. Evidence shows that front-of-package labeling and sugar-sweetened beverage levies are effective in some regions. Healthy food subsidies and purchase incentives yield mixed but promising results, especially among low-income groups. However, socioeconomic disparities, industry resistance, weak regulations, and poor multisector and public-private partnerships (PPPs) governance limit their scalability and sustainability.ConclusionsCurrent global food policy efforts are insufficient to curb the escalating obesity epidemic. Transformative, multisectoral, and equity-focused policy frameworks augmented by digital tools for monitoring, enforcement, and targeted health promotion are critical to accelerate progress and reduce inequities. Priority should be given to regulating UPFs, standardizing labels, tightening marketing controls, and integrating obesity prevention into health policies. Global Food Rules and the Fight Against Obesity: Why Current Efforts Fall Short and What Can Be Done to Create Fair, Healthy, and Sustainable Food Systems for Everyone.

BackgroundDespite well-documented health benefits, fruit and vegetable (F&V) intake remains below recommended levels globally.ObjectivesThis scoping review aimed to identify effective intervention strategies to increase F&V intake.MethodsWe searched PubMed and Web of Science (February 2023) for intervention studies assessing impact on F&V intake. Eligibility criteria included studies published in English since 2012, a valid control group, ≥2 weeks duration, and ≥50 participants per intervention arm. Analysis was done by intervention comparison. Findings were described by summarizing proportion of intervention comparisons reporting statistically significant increases in fruit, vegetable and/or combined F&V intake across standalone (nutrition communication, social protection, agriculture or food environment restructuring) and multi-component strategies.ResultsA total of 284 intervention comparisons (223 unique studies) were included. The majority of comparisons (191/284) came from high-income countries (HICs) and 93/284 from low- and middle-income countries (LMICs). Nutrition communication was the most common standalone strategy, with 121/218 comparisons reporting positive impacts on fruit, vegetable and/or combined F&V intake. Fewer studies evaluated standalone social protection (13/284), food environment restructuring (4/284), or agriculture strategies (3/284). Among the limited interventions, 7/13 social protection and 3/4 food environment restructuring comparisons reported positive impacts, while none of the 3 standalone agricultural interventions did. Multi-component interventions demonstrated potential with 28/46 comparisons having positive impacts.ConclusionsSome of the intervention strategies showed potential for increasing fruit and/or vegetable intake. However, given the heterogeneity of the interventions, small number of studies for some strategies and limited evidence from LMICs, more rigorous, context-specific research is needed. What works to increase fruit and vegetable intake? A global review of intervention strategies.Plain language summaryBackgroundEating enough fruit and vegetables is important for maintaining good health, but most people do not eat the recommended amounts. Many strategies have been tested to encourage fruit and vegetable intake, but it is unclear how successful they have been.ObjectiveThis study reviewed the success of different types of strategies to understand which ones were most likely to increase fruit and/or vegetable intake.MethodsWe analyzed 284 comparisons from 223 unique studies that tested interventions to increase fruit and/or vegetable intake. These included nutrition communication (e.g. education, cooking skills, diet counselling), social protection programs (e.g. food assistance or financial incentives), agricultural programs (e.g. school or home gardens), and food environment changes (e.g. making fruits and vegetables more available in schools or workplaces).FindingsThe majority of interventions included in this review were conducted in high-income countries (191/284) and the rest came from low- and middle-income countries (93/284).Nutrition communication was the most common standalone strategy. Of the 218 interventions, 56% increased fruit and/or vegetable intake.The other standalone strategies were less common, although 7 of 13 social protection and 3 of 4 food environment interventions reported positive impacts, whereas none of the 3 agriculture interventions did.Of the 46 multi-component interventions that combined 2 or more strategies, such as pairing nutrition communication with cash or home garden, about 61% reported positive impacts on fruit and/or vegetable intake.ConclusionsAlthough some strategies showed promise, the variability of the interventions, small number of studies in some cases, and limited evidence from LMICs indicate a need for additional research to help us better understand successful interventions for increasing fruit and/or vegetable intake.

Food environments are rapidly changing in low- and middle-income countries (LMICs), leading to dietary shifts. Many gaps exist in the measurement of food environments in LMICs making it difficult to characterize the linkages between food environments and diets. The objective of this study was to examine the feasibility of implementing USAID Advancing Nutrition's Market Food Environment Assessment (MFEA)-a suite of 7 non-resource intensive food environment assessments. We implemented the MFEA package in 4 countries (Liberia, Honduras, Nigeria, and Timor-Leste) and assessed the feasibility of implementing the package by conducting a descriptive analysis, using both qualitative and quantitative data of enumerators' feedback collected through training evaluations, feedback forms, detailed notes from meetings, and final reports from in-country partners. Overall, we found it feasible to implement the MFEA, some assessments being easier to implement and more practical than others. Several key themes related to the MFEA implementation were identified across the countries, including: the potential for vendors to be hesitant to engage in assessments; the importance of ascertaining buy-in from local officials; the need to shift toward electronic, rather than paper-based, data collection; difficulties in selecting markets; the time constraints of conducting some of the assessments; and the need for better alignment between the instructions, data collection, and data analysis sheets. The package of food environment assessments, with minimal additional refinement, can be used to characterize market food environments in LMIC settings to inform context-specific interventions. Testing the feasibility of implementing a package of 7 assessments to measure factors influencing food access in low-resource settings. Why was the study done? We know that there is a relationship between the availability, affordability, and acceptability of the foods that populations have access to and their diets. In resource-poor settings, the foods that people have access to are rapidly changing, leading to shifts in diet and nutrition outcomes. To better understand the connection between the environments from which people access food and their diets, we need to be able to measure factors influencing food access in diverse settings. However, the ways we can measure factors influencing food access in low-income settings are often unclear. We completed this study to test the feasibility of implementing a package of 7 assessments that measured market access, food availability, food affordability, promotion of food, the desirability of fruits and vegetables, among others in 4 countries (Liberia, Honduras, Nigeria, and Timor-Leste) to understand if this package of assessments could be used by practitioners to inform their in-country activities related to improving food access and diets.What did the researchers do? We implemented the 7 assessments in different market settings in 4 countries. We then asked the in-country research team implementing the assessments to evaluate what worked, what didn't work, and what needed more clarity in terms of the implementation of the assessments.What did researchers find? We found that overall, the assessments were feasible to implement across the different settings but that some assessments were more labor intensive than others. The research teams implementing the assessments identified aspects of the assessments that were difficult to implement as well as those that were straightforward.What do the findings mean? The findings have provided insight into the feasibility of implementing the 7 assessments and indicated further changes that were needed to refine the assessments to make it easy for practitioners to use them to inform their own work.

A randomized controlled trial in Bangladeshi children aged 12 to 18 months with moderate acute malnutrition found that dietary supplementation with the microbiota-directed complementary food (MDCF-2) significantly improved weight gain and repaired gut microbiota compared to the ready-to-use supplementary food. However, the MDCF-2 formulation was made daily from locally available ingredients and the need for a packaged, nutritionally compliant, and organoleptically acceptable MDCF-2 prototype was essential for future large-scale clinical studies. The study aimed to develop and assess the acceptability of 3 alternative foil-packaged formulations of MDCF-2 in comparison to current MDCF-2. Of the 3 packaged formulations, the Jumpstart version was provided in 2 sachets, the other 2 formulations were provided in a retort-stable foil pouch extended by sterilization, and microbiological growth was monitored over 10 months. The acceptability study included 40 children aged 8 to 12 months living in an urban slum in Dhaka, and the organoleptic properties were assessed using a 7-point hedonic scale. In the 100 g distributed over the 2 sessions, children consumed 82.5 ± 7.84 g (mean ± SD) of kitchen-prepared MDCF-2, 85.4 ± 7.15 g of the "Jumpstart" MDCF-2 formulation, 85.4 ± 8.70 g of the MDCF-2 with green banana powder, and 86.2 ± 4.26 g of the MDCF-2 with sweet potato formulation. The "Jumpstart" MDCF-2 and MDCF-2 with sweet potato achieved the highest overall acceptability scores on the hedonic scale; although none of the shelf-stable formulations were significantly different from the kitchen-prepared MDCF-2. Packaged, shelf-stable prototypes of MDCF-2 exhibited comparable acceptability among Bangladeshi children aged 8 to 12 months to the original freshly prepared formulation. Development and Acceptability of Shelf-Stable Microbiota-Directed Complementary Foods. Countries around the world are making progress in fighting malnutrition, but it may be challenging to achieve the global nutrition targets for undernourished children by 2025 at the current rate. To address this problem, we need special types of food that can help children grow, develop properly, and sustain their growth. Children with moderate acute malnutrition have imbalanced gut bacteria. By providing them with the right nutrition, we can restore the healthy bacteria in their gut using a special food called microbiota-directed complementary food (MDCF). Currently, this food is made daily in the icddr, b established field kitchen, which follows standard production measures to control the quality of MDCF preparation, but we need to create stable prototypes that can be stored and used in different settings. This study was designed to develop shelf-stable new formulations in industrial settings and check their acceptability among children with moderate acute malnutrition. The shelf life of the food was extended using a sterilization method, and its microbiological safety was monitored for a year. The actual consumption and acceptability of these foods were evaluated and all these formulations were acceptable by the children and their mother. The children consumed all 4 food formulations in substantial quantities, with consumption rates exceeding 80% for each formulation. This study showed positive results in Bangladesh, but more research is needed to see if these formulations work well in other geographies and over longer periods.

Studies on intrahousehold inequality in food distribution typically have focused on the distribution of total energy within the household. While some members within the household can satiate their hunger primarily from the consumption of inexpensive staple food items, others can consume a significantly larger share of much more expensive nonstaple food items rich in bioavailable micronutrients. This potential inequality, which significantly impacts micronutrient malnutrition in developing countries, can be influenced by the gender-related sociocultural norms. This article uses a "food share over energy share (FS/ES)" methodology applied to the Philippines 2013 intrahousehold individual food consumption survey to examine patterns of dietary quality by age and gender. No pattern of age or gender discrimination is found; females consume most nonstaple foods somewhat more intensively than males. Preschoolers and young children relatively intensively consume higher amounts of milk and milk products, eggs, processed meat, noodles, sweets/desserts, sugars/syrups, and chocolate drinks. Adults relatively intensively consume fresh meat, organ meat, fish and seafood, vegetables, coffee, and alcohol. Adolescents transition between the two patterns as they grow older. The FS/ES methodology focuses on distribution choices of specific foods that family members explicitly know about. The implications of these behavioral choices (some foods are nutrient-dense, others not) for meeting nutrient requirements (of which most households are unaware) may be investigated separately. Several types of follow-up studies using the FS/ES methodology are suggested for a better understanding of the factors that drive food distribution behavior, which is key to effective nutrition messaging. Distribution of food among household members in the Philippines: Understanding how we share meals. This study explores how food is divided among members in households. Staple foods are inexpensive sources of energy to stave off hunger. Nonstaple foods are denser in vitamins and minerals, but are much more expensive sources of energy, especially fish and animal products. Societal norms, especially those related to gender, influence how this sharing happens, which affects the quality of diets. We use a method called “food share over energy share” to analyze data from household food intake surveys conducted in the Philippines in 2013 to study patterns of family sharing of several food groups which together comprise all foods consumed. There are substantial differences in the shares of intake of specific food groups between age groups, but for the most part not between males and females within the same age group. Infants and young children tend to eat more dairy products, eggs, processed meats, noodles, sweets, and chocolate drinks. Conversely, adults consume more fresh meat, organ meat, fish, vegetables, coffee, and alcohol. Teenagers shift between these patterns as they grow older. When we looked at which group consumed the most expensive foods most intensely, it was highest for infants, followed by preschoolers (24–59 months). It is also worth noting that breastfeeding is more common among female infants compared to male infants. The food share over energy share methodology highlights how age and gender impact how food is shared in households, and specifically for this article how this can affect the quality of diets in the Philippines.

Many recent efforts focus on promoting neglected and underutilized species (NUS) for improved nutrition, but consumption depends on various factors. With this in mind, this study aims to understand the factors associated with the consumption patterns of Adansonia digitata, Ocimum gratissimum, Vigna radiata, and Moringa oleifera by households in Atacora, northern Benin. To achieve this, a food consumption survey was carried out in 3 communes. Two villages per commune were randomly selected to carry out the food consumption frequencies of households through a 7-day recall for periods of abundance and scarcity. A multinomial regression model was used to explain the consumption frequency of species depending on socio-demographic factors and seasonality. Different parts of these different species targeted were used in various forms to prepare sauces, porridges, juices, etc. Baobab- and moringa-based foods appeared to be the most widely consumed foods, regardless of the season. Even though fresh moringa leaves sauce and baobab seeds sauce were consumed mostly in periods of scarcity. The probability of rarely consuming foods made from these species was lower for households living in Toucoutouna and Tangui&#xe9;ta compared to Natitingou. Furthermore, the consumption of these foods was usually higher for mothers who were students, hairdressers or seamstresses compared to housewives (P&#x2009;<&#x2009;0.05). The consumption patterns then vary from species to species and are influenced by demographic factors such as household location and mother's occupation. Promoting NUS among the population is essential to increase awareness of their nutritional importance and improve their consumption. Factors Affecting Consumption of Neglected and Underutilized Species in Atacora, Northern Benin. In recent years, many efforts have been made to improve the use of neglected and under-utilized plant species in food production. It should be noted that these plant species make a significant contribution to the supply of elements essential for good nutrition. However, several factors can influence their consumption by households. This study therefore aims to understand the factors associated with the dietary habits of neglected species such as Adansonia digitata, Ocimum gratissimum, Vigna radiata, and Moringa oleifera by households in Atacora, northern Benin. A survey of their eating habits was carried out in 3 communes in the Atacora department. Two villages per commune were randomly selected to carry out this household survey over the last 7 days for periods of food abundance and scarcity. The various target species&#x2019; leaves, fruits, kernels, and seeds were used in various forms to prepare sauces, porridges, juices, etc. Mainly baobab- and moringa-based foods seem to be widely consumed whatever the season. Indeed, baobab seed sauce, baobab leaves sauce and fresh moringa leaves sauce were mainly consumed in times of food scarcity while fresh baobab leaves sauce was predominantly consumed during abundance. Households living in Toucoutouna consume less food made from these species, unlike those living in Tangui&#xe9;ta. Moreover, consumption of these foods for 5 or more days a week was higher for mothers who were students, hairdressers or seamstresses than for housewives. It is therefore essential to promote neglected and under-utilized species among the population to increase awareness of their nutritional importance and improve their consumption.

ObjectiveThis study aimed to characterize the factors influencing dietary diversity scores (DDS) of infants whose caregivers were classified as doers (those who fed a more diverse diet) and non-doers (those who fed a less diverse diet).MethodsThis study was conducted using a multiphase study design and guided by a biocultural framework. Phase 1. Interviews with community leaders (n&#x2009;=&#x2009;13) and direct 6-h household observations (n&#x2009;=&#x2009;10) were used to formatively explore factors influencing diet. Phase 2. A dietary assessment (n&#x2009;=&#x2009;81) was used to determine dietary diversity of indexed infants. Phase 3. A biocultural survey and direct 3-h. observations were conducted among indexed infants (6-9 months) (n&#x2009;=&#x2009;80) to understand the biocultural factors influencing infant DDS. Phase 4. Interviews (n&#x2009;=&#x2009;34) were conducted among indexed caregivers to understand why and how biocultural factors shape infant DDS. Dietary data were analyzed, and biocultural survey variables were subjected to a forward stepwise linear regression. Textual data were analyzed to identify salient biocultural factors.ResultsFindings revealed that infants had an average DDS of 2. Having water access in the household, owning land for homestead food production, and feeding infants the same foods caregivers consume were positively associated with DDS. Conversely, adhering to food proscriptions was negatively associated with DDS. Most caregivers were food insecure and employed both food and non-food-based coping strategies to feed their infants.ConclusionDecreasing adherence to food rules, promoting homestead food production, and promoting non-food-based coping strategies may improve infant DDS in Guinea. This study aimed to characterize the factors influencing dietary diversity scores (DDS) of infants aged 6 to 9 months whose caregivers were classified as doers (fed a more diverse diet) and non-doers (fed a less diverse diet) by operationalizing an Ecological Model of Food and Nutrition framework. We used semistructured interviews, direct observations, and survey methods to explore the factors influencing the DDS of infants. Based on mixed-methods findings, 10 factors differed between doers and non-doers, such as food rules, food symbolism, water, and land access. Tailored interventions that consider factors that differ between doers and non-doers may help improve infant DDS in Guinea.

Adequate amounts of fruit and vegetables (F&V) are an important part of a healthy diet, yet intake is suboptimal in most population groups worldwide. To better understand the evidence of strategies aiming to improve F&V intake, we conducted a scoping review of interventions assessing the impact on F&V intake, including those aiming to improve F&V intake explicitly and those targeting diet, health, lifestyle, or food environment generally. Among all eligible interventions reviewed, most of which were implemented in high-income countries, about half reported a significant positive impact on fruit and/or vegetable intake. Interventions that used a multicomponent strategy (61%) and those that focused on F&V specifically (72%) were most likely to find a significant increase in fruit and/or vegetable intake. Detailed summaries are provided in 2 accompanying articles. In the present article, we put these findings into perspective. Specifically, we considered the evidence for 4 target countries of the Fruit and Vegetables for Sustainable Healthy Diets Initiative: Benin, the Philippines, Sri Lanka, and Tanzania. When considering available evidence at the national level, there is a paucity of information from intervention trials despite evidence of inadequate F&V intakes in each of these countries. When considering available evidence at the global level, and especially for low-and-middle income countries, there is a critical need to strengthen the evidence across various intervention strategies, particularly related to targeting, timing, intensity, duration, frequency, and other key characteristics, to better understand how to enhance their impact on F&V intake in various population groups and contexts. Eating enough fruit and vegetables is important for health, but most population groups worldwide do not eat enough. To better understand the evidence of strategies aiming to improve fruit and vegetable intake, we conducted a scoping review of interventions assessing the impact on fruit and vegetable intake. We considered intervention strategies that aimed to improve fruit and vegetable intake specifically and also those targeting diet, health, lifestyle, or food environment generally. Most of the eligible interventions were conducted in high-income countries. About half of all eligible interventions reviewed reported a significant positive impact on fruit and/or vegetable intake. Interventions that used a multicomponent strategy (61%) and those that focused on F&V specifically (72%) were most likely to find a significant increase in fruit and/or vegetable intake. Detailed summaries are provided in 2 accompanying articles. Here, we put these findings into perspective. Specifically, we considered the evidence for 4 target countries of the Fruit and Vegetables for Sustainable Healthy Diets Initiative: Benin, the Philippines, Sri Lanka, and Tanzania. When considering available evidence at the national level, there is limited information from intervention trials despite evidence of inadequate fruit and vegetable intakes in each of these countries. When considering available evidence at the global level, and especially for low-and-middle income countries, there is a critical need to strengthen the evidence across various intervention strategies, particularly related to targeting, timing, intensity, duration, frequency, and other key characteristics, to better understand how to enhance their impact on fruit and vegetable intake in various population groups and contexts.

The gender-gap in power is still persistent around the globe. Nutrition-Sensitive Agriculture (NSA) interventions have been implemented to increase women's empowerment as a goal in itself, and as a pathway to food and nutrition security (FNS). However, contradicting evidence exists on whether the interventions, besides food security, realize women's empowerment. Furthermore, the concept of women's empowerment has different meanings across different cultures, regions, and countries. To assess the understanding of, and perspectives on, women's empowerment among different stakeholders in the context of an NSA project in Laos, and to assess whether this project contributes to women's empowerment and FNS. Semistructured interviews were conducted with local implementers of NSA interventions (n&#x2009;=&#x2009;13) and senior program managers and advisors (n&#x2009;=&#x2009;5). Six focus group discussions were conducted with community members (n&#x2009;=&#x2009;46). Our findings reveal that community members had a materialistic understanding and local implementers an instrumental understanding, in contrast to senior program managers and advisors, who had an egalitarian understanding of women's empowerment. The level of women's empowerment in Nong was considered low by all respondents. Furthermore, respondents reported that the NSA interventions had a positive impact on FNS, but not on women's empowerment. In a community in which both women's empowerment and FNS are low, working with women may contribute to FNS, but not necessarily contribute to women's empowerment. Nevertheless, from an emic perspective, women do feel more empowered as the interventions contributed to increased household capacity to address FNS. Does our project lead to having enough food and improved women's status in communities living in rural, mountainous areas in Laos? Many women around the globe, particularly in low- and middle-income countries, belong to the most disempowered groups of society as they experience economic and social disadvantages relative to men. Previous studies have demonstrated that empowering women can result in increased food and nutrition security (FNS), as well as economic growth. Therefore, this study investigated whether Nutrition-Sensitive Agriculture (NSA) projects improved women's empowerment (WE) and FNS in remote villages in Laos. The study's findings indicated that while NSA projects did increase FNS, they had no positive impact on WE which was considered to be low by all participants and even increased the already high workload of women. The study also discovered that community members, grassroots implementers of the NSA interventions, and senior program managers and advisers (SPMAs) all had different conceptual understandings of WE, highlighting the conceptual unclarity of WE. SPMAs perceived WE as working toward (gender)equality and moving away from gender-based activities. This was in contrast to community members and local implementers, who understood WE as the capacity to perform well in their gender-based tasks. Consequently, we think we are all working toward the same construct of WE, but due to the conceptual unclarity we are all working toward other goals which result in the risk of &#x201c;using&#x201d; women rather than working toward the end goal of WE. Therefore, our study suggests that conceptual clarity of the concept you are working on in a particular project context, in this case WE, is essential for implementing interventions based on it.

BackgroundOn 6 February 2023, 2 major and aftershock earthquakes occurred in T&#xfc;rkiye. These earthquakes caused disasters in Kahramanmara&#x15f;, Hatay, and its surroundings. More than 50 000 people lost their lives. The day after the earthquakes, disaster/emergency kitchens were established in these cities with the initiatives of various institutions and organisations. One of these kitchens is the 'Anadolu Mutfa&#x11f;&#x131;', which was established by Anadolu University in 2023. Approximately 15 000 people benefited from the emergency kitchen in Belen district of Hatay every day.ObjectiveIn this study, the daily needs of adults eating in this kitchen were evaluated. Additionally, the basic problems and requirements encountered during the operation of nutrition services are included.MethodsBreakfast, lunch, and dinner menus served in the emergency kitchen were monitored on-site by the researcher for a week and the amounts served to 1 person were recorded. Daily energy and nutrient values were calculated. These values were evaluated using T&#xfc;rkiye Nutrition Guide 2022 reference values.ResultsIt was determined that the energy intake of adults fed from the disaster/emergency kitchen was sufficient; however, the daily recommended intake of important minerals and vitamins such as calcium and vitamins E and C was not met. In addition, it was observed that daily water consumption of individuals was insufficient. In addition, it was also observed that those with chronic diseases had difficulty in accessing the special diet products they needed.ConclusionIn such crisis, it is recommended that strategies for community nutrition should be developed, updated, coordinated, and implemented immediately. On 6 February 2023, 2 major earthquakes with horribly destructive consequences occurred in T&#xfc;rkiye. Thousands of lives were lost, with many more injured and missing in 10 cities. It is possible to say that these effects of the earthquake are still continuing more than 2 years later, many people continue their lives in containers or temporary houses, and there is a long period of uncertainty and mourning. When the disaster first occurred, millions of volunteers travelled to the region to support search and rescue operations as well as the provision of daily basic needs. One of them was Anadolu Mutfa&#x11f;&#x131; and its volunteers. In this study, the one-week menu prepared at the Anadolu Mutfa&#x11f;&#x131; soup kitchen and its impact on meeting nutritional needs were evaluated. From this point of view, it is suggested that there is insufficiency in providing diversity in the menu due to problems in food supply and storage, and that basic issues such as drinking water supply and distribution should still be more prepared in major disasters.

BackgroundVitamin A (VA) deficiency affects approximately 15% of preschool-aged children in the Philippines (serum retinol&#x2009;<0.7&#x2005;&#x3bc;mol/L). Data on school-aged children are lacking.ObjectiveTo characterize intake of VA-rich foods and VA status among school-aged children in 3 areas of the Philippines at high risk of undernutrition.MethodsWe conducted a cross-sectional study, randomly selecting n&#x2009;=&#x2009;520 children from primary schools in 3 high-risk provinces. We collected data on household characteristics, past-week food intake, and children's weights and heights. Venous blood samples were drawn and analyzed for plasma retinol, C-reactive protein, and &#x3b1;1-acid glycoprotein.ResultsMost children (96.7%) had consumed preformed VA-rich foods at least once in the prior week, mainly eggs and fortified foods, with a median consumption frequency of 7 times [p25, p75: 4, 12]. While 93.7% had consumed proVA-rich foods-mainly dark green leafy vegetables-the frequency was lower (5 times [2, 9]). Approximately one-quarter took multinutrient supplements (median 600&#x2005;&#x3bc;g retinol equivalents [400, 1185]). The mean (&#xb1; SD) plasma retinol concentration was 0.95&#x2009;&#xb1;&#x2009;0.23&#x2005;&#x3bc;mol/L. The prevalence of VA deficiency (retinol <0.70&#x2005;&#x3bc;mol/L) was 13.6% (4.9% adjusted for inflammation), and 59.0% (52.0% adjusted for inflammation) had marginal status (0.70-1.05&#x2005;&#x3bc;mol/L).ConclusionsThe VA status of school-aged children in high-risk areas was similar to that of preschool-aged children nationally. Despite adjusting for inflammation, most children were classified as having marginal VA status that could be improved by increasing intake of the available preformed and proVA-rich foods in the study area. Vitamin A intakes and status of school-aged children in high-risk areas of the PhilippinesPlain language summaryVitamin A (VA) deficiency is a nutritional concern in the Philippines, affecting about 15% of young children nationally. However, there has been little research on VA deficiency among school-aged children. This age group may be at particular risk as they are not targeted with interventions like high-dose VA supplements. Our study focused on school-aged children in 3 areas of the country known for high rates of undernutrition. We examined their intake of VA-rich foods and measured their VA status. We found that &#x223c;14% of schoolchildren were affected by VA deficiency, similar to the prevalence found among younger children. Additionally, a large proportion of children with marginal VA levels could benefit from increased intake of the VA-rich foods available in this setting. For example, while some children were consuming eggs and milk, the frequency of consumption was low. Our findings highlight the importance of ensuring that children have regular access to VA-rich foods, particularly in areas where undernutrition is prevalent. Incorporating more VA-rich foods into school-based feeding programs could be a crucial step in addressing this nutritional gap and improving the health of school-aged children in the Philippines.

BackgroundKenya has shown progress in social, economic, and health indicators over the past 2 decades. Yet, malnutrition remains a critical public health issue. Effective Multisectoral Nutrition Governance (MNG) is an enabling determinant of nutrition ensures that nutrition policies are well-coordinated, adequately funded, and effectively implemented, leading to better nutrition outcomes.ObjectiveOur study assessed the status, evolution, and factors associated with MNG in Kenya using a cross-sectional design at 2 distinct time points (2012 and 2023). The 2 distinct time points provided valuable comparative perspectives allowing for the assessment of progress and trends in MNG allowing further analysis.MethodsThe study targeted 96 government and nongovernmental staff from eligible ministries at the national level. It used a structured closed-ended questionnaire adapted from a validated Nutrition Governance Index.ResultsOur findings reveal an improvement in MNG status, from 58.4% in 2012 to 71.1% in 2023 (P&#x2009;<&#x2009;.01). The 6 MNG domains demonstrated varying performance levels, with mean scores ranging from 3.1 to 4.0 (out of 5). Despite the performance variation, the domains contributed equally to the MNG status. A positive relationship was found between the MNG score and respondent affiliation with the Ministry of Health and the level of prioritization of nutrition in a ministry (P&#x2009;<&#x2009;.05).ConclusionsFurther efforts are needed to strengthen specific MNG domains, particularly nutrition financing, transparency, accountability, and capacity, to ensure progress in tackling malnutrition in Kenya. These findings can inform efforts to enhance MNG strategies to improve nutrition outcomes sustainably in Kenya. Study to Assess the Status of Effective Governance for Delivering Multisectoral Nutrition Programs in Kenya and Identify Factors that Influence Its Effectiveness.

BackgroundLow- and middle-income countries (LMICs) developing dietary guidelines often face challenges in translating nutrient requirements into practical, culturally acceptable recommendations due to limited data and technical resources. To address this gap, the Food and Agriculture Organization (FAO) developed FAO DietSolve, a user-friendly tool designed to support such efforts through a systematic and evidence-based approach.ObjectiveTo present an overview of the FAO DietSolve methodology, demonstrating its application through a hypothetical example, and highlighting its utility in supporting the development of dietary guidelines in LMICs.MethodsFAO DietSolve uses a mathematical optimization approach using Microsoft Excel's Solver add-in. It combines food groups that meet both nutritional constraints (energy and nutrient requirements) and acceptability constraints (minimum/maximum limits for each food group), while optimizing an objective function. The tool also allows for integration of additional sustainability criteria such as cost, cultural acceptability, and environmental impact into developed dietary patterns. Food groupings are based on representative foods and food consumption data. Objective functions can vary, such as minimizing deviation from observed dietary patterns.ResultsThe tool has been utilized by 8 LMICs in developing their national dietary guidelines. The optimized dietary patterns generated have supported the creation of food selection guides tailored to different population groups and informed food graphics.ConclusionsFAO DietSolve provides LMICs with a practical, data-driven method for developing comprehensive, sustainable, and culturally appropriate dietary patterns. It enables countries to address multiple dimensions of diets and food systems, in line with FAO's new food systems-based dietary guidelines methodology. FAO DietSolve: A tool for low- and middle-income countries developing dietary guidelines.