Constraints on good child-care practices and nutritional status in urban Dar-es-Salaam, Tanzania

BACKGROUND: Care is increasingly being recognized as a crucial input to child health and nutrition, along with food security, availability of health services, and a healthy environment. Although significant gains have been made in the fight against malnutrition in Tanzania, the nutritional status of preschool children in urban areas is not improving. OBJECTIVE: To assess child-care practices and the nutritional status of infants and young children with the aim of improvingfeeding practices and child nutritional status. METHODS: A cross-sectional study was undertaken in urban Dar-es-Salaam, Tanzania. The study involved 100 randomly selected mothers of children 6 to 24 months old from households in Ilala Municipality, one of the three municipalities that constitute the Dar-es-Salaam City Council. Data were collected by a structured questionnaire, spot-check observations, and anthropometric measurements. RESULTS: The prevalence rates of stunting, underweight, wasting, and morbidity were 43%, 22%, 3%, and 80%, respectively. The prevalence of exclusive breastfeeding was very low (9%), and most stunted children (88%) were not exclusively breastfed for the first 6 months. The mean age at which complementary foods and fluids were introduced was 3.26 +/- 1.12 months (range, 1 to 5 months). The fluids given were mainly water and thin cereal-based porridge. More than half of the households practiced good hygiene. Most of the psychosocial practices (e.g., caregiver's attention, affection, and involvement in child feeding, hygiene, health care, and training) were performed by mothers, except for cooking and feeding the children and child training, which were done mostly by alternative caregivers. Nearly half of the mothers (44%) worked out of the home. The mean number of working hours per day was long (10.32 +/- 2.13), necessitating the use of alternative caregivers. A negative correlation was found between height-for-age z-scores and the number of hours mothers worked outside the home. CONCLUSIONS: The prevalence rates of chronic malnutrition and morbidity are high, and child-feeding practices are inadequate in this urban population. Maternal employment and educational characteristics constrain good child-care practices, and alternative caregivers are taking a more important role in child care as mothers join the work force. We recommend that formative research be conducted to study the actual practices of caregivers in order to form the basis for a child-care education program. There is also a need to strengthen national health system support for improved child feeding.     

Child's gender and household food insecurity are associated with stunting among young Pakistani children residing in urban squatter settlements

BACKGROUND: The nutritional status of children is a good indicator of the overall well-being of a society and reflects food security as well as existing health-care and environmental conditions. In Pakistan, it is estimated that nearly 40% to 50% of children under the age of five are stunted. Due to greater economic opportunities available to the urban population as compared to the rural, it was believed that economic resources existed in poor urban Pakistani households but that the households lacked the skills and knowledge to translate their resources into good care and feeding practices. OBJECTIVE: This study aimed 1) to assess the prevalent care and feeding practices among children aged 6 to 18 months residing in the squatter settlements of Karachi and 2) to identify care and feeding practices, as well as any other underlying factors, associated with stunting. METHODS: A cross-sectional survey was conducted in eight settlements between October and December 2000. A total of 433 mothers of eligible children were interviewed with the use of structured questionnaires. Final analysis using multiple logistic regression was conducted on 399 mother-child pairs. RESULTS: Female children were nearly three times more likely to be stunted than male children. Households that were food insecure with hunger were also three times more likely than other households to have a stunted child. Lack of maternal formal schooling (adjusted prevalence odds ratio, 2.9; 95% confidence interval, 1.4 to 3.8) and large household size (adjusted prevalence odds ratio, 1.7; 95% confidence interval, 1.0 to 3.8) were also associated with stunting. Even though certain care and feeding practices were significant at the univariate level, they were not significant in the final multivariate analysis and so were excluded from the final model. CONCLUSIONS: In households where food insecurity exists, knowledge of care practices may not be sufficient, and interventions such as food subsidies must precede or accompany educational efforts. Further follow-up is required to explore the effect of gender differences on child care.     

Women's empowerment and domestic violence: the role of sociocultural determinants in maternal and child undernutrition in tribal and rural communities in South India

BACKGROUND: Moderate malnutrition continues to affect 46% of children under five years of age and 47% of rural women in India. Women's lack of empowerment is believed to be an important factor in the persistent prevalence of malnutrition. In India, women's empowerment often varies by community, with tribes sometimes being the most progressive. OBJECTIVE: To explore the relationship between women's empowerment, maternal nutritional status, and the nutritional status of their children aged 6 to 24 months in rural and tribal communities. METHODS: This study in rural Karnataka, India, included tribal and rural subjects and used both qualitative and quantitative methods of data collection. Structured interviews with mothers were performed and anthropometric measurements were obtained for 820 mother-child pairs. The data were analyzed by multivariate and logistic regression. RESULTS: Some degree of malnutrition was seen in 83.5% of children and 72.4% of mothers in the sample. Biological variables explained most of the variance in nutritional status, followed by health-care seeking and women's empowerment variables; socioeconomic variables explained the least amount of variance. Women's empowerment variables were significantly associated with child nutrition and explained 5.6% of the variance in the sample. Maternal experience of psychological abuse and sexual coercion increased the risk of malnutrition in mothers and children. Domestic violence was experienced by 34% of mothers in the sample. CONCLUSIONS: In addition to the known investments needed to reduce malnutrition, improving women's nutrition, promoting gender equality, empowering women, and ending violence against women could further reduce the prevalence of malnutrition in this segment of the Indian population.     

Dietary standards and goals for the People's Republic of China with special emphasis on nutritional requirements of Chinese infants

A recent dietary survey shows that protein, energy and the majority of the mineral and vitamin intakes of the people in China are sufficient to meet their physiologic requirements. However, the dietary energy derived from cereals appear to be high and the dietary protein derived from animal foods is low. Thus, to improve the nutritional status of the Chinese people, a greater consumption of animal food is encouraged. The goal of an adequate adult diet is to maintain optimal health through a balanced intake of energy and all the essential nutrients. This can be achieved in China by the increase in food production through agriculture, fishery and animal husbandry, and by national planning utilizing the Recommended Dietary Allowances as the standard. Children are the future of our country. Hence, research on child nutrition should receive priority, particularly in the area of protein and energy requirements of pre-school children.     

Assessment of the nutritional status of preschool-age children during the second Intifada in Palestine

BACKGROUND: The Palestinian economy has dramatically deteriorated at all levels since the Al-Aqsa Intifada (uprising) began in 2000, resulting in an unprecedented catastrophe to the livelihoods of the Palestinians residing in the West Bank and Gaza. It was also marked by lack of household physical and financial access to food and health care, which placed children at increased risk of malnutrition and poor health. This prompted a significant increase in food aid from 2002 until the summer of 2003. OBJECTIVES: To assess the nutritional status of children 6 to 59 months of age after 1 year of food assistance. METHODS: In the West Bank and Gaza, a nationally representative sample of children 6 to 59 months of age was randomly selected with a validated multistage clustered design, with the Health Survey 1999 sample used as the sampling frame. The sample was stratified according to governorate, place of residence (urban, nonurban, or refugee camp), locality, and size of locality (number of households). A cross-sectional survey of nutritional status was carried out. Data were collected by interviews with the primary caregivers of the children. Measurements were made of children's weight and height or length. Food-intake data were collected by the 24-hour food-recall method with the use of a booklet of photographs of foods commonly eaten in Palestine. RESULTS: A total of 3,089 children were assessed, of whom 3.1% in the West Bank and 3.9% in the Gaza Strip were suffering from acute malnutrition; the prevalence of chronic malnutrition was 9.2% in the West Bank and 12.7% in the Gaza Strip (p = .02). Sex, refugee status, locality, and maternal education were not significantly associated with acute malnutrition by logistic regression analysis, whereas infants 6 to 23 months of age were significantly at risk. Calorie and protein intakes were generally lower than recommended dietary allowances. CONCLUSIONS: The prevalence rates of both acute and chronic malnutrition among children in the West Bank and Gaza are significantly higher than the national Palestinian averages. There is a need to establish nutritional surveillance systems to monitor the nutritional status of children in conflict areas.     

Relationship between paternal involvement and child malnutrition in a rural area of Vietnam

BACKGROUND: Malnutrition is a public health problem in Vietnam. Child health and the status of women have been targets for various health programs in the country. In general, reports in the literature suggest that care is positively correlated with positive nutritional status of children. In the household, the father is considered a resource for care. However, the role of paternal care in health programs has not received the attention it deserves. OBJECTIVE: To identify associations between the involvement of fathers in child care and housework and the nutritional status of children under 3 years of age. METHODS: This cross-sectional study was based on a random sample of 547 children under 3 years of age from intact families and their biological parents. The main outcome variable was child nutrition. Predictor variables represented two domains of father's involvement. Multivariable general linear modeling and multivariable logistic regression modeling were performed with the use of a combination of stepwise and hierarchical approaches in data analysis. RESULTS: The overall prevalence of underweight among children was 19.1%, and the prevalence of stunting was 14.4%. Children whose fathers did not bring them to a medical facility for immunization were about 1.7 times more likely to be underweight and stunted than those whose fathers did bring them for immunization after child's age, household economic status, and mother's education were controlled for. Father's involvement in housework was not found to be related to the prevalence of malnutrition. CONCLUSIONS: Paternal involvement in child immunization should be encouraged by health-care providers who manage immunization programs.     

油莎豆的营养成分、生物活性及其应用研究进展

油莎豆是一种含有丰富的营养成分和多种生物活性物质的新兴油料植物,凭借着高油酸和淀粉含量,以及抗氧化、降血糖血脂、抗菌等生物活性,受到食品、营养保健和畜牧生产领域的广泛关注。近年来,油莎豆在食品、保健品和畜牧生产等领域的应用范围逐渐扩大,系统研究油莎豆的营养特性及其生物活性具有重要意义。本文概括了近年来油莎豆主要营养成分(油脂、蛋白质及多糖等)及其生物活性(降低血糖血脂、抑菌和抗氧化等)的最新研究进展,同时总结了油莎豆在食品、畜牧养殖与医疗保健等领域的综合利用现状,分析了存在的问题,展望了油莎豆未来的发展方向,以期为油莎豆资源的深度开发利用提供理论依据。     

Concentrations of polybrominated diphenyl ethers, polychlonnated biphenyls, and polychlorobiphenylols in serum from pregnant Faroese women and their children 7 years later

The objective of this study was to assess blood concentrations of polybrominated diphenyl ethers (PBDEs) and polychlorinated biphenyls (PCBs), and their polychlorobiphenylol (OH-PCB) metabolites in humans with a high seafood intake. Samples were obtained from pregnant women in the Faroe Islands in 1994-1995 and from their children at 7 years of age to examine maternal transfer of the compounds to their child, age-dependent metabolism, and temporal changes. Maternal serum was dominated by 2,2',4,4'-tetrabromodiphenyl ether (BDE-47), while 2,2',4,4',5,5'-hexabromodiphenyl ether (BDE-153) prevailed in the children's serum seven years later. DecaBDE was present in both mothers and children up to 3 and 6 ng/g lipid weight, respectively. The sigmaPCB concentration in the children averaged about 60% of the concentrations in their mothers, with median levels for both above 1 microg/g lipid weight and .with similar PCB congener patterns. sigmaOH-PCB serum concentrations from the mothers and their children showed ranges of 1.8-36 ng/g wet weight (ww) and 0.49-22 ng/g ww, respectively, with all OH-PCB congener concentrations being lower in the children, except for 2,3,3',4',5-pentachloro-4-biphenylol (4-OH-CB107). Children at 7 years of age are exposed to PCBs at levels only slightly below those of their mothers, and the increased 4-OH-CB107 concentrations in children could be due to age-related differences in PCB metabolism. The PBDE concentrations were similar in both mothers and their children. The main persistent organic pollutant concentrations in the children are most probably due to other environmental exposure than maternal transfer.     

Nutritional status in postconflict Afghanistan: evidence from the National Surveillance System Pilot and National Risk and Vulnerability Assessment

BACKGROUND: Two large-scale studies, the National Surveillance System (NSS) Pilot Study (2003-2004) and the National Risk and Vulnerability Assessment (NRVA) 2003, were conducted by government, United Nations, and nongovernmental organizations in Afghanistan, as part of wider efforts characterizing Afghan livelihoods in relation to particular outcomes of interest: vulnerability to poverty, food insecurity, and malnutrition. OBJECTIVE: To present the data from these two surveys with nutrition as the key outcome of interest, and to further construct the understanding of the underlying causes of malnutrition, thus providing public health practitioners and other sector specialists with insight into how a variety of sectoral programs can impact nutritional outcomes in Afghanistan. METHODS: The NSS gathered information on livelihoods, food security, and nutrition from 20 to 40 randomly selected households in each of 26 purposively selected sentinel sites (representative of livelihood zones) during November-December 2003 and May-June 2004. The NRVA gathered information nationally from households selected with a two-stage sampling (based on livelihood zone and then socioeconomic group) during July-September 2004. RESULTS: Acute malnutrition is below emergency levels for children under five. The level of chronic malnutrition in children under five indicates a problem of public health importance. Dietary diversity in Afghanistan is not as low as expected but still shows room for improvement, particularly in remote areas and with respect to food groups associated with adequate micronutrient intake. The findings also suggest that in addition to lack of adequate household food intake, recurrent illness and suboptimal infant and young child feeding and hygiene practices contribute to poor nutritional outcomes in this age group. The survey also found poor access to health care, markets, and water for household use. CONCLUSIONS: Improving nutritional status requires a multipronged approach, directly targeting malnutrition, coupled with economic growth, household livelihood security, social protection, access to public health services, and water and sanitation. Nutrition policy, programming, and monitoring need to reflect the immediate and underlying causes of malnutrition. Future research needs to be designed to quantify the relative contribution of underlying causes of poor nutrition, allowing practitioners to prioritize responses aimed at improving nutritional outcomes.     

Breastfeeding and mixed feeding practices in Malawi: timing, reasons, decision makers, and child health consequences

BACKGROUND: In order to effectively promote exclusive breastfeeding, it is important to first understand who makes child-care and child-feeding decisions, and why those decisions are made; as in most parts of the world, exclusive breastfeeding until 6 months of age is uncommon in Malawi. OBJECTIVE: To characterize early infant foods in rural northern Malawi, who the decision-makers are, their motivation, and the consequences for child growth, in order to design a more effective program for improved child health and nutrition. METHODS: In a rural area of northern Malawi, 160 caregivers of children 6 to 48 months of age were asked to recall the child's age at introduction of 19 common early infant foods, who decided to introduce the food, and why. The heights and weights of the 160 children were measured. RESULTS: Sixty-five percent of the children were given food in their first month, and only 4% of the children were exclusively breastfed for 6 months. Mzuwula and dawale (two herbal infusions), water, and porridge were common early foods. Grandmothers introduced mzuwula to protect the children from illness; other foods were usually introduced by mothers or grandmothers in response to perceived hunger. The early introduction of porridge and dawale, but not mzuwula, was associated with worse anthropometric status. Mzuwula, which is not associated with poor growth, is usually made with boiled water and given in small amounts. Conversely, porridge, which is associated with poor child growth, is potentially contaminated and is served in larger amounts, which would displace breastmilk. CONCLUSIONS: Promoters of exclusive breastfeeding should target their messages to appropriate decision makers and consider targeting foods that are most harmful to child growth.     

Micronutrient fortification: WFP experiences and ways forward

Micronutrient deficiencies represent a largely invisible, but often devastating, form of malnutrition that is particularly prevalent among WFP's beneficiary populations already lacking sufficient food. Known effects of micronutrient deficiencies include impaired physical and mental growth among children, iron-deficiency anemia, maternal mortality, low adult labor productivity and blindness. WFP makes important, often pioneering contributions to overcoming such deficiencies through: Careful attention to micronutrients in needs assessment and ration planning, Delivering fortified foods, particularly to nutritionally-vulnerable groups, on an increasingly large scale, Promotion and use of locally-produced and fortified commodities in more than a dozen low income, food deficit countries, Advocacy for fortification at national and international policy levels. Important activities in local processing and fortification have recently taken place in countries like Zambia, Angola, Bangladesh, India, Nepal, and in the context of the regional southern Africa drought emergency. Each case demonstrates that where micronutrient deficiencies are an operational concern local fortification is possible, albeit challenging. Several ongoing assessments of the impact of such initiatives suggest important nutritional benefits. That said, challenges remain in terms of technical and managerial capacity constraints, the need for systematic compliance with procurement specifications and quality control, clearer policies on micronutrient content labeling, and the need for cash resources to support many aspects associated with local processing and fortification activities.     

Synergies and tradeoffs between cash crop production and food security: a case study in rural Ghana

Despite dramatic improvements in global crop yields over the past half-century, chronic food insecurity persists in many parts of the world. Farming crops for sale (cash cropping) has been recommended as a way to increase income that can, in turn, improve food security for smallholder farmers. Despite long-term efforts by development agencies and government to promote cash cropping, there is limited evidence documenting a relationship between these crops and the food security of households cultivating them. We used a mixed methods approach to build a case study to assess these relationships by collecting quantitative and qualitative data from cacao and oil palm farmers in the Ashanti region of Ghana. Three dimensions of food security were considered: food availability, measured by the months in a year households reported inadequate food; food access, indicated by the coping strategies they employed to secure sufficient food; and food utilization, gauged by the diversity of household diets and anthropometric measurements of child nutritional status. We found significant negative relationships between each of these pillars of food security and a household’s intensity of cash crop production, measured by both quantity and area. A qualitative assessment indicated community perception of these tradeoffs and identified potential mechanisms, including increasing food prices and competing activities for land use, as underlying causes. The adverse relationship between cash crop production and household food security observed in this paper calls for caution; results suggest that positive relationships cannot be assumed, and that further empirical evidence is needed to better understand these tradeoffs.     

Is agriculture connected with stunting in Indonesian children living in a rice surplus area? A case study in Demak regency,central Java

Central Java province plays the main role in the production of food for national stocks in Indonesia, in which Demak is one of the 35 Regencies. Demak Regency had the sixth highest rice productivity in 2013, but at the same time, the seventh highest percentage of child malnutrition. This paradox between high rice productivity and low nutritional status of children triggered an interest in analyzing the correlations between agricultural production of households in the Demak Regency and the prevalence of stunting of children under-five. In December 2014 to February 2015, a cross-sectional survey was carried out in three sub-districts in Demak (Karanganyar, Dempet and Gajah) having the highest rice production and at the same time poor nutritional status of under-five children. The oldest under-five children from farmer family backgrounds were selected. Data on general characteristics, anthropometry of the children, as well as household socio-economics, including agricultural characteristics were obtained. Of the 335 children, 31.9% of them were stunted. A higher proportion of households that grew rice solely or mainly for own consumption (62.4%) and had significantly smaller sized rice-fields (p = 0.041) had stunted rather than non-stunted children. In total, rice production, farm income and agriculture diversity of families with non-stunted children were not significantly different from those of stunted children. However, yearly expenditure for improving family health and environmental conditions were significantly higher among non-stunted than stunted children (p = 0.044). Family decisions about what to spend money on also seemed to influence the nutritional status of the children, rather than nutritional diversity or revenue from agriculture itself. Therefore, improvement of agricultural production and diversity should be accompanied by education on household expenditure.     

A laboratory-based assessment of mother-child snack food selections and child snack food consumption: Associations with observed and maternal self-report of child feeding practices

This study explored how mothers' observed and self-reported child feeding practices (child control over food choices, encouragement of balance and variety, and teaching about nutrition) were associated with mother-child snack food selections and child snack food consumption in a laboratory setting. Mothers (N = 107) and their 4.5-year-old children (52% female) selected up to 5 snack foods (out of 9 snack foods: 6 higher-energy-density [ED] and 3 lower-ED) for optional child consumption throughout a one-hour laboratory visit. Mothers’ in-the-moment child feeding practices during the snack food selection task were coded using observational coding schemes, and mothers’ global child feeding practices (i.e., across meals and snacking occasions) were self-reported using the Comprehensive Feeding Practices Questionnaire (Musher-Eizenman & Holub, 2007). Results of multiple linear regression analyses with covariates showed that higher-ED snack food selections were positively associated with observed child control over food choices (B = 0.35, SE = 0.12, p = .006) and self-reported teaching about nutrition (B = 0.49, SE = 0.19, p = .010), and negatively associated with self-reported encouragement of balance and variety (B = −0.66, SE = 0.24, p = .007). Lower-ED snack food selections were positively associated with self-reported encouragement of balance and variety (B = 0.53, SE = 0.20, p = .008). Child consumption of higher-ED or lower-ED snack foods were not significantly associated with mothers’ child feeding practices (observed or self-reported). We discuss the implications of these findings for future research on children’s snack food selection and consumption.     

Dietary and physical activity patterns of 8- to 10-year-old urban schoolchildren in Manila,Philippines

This report is the second part of a study on the nutrition of urban schoolchildren in the city of Manila; the first part was on nutritional status. The primary purpose of the study was to gather data that will assist authorities in planning and implementing nutrition education programs focused on the growing problem of obesity and overweight in children. The study included 1,208 children 8 to 10 years of age, who were randomly selected from all public and private schools in the city of Manila. Data on the children's dietary and physical activity patterns, together with information on nutrition-related knowledge, attitudes, and preferences of the children and their parents, were gathered by interviews and self-administered questionnaires. There were distinct differences in dietary and physical activity patterns between the two groups of children. Children from private schools, who are generally of higher socioeconomic status than those from public schools, tended to consume more total food, more animal foods, fats, and oils, and more beverages, resulting in higher intakes of calories, protein, iron, and vitamin A than public schoolchildren. Moreover, children from private schools were apparently less physically active, were more likely to be driven to school instead of walking, and were more likely to prefer television and computer games over outdoor games. These differences agree with an earlier report on the nutritional status of the children as determined by anthropometry, which showed a higher proportion of overnutrition and a lower proportion of undernutrition among private schoolchildren than among public schoolchildren. Although the emphasis in public schools should be on prevention and control of undernutrition in children, private schools should begin to look at the emerging problem of overnutrition and the role of physical activity programs in the health of children. The information on the knowledge, attitudes, and preferences of the children and their parents showed that parents or guardians, teachers, and television influence the nutritional practices of schoolchildren. These groups should therefore be the major targets for nutrition education programs meant to improve the nutrition and health of schoolchildren.     

重庆市失独家庭中糖尿病患者膳食营养状况调查分析

目的 调查重庆市失独家庭中糖尿病患者膳食营养状况。方法 随机抽取重庆市失独家庭中糖尿病患者100例作为观察组, 同时选取100例正常家庭中的健康人群作为对照组, 调查2组人群膳食营养状况。 结果 重庆市失独家庭中糖尿病患者身体体重指数明显高于健康人群[(26.95±3.02) vs. (25.26±3.39) kg/m2, P<0.01]; 肥胖比例显著高于健康人群(32.00% vs. 18.00%, P<0.05)。重庆市失独家庭中糖尿病患者谷物、油脂类、禽肉类、豆类、盐摄入量较正常人群增高(P<0.05), 而乳类、蔬菜类、鱼虾类、蛋类、水果摄入量较正常人群降低(P<0.05)。通过对比糖尿病患者推荐摄入量发现重庆市失独家庭中糖尿病患者谷物、油脂类、禽肉类、豆类、盐摄入量超量, 而乳类、蔬菜类、鱼虾类、蛋类、水果摄入量不足。重庆市失独家庭中糖尿病患者热量、碳水化合物和脂肪摄入量高于正常人群, 而蛋白质摄入量低于正常人群(P<0.05)。重庆市失独家庭中糖尿病患者焦虑自我评分、抑郁自我评分高于正常人群(P<0.05)。焦虑自我评分、抑郁自我评分与热量、蛋白质、脂肪摄入正相关, 与蛋白质摄入负相关(P<0.05)。结论 重庆市失独家庭中糖尿病患者热量摄入较多, 其中碳水化合物、脂肪、盐摄入较多, 而蛋白质摄入偏少, 与心理健康状况有关, 应加强对这类人群的饮食教育和心理健康建设。     

Food purchase patterns indicative of household food access insecurity,children’s dietary diversity and intake,and nutritional status using a newly developed and validated tool in the Peruvian Amazon

Food security, defined as the capacity to acquire preferred food at all times, can manifest in many dimensions. Following a mixed methods approach used in India and Burkina Faso, we developed a 58-item experience-based measure in the Peruvian Amazon, based on investigator observations, relevant literature, and pre-testing with community field workers. The tool encompasses seven dimensions of food security and included measures of (1) food purchases, frequency of purchase, and location of acquisition, (2) food expenses, (3) coping mechanisms, (4) preparation of leftover food, (5) food safety (refrigerator access), (6) fishing intensity and (7) selling food. The survey was piloted among 35 randomly selected families from the Malnutrition Enteric Disease (MAL-ED) birth cohort in Santa Clara, Peru and the surrounding communities. Subsequently, based on a focus group discussion, a pile-sorting exercise, and pilot results, we reduced the survey to 36 items to be collected monthly among 203 MAL-ED households from November 2013 to January 2015. Validity and reliability were then assessed using principal component analysis and exploratory factor analysis, revealing four groups of purchase and coping strategy behaviors: (1) Sweets and sugary items, (2) Less preferred, (3) More preferred, and (4) Minimum meal. Internal consistency of the final 22-item scale had an acceptable cutoff of Cronbach’s α of 0.73. Criterion and construct validity of the factor groups revealed there were: (1) food purchase patterns that were distinctive to quality and quantity aspects of the Household Food Insecurity Access scale, (2) unique correlations of child’s intake of fats, animal source protein, fiber and other micronutrients, (3) household purchase patterns from the “more preferred” group (fish, red meat) associated with child’s weight-for-age. Food purchase and frequency, and context-specific behaviors at the household level can be used as surrogates for dietary intake patterns and nutritional status among children. Food purchase and frequency measurement is a quick, objective, non-intrusive survey method that could be used as an indicator for acute changes in household food security status with appropriate pilot testing and validation.     

Effect of maternal dietary vitamin C intake on the level of vitamin C in breastmilk among nursing mothers in Baghdad,Iraq

The vitamin C content of breastmilk was investigated in a group of nursing mothers attending maternal and child health centers in Baghdad during 1998-2000. Two hundred healthy, nonsmoking, 28- to 38-year-old lactating women were studied. Individual samples of breastmilk were obtained for estimation of vitamin C. Dietary data were collected by using 24-hour food recalls. The mean intake of vitamin C was far below the Food and Agriculture Organization/World Health Organization requirement of 26 +/- 2.13 (SD) mg/day). The vitamin C content of breastmilk was significantly correlated with the maternal intake of vitamin C (r = 0.61, p < .01). The vitamin C content of breastmilk varied with the season. The level was much higher in summer (3.9 +/- 1.05 mg/100 ml) than in winter (3.02 +/- 2.01 mg/100 ml; p < .05). This fluctuation indicates the dependence of breastmilk vitamin C on dietary intake. The results show the need to increase the consumption of vegetables and fruits and to monitor maternal ascorbic acid intake.     

Cross-national differences in child food neophobia: A comparison of five European countries

Food neophobia (FN) has been extensively explored, especially in children. However, very few studies have compared this food behavior in children from different countries. Considering the clear diversity between European countries in feeding practices and food consumption, it is important to deepen the understanding of cross-national differences in child FN. The aim of this study was to explore and compare FN in five European countries (Finland, Italy, Spain, Sweden and UK) using a food neophobia scale specifically designed for children. Five hundred and twenty-nine children (54% girls) aged 9–12 years were recruited from schools in each country and were asked to complete the Italian Child Food Neophobia Scale (ICFNS, Laureati, Bergamaschi et al., 2015), which was translated into each respective language. Parents (n ≈ 300) completed a food consumption frequency questionnaire for their child, and provided background information. Reliability of the tool was assessed through internal consistency and temporal stability. Total internal consistency was 0.76. When calculated by country, internal consistency was satisfactory (Cronbach’s alpha >0.70) for all countries. FN was negatively associated to fruit and vegetable consumption, liking of wholegrain biscuits, and timing of introduction of semi-solid food. There were small but significant cross-national differences in FN with British and Swedish children being the most neophobic and significantly higher in FN than Finnish children, who were the most neophilic. Results indicate that the tool can be successfully used in all the tested countries with children in the age range of 9–12 years. The tool can be useful to measure the effects of interventions aiming at changing food behaviors, such as reducing FN, among children.