Enhancing health benefits of milled rice: current status and future perspectives

Milled rice is an essential part of the regular diet for approximately half of the world’s population. Its remarkable commercial value and consumer acceptance are mostly due to its promising cooking qualities, appealing sensory properties, and longer shelf life. However, the significant loss of the nutrient-rich bran layer during milling makes it less nutritious than the whole grain. Thus, enhancing the nutritive value of milled rice is vital in improving the health and wellbeing of rice consumers, particularly for those residing in the low-economic zones where rice is the primary source of calories and nutrition. This article provides a critical review on multiple frontiers of recent interventions, such as (1) infusing the genetic diversity to enrich amylose and resistant starch to reduce glycaemic index, (2) enhancing the minerals and vitamins through complementary fortification and biofortification as short and long-term interventions, and (3) developing transgenic solutions to improve the nutrient levels of milled rice. Additionally, the review highlights the benefits of functional ingredients of milled rice to human health and the potential of enhancing them in rice to address the triple burden of malnutrition. The potential merit of milled rice concerning food safety is also reviewed in this article

The Relationship Of Child Growth To Nutrients, Foods, Food Groups And Feeding Behaviors During The Complementary Feeding Period: Understanding Cultural And Biologic Realities In A Peri-Urban Philippine Commmunity

This study was motivated by a desire for a deeper understanding of why Filipino infants are undernourished so early in their lives, and what might be done to prevent this. Data from an urban poor Philippine community was used to conduct an analysis of complementary feeding (CF) practices and behaviors from two different perspectives: the biological and the sociocultural. The underlying structure was provided by a global situation where scientifically-based guidelines for CF had been framed, and a set of indicators, to track progress in adherence to these guidelines and achievement of policy and program goals based on them, were in the process of validation. The over-all objective was to determine how the main CF indicators - Diet Diversity (DD) and Meal Frequency (MF) - would perform in assessing the status of infants 6 - 11 months old , and how this kind of assessment might ultimately be of use. Ethnographic techniques were used to investigate the conceptual agreement between nutritional/public health professionals and mothers of the study infants. Definitional issues about foods and liquids, mothers' perceptions of breastmilk as a unique part of the infant's diet, and local concepts about meals and snacks and breastmilk were identified that have the potential to generate inaccurate communication as well as introduce a problem for DD and MF construction. This study demonstrates why local adaptation is essential. DD is related to growth, but not the individual food groups; adding MF weakens this predictive association. The rationale for DD's use as an indicator of diet quality is its relationship with mean micronutrient adequacy(MMDA). MMDA was found inadequate even at the highest DD score. Intake of fortified products led to an attentuation of the relationship between MMDA and DD. The contributions of each food group to MMDA with each unit increase in DD is the same for breastfed (BF) and nonbreastfed (NBF) infants if breastmilk is counted as a food group. Not accounting for breastmilk's contributions to DD, as is the current practice, is conceptually counter-intuitive and potentially confusing requiring separate cut-offs for the BF and NBF

Development of a Low-Cost Electronic Data Collection Tool for a Health Facility Survey: Lessons Learned in the Field

The process of selecting and developing a data collection tool for a health facility survey study is described. Several methodologies were considered, and an Android app development platform was chosen to fulfil the requirements of the study. The platform was adopted for its low resource cost, low capacity requirement, efficient and effective community responsiveness and progressive inclusion of functionalities. Data loss was 3.4%, with proposed contributing factors such as network intermittency, malware leading to disuse (necessitating manual encoding), and asynchrony of system interfaces, though the percentage of loss attributable to each factor is indeterminate. Several considerations need to be taken into account prior to employing ICTs for research, namely, requirements of the study, resources available, and how each option being considered fulfils the requirements and proves sustainable given the resources. Planning, risk assessment, and maintenance are important phases in the development of the data collection tool

Technical Report: Assessment of the Impacts of Climate Change on Human Health and Nutrition

Its geographic location and economic situation makes the Philippines highlyvulnerable to impacts of climate change and extreme weather events that cause considerable disruptions to food systems, affecting food security, nutrition and health especially of the most vulnerable groups. This study aims to assess the effects of exposure to extreme weather conditions, classified as natural disasters, on the proportion of households meeting the recommended energy intake (REI), and the prevalences of stunting and wasting among children under-five years old, chronic energy deficiency (CED) among lactating mothers and elderly adults and nutritionally at-risk pregnant women. This study utilized cross-sectional data from the 2013 and 2015 National Nutrition Surveys conducted nationwide by the Department of Science and Technology- Food and Nutrition Research Institute (DOST-FNRI). Exposure data came from the National Disaster Risk Reduction Management Council (NDRRMC) for typhoons and floods, the Philippine Rice Information System (PRISM) of the International Rice Research Institute (IRRI) for drought, and from the Bureau of Agricultural Statistics- Philippine Statistics Authority (BAS-PSA) for palay production. Logistic regression models were adjusted for sex, age, civil status, education, household size, work and place of work of the household head, ethnicity, illness for the past 2 weeks, avail of prenatal and mothers class for pregnant women, months of lactation for lactating mothers, hypertension for elderly, food security, membership to Philhealth, participation to Four Ps, place of residence, wealth index, palay production, and exposure to climate variables typhoons and floods one month up to six months prior to survey and drought for the first quarter of 2015 and 2016. Bivariate results showed that socioeconomic status, household size, food security status, sex, age, civil status, belonging to an indigenous group, exposure to typhoons, floods and drought had significant associations with nutrition outcomes. In full models, belonging to the poorest quintile, large and food insecure households increase the odds of stunting and wasting in children 0 to 59 months old, of chronic energy deficiency in elderly adults and lactating mothers and for pregnant women to become nutritionally at-risk . Households who are engaged in agriculture were more likely to meet the REI. The effect of exposure to typhoons and floods on meeting the REI at household level was positive at three (3) months but was negative at 6 months. Among households in the Mindanao areas, exposure to drought in either the first quarter of 2015 or 2016 only, increased the likelihood of children below five years old to become stunted and among elderly adults to become CED. However, elderly adults exposed to drought for both the first quarter of 2015 and the first quarter of 2016 made them less likely to become CED. The time of exposure to these natural 5 disasters, whether typhoons, floods or drought, appears to affect the outcomes analyzed. Cohort data would help to better understand the continuing effects of such exposures. These results provide vital inputs for more strategic responses to climate change adaptation and mitigation programs of the government particularly for vulnerable population groups

Health in Southeast Asia 2 Maternal, neonatal, and child health in southeast Asia: towards greater regional collaboration

Although maternal and child mortality are on the decline in southeast Asia, there are still major disparities, and greater equity is key to achieve the Millennium Development Goals. We used comparable cross-national data sources to document mortality trends from 1990 to 2008 and to assess major causes of maternal and child deaths. We present inequalities in intervention coverage by two common measures of wealth quintiles and rural or urban status. Case studies of reduction in mortality in Thailand and Indonesia indicate the varying extents of success and point to some factors that accelerate progress. We developed a Lives Saved Tool analysis for the region and for country subgroups to estimate deaths averted by cause and intervention. We identified three major patterns of maternal and child mortality reduction: early, rapid downward trends (Brunei, Singapore, Malaysia, and Thailand), initially high declines (sustained by Vietnam but faltering in the Philippines and Indonesia), and high initial rates with a downward trend (Laos, Cambodia, and Myanmar). Economic development seems to provide an important context that should be coupled with broader health-system interventions. Increasing coverage and consideration of the health-system context is needed, and regional support from the Association of Southeast Asian Nations can provide increased policy support to achieve maternal, neonatal, and child health goals

Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults

<p>Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5–19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5–19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). Findings Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (−0·01 kg/m² per decade; 95% credible interval −0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m² per decade (0·69–1·35, PP&gt;0·9999) in central Latin America and an increase of 0·95 kg/m² per decade (0·64–1·25, PP&gt;0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m² per decade (−0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m² per decade (0·50–1·06, PP&gt;0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4–1·2) in 1975 to 5·6% (4·8–6·5) in 2016 in girls, and from 0·9% (0·5–1·3) in 1975 to 7·8% (6·7–9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0–12·9) in 1975 to 8·4% (6·8–10·1) in 2016 in girls and from 14·8% (10·4–19·5) in 1975 to 12·4% (10·3–14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7–29·6) among girls and 30·7% (23·5–38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44–117) million girls and 117 (70–178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24–89) million girls and 74 (39–125) million boys worldwide were obese. Interpretation The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults. Funding Wellcome Trust, AstraZeneca Young Health Programme.</p

Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults

Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5–19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5–19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). Findings Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (−0·01 kg/m2 per decade; 95% credible interval −0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69–1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64–1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (−0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50–1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4–1·2) in 1975 to 5·6% (4·8–6·5) in 2016 in girls, and from 0·9% (0·5–1·3) in 1975 to 7·8% (6·7–9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0–12·9) in 1975 to 8·4% (6·8–10·1) in 2016 in girls and from 14·8% (10·4–19·5) in 1975 to 12·4% (10·3–14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7–29·6) among girls and 30·7% (23·5–38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44–117) million girls and 117 (70–178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24–89) million girls and 74 (39–125) million boys worldwide were obese. Interpretation The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults