Multi-micronutrient-fortified biscuits decreased the prevalence of anaemia and improved iron status, whereas weekly iron supplementation only improved iron status in Vietnamese school children

In Vietnam, nutrition interventions do not target school children despite a high prevalence of micronutrient deficiencies. The present randomised, placebo-controlled study evaluated the impact of providing school children (n 403) with daily multiple micronutrient-fortified biscuits (FB) or a weekly Fe supplement (SUP) on anaemia and Fe deficiency. Micronutrient status was assessed by concentrations of Hb, and plasma ferritin (PF), transferrin receptor (TfR), Zn and retinol. After 6 months of intervention, children receiving FB or SUP had a significantly better Fe status when compared with the control children (C), indicated by higher PF (FB: geometric mean 36·9 (95% CI 28·0, 55·4) μg/l; SUP: geometric mean 46·0 (95% CI 33·0, 71·7) μg/l; C: geometric mean 34·4 (95% CI 15·2, 51·2) μg/l; P<0·001) and lower TfR concentrations (FB: geometric mean 5·7 (95% CI 4·8, 6·52) mg/l; SUP: geometric mean 5·5 (95% CI 4·9, 6·2) mg/l; C: geometric mean 5·9 (95% CI 5·1, 7·1) mg/l; P=0·007). Consequently, body Fe was higher in children receiving FB (mean 5·6 (sd 2·2)mg/kg body weight) and SUP (mean 6·1 (sd 2·5)mg/kg body weight) compared with the C group (mean 4·2 (sd 3·3)mg/kg body weight, P<0·001). However, anaemia prevalence was significantly lower only in the FB group (1·0%) compared with the C group (10·4%, P=0·006), with the SUP group being intermediate (7·4%). Children receiving FB had better weight-for-height Z-scores after the intervention than children receiving the SUP (P=0·009). Vitamin A deficiency at baseline modified the intervention effect, with higher Hb concentrations in vitamin A-deficient children receiving FB but not in those receiving the SUP. This indicates that vitamin A deficiency is implicated in the high prevalence of anaemia in Vietnamese school children, and that interventions should take other deficiencies besides Fe into account to improve Hb concentrations. Provision of biscuits fortified with multiple micronutrients is effective in reducing anaemia prevalence in school childre

Markets for Nutrition: What Role for Business?

Policymakers are increasingly seeking to use food systems to help reduce rates of chronic undernutrition and to use markets to deliver nutrient?rich foods to vulnerable populations. This article examines how this might be achieved, drawing lessons from three intervention types: ready?to?use therapeutic foods (RUTFs), mandatory fortification and voluntarily fortified products. We find that a common set of constraints tends to inhibit markets from delivering nutrition and makes it difficult to reach populations at the ‘bottom of the pyramid’. Overcoming these constraints requires a shift from working at the level of individual businesses to that of market and food systems. It also suggests a need for renewed focus on the effectiveness of products in reaching key groups, on the informal markets that serve the poor and on the inherent complexity of market systems. These findings suggest that food and nutrition policies and partnerships should be based on principles of experimentation and adaptive learning

LA RÉFLEXIOn - De la topique à la stylistique

§1. « L’entretien intérieur de l’âme avec elle-même a été appelé réflexion (dianoia) », Platon, Sophiste, 263e. Entretien traduit « dialogos » ; ou dialo­gue selon d’autres traductions : entretien ou dialogue, cela revient-il exactement au même ? À travers le terme d’entretien nous pouvons entendre l’idée d’attention portée à soi-même, comme si l’âme prenait souci d’elle-même, ou soin d’elle-même. C’est ce qu’entend par exemple Heidegger lorsqu’il propose de tra­duire le terme de Logos, non p..

Les écrits de Soulages

La peinture de Pierre Soulages est animée par la volonté d'éliminer de la toile toute tentative de signifier, afin de mettre le regardeur face à la présence, au surgissement immédiat de ce qui se tient là. En cela la peinture est proche, selon nous, de la musique, pur jeu des intensités et des rythmes sonores, c'est à dire du temps. Pourquoi Pierre Soulages se réfère-t-il si peu à la musique et si souvent à la poésie, art de la signification s'il en est? Et quelle importance faut-il reconnaître alors au temps dans l'expérience de l'art, de la peinture en particulier? C'est ce point que nous tentons, à notre tour, de développe

A sustainable food support for non-breastfed infants : implementation and acceptability within a WHO mother-to-child HIV transmission prevention trial in Burkina Faso

Objective: To provide HIV-positive mothers who opted for exclusive breastfeeding or formula feeding from birth to 6 months postpartum as a means of prevention of mother-to-child transmission (PMTCT) of HIV with a sustainable infant food support programme (FSP) from 6 to 12 months postpartum. We describe the implementation and assessment of this pilot initiative. Design: The FSP included a 6-month provision of locally produced infant fortified mix (IFM; 418 kJ/100 g of gruel) for non-breastfed infants coupled with infant-feeding and psychosocial counselling and support. Acceptability and feasibility were assessed in a subsample of sixty-eight mother-infant pairs. Setting: The FSP was developed in collaboration with local partners to support. participants in a PMTCT prevention study. Formula WAS provided for free from 0 to 6 months postpartum. Cessation by 6 months was recommended for breast feeding mothers. Results: The FSP was positively received and greatly encouraged breastfeeding mothers to cease by 6 months. As recommended, most infants were given milk as an additional replacement food, mainly formula subsidised by safety networks. Among daily IFM consumers, feeding practices were satisfactory overall; however, the IFM was shared within the family by more than one-third of the mothers. Cessation of IFM consumption was observed among twenty-two infants, seventeen of whom were fed milk and five neither of these. Conclusions: Without any food support most mothers would have been unable to provide appropriate replacement feeding. The food security of non-breastfed infants urgently needs to be addressed in HIV PMTCT programmes. Our findings on a simple cost-effective pioneer intervention provide an important foundation for this process