The Influence of a Centrally-Procured School Food Program on Consumption and Instances of Fruits and Vegetables in School-Age Children

Background: In Canada, 70% of youth are not meeting the recommended five servings of fruits and vegetables (FV) daily. School nutrition programs are one strategy for improving dietary habits in youth. Methods: A two-year pilot cluster randomized controlled trial was implemented within Southwestern Ontario to assess how a ten-week centrally-procured school food program (CPSFP) influences students’ consumption and instances of FV compared to the traditional school nutrition program (TSNP). Results: Children were 9-13 years of age; 30 schools received the CPSFP and 30 received the TSNP. Vegetable consumption did not change with the CPSFP (mean=0.0; SD=1.0) or the TSNP (mean=0.0; SD=1.0; p=0.94). Fruit consumption did not change with the CPSFP (mean=0.0; SD=1.4) and decreased by 0.1 servings (SD=1.4) with the TSNP (p=0.06). Instances of vegetables and fruit were similar between groups. Conclusions: The CPSFP resulted in no significant change in consumption or instances of FV

Large-scale food fortification has great potential to improve child health and nutrition

Purpose of review: Undernutrition, including micronutrient deficiencies, continues to plague children across the world, particularly in low and middle-income countries (LMICs). The situation has worsened alongside the SARS-CoV-2 pandemic because of major systemic disruptions to food supply, healthcare, and employment. Large-scale food fortification (LSFF) is a potential strategy for improving micronutrient intakes through the addition of vitamins and minerals to staple foods and improving the nutritional status of populations at large.Recent findings: Current evidence unquestionably supports the use of LSFF to improve micronutrient status. Evidence syntheses have also demonstrated impact on some functional outcomes, including anemia, wasting, underweight, and neural tube defects, that underpin poor health and development. Importantly, many of these effects have also been reflected in effectiveness studies that examine LSFF in real-world situations as opposed to under-controlled environments. However, programmatic challenges must be addressed in LMICs in order for LSFF efforts to reach their full potential.Summary: LSFF is an important strategy that has the potential to improve the health and nutrition of entire populations of vulnerable children. Now more than ever, existing programs should be strengthened and new programs implemented in areas with widespread undernutrition and micronutrient deficiencies

Malaria reduction drove childhood stunting decline in Uganda: A mixed-methods country case study

Background: Uganda has achieved a considerable reduction in childhood stunting over the past two decades, though accelerated action will be needed to achieve 2030 targets.Objectives: This study assessed the national, community, household, and individual-level drivers of stunting decline since 2000, along with direct and indirect nutrition policies and programs that have contributed to nutrition change in Uganda.Design: This mixed-methods study used 4 different approaches to determine the drivers of stunting change over time: 1) a scoping literature review; 2) quantitative data analyses, including Oaxaca-Blinder decomposition and difference-in-difference multivariable hierarchical modeling; 3) national and community-level qualitative data collection and analysis; and 4) analysis of key direct and indirect nutrition policies, programs, and initiatives. Results: Stunting prevalence declined by 14% points from 2000 to 2016, though geographical, wealth, urban/rural, and education-based inequalities persist. Child growth curves demonstrated substantial improvements in child height-for-age z-scores (HAZ) at birth, reflecting improved maternal nutrition and intrauterine growth. The decomposition analysis explained 82% of HAZ change, with increased coverage of insecticide-treated mosquito nets (ITNs; 35%), better maternal nutrition (19%), improved maternal education (14%), and improved maternal and newborn healthcare (11%) being the most critical factors. The qualitative analysis supported these findings, and also pointed to wealth, women\u27s empowerment, cultural norms, water and sanitation, dietary intake/diversity, and childhood illness as important. The 2011 Uganda Nutrition Action Plan (UNAP) was an essential multi-sectoral strategy that shifted nutrition out of health and mainstreamed it across related sectors. Conclusions: Uganda\u27s success in stunting reduction was multi-factorial, but driven largely through indirect nutrition strategies delivered outside of health. To further improve stunting, it will be critical to prioritize malaria-control strategies, including ITN distribution campaigns and prevention/treatment approaches for mothers and children, and deliberately target the poor, least educated and rural populations along with high-burden northern and western districts

Epigenetic analysis leads to identification of HNF1B as a subtype-specific susceptibility gene for ovarian cancer

Contains fulltext : 118378.pdf (publisher's version ) (Open Access)HNF1B is overexpressed in clear cell epithelial ovarian cancer, and we observed epigenetic silencing in serous epithelial ovarian cancer, leading us to hypothesize that variation in this gene differentially associates with epithelial ovarian cancer risk according to histological subtype. Here we comprehensively map variation in HNF1B with respect to epithelial ovarian cancer risk and analyse DNA methylation and expression profiles across histological subtypes. Different single-nucleotide polymorphisms associate with invasive serous (rs7405776 odds ratio (OR)=1.13, P=3.1 x 10(-10)) and clear cell (rs11651755 OR=0.77, P=1.6 x 10(-8)) epithelial ovarian cancer. Risk alleles for the serous subtype associate with higher HNF1B-promoter methylation in these tumours. Unmethylated, expressed HNF1B, primarily present in clear cell tumours, coincides with a CpG island methylator phenotype affecting numerous other promoters throughout the genome. Different variants in HNF1B associate with risk of serous and clear cell epithelial ovarian cancer; DNA methylation and expression patterns are also notably distinct between these subtypes. These findings underscore distinct mechanisms driving different epithelial ovarian cancer histological subtypes