Seasonal Variation in the Proximal Determinants of Undernutrition During the First 1000 Days of Life in Rural South Asia: A Comprehensive Review

In this review, the influence of seasonal variation on undernutrition during the first 1000 days of life of life in rural South Asia is conceptualized using a modified framework developed under the “Tackling the Agriculture and Nutrition Disconnect in India” project. Evidence for the existence and extent of seasonality is summarized from 14 studies reporting on six proximal determinants of undernutrition. A limited number of studies examine seasonal variation in risk factors for this age group. All available studies, however, report a compelling finding of significant seasonal variation for at least one determinant of undernutrition. Research to clarify mechanisms for potentially adverse effects of seasonal variation on health and nutritional status during the first 1000 days of life is needed.Department for International Development (DFID

Food biofortification : reaping the benefits of science to overcome hidden hunger

Biofortification is a process of increasing the density of minerals and vitamins in a food crop through conventional plant breeding, genetic engineering, or agronomic practices (primarily use of fertilizers and foliar sprays). Biofortified staple food crops, when substituted consistently for non-biofortified staple food crops, can generate measurable improvements in human nutrition and health. This monograph describes the progress made in developing, testing, and disseminating biofortified staple food crops, primarily through the use of conventional plant breeding, summarizing the activities of two consortiums of inter-disciplinary collaborating institutions led the HarvestPlus program and the International Potato Center (CIP). We focus on laying out the evidence base proving the effectiveness and impact to date of biofortified crops. Results of a large number of nutritional bioavailability and efficacy trials are summarized (Chapter 2), crop development techniques and activities are presented and variety releases documented for a dozen staple food crops in low and middle income countries (LMICs) in Africa, Asia, and Latin America (Chapter 3), and strategies for promoting the uptake of specific biofortified crops are discussed, concurrent with policy advocacy to encourage key institutions to mainstream the promotion, and use of biofortified crops in their core activities (Chapters 4 and 5). Statistics will be presented on numbers of farm households adopting biofortified crops (Chapters 3 and 4), now available to farmers in 40 low and middle income countries (LMICs). Each section will outline the way forward on additional future activities required to enhance the development and impact the biofortification through conventional plant breeding. No biofortified staple food crop developed through transgenic techniques has been fully de-regulated for release to farmers in LMICs. Yet transgenic techniques hold the potential for a several-fold increase in the impact/benefits of biofortified crops. This potential is described in Chapter 6 which discusses developmental research already completed, including achieving higher densities of single nutrients than is possible with conventional breeding, combining multiple nutrient traits in single events, slowing down/reducing the level of degradation of vitamins after harvesting, and combining superior agronomic traits with nutrient traits in single events. A final chapter summarizes and discusses key questions and issues that will influence the ultimate mainstreaming of biofortified crops in food systems in LMICs and will allow maximization of the benefits of biofortification

Cross-Sectional and Longitudinal Associations between Household Food Security and Child Anthropometry at Ages 5 and 8 Years in Ethiopia, India, Peru, and Vietnam

En: Journal of Nutrition, No. 145, pp. 1924-1933. doi:10.3945/jn.115.210229Background: Poor childhood nutritional status has lifetime effects and food insecurity is associated with dietary practices that can impair nutritional status. Objectives: We assessed concurrent and subsequent associations between food insecurity and height-for-age z scores (HAZs) and body mass index–for-age z scores (BMI-Zs); evaluated associations with transitory and chronic food insecurity; and tested whether dietary diversity mediates associations between food insecurity and nutritional status. Methods: We used data from the Young Lives younger cohort composed of children in Ethiopia (n = 1757), India (n =1825), Peru (n = 1844), and Vietnam (n = 1828) recruited in 2002 (round 1) at ;1 y old, with subsequent data collection at 5 y in 2006 (round 2) and 8 y in 2009 (round 3). Results: Children from food-insecure households had significantly lower HAZs in all countries at 5 y (Ethiopia, 20.33; India, 20.53; Peru, 20.31; and Vietnam, 20.68 HAZ; all P < 0.001), although results were attenuated after controlling for potential confounders (Ethiopia, 20.21; India, 20.32; Peru, 20.14; and Vietnam, 20.27 HAZ; P < 0.01). Age 5 y food insecurity predicted the age 8 y HAZ, but did not add predictive power beyond HAZ at age 5 y in Ethiopia, India, or Peru. Age 5 y food insecurity predicted the age 8 y BMI-Z even after controlling for the 5 y BMI-Z, although associations were not significant after the inclusion of additional confounding variables (Ethiopia, P = 0.12; India, P = 0.29; Peru, P = 0.16; and Vietnam, P = 0.51). Chronically food-insecure households had significantly lower HAZs than households that were consistently food-secure, although BMI-Zs did not differ by chronic food-insecurity status. Dietary diversity mediated 18.8–30.5% of the association between food security and anthropometry in Vietnam, but mediated to a lesser degree (8.4–19.3%) in other countries. Conclusions: In 4 countries, food insecurity at 5 y of age was associated with both HAZ and BMI-Z at age 8 y, although the association was attenuated after adjusting for other household factors and anthropometry at age 5 y, and remained significant only for the HAZ in Vietnam

Iron biofortified rice improves the iron stores of non-anemic Filipino women

Iron deficiency is the most prevalent nutritional deficiency in the world affecting an estimated 3.5 billion people. Among the most at risk in developing countries, are women of reproductive age. Strategies to alleviate the problem are public education to improve diets, supplementation, and iron fortification of the food supply. Biofortification of staple food crops is a new approach to complement existing interventions. Developing staple food crops with substantial amounts of micronutrients such as iron, zinc, and pro‐vitamin A through conventional breeding and biotechnology has the potential to significantly improve nutritional status of vulnerable groups. In processed and cooked form, biofortified high iron rice developed through conventional breeding at the International Rice Research Institute has four to five times more iron than commercially available rice. Sensory evaluation prior to the feeding study showed that high‐iron rice was comparable with the commercial rice.Non-PRIFPRI1; HarvestPlusHarvestPlu

Altitude Differences in Body Composition among Bolivian Newborns

Human fetal growth, reflected in birth weight and linear dimensions of the newborn, is decreased at high altitude although the causal role of hypoxia remains presumptive. In an effort to isolate the source of fetal growth deficit in high-altitude newborns, we examined newborn body composition in a sample which included 175 infants from high altitude and 71 from low altitude in Bolivia. After controlling for variation associated with sex of the infant, ethnic group, parity and maternal size, birth weight was reduced 339 grams at high altitude and crown-heel length was reduced 1 cm, but the sum of five skinfolds was almost 5 mm greater. Newborn brachial muscle area did not vary by altitude. These results indicate that fetal undemutrition is not responsible for the reduced newborn dimensions observed at high altitude and further suggest that hypoxia may exert a direct effect on human fetal growth

Physical Growth and Maximal Work Capacity in Preadolescent Boys at High-altitude

Maximal exercise tests were given to 67 boys of European ancestry and between the ages of 8.8 and 13.1 years in La Paz, Bolivia (mean altitude of 3600m). Thirty-four of the boys were born at high altitude while the remaining 33 were born at low altitude. The boys born at high altitude were significantly fatter than the low-altitude born boys after controlling for age and had larger chest circumferences after controlling for stature. Otherwise the samples were morphologically similar. Also, the statures and weights of the boys in both groups were similar to those of normal U.S. boys, suggesting that their growth may not have been affected by hypoxia to any great extent. Although most measures of maximal work performance, including maximal aerobic power (V02max), did not differ significantly between the samples, maximal work output was significantly greater in the high- altitude born boys than in the low-altitude born boys. Length of residence at high altitude and maximal work output were positively related in the low-altitude born boys but no other relationships were found between maximal work performance and length of exposure to hypobaric hypoxia. The considerable individual variability in the responses of these boys to maximal exercise may have masked these relationships, however, and longitudinal studies may be needed to reveal developmental adaptations to hypoxia

Hemoglobin correction factors for estimating the prevalence of iron deficiency anemia in pregnant women residing at high altitudes in Bolivia

This study had two primary objectives: 1) to derive a method to determine hemoglobin cutoffs that could be used to better estimate the prevalence of iron deficiency anemia in pregnancy at high altitudes and 2) to estimate the prevalence of anemia in a sample of pregnant women residing in two cities in Bolivia, La Paz (3 600 meters) and El Alto (4 000 meters). We derived a hemoglobin-altitude curve from previously published data on the mean hemoglobin concentrations of nonanemic women of childbearing age at various altitudes. In addition, we abstracted data on hemoglobin concentration during pregnancy from medical records of women from La Paz and El Alto who had given birth at a maternity hospital in La Paz between January and June of 1996. Using our approach and two other previously published, currently used methods, we calculated and compared prevalences of iron deficiency anemia in this population using hemoglobin cutoffs determined from a hemoglobin-altitude curve corrected for pregnancy. The hemoglobin-altitude curve derived in this study provided a better fit to data for women of childbearing age than the two other models. Those models used cutoffs based on non-iron-replete populations of children or men, both of which were residing below 4 000 m, and then extrapolated to women and higher altitudes. The estimated prevalences of iron deficiency anemia in pregnancy using the hemoglobin cutoffs determined in this study were higher than those estimated by the two other approaches

Changes in family income status and the development of overweight and obesity from 2 to 15 years: a longitudinal study

BACKGROUND: An emerging body of research suggests the trajectory of a family’s income affects children’s health and development more profoundly than the often-measured income at a single time point. The purpose of this study was to examine the associations between changes in family income status, early-life risk factors, and body mass index (BMI) z-score trajectory from age 2 to 15 years. METHODS: This longitudinal study employed a birth cohort (n = 595) located in a rural region of New York State. Data were collected through an audit of medical records and mailed questionnaires. Family low-income and BMI z-score trajectories were identified using latent-class modeling techniques that group children based on similar trends across time. We examined five early-life risk factors in relation to income and BMI z-score trajectories: maternal overweight/obesity, maternal gestational weight gain, maternal smoking during pregnancy, breastfeeding duration, and early-life weight gain trajectory. We used multinomial logistic regression models to estimate the odds of being in a BMI z-score trajectory group based on income trajectory and early-life risk factors. RESULTS: Children who remain low-income throughout childhood were more likely to maintain overweight (AOR = 2.55, 95% CI = 1.03, 5.42) and children who moved into low-income during childhood were more likely to be obese (AOR = 2.36, 95% CI = 1.12, 5.93) compared to children who were never low-income. Maternal overweight/obesity was significantly associated with a child become obese (AOR = 8.31, 95% CI = 3.80, 18.20), become overweight (AOR = 2.37, 95% CI = 1.34, 4.22), and stay overweight (AOR = 1.79, 95% CI = 1.02, 3.14). Excessive gestational weight gain was associated with increased likelihood of a child becoming overweight trajectory (AOR = 2.01, 95% CI = 1.01, 4.00). CONCLUSIONS: Our findings further supports the growing evidence that there are several preventable early-life risk factors that could be targeted for intervention. This study provides new evidence that remaining in low-income and moving into low-income increases risk for adolescent overweight and obesity

The Effects of High Altitude on Body Size and Composition of the Newborn Infant in Southern Peru

Various parameters of achieved growth are analyzed for 72 Peruvian newborn infants. The effects of high altitude on fetal growth are assessed by comparing newborns at high altitude in the city of Puno (alt. 3879 m) with newborns at low altitude in the city of Tacna (alt. 568 m). Other sources of biological variation such as sex, parity, ethnic group and mother s age are also considered in the analysis. Measures of body size (weight, crown-heel length, lower limb length) body composition (triceps and subscapular skinfolds, and brachial fat cross-sectional area) and skeletal development (humerus compact bone) are all significantly reduced at high altitude. These altitude differences persist and are generally increased when other intervening variables are controlled through covariance analysis. It is suggested from these data that most of the fetal growth disruption at high altitude occurs during the last trimester of gestation when fat deposition and limb growth are most notably affected