Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.publishedVersio

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.publishedVersio

Biofortification, crop adoption and health information: Impact pathways in Mozambique and Uganda

Biofortification, breeding staple food crops to be dense sources of essential micronutrients, is fast emerging as a strategy to fight micronutrient malnutrition. Large scale biofortification investments are being made in several developing countries, but until recently little rigorous evidence about the impact of these investments has been available. In this paper, we report findings from randomized impact evaluations conducted in both Mozambique and Uganda to study the impact of large-scale pilot projects conducted between 2006 and 2009 to introduce provitamin-A-rich orange-fleshed sweet potato (OFSP) as a strategy to reduce vitamin A deficiency. In both countries, projects randomly assigned interventions of different cost and intensity to distribute OFSP vines, train households to grow OFSP, and disseminate the health benefits of vitamin A. We compare the impact of the interventions within and across the two countries on OFSP adoption, knowledge about vitamin A, and dietary intake of vitamin A by children, and use causal mediation analysis (Imai et al. 2011) to examine the impact pathways on vitamin A consumption. After two years of intervention, in both countries the project led to OFSP adoption rates of 61-68 percent among project households, improved household knowledge about vitamin A, and nearly doubled average dietary intake of vitamin A, with no difference between the more and less intense intervention models. Evidence suggests that vine access played the most important role in explaining the impact on vitamin A consumption in both countries. Consequently, future programs can be designed to have similar impacts at even lower cost

Biofortification, Crop Adoption and Health Information: Impact Pathways in Mozambique and Uganda

Biofortification, breeding staple food crops to be dense sources of essential micronutrients, is fast emerging as a strategy to fight micronutrient malnutrition. Large scale biofortification investments are being made in several developing countries, but until recently little rigorous evidence about the impact of these investments has been available. In this paper, we report findings from randomized impact evaluations conducted in both Mozambique and Uganda to study the impact of large-scale pilot projects conducted between 2006 and 2009 to introduce provitamin-A-rich orange-fleshed sweet potato (OFSP) as a strategy to reduce vitamin A deficiency. In both countries, projects randomly assigned interventions of different cost and intensity to distribute OFSP vines, train households to grow OFSP, and disseminate the health benefits of vitamin A. We compare the impact of the interventions within and across the two countries on OFSP adoption, knowledge about vitamin A, and dietary intake of vitamin A by children, and use causal mediation analysis (Imai et al. 2011) to examine the impact pathways on vitamin A consumption. After two years of intervention, in both countries the project led to OFSP adoption rates of 61-68 percent among project households, improved household knowledge about vitamin A, and nearly doubled average dietary intake of vitamin A, with no difference between the more and less intense intervention models. Evidence suggests that vine access played the most important role in explaining the impact on vitamin A consumption in both countries. Consequently, future programs can be designed to have similar impacts at even lower cost