Dietary patterns by cluster analysis in pregnant women: relationship with nutrient intakes and dietary patterns in 7-year-old offspring

© 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd. Little is known about how dietary patterns of mothers and their children track over time. The objectives of this study are to obtain dietary patterns in pregnancy using cluster analysis, to examine women's mean nutrient intakes in each cluster and to compare the dietary patterns of mothers to those of their children. Pregnant women (n = 12 195) from the Avon Longitudinal Study of Parents and Children reported their frequency of consumption of 47 foods and food groups. These data were used to obtain dietary patterns during pregnancy by cluster analysis. The absolute and energy-adjusted nutrient intakes were compared between clusters. Women's dietary patterns were compared with previously derived clusters of their children at 7 years of age. Multinomial logistic regression was performed to evaluate relationships comparing maternal and offspring clusters. Three maternal clusters were identified: ‘fruit and vegetables’, ‘meat and potatoes’ and ‘white bread and coffee’. After energy adjustment women in the ‘fruit and vegetables’ cluster had the highest mean nutrient intakes. Mothers in the ‘fruit and vegetables’ cluster were more likely than mothers in ‘meat and potatoes’ (adjusted odds ratio [OR]: 2.00; 95% Confidence Interval [CI]: 1.69–2.36) or ‘white bread and coffee’ (OR: 2.18; 95% CI: 1.87–2.53) clusters to have children in a ‘plant-based’ cluster. However the majority of children were in clusters unrelated to their mother dietary pattern. Three distinct dietary patterns were obtained in pregnancy; the ‘fruit and vegetables’ pattern being the most nutrient dense. Mothers' dietary patterns were associated with but did not dominate offspring dietary patterns

Understanding the veterinary antibiotics supply chain to address antimicrobial resistance in Lao PDR: Roles and interactions of involved stakeholders

International audienceIn response to the global call to mitigate risks associated with antimicrobial resistance (AMR), new regulations on the access and use of veterinary antibiotics are currently being developed by the Lao government. This study aims to explore how the implementation of these new regulations might effectively reduce and adapt the sale, distribution and use of veterinary antibiotics in Lao PDR. To this end, we used the theory of change, framing the AMR issue within the context of the stakeholders involved in the veterinary antibiotics supply chain. Qualitative and quantitative methods were used to collect data, based on questionnaires (n=36 antibiotic suppliers, n=96 chicken farmers, n=96 pig farmers), and participatory tools such as a workshop (n=10 participants), semi-structured interviews (n=20), and focus group discussions (n=7 participants). The stakeholders' understanding of the AMR issue and potential challenges related to the implementation of new regulations regarding access and use of antibiotics, were also investigated. We mapped the veterinary antibiotic supply chain in Lao PDR, and analysed the roles and interactions of its stakeholders. Twenty-three stakeholders representing the private and the public sectors were identified. Many informal and formal links connected these stakeholder within this supply chain. The lack of veterinarian-farmer interaction and the evolving nature of the veterinary antibiotics supply chain accentuated the challenges of achieving behaviour change through regulations. Most of the antibiotics found on farms were categorized by the World Health Organisation's as critically important antibiotics used in human medicine. We argue that AMR risk mitigation strategy requires dialogue and engagement between private and public sectors stakeholders, involved in the importation, distribution, sale and use of veterinary antibiotics. This study further highlighted that AMR is a complex adaptive challenge requiring multi-sectoral approach. We believed that a sustainable approach to reduce and adapt veterinary antibiotics use should be prepared in collaboration with stakeholders from private and public sectors identified in this study, in addition to the new regulations. This collaboration should start with the co-construction of a common understanding of AMR issue and of the objectives of new regulations