Association between wasting and food insecurity among children under five years: findings from Nepal demographic health survey 2016

Background Wasting is a consequence of food insecurity, inappropriate dietary practices, and inadequate caring and feeding practices. The present study assessed association between wasting and household food insecurity among under 5 years old children, along with other socio-demographic characteristics. Methods This study is a secondary analysis of the Nepal Demographic and Health Survey 2016. The survey is cross-sectional in design with use of standardized tools. The sampling frame used is an updated version of the frame from the 2011 National Population and Housing Census. The participants were children under 5 years of age (n = 2414). Logistic regression was carried out to identify the odds of being wasted for children belonging to different levels of food insecure households using odds ratio and 95% confidence intervals. Results The prevalence of wasting increased with the level of food insecurity, from mild (9.4%) to moderate (10.8%) and to severe (11.3%). The highest proportions of wasted children were in Province 2 (14.3%), from rural areas (10.1%), born to mothers with no education (12.4%) and from a richer quintile (11.3%). Children belonging to severe food insecure households had 1.36 (95%CI 0.72–2.57) adjusted odds of being wasted and those belonging to mild food insecure and moderately food insecure households had 0.98 (95%CI 0.64-1.49) and 1.13 (95%CI 0.65–1.97) odds of being wasted respectively. Province 1 (AOR 2.06, 95%CI 1.01–4.19) and Province 2 (AOR 2.45, 95%CI 1.22–4.95) were significantly associated with wasting. Conclusion Considering the increment in childhood wasting as per level of food insecurity, an integrated intervention should be developed in Nepal that, 1. addresses improving knowledge and behavior of community people with respect to diet and nutrition; 2. reduce the problem of food insecurity through agricultural interventions

Micronutrient malnutrition and biofortification: recent advances and future perspectives

Micronutrients malnutrition is of great public health importance in several parts of the world, especially the developing and underdeveloped countries. It has been estimated that about 2 billion people, about one third of the world’s population, are deficient in one or more mineral elements. Although required in traces, these mineral elements are involved in many vital metabolic functions. Micronutrient deficiencies in humans can be remedied through food diversification, mineral supplementation, food fortification, and biofortification. Biofortification is the strategy of increasing the content of bioavailable nutrients in the edible parts of staple food crops for better human nutrition. Staple crops such as maize, rice, and wheat provide most of the calories for low-income families around the globe. However, staple crop-based diets fall far short in providing the required amounts of micronutrients and heavy reliance on staple food is the root cause of micronutrient malnutrition. Biofortification includes the enhanced uptake of such minerals from soils, their transport to edible plant parts, and improving the bioavailability of these minerals. International initiatives have recently released several plant cultivars with increased bioavailable micronutrient concentrations in their edible parts. The use of these biofortified cultivars is expected to mitigate micronutrient malnourishment in large populations especially in Africa. Crop breeding, genetic manipulation, and application of mineral fertilizers are the bases of biofortification strategies and have enormous potential to address micronutrient malnourishment. In this chapter, crop biofortification for zinc, iron, vitamin A, and iodine has been discussed. Biofortification is a proven strategy to combat micronutrient deficiency in large populations, particularly for those living in developing countries. However, to make it more effective, efficient, and acceptable for people, better planning, implementation, monitoring, and evaluation of biofortification programs are needed to produce cost-effective and socially acceptable biofortified food crops. Food safety, quality assurance, and legal framework also need to be considered while developing any biofortification strategy