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Women empowerment is an underlying factor of child feeding and nutrition. However, the lack of standardized measurements has made it difficult to design interventions that embed women empowerment and measure their impacts. This study aimed to assess temporal trends in women empowerment in Ethiopia and evaluate their contribution towards improving dietary diversity in infants and young children. We used women and child data from the Ethiopian Demographic and Health Survey 2005, 2011, and 2016, yielding a total sample of 6113 mother–child pairs. The survey‐based women's empowerment index (SWPER) developed and validated for use in Africa was used to assess three dimensions of women empowerment: (i) social autonomy, (ii) decision making; and (iii) attitude to violence. We used multiple‐linear and multivariable logistic regression to assess the associations between SWPER and the number of food groups consumed/and the minimum dietary diversity (MDD). To determine drivers of changes over time, a regression decomposition analysis was run. Women empowerment indices have improved over the 2005–2016 period, but a significant proportion of women had low standardized SWPER scores for autonomy/social independence (47%) and attitude to violence (49%) domains in 2016. SWPER autonomy and SWPER decision‐making scores were strongly associated with the odds of meeting MDD. Changes in women empowerment accounted for 17% of the improvements in MDD between 2005 and 2016. SWPER was a stronger predictor of the change in MDD, than known predictors like wealth, child age, and urban residence. As a critical underlying driver of child nutrition, women empowerment should be boldly addressed and integrated in nutrition interventions. [ABSTRACT FROM AUTHOR]

Ensuring diet quality in the first 2 years of life is critical to preventing malnutrition and instilling healthy food preferences. Children's diet quality has changed little over time and inequalities by socioeconomic status, rural–urban residence, but also by food group may exist. Using data from the 2011, 2016 and 2019 demographic and health surveys (DHS), we estimated the prevalence and inequalities in the minimum diet diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD). We further assessed food group‐level inequities. In 2019, only 13.5% of children 6–23 months of age met the MDD, 55% met the MMF and only 11% met the MAD indicator. Absolute and relative measures of inequality were calculated. Modest increases in MDD, MMF and MAD were observed over the past decade (2011–2019). These modest improvements were concentrated in limited geographical areas, among children in wealthier households, and urban residents. Unhealthy practices such as bottle‐feeding and zero fruit and vegetables have been increasing; whereas, inequities in the consumption of nutrient‐dense foods have widened. Nevertheless, children from the wealthiest quintile also failed to meet the MDD. Multisectoral efforts that span from diversifying the food supply, regulating the marketing of unhealthy foods, and promoting minimal processing of perishables (i.e., to extend shelf‐life) are needed. Context‐adapted behavioural change communication along with nutrition‐sensitive social protection schemes are also needed to equitably improve the diet quality of children in Ethiopia. Key messages: Improvements in child diet quality are concentrated in limited geographical areas, primarily among wealthier households, and urban residents.Unhealthy practices such as bottle‐feeding and zero fruit and vegetables have been increasing over the past decade.Inequalities in the consumption of nutrient‐dense foods have been widening in the last decade. [ABSTRACT FROM AUTHOR]

Despite sustained nutrition education, consumption of animal source foods (ASFs) has been hindered by their low availability, accessibility and affordability. Drying eggs into powder can reduce transport/storage costs, increase shelf‐life and allow easier dosage for use of smaller portions. This study aimed to evaluate the contribution of integrating egg powder to the nutrient adequacy and affordability of diets. Using the 'cost of the diet' analysis, we simulated the incorporation of egg powder into households' and children's diet and evaluated its contribution to the nutrient adequacy and affordability of diets. Analysis of the household consumption and expenditure survey (HCES 2016) revealed that only 0.2% of the total consumption expenditure was allocated for eggs, far below the 2.2% and 4.3% required to allow the consumption of one egg a day by the average and the poorest households, respectively. However, the minimum‐cost nutritious diet required only 2.5 g of egg powder/person/day to reduce the cost of the optimized diet by 14% (0–24%), allowing an additional 1.2 million households (~4–6 million individuals) afford the optimized diet. The optimized diet for a child 6–23 months of age could be afforded by all households, except by those in the poorest wealth quintile. But, free distribution of egg powder to households in the poorest wealth quintile, if supplemented by effective nutrition education, can allow them to afford the minimum‐cost nutritious diet for their 6‐ to 23‐month child. The simple dehydration of egg into egg powder can have a substantial contribution towards increased egg consumption by increasing the affordability of the minimum‐cost nutritious diet. [ABSTRACT FROM AUTHOR]

To address high rates of malnutrition among children from vulnerable households in Rwanda, the government initiated a national food supplementation programme. A before and after evaluation, using repeat cross‐sectional surveys in randomly selected villages was conducted; aimed at assessing the effectiveness of providing fortified blended food (FBF) to children 18–23 months of age, pregnant and lactating women in the lowest tier of Rwanda's social support system. Data were collected in 2017, 2018 and 2021 through interviews with caregivers; anthropometric measurements and a capillary blood sample were obtained from children. The primary statistical analysis compared the nutritional status of children before and after the introduction of FBF. We enroled 724 children during each survey. The prevalence of stunting declined from 47% to 35% between 2017 and 2021; in 2018, the prevalence of stunting was 43%. Children had a 42% reduction in the odds of being stunted (adjusted odds ratio [AOR]: 0.58, 95% confidence interval [CI]: 0.47–0.74, p < 0.001) from 2017 to 2021 even after adjusting for inherent, distal, proximal, and intermediate covariates. The reduction in stunting observed within the first year of the programme was not statistically significant (AOR: 0.83, 95% CI: 0.67–1.03, p < 0.091). We observed meaningful reductions in the prevalence of stunting among children which coincided with the introduction of Government‐led initiative to reduce malnutrition. The Rwandan Government has committed to improving the living conditions of vulnerable households and has made strong investments in reducing malnutrition. The impact of these investments can be seen in the overall trend towards improved nutritional status highlighted in this evaluation. Key messages: The national distribution of fortified blended food (FBF) to pregnant and lactating women and 6‐ to 23‐month‐old children living in the most vulnerable households was associated with a meaningful reduction in stunted linear growth, iron deficiency and anaemia among young children after 5 years.This study indicates that stunted linear growth, in early childhood, can be reduced over 5 years when the government is committed to and invests in improving the living conditions of vulnerable households, including the national food supplementation programme.It was attainable to distribute FBF to vulnerable pregnant and lactating women and 6‐ to 23‐month‐old children, in a national programme, over the 5‐year evaluation period, including during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Animal flesh foods are rich in bioavailable iron but infrequently consumed by young children. We aimed to determine whether flesh food intake was associated with iron and anaemia status among 585 Malawian infants enroled in a 6‐month egg‐feeding trial. The percentage of days of small fish, large fish and meat consumption were assessed through weekly 7‐day animal‐source food screeners. Grams of intake were assessed through 24‐h recalls conducted at 6–9, 9–12 and 12–15 months of age. Plasma ferritin, soluble transferrin receptor (sTfR) and haemoglobin concentrations were measured at 6–9 and 12–15 months of age. Iron biomarkers were adjusted for inflammation during analysis. At enrolment, each flesh food category was consumed by <5% of children in the past 24 h. Over the next 6 months, small fish, large fish and meat were consumed on 25%, 8% and 6% of days, respectively, with mean usual intakes of <5 g/day. More frequent small fish consumption was associated with lower sTfR (geometric mean ratio [95% CI]: 0.98 mg/L [0.96, 1.00] per 10 percentage point difference) but not ferritin (1.03 µg/L [0.98, 1.07]) or haemoglobin (1.01 g/dL [1.00, 1.01]). Large fish consumption was associated with higher anaemia (prevalence ratio [95% CI]: 1.09 [1.01, 1.19]) and lower iron deficiency (0.96 [0.93, 1.00]) prevalence. Gram intakes of flesh food categories were not associated with any iron or anaemia indicators. Small fish were a primary contributor to flesh food intake in this cohort of Malawian children, although usual portions were small. Fish was associated with modest improvements to iron status, but meat was too infrequent to be associated with anaemia and iron deficiency. Key messages: Small fish was the most frequently consumed flesh food among young children: 4% at enrolment and 40% at the 6‐month follow‐up. On average, children consumed small fish once every 4 days.Despite small usual portions of about 5 g/day, frequent consumption of small fish was associated with moderate improvements in iron status.Large fish consumption was associated with lower iron deficiency but not with mean plasma ferritin or sTfR. Meat was infrequently consumed and not associated with any iron or anaemia measures.Reducing the burden of iron deficiency among young Malawian children may require provision of supplemental dietary iron, improved complementary feeding practices, addressing underlying barriers to flesh food consumption and controlling inflammation and infectious diseases. [ABSTRACT FROM AUTHOR]

This research describes the proportion of children in four low‐ and middle‐income countries with adequate dietary practices at 6, 12, 18 and 24 months of age and how these practices changed over time using the World Health Organisation and UNICEF's infant young child feeding (IYCF) indicators. The associations between the IYCF indicators and anthropometric z‐scores from 6 to 24 months, and between the IYCF indicators and the family care indicators (FCIs) at 24 months are described. This was a longitudinal study of offspring from participants in the Women First Preconception Maternal Nutrition Trial conducted in Sud‐Ubangi, Democratic Republic of Congo; Chimaltenango, Guatemala; Belagavi, North Karnataka, India; and Thatta, Sindh Province, Pakistan. The frequency of the minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum adequate diet (MAD) increased between 6 and 24 months, but even at 24 months MAD remained below 50% at all sites. MDD (β = 0.12; 95% CI = 0.04−0.22) and MMF (β = 0.10; 95% CI = 0.03−0.17) were positively associated with length‐for‐age z‐score at 24 months. All IYCF indicators were positively associated with mean total FCI score: MDD (proportion ratio [PR] = 1.04; 95% CI = 1.02−1.07), MMF (PR = 1.02; 95% CI = 1.01−1.04), MAD (PR = 1.05; 95% CI = 1.02−1.08). Although there are multiple barriers to young children having an adequate diet, our results support a positive association between familial interactions and improved IYCF feeding practices. Key messages: Minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum adequate diet (MAD) increased from 6 to 24 months of age, but MAD remained below 50% frequency at all sites at 24 months.MDD and MMF were positively associated with length‐for‐age z‐scores at 24 months.The total family care indicator score was positively associated with all three infant young child feeding indicators at 24 months. [ABSTRACT FROM AUTHOR]

To promote maternal and infant health, there is a need to optimise the dietary pattern of pregnant women to reduce perinatal depression. This prospective cohort study was conducted from June 2020 to February 2022, 300 women from a medical center were interviewed during late pregnancy and at 4–6 weeks postpartum. Dietary patterns were derived by factor analysis using a semiquantitative food frequency questionnaire. Symptomatic depression was defined using the Edinburgh Postpartum Depression Scale (EPDS, ranged 0–30). Their dairy, vegetable and fruit intakes were below the Taiwanese recommendations for pregnant women. Symptomatic depression (EPDS ≥10) affected 31.3% in the third trimester and 35.7% postpartum. Pre‐ and post‐EPDS scores were positively correlated (r = 0.386, p < 0.001). Approximately 55% of those depressed before delivery were also depressed postpartum. For late pregnancy, four dietary patterns were identified ('Good oil', 'Vegetables and fruits', 'Omnivorous' and 'Refined‐grain and organ meats'). Dietary patterns were classified according to quartiles (Q). Higher omnivorous pattern scores reduced the risk of depression. For prenatal depression, with Q1 as a reference, the risk was reduced by 38% for Q2, 43% for Q3 and 59% for Q4 (p for trend = 0.068). These findings became evident postpartum (reduced risk by 68% for Q2, 69% for Q3 and 70% for Q4 (p = 0.031; p for trend = 0.0032). The association between dietary patterns and depression encourages the routine nutritional management of pregnant women. Key messages: Perinatal women have a higher prevalence of symptomatic depression, and more than half of women with antenatal depression also have postpartum depression.Pregnant women often face challenges in trying to achieve a healthy diet, as reflected in our findings on low vegetable and fruit intake.An omnivorous pattern was found to protect against symptomatic depression in late pregnancy, which persisted into the early postpartum period.Through effective nutritional counselling, paying attention to the risk of depression in perinatal women is expected to reduce women's pregnancy anxiety. [ABSTRACT FROM AUTHOR]