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It is estimated that billions of people around the world are affected by micronutrient deficiencies. Madagascar is considered to be particularly nutritionally vulnerable, with nearly half of the population stunted, and parts of the country facing emergency, near famine-like conditions (IPC4). Although Madagascar is generally considered among the most undernourished of countries, empirical data in the form of biological samples to validate these claims are extremely limited. Our research drew data from three studies conducted between 2013-2020 and provided comprehensive biomarker profile information for 4,710 individuals from 30 communities in five different ecological regions during at least one time-point. Estimated prevalences of nutrient deficiencies and inflammation across various regions of rural Madagascar were of concern for both sexes and across all ages, with 66.5% of the population estimated to be deficient in zinc, 15.6% depleted in vitamin B12 (3.6% deficient), 11.6% deficient in retinol, and lower levels of iron deficiency (as indicated by 11.7% deficient in ferritin and 2.3% deficient assessed by soluble transferrin receptors). Beyond nutrient status biomarkers, nearly one quarter of the population (24.0%) exhibited chronic inflammation based on high values of α-1-acid glycoprotein, and 12.3% exhibited acute inflammation based on high values of C-reactive protein. There is an 8-fold difference between the lowest and highest regional observed prevalence of vitamin B12 deficiency, a 10-fold difference in vitamin A deficiency (based on retinol), and a 2-fold difference in acute inflammation (CRP) and deficiencies of zinc and iron (based on ferritin), highlighting strong geographical variations in micronutrient deficiencies across Madagascar.

A decade of research on gluten-related disorders (GRDs) is reviewed in this study, with a particular emphasis on celiac disease (CD) and non-celiac gluten sensitivity (NCGS). GRDs are triggered by the ingestion of gluten and gluten-like proteins found in wheat, barley, and rye. These proteins lead to intestinal damage in celiac disease, an autoimmune condition characterized by villous atrophy and a variety of gastrointestinal and extraintestinal symptoms. More enigmatic and less understood, NCGS involves symptoms similar to CD but without the immunological reaction or intestinal damage. Recent years have seen advances in the understanding of GRDs, particularly in connection to how intestinal microbiota influences disease progression and patient outcomes. The gluten-free diet (GFD) is still the standard therapy recommended for GRDs despite significant challenges, as discussed in this article. Precise diagnostic methods, patient education and dietary counseling are critical for improving patients' quality of life. The purpose of this review is to provide a more clear and up-to-date understanding of GRDs, and to help further research on this important topic. [ABSTRACT FROM AUTHOR]

Background/Objectives: Optimal infant and young child feeding (IYCF) practices are crucial to addressing the double burden of malnutrition (DBM), encompassing undernutrition (including micronutrient deficiencies) and overnutrition. This study examined the demographic and socioeconomic determinants of IYCF practices, and their impacts on the DBM among 2039 Vietnamese children aged 6–23 months from the General Nutrition Survey 2020. Methods: Thirteen IYCF indicators recommended by the WHO/UNICEF were evaluated. Associations between IYCF indicators and outcome variables were assessed using logistic regressions. Results: The prevalence of stunting, underweight, and overweight subjects was 10.9%, 5.6%, and 3.1%, respectively. Low serum zinc affected 56.7% of children, while 14.3% had low serum retinol, 31.2% had anemia, and 34.6% had iron deficiency (ID). Only 36.7% of children achieved minimum dietary diversity (MDD), and 29.0% achieved the minimum acceptable diet (MAD). Children from the younger age group (6–11 months), ethnic minorities, those living in rural/mountainous regions, and poorer wealth quintiles had reduced odds of meeting IYCF criteria, including MDD and MAD. Infants meeting MDD had reduced odds of stunting [adjusted odds ratio (95% confidence intervals): 0.61 (0.41, 0.92)], and ID [0.69 (0.54, 0.88)]. Children meeting MAD had reduced odds of anemia [0.72 (0.57, 0.91)], ID [0.66 (0.52, 0.84)], and low serum retinol [0.63 (0.41, 0.99)]. Continued breastfeeding (12–23 months) reduced the odds of being underweight [0.50 (0.27, 0.92)] and of having low serum zinc [0.70 (0.52, 0.96)]. Adequate minimum milk feeding frequency had increased odds of being overweight [3.33 (1.01, 11.09)]. Conclusions: Suboptimal IYCF practices were significant predictors of the DBM among Vietnamese children, with evident age-specific, geographical, and socioeconomic disparities. [ABSTRACT FROM AUTHOR]

AbstractBiofortification (increasing the micronutrient content of food before harvest) has been successfully used to nutritionally improve staple foods in low- and middle-income countries. This approach could also help address micronutrient shortfalls in at-risk populations in high-income countries (HICs), however, the potential of biofortification interventions in this context is not well understood. The aim of this scoping review is to assess the nature and extent of available research evidence on biofortified foods in relation to human consumption in HICs. Literature searches were conducted in MEDLINE, WoS, ProQuest, CINAHL, AGRIS and Epistemonikos. Forty-six peer-reviewed articles were included. Most research was conducted in the USA (n = 15) and Italy (n = 11), on cereal crops (n = 14) and vegetables (n = 11), and on selenium (n = 12) and provitamin A (n = 11). Seven research domains were identified in the literature: bioavailability (n = 17); nutrient stability (n = 11); opinions and attitudes (n = 9); functionality (n = 9); sensory properties (n = 2); safety (n = 1); and modeling (n = 1). Evidence from HICs in each domain is limited. There is a need for more research particularly in areas sensitive to the cultural and socio-economic context. [ABSTRACT FROM AUTHOR]

Introduction: Depression is considered one of the principles of debility in most of the world and the main share in general increased universal burden of diseases. The top important complication of depression from the point of the patient’s view is social and living problems, which lead to permanent disability. THE OBJECTIVE OF THE STUDY: Weight changes could occur with depression due to variability of appetite, so this study was to define the association between iron deficiency anemia (IDA) and depression disorders. PATIENTS AND METHODS: One hundred participants enrolled in the study with a mean age of 37 ± 8.2 years in this case–control study conducted in Diwanyiah Educational Hospital from February 1 to May 1, 2022, the study enrolled patients with depression features visiting the psychiatric clinic in the hospital selected as cases and matched age and sex selected from another clinic in the same hospital or attendant with patients as control. Results: The mean age for healthy control was 36.3 years and for cases, it was 38.5 years; there were 64% of patients and 16% of healthy control had anemia, whereas, for depression, patients 32% not presenting with anemia and 84% of control had no anemia. Conclusion: This study highlights the association between IDA and depression disorder.

Malnutrition, which includes macro- and micronutrient deficiencies, is common in individuals with allergic dermatitis, food allergies, rhinitis, and asthma. Prolonged deficiencies of proteins, minerals, and vitamins promote Th2 inflammation, setting the stage for allergic sensitization. Consequently, malnutrition, which includes micronutrient deficiencies, fosters the development of allergies, while an adequate supply of micronutrients promotes immune cells with regulatory and tolerogenic phenotypes. As protein and micronutrient deficiencies mimic an infection, the body's innate response limits access to these nutrients by reducing their dietary absorption. This review highlights our current understanding of the physiological functions of allergenic proteins, iron, and vitamin A, particularly regarding their reduced bioavailability under inflamed conditions, necessitating different dietary approaches to improve their absorption. Additionally, the role of most allergens as nutrient binders and their involvement in nutritional immunity will be briefly summarized. Their ability to bind nutrients and their close association with immune cells can trigger exaggerated immune responses and allergies in individuals with deficiencies. However, in nutrient-rich conditions, these allergens can also provide nutrients to immune cells and promote health. [ABSTRACT FROM AUTHOR]

Knowledge, Attitudes, and Practices (KAP) studies offer valuable insights into the socio-cultural, psychological, and behavioral determinants of nutrition. This study aims to assess nutrition KAP during pregnancy and lactation in selected areas of Adilabad and Kumaram Bheem Asifabad districts, Telangana, India. A cross-sectional KAP survey was conducted on 536 individuals from February to March 2020, employing tablet-based data collection for pregnant women, lactating mothers, young mothers, and frontline staff. Departing from the standard equal-weight approach, we assigned different weights to responses based on existing literature and stakeholder consultation, acknowledging the varying significance of each response. This novel approach aims to mitigate the risk of overestimating or underestimating factors, thereby designing more effective policy interventions tailored to societal complexities. The results reveal that regarding the three micronutrients (Iron, vitamin A, and Iodine), the knowledge levels of pregnant women, lactating mothers, and young mothers were low, that is, less than 50% when compared with the functionaries/frontline staff. Pregnant women scored low on attitudes regarding micronutrients compared to lactating mothers, young mothers, and functionaries/frontline staff. Attitudes translate into practices; however, the data revealed that pregnant women, lactating mothers, and young mothers were not adopting appropriate dietary and nutrition practices except for the micronutrient iodine. The inadequate knowledge of all categories of respondents indicates a gap in nutrition literacy and education. The results point to the urgent need for policy action for nutrition education interventions among the vulnerable population. [ABSTRACT FROM AUTHOR]

Micronutrient interventions can reduce child mortality. By applying Micronutrient Intervention Modeling methods in Senegal, Burkina Faso, and Nigeria, we estimated the impacts of bouillon fortification on apparent dietary adequacy of vitamin A and zinc among children and folate among women. We then used the Lives Saved Tool to predict the impacts of bouillon fortification with ranges of vitamin A, zinc, and folic acid concentrations on lives saved among children 6–59 months of age. Fortification at 250 µg vitamin A/g and 120 µg folic acid/g was predicted to substantially reduce vitamin A– and folate‐attributable deaths: 65% for vitamin A and 92% for folate (Senegal), 36% for vitamin A and 74% for folate (Burkina Faso), and >95% for both (Nigeria). Zinc fortification at 5 mg/g would avert 48% (Senegal), 31% (Burkina Faso), and 63% (Nigeria) of zinc‐attributable deaths. The addition of all three nutrients at 30% of Codex nutrient reference values in 2.5 g bouillon was predicted to save an annual average of 293 child lives in Senegal (3.5% of deaths from all causes among children 6–59 months of age), 933 (2.1%) in Burkina Faso, and 18,362 (3.7%) in Nigeria. These results, along with evidence on program feasibility and costs, can help inform fortification program design discussions. [ABSTRACT FROM AUTHOR]

Biofortification is a sustainable solution to the micronutrient malnutrition problem in the world through enhancing the nutritional density of staple foods using different approaches. It mainly deals with the issue of hidden hunger which affects billions of people, especially from the developing world where their diets lack micronutrients. Crops like rice, wheat, maize, beans and others fortified with iron, zinc and vitamins among others assist in increasing the bioavailability of these nutrients in economic terms. Agronomic biofortification involves the use of fertilizers with micronutrients, conventional breeding involves choosing crop varieties with high nutrient density from a pool of germplasm while genetic engineering has the added advantage of precise nutrient enhancement seen in the case of golden rice - beta-carotene. Obstacles include socioeconomic ones, culture, and regulatory factors present are the facts, but organizations such as HarvestPlus have proven the ability of biofortified crops in the fight against malnutrition. The prospects involve scaling up and shifting to multi-nutrient biofortification, as well as other types of genetic engineering in order to meet the nutritive needs. Changes in the policy and sharpening the community's perception of the importance of the cultivation of biofortified crops within agricultural systems are central to improving dietary quality and thus the well-being across the human population. [ABSTRACT FROM AUTHOR]

Abstract Background Childhood malnutrition in all forms is a major public health issue worldwide. This review systematically examined the prevalence and determinants and identify the potential interventions and current gap in addressing malnutrition including undernutrition, overnutrition and micronutrient deficiencies (MNDs) in Vietnamese children aged 0–18 years old. Methods Embase, Scopus, PubMed, and Web of Science were systematically searched through June 2022 to identify relevant articles published within the past 25 years. Study selection and data extraction were performed by one reviewer and checked for accuracy by the other two reviewers in accordance with PRISMA guideline. Risk of publication bias was assessed using American Dietetic Association Quality Criteria Checklist. Results Seventy-two studies that met the inclusion criteria were included. Undernutrition has decreased over time but still 22.4%, 5.2% and 12.2% of children under 5 were stunted, wasted and underweight, respectively. Anaemia, iron, zinc, and vitamin D deficiencies were the more common forms of MNDs, the prevalence varied by age, region, and socioeconomic group. Population-based surveys reported that 11% and 48% of children aged 0–11 years old were iron and vitamin D deficient, respectively. Zinc deficiency affected almost one-quarter of the children and adolescents. Retinol deficiency was of less concern (

The increasing prevalence of bariatric surgery among women of childbearing age raises critical questions about the correct management of pregnancy following these procedures. This literature review delves into the multifaceted considerations surrounding pregnancy after bariatric surgery, with a particular focus on the importance of preconception counselling, appropriate nutrition assessment, and the necessity of correct folic acid supplementation. Key areas of investigation include nutrient absorption challenges, weight gain during pregnancy, and potential micronutrient deficiencies. Examining the relationship between bariatric surgery and birth defects, particularly heart and musculoskeletal issues, uncovers a twofold increase in risk for women who underwent surgery before pregnancy, with the risk emphasized before folic acid fortification. In contrast, a nationwide study suggests that infants born to mothers with bariatric surgery exhibit a reduced risk of major birth defects, potentially associated with improved glucose metabolism. In addition, this review outlines strategies for managing gestational diabetes and other pregnancy-related complications in individuals with a history of bariatric surgery. By synthesizing existing literature, this paper aims to provide healthcare providers with a comprehensive framework for the correct management of pregnancy in this unique patient population, promoting the health and well-being of both mother and child. [ABSTRACT FROM AUTHOR]

Background/Objectives: Optimal infant and young child feeding (IYCF) practices are crucial to addressing the double burden of malnutrition (DBM), encompassing undernutrition (including micronutrient deficiencies) and overnutrition. This study examined the demographic and socioeconomic determinants of IYCF practices, and their impacts on the DBM among 2039 Vietnamese children aged 6–23 months from the General Nutrition Survey 2020. Methods: Thirteen IYCF indicators recommended by the WHO/UNICEF were evaluated. Associations between IYCF indicators and outcome variables were assessed using logistic regressions. Results: The prevalence of stunting, underweight, and overweight subjects was 10.9%, 5.6%, and 3.1%, respectively. Low serum zinc affected 56.7% of children, while 14.3% had low serum retinol, 31.2% had anemia, and 34.6% had iron deficiency (ID). Only 36.7% of children achieved minimum dietary diversity (MDD), and 29.0% achieved the minimum acceptable diet (MAD). Children from the younger age group (6–11 months), ethnic minorities, those living in rural/mountainous regions, and poorer wealth quintiles had reduced odds of meeting IYCF criteria, including MDD and MAD. Infants meeting MDD had reduced odds of stunting [adjusted odds ratio (95% confidence intervals): 0.61 (0.41, 0.92)], and ID [0.69 (0.54, 0.88)]. Children meeting MAD had reduced odds of anemia [0.72 (0.57, 0.91)], ID [0.66 (0.52, 0.84)], and low serum retinol [0.63 (0.41, 0.99)]. Continued breastfeeding (12–23 months) reduced the odds of being underweight [0.50 (0.27, 0.92)] and of having low serum zinc [0.70 (0.52, 0.96)]. Adequate minimum milk feeding frequency had increased odds of being overweight [3.33 (1.01, 11.09)]. Conclusions: Suboptimal IYCF practices were significant predictors of the DBM among Vietnamese children, with evident age-specific, geographical, and socioeconomic disparities.

Low vitamin A (VA) status is common among lactating women in low-income countries. Lactation has substantial effects on mother's metabolism and VA is required in multiple biological processes, including growth, vision, immunity, and reproduction. The objective of this pilot study was to use metabolomics profiling to conduct a broad, exploratory assessment of differences in plasma metabolites associated with low VA status versus VA adequacy in lactating women. Plasma samples from lactating women who participated in a survey in Samar, Philippines, were selected from a cross-sectional study based on plasma retinol concentrations indicating low (VA-; n = 5) or adequate (VA+; n = 5) VA status (plasma retinol 1.05 µmol/L). The plasma results collected from 6 metabolomics assays (oxylipins, endocannabinoids, bile acids, primary metabolomics, biogenic amines, and lipidomics) were compared by group using liquid chromatography mass spectrometry. Twenty-eight metabolites were altered in the VA- versus VA+ status groups, with 24 being lipid mediators (P < .05). These lipid mediators included lower concentrations of arachidonic acid- and eicosapentaenoic acid-derived oxylipins, as well as lysophospholipids and sphingolipids, in the VA- group (P < .05). Chemical similarity enrichment analysis identified hydroxy-eicosatetraenoic acids, hydroxy-eicosapentaenoic acids, and dihydroxy-eicosatetraenoic acids as significantly altered oxylipin clusters (P < .0001, false discovery rate [FDR] P < .0001), as well as sphingomyelins, saturated lysophosphatidylcholines, phosphatidylcholines, and phosphatidylethanolamines (P < .001, FDR P < .01). The multiassay nutritional metabolomics profiling of low VA status compared with adequacy in lactating women was characterized by reduced lipid mediator concentrations. Future studies with stronger study designs and larger sample size are needed to confirm and validate these preliminary results.

Summary: Two plant production-based strategies – biofortification and dietary diversification – have been advocated to overcome micronutrient deficiencies, which are major contributors to morbidity and mortality worldwide. The respective benefits and effectiveness of these two strategies are the subject of controversy. Expanding the scope of this debate beyond the sole nutritional outcomes, and using a food system approach, this interdisciplinary review aims to providing a novel and holistic perspective on the ongoing debate. The literature shows that biofortification can be an effective medium-term strategy to tackle nutritional risk in vulnerable populations in some contexts, but that it also may have negative environmental, economic, and social impacts. Dietary diversification, on the other hand, is known to be a sustainable way to overcome micronutrient deficiencies, bringing with it long-term benefits, including nutritional, and beyond, the provision of ecosystem services. Dietary diversification is however challenging to implement, with benefits that are not immediate. Biodiversity as a basis of human diets is critically important to improving both human and environmental health. Diet diversification through increased mobilisation of biodiversity in food systems deserves much more attention and support in policies for food and nutrition in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

To analyse the association of socio-demographic and health factors with vitamin D insufficiency and 25-hydroxyvitamin D (25(OH)D) concentration in Brazilian children aged 6–59 months. Data from 8145 children from the Brazilian National Survey on Child Nutrition (ENANI-2019) were analysed. The serum concentration of 25(OHD)D was measured using a chemiluminescent immunoassay. The prevalence of vitamin D insufficiency (25(OH)D < 50 nmol/l) and 95 % CI was calculated. Logistic and linear regression models were used to identify the variables associated with vitamin D insufficiency and serum 25(OH)D concentrations, respectively. The mean 25(OH)D concentration was 98·6 ± 36·0 nmol/l, and 4·3 % of the children presented vitamin D insufficiency. Children aged 6–23 months (OR = 2·23; 95 % CI 1·52, 3·26); belonging to Southeast (OR = 5·55; 95 % CI 2·34, 13·17) and South (OR = 4·57; 95 % CI 1·77, 11·84) regions; the second tertile of the National Wealth Score (OR = 2·14; 95 % CI 1·16, 3·91) and winter (OR = 5·82; 95 % CI 2·67, 12·71) and spring (OR = 4·84; 95 % CI 2·17, 10·80) seasons of blood collection were associated with a higher chance of vitamin D insufficiency. Female sex (β = −5·66, 95 % CI − 7·81, −3·51), urban location (β = −14·19, 95 % CI −21·0, −7·22) and no vitamin D supplement use (β = −6·01, 95 % CI −9·64, −2·39) were inversely associated with serum 25(OH)D concentration. The age of children and the Brazilian geographical region of household location were the main predictors of vitamin D insufficiency. In Brazil, vitamin D insufficiency among children aged 6–59 months is low and is not a relevant public health problem. [ABSTRACT FROM AUTHOR]

The implications of young childhood undernutrition on health, development and productivity are grave. In the last two decades, global and Indian studies on undernutrition in under five years have concluded that stunting and underweight rate increases steadily between 0-24 mo, and then stabilises. The available evidence highlights the significance of concentrating interventions to tackle child undernutrition in the first 1000 d of life, which should aim at universal coverage of essential nutrition interventions (ENIs) and maternal-child health care package comprising maternal nutrition care, adoption of appropriate infant and young child feeding practices (IYCF), iron-folic acid supplementation, immunization, deworming, appropriate management of childhood illness etc. Additionally, it is critical to address context specific nutrition sensitive measures such as socio-economic empowerment of women, preventing domestic violence, adolescent conception, appropriate water -sanitation-hygiene and family planning services etc. Mapping of the 'at risk' households having a member falling in the 1000 d window needs special attention and is central to the ongoing efforts in India through the National Nutrition Mission/ POSHAN Abhiyaan. However, for effective implementation, there is an urgent need to consider to shift the lead responsibility of ENIs in the first 1000 d of life to the health care system in India and strategize to integrate maternal nutrition care interventions and establishing of IYCF practices by ensuring optimum use of contacts with antenatal care and routine child immunization services. [ABSTRACT FROM AUTHOR]

It is estimated that billions of people around the world are affected by micronutrient deficiencies. Madagascar is considered to be particularly nutritionally vulnerable, with nearly half of the population stunted, and parts of the country facing emergency, near famine-like conditions (IPC4). Although Madagascar is generally considered among the most undernourished of countries, empirical data in the form of biological samples to validate these claims are extremely limited. Our research drew data from three studies conducted between 2013–2020 and provided comprehensive biomarker profile information for 4,710 individuals from 30 communities in five different ecological regions during at least one time-point. Estimated prevalences of nutrient deficiencies and inflammation across various regions of rural Madagascar were of concern for both sexes and across all ages, with 66.5% of the population estimated to be deficient in zinc, 15.6% depleted in vitamin B12 (3.6% deficient), 11.6% deficient in retinol, and lower levels of iron deficiency (as indicated by 11.7% deficient in ferritin and 2.3% deficient assessed by soluble transferrin receptors). Beyond nutrient status biomarkers, nearly one quarter of the population (24.0%) exhibited chronic inflammation based on high values of α-1-acid glycoprotein, and 12.3% exhibited acute inflammation based on high values of C-reactive protein. There is an 8-fold difference between the lowest and highest regional observed prevalence of vitamin B12 deficiency, a 10-fold difference in vitamin A deficiency (based on retinol), and a 2-fold difference in acute inflammation (CRP) and deficiencies of zinc and iron (based on ferritin), highlighting strong geographical variations in micronutrient deficiencies across Madagascar.

Abstract Of late, the global supply of wheat is increasingly becoming lower and lower due to the continuing Russia–Ukraine war, blockages of major seaports as a result of the war and climate change. Importing countries are hardest hit as prices skyrocket. Millions of people relying on bread as staple food are affected in multiple ways. New methods to prepare composite bread that meets sensory and nutritional needs of consumers are needed to help address the problem. This study modified the standard recipe and developed bread with 20%, 30% and 50% of the wheat flour substituted by puree from NUA 45 biofortified beans. Ascorbic acid was added to improve the functionality of the yeast and the quality of the bread. Testers rated the 20% bean puree bread as the most acceptable. The appearance, flavour and taste imparted by the bean puree and lemon juice were the major sensory attributes for acceptance, accounting for over 65.79% of the variance in the principal component analysis. Although the test bread was slightly denser than the traditional one with 100% wheat flour, the bean puree enhanced the nutritional quality with average proximate values of protein found to be 1.66 ± 0.18, fat 7.42 ± 0.36, carbohydrates 57.19 ± 0.27, iron 2.04 ± 0.03 and zinc 2.25 ± 0.02 per 100 g of sample. The study concludes that puree from beans can be used to replace 20%–30% of wheat flour in bread making. The bread can be an option for people interested in variety, heavier meals and nutrition.

Background: Indonesia ranks fifth in terms of the number of stunted children and there has been little change in the stunting prevalence in the last decade. In earlier observational studies conducted in 2014-2015, we identified several key underlying problems with the potential to impact stunting in Sumedang district, West Java, Indonesia. Deficits in intakes of growth-limiting micronutrients were observed, most notably calcium, iron, zinc, and vitamin A, emphasizing the need for a food-based intervention to overcome these micronutrient deficits in the diets of mothers and their infants. Methods: A double-blind placebo-controlled cluster randomised trial comparing the effect of daily consumption of 75 grams of locally produced micronutrient-enriched crackers (MEC) (intervention group) compared to placebo crackers (control group) by mothers at two-time intervals: (i) from the 8-14 weeks of pregnancy to delivery (i.e., 28-34 weeks of consumption of MEC) on birth length, and (ii) from the 8-14 weeks of pregnancy to 5 months post-partum on attained linear growth and linear growth velocity of breast-fed infants. A total of 324 pregnant women from 28 clusters (villages) located in 3 sub-districts in Sumedang district, West Java, Indonesia, will be randomly assigned to either intervention (n=14 villages) or control (n=14 villages). Discussi on: This will be the first study in Indonesia to use crackers based on powdered eggshells and chicken liver, in a form which is acceptable, safe, and has a long shelf life. If daily consumption of MEC for 6 months during pregnancy can enhance birth length, or their continued daily consumption for 5 months postpartum improves both attained and incremental linear growth at 5 months of age, then scaling-up in Indonesia may be considered. Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04564222 ; 25 th September 2020.

Our global food system lacks the critically needed micronutrients to meet the daily requirements of the most at-risk populations. Diets also continue to shift toward unhealthy foods, including the increased intake of salt. While most countries exceed the WHO's recommended levels, sodium does play an essential physiological role. Table salt and other salt-containing condiments, such as bouillon, also have cultural importance, as they are used to enhance the flavor of foods cooked at home. Given their universal consumption across income classes and both urban and rural populations, these condiments are an integral part of the food system and should, therefore, be part of its transformation. Fortification of salt and salt-containing condiments can play a catalytic role in the delivery of population-wide nutritional and health benefits. With relatively consistent levels of intake across the population, these condiments hold high potential for delivering micronutrients beyond iodine while also reducing concerns related to high micronutrient intake, particularly so in countries where the industries are relatively consolidated. As a flexible and complementary strategy to an evolving food system, fortification levels can also be adjusted over time to ensure micronutrient delivery targets continue to be achieved as the system improves, whether through lower intakes of sodium in line with WHO recommendations, enhanced consumption of nutrient-dense foods, and/or broader adoption of biofortified crops. Future areas of innovation are required to realize this vision, including developing affordable salt substitutes to meet cost requirements of consumers in low-and middle-income countries, improving the stability and bioavailability of the micronutrients in condiments so that delivery targets can be reached without affecting sensory attributes, and the development of efficient systems for monitoring population intake and micronutrient status to inform fortification program design and management. Rather than being considered antithetical to the transformation, multiply-fortified salt and bouillon can strengthen our ability to meet the cultural, sensory, nutritional, and health needs of an evolving food system.

Abstract Background Metabolic syndrome is on the rise in India and is primarily linked to obesogenic dietary habits. The synergy of both is a prominent risk factor for cardiovascular diseases (CVDs). Hence, the present study aims to unveil clusters at high risk of metabolic syndrome and ascertain cluster characteristics based on dietary patterns among adolescents aged 10–19 years. Data and methods The study utilizes secondary data, i.e., Comprehensive National Nutrition Survey conducted in 2016-18. The study sample includes children and adolescents aged 10–19 years. An unsupervised learning algorithm was used to ascertain possible clusters in the data based on individuals’ dietary patterns. The k-means were used to cluster the data according to their dietary patterns. To determine the number of clusters elbow method was used, and appropriate validation indices were also obtained for the final k. Further, to ascertain the distribution of the obesogenic dietary patterns and metabolic conditions in each cluster was analysed. Bivariate descriptive analysis was used to draw further inferences. Results The k-means clusters identified five optimum clusters based on 12,318 adolescents (6333 males (mean age:14.2 ± 2.8) and 5985 females (mean age:14.3 ± 2.8)) 17 dietary patterns. Clusters were named based on how prudent these were in terms of consuming a healthy diet. Cluster phenotypic characteristics were defined as follows: a cluster of obesogenic diets (24%) constituted the highest proportion of the total sample and was significantly suffering from obesity (p

Background and objective: Malnutrition and micronutrient deficiencies represent significant concerns in geriatric care, leading to adverse health outcomes in older adults. The study aimed to investigate the prevalence and determinants of micronutrient deficiencies in malnourished older hospitalized patients. Design and setting: This prospective, observational study was conducted in a geriatric acute care unit. Participants: The study included 156 malnourished older adults. Measurements: Malnutrition was identified using the Mini Nutritional Assessment-Short Form. Micronutrient status was assessed through serum analysis of vitamins (A, B1, B6, B12, C, D, E, H, K, folic acid) and minerals (iron, zinc, copper, selenium) within 24 h post-admission. Results: The average patient age was 82.3 ± 7.5 years, with 69% female. The results revealed a high prevalence of micronutrient deficiencies, with 90% of patients exhibiting deficiencies in three or more micronutrients. Notably, every patient presented at least one micronutrient deficiency. Common deficiencies were found in vitamins C (75%), D (65%), H (61%), and K (45%), as well as folic acid (37%), iron (31%), zinc (36%) and selenium (35%). In binary regression analysis, the amount of previous weight loss was significantly associated with a higher prevalence of multiple (>2) micronutrient deficiencies (P = 0.045). Other variables such age (P = 0.449), gender (P = 0.252), BMI (P = 0.265) and MNA-SF score (P = 0.200) did not show any significant association with the prevalence multiple micronutrient deficiencies. Conclusion: The high prevalence of micronutrient deficiencies in malnourished older hospitalized patients underscore the urgent need for targeted interventions to address micronutrient deficiencies in this population, promoting their health status.

Abstract Objective: To conduct a systematic review of the published peer-reviewed articles on the biochemical assessment of nutritional status of South African infants, children and adolescents in 1997–2022. Design: Online databases (Pubmed, CINAHL, EbscoHost and SAePublications) were used to identify thirty-nine papers. Setting: South Africa, 1997–2022. Participants: Infants, children and adolescents. Results: Vitamin A deficiency prevalence was 35–67 % before 2001 and mostly below 16 % after 2008. Anaemia ranged from 5·4 to 75·0 %, with 36–54 % of infants below 1 year being anaemic. Among 0- to 6-year-olds, iron deficiency (ID) was 7·2–39·4 % in rural and 16–41·9 % in urban areas. Zn deficiency remained high, especially among 0- to 6-year-olds, at 39–48 %. Iodine insufficiency (UIC < 100 µg/l) was between 0 and 28·8 %, with excessive levels in two areas. Vitamin D deficiency was 5 % for 11- to 17-year-olds in one urban study but 33–87 % in under 10-week-old infants. The 2005 national survey reported sufficient folate status among 0- to 6-year-olds, and vitamin B12 deficiency was 0–21 %. Low-grade inflammation was between 5 % and 42 % depending on the biomarker and cut-offs. Conclusions: Vitamin A status may have improved meaningfully during the last 25 years in South Africa to below 16 %, and iodine and folate deficiency appears to be low particularly among 0- to 6-year-olds. However, confirmation is needed by a national survey. Anaemia, Fe and Zn deficiencies still pose severe problems, especially among 0- to 6-year-olds. Sufficient data on vitamin D and B12 status are lacking.

One in three women of reproductive age is obese. The mainstay treatment for obesity is bariatric surgery, and the following weight reduction results in a decrease in pregnancy adverse effects, including gestational diabetes mellitus, pregnancy-induced hypertension, and macrosomia. However, nutritional and vitamin deficiencies due to changes in the gastrointestinal tract after bariatric surgery are associated with an increase in the risk of fetal growth retardation and small for gestational-age neonates. The purpose of this review was to analyze the available recent literature on the subject of the management of pregnancy after bariatric surgery. We searched for available articles from 2007 to 2023 and chose articles of the greatest scientific and clinical value. Micronutrient, vitamin, and protein supplementation is recommended in the prenatal period and throughout the pregnancy. It is advised that pregnant women with a history of bariatric surgery should be provided with regular specialist dietary care. There is still a lack of recommendations about the optimum gestational weight gain after different types of bariatric surgery and for patients of different metabolic statuses. Women of reproductive age undergoing bariatric procedures should be provided with appropriate counseling about adequate contraception, the recommended time-to-conception interval, and the positive and negative influence of bariatric surgery on perinatal outcomes. [ABSTRACT FROM AUTHOR]

Due to sustainability concerns related to current diets and environmental challenges, it is crucial to have sound policies to protect human and planetary health. It is proposed that sustainable diets will improve public health and food security and decrease the food system's effect on the environment. Micronutrient deficiencies are a well‐known major public health concern. One‐third to half of the world's population suffers from nutrient deficiencies, which have a negative impact on society in terms of unrealised potential and lost economic productivity. Large‐scale fortification with different micronutrients has been found to be a useful strategy to improve public health. As a cost‐effective strategy to improve micronutrient deficiency, this review explores the role of micronutrient fortification programmes in ensuring the nutritional quality (and affordability) of diets that are adjusted to help ensure environmental sustainability in the face of climate change, for example by replacing some animal‐sourced foods with nutrient‐dense, plant‐sourced foods fortified with the micronutrients commonly supplied by animal‐sourced foods. Additionally, micronutrient fortification considers food preferences based on the dimensions of a culturally sustainable diet. Thus, we conclude that investing in micronutrient fortification could play a significant role in preventing and controlling micronutrient deficiencies, improving diets and being environmentally, culturally and economically sustainable. [ABSTRACT FROM AUTHOR]

Background: The existence of multiple forms of malnutrition is a growing problem in developing countries. Children living in the Eastern Cape have a relatively high prevalence of cardiovascular disease (CVD) risk factors and food insecurity, suggesting the possibility of the several coexisting forms of malnutrition. Due to the negative long-term consequences of undernutrition, overnutrition and, to a greater extent, a combination of both, it is important for this issue to be identified early in children and addressed. Aim: This study was undertaken to investigate the prevalence of the different forms of malnutrition in children living in the Eastern Cape province. Methods: Secondary analysis of a cross-sectional sample of 237 school-aged children, aged 6–18 years, in the Eastern Cape province of South Africa was conducted. The variables included in the analysis were the demographic data, anthropometric data and biochemical data, specifically blood profiles related to micronutrient deficiencies and CVD risk factors. Fisher’s exact test was used to compare the prevalence rates of several coexisting forms of malnutrition in the children. All data analysis was conducted in R version 4.0.3 and statistical significance was set at 0.05. Results: In children with overweight/obesity, 13.6% had a micronutrient deficiency, while 37.71% of the children within the normal weight range had coexisting micronutrient deficiencies and CVD risk factors. The prevalence of folate deficiency was 73.0%, iron deficiency 6.3%, and hyperglycaemia was at 10.6%. Fisher’s exact test was used to compare the prevalence rates between genders and no statistically significant differences were observed. Conclusion: Further research is needed to understand the relatively high prevalence of CVD risk factors in these children within the normal weight range and to investigate how dietary intake contributes to the overall double burden of malnutrition in children.

The increasing prevalence of bariatric surgery among women of childbearing age raises critical questions about the correct management of pregnancy following these procedures. This literature review delves into the multifaceted considerations surrounding pregnancy after bariatric surgery, with a particular focus on the importance of preconception counselling, appropriate nutrition assessment, and the necessity of correct folic acid supplementation. Key areas of investigation include nutrient absorption challenges, weight gain during pregnancy, and potential micronutrient deficiencies. Examining the relationship between bariatric surgery and birth defects, particularly heart and musculoskeletal issues, uncovers a twofold increase in risk for women who underwent surgery before pregnancy, with the risk emphasized before folic acid fortification. In contrast, a nationwide study suggests that infants born to mothers with bariatric surgery exhibit a reduced risk of major birth defects, potentially associated with improved glucose metabolism. In addition, this review outlines strategies for managing gestational diabetes and other pregnancy-related complications in individuals with a history of bariatric surgery. By synthesizing existing literature, this paper aims to provide healthcare providers with a comprehensive framework for the correct management of pregnancy in this unique patient population, promoting the health and well-being of both mother and child.

Summary: Background: Nutrition inadequacy during childhood and adolescence can cause suboptimal growth, intergenerational effects on offspring and an increased risk of chronic diseases in adulthood. There is little information on the prevalence and drivers of malnutrition in children aged 5–19 years, in the South-East Asian setting, since most existing interventions have to date targeted undernutrition. We assessed the national prevalence of nutritional indicators, their trends, and associated risk factors among children aged 5–19 years from 11 countries of WHO South-East Asia Region (SEA Region) in order to provide evidence to guide future policy direction. Methods: We included 5,210,646 children for analysis from 345 studies and 25 survey datasets. A Newcastle-Ottawa Scale was used to assess the quality of the study. Bayesian regression models were used to estimate the prevalence of malnutrition between 2000 and 2030, and a series of subgroup analyses were performed to assess variation in pooled estimates by different socio-demographic and lifestyle factors. The protocol was registered with PROSPERO database (CRD42023400104). Findings: Overall, pooled analysis demonstrated that indicators of undernutrition in SEA is predicted to decrease between 2000 and 2030 including stunting (36.6%–27.2%), thinness (29.5%–6.2%), and underweight (29.2%–15.9%). However, a substantial increase in prevalence of overweight (6.0% in 2000–16.9% in 2030), and obesity (2.6%–9.5%) are predicted. The prevalence of micronutrient deficiencies between 2000 and 2030 is predicted to decrease–vitamin A by 84% and vitamin D by 53%. Parents' education levels and household wealth were inversely associated with malnutrition. Children's health-related behaviours, such as unhealthy dietary habits and spending more time watching TV, playing games, or using the computer, were associated with increased chance of overweight and obesity. There were no clear signs of publication bias in our study. Interpretation: Our analysis highlights the pattern of a double burden of malnutrition, with clear differences between different socio-demographic groups. Despite a substantial reduction in the prevalence of stunting, underweight, and anaemia since 2000, an emerging increase in overweight/obesity and micronutrient deficiencies warrants urgent attention. Funding: World Health Organization Regional Office for South-East Asia New Delhi, India.

Micronutrient deficiencies (MNDs), also known as hidden hunger, affect more than a quarter of the global population. Agronomic biofortification helps to increase the concentration of a target mineral in food crops and improve human mineral dietary intake. It is a means of providing nutrient-dense foods to a larger population, especially among rural resource-poor settings, providing that they have access to mineral fertilizers. However, the feasibility of agronomic biofortification in combating hidden hunger depends on several factors in addition to fertilizer access, including crop type, genotype, climate, soils, and soil mineral interactions. Consideration of its effectiveness in increasing human mineral intake to the daily requirements and the improvement of human health and the cost-effectiveness of the program is also important. In this paper, we review the available literature regarding the potential effectiveness and challenges of agronomic biofortification to improve crop micronutrient concentrations and reduce hidden hunger. [ABSTRACT FROM AUTHOR]

Simple Summary: Despite considerable advances in esogastric cancer surgeries, postoperative malnutrition remains a significant yet overlooked challenge. It triggers weight loss, muscle mass reduction, and essential nutrient deficiencies, detrimentally impacting patients' quality of life and prognosis. Our study reveals that micronutrient deficiencies are just as prevalent in patients post-esophagectomy as after partial or total gastrectomy. These findings underscore the need for proactive measures, including prevention, early detection, and prompt management. Primary surgical indications for the esophagus and stomach mainly involve cancer surgeries. In recent years, significant progress has been made in the field of esogastric surgery, driven by advancements in surgical techniques and improvements in perioperative care. The rate of resectability has increased, and surgical strategies have evolved to encompass a broader patient population. However, despite a reduction in postoperative mortality and morbidity, malnutrition remains a significant challenge after surgery, leading to weight loss, muscle mass reduction, and deficiencies in essential nutrients due to digestive complications. Malnutrition worsens quality of life and increases the risk of tumor recurrence, significantly affecting prognosis. Nevertheless, the nutritional consequences following surgery are frequently overlooked, mainly due to a lack of awareness regarding their long-term effects on patients who have undergone digestive surgery, extending beyond six months. Micronutrient deficiencies are frequently observed following both partial and total gastrectomy, as anticipated. Surprisingly, these deficiencies appear to be similarly prevalent in patients who have undergone esophagectomy with iron, vitamins A, B1, B12, D, and E deficiencies commonly observed in up to 78.3% of the patients. Recognizing the distinct consequences associated with each type of intervention underscores the importance of implementing preventive measures, early detection, and prompt management. [ABSTRACT FROM AUTHOR]

The existence of multiple forms of malnutrition is a growing problem in developing countries. Children living in the Eastern Cape have a relatively high prevalence of cardiovascular disease (CVD) risk factors and food insecurity, suggesting the possibility of the several coexisting forms of malnutrition. Due to the negative long-term consequences of undernutrition, overnutrition and, to a greater extent, a combination of both, it is important for this issue to be identified early in children and addressed. This study was undertaken to investigate the prevalence of the different forms of malnutrition in children living in the Eastern Cape province. Secondary analysis of a cross-sectional sample of 237 school-aged children, aged 6–18 years, in the Eastern Cape province of South Africa was conducted. The variables included in the analysis were the demographic data, anthropometric data and biochemical data, specifically blood profiles related to micronutrient deficiencies and CVD risk factors. Fisher's exact test was used to compare the prevalence rates of several coexisting forms of malnutrition in the children. All data analysis was conducted in R version 4.0.3 and statistical significance was set at 0.05. In children with overweight/obesity, 13.6% had a micronutrient deficiency, while 37.71% of the children within the normal weight range had coexisting micronutrient deficiencies and CVD risk factors. The prevalence of folate deficiency was 73.0%, iron deficiency 6.3%, and hyperglycaemia was at 10.6%. Fisher's exact test was used to compare the prevalence rates between genders and no statistically significant differences were observed. Further research is needed to understand the relatively high prevalence of CVD risk factors in these children within the normal weight range and to investigate how dietary intake contributes to the overall double burden of malnutrition in children. [ABSTRACT FROM AUTHOR]

In order to address human zinc deficiency, fortifying staple foods with zinc is a safe and cost-effective solution. To ensure the nutritional properties and quality of a final product, zinc tolerance of the microorganisms involved in the fermentation is necessary. Bread, which is widely consumed, occupies a substantial place in many people's diets, and is often based on a sourdough making process; thus, it might be an important headlining product. This study investigated the zinc tolerance of yeasts and lactic acid bacteria that are specifically suited to produce sourdough bread made with cricket powder hydrolysate and wheat flour. Amongst the yeasts, Kazachstania servazzii KAZ2 and Kazachstania unispora FM2 were only slightly affected in regard to cell growth and colony-forming ability when cultured in YPD broth spiked with 0.5 or 1 mM ZnSO4, respectively. Yarrowia lipolytica RO25 showed a higher tolerance for up to 2.5 mM zinc (ZnSO4). All the yeast strains were capable of accumulating zinc in the range between 200 and 400 fg/cell. The heterofermentative lactic acid bacterium Fructilactobacillus sanfranciscensis DG1 appeared to have a moderate zinc requirement and was homeostatically balanced, even under a high 20 mM extracellular ZnSO4 load. A better understanding of zinc homeostasis in yeast and lactic acid bacteria for food industry applications may lead to improvements in zinc fortification, which might contribute to diminishing Zn deficiencies, especially in vulnerable population groups. [ABSTRACT FROM AUTHOR]

To evaluate variations in micronutrient biomarker concentrations and deficiencies across the menstrual cycle in a cohort of healthy women. This prospective cohort study was conducted among healthy women of reproductive age living in the State College area, Pennsylvania, (n = 45). Data collection occurred at the early follicular phase, the late follicular phase, and the midluteal phase. Fasting blood samples were collected to measure micronutrient biomarkers. At the early follicular phase, the mean ± SD concentrations for zinc, copper, magnesium, and retinol were 81.8 ± 16.2 µg/dL, 80.1 ± 12.8 µg/dL, 17.9 ± 1.4 mg/L, and 39.4 ± 9.3 µg/dL, respectively. The geometric mean (95% CI) for manganese, iron and ferritin concentrations were 1.51 [1.21, 1.87] µg/L, 106.7 [90.8, 125.4] µg/dL, and 26.4 [20.5, 34.0] µg/L, respectively. Mean concentrations of zinc and magnesium declined by 6.6% (p = 0.009) and 4.6% (p < 0.001) from the early follicular phase to the midluteal phase, respectively. Other biomarkers remained relatively constant across the cycle. At the early follicular phase, the prevalence of low serum concentrations for zinc, copper, magnesium, manganese, iron, and ferritin was 22%, 7%, 29%, 13%, 14%, and 28%, respectively. Also, in early follicular phase, 36% had anemia, and 13% specifically had iron deficiency anemia. The prevalence of magnesium deficiency was significantly higher at the midluteal phase vs. the early follicular phase (p = 0.025). Our study suggests that while many micronutrient concentrations are relatively constant across the menstrual cycle in healthy women, zinc and magnesium decline, and the prevalence of magnesium deficiency increases. Supplemental data for this article is available online at [ABSTRACT FROM AUTHOR]

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The presence of obesity is associated with dysregulated innate immune responses, including macrophages. The research field of immunometabolism dictates that immune cell function is determined by metabolic status. Obesity is associated with micronutrient deficiencies, including Vitamin D and zinc, which have been attributed widespread immunomodulatory effects. Limited information is available regarding the immunometabolic effects of micronutrients, including Vitamin D and zinc, on macrophages. More studies are needed to identify the immunometabolic effects of putative micronutrient interventions that might help improve innate immune cell functions during obesity. Metabolism is a crucial determinant of innate immune cell function, including macrophages. The availability of macro- and micronutrients impacts macrophage metabolism and, thus, function. Obesity is often accompanied by innate immune cell dysfunction driving various complications. In contrast to macronutrients, micronutrient deficiencies are frequently observed during obesity. Due to their widespread immunomodulatory effects, targeting micronutrient deficiencies (e.g., vitamin D, zinc, etc.) during obesity may serve to restore innate immune function and prevent or alleviate the development of complications. Obesity is associated with the development of various complications, including diabetes, atherosclerosis, and an increased risk for infections, driven by dysfunctional innate immune responses. Recent insights have revealed that the availability of nutrients is a key determinant of innate immune cell function. Although the presence of obesity is associated with overnutrition of macronutrients, several micronutrient deficiencies, including Vitamin D and zinc, are often present. Micronutrients have been attributed important immunomodulatory roles. In this review, we summarize current knowledge of the immunomodulatory effects of Vitamin D and zinc. We also suggest future lines of research to further improve our understanding of these micronutrients; this may serve as a stepping-stone to explore micronutrient supplementation to improve innate immune cell function during obesity. [ABSTRACT FROM AUTHOR]

Micronutrient deficiencies are widespread among pregnant women in low- and middle-income countries (LMIC) and lead to potentially adverse effects for mother and baby. In Bangladesh, maternal malnutrition remains a severe problem, with high rates of anemia (49.6% of pregnant women and 47.8% of lactating women are anemic) and other nutritional deficiencies. A Knowledge, Attitudes, and Practices (KAP) study was conducted to assess Bangladeshi pregnant women's perceptions and related behaviors, as well as awareness and knowledge among pharmacists and healthcare professionals concerning prenatal multivitamin supplements. This was done in both rural and urban areas across Bangladesh. A total of 732 quantitative interviews were conducted (330 with providers and 402 with pregnant women, with an equal split between urban and rural areas for both sets of audiences; 200 women were users of prenatal multivitamin supplements, while 202 women were aware non-users). The study identified a few findings that can guide further research or market-based interventions to reduce micronutrient deficiencies. These include most pregnant women not knowing the right time to start multivitamin supplements (56.0%, [n = 225], stating that a woman should start taking supplements 'after the first trimester'), not knowing their benefits, and how they help both the mother and baby–only 29.5% [n = 59] stated that they believed the supplements helped their baby to grow well). Further, barriers to taking the supplements include women believing a nutritious diet is a substitute (88.7% [n = 293]), and a perceived lack of support from other family members (21.8%, [n = 72]). This suggests that there is a need for further awareness-raising among all pregnant women, their family members, and providers. [ABSTRACT FROM AUTHOR]

"Hidden hunger", the deficiency of important mineral micronutrients, affects more than 2 billion people globally. Adolescence is unquestionably a period of nutritional risk, given the high nutritional requirements for growth and development, erratic or capricious diets and the increased consumption of snacks. This study applied the rational food design approach to obtain micronutrient-dense biscuits by combining chickpea and rice flours to achieve an optimal nutritional profile, crunchy texture and appealing flavour. The perception of 33 adolescents regarding the suitability of such biscuits as a mid-morning snack was examined. Four biscuits were formulated, with different ratios of chickpea and rice flours (CF:RF): G100:0, G75:25, G50:50 and G25:75. Nutritional content, baking loss, acoustic-texture and sensory analyses were carried out. On average, the mineral content of biscuits with the CF:RF ratio of 100:0 doubled compared with the 25:75 formula. The dietary reference values for iron, potassium and zinc reached 100% in the biscuits with CF:RF ratios of 50:50, 75:25 and 100:0, respectively. The analysis of mechanical properties revealed that samples G100:0 and G75:25 were harder than the others. Sample G100:0 showed the highest sound pressure level (Smax). Sensory analysis showed that increasing the proportion of CF in the formulation augments the grittiness, hardness, chewiness and crunchiness. Most of the adolescents (72.7%) were habitual snack consumers; 52% awarded scores ≥ 6 (out of 9) to biscuit G50:50 for its overall quality, 24% described its flavour as "biscuit" and 12% as "nutty". However, 55% of the participants could not pinpoint any dominant flavour. In conclusion, it is possible to design nutrient-dense snacks that meet the micronutrient requirements and sensory expectations of adolescents by combining flours naturally rich in micronutrients. [ABSTRACT FROM AUTHOR]

IntroductionThis qualitative study evaluates a nutrition and hygiene education program led by trained community nutrition scholars for 5,000 mothers of small children in the Khulna and Satkhira districts in southern Bangladesh. The objectives of this study are as follows: (1) understanding the processes and reasonings behind mothers' improvement in child feeding, food preparation, hygiene, and homestead garden production, (2) understanding men's roles in facilitating women's behavioral changes, and (3) assessing the degree of changes in subjective notions of self-confidence, decision-making, and recognition among mothers and nutrition scholars.MethodsData were collected through 14 focus group discussions with 80 participants and in-depth interviews with 6 women community nutrition scholars. Data was then analysed qualitatively by drawing on direct quotes from focus group discussions and interviews with detailed interpretation and account for respondents' behaviors and perceptions.ResultsOverall findings confirm behavior changes by women, their spouses, and other family members. Many women were able to independently decide to change food allocation and child feeding practices after gaining self-confidence through the training. Men performed vital roles, such as purchasing nutritious food in local markets, providing labor for land preparation of homestead gardens, and defending the women from the resistance to change by their mothers-in-law.DiscussionWhile the study supports the literature that women's bargaining power in food/resource allocation is critical in child health and nutrition, the evaluation found that this process involves negotiations among family members. Engaging men and mothers-in-law in nutrition interventions have great potential to make nutrition interventions more effective.

BackgroundFood crop micronutrient concentrations can be enhanced through agronomic biofortification, with the potential to reduce micronutrient deficiencies among rural population if they have access to fertilizers. Here we reported the impact of agronomic biofortification on finger millet grain zinc (Zn) and iron (Fe) concentration.MethodsA field experiment was conducted in farmers’ fields in Ethiopia in two locations; over two seasons in one district (2019 and 2020), and over a single season (2019) in a second district. The experimental design had 15 treatment combinations comprising 3 finger millet varieties and 5 soil-applied fertilizer treatments: (T1) 20 kg ha−1 FeSO4 + 25 kg ha−1 ZnSO4 + NPKS; (T2) 25 kg ha−1 ZnSO4 + NPKS; (T3) NPKS; (T4) 30% NPKS; (T5) 20 kg ha−1 FeSO4 + NPKS. The treatments were studied at two slope positions (foot and hill), replicated four times in a randomized complete block design.ResultsGrain Zn concentration increased by 20% in response to Fe and Zn and by 18.9% due to Zn addition. Similarly, grain Fe concentration increased by 21.4% in T1 and 17.8% in T5 (Fe). Zinc fertilizer application (p

IntroductionCurrent research on micronutrient deficiency indicates positive outcomes associated with utilizing biofortified beans in mitigating nutrition-related iron and zinc deficiencies, primarily in Sub-Saharan Africa. The common bean is however not palatable in its raw state and requires cooking before consumption. Existing research on the cooking qualities and nutrient retention of these novel biofortified common bean varieties is nonetheless scant, notably in Burundi.Materials and methodsThis study determined water absorption capacity, cooking yield, cooking time, and iron and zinc retention of 9 biofortified common bean varieties with Kinure, a traditional non-biofortified variety, as the control. The study employed a 10 × 2 completely randomized design in a factorial arrangement. The first factor was bean varieties with ten levels, and the second was pre-treatment with two levels, soaking and not soaking. Standard methods were used to analyze cooking properties and mineral retention, and experiments replicated thrice. Data analysis was conducted at a 95% confidence level and included Analysis of Variance and t-test comparison studies. Post-hoc analysis was performed using Tukey's Honestly Significant Difference.Results and discussionCooking properties and mineral retention varied significantly between soaked and unsoaked bean varieties (P < 0.05) and in comparison, to Kinure (P < 0.05 and P < 0.001). Water absorption capacity varied from 64.51% to 116.3%. Soaked beans recorded half the total cooking time needed to cook unsoaked beans (77.62 versus 156.86 minutes), had higher cooking yields (289.77% versus 259.82%), and reduced Fe (121.58 versus 167.8%) and Zn (127.74% versus 145.15%) retention. Compared to Kinure, soaking resulted in longer cooking times, lower cooking yields in the biofortified common beans, and an insignificant effect on their zinc retention. A significant correlation between iron and zinc retention (r = 0.445), water absorption capacity and iron retention (r = −0.0425) and water absorption capacity and zinc retention (r = −0.477) were recorded. Three clusters were also observed; iron and zinc retention, cooking yields, and water absorption capacity, and cooking time. It was observed that, soaking common beans before cooking reduces cooking time and increases cooking yield in both biofortified and traditional common bean varieties. Moreover, biofortified common beans are a good source of iron and zinc and could considerably alleviate micronutrient deficiencies, particularly in developing countries.

Chronic alcohol consumption is a well-known etiological factor for both chronic pancreatitis (CP) and liver cirrhosis. However, there is discussion over how often these two entities are present together in the same patient. The main goal of our study is to establish the prevalence of CP and low fecal elastase (FE-1) in patients with decompensated liver disease (DLD). In addition, we aim to identify the demographic, epidemiological and clinical factors associated with EPI and CP in patients with decompensated liver cirrhosis. This was an observational single-center study including 119 consecutive patients hospitalized for acute decompensation of cirrhosis, mostly of alcoholic etiology. Patients underwent computed tomography (CT) or magnetic resonance imaging (MRI) to assess the radiological features of CP. We also performed two FE-1 tests and complete blood tests to assess the presence of exocrine pancreatic insufficiency (EPI) and nutritional status, including micronutrients. The results of our study show that 32 patients (26.9%) had low fecal elastase suggesting EPI and 11 (9.2%) had CP. Patients meeting radiological CP criteria had lower FE-1 than patients without CP. There were no statistically significant differences in micronutrient deficiencies according to the presence of CP or not. Likewise, we did not find any statistically significant differences in micronutrient deficiencies among patients with normal and low FE-1 indicative of EPI. FE-1 alone may not be suitable for assessing EPI in patients with acute DLD. Detecting co-existing pancreatic disease may be important in a subset of patients with DLD, when the FE-1 levels are significantly low, potentially suggestive of a pancreatic anomaly. Moreover, the clinical manifestations of EPI and CP are not useful in detecting CP in DLD patients. Likewise, CP cannot explain all causes of EPI in these patients. [ABSTRACT FROM AUTHOR]

Human micronutrient deficiencies in sub-Saharan Africa are connected through complex pathways to soils and how soils are managed. Interventions aiming directly at nutrient consumption, such as supplements and food fortification, have direct impacts but are often limited in their reach and require continuous support. In contrast, less direct changes, such as agricultural diversification and agronomic biofortification, are complicated by a wide array of factors that can limit progress toward nutritional outcomes. However, changes in agriculture and dietary patterns, if successfully linked to deficiencies, provide a more systemic transformation with the potential to achieve wide-reaching and self-perpetuating attainment of nutritional goals. The purpose of this paper is to advance theoretical frameworks and research methods for holistic analysis of agriculture-based interventions for micronutrient deficiencies. We synthesize lessons from the literature and from the Africa RISING project in Malawi and Tanzania about the connections between soil nutrients and human micronutrient deficiencies from the perspective of the five domains of sustainable intensification (productivity, economic, environmental, human condition and social). We present a menu of indicators for future research on the soil-plant-food-nutrition pathway related to micronutrient deficiency and smallholder farming that need to be considered to effectively assess how agricultural interventions may or may not result in the desired nutritional outcomes. Ultimately, addressing micronutrient deficiencies through agricultural interventions requires a holistic approach that considers all five domains. Research on soil-nutrition linkages should consider the feedback loops across the five domains of sustainable intensification. Interdisciplinary and participatory research to effectively link soils to human health supports sustainable development. [Display omitted] • Human micronutrient deficiencies in sub-Saharan Africa are connected through complex pathways to how soils are managed. • We synthesize experiences from Malawi and Tanzania with literature on crop management for human micronutrient deficiencies. • Addressing micronutrient deficiencies requires considering productivity, economic, environmental, social and human domains. • Research on soil-nutrition linkages should consider the feedback loops across the 5 domains of sustainable intensification. • Interdisciplinary and participatory research to effectively link soils to human health supports sustainable development. [ABSTRACT FROM AUTHOR]