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Lipid‐based nutritional supplements (LNS) and fortified blended flours (FBF) are widely used to increase the nutrient density of children's diets and improve their health, but their effectiveness could be modified by displacement of other foods. We reanalysed data from a cost‐effectiveness trial comparing impacts on anthropometry of three FBFs (Corn Soy Blend Plus [CSB+], Corn Soy Whey Blend [CSWB], SuperCereal Plus [SC+]) and one LNS (Ready‐to‐use Supplementary Food [RUSF]) among infants aged 7–23 months in Burkina Faso. Using dietary diversity data from a single 24‐h recall period (n = 1,591 children, observed once over 18‐month study period), we fit logistic regression models to estimate differences in intake of each food group making up the infant and young child minimum dietary diversity score and linear models to test for differences in dietary diversity score among children in each supplement arm. We tested for differences in breastfeeding time using the subsample for which breastfeeding was observed (n = 176). Children who consumed one of the three FBFs had lower odds of consuming household grains, roots and tubers compared with the LNS consumers (odds ratios [ORs] = 0.35–0.47; 95% confidence intervals [CIs]: 0.20–1.05). Consumption of other foods, dietary diversity and breastfeeding did not differ significantly at the 5% significance level. FBFs displaced the household's own cereals more than LNS, with no difference in the child's consumption of other more nutrient‐rich family foods. Given limited stomach capacity and feeding time, providing fortified cereals may help improve children's overall diet quality in settings where children would otherwise be fed nutrient‐poor root crops or cereal grains. [ABSTRACT FROM AUTHOR]

Corn Soy Blend (CSB) porridge is commonly prepared with oil for treatment of moderate acute malnutrition (MAM). A recent review recommended that 30 g of oil be used with 100 g of CSB to increase energy density and micronutrient absorption. This study assessed the effectiveness and cost-effectiveness of program changes aimed at achieving that target oil:CSB ratio in prepared porridge. Caregivers of children in MAM supplementary feeding programs were assigned to three groups: a control group received monthly rations of 1 L oil, 8 kg CSB in bulk, and social and behavior change communication (SBCC); intervention groups received 2.6 L oil, 8 kg CSB provided either in bulk (Group 1) or four 2-kg packages with printed messages (Group 2), and enhanced SBCC emphasizing the target oil:CSB ratio. Compared to the control, both intervention groups had higher mean added oil per 100 g CSB (18 g, p < 0.01, and 13 g, p= 0.04, higher in groups 1 and 2, respectively), and greater odds of meeting or exceeding the target ratio (28.4, p< 0.01, and 12.7, p= 0.02, in groups 1 and 2, respectively). Cost per caregiver reaching the target ratio was most favorable in Group 1 ($391 in Group 1, $527 in Group 2, and $1,666 in the control). Enhanced SBCC combined with increased oil ration resulted in increased use of oil in CSB porridge in a supplementary feeding program. Modified packaging did not improve effectiveness. However, both interventions were more cost-effective than standard programming. [ABSTRACT FROM AUTHOR]

An official goal of the Food Stamp Program (FSP) is to reduce household food insecurity, which the federal government measures using an 18-item survey module. This study combines features of "dose-response" and "participant/non-participant comparison" research designs to examine the impact of total income on individual food security items among 10,175 FSP participants and 144,372 non-participants using data from the 2001-2004 Current Population Surveys (CPS). We calculated the log odds of affirming 8 adult-specific items: worried food would run out, food bought didn't last, couldn't afford balanced meals, an adult cut or skipped meals, ate less, went hungry, lost weight, or did not eat for a whole day. FSP participants had higher odds of affirming each of the 8 items. As total income increased, the odds of affirming each of the 8 food security items decreased for FSP participants and non-participants. In addition, we measured "participant/non-participant difference" for a particular item as the log odds of affirmative response for participants at a particular total income level minus the log odds of affirmative response for non-participants at the same total income level. Across all income levels, the participant/non-participant difference was greatest for the least severe food security items, "worried food would run out" and "food bought didn't last" and smallest for the most severe, "did not eat for a whole day". [ABSTRACT FROM AUTHOR]

Introduction: While fruit and vegetables consumption has been linked to lower risk of chronic disease and obesity, there has not been any large-scale household study to demonstrate an association between fruit and vegetable consumption and healthy weight. Objective: This study analyzes the association between fruit and vegetable consumption and healthy family weight in Mexican families. Methods: The study estimated grams of fruit and vegetable consumption as a proportion of the total household food expenditure from 4,128 households in the Mexican Family Life Survey 2002. Households with pregnant women, underweight members or missing anthropometry measures were excluded from analysis. Remaining households were classified as either "healthy" or "not healthy" based on the presence or absence of an overweight/obese member. Result: Only 8.2% of the households were classified as having a "healthy weight", more so in the rural areas (9.2%) than the urban areas (7.0%) (p<0.05). The mean dietary intake from fruit and vegetable was 25.2±14.4%, and varied by region, p<.001. The conditional logistic regression odds ratio predicting household "healthy" weight status from intake from fruits and vegetables was 2.29, adjusted for socio-economic level, urban/rural area and adult equivalent (p<0.05). Conclusion: Fruit and vegetable consumption significantly predicts healthy family weight. [ABSTRACT FROM AUTHOR]

Aim: To investigate the impact of prime age adult mortality (PAM) on child mortality and change annualized height-for-age Z-score (HAZ score) of children below eight years of age. The term "prime age" refers to adults between 15 to 54 years of age. Data: Four rounds of Ethiopia Rural Household Survey (ERHS) panel data set (1994-1997). Methods: This paper employed propensity score matching (PSM) with a difference in difference (DID) estimator to control for endogeneity of PAM to child survival and growth. Results: Bereavement (child living in a household with PAM) increased the probability of child mortality but did not significantly affect linear growth, conditional on survival. Bereavement increased the probability of death (but not growth) for both boys and girls, but girls fared worse than boys. Impact of bereavement on child survival but not linear growth was mediated through the relationship of the child to the household head. Becoming bereaved had a significant impact on the mortality probabilities of children only in the poorest tertile. Poorest surviving bereaved children grew half a standard deviation slower than their matched non-bereaved counterparts in the same economic group. The gender and position of the deceased did not affect the mortality and growth of bereaved children. Conclusion: Preventing PAM itself is an important policy strategy to improve children's health and longevity. [ABSTRACT FROM AUTHOR]