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Start Over Author "Rai, Anjana" Topic medicine and health sciences
4 results on '"Rai, Anjana"'

1. Consumption of rice, acceptability and sensory qualities of fortified rice amongst consumers of social safety net rice in Nepal

Author

Rai, Anjana, Maharjan, Macha Raja, Harris Fry, Helen A., Chhetri, Parbati K., Wasti, Purna Chandra, and Saville, Naomi M.

Subjects
Asia, Livestock, Physiology, Science, Crops, Surveys, Research and Analysis Methods, Geographical Locations, Nepal, Plant and Algal Models, Medicine and Health Sciences, Grasses, Nutrition, Survey Research, Organisms, Food Consumption, Biology and Life Sciences, Eukaryota, food and beverages, Agriculture, Plants, Diet, Experimental Organism Systems, Research Design, Food, People and Places, Animal Studies, Medicine, Rice, Physiological Processes, Research Article, Crop Science, Cereal Crops
Abstract

INTRODUCTION: Micronutrient deficiencies are prevalent in Nepal where starchy foods constitute a large proportion of diets and consumption of micronutrient-rich foods is inadequate. We conducted a study to determine whether rice would be an appropriate vehicle for micronutrient fortification in Nepal. MATERIALS AND METHODS: In Bajura in remote rural Nepal, we conducted a household survey to characterize rice intakes in 195 households, and a double-blinded acceptability test with 177 social safety net rice consumers ≥18 years of age. Of these, 168 tasted fortified and unfortified rice to assess whether respondents could differentiate between fortified and non-fortified rice and their sensory properties. Rice was fortified by blending hot extruded kernels containing 6 micronutrients together with non-fortified rice at a 1:99 ratio. We used binomial tests to assess whether participants could correctly differentiate fortified rice, from non-fortified rice and paired t-tests to compare scores for sensory qualities of cooked fortified and non-fortified rice. We used multiple regression to test associations between per capita consumption and age, gender, wealth and food security. RESULTS: Per capita consumption of rice (median 216g/day, IQR 144.0, 288.0) did not vary by wealth but was +52.08g, (95% CI 10.43, 93.72) higher amongst moderately to severely food insecure households compared with food secure / mildly food insecure. Most respondents could not differentiate fortified rice from non-fortified rice: 37.5% identified uncooked fortified rice and 39.3% cooked rice, which was not different from the 33% expected by chance (p = 0.22 and p = 0.09 respectively). The sensory qualities of fortified rice were acceptable (scoring 3.9 out of 5) and did not differ from non-fortified rice (p>0.05). CONCLUSION: A rice fortification programme implemented through the Nepal Food Corporation's social safety nets has potential because purchase and consumption of rice is high and fortified rice is acceptable among consumers in remote food insecure areas of Nepal.

Published
2019

2. Impact on birth weight and child growth of Participatory Learning and Action women’s groups with and without transfers of food or cash during pregnancy : Findings of the low birth weight South Asia cluster-randomised controlled trial (LBWSAT) in Nepal

Author

Saville, Naomi M, Shrestha, Bhim P, Style, Sarah, Harris-Fry, Helen, Beard, B James, Sen, Aman, Jha, Sonali, Rai, Anjana, Paudel, Vikas, Sah, Raghbendra, Paudel, Puskar, Copas, Andrew, Bhandari, Bishnu, Neupane, Rishi, Morrison, Joanna, Gram, Lu, Pulkki-Brännström, Anni-Maria, Skordis-Worrall, Jolene, Basnet, Machhindra, De Pee, Saskia, Hall, Andrew, Harthan, Jayne, Thondoo, Meelan, Klingberg, Sonja, Messick, Janice, Manandhar, Dharma S, Osrin, David, Costello, Anthony, Saville, Naomi M [0000-0002-1735-3684], and Apollo - University of Cambridge Repository

Subjects
Adult, Medicin och hälsovetenskap, Adolescent, Physiology, Maternal Health, lcsh:Medicine, Medical and Health Sciences, Families, Labor and Delivery, Young Adult, Nepal, Pregnancy, Medicine and Health Sciences, Birth Weight, Humans, Learning, lcsh:Science, Child, Children, Health Education, Nutrition, Behavior, Anthropometry, Body Weight, lcsh:R, Obstetrics and Gynecology, Biology and Life Sciences, Infant, Public Health, Global Health, Social Medicine and Epidemiology, Middle Aged, Health Care, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Physiological Parameters, Age Groups, People and Places, Birth, Women's Health, Population Groupings, lcsh:Q, Female, Growth and Development, Anatomy, Health Statistics, Morbidity, Infants, Research Article
Abstract

BACKGROUND: Undernutrition during pregnancy leads to low birthweight, poor growth and inter-generational undernutrition. We did a non-blinded cluster-randomised controlled trial in the plains districts of Dhanusha and Mahottari, Nepal to assess the impact on birthweight and weight-for-age z-scores among children aged 0-16 months of community-based participatory learning and action (PLA) women's groups, with and without food or cash transfers to pregnant women. METHODS: We randomly allocated 20 clusters per arm to four arms (average population/cluster = 6150). All consenting married women aged 10-49 years, who had not had tubal ligation and whose husbands had not had vasectomy, were monitored for missed menses. Between 29 Dec 2013 and 28 Feb 2015 we recruited 25,092 pregnant women to surveillance and interventions: PLA alone (n = 5626); PLA plus food (10 kg/month of fortified wheat-soya 'Super Cereal', n = 6884); PLA plus cash (NPR750≈US$7.5/month, n = 7272); control (existing government programmes, n = 5310). 539 PLA groups discussed and implemented strategies to improve low birthweight, nutrition in pregnancy and hand washing. Primary outcomes were birthweight within 72 hours of delivery and weight-for-age z-scores at endline (age 0-16 months). Only children born to permanent residents between 4 June 2014 and 20 June 2015 were eligible for intention to treat analyses (n = 10936), while in-migrating women and children born before interventions had been running for 16 weeks were excluded. Trial status: completed. RESULTS: In PLA plus food/cash arms, 94-97% of pregnant women attended groups and received a mean of four transfers over their pregnancies. In the PLA only arm, 49% of pregnant women attended groups. Due to unrest, the response rate for birthweight was low at 22% (n = 2087), but response rate for endline nutritional and dietary measures exceeded 83% (n = 9242). Compared to the control arm (n = 464), mean birthweight was significantly higher in the PLA plus food arm by 78·0 g (95% CI 13·9, 142·0; n = 626) and not significantly higher in PLA only and PLA plus cash arms by 28·9 g (95% CI -37·7, 95·4; n = 488) and 50·5 g (95% CI -15·0, 116·1; n = 509) respectively. Mean weight-for-age z-scores of children aged 0-16 months (average age 9 months) sampled cross-sectionally at endpoint, were not significantly different from those in the control arm (n = 2091). Differences in weight for-age z-score were as follows: PLA only -0·026 (95% CI -0·117, 0·065; n = 2095); PLA plus cash -0·045 (95% CI -0·133, 0·044; n = 2545); PLA plus food -0·033 (95% CI -0·121, 0·056; n = 2507). Amongst many secondary outcomes tested, compared with control, more institutional deliveries (OR: 1.46 95% CI 1.03, 2.06; n = 2651) and less colostrum discarding (OR:0.71 95% CI 0.54, 0.93; n = 2548) were found in the PLA plus food arm but not in PLA alone or in PLA plus cash arms. INTERPRETATION: Food supplements in pregnancy with PLA women's groups increased birthweight more than PLA plus cash or PLA alone but differences were not sustained. Nutrition interventions throughout the thousand-day period are recommended. TRIAL REGISTRATION: ISRCTN75964374.

Published
2018

3. Correlates and inequality of underweight and overweight among women of reproductive age: Evidence from the 2016 Nepal Demographic Health Survey.

Author

Rai, Anjana, Gurung, Swadesh, Thapa, Subash, and Saville, Naomi M.

Subjects
*CHILDHOOD obesity, *OBESITY, *DEMOGRAPHIC surveys, *OVERWEIGHT women, *SOCIAL status, *HEALTH surveys, *EQUALITY
Abstract

Introduction: Understanding socio-economic correlates and inequality of underweight and overweight is crucial to develop interventions to prevent adverse health outcomes. Materials and methods: We analysed Nepal Demographic and Health Survey 2016 data from 6,069 women aged 15–49 years. WHO cut-offs for Body Mass Index categorised as: underweight (<18.5 kg/m2), normal weight (18.5kg/m2 to 24.9kg/m2) and overweight/ obesity (> = 25.0 kg/m2) were used. We used multinomial logistic regression to explore associations of factors with Body Mass Index and concentration indices to estimate socio-economic inequalities. Results: Higher risk of underweight was found in age group 15–19 (RRR 3.08, 95% CI: 2.29–4.15), 20–29 (RRR 1.64, 95% CI: 1.29–2.08) and in lowest (RRR 1.60, 95% CI: 1.03–2.47) and second wealth quintiles (RRR 1.77 (95% CI: 1.18–2.64). Education, occupation, urban/rural residence and food security were not associated with underweight (p>0.05). Lower risk of overweight/obesity was found in age group 15–19 (RRR 0.07, 95% CI: 0.05–0.10), 20–29 (RRR 0.40, 95% CI: 0.32–0.51), in manual occupation (RRR 0.58, 95% CI: 0.46–0.74) and in lower quintiles. Women with primary (RRR 1.91, 95% CI: 1.36–2.67), secondary education (RRR 1.42, 95% CI 1.00, 2.01) were at increased risk of overweight/obesity. Household food security and urban/rural residence were not associated with overweight/obesity (p>0.05). Socioeconomic inequalities were detected, with overweight/obesity strongly concentrated (concentration index: 0.380) amongst the higher quintiles and underweight concentrated (concentration index: -0.052) amongst the poorest. Conclusion: Nutrition programmes should target younger and poor women to address undernutrition and higher wealth group women to address overnutrition. Equity based nutrition interventions improving socio-economic status of poor households may benefit undernourished women. Interventions to encourage physical activity as women age and among wealthier women as well as healthy eating for prevention of under- and over-nutrition are needed. [ABSTRACT FROM AUTHOR]

Published
2019
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4. Impact on birth weight and child growth of Participatory Learning and Action women’s groups with and without transfers of food or cash during pregnancy: Findings of the low birth weight South Asia cluster-randomised controlled trial (LBWSAT) in Nepal

Author

Saville, Naomi M., Shrestha, Bhim P., Style, Sarah, Harris-Fry, Helen, Beard, B. James, Sen, Aman, Jha, Sonali, Rai, Anjana, Paudel, Vikas, Sah, Raghbendra, Paudel, Puskar, Copas, Andrew, Bhandari, Bishnu, Neupane, Rishi, Morrison, Joanna, Gram, Lu, Pulkki-Brännström, Anni-Maria, Skordis-Worrall, Jolene, Basnet, Machhindra, and de Pee, Saskia

Subjects
CHILD development, BIRTH weight, MALNUTRITION, PREGNANCY complications, RANDOMIZED controlled trials
Abstract

Background: Undernutrition during pregnancy leads to low birthweight, poor growth and inter-generational undernutrition. We did a non-blinded cluster-randomised controlled trial in the plains districts of Dhanusha and Mahottari, Nepal to assess the impact on birthweight and weight-for-age z-scores among children aged 0–16 months of community-based participatory learning and action (PLA) women’s groups, with and without food or cash transfers to pregnant women. Methods: We randomly allocated 20 clusters per arm to four arms (average population/cluster = 6150). All consenting married women aged 10–49 years, who had not had tubal ligation and whose husbands had not had vasectomy, were monitored for missed menses. Between 29 Dec 2013 and 28 Feb 2015 we recruited 25,092 pregnant women to surveillance and interventions: PLA alone (n = 5626); PLA plus food (10 kg/month of fortified wheat-soya ‘Super Cereal’, n = 6884); PLA plus cash (NPR750≈US$7.5/month, n = 7272); control (existing government programmes, n = 5310). 539 PLA groups discussed and implemented strategies to improve low birthweight, nutrition in pregnancy and hand washing. Primary outcomes were birthweight within 72 hours of delivery and weight-for-age z-scores at endline (age 0–16 months). Only children born to permanent residents between 4 June 2014 and 20 June 2015 were eligible for intention to treat analyses (n = 10936), while in-migrating women and children born before interventions had been running for 16 weeks were excluded. Trial status: completed. Results: In PLA plus food/cash arms, 94–97% of pregnant women attended groups and received a mean of four transfers over their pregnancies. In the PLA only arm, 49% of pregnant women attended groups. Due to unrest, the response rate for birthweight was low at 22% (n = 2087), but response rate for endline nutritional and dietary measures exceeded 83% (n = 9242). Compared to the control arm (n = 464), mean birthweight was significantly higher in the PLA plus food arm by 78·0 g (95% CI 13·9, 142·0; n = 626) and not significantly higher in PLA only and PLA plus cash arms by 28·9 g (95% CI -37·7, 95·4; n = 488) and 50·5 g (95% CI -15·0, 116·1; n = 509) respectively. Mean weight-for-age z-scores of children aged 0–16 months (average age 9 months) sampled cross-sectionally at endpoint, were not significantly different from those in the control arm (n = 2091). Differences in weight for-age z-score were as follows: PLA only -0·026 (95% CI -0·117, 0·065; n = 2095); PLA plus cash -0·045 (95% CI -0·133, 0·044; n = 2545); PLA plus food -0·033 (95% CI -0·121, 0·056; n = 2507). Amongst many secondary outcomes tested, compared with control, more institutional deliveries (OR: 1.46 95% CI 1.03, 2.06; n = 2651) and less colostrum discarding (OR:0.71 95% CI 0.54, 0.93; n = 2548) were found in the PLA plus food arm but not in PLA alone or in PLA plus cash arms. Interpretation: Food supplements in pregnancy with PLA women’s groups increased birthweight more than PLA plus cash or PLA alone but differences were not sustained. Nutrition interventions throughout the thousand-day period are recommended. Trial registration: . [ABSTRACT FROM AUTHOR]

Published
2018
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