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Balanced protein-energy supplementation can improve the nutritional status of pregnant women and birthweight. The cost of prenatal supplementation is often beyond the reach of mothers in low-income countries. In this study of undernourished pregnant women, the aim was to develop an affordable, locally produced, balanced protein-energy food-based supplement and test its acceptance. A small business enterprise was established. With a commitment to local-level applied research, a balanced protein-energy supplement was developed using locally available, affordable, and preferred foods. A 30-day acceptability study was conducted among 10 pregnant women between September and October 2012 in a rural district of northern Bangladesh. A questionnaire was administered at days 15 and 30 to assess women's perceptions and experience regarding compliance, organoleptic qualities, as well as personal and community attitudes toward the supplement and study. The primary outcome was compliance. All 10 women completed the 15- and 30-day questionnaires. The supplement was redeveloped at day 15 based on feedback from the follow-up survey and formal and informal feedback. By day 30, women consumed an average of 29.7 packets of the supplement of the 30 packets received. We concluded that the redeveloped locally produced food-based supplement was well accepted by pregnant women. Study findings have contributed toward the design of an efficacy trial currently underway. [ABSTRACT FROM AUTHOR]

The global burden of malnutrition remains unacceptably high. Malnutrition is a universal issue restricting development and slowing progress. Malnutrition is responsible for more illness and ill-health than any other cause worldwide. Despite underlying determinants of undernutrition being well understood for decades, millions of children worldwide face multiple malnutrition burdens, and women face a higher burden than men when it comes to malnutrition due to higher nutrient needs. Despite these alarming statistics, significant strides are being made. Globally, stunting rates among children have declined and many countries are on their way to achieving at least one nutritional status target for 2025. However, a broader range of stakeholders must be more fully engaged if malnutrition is to be reduced in a sustainable manner, including increased engagement from the private sector. To support achievement of the 2030 Sustainable Development Goal of ending all forms of malnutrition (goal 2.2), there must be urgent and decisive actions by all stakeholders to address existing data gaps, present new food systems innovations, ensure nutritious diets for all, fully finance nutrition action, and adhere to global commitments., (© 2020 S. Karger AG, Basel.)

Objective: To investigate the association of seasonality with dietary diversity, household food security and nutritional status of pregnant women in a rural district of northern Bangladesh., Design: A cross-sectional study was conducted from February 2013 to February 2015. Data were collected on demographics, household food security (using the Household Food Insecurity Access Scale), dietary diversity (using the women's dietary diversity questionnaire) and mid-upper arm circumference. Descriptive statistics were used to explore demographics, dietary diversity, household food security and nutritional status, and inferential statistics were applied to explore the role of seasonality on diversity, household food security and nutritional status., Setting: Twelve villages of Pirganj sub-district, Rangpur District, northern Bangladesh., Subjects: Pregnant women (n 288)., Results: Seasonality was found to be associated with dietary diversity (P=0·026) and household food security (P=0·039). Dietary diversity was significantly lower in summer (P=0·029) and spring (P=0·038). Food security deteriorated significantly in spring (P=0·006) and late autumn (P=0·009)., Conclusion: Seasons play a role in women's household food security status and dietary diversity, with food security deteriorating during the lean seasons and dietary diversity deteriorating during the second 'lesser' lean season and the season immediately after. Interventions that aim to improve the diet of pregnant women from low-income, subsistence-farming communities need to recognise the role of seasonality on diet and food security and to incorporate initiatives to prevent seasonal declines.