Dietary diversity as a modifier of the effect of supplementation with multiple micronutrients during pregnancy on low birth weight in a randomized controlled trial in Bangladesh.

Background: Meta-analysis of trials of multiple micronutrient supplements (MMS) compared with iron-folic acid (IFA) suggests an overall benefit of 12% on low birth weight (LBW).

Objectives: Building on prior work showing that MMS is more effective in anemic and higher body mass index females; this paper explores whether dietary quality modifies the effect of MMS on birth weight.

Methods: A 7-day food frequency questionnaire was administered in late pregnancy to 19,160 pregnant participants in the JiVitA-3 cluster-randomized controlled trial of MMS compared with IFA supplementation in Bangladesh.

Food Substitution and Waste Reduction Can Reduce the Environmental Impacts and Food Costs of School Meal Programs in the United States: An 2011-2018 NHANES Analysis.

Background: US school meal programs serve billions of meals annually; however, little is known about their environmental impacts.

Objective: This study estimated the daily greenhouse gas emissions (GHGE), water scarcity footprint (WSF), and food cost associated with food consumed in the National School Lunch Program and School Breakfast Program, and modeled the association of food substitutions and food waste reduction.

Design: A cross-sectional analysis of Day-1 dietary intake in the National Health and Nutrition Examination Survey, 2011-2018.

Are healthier diets more sustainable? A cross-sectional assessment of 8 diet quality indexes and 7 sustainability metrics.

Background: A comparison of commonly used diet quality indexes (DQIs) and their association with multiple indicators of sustainability has not been performed, which limits policy action.

Objectives: To evaluate the associations between 8 DQIs and 7 sustainability indicators in a nationally representative sample in the United States.

Methods: In this cross-sectional analysis, dietary data from the National Health and Nutrition Examination Survey (2011-2018, n = 18,522 ≥20 y) were merged with data on greenhouse gas emissions (GHGE), cumulative energy demand (CED), water scarcity footprint (WSF), land, fertilizer nutrients, pesticides, and food prices from multiple publicly available databases.

Changes in urbanicity and household availability of and proximity to food vendors from 2004 to 2020 in a rural district of northwestern Bangladesh.

Background: The nutrition transition underway in South Asia is likely mediated by changes to the food environment. Yet, few studies have been conducted in rural areas of South Asia to describe how the food environment has changed.

Objective: This analysis assessed changes in household availability of and proximity to markets, grocery shops, and tea shops over a 16-year time period in Gaibandha, Bangladesh.

Reduced red and processed meat consumption is associated with lower diet costs in US households: a national analysis of protein substitutions.

Objective: To examine the association between red and processed meat consumption and total food expenditures in US households and explore whether households could reduce food costs by substituting these meats with other protein sources such as poultry, seafood, eggs and plant proteins.

Design: Cross-sectional study using data from the National Household Food Acquisition and Purchase Survey (FoodAPS). Using adult male equivalents (AME) for standardisation, we categorised red and processed meat purchases into quintiles.

Measuring Community Urbanicity and Its Influence on Household Food Security Across Nepal's Agroecological Zones.

Background: Urbanization influences food systems and food security, but research on these associations in low- and middle-income countries remain limited, partly because of the binary and unstandardized "urban compared with rural" classifications.

Objectives: To develop a community urbanicity scale, to assess its associations with household food security, and to explore whether agricultural occupation modifies this relationship across the 3 agroecological zones (mountain, hill, ) of Nepal.

Methods: Data came from a nationally and agroecologically representative, multistaged 2013 agri-food system survey of 4285 households with children <5 y in 63 communities (wards) in Nepal.

Targeting strategies for balanced energy and protein (BEP) supplementation in pregnancy: study protocol for the TARGET-BEP cluster-randomized controlled trial in rural Bangladesh.

Background: The World Health Organization (WHO) recommends balanced energy and protein (BEP) supplementation be provided to all pregnant women living in undernourished populations, usually defined as having a prevalence > 20% of underweight women, to reduce the risk of stillbirths and small-for-gestational-age neonates. Few geographies meet this threshold, however, and a large proportion of undernourished women and those with inadequate gestational weight gain could miss benefiting from BEP. This study compares the effectiveness of individual targeting approaches for supplementation with micronutrient-fortified BEP vs.

Acceptability of a balanced energy protein (BEP) supplement for pregnant women in Bangladesh.

Balanced energy protein (BEP) supplementation in pregnancy is recommended in the context of undernutrition for the reduction of small-for-gestational age neonates and stillbirths. To inform an effectiveness trial, we evaluated the acceptability of a packaged, ready-to-eat fortified BEP product among women of reproductive age and their health care providers (HCPs) in rural Bangladesh and explored the feasibility of adhering to daily supplementation. We implemented a formative study using focus groups discussions with women (n = 29) and HCPs (n = 17) to introduce the product and investigate components of acceptability.

Evaluating preschool linear growth velocities: an interim reference illustrated in Nepal.

Objective: An annualised linear growth velocity (LGV) reference can identify groups of children at risk of growing poorly. As a single velocity reference for all preschool ages does not exist, we present an interim tool, derived from published, normative growth studies, for detecting growth faltering, illustrating its use in Nepali preschoolers.

Design: The WHO Child Growth Velocity Standard was adapted to derive 12-month increments and conjoined to the Tanner-Whitehouse Height Velocity Reference data yielding contiguous preschool linear growth annualised velocities.

Factors associated with diet diversity among infants and young children in the Eastern and Southern Africa region.

This study explores common factors associated with not meeting minimum dietary diversity (MDD) among 27,072 children aged 6-23 months in Eastern and Southern Africa using data from nine Demographic and Health Surveys from 2013 to 2016. MDD was defined as consumption of more than or equals to five of eight food groups including breast milk in the past 24 h. Equity gaps were calculated as the difference in MDD prevalence between the top and bottom wealth quintiles.

Cognitive testing of questions about antenatal care and nutrition interventions in southern Nepal.

Large scale surveys such as the Demographic and Health Surveys (DHS) are used to measure the coverage and quality of antenatal care (ANC)-related services. Studies have increasingly validated questions from these surveys, though few have explored respondent comprehension or associated thought processes. This study aimed to use cognitive testing and validation approaches to understand how survey respondents understand questions related to ANC-related nutrition services.

Retail Purchases of Red and Processed Meat by State in the United States.

The specific aim was to characterize retail purchases of red and processed meat and other major protein-rich foods in the U.S. and by state.

Dietary Diversity and Dietary Patterns in School-Aged Children in Western Kenya: A Latent Class Analysis.

Inadequate diet among children has both immediate and long-term negative health impacts, but little is known about dietary diversity and dietary patterns of school-aged children in rural Kenya. We assessed dietary diversity and identified dietary patterns in school-aged children in Western Kenya using a latent class approach. We collected dietary intake using a 24 h dietary recall among students in elementary schools in two rural villages (hereafter village A and B) in Western Kenya in 2013.

Affordability influences nutritional quality of seafood consumption among income and race/ethnicity groups in the United States.

Background: The 2020 US Dietary Guidelines for Americans recommend that the US population consume more seafood. Most analyses of seafood consumption ignore heterogeneity in consumption patterns by species, nutritional content, production methods, and price, which have implications for applying recommendations.

Objectives: We assessed seafood intake among adults by socioeconomic and demographic groups, as well as the cost of seafood at retail to identify affordable and nutritious options.

Season of Data Collection of Child Dietary Diversity Indicators May Affect Conclusions About Longer-Term Trends in Peru, Senegal, and Nepal.

Background: The WHO-UNICEF minimum dietary diversity (MDD) indicator for children aged 6-23 mo is a global monitoring indicator used to track multi-year population-level changes in dietary quality, but the influence of seasonality on MDD estimates remains unclear.

Objectives: To examine how seasonality of data collection may influence population-level MDD estimates and inferences about MDD changes over multiple survey years.

Methods: We selected countries with 3 or more consecutive years of MDD data collection, including continuous national Demographic Health Surveys in Senegal (2012-2017;  = 12,183) and Peru (2005-2016;  = 35,272) and the Policy and Science for Health, Agriculture, and Nutrition sentinel site seasonal surveys (covering 3 seasons/y) in Nepal (2013-2016;   = 1309).

The Risk Factors for Child Anemia Are Consistent across 3 National Surveys in Nepal.

Background: Anemia is an etiologically heterogeneous condition affecting over half of preschool-aged children in South Asia. An urgent need exists to elucidate context-specific causes of anemia to effectively address this issue.

Objectives: This study investigated national trends and stability in the prevalence of child anemia and associated risk factors from 2013 to 2016 in Nepal.

Factors associated with dietary diversity among pregnant women in the western hill region of Nepal: A community based cross-sectional study.

Background: Dietary diversity can play an important role in providing essential nutrients for both mother and fetus during pregnancy. This study aimed to assess the factors associated with dietary diversity during pregnancy in the western hill region of Nepal.

Methods: A cross-sectional study of 327 pregnant women was conducted in an urban municipality of Baglung district in the western hill region of Nepal.

Characterization of pubertal development of girls in rural Bangladesh.

This study aimed to describe the timing and patterns of pubertal maturation of girls living in rural Bangladesh. Starting in September 2015, a total of 15,320 girls from a birth cohort, aged 9 to 15 years at initial encounter, were visited twice at about a one year interval, typically in their birth month. Participants were asked to self-report extent of pubertal maturation, including breast development, pubic hair growth and age at menarche, if applicable.

Sustained intake of animal-sourced foods is associated with less stunting in young children.

The value of animal-sourced foods (ASFs) in providing key nutrients, particularly for child growth and where diets are of low quality, is understood mainly from cross-sectional assessment of current consumption. Longitudinal panel data from Nepal, Bangladesh and Uganda were used here to assess associations among previous (lagged) and contemporaneous ASF intake with linear growth of children aged 6-24 months. Lagged ASF consumption was significantly correlated with a 10% decline in stunting in Nepali children who consumed any ASF in the previous year, while current intake was associated with a 9% decline in stunting in Uganda.

Nutrition and origin of US chain restaurant seafood.

Background: Seafood has a nutritional profile that can be beneficial to human health, which gives it a role to play in healthy diets. In addition, because its production and harvesting can have fewer environmental impacts than some forms of animal protein, it can contribute to sustainable diets. However, the positive health and environmental outcomes are not guaranteed-they depend on how seafood is prepared and served and whether it is sourced from sustainable fisheries and aquaculture industries.