Examining differences in postpartum depression, anxiety, and stress levels among women in the first six months after birth based on breastfeeding patterns using subjective and objective measures: A national representative sample from Jordan.

Objective: Studies have reported a lower incidence of postpartum depression, anxiety, and perceived stress among exclusive breastfeeding mothers compared to non-exclusive and formula-feeding mothers. However, the molecular mechanisms underlying the protective action of exclusive breastfeeding against these mental disorders remain unclear. This study examined the differences between exclusive and non-exclusive breastfeeding mothers in terms of postpartum depression, anxiety, and perceived stress, measured subjectively and objectively (based on cortisol, immunoglobulin A, and ghrelin saliva levels).

The Impact and Sustainability of Multisector Interventions to Improve Water Quality and Food Safety in Complex Environments: A Cluster-Randomized Controlled Trial in Northern Uganda.

In complex environments characterized as protracted humanitarian settings where public services are largely lacking, food and water contamination are significant contributors to malnutrition. Multisector, multilevel, community-driven programs may address these issues simultaneously and synergistically. A 1:1:1 cluster randomized controlled design was used to evaluate the effectiveness of two social and behavior change interventions in northern Uganda aimed at enabling participants to assess and act on key drivers of malnutrition: a core nutrition impact and positive practice (NIPP) intervention versus an NIPP+ intervention, which included additional nudges toward adopting improved technologies, compared with a control arm (NCT04209569).

Women's input and decision-making in agriculture are associated with diet quality in rural Tanzania.

Background: Women's empowerment is one critical pathway through which agriculture can impact women's nutrition; however, empirical evidence is still limited. We evaluated the associations of women's participation, input, and decision-making in key agricultural and household activities with women's diet quality.

Methods: We analyzed data from a cross-sectional study of 870 women engaged in homestead agriculture.

Deteriorating complementary feeding practices and dietary quality in Jordan: Trends and challenges.

Quality complementary feeding (CF) of infants and young children is key to their growth and development. But in Jordan, providing appropriate CF remains a challenge. This study assesses trends in infant and young child feeding (IYCF) practices, and consumption by infants and young children aged 6-23 months of breast milk substitutes (BMSs), sugar-sweetened beverages (SSBs), and micronutrient-rich foods in Jordan from 1990 to 2017.

Beyond the Food Systems Summit: Linking Recommendations to Action-The True Cost of Food.

A transformation of food systems is needed to achieve the 17 Sustainable Development Goals specified in the 2030 Agenda for Sustainable Development. Recognizing the true costs and benefits of food production and consumption can help guide public policy decisions to effectively transform food systems in support of sustainable healthy diets. A new, expanded framework is presented that allows the quantification of costs and benefits in three domains: health, environmental, and social.

Relationship between Animal Sourced Food Consumption and Early Childhood Development Outcomes.

Early-childhood development (ECD) is an important determinant of a child’s cognitive ability, learning, productivity, and lifetime earnings. Animal-sourced food (ASF), which is a rich source of high-quality protein and micronutrients, has been linked with ECD outcomes. This study investigates the relationship between the number, frequency, and cumulative consumption of ASF at 6, 9, 12, and 18 months of age and ECD outcomes at 24 months of age, controlling for physical growth.

Assessing an aflatoxin exposure biomarker: Exploring the interchangeability and correlation between venous and capillary blood samples.

Exposure to dietary aflatoxins has been recognized as a potential threat to child nutrition and growth, in addition to being a known carcinogen. The ability to accurately assess concentration of aflatoxin in the blood of at-risk individuals is therefore very important to inform public health policies and on-the-ground programs around the world. Venous blood is frequently used to quantify biomarkers of exposure such as AFB1-lysine adducts.

Child stunting starts in utero: Growth trajectories and determinants in Ugandan infants.

Childhood stunting remains a public health burden worldwide. Although many studies have examined early life and in-utero risk factors; most have been observational and have used analytic techniques that make inferences limited to population means, thereby obscuring important within-group variations. This study addressed that important gap.

Dietary determinants of aflatoxin B1-lysine adduct among infants in Nepal.

Background: Aflatoxins are mycotoxins produced by naturally occurring fungi on food, and aflatoxin B (AFB) is carcinogenic, immunotoxic and hepatotoxic. This study assesses the relationship between AFB in Nepali infants at 12 months of age and their diet at 9 and 12 months of age.

Methods: The study used data collected from 1329 infants enrolled in the AflaCohort Study.

Dietary Outcomes, Nutritional Status, and Household Water, Sanitation, and Hygiene (WASH) Practices.

Background: The Government of Ethiopia has made a major commitment toward improving food security, diet, nutrition, and health through a series of national nutrition plans. The focus of these plans is on providing both nutrition-specific as well as nutrition-sensitive approaches for achieving national priorities for health and nutrition. The present study conducted a secondary analysis of data provided through a larger birth cohort study conducted in Ethiopia between 2014 and 2016.

The Role of Household Assets in Improving Women's Dietary Diversity in Ethiopia.

Background: ENGINE (Empowering New Generations for Improved Nutrition and Economic Opportunities) was a US Agency for International Development (USAID)-funded project implemented in Ethiopia from 2011 to 2016. ENGINE used a multisectoral approach to achieve the goals articulated in the Government of Ethiopia's National Nutrition Plan, among which is improvement in the dietary intakes of women and preschool-aged children.

Objectives: The objectives of the present research are 2-fold: ) to document trends in women's dietary diversity (WDD) and ) to identify factors associated with dietary diversity for women.

The One Nutrition in Complex Environments (ONCE) study protocol: a cluster-randomized multi-level multi-sectoral intervention to improve nutrition in Uganda.

Objective: To implement and measure the effects of a multi-level multi-sectoral social behavior change (SBC) intervention in Agago District of Northern Uganda and to determine the potential for scale-up.

Intervention: Compare the Nutrition Impact and Positive Practice (NIPP) approach to a NIPP+ approach. The NIPP approach involves nutrition education and SBC, whereas the NIPP+ adds agricultural inputs, training, and tools to support improved farm and water quality practices.

Effects of Iron and Vitamin A Levels on Pregnant Women and Birth Outcomes: Complex Relationships Untangled Using a Birth Cohort Study in Uganda.

Introduction: Women and infants are among the most vulnerable groups for micronutrient deficiencies. Pregnancy micronutrient status can affect birth outcomes and subsequent infants' growth.

Methods: We determined the relationship between maternal iron and vitamin A status at delivery using several biomarkers (ferritin, soluble transferrin receptor [sTFR], body iron stores [BIS], hemoglobin and retinol binding protein [RBP]) and birth outcomes (body weight, Z-scores, head circumference, small-for-gestational-age and preterm birth) in rural Uganda.

Exposure to multiple mycotoxins, environmental enteric dysfunction and child growth: Results from the AflaCohort Study in Banke, Nepal.

Evidence of the impact of exposure to multiple mycotoxins and environment enteric dysfunction (EED) on child growth is limited. Using data from a birth cohort study, the objectives of this study were to (a) quantify exposure to multiple mycotoxins (serum aflatoxin [AFB ] and ochratoxin A [OTA], urinary fumonisin [UFB ] and deoxynivalenol [DON]), as well EED (lactulose:mannitol [L:M] ratio); (b) examine the potential combined effects of multiple mycotoxin exposure and EED on growth. Multivariate regressions were used to identify associations between growth measurements (length, weight, anthropometric z-scores, stunting and underweight) at 24-26 months of age and exposure to mycotoxins and EED at 18-22 months (n = 699).

Nutrition Capacity Building to Meet National Priorities: Lessons Learned in Developing and Implementing Malawi's First Dietetics Program.

The current nutrition situation in Malawi, characterized by high rates of malnutrition in communities and hospitals and a rapidly increasing burden of overweight/obesity and diet-related noncommunicable diseases, highlights the urgent need for registered dietitians, who have a proven track record in the prevention and management of all forms of malnutrition and improving patient outcomes. However, dietetics practice has been described as underdeveloped and fragmented in many parts of Africa, exacerbated by a severe and chronic shortage of dietetics professionals and a lack of nutrition and dietetic education programs in most African countries.We share early lessons learned in the development and implementation of the first dietetics program in Malawi.

Consumption of animal source foods, especially fish, is associated with better nutritional status among women of reproductive age in rural Bangladesh.

In rural Bangladesh, intake of nutrient-rich foods, such as animal source foods (ASFs), is generally suboptimal. Diets low in nutrients and lacking in diversity put women of reproductive age (WRA) at risk of malnutrition as well as adverse birth outcomes. The objective of this study was to assess the relationship between maternal dietary diversity, consumption of specific food groups and markers of nutritional status, including underweight [body mass index (BMI) < 18.

Changes of Plasma Amino Acid Profiles in Infants With a Nutrient-Fortified Complementary Food Supplement: Evidence From a 12-Month Single-Blind Cluster-Randomized Controlled Trial.

Stunting is reportedly associated with low circulating levels of essential amino acids (EAAs). This study examined the effect of a macronutrient- and micronutrient-fortified complementary food supplement (KOKO Plus) on specific plasma EAA levels and stunting in infants aged 6-18 months. In a single-blind cluster-randomized controlled trial conducted in Ghana, infants were enrolled at 6 months and followed until 18 months.

Effective nutrition governance is correlated with better nutrition outcomes in Nepal.

Background: The public health burden of undernutrition remains heavy and widespread, especially in low-income countries like Nepal. While predictors of undernutrition are well documented, few studies have examined the effects of political will and quality of policy or program implementation on child growth.

Methods: Data were collected from two nationwide studies in Nepal to determine the relationship between a metric of nutrition 'governance' (the Nutrition Governance Index), derived from interviews with 520 government and non-government officials responsible for policy implementation and anthropometry measured for 6815 children in 5556 households.

Food Systems as Drivers of Optimal Nutrition and Health: Complexities and Opportunities for Research and Implementation.

The Sustainable Development Goals (SDGs) are intricately linked to food systems. Addressing challenges in food systems is key to meeting the SDGs in Africa and South Asia, where undernutrition and micronutrient deficiencies persist, alongside increased nutrition transition, overweight and obesity, and related chronic diseases. Suboptimal diets are a key risk factor for mortality and 3 billion people cannot afford a healthy diet; in addition, food systems are not prioritizing environmental sustainability.

Dietary intake of sulfur amino acids and risk of kwashiorkor malnutrition in eastern Democratic Republic of the Congo.

Background: Kwashiorkor is an often-fatal type of severe acute malnutrition affecting hundreds of thousands of children annually, but whose etiology is still unknown. Evidence suggests inadequate sulfur amino acid (SAA) status may explain many signs of the condition but studies evaluating dietary protein intake in relation to the genesis of kwashiorkor have been conflicting. We know of no studies of kwashiorkor that have measured dietary SAAs.

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.

The effect of maternal depressive symptoms on infant feeding practices in rural Ethiopia: community based birth cohort study.

Background: Maternal depression and other psychosocial factors have been shown to have adverse consequences on infant feeding practices. This study explored the longitudinal relationship of maternal depressive symptoms and other selected psychosocial factors with infant feeding practices (IFPs) in rural Ethiopia using summary IFP index.

Methods: This study uses existing data from the ENGINE birth cohort study, conducted from March 2014 to March 2016 in three districts in the southwest of Ethiopia.

Aflatoxin exposure and child nutrition: measuring anthropometric and long-bone growth over time in Nepal.

Background: Naturally occurring aflatoxins may contribute to poor growth and nutritional statuses in children.

Objectives: We analyzed the relationship between contemporary and lagged aflatoxin exposure and 1) length-for-age z-score (LAZ); and 2) length, knee-heel length, stunting, weight-for-age z-score (WAZ), and weight-for-length z-score (WLZ).

Methods: We conducted a longitudinal birth cohort study involving 1675 mother-infant dyads in rural Nepal.

Biomarkers of environmental enteric dysfunction are differently associated with recovery and growth among children with moderate acute malnutrition in Sierra Leone.

Background: Environmental enteric dysfunction (EED) may influence growth during and recovery from moderate acute malnutrition (MAM), however, biomarkers to assess these relations have yet to be identified.

Objectives: The objectives of this study were to: 1) develop a score for EED based on host fecal mRNA transcripts, 2) compare biomarkers of EED with each other, and 3) examine associations between the EED biomarkers and recovery from MAM and growth outcomes.

Methods: In a cohort of 520 Sierra Leonean MAM children, biomarkers of EED included the lactulose: mannitol (L: M) test, 15 host fecal mRNA transcripts, and host fecal proteins [α-1-antitrypsin (AAT), myeloperoxidase (MPO), neopterin (NEO)].

Prenatal dietary diversity may influence underweight in infants in a Ugandan birth-cohort.

Growth faltering in early childhood is prevalent in many low resource countries. Poor maternal dietary diversity during pregnancy has been linked with increased risk of fetal growth failure and adverse birth outcomes but may also influence subsequent infant growth. Our aim is to assess the role of prenatal maternal dietary diversity in infant growth in rural Uganda.