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Khan N.C.,Vietnam Food Safety Administration | Van Huan P.,National Institute of Nutrition | Van Nhien N.,National Institute of Nutrition | Tuyen L.D.,National Institute of Nutrition | And 2 more authors.
Public Health Nutrition | Year: 2010

Objective To characterize the relationship between serum carotenoids, retinol and anaemia among pre-school children.Design A cross-sectional study was conducted in two groups: anaemic and non-anaemic. Serum levels of retinol,-carotene,-carotene,-cryptoxanthin, lycopene, lutein and zeaxanthin were measured in the study subjects.Setting Six rural communes of Dinh Hoa, a rural and mountainous district in Thai Nguyen Province, in the northern mountainous region of Vietnam.Subjects A total of 682 pre-school children, aged 12-72 months, were recruited.Results Geometric mean serum concentrations of carotenoids (mol/l) were 0056 for-carotene, 0161 for-carotene, 0145 for-cryptoxanthin, 0078 for lycopene, 0388 for lutein and 0075 for zeaxanthin. The mean levels of Hb and serum retinol were 1088 g/l and 102 mol/l, respectively. The prevalence of anaemia and vitamin A deficiency was 537 % and 78 %, respectively. After adjusting for sex and stunting, serum retinol concentrations (mol/l; OR = 206, 95 % CI 110, 386, P = 0024) and total provitamin A carotenoids (mol/l; OR = 152, 95 % CI 101, 228, P = 0046) were independently associated with anaemia, but non-provitamin A carotenoids (mol/l; OR = 093, 95 % CI 063, 137, P = 0710) were not associated with anaemia.Conclusions Among pre-school children in the northern mountainous region of Vietnam, the prevalences of vitamin A deficiency and anaemia are high, and serum retinol and provitamin A carotenoids are independently associated with anaemia. Further studies are needed to determine if increased consumption of provitamin A carotenoids will reduce anaemia among pre-school children. Copyright © 2010 The Authors. Source


Thorne-Lyman A.L.,Harvard University | Valpiani N.,Tufts University | Sun K.,Johns Hopkins University | Semba R.D.,Johns Hopkins University | And 8 more authors.
Journal of Nutrition | Year: 2010

In Bangladesh, rice prices are known to be positively associated with the prevalence of child underweight and inversely associated with household nongrain food expenditures, an indicator of dietary quality. The collection of reliable data on household expenditures is relatively time consuming and requires extensive training. Simple dietary diversity scores are increasingly used as measures of food security and as proxies for nutrient adequacy. This study examines associations between a simple dietary diversity score and commonly used indicators of socioeconomic status in Bangladesh. Data representative of rural Bangladesh was collected from 188,835 households over 18 rounds of bi-monthly data collection from 2003-2005. A simple household dietary diversity score was developed by summing the number of days each household consumed an item from each of 7 food groups over a 7-d period. The dietary diversity score was associated with per capita nongrain food expenditures (r = 0.415), total food expenditures (r = 0.327), and total household expenditures (r = 0.332) using Spearman correlations (all P<0.0001). The frequency ofmeat and egg consumption showed greater variation across quintiles of total monthly expenditure than other items contributing to the dietary diversity score. After controlling for other measures of socioeconomic status in multiple linear regression models, the dietary diversity score was significantly associated with monthly per capita food and total expenditures. Low dietary diversity during the period prior to major food price increases indicates potential risk for worsening of micronutrient deficiencies and child malnutrition in Bangladesh. © 2010 American Society for Nutrition. Source


Campbell A.A.,Johns Hopkins University | De Pee S.,Nutrition Service | Sun K.,Johns Hopkins University | Kraemer K.,In.Sight | And 6 more authors.
Journal of Nutrition | Year: 2010

In Bangladesh, poor rural families often deal with high food costs by purchasing primarily rice. Our objective was to characterize the relationship between household expenditure on rice and nonrice foods with maternal and child malnutrition. Food expenditure data and anthropometry were obtained in a population-based sample of 304,856 households in the Bangladesh Nutrition Surveillance Project, 2000-2005. Food expenditures were categorized as rice and nonrice foods and expressed as quintiles of proportional food expenditure. Of children aged 6-11, 12-23, and 24-59 mo, the prevalence of stunting was 33.5, 56.3, and 53.1%, respectively. The prevalence of maternal underweight (BMI<18.5 kg/m2) was 37.3%. Among children aged 6-11, 12-23, and 24-59 mo, rice expenditures were associated with stunting [odds ratio (OR) 1.11, 95%CI 1.02-1.20, P=0.01;OR1.09,95%CI 1.04-1.13, P<0.0001;OR1.13,95%CI 1.08-1.18, P<0.0001), respectively, among families in the highest compared with the lowest quintile, adjusting for potential confounders, and nonrice food expenditures were associated with stunting (OR 0.87, 95% CI 0.80-0.95, P = 0.002; OR 0.86, 95% CI 0.83-0.90, P < 0.0001; OR 0.89, 95% CI 0.85-0.94, P < 0.0001) among families in the highest compared with the lowest quintile, adjusting for potential confounders. In the highest compared with the lowest quintile, rice expenditures (OR 1.12, 95% CI 1.08-1.15, P < 0.0001) and nonrice food expenditures (OR 0.93, 95% CI 0.90-0.96, P < 0.0001) were associated with maternal underweight. Households that spent a greater proportion on nonrice foods and less on rice had a lower prevalence of maternal and child malnutrition. © 2010 American Society for Nutrition. Source


Rah J.H.,In.Sight | Akhter N.,Helen Keller International Asia Pacific | Semba R.D.,Johns Hopkins University | Pee S.D.,World Food Programme | And 6 more authors.
European Journal of Clinical Nutrition | Year: 2010

Background/Objectives: Dietary diversity is associated with overall quality and nutrient adequacy of the diet in low-income countries. We determined the association between dietary diversity and stunting among children aged 6-59 months in rural Bangladesh.Subjects/Methods: In total, 165 111 under-fives who participated in the National Surveillance Project in 2003-2005 were included in the analysis. Dietary diversity score (DDS) was constructed through the summation of the number of days each of the nine food groups was consumed in the previous week. The association between stunting and DDS was determined adjusting for confounders using logistic regression models. All analyses were performed separately for children aged 6-11, 12-23 and 24-59 months. Results: One-half of the children were stunted. In multivariate analyses, compared with low DDS, high dietary diversity was associated with a 15, 26 and 31% reduced odds of being stunted among children aged 6-11, 12-23 and 24-59 months, respectively, after adjusting for all potential confounders (odds ratio (OR)0.85, 95% confidence interval (CI): 0.76-0.94; OR0.74, 95% CI: 0.69-0.79; OR0.69, 95% CI: 0.66-0.73). In all groups, children who were still breastfed were more likely to have limited diversity (OR1.88, 95% CI: 1.32-2.67; OR1.71, 95% CI: 1.52-1.92; OR1.15, 95% CI: 1.11-1.19). Those having diarrhea in the past week and coming from families with low socioeconomic status were more likely to have decreased diversity (P<0.05).Conclusions:Reduced dietary diversity is a strong predictor of stunting in rural Bangladesh. The inclusion of a variety of food groups into complementary foods may be essential to improve child nutritional status. © 2010 Macmillan Publishers Limited All rights reserved. Source


Semba R.D.,Johns Hopkins University | Campbell A.A.,Johns Hopkins University | Sun K.,Johns Hopkins University | de Pee S.,Nutrition Service | And 6 more authors.
Asia Pacific Journal of Clinical Nutrition | Year: 2011

Food insecurity is common in developing countries and related to the physical well being of families. Household food insecurity is intended to reflect a household's access, availability, and utilization of food. The relationship between paternal smoking and household food insecurity has not been well characterized. The objective of this study was to examine the relationship of paternal smoking with household food insecurity among poor families in rural Indonesia. In a cross-sectional study of 26,380 rural households in the Indonesian Nutrition Surveillance System in 2003, we examined the relationship between paternal smoking and household food insecurity score, as measured using a 9-item food security questionnaire. The prevalence of paternal smoking was 72.9%. In families with and without a father who smoked, the mean (standard error) household food insecurity score was 1.83 (0.01) and 1.48 (0.02), respectively (p<0.0001). Paternal smoking was associated with greater household food insecurity score (p<0.0001) in a multivariable linear regression model, adjusting for maternal age, maternal education, weekly household expenditure per capita, and province. Among poor families in rural Indonesia, households with a father who smokes are at greater risk of household food insecurity. Source

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