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Robinson N.R.,Mondelez International | Gin J.,Mondelez International | Kamath-Jha S.,Mondelez International | Infantes M.,Mondelez International | And 3 more authors.
Food and Nutrition Bulletin | Year: 2014

Background: Partnerships between corporate entities and non-governmental organizations (NGOs) involved in delivering community focused health and well-being programs are becoming increasingly valuable especially in the context of promoting healthy lifestyles around the globe. The Mondelēz International Foundation (MIF) has funded healthy lifestyles community based programs targeting children and youth through partnership with seven global NGOs. To assess collective impact of these programs, it is crucial to identify best practices and common impact indicators that can be measured across programs. MIF therefore organized the Healthy Lifestyles Evaluation Workshop to explore these pertinent questions. Objective: Share best practices and identify common impact indicators to measure the success of current and future MIF funded healthy lifestyles programs. Methods: Analysis of the Program Impact Pathways (PIPs) and measured output of each of the seven programs. Results: Individual and combined analysis of PIPs of the seven NGO programs led to identification of three critical impact indicators: nutrition knowledge, physical activity, and healthier eating, and also enabled NGOs to identify pathways to improve program delivery among the target population. Conclusions: This workshop enabled MIF and partner NGOs to came together to align on metrics and future engagement approaches for promoting and evaluating community based healthy lifestyles programs. © 2014 (supplement), The Nevin Scrimshaw International Nutrition Foundation.


Ghosh S.,Tufts University | Ghosh S.,Nevin Scrimshaw International Nutrition Foundation | Kurpad A.,St Johns Medical College | Tano-Debrah K.,University of Ghana | And 4 more authors.
Journal of Nutritional Science and Vitaminology | Year: 2015

Prevention of malnutrition in infants and children is multifaceted and requires the following: access to and intake of nutritious food starting at birth with exclusive breastfeeding for the first 6 mo of life, continued breastfeeding in combination with complementary foods from 6-24 mo of age, access to clean drinking water and sanitation, and access to preventive and curative health care (including prenatal). Nutrient-dense complementary foods can improve nutritional status and have long-term benefits; however, in a review of plant-based complementary foods in developing countries, most of them failed to meet many micronutrient requirements. There is need to provide other cost-effective alternatives to increase the quality of the diet during the complementary feeding stage of the lifecycle. This paper provides an overview of the development, testing, efficacy and effectiveness of the delivery of KOKO Plus on the growth and nutritional status of infants 6-24 mo of age. © 2015, Center for Academic Publications Japan. All rights reserved.


Uauy R.,Nevin Scrimshaw International Nutrition Foundation | Uauy R.,University of Chile | Kurpad A.,St Johns Medical College | Tano-Debrah K.,University of Ghana | And 5 more authors.
Journal of Nutritional Science and Vitaminology | Year: 2015

Over a third of all deaths of children under the age of five are linked to undernutrition. At a 90% coverage level, a core group of ten interventions inclusive of infant and young child nutrition could save one million lives of children under 5 y of age (15% of all deaths) (Lancet 2013). The infant and young child nutrition package alone could save over 220,000 lives in children under 5 y of age. High quality proteins (e.g. milk) in complementary, supplementary and rehabilitation food products have been found to be effective for good growth. Individual amino acids such as lysine and arginine have been found to be factors linked to growth hormone release in young children via the somatotropic axis and high intakes are inversely associated with fat mass index in pre-pubertal lean girls. Protein intake in early life is positively associated with height and weight at 10 y of age. This paper will focus on examining the role of protein and amino acids in infant and young child nutrition by examining protein and amino acid needs in early life and the subsequent relationship with stunting. © 2015, Center for Academic Publications Japan. All rights reserved.


Akalu G.,Ethiopian Health and Nutrition Research Institute EHNRI | Taffesse S.,Ethiopian Health and Nutrition Research Institute EHNRI | Gunaratna N.S.,Nevin Scrimshaw International Nutrition Foundation | De Groote H.,International Maize and Wheat Improvement Center
Food and Nutrition Bulletin | Year: 2010

Background. Undernutrition is a persistent problem in Africa, especially in rural areas where the poor largely depend on staples and have limited access to a diverse diet. Quality protein maize (QPM) consists of maize varieties biofortified with increased lysine and tryptophan levels. Several studies in controlled settings have indicated the positive impact of QPM on the nutritional status of children. Objective. Two 1-year, randomized, controlled studies were undertaken to measure the effect of QPM on the nutritional status of children consuming typical maize-based diets when QPM was cultivated by their households in the western Ethiopian highlands. Methods. The first study used a cluster-randomized design with 151 children aged 5 to 29 months; the second study used a completely randomized design with 211 children aged 7 to 56 months. In both studies, half of the households were provided with QPM seed and the other half with seed of an improved conventional maize variety. Results. Undernutrition was pervasive, and maize was the dominant food in the children's complementary diets. In the first study, a positive effect of QPM was observed for weight but not height, with children in the QPM group recovering from a drop in weight-for-height. In the second study, children consuming conventional maize progressively faltered in their growth, whereas children consuming QPM did not change significantly in height-for-age and had a marginal increase in weight-for-age. Conclusions. These studies indicate that in major maize-producing and -consuming areas of Africa, home cultivation and use of QPM in children's diets could reduce or prevent growth faltering and may in some cases support catch-up growth in weight. © 2010, The United Nations University.


Gunaratna N.S.,Nevin Scrimshaw International Nutrition Foundation | De Groote H.,International Maize and Wheat Improvement Center | Nestel P.,University of Southampton | Pixley K.V.,International Maize and Wheat Improvement Center | McCabe G.P.,Purdue University
Food Policy | Year: 2010

Biofortification, or the improvement of nutritional quality in food crops, is a promising strategy to combat undernutrition, particularly among the rural poor in developing countries. However, traditional methods of impact assessment are inadequate for biofortified crops, as they do not consider their nutritional benefits. Evidence for the nutritional impact of maize varieties with improved protein quality, collectively known as quality protein maize (QPM), was evaluated using meta-analysis of randomized, controlled studies in target communities. A new and generalizable effect size was proposed to quantify the impact of QPM on a key outcome, child growth. The results indicated that consumption of QPM instead of conventional maize leads to a 12% (95% CI: 7-18%) increase in the rate of growth in weight and a 9% (95% CI: 6-15%) increase in the rate of growth in height in infants and young children with mild to moderate undernutrition from populations in which maize is the major staple food. The proposed effect size and use of bootstrapping to determine statistical significance addressed some methodological limitations in the existing studies. © 2009 Elsevier Ltd.


Ghosh S.,Tufts University | Ghosh S.,Nevin Scrimshaw International Nutrition Foundation | Suri D.,Nevin Scrimshaw International Nutrition Foundation | Uauy R.,Nevin Scrimshaw International Nutrition Foundation | Uauy R.,University of Chile
British Journal of Nutrition | Year: 2012

Dietary protein and amino acid requirement recommendations for normal "healthy" children and adults have varied considerably with 2007 FAO/WHO protein requirement estimates for children lower, but dietary essential AA requirements for adults more than doubled. Requirement estimates as presented do not account for common living conditions, which are prevalent in developing countries such as energy deficit, infection burden and added functional demands for protein and AAs. This study examined the effect of adjusting total dietary protein for quality and digestibility (PDCAAS) and of correcting current protein and AA requirements for the effect of infection and a mild energy deficit to estimate utilizable protein (total protein corrected for biological value and digestibility) and the risk/prevalence of protein inadequacy. The relationship between utilizable protein/prevalence of protein inadequacy and stunting across regions and countries was examined. Data sources (n = 116 countries) included FAO FBS (food supply), UNICEF (stunting prevalence), UNDP (GDP) and UNSTATS (IMR) and USDA nutrient tables. Statistical analyses included Pearson correlations, paired-sample/non-parametric t-tests and linear regression. Statistically significant differences were observed in risk/prevalence estimates of protein inadequacy using total protein and the current protein requirements versus utilizable protein and the adjusted protein requirements for all regions (p<0.05). Total protein, utilizable protein, GDP per capita and total energy were each highly correlated with the prevalence of stunting. Energy, protein and utilizable protein availability were independently and negatively associated with stunting (p< 0.001), explaining 41%, 34% and 40% of variation respectively. Controlling for energy, total protein was not a statistically significant factor but utilizable protein remained significant explaining ∼45% of the variance (p = 0.017). Dietary utilizable protein provides a better index of population impact of risk/prevalence of protein inadequacy than crude protein intake. We conclude that the increased demand for protein due to infections and mild to moderate energy deficits, should be appropriately considered in assessing needs of populations where those conditions still prevail. © 2012 The Authors.


Ghosh S.,Nevin Scrimshaw International Nutrition Foundation | Ghosh S.,Tufts University | Tano-Debrah K.,University of Ghana | Aaron G.J.,Global Alliance for Improved Nutrition | And 13 more authors.
Annals of the New York Academy of Sciences | Year: 2014

Reaching vulnerable populations in low-resource settings with effective business solutions is critical, given the global nature of food and nutrition security. Over a third of deaths of children under 5 years of age are directly or indirectly caused by undernutrition. The Lancet series on malnutrition (2013) estimates that over 220,000 lives of children under 5 years of age can be saved through the implementation of an infant and young child feeding and care package. A unique project being undertaken in Ghana aims to bring in two elements of innovation in infant and young child feeding. The first involves a public-private partnership (PPP) to develop and test the efficacy and effectiveness of the delivery of a low-cost complementary food supplement in Ghana called KOKO Plus™. The second involves the testing of the concepts of social entrepreneurship and social business models in the distribution and delivery of the product. This paper shares information on the ongoing activities in the testing of concepts of PPPs, social business, social marketing, and demand creation using different delivery platforms to achieve optimal nutrition in Ghanaian infants and young children in the first 2 years of life. It also focuses on outlining the concept of using PPP and base-of-the-pyramid approaches toward achieving nutrition objectives. © 2014 New York Academy of Sciences.


Ghosh S.,Nevin Scrimshaw International Nutrition Foundation | Ghosh S.,Tufts University | Smriga M.,Ajinomoto Co. | Vuvor F.,University of Ghana | And 5 more authors.
American Journal of Clinical Nutrition | Year: 2010

Background: Lysine affects diarrhea and anxiety via effects on serotonin receptors, enhanced intestinal repair, and sodium chloride-dependent opioid peptide transport. Objective: The objective was to investigate the effects of lysine supplementation on morbidity, growth, and anxiety in children and adults of peri-urban areas of Accra, Ghana. Design: In a double-blind randomized trial, the effect of lysine supplementation (1 g lysine/d) compared with that of placebo was examined in 2 groups of men, women, and children (n = 271). Primary outcomes included diarrheal and respiratory morbidity, growth, and anxiety and complement C3, C-reactive protein, serum cortisol, transferrin, and ferritin values. Independent-sample t tests, odds ratios, generalized estimating equations, 4-parameter sinusoid regression, and generalized linear models were used. Results: Thirty percent of men, 50% of women, and 15% of children were at risk of lysine inadequacy. Supplementation in children reduced diarrheal episodes [19 lysine, 35 placebo; odds ratio (OR): 0.52; 95% CI: 0.29, 0.92; P = 0.046] and the total number of days ill (21 lysine, 47 placebo; OR: 0.44; 95% CI: 0.26, 0.74; P = 0.034). Mean days ill per child per week (0.058 6 0.039 lysine, 0.132 ± 0.063 placebo; P = 0.017) were negatively associated with weight gain with control for baseline weight and study group (P = 0.04). Men had fewer coryza episodes (23 lysine, 39 placebo; OR: 0.60; 95% CI: 0.36, 1.01; P = 0.05), total number of days ill (lysine: 130; placebo: 266; OR: 0.51; 95% CI: 0.28, 0.93; P = 0.03), and mean days ill per person per week (lysine: 0.21 ± 0.23; placebo: 0.41 ± 0.35; P = 0.04). Serum ferritin (P = 0.045) and C-reactive protein (P = 0.018) decreased in lysine-supplemented women but increased in placebo-supplemented women. Conclusion: Lysine supplementation reduced diarrheal morbidity in children and respiratory morbidity in men in Ghana. © 2010 American Society for Nutrition.


PubMed | Nevin Scrimshaw International Nutrition Foundation
Type: Journal Article | Journal: The American journal of clinical nutrition | Year: 2010

Lysine affects diarrhea and anxiety via effects on serotonin receptors, enhanced intestinal repair, and sodium chloride-dependent opioid peptide transport.The objective was to investigate the effects of lysine supplementation on morbidity, growth, and anxiety in children and adults of peri-urban areas of Accra, Ghana.In a double-blind randomized trial, the effect of lysine supplementation (1 g lysine/d) compared with that of placebo was examined in 2 groups of men, women, and children (n = 271). Primary outcomes included diarrheal and respiratory morbidity, growth, and anxiety and complement C3, C-reactive protein, serum cortisol, transferrin, and ferritin values. Independent-sample t tests, odds ratios, generalized estimating equations, 4-parameter sinusoid regression, and generalized linear models were used.Thirty percent of men, 50% of women, and 15% of children were at risk of lysine inadequacy. Supplementation in children reduced diarrheal episodes [19 lysine, 35 placebo; odds ratio (OR): 0.52; 95% CI: 0.29, 0.92; P = 0.046] and the total number of days ill (21 lysine, 47 placebo; OR: 0.44; 95% CI: 0.26, 0.74; P = 0.034). Mean days ill per child per week (0.058 0.039 lysine, 0.132 0.063 placebo; P = 0.017) were negatively associated with weight gain with control for baseline weight and study group (P = 0.04). Men had fewer coryza episodes (23 lysine, 39 placebo; OR: 0.60; 95% CI: 0.36, 1.01; P = 0.05), total number of days ill (lysine: 130; placebo: 266; OR: 0.51; 95% CI: 0.28, 0.93; P = 0.03), and mean days ill per person per week (lysine: 0.21 0.23; placebo: 0.41 0.35; P = 0.04). Serum ferritin (P = 0.045) and C-reactive protein (P = 0.018) decreased in lysine-supplemented women but increased in placebo-supplemented women.Lysine supplementation reduced diarrheal morbidity in children and respiratory morbidity in men in Ghana.


PubMed | Nevin Scrimshaw International Nutrition Foundation
Type: | Journal: Journal of nutritional science and vitaminology | Year: 2015

Over a third of all deaths of children under the age of five are linked to undernutrition. At a 90% coverage level, a core group of ten interventions inclusive of infant and young child nutrition could save one million lives of children under 5 y of age (15% of all deaths) (Lancet 2013). The infant and young child nutrition package alone could save over 220,000 lives in children under 5 y of age. High quality proteins (e.g. milk) in complementary, supplementary and rehabilitation food products have been found to be effective for good growth. Individual amino acids such as lysine and arginine have been found to be factors linked to growth hormone release in young children via the somatotropic axis and high intakes are inversely associated with fat mass index in pre-pubertal lean girls. Protein intake in early life is positively associated with height and weight at 10 y of age. This paper will focus on examining the role of protein and amino acids in infant and young child nutrition by examining protein and amino acid needs in early life and the subsequent relationship with stunting.

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