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Daniel C.R.,U.S. National Cancer Institute | Prabhakaran D.,Center for Chronic Disease Control | Kapur K.,Steno Diabetes Center | Graubard B.I.,U.S. National Cancer Institute | And 12 more authors.
Nutrition Journal | Year: 2011

Background. The role of diet in India's rapidly progressing chronic disease epidemic is unclear; moreover, diet may vary considerably across North-South regions. Methods. The India Health Study was a multicenter study of men and women aged 35-69, who provided diet, lifestyle, and medical histories, as well as blood pressure, fasting blood, urine, and anthropometric measurements. In each region (Delhi, n = 824; Mumbai, n = 743; Trivandrum, n = 2,247), we identified two dietary patterns with factor analysis. In multiple logistic regression models adjusted for age, gender, education, income, marital status, religion, physical activity, tobacco, alcohol, and total energy intake, we investigated associations between regional dietary patterns and abdominal adiposity, hypertension, diabetes, and dyslipidemia. Results. Across the regions, more than 80% of the participants met the criteria for abdominal adiposity and 10 to 28% of participants were considered diabetic. In Delhi, the "fruit and dairy" dietary pattern was positively associated with abdominal adiposity [highest versus lowest tertile, multivariate-adjusted OR and 95% CI: 2.32 (1.03-5.23); Ptrend= 0.008] and hypertension [2.20 (1.47-3.31); Ptrend< 0.0001]. In Trivandrum, the "pulses and rice" pattern was inversely related to diabetes [0.70 (0.51-0.95); P trend= 0.03] and the "snacks and sweets" pattern was positively associated with abdominal adiposity [2.05 (1.34-3.14); P trend= 0.03]. In Mumbai, the "fruit and vegetable" pattern was inversely associated with hypertension [0.63 (0.40-0.99); Ptrend= 0.05] and the "snack and meat" pattern appeared to be positively associated with abdominal adiposity. Conclusions. Cardio-metabolic risk factors were highly prevalent in this population. Across all regions, we found little evidence of a Westernized diet; however, dietary patterns characterized by animal products, fried snacks, or sweets appeared to be positively associated with abdominal adiposity. Conversely, more traditional diets in the Southern regions were inversely related to diabetes and hypertension. Continued investigation of diet, as well as other environmental and biological factors, will be needed to better understand the risk profile in this population and potential means of prevention. © 2011 Daniel et al; licensee BioMed Central Ltd.


Srinivasan P.,Government Primary Health Center | Lawa H.R.,UN World Food Programme | Rosado J.L.,Autonomous University of Queretaro | Al Mamun A.,University of Queensland | And 6 more authors.
Acta Tropica | Year: 2016

A randomised, double-blind, placebo-controlled trial was carried out among Mexico children aged 6-15 months to determine how household characteristics modify vitamin A and zinc supplementation efficacy on Ascaris lumbricoides, Giardia intestinalis and Entamoeba histolytica/E. dispar infection durations. Children assigned to receive vitamin A every 2 months, a daily zinc supplement, a combined vitamin A-zinc supplement or a placebo were followed for 1 year. Parametric hazard models were fit to infection durations stratified by personal and household factors. Children supplemented with vitamin A and zinc combined from households lacking piped water and children in all three treatment arms from households with dirt floors had longer G. intestinalis and A. lumbricoides infection durations than their counterparts, respectively. Shorter E. histolytica/E.dispar durations were found among zinc-supplemented children of mothers who had <6 years of education and no indoor bathrooms. Heterogeneity in supplementation efficacy among children may reflect differences in exposure risk and baseline immune responses. © 2016 Elsevier B.V.


PubMed | Autonomous University of Queretaro, QIMR Berghofer Medical Research Institute, National Autonomous University of Mexico, University of Queensland and 3 more.
Type: | Journal: Acta tropica | Year: 2016

A randomised, double-blind, placebo-controlled trial was carried out among Mexico children aged 6-15 months to determine how household characteristics modify vitamin A and zinc supplementation efficacy on Ascaris lumbricoides, Giardia intestinalis and Entamoeba histolytica/E. dispar infection durations. Children assigned to receive vitamin A every 2 months, a daily zinc supplement, a combined vitamin A-zinc supplement or a placebo were followed for 1 year. Parametric hazard models were fit to infection durations stratified by personal and household factors. Children supplemented with vitamin A and zinc combined from households lacking piped water and children in all three treatment arms from households with dirt floors had longer G. intestinalis and A. lumbricoides infection durations than their counterparts, respectively. Shorter E. histolytica/E.dispar durations were found among zinc-supplemented children of mothers who had <6 years of education and no indoor bathrooms. Heterogeneity in supplementation efficacy among children may reflect differences in exposure risk and baseline immune responses.


News Article | March 2, 2017
Site: www.theguardian.com

Simon Modi, 17, has just crossed into Yumbe in northern Uganda from South Sudan and within a few hours will be bussed to Bidi Bidi, one of world’s largest refugee settlements. Within 24 hours, he and his relatives will be settled on a half-acre plot with the tools to farm and build a home. The Ugandan refugee operation is seamless. But for now, it fails to sooth Modi. All he knows is that his father was shot, he missed his exams, and his mother is trudging through savannah with six children. “Maybe tomorrow they will arrive. If not, I will go back to find them!” Three other boys clasp their heads. “We learned their story when they were crying,” says Mohamed Bran, who runs the collection point for refugees. “Their mother was killed, the fate of their father unknown.” Refugees are pouring in. Bran keeps a list of why. Besides “killing and torturing” are “abduction of men, trading has stopped, no schools, looting of properties”. “It was preventive fleeing,” says Charlie Yaxley of the UN high commissioner for refugees. “Now it is actual violence. They go through forest because of armed groups on the road.” On 21 February South Sudan declared famine. It is horribly grim. Yet inside Uganda something extraordinary is happening. The country has a no camp policy and has settlements instead – swathes of land availed to refugees. Refugees can move freely, work and own a business. “Uganda is incredibly switched on,” says Musarait Kashmiri from African Initiatives for Relief and Development, which has opened 343km of roads in Bidi Bidi. “Uganda is a showcase,” says Yaxley. The settlement has churches under trees, health units and schools for refugee and local children. Most refugees are ready to farm. “Since we crossed, we have not heard guns,” says Helena Kujang,who “followed the footsteps of citizens” to safety. “We are going to grow our own food. All the seeds that are available, we will plant.” Several reasons exist for Uganda’s outlier levels of hospitality. Its commissioner for refugees, David Kazungu, says “Ugandans have been in exile and know what it means, and refugees are important for social and economic transformation.” Jens Hesemann suggests the last might be key. A 2016 study by University of California Davis and the UN World Food Programme found that “refugees’ purchases benefit local and national economies, and economic benefits exceed the amount of donated aid”. “In many countries such an influx would have led to a crisis,” says the UNHCR senior field coordinator. “Here it’s working.” A small cotton farmer extols the change. “The refugees are an opportunity,” says Hamza Yassin, 23. “Before they came, this place was empty. But they’ve created a marketplace. We can now buy things close by.” “Providing land to refugees allows them to immediately start settling, as no one knows how long they will have to stay,” says Yann Libessart of Médecins Sans Frontières. “Markets will expand, and the distinction between a South Sudanese refugee settlement and a Ugandan village eventually blur. This could give an economic boost.” But Uganda’s great undertaking could go wrong. “The hosts have been outstanding and the settlement model is unique,” says Hesemann. “But it comes with high expectations that if communities host refugees, they will benefit. It needs to be followed with concrete funding, or it risks disenfranchising the community.” However, just 36% of the $251m (£204m) needed in 2016 has come through, and at least three further settlements have had to open since Bidi Bidi filled up. There is also a clear and present danger of profound environmental damage to a district already poor, losing soil, entirely dependent on wood to cook and build, and reliant on economic activities that degrade natural resources, such as sand mining, which breaks down riverbanks, and charcoal, brick making and tobacco curing, which consume millions of trees a year. “Almost all the population depends on the environment so anything that happens to it is a big problem,” says Serbeet Kawawa, Yumbe’s natural resources officer. “The question is how to make refugees and host communities lead a sustainable life.” Yumbe already teeters on food insecurity, and water is so scarce that it is tanked from the Nile to refugees. “What we are seeing is a total destruction of trees,” says district agriculture officer Rashid Kawawa. “They clear their land and use the standing ones for fuel. We risk losing our big ones, which are important for biodiversity and rain.” This also worries farmer Yasin. “I doubt we shall experience our wet season,” he says. One project is marking “1,000 mother trees of biological importance like mahogany and shea,” explains forest officer Zabibu Ocogour. But much more needs to be done, like “a programme to explain what we are doing. The refugees may not understand.” Planting and regenerating trees will give refugees prunings to cook with, reduce pressure on natural vegetation and address assaults on women collecting wood. FAO’s Guidance on safe access on firewood and alternative energy in humanitarian settings advocates woodlots, efficient stoves, and farming that produces food and fuel. Serbeet Kawawa appreciates the humanitarian shift. “It used to be rehabilitation after repatriation. Now it is prevent damage right from the start.” “We emphasise stopping uncontrolled bush burning,” adds Timothy Olum Ojwi of the Lutheran World Federation. “The challenge is the long dry spell. Planting has to wait. But we give refugees 70% of everything we do, and host communities are happy because they receive 30%.” This current exemplary state needs urgent support: 300,000 refugees from South Sudan are expected in 2017, according to UNHCR, and a projected $558m (£453m) will be needed for all South Sudanese, now totalling 762,672, in Uganda this year. “The authorities, humanitarian community and environment can only cope with so much,” says MSF’s Libessart. Cathy Watson is chief of programme development at the World Agroforestry Centre in Nairobi. Join our community of development professionals and humanitarians. Follow @GuardianGDP on Twitter


Chhetri N.,Arizona State University | Subedi M.,UN World Food Programme | Ghimire S.,James Hutton Institute
Climate and Development | Year: 2013

Climate change continues to threaten the lives and livelihoods of small farmers of Nepal. Given the importance of Nepal's agriculture to the nation's economy, potential impacts of climate variability and change on national food security is a cause for concern. Notwithstanding this challenge, efforts are being made to identify the climate-change impacts on agriculture and actions that farmers and their supporting institutions can take to adapt. The repository of local agro-ecological knowledge available across Nepalese communities is worth exploring. This study, through analysis of four examples of innovative agricultural practices - referred to here as niche-based, details the responses of farmers and their supporting institutions to climatic limitations in Nepal. We identify and synthesize commonalities of the four case studies that may be integral to climate-change adaptation as: (1) the need for participation, flexibility and integration of all stakeholders in the process of innovating adaptation technologies; and (2) the potential for farmers (end-users) and their supporting institutions to take on more leadership and responsibility to sustain the effectiveness of adaptation measures. © 2013 Copyright Taylor and Francis Group, LLC.


Pearson B.L.,UN World Food Programme | Ljungqvist B.,UN World Food Programme
Food and Nutrition Bulletin | Year: 2011

Background. Renewed Efforts Against Child Hunger (REACH) is the joint United Nations initiative to address Millennium Development Goal (MDG) 10, Target 3, i.e., to halve the proportion of underweight children under 5 years old by 2015. The United Nations Food and Agriculture Organization (FAO), the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the World Food Programme (WFP), and the International Fund for Agricultural Development (IFAD) developed and tested a facilitation mechanism to act as a catalyst for scaling up multisectoral nutrition activities. Objective. The UN-REACH partners developed pilot projects in Mauritania and Lao PDR from 2008 to 2010 and deployed facilitators to improve nutrition governance and coordination. Review missions were conducted in February 2011 to assess the REACH approach and what it achieved. Methods. The UN review mission members reviewed documents, assessed policy and management indicators, conducted qualitative interviews, and discussed findings with key stakeholders, including the most senior UN nutrition directors from all agencies. Results. Among other UN-REACH achievements, the Prime Minister of Mauritania agreed to preside over a new National Nutrition Development Council responsible for high-level decision-making and setting national policy objectives. REACH facilitated the completion of Lao's first national Nutrition Strategy and Plan of Action and formation of the multistakeholder Nutrition Task Force. During the REACH engagement, coordination, joint advocacy, situation analysis, policy development, and joint UN programming for nutrition were strengthened in Lao PDR and Mauritania. Conclusions. Improvements in the nutrition governance and management mechanisms in Mauritania and Lao PDR were observed during the period of REACH support through increased awareness of nutrition as a key development objective, establishment of governmental multisectoral coordinating mechanisms, improved government capacity, and new joint UN-government nutrition programming. © 2011, The United Nations University.

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