Intake Of Animal Source Foods Research Articles

Plant-based diets–impacts of consumption of little or no animal-source foods on human health

The world, in 2024, faces both climate and biodiversity crises, and the food system does contribute significantly to these crises. For some, the solution is simple - intakes of animal source foods (ASFs) should be considerably reduced, and consumption of plant-source foods (PSFs) should be greatly increased. Advocates for such a dietary transformation express confidence that plant-based diets will not only benefit planetary health, but will provide nutrient adequacy for all, and will also result in considerable protection from chronic non-communicable diseases (NCDs). However, as described in this perspective, the dramatic reductions in ASFs, entailed by many plant-based diets, will worsen already prevalent micronutrient and protein deficiencies. The protections provided by plant-based diets against NCDs appear to be more strongly associated with reduced intakes of calories and salt, and increased intakes of fruit, vegetables, nuts and whole grains, rather than with reduced intakes of ASFs. Any possible absolute adverse effects of red and processed meat consumption on NCDs are very small and uncertain. Other ASFs either appear to have no impact on NCDs (poultry meat and eggs), or are associated with protections against obesity, cardiovascular events, brain disorders and some cancers (seafood and dairy). Rigorous randomized controlled trials of all newly proposed environmentally-protective plant-based diets are required, so as to provide clear-cut evidence of micronutrient and protein adequacy, with or without, supplementation, fortification and/or biofortification. In the meantime, dietary guidelines should advise moderating excessive consumption, rather than substantially limiting or excluding ASFs from the human diet.

Food Transfers, Cash Transfers, Behavior Change Communication and Child Nutrition: Evidence from Bangladesh

Abstract This paper reports the results of two 2-year randomized control trials in two poor rural areas of Bangladesh. Treatment arms included monthly cash transfers, monthly food rations of equivalent value to the cash transfers, and mixed monthly cash and food transfers, and treatment arms—one with food and one with cash—that combined transfers with nutrition-behavior communication change (BCC). This design enables a comparison of transfer modalities within the same experiment. Intent-to-treat estimators show that cash transfers and nutrition BCC had a large impact on nutritional status, a 0.25 standard deviation increase in height-for-age z-scores and a 7.8 percentage point decrease in stunting prevalence. No other treatment arm affected anthropometric outcomes. Mechanisms underlying these impacts are explored. Improved diets—particularly increased intake of animal source foods in the cash plus BCC arm—are consistent with the improvements observed in this paper.

Is Increasing Diet Diversity of Animal-Source Foods Related to Better Health-Related Quality of Life among Chinese Men and Women?

Diet plays a crucial role in regulating individuals' lifestyles and is closely related to health. The intake of animal-sourced foods (ASF) provides the human body with high-quality protein and various micronutrients. This study aimed to investigate whether the diversity of animal foods has a positive impact on the health-related quality of life (HRQoL) among residents. The data came from the Shaanxi baseline survey of the Northwest Chinese Regional Ethnic Cohort Study, which recruited more than 100 thousand participants aged 35 to 74 from five provinces between June 2018 and May 2019. A total of 39,997 participants in Shaanxi (mean age: 50 years; 64% women) were finally included in this current study. The animal source food diet diversity score (ASFDDS) was established based on the frequency of consuming pork, mutton, beef, poultry, seafood, eggs, pure milk, and yogurt. The physical component score (PCS) and mental component score (MCS), ranging from 0 to 100 on the 12-Item Short Form Survey (SF-12), were used to assess participants' HRQoL. Better PCS/MCS was defined as scores higher than the 90th percentile. The results showed that men had a higher intake of ASF and ASFDDS than women. After adjusting for potential confounders, compared with those who never or rarely consumed animal foods, the likelihood of having better PCS and MCS increased by 16% (OR = 1.16, 95%CI: 1.01-1.34) and 24% (OR = 1.24, 95%CI: 1.03-1.448), respectively, in men with an ASFDDS ≥ 2. In women, a 34% increase (OR = l.34, 95%CI: 116-l.54) likelihood for better PCS was observed for an ASFDDS ≥ 2, but no association was observed for MCS. Increasing each specific animal source's food intake was associated with better PCS after adjusting for all covariates. However, for MCS, positive associations were only observed in seafood consumption among men and eggs among women. Restricted cubic splines showed a substantial dose-response association between intake frequency of animal-source foods and PCS, both in men and women. The study suggests that a diverse intake of animal-sourced foods can potentially improve the HRQoL of Chinese adults.

Associations of animal source foods, cardiovascular disease history, and health behaviors from the national health and nutrition examination survey: 2013–2016

BackgroundSome individuals adopt vegetarian or plant-based diets to improve their health. Observational evidence suggests diets composed of higher amounts of animal-source foods (ASFs) are associated with increased risk for disease and early mortality. In many of these studies, those who ate fewer animal-source foods reported fewer disease risk factors and unhealthy behaviors, which could indicate bias. PurposeThis study aims to examine the relationships between ASF consumption, health behaviors, and cardiovascular disease (CVD) prevalence in a population-representative sample of U.S. civilians controlling for confounders. MethodsRespondent data were collected from the National Health and Nutrition Examination Survey (NHANES) 2013–2016 collection years. Collected data included demographics, ASF intake, healthy lifestyle variables, body mass index, and blood lipids. ResultsThere was a higher proportion of those with CVD history who consumed red meat (61.3%; C.I. 41.7%–77.8%), but the proportion was lower for white (23.3%; C.I. 12.6%–39.0%) and processed meat (15.4%; C.I. 6.5%–32.3%). When adjusted for sex, the odds of CVD history increased for red meat compared to processed meat consumption (OR 2.95; C.I. 1.14–7.66). Unhealthy lifestyle increased the odds of CVD history by nearly 8-fold (OR 7.8; C.I. 3.44–17.7). Individual factors including age, smoking history, body mass index, and blood lipids, and demographic factors, including education level, race, and income, were also associated with increased odds for CVD history. ROC analysis revealed 77.2% AUC for CVD history classified by individual factors (BMI ≥30 kg/m**2, ≤ 30 min moderate physical activity, smoker, fiber intake ≤25 g, dental visit more than two years ago, and age above 60 years). Three or more factors moderately predicted CVD history when optimized for sensitivity (73.4%) and specificity (71%). Adjusted for sex, the relationship between CVD and moderate physical activity became stronger possibly reflecting lifestyle changes. Despite evidence of lifestyle changes, modifiable risk factors persisted in the CVD group. CVD diagnosis in males was substantially delayed compared to females concerning the sex-specific age cutoff associated with higher risk. The healthy lifestyle group was characterized by earlier CVD diagnosis and fewer overall risk factors compared to the unhealthy lifestyle group. ConclusionCVD history was strongly associated with demographic, lifestyle, and dietary factors. Future research should focus on multidimensional models for disease risk stratification and prevention, including individual, behavioral, and sociodemographic factors.

Addressing child and maternal nutrition: a qualitative study on food prescriptions and proscriptions determining animal source food consumption in rural Kenya

Animal source foods (ASFs) can play a critical role in the nutritional well-being of women and children. Although livestock ownership may translate to high availability of ASFs, community food prescriptions and proscriptions may determine consumption patterns and subsequent human nutritional status. This study sought to understand the existing dietary practices and underlying prescriptions and proscriptions of ASFs among women and children in Siaya County in western Kenya. The study was carried out among the Luo ethnic group in Siaya, western Kenya, within a livestock-keeping community where more than 90% of households kept at least one livestock species. Qualitative data collection was completed through 35 key informant interviews and 6 focus group discussions conducted between October and December 2018. Thematic analysis was used to establish and interpret patterns and relationships from emerging themes. We found male favoritism in food allocation and prohibition of eggs and (parts of) chicken, fish and meat for women and children, potentially contributing to low consumption of ASFs. Customary rites and ceremonies like funeral provided opportunities for the less fortunate to consume otherwise unaffordable and highly valued ASFs like meat. Religious beliefs and practices, unlike other cultural food beliefs and practices, remain rigid to change and thus contribute to low consumption of own-produced or locally available ASFs. To address protein malnutrition among these groups, our findings suggest improvement of animal production should be accompanied by interventions that address customary food prescriptions and proscriptions that may perpetuate low intake of ASFs especially among women of child-bearing age, mothers, pregnant women and children.

Child-Owned Poultry Intervention Effects on Hemoglobin, Anemia, Concurrent Anemia and Stunting, and Morbidity Status of Young Children in Southern Ethiopia: A Cluster Randomized Controlled Community Trial.

Cereal-based diets contribute to anemia in Ethiopian children. Eggs have nutrients to boost hemoglobin levels as well as counter concurrent anemia and stunting (CAS) and morbidity status. A community trial, targeting 6-18 months old children, was conducted in Halaba. Two clusters were randomly selected and allocated to intervention (N = 122) and control (N = 121) arms. Intervention group (IG) children received egg-laying hens with caging in a cultural ceremony declaring child ownership of the chickens. Parents promised to feed eggs to the child. Health and agriculture extension workers promoted egg feeding, poultry husbandry, and sanitation to IG families. Control group (CG) had standard health and agriculture education. At baseline, groups were not different by hemoglobin, anemia, CAS, and morbidity status. Mean hemoglobin was 11.0 mg/dl and anemia prevalence was 41.6%. About 11.9% of children had CAS and 52.3% were sick. Using generalized estimating equations, the intervention increased hemoglobin by 0.53 g/dl (ß:0.53; p < 0.001; 95%CI: 0.28-0.79). IG children were 64% (p < 0.001; odds ratio [OR]:0.36; 95%CI: 0.24-0.54) and 57% (p = 0.007; OR: 0.43; 95%CI: 0.21-0.73) less likely to be anemic and have CAS, respectively, than CG, with no difference in morbidity. Child-owned poultry intervention is recommended in settings where anemia is high and animal-source food intake is low.

Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.

Awareness of the Link Between the Consumption of Ultra-Processed Food and Colorectal Cancer Risk in Saudi Arabia.

Introduction Cancer is a group of diseases with uncontrollable growth of abnormal cells. Colorectal cancer (CRC) is one of the most common cancers. Increased intake of animal-source foods, sedentary lifestyle, decreased physical activity, and increased prevalence of excess body weight are independently associated with CRC risk. Additional risk factors include heavy alcohol consumption, cigarette smoking, and consumption of red or processed meat. Ultra-processed food (UPF) is made utilizing multiple components and a number of procedures. Soft drinks and salty or sugary snacks typically contain a lot of added sugar, fats, and processed carbohydrates, which negatively affect the balance of the gut bacteria, nutrients, and bioactive substances that are necessary for the prevention of CRC. The aim of this study is to assess the awareness of the general population in Saudi Arabia toward the relationship between UPF and CRC. Methods A cross-sectional questionnaire-based study was conducted in Saudi Arabia between June and December, 2022. Result The study involved 802 participants, of which 84% consumed UPF and 71% were aware of the link between UPF and CRC. Only 18.3% were familiar with the particular type of UPF and only 29.4% knew how to prepare them. The prevalence of participants who were aware of the link between UPF and CRC was significantly more among the older age groups, people living in the Eastern Region, and those who knew how to manufacture UPF, while the prevalence of awareness was significantly less among those who regularly consumed UPF. Conclusion The study showed that a significant portion of subjects regularly ate UPF, and only a few were aware of its link to CRC. This highlights the need for greater awareness of the fundamentals of UPF and its impact on health. Governmental organizations should develop a strategy to raise public awareness of excessive UPF use.

Association between dietary fat intake and colorectal cancer: A multicenter case-control study in Iran.

The evolving trends in colorectal cancer (CRC) as one of the most common malignancies worldwide, have likely been influenced by the implementation of screening programs and changes in lifestyle habits. Changing lifestyle, including the shift in diet composition with higher fat, sugar, and animal-source foods intake, led to an increasing burden of CRC in countries undergoing rapid socioeconomic improvement. Results for the link between specific fatty acids (FAs) and CRC are generally inconclusive and more limited in developing countries than elsewhere. This study aims to investigate the association between FA intakes and CRC and its anatomical subsites in a large Iranian case-control study. A food frequency questionnaire was used to collect information on dietary intake in 865 cases and 3206 controls. We conducted multivariate logistic regression models to calculate the odds ratio (OR) and 95% confidence interval (CI). We found positive association between CRC and high intake of dietary total fat (OR highest quartile Q4 = 1.77, 95% CI = 1.32-2.38), cholesterol (ORQ4 = 1.58, 95% CI = 1.22-2.05), and palmitoleic acid (ORQ4 = 2.16, 95% CI = 1.19, 3.91), and an inverse association with high intake of dietary heptanoic acid (ORQ4 = 0.33, 95% CI = 0.14, 0.79) and low intake of palmitic acid (OR lowest quartile Q2 = 0.53, 95% CI = 0.31-0.88). None of the fat variables were associated with rectal cancer. Our study suggests that the recommendation of limited consumption of fats may decrease the risk of CRC among the Iranian population.

Educational intervention and livestock ownership successfully improved the intake of animal source foods in 6-23 months old children in rural communities of Northern Ethiopia: Quasi-experimental study.

Animal source foods (ASFs) are rich in high-quality proteins, including essential amino acids and highly bioavailable micronutrients vital for child growth and cognitive development. But, the daily consumption of ASFs among 6-23 months old children is very low in Tigray, Northern Ethiopia. The study aimed to assess the effectiveness of nutrition education intervention to improve the consumption of ASFs among 6-23 months old children from rural communities with strict religious fasting traditions of avoiding intake of ASFs in Northern Ethiopia. A quasi-experimental study was conducted in two food insecure districts namely Samre Seharti (intervention) and Tanqua Abergele (comparison). The mother-child pairs in the intervention group (n = 140) received nutrition education based on the barriers and available resources for optimal consumption of ASFs among children and followed up for nine months. The mother-child pairs in the comparison group (n = 153) received routine nutrition education. The data were collected using a pre-tested structured questionnaire. The baseline and endline data assessment included interviews on socio-demographic and socio-economic status, dietary intake, and child feeding practices. The effectiveness of the intervention was measured using the difference-in-difference (DID) analysis model. At endline, the consumption of ASFs among children was 19.5 percentage points higher in the intervention group compared with the comparison group (p = 0.008). In addition, there was a significant increase in egg consumption among children in the intervention group (DID of 16.9, p = 0.012) from the comparison group. No child was consuming meat at baseline in both the intervention and comparison arms and it was very low at endline (5.2% vs. 7.9%). Overall, the proportion of children that consumed eggs in the intervention group was higher than in the comparison group in households that owned sheep and goats (4.8% vs. 21.4%, p = 0.050) and chicken (6.3% vs. 43.8%, p = 0.002) after education interventions. However, no statistically significant difference was observed between cow ownership and milk consumption among children (p&gt;0.05). Age-appropriate educational interventions for mothers and owning small livestock in the household can improve the consumption of ASFs and eventually the minimum diet diversity of children in communities with strict religious traditions of avoiding ASFs during the fasting seasons.

Higher Dietary Intake of Animal Protein Foods in Pregnancy Is Associated with Lower Risk of Adverse Birth Outcomes

The prevalence of adverse birth outcomes is highest in resource-limited settings such as sub-Saharan Africa. Maternal consumption of diets with adequate nutrients during pregnancy may protect against these adverse outcomes. The objective was to determine the association between maternal dietary consumption of animal source foods (ASFs) and the risk of adverse birth outcomes among HIV-negative pregnant women in Tanzania. Using dietary intake data from 7564 HIV-negative pregnant women, we used Poisson regression with the empirical variance (generalized estimating equation) to estimate the RR of adverse birth outcomes-preterm birth, very preterm birth, small for gestational age (SGA), low birth weight (LBW), stillbirth, and neonatal death-for higher and lower frequency of ASF intake. Median daily dietary intake of animal protein was 17 g (IQR: 1-48 g). Higher frequency of ASF protein intake was associated with lower risk of neonatal death (quartile 4 compared with quartile 1; RR: 0.59; 95% CI: 0.38, 0.90; P-trend = 0.01). Higher fish intake was associated with lower risk of very preterm birth (high tertile compared with low; RR: 0.76; 95% CI: 0.58, 0.99; P-trend = 0.02). Any meat intake was protective of preterm birth (RR: 0.73; 95% CI: 0.65, 0.82; P < 0.001), very preterm birth (P < 0.001), LBW (P < 0.001), and neonatal death (P = 0.01) but was associated with increased risk of SGA (RR:1.19; 95% CI: 1.01, 1.36; P = 0.04). Any egg intake was protective of very preterm birth (RR: 0.50; 95% CI: 0.31, 0.83; P = 0.01) as compared with no egg intake. Finally, any dairy intake was associated with lower risk of preterm birth (RR: 0.82; 95% CI: 0.68, 0.98; P = 0.03) and very preterm birth (RR: 0.53; 95% CI: 0.34, 0.84; P = 0.01). Higher frequency of dietary intake of ASF is associated with lower risk of adverse birth outcomes in urban Tanzania. Promoting prenatal dietary intake of ASF may improve birth outcomes in this region and similar resource-limited settings.

New frontiers in risk assessments related to diets, health and the environment

Abstract Based on the sustainable development goals agenda, public health experts should approach the study of planetary diets, environment, and health with a holistic approach that includes both human and planetary health. Modelling studies help in estimating priorities while attaining differences across countries. Future scenarios vary according to priorities to be set. When aiming only at fulfilling food-security objectives, studies suggest that reductions in premature mortality have few environmental co-benefits. In contrast, modelling studies that include environmental goals indicate the potential for reducing environmental impacts while improving diet quality and overall health outcomes, especially in high-income countries. The scenarios indicate that focusing on dietary changes towards healthy and balanced dietary pattern seems an ideal strategy to improve both mortality risk and the environmental impact, although the magnitude of the effects may vary across countries. Weight and dietary risk factors have traditionally been considered separate categories. A new approach can be proposed for attributing weight-related risks to food intake at global, regional, and national levels. When comparing current consumption patterns to diets that for each country minimise diet and weight-related risks, a total of 5 million weight-related deaths in 2019 were attributed to the overconsumption of refined grains, dairy, red and processed meat, sugar, and eggs, and to the underconsumption of oils, and legumes, among others. A large share of deaths attributable to high intake of animal source foods and imbalanced grain intake occurred in countries with the higher high human development index, while more than a third due to imbalanced sugar and oil intake occurred in medium ones. Attributing weight-related risks to food intake can inform food-based interventions for reducing the burden of preventable deaths associated with imbalanced weight levels.

Adequate vitamin B12 and folate status of Norwegian vegans and vegetarians.

Plant-based diets may increase the risk of vitamin B12 deficiency due to limited intake of animal-source foods, while dietary folate increases when adhering to plant-based diets. In this cross-sectional study, we evaluated the B12 and folate status of Norwegian vegans and vegetarians using dietary B12 intake, B12 and folic acid supplement use, and biomarkers (serum B12 (B12), plasma total homocysteine (tHcy), plasma methylmalonic acid (MMA) and serum folate). Vegans (n 115) and vegetarians (n 90) completed a 24-h dietary recall and a FFQ and provided a non-fasting blood sample. cB12, a combined indicator for evaluation of B12 status, was calculated. B12 status was adequate in both vegans and vegetarians according to the cB12 indicator; however 4 % had elevated B12. Serum B12, tHcy, MMA concentrations and the cB12 indicator (overall median: 357 pmol/l, 9·0 µmol/l, 0·18 µmol/l, 1·30 (cB12)) did not differ between vegans and vegetarians, unlike for folate (vegans: 25·8 nmol/l, vegetarians: 21·6 nmol/l, P = 0·027). Serum B12 concentration < 221 pmol/l was found in 14 % of all participants. Vegetarians revealed the highest proportion of participants below the recommended daily intake of 2 µg/d including supplements (40 v. 18 %, P < 0·001). Predictors of higher serum B12 concentrations were average daily supplement use and older age. Folate deficiency (< 10 nmol/l) was uncommon overall (< 2·5 %). The combined indicator cB12 suggested that none of the participants was B12-depleted; however, low serum B12 concentration was found in 14 % of the participants. Folate concentrations were adequate, indicating adequate folate intake in Norwegian vegans and vegetarians.

Egg consumption of children under two years of age through a child-owned poultry and nutrition intervention in rural Ethiopia: A community-based randomized controlled trial

Egg consumption is associated with better child health and nutrition. Though a relatively cheap animal source food, under-two years aged Ethiopian children rarely eat egg. This study tested effects of a child-owned poultry intervention integrated with nutrition education on egg intake. Targeting 6–18 months children, the trial was conducted in Southern Ethiopia from May to November 2018. Clusters were randomly selected and allocated to intervention and control arms. Children in the intervention group (N = 127) received two egg-laying local hens and caging materials in a cultural and religious gifting ceremony. Parents promised to not sell nor share the chickens and eggs, present two more hens, replace those that died, and feed all eggs produced to the chicken-owner child on the basis of one-egg-a-day. Cage utilization, proper poultry husbandry and environmental sanitation, as well as egg feeding, were promoted. Controls (N = 126) received the regular community-based nutrition and agriculture education. Child-owned poultry increased significantly in intervention ( p < 0.001 ) (β = 3.856; 95% CI of 3.553–4.159). Egg intake was 72% vs 20.7% among intervention and control children, respectively, at end line ( p < 0.001 ; Odds ratio = 3.841; 95% CI = 2.640–5.589). Mean eggs [SD] consumed by the week before end line significantly increased in intervention (4.85 [2.41]) compared to control (0.4 [0.61]) (p < 0.001; β = 2.202; 95% CI = 1.971–2.433) children. Child-owned hen flock size was strongly associated with egg intake (r = 0.975; p < 0.001 ). Nearly one-third of children in intervention met the minimum dietary diversity ( p = 0.016 ; Odds ratio = 1.857; 95% CI = 1.120–3.078). Vitamin-A rich fruits and vegetables consumption (p = 0.027) increased in intervention, as a result of sales of excess eggs. Enabling children to be owners of chickens together with nutrition education significantly increased chicken production and egg consumption. We recommend integration of child-owned poultry into ongoing malnutrition prevention activities particularly in resource-poor settings where undernutrition is high and animal source food intake is low. (Trial registration = NCT03355222). • Egg intake is very low among under two years age children of Halaba, South Ethiopia. • Enabling children to be owners of chickens coupled with nutrition promotion significantly increased chicken production and egg consumption sustainably. An added advantage of increased intake of Vitamin A-rich fruits and vegetables was observed from the sale of excess eggs. The intervention resulted in higher dietary diversity increasing the proportion of children who met the minimum dietary diversity cut off. • Nutrition-sensitive poultry intervention stressing child ownership is recommended to be integrated into ongoing malnutrition prevention programs particularly in countries like Ethiopia where the burden of undernutrition is high and intake of animal source foods is low.

Formative Research to Inform Market-Based Interventions to Increase Egg Purchase and Consumption in Tigray, Ethiopia.

Animal source foods (ASFs) have a demonstrated ability to improve child health yet are underutilized by many communities faced with malnutrition. Recognizing that improving knowledge about the benefits of consuming ASFs alone is not adequate to change behavior, the Studying Animal Food Markets in Rural Areas (SAFIRA) pilot project planned to test a market-based intervention to increasing the intake of ASFs by children 6-23 months in rural Tigray, Ethiopia. Our process of designing in-market behavior change strategies involved identifying the project's target ASF, cocreating and testing marketing interventions, and understanding barriers and enablers driving key retailer behaviors. Qualitative research methods including focus group discussions, key informant interviews, trials of improved practices, and transect walks were used throughout 2 rounds of formative research. The first round of formative research led the project to focus on eggs, and the second round resulted in an improved understanding of the Tigrayan local food markets and egg consumption. Consumers were receptive to nutrition messaging from trusted community members and consider eggs to be healthy and affordable relative to other ASFs. Despite a willingness on the part of egg retailers in Tigrayan markets to try new practices to market eggs to consumers, formative research revealed that retailers function primarily as aggregators, moving eggs toward urban markets, correcting a foundational assumption that households routinely purchase eggs at local markets. These findings demonstrate the importance of formative research to inform design-especially in the development of context-specific behavior change interventions situated within local marketplaces.

Biomarkers of Choline Metabolism in Women of Reproductive Age in Southern India

ObjectivesInadequate maternal choline intake during pregnancy has been associated with adverse pregnancy and child health outcomes – and has been identified as a potential risk factor for neural tube defects. However, there is limited data on biomarkers of choline metabolism in women of reproductive age (WRA), and few representative population-level data from India. The objective of this analysis was to examine biomarkers of choline metabolism and their correlates in WRA, as part of a population-based biomarker survey in Southern India.MethodsParticipants were WRA (15–40y; n = 980) who were not pregnant or lactating. Free choline, betaine, dimethylglycine, methionine, and trimethylamine N-oxide concentrations were evaluated via liquid chromatography tandem mass spectrometry. Linear regression models were used to examine sociodemographic (e.g., age, parity), dietary (e.g., frequency of animal source food intake), and anthropometric (e.g., body mass index [BMI], waist circumference, waist-hip ratio) correlates of biomarkers of choline metabolism, including betaine concentrations and betaine to choline ratio (B:C).ResultsBetaine concentrations (GM: 44.2 μmol/L [95% CI: 43.4, 45.0]) were 4-fold higher compared to free choline (11.1μmol/L [10.9, 11.2]) levels, with an average B:C of 4.0 [3.9, 4.1]. Increased age (β: −0.01 [SE: 0.002], P < 0.0001), multiparity (multiparous/primiparous vs. nulliparous, P < 0.0001), and increased frequency of animal source food intake (poultry, p = 0.004; red meat, p = 0.01), were associated with lower B:C. Higher BMI (betaine: β: −0.004 [SE: 0.002], p = 0.02; B:C: β: −0.02 [SE: 0.002], P < 0.0001), waist circumference (betaine: −0.002 [0.001], p = 0.02; B:C: −0.01 [0.001], P < 0.0001), and waist-hip ratio (betaine: −0.31 [0.15], p = 0.04; B:C: −1.02 [0.16], P < 0.0001), were also associated with lower betaine concentrations and B:C.ConclusionsIn this population, higher BMI and central adiposity were associated with lower betaine concentrations and B:C. Findings from this biomarker survey will inform prospective research on the role of choline biomarkers in the health and nutritional requirements of WRA.Funding SourcesCenters for Disease Control and Prevention (5U01DD001007), University of South Carolina Disability Research and Dissemination Center; Cornell DNS; NIH T32DK007158 (HMG); NIH 5T32HD087137 (AF).

Sustainability of Diets in Mexico: Diet Quality, Environmental Footprint, Diet Cost, and Sociodemographic Factors.

BackgroundLittle is known about the current intake of sustainable diets globally and specifically in middle-income countries, considering nutritional, environmental and economic factors.ObjectiveTo assess and characterize the sustainability of Mexican diets and their association with sociodemographic factors.DesignDietary data of 2,438 adults within the National Health and Nutrition Survey 2012 by integrating diet quality measured by the Healthy Eating Index (HEI-2015), diet cost, and four environmental indicators were analyzed: land use (LU), biodiversity loss (BDL), carbon footprint (CFP), and blue water footprint (BWFP). We defined healthier more sustainable diets (MSD) as those with HEI-2015 above the overall median, and diet cost and environmental indicators below the median. Logistic regression was used to evaluate the association of sociodemographic factors with MSD.ResultsMSD were consumed by 10.2% of adults (4% of urban and 22% of rural), who had lower intake of animal-source foods, unhealthy foods (refined grains, added sugar and fats, mixed processed dishes and sweetened beverages), fruits, and vegetables, and higher intake of whole grains than non-MSD subjects. Characteristics of MSD vs. non-MSD (urban; rural) were: HEI-2015 (62.6 vs. 51.9; 66.8 vs. 57.6), diet-cost (1.9 vs. 2.8; 1.9 vs. 2.5 USD), LU (3.3 vs. 6.6; 3.2 vs. 5.9 m2), BDL (105 vs. 780; 87 vs. 586 species × 10−10), BWFP (244 vs. 403; 244 vs. 391 L), and CFP (1.6 vs. 4.4; 1.6 vs. 3.7 kg CO2eq). Adults from rural vs. urban (OR 2.7; 95% CI: 1.7, 4.1), or from the South (OR 2.1; 95% CI: 1.1, 3.9), Center (OR 2.3; 95% CI: 1.3, 4.4) vs. the North were more likely to consume MSD, while adults with high vs. low socioeconomic status were less likely (OR 0.17; 95% CI: 0.09, 0.3).ConclusionsThe MSD is a realistic diet pattern mainly found in disadvantaged populations, but diet quality is still sub-optimal. Increased consumption of legumes, fruits, and vegetables, and a reduction in unhealthy foods, is required to improve nutritional quality of diets while ensuring their environmental sustainability.

Global, regional, and national consumption of animal-source foods between 1990 and 2018: findings from the Global Dietary Database

SummaryBackgroundDiet is a major modifiable risk factor for human health and overall consumption patterns affect planetary health. We aimed to quantify global, regional, and national consumption levels of animal-source foods (ASF) to inform intervention, surveillance, and policy priorities.MethodsIndividual-level dietary surveys across 185 countries conducted between 1990 and 2018 were identified, obtained, standardised, and assessed among children and adults, jointly stratified by age, sex, education level, and rural versus urban residence. We included 499 discrete surveys (91·2% nationally or subnationally representative) with data for ASF (unprocessed red meat, processed meat, eggs, seafood, milk, cheese, and yoghurt), comprising 3·8 million individuals from 134 countries representing 95·2% of the world population in 2018. We used Bayesian hierarchical models to account for differences in survey methods and representativeness, time trends, and input data and modelling uncertainty, with five-fold cross-validation.FindingsIn 2018, mean global intake per person of unprocessed red meat was 51 g/day (95% uncertainty interval [UI] 48–54; region-specific range 7–114 g/day); 17 countries (23·9% of the world's population) had mean intakes of at least one serving (100 g) per day. Global mean intake of processed meat was 17 g/day (95% UI 15–21 g/day; region-specific range 3–54 g/day); seafood, 28 g/day (27–30 g/day; 12–44 g/day); eggs, 21 g/day (18–24 g/day; 6–35 g/day); milk 88 g/day (84–93 g/day; 45–185 g/day); cheese, 8 g/day (8–10 g/day; 1–34 g/day); and yoghurt, 20 g/day (17–23 g/day; 7–84 g/day). Mean national intakes were at least one serving per day for processed meat (≥50 g/day) in countries representing 6·9% of the global population; for cheese (≥42 g/day) in 2·3%; for eggs (≥55 g/day) in 0·7%; for milk (≥245 g/day) in 0·3%; for seafood (≥100 g/day) in 0·8%; and for yoghurt (≥245 g/day) in less than 0·1%. Among the 25 most populous countries in 2018, total ASF intake was highest in Russia (5·8 servings per day), Germany (3·8 servings per day), and the UK (3·7 servings per day), and lowest in Tanzania (0·9 servings per day) and India (0·7 servings per day). Global and regional intakes of ASF were generally similar by sex. Compared with children, adults generally consumed more unprocessed red meat, seafood and cheese, and less milk; energy-adjusted intakes of other ASF were more similar. Globally, ASF intakes (servings per week) were higher among more-educated versus less-educated adults, with greatest global differences for milk (0·79), eggs (0·47), unprocessed red meat (0·42), cheese (0·28), seafood (0·28), yoghurt (0·22), and processed meat (0·21). This was also true for urban compared to rural areas, with largest global differences (servings per week) for unprocessed red meat (0·47), milk (0·38), and eggs (0·20). Between 1990 and 2018, global intakes (servings per week) increased for unprocessed red meat (1·20), eggs (1·18), milk (0·63), processed meat (0·50), seafood (0·44), and cheese (0·14).InterpretationOur estimates of ASF consumption identify populations with both lower and higher than optimal intakes. These estimates can inform the targeting of intervention, surveillance, and policy priorities relevant to both human and planetary health.FundingBill & Melinda Gates Foundation and American Heart Association.

Animal-source foods as a suitable complementary food for improved physical growth in 6 to 24-month-old children in low- and middle-income countries: a systematic review and meta-analysis of randomised controlled trials.

Although animal-source foods are suitable complementary food for child growth in low- and middle-income countries (LMICs), their efficacy is still under discussion. This systematic review and meta-analysis was done to investigate the suitability of animal-source foods intake on child physical growth in LMICs. A systematic literature search was done using electronic databases and scanning the reference list of included studies, previous meta-analysis and systematic reviews. Paper selection was based on the PICO (ST) criteria. Papers were selected if based on 6 to 24-month-old children, if they were randomised controlled trials evaluating the effect of complementary animal-based food supplementation of any natural origin, if reporting at least a measure of body size and published after 2000. The PRISMA guidelines for reporting systematic review was followed in the paper selection. Fourteen papers were included in the systematic review and eight were considered for the meta-analysis. Animal-based food supplementation resulted in a higher length-for-age LAZ and weight-for-age (WAZ) Z-scores compared with the control group with random effect size of 0·15 (95 % CI 0·02, 0·27) and 0·20 (95 % CI 0·03, 0·36), respectively. Results were confirmed after influence analyses, and publication bias resulted as negligible. An increased effect on LAZ and WAZ was observed when the food supplementation was based on egg with effect size of 0·31 (95 % CI = -0·03, 0·64) and 0·36 (95 % CI = -0·03, 0·75), respectively. Animal-source foods are a suitable complementary food to improve growth in 6 to 24-month-old children in LMICs.

Gender relations in livestock production and animal-source food acquisition and consumption among smallholders in rural Timor-Leste: A mixed-methods exploration

Among smallholders, gender relations shape how agricultural products are produced and how foods are acquired and consumed, which impacts food security and nutrition. In Timor-Leste, most rural households own multiple livestock species, yet intake of animal-source foods (ASF) is low and malnutrition high. This study explores how gender relations inform livestock production and ASF acquisition and consumption in four Timorese villages in Baucau and Viqueque districts. We examined women's empowerment within the relational sphere of gender relations and applied a qualitative-dominant mixed-methods design. We used ownership and decision-making data from the Abbreviated Women's Empowerment in Agriculture Index (n = 161 women, n = 106 men) and 24-hr ASF recalls (n = 161 mother-child pairs). Findings were complemented with those from 33 semi-structured interviews, mostly with women and/or their husbands, analyzed through the Gender Relations Framework. We found that most women and men reported joint livestock ownership and joint decision-making on production and income. However, interviews revealed that for many women, joint decisions meant requiring their husband's consent, without which they would not proceed with selling livestock or purchasing ASF. Women's unequal bargaining position was influenced by social norms on the gendered division of labor, and by men's role and framing as income generators. In a setting where rice security was a priority concern, ASF were considered non-essential and unaffordable. Mixed-methods are valuable to understand the contextual significance of decision-making processes, as only through qualitative methods did the limited agency of women to exercise their voice in shaping final decisions become apparent. In their design, nutrition-sensitive programmes could include men as important actors in financial decisions that might affect dietary composition.