Community-based Nutrition Interventions Research Articles

The Effect of a Community-Based Complementary Feeding Education Program on the Nutritional Status of Infants in Polokwane Municipality, Limpopo Province, South Africa

Background: Appropriate complimentary feeding (CF) has the potential to improve growth and development in infants from 6 months to 2 years of age. This study’s aim was to assess the effect of a CF education program on the nutritional status of infants aged 3–12 months in the Polokwane Municipality. Methods: A longitudinal (non-randomized), quasi-experimental intervention study was conducted among 187 caregivers. The caregiver-infant pairs (CIPs) in the intervention group (n = 95) received CF education and a six-month telephone follow-up support. The CIPs in the control group (n = 94) received no intervention. We collected data at baseline and end line using structured questionnaires. Intervention effectiveness was evaluated by comparing mean changes in anthropometric measurements between intervention and control groups using difference-in-difference analysis. Per protocol, analysis was run. Results: The results show that the children in the intervention group gained more weight after the intervention, were taller, and the mid-upper arm circumference (MUAC) increased more than in the control group. At baseline, the weight of infants was 7.37 ± 0.83 and 6.69 ± 0.13 kg in the intervention and control. At end line, significant weight and length gain were observed in the intervention group (difference-in-difference (DID) = 1.82 kg, p < 0.001) and (DID = 7.78 cm, p < 0.01), respectively. The intervention group showed significant gain in MUAC of 1.68 cm (p = 0.047), with no noticeable effect on the head circumference at end line; DID (0.16 cm; p = 0.950). Conclusions: Community-based nutrition intervention programs can effectively improve the anthropometric nutritional status of children aged 3–12 months.

Facilitators and barriers to implementing complex community-based interventions for addressing acute malnutrition in low- and lower-middle income countries: A scoping review.

Background: Community-based nutrition interventions have been established as the standard of care for identifying and treating acute malnutrition among children 6-59 months in low- and lower-middle-income countries. However, limited research has examined the factors that influence the implementation of the community-based component of interventions that address severe acute malnutrition and moderate acute malnutrition among children. Aim: The objective of this review was to identify and describe the facilitators and barriers in implementing complex community-based nutrition interventions to address acute malnutrition among children in low- and lower-middle-income countries. Methods: This review used a systematic search strategy to identify existing peer-reviewed literature from three databases on complex community-based interventions (defined as including active surveillance, treatment, and education in community settings) to address severe acute malnutrition and moderate acute malnutrition in children. Results: In total, 1771 sources were retrieved from peer-reviewed databases, with 38 sources included in the review, covering 26 different interventions. Through an iterative deductive and inductive analysis approach, three main domains (household and interpersonal, sociocultural and geographical; operational and administrative) and eight mechanisms were classified, which were central to the successful implementation of complex community-based interventions to address acute child malnutrition. Conclusion: Overall, this review highlights the importance of addressing contextual and geographical challenges to support participant access and program operations. There is a need to critically examine program design and structure to promote intervention adherence and effectiveness. In addition, there is an opportunity to direct resources towards community health workers to facilitate long-term community trust and engagement.

The effectiveness of integrated community-based nutrition interventions in improving infant and young child feeding practices in Palestine: a randomized control trial

The effectiveness of integrated community-based nutrition interventions in improving infant and young child feeding practices in Palestine: a randomized control trial

Women empowerment through involvement in community-based health and nutrition interventions: Evidence from a qualitative study in India.

Women's empowerment is fundamental for realizing unalienable human rights and is vital to sustainable development outcomes. In India, the SWABHIMAAN intervention program was an integrated multi-sectoral strategy to improve girls' and women's nutrition before conception, during pregnancy, and after childbirth. This study assesses the role of self-help-group (SHGs) in improving the effectiveness of community health interventions and its impact on their self-empowerment. Qualitative data gathered through in-depth interviews (IDI) with community-based SHG members involved as Nutrition Friend (Poshan Sakhi-PS) in the SWABHIMAAN program in 2018 was used for analysis. Informed consent procedures were followed, and only those who voluntarily consented to the interview were interviewed. Twenty-five IDIs of purposively selected PSs in three states (Bihar, n = 9; Chhattisgarh, n = 8; and Odisha, n = 8) were analyzed thematically, according to Braun & Clarke (2006). NVivo 12 software was used for organizing and coding data. Three central themes that emerged to explain women's empowerment were (1) Barriers & redressal mechanisms adopted by PS, (2) PS as a change-maker, and (3) Changes in the life of PS. The study found that women perceive themselves as more empowered through involvement in the SWABHIMAN intervention program, besides improving the community's and their households' nutritional status. The results suggest that policies and programs on health and nutrition interventions need to involve peer women from the community, leading to more effective outcomes. Empowering women and closing gender gaps in employment/work are critical to achieving the 2030 Sustainable Development Goals.

Effect of a community-based nutrition intervention program about dietary immunonutrients during COVID-19 pandemic

Background: The global agitation caused by the coronavirus disease of 2019 has emerged the need to make today’s population more aware of immune health to protect against disease and illness. Thus, we conducted a community-based nutrition intervention program that puts forward immunonutrition in the limelight.Objectives: To study the effects of a community-based nutrition intervention program on (a) the significance of immunonutrients, (b) its rich sources and (c) its role to boost immunity against viral infections and diseases among a local community in Chennai city.Material and Methods: This study used the pretest-posttest design consisting of pre-and post-survey conducted from 400 active participants selected by the random sampling method. Pretest and posttest involved the assessment tools like the 4-point Likert scale and 7-item food frequency questionnaire. The employed intervention strategies include the distribution of informative pamphlets and offering individual nutrition counselling that highlights the benefits of consuming immunonutrients- rich foods. Results: The mean pretest score based on the perception of participants on the importance of immunonutrients was 2.022±0.856. Significant associations between age, education level, and socioeconomic status with the perception levels of the participants were observed (P<0.001). A mean difference of 1.1200±0.0603 was observed when compared with the posttest responses conducted three months after the intervention, showing a significant increase in their perception level (P<0.001). Additionally, the consumption of immunonutrients rich foods studied using the 7-item food frequency questionnaire, also increased.Conclusions: Our intervention program was found remarkably effective for improving the awareness and consumption level of locally available, cost-effective immune-boosting foods among the participants and their intention toward healthy eating behaviour. Thus, a community-based nutrition intervention program would help upgrade awareness about the synergism of nutrition, immunity, and infection.

Recipes for Health: A Community-Based Nutrition and Culinary Intervention.

Obesity is a major public health concern in the United States, especially since it has been associated with an increased incidence of multiple co-morbidities. Positive eating behavior modifications learned through nutrition education sessions are the main interventions proposed to target overweight and obesity. The aim of this study was to determine if nutrition education and hands-on cooking classes will result in improvement in eating habits and cooking skills tomanage chronic disease. Methods: A convenience sample of 21 participants were recruited from primary health clinics in Miami-Dade, Broward, and Palm Beach counties. A total of eight weekly virtual lessons were conducted, which included both a culinary and a nutrition education portion. At baseline and post-intervention, participants filled out a validated questionnaire with questions related to nutrition knowledge and behavior, fruit and vegetable consumption, and cooking skills. Weight was self-reported. Statistical analysis was conducted using IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States) and included descriptive statistics and a paired t-test to compare pre- and post-intervention data. Throughout the eight weeks, subject attendance ranged from 61-95%. Nineteen participants completed the post-intervention questionnaire. Results showed a statistically significant mean weight loss of 3.74 ±5.26 lbs (p=0.006) and a statistically significant mean BMI change of -0.66 ±0.86 (p=0.004) at post-intervention compared to baseline. In addition, subjects reported increased confidence in dietary habits and culinary skills post-intervention. Our results show exciting data in support of this project's objectives that a healthy cooking intervention can increase nutrition knowledge, increase confidence in healthy food choices, increase confidence in food preparation skills, and improve weight and BMI in participants.

Beneficiary and Local Stakeholder Participation in Community-Based Nutrition Interventions

ABSTRACTBeneficiary and local stakeholder participation is an essential element to the success of community-based nutrition interventions. We sought to define active participation and review the available evidence on beneficiary and local stakeholder participation in community-based nutrition interventions in Africa. From reviewing the literature, we provide a reflective assessment on the process and findings. Participation falls on a continuum of community involvement from passive (no real involvement) to empowerment and community ownership (full active involvement). However, we found a clear gap in the research on defining active participation and identifying what constitutes active participation on behalf of beneficiaries and local stakeholders. However, progress was found; evidence included the use of participatory methods to engage beneficiaries and local stakeholders in the assessment and design phase. Beneficiary and local stakeholder participation in delivering interventions has moved forward with quantitative measures from process evaluation and implementation science. Research has started on the extent of beneficiary engagement (as recipients) and connecting this to outcomes. Evaluation has benefited from qualitative inquiry with insights from participants on engagement itself, and the barriers and facilitators to engagement. Yet questions remain in each study phase around defining and quantifying active participation and in understanding the personal, social, and motivational elements of active participation. We offer a simple framework to stimulate thought and commitment to research on participation in community-based nutrition interventions.

Recipes for Health: A Community-Based Nutrition Intervention

Recipes for Health: A Community-Based Nutrition Intervention

Anaemia, anthropometric undernutrition and associated factors among mothers with children younger than 2years of age in the rural Daledistrict, southernEthiopia: A community-based study.

Mothers in resource‐poor settings are affected by different forms of undernutrition. However, the nutritional status of mothers in rural areas, particularly after delivery, is not well documented. This study assessed haemoglobin levels and body mass index (BMI) of mothers with children below 2 years of age in a rural district of southern Ethiopia. Factors associated with low haemoglobin levels and low BMI were analysed. A community‐based cross‐sectional study was conducted among 931 mother‐child pairs. Structured and standard questionnaires were used to collect data on background information, 24 h dietary recalls, and household food insecurity. Anthropometric and haemoglobin level assessments were performed. Anaemia was defined as haemoglobin levels below 12.0 g/dl, and anthropometric undernutrition was defined as a BMI <18.5 kg/m2. Multilevel linear regression was used to determine associations. Out of 931 mothers, 12.8% were anaemic and 12.6% had a BMI <18.5 kg/m2. The prevalence of minimum dietary diversity was 37.8%. The majority (78.5%) of the households were food insecure. Weight (β 0.02; 95% CI: 0.003−0.03), dietary diversity (β 0.08; 95% CI: 0.03−0.12) and secondary school attendance (β 0.34; 95% CI: 0.08−0.59) were associated with the mothers' haemoglobin level. Dietary diversity (β 0.08; 95% CI: 0.01−0.16) and household's wealth (β 0.6; 95% CI: 0.27−0.94) were associated with the mothers' BMI. Findings suggest that education and community‐based nutrition interventions must be strengthened to ensure household food security. Implementation of the national food‐based strategies should be considered, to improve the dietary diversity and nutritional status of mothers.

Community-based group physical activity and/or nutrition interventions to promote mobility in older adults: an umbrella review

BackgroundPhysical activity and a healthy diet are important in helping to maintain mobility with aging. This umbrella review aims to identify group-based physical activity and/or nutrition interventions for community-dwelling older adults that improve mobility-related outcomes.MethodsFive electronic databases (MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Sociological s) were searched from inception to December 2021. Eligibility criteria included systematic reviews exploring the effectiveness of physical activity or structured exercise, alone or combined with nutrition interventions on mobility-related outcomes (aerobic capacity, physical function, balance, falls/safety, muscle strength, health-related quality of life/wellbeing). Interventions must have been delivered in a group setting to community-dwelling older adults aged 55+. Two reviewers independently performed eligibility screening, critical appraisal (using AMSTAR 2) and data extraction. The GRADE approach was used to reflect the certainty of evidence based on the size of the effect within each mobility-related outcome category. Older adult/provider research partners informed data synthesis and results presentation.ResultsIn total, 62 systematic reviews (1 high, 21 moderate, 40 low/critically low quality) were identified; 53 included physical activity only, and nine included both physical activity and nutritional supplements. No reviews included nutrition interventions alone. Combined aerobic/resistance, general physical activity, and mind-body exercise all improved physical function and balance (moderate-high certainty). Aerobic/resistance training improved aerobic capacity (high certainty). Resistance training and general physical activity improved muscle strength (moderate certainty). Aerobic/resistance training and general physical activity are likely to reduce falls among older adults (moderate certainty). There was no evidence of benefit for nutritional supplementation with physical activity.ConclusionsGroup-based physical activity interventions that combine aerobic and resistance, general PA and mind-body exercise can improve measures of mobility in community-dwelling older adults. We found no reviews focused on nutrition only, highlighting a gap in the literature.

Factors Associated With the Nutritional Status of Infants and Young Children From Rural Honduras

ObjectivesMalnutrition is a major public health problem in children. Undernutrition and excessive weight at young ages are associated with life-long consequences. The main objective of this study was to characterize the sociodemographic and food insecurity factors associated with the nutritional status of rural children ages 6 to 24 months living in 27 rural communities in Intibucá, Honduras. MethodsThis secondary analysis of baseline data included a total of 402 children ages 6 to 24 months who were recruited to participate in a cluster-non-randomized trial of a community-based nutrition intervention. Data were collected in January 2021 through a survey that assessed food insecurity and dietary diversity, and measurement of weight and length by community health workers. The associations between explanatory variables (sociodemographic and food insecurity factors) and binary outcomes including stunting (length-for-age z-score < –2); underweight (weight-for-age z-score < –2); overweight (weight-for-length > 2); and wasting (weight-for-length < –2), were explored using generalized linear mixed models with community cluster as a random effect. ResultsParticipant’s mean age was of 15.54 ± 5.63 months. The prevalence of stunting, underweight, overweight, and wasting were 18.41%, 4.49%, 6.00%, and 1.00%, respectively. The 74.8% of households reported being food insecure. The odds of being stunted decreased by 15% in children with more diverse diets [AOR = 0.85; 95% CI (0.73–0.98)]; females had 71% lower odds of being underweight [AOR = 0.29; 95% CI (0.09–0.93)]. More time breastfeeding was associated with 10% lower odds of being overweight [AOR = 0.90; 95% CI (0.84–0.97)]. No factors were associated with wasting. ConclusionsContinued breastfeeding up to two years of age may be beneficial to avoid excessive weight in young children from rural areas in Honduras. Increased dietary diversity may help prevent stunting in the region. A community-based implementation research study is undergoing. This intervention includes the provision of vouchers to mothers of 6 to 24 month-old children. Vouchers are exchanged for locally produced eggs intended to be offered to the child daily. Further research characterizing complementary feeding practices and child gender in rural Honduras is needed. Funding SourcesThis study is funded by Shoulder to Shoulder Inc.

The role of communication, building relationships, and adaptability in non-profit organisational capacity for health promotion.

While the non-profit sector has an integral role in health promotion, it is unclear whether these organisations have the capacity for health promotion activities. This study aims to explore and describe capacity changes of a non-profit organisation during a 3-year community-based nutrition intervention. The non-profit organisation, with 3800 members throughout the state of Queensland, Australia, implemented a 3-year food literacy community-based intervention. A team of qualified nutritionists delivered the program in partnership with community-based volunteers. A separate aim of the intervention was to build capacity of the non-profit organisation for health promotion. A qualitative study was undertaken, using a social constructivist approach to explore organisational capacity changes longitudinally. All relevant participants including non-profit executive managers and nutritionists were included in the study (100% response rate). Data collection included semi-structured interviews (n = 17) at multiple intervention time points and document analysis of program newsletters (n = 21). Interview transcripts and documents were analysed separately using thematic and content analysis. Codes and categories between the two data sources were then compared and contrasted to build themes. Organisational capacity was predominantly influenced by four themes; ‘communicating’, ‘changing relationships’, ‘limited organisational learning’ and ‘adaptability and resistance to change’. Developing non-profit organisational health promotion capacity appears to require focusing on fostering communication processes and building positive relationships over time. Capacity changes of the non-profit organisation were not linear, fluctuating across various levels over time. Assessing non-profit organisational capacity to implement community interventions by describing adaptive capacity, may help researchers focus on the processes that influence capacity development.

Community-based physical activity and/or nutrition interventions to promote mobility in older adults: An umbrella review.

Background: Physical activity and a healthy diet are important in helping to maintain mobility and quality of life with aging. Delivery of physical activity and nutrition interventions in a group setting adds the benefits of social participation. Several published systematic reviews have explored a broad range of PA and/or nutrition interventions for older adults, making it challenging to bring together the best scientific evidence to inform program design and to inform multicomponent intervention development. This umbrella review aims to identify group-based physical activity and nutrition interventions for community-dwelling older adults that improve mobility. Methods: Five electronic databases (MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Sociological Abstracts) were searched from inception to April 28, 2020. Eligibility criteria included systematic reviews exploring the effectiveness of physical activity and/or nutrition interventions, delivered in a group setting for community-dwelling older adults. Two reviewers independently performed eligibility screening, critical appraisal (using AMSTAR 2) and data extraction. The GRADE approach was used to assess the overall certainty of the evidence. Older adult/provider research partners informed data synthesis and results presentation. Results: In total, 54 systematic reviews (1 high, 21 moderate, 32 low/critically low quality) were identified; 46 included physical activity only, and eight included both physical activity and nutritional supplements. No reviews included nutrition interventions alone. Combined aerobic/resistance, general physical activity, and mind-body exercise all improved physical function and balance (moderate-high certainty). Aerobic/resistance training improved aerobic capacity (high certainty). Resistance training and general physical activity improved muscle strength (moderate certainty). Aerobic/resistance training and general physical activity are likely to reduce falls among older adults (moderate certainty). There was no evidence of benefit for nutritional supplementation with physical activity. Conclusions: Multicomponent group-based physical activity interventions can improve measures of mobility in community-dwelling older adults. We found no reviews focused on nutrition only, highlighting a gap in the literature.

Comparison of Nutritional Status of Adolescent Girls in Nutrition Intervention and Non- Intervention Area

Background: Adolescence is growing period when requirements for all nutrients increase. Hence, it is essential to improve nutritional status through nutrition interventions. Addressing the nutritional needs of adolescents could be an important step towards breaking the vicious cycle of intergenerational malnutrition. Objective: To assess and compare nutritional status of adolescent school girls in nutritional intervention and non-intervention area. Methods: A cross-sectional analytic study was conducted at Laxmipur sadar upazila as nutrition intervention area &amp; neighboring Chatkhil upazila as non–nutrition intervention area. A total of 367 adolescent girls of age 10-19 years were selected purposively of them 177 and 190 were selected from intervention and non-intervention area respectively. Anthropometric data of the study subjects were collected by using standard techniques. Body mass index (BMI) and anemia were classified according to WHO cut off levels. Food intake pattern was observed by using seven days food frequency questionnaire (FFQ). Results: The mean age(±SD) years of adolescent girls was 14.29±0.97 (yrs) in intervention and 14.55±1.23 (yrs) in non-intervention area. .Among the adolescents, the proportion of under nutrition was significantly higher in the non-intervention area compare to intervention area (64% vs 47.5%, p&lt;0.001). In the intervention area about 46% girls had normal BMI where as in the non-intervention area only 27% girls had normal BMI. The percentage of overweight was similar in both the areas. Anemia was significantly higher in non-intervention area (p&lt;0.001). Highly significant association was found between father education and mother occupation with BMI (p=0.047) and (p=0.001) in intervention area. Strong significant association was found between education and occupation of mother with BMI (p=0.001) in non-intervention area. Conclusion: This study concludes that nutritional status was better in nutrition intervention area than non-intervention area so community-based nutrition intervention is effective for better nutritional status of adolescent girls.

Effect of community-based nutritional counseling intervention on children's eating habits.

Aim:This study aimed to assess the outcome of community-based nutritional counseling interventions on eating habits of rural-dwelling children.Methods:A group-randomized trial design was used in this study. A total of 108 rural-dwelling children from a community in the Enugu North agricultural zone, Enugu State, who participated in the study. The children were randomly assigned to 2 groups: the treatment group (n = 54) and the no-treatment control group (n = 54). The child eating behavior questionnaire was used for data collection. Parents of the participating children within each study group completed the child eating behavior questionnaire at 3 time points. The data collected were analyzed using an independent sample t test at a probability level of .05.Result:The outcome of the study showed that the children's eating habits in the treatment group improved positively following the community-based nutritional counseling intervention. The positive gain from exposure to the community-based nutritional counseling intervention program was sustained during follow-up for children in the treatment group compared with the no-treatment group.Conclusion:The community-based nutrition counseling intervention carried out among children in rural communities had a positive adjustment in children's eating habits. The intervention requires the constant collaboration of professional childhood educators, caregivers, home economists, school staff, healthcare specialists, families, and the children themselves. Furthermore, there is a need for future long-term evaluations of the effects of community-based nutritional counseling interventions on children's nutrition and eating habits.

Nutrition Knowledge and Dietary Intake in Pregnancy in Rural Malawi: Comparing Supplementary Nutrition Education and -Counseling With Routine Antenatal Care

Abstract Objectives To describe and compare changes in nutrition knowledge, perception and dietary habits between the intervention and control group and to evaluate the effects of nutrition knowledge on dietary diversification among the two study groups. Methods This study was a two armed randomised control trial. We recruited 257 women (gestational week 9–12) of which 195 (76%) were available for analyses: intervention 92; Control 103) the women were assessed at inclusion (baseine) and two weeks before the expected date of delivery (study end-point) for differences in nutrition knowledge, perception (using a structured questionnaire) and dietary habits (assessing dietary diversity score). We performed descriptive analyses to assess these differences between the two study groups. Three-level linear multilevel regression models with random intercept and random effect of time on participant at level 1 and village level 2 were used to expore the association between nutrition knowledge and dietary habits Results Our results show that both nutrition knowledge and dietary diversity improved in both study groups, but the improvement were significantly higher in the intervention group at study-end point. Increase in nutrition knowledge was associated with improved dietary diversity only among women in the intervention group. Moreover, women in the intervention group improved their nutrition perception and behaviour. Conclusions Our results provide evidence that poor nutrition knowledge is a barrier to consumption of healthy diet during pregnancy, thus supporting the relevance for augmenting nutrition education offered at ANC with supplementary and community-based nutrition interventions. We thus suggest that efforts should be made to strengthen the education component of ANC services as these are decentralized and locally accessible in Malawi and other low-income countries Funding Sources This project was funded by the University of Oslo, The Global Health and Vaccination Program (GLOBVAC) of the research council of Norway and by the Throne Holst foundation.

Diet and Exercise for FRAILty (DEFRAIL): protocol for a study to examine the effect of a novel community-based group exercise and nutritional intervention, designed to reverse frailty in older adults

IntroductionFrailty refers to a multifaceted age-related loss of physiological reserve. Aside from the immediate challenges it presents, it is also associated with various adverse health outcomes. Given our ageing population,...

Effect of nutritional education intervention to reduce anaemia during pregnancy in Dodoma City, Tanzania: protocol for a cluster randomized controlled trial.

The objective of this study is to assess the effectiveness of community-based nutritional intervention in reducing the burden of anaemia during pregnancy. Study design will be a cluster-randomized controlled trial. Study setting will be peri-urban wards of Dodoma City. The study will have two arms (the interventional and the control arms). A total of 400 pregnant women at second trimester will be recruited. The study will consist of four phases in four months for both the interventional and the control arms namely: baseline, first and second follow-up and end-line surveys. During each phase, participants from both arms will be measured for haemoglobin concentration and assessed for gestational age, dietary practices and knowledge about anaemia. Furthermore, all participants will receive iron and folic acid supplements, sulphadoxinepyrimethamine and mebendazole tablets throughout the entire period of the study. Nutritional education will be provided to the interventional arm only during each phase. Main outcomes of the study will be changes in haemoglobin concentration, nutritional knowledge and dietary practices at each phase after the baseline survey in the interventional compared to the control arm. Descriptive statistics will be used to describe the participants. Independent and paired t-tests will be performed to make comparisons between and within groups. P-values less than 0.05 will be considered statistically significant. Trial registration PACTR Registry, PACTR202007617885299. Registered on 28 May 2020.

Effectiveness of a Singaporean Community-Based Physical Activity and Nutrition Intervention: A Cluster Randomized Controlled Trial.

This study examined the effectiveness of a 6-month intervention to improve the health behaviors and outcomes among women aged 50 years and older. A sample of 580 (intervention n = 295; control n = 285) women was recruited from 26 recreational centers. Only the intervention group participated in the Singapore Physical Activity (PA) and Nutrition Study (SPANS), received health resources (calendar, recipe, and booklets) and motivational support from program ambassadors. The intervention group showed significant improvements in moderate-intensity PA, vigorous-intensity PA, and total PA (P < .001), increased intake frequency of fruit and vegetables (P = .049), a reduction in salt and sugary beverage intake (P ≤ .042), and reductions in systolic blood pressure (BP; -3.68 mm Hg), diastolic BP (-3.54 mm Hg), and percentage body fat (-2.13%; P ≤ .020) when compared with the control group. The SPANS appeared to be efficacious in improving PA and dietary behaviors, reducing BP and percentage body fat among Singaporean women.

A Community-Based School Nutrition Intervention Improves Diet Diversity and School Attendance in Palestinian Refugee Schoolchildren in Lebanon.

ABSTRACTBackgroundSchool feeding programs have the potential to supply children with healthy school food, alleviate short-term hunger, and improve children's educational outcomes.ObjectivesWe linked community kitchens to a subsidized school snack intervention and assessed the impact of this intervention on nutritional (diet diversity, hemoglobin, and anthropometry) and educational (attendance and academic performance) outcomes of Palestinian refugee schoolchildren.MethodsWe collected data from 1362 students (aged 5–15 y) and their parents at baseline, and at an 8-mo follow-up in 2 control and 2 intervention schools. We conducted linear, logistic, and negative binomial regression analyses to assess changes in outcomes of children participating in the intervention schools compared with children in control schools (intention-to-treat). We also assessed the impact of the snack intervention in children who participated ≥50% of the time (HP, high-participation) compared with those who participated <50% (LP, low-participation), or who only received nutrition education (control) (per protocol). All the analyses were adjusted for child age and gender, maternal education, household expenditure, and school-level clustering effect.ResultsAt endline, there were 648 children in the control group, and within the intervention group, 260 children were LP and 454 were HP. There was a significantly greater increase in overall diet diversity score and dairy consumption in the HP group compared with controls. Both LP and HP groups were more likely to consume proteins, and less likely to consume desserts than controls. Furthermore, the HP group had a significant increase in hemoglobin, and both LP and HP groups had a significant decrease in school absenteeism compared with controls.ConclusionsThis community-based school nutrition intervention had a positive impact on diet diversity, hemoglobin, and school attendance of children.