Extra Meal Research Articles

Administration of a diabetes-specific formula can improve postprandial glycemic control and delay insulin use in gestational diabetes mellitus: a randomized controlled trial from two centers

Background and AimsThere have been limited studies on the application of a diabetes-specific formula in gestational diabetes mellitus (GDM), the role of which has not been well studied. We explored the effect of a diabetes-specific formula on blood glucose levels, insulin use and pregnancy outcomes in GDM patients. MethodsIn this randomized controlled study, 112 GDM patients were randomly assigned to the intervention group (56) and the control group (56). Both groups received individualized dietary counseling. The intervention group consumed a soy-protein-based, high-monounsaturated-fatty-acid, and multi-fiber diabetes-specific formula as milk replacement for breakfast and an extra meal after dinner. All participants were followed up every two weeks until delivery. The blood glucose levels, insulin use and pregnancy outcomes between the groups were compared. ResultsCompared to the control group, the intervention group had significantly lower 2h postprandial blood glucose levels after breakfast (5.84±0.56 vs. 6.15±0.44mmol/L, p=0.008), and exhibited higher postprandial time in range values (83.80% vs. 78.95%, p=0.045). The intervention group used insulin later (33 vs. 28 weeks, p=0.015) and for fewer days (36 vs 78 days, p=0.024), but no differences in the proportion, dose or frequency of insulin use between the groups. There were no significant differences in pregnancy outcomes between the groups. ConclusionsThe diabetes-specific formula significantly decreased postprandial blood glucose levels and improved postprandial glycemic control in GDM patients. Moreover, it delayed the initiation of insulin use and reduced the duration of insulin therapy. Our findings may offer a potential new approach for achieving better personalized blood glucose control in GDM patients. Registration number of Clinical TrialNCT03957603 (registered at ClinicalTrials.gov).

2287 Residents with dementia had an increase in BMI after the introduction of an extra meal in nursing homes in Norway

Abstract Introduction The past decade, many nursing homes in Norway have introduced an extra meal daily, with a hot lunch, and pushing dinner to later in the day. This initiative aims to reduce the long-time interval between breakfast and supper. This study examines how an extra meal affects the residents’ body mass index (BMI) at nursing homes in Norway. Research questions include how an extra meal affects BMI among residents in the dementia unit. Method We used a cross-sectional design to analyse data from residents over 65 years old in dementia care units. Both parametric and non-parametric statistical tests were used to evaluate changes in BMI. Results The results of the study show that the dementia unit experienced an increase in BMI following the introduction of an extra meal. At most, we saw a weight gain of up to 7 kg over two years among residents. Our study reveals that the introduction of an extra meal resulted in a slight increase in BMI among the residents with dementia, which does not correspond with previous studies indicating malnutrition among these residents. The dementia disease reduces functional abilities, and challenges related to mealtime behaviour, restlessness, and depression can lead to weight loss. The fact that our results show a slight increase in BMI at the dementia units may be related to these residents often being troubled with restlessness and not finding the peace to consume a full meal. By introducing an extra meal, the total food intake increases since residents still eat a little at each meal, and focusing more on accommodating each resident might have influenced the increase in BMI values. Conclusion The study indicates that the introduction of an extra meal has a positive effect on the BMI value of residents with dementia in nursing homes.

Quartermaking: method to create hospitality and inclusion

Problem statement: In 2002 Article 107 sets in motion a gradual reduction in the number of psychiatric beds in Belgium. An important moment, because it is the first acknowledgement in centuries that an admission to hospital may not always be the best choice. A transformation to community based mental health care is difficult to achieve in a community that is intolerant and stigmatizing. Loneliness and exclusion amplify mental health problems.
 Objective: Changing society to be more hospitable for people with severe mental ill health. The action is called “quartermaking” (Doortje Kal. ”kwartiermaken”). Social workers are not used to work with this group. Caregivers in psychiatry are not used to work in communities. A new function is created: social workers who have experience with people with psychotic symptoms: “neighbourhood oriented quartermaking”
 Target group: Quarter making is working on inclusion for people who feel excluded because of their mental ill health. Quarter makers support volunteers, citizens, in understanding the dynamics of psychosis. They try to create space and organize places that are not only accessible to the peer group of people with mental ill health. 
 Actions: “Hartelijke plekken” (warm places) is a quartermaking project. On a city map one can find locations of coffeebars, musea… where citizens have bought an extra coffee, extra meal, extra ticket… for people in need. Psychiatric institutions and Factteams are encouraged to organize outreach work in the community. Peergroup centers work by the principles of quartermaking and move away from segregation to inclusion. “Neighbourhood oriented quartermaking” is a new function and a method. Quarter makers are trained. Intervision is organized. I published two books on the subject. One is translated in English and is going to be published by Routledge in April 2023.
 Impact: For six years quartermaking is known as a method for inclusion in Flanders, particularly in the field of mental health. 
 A psychiatric institution organised a structural partnership with the local community based on a care hotline and consultation platform. The care hotline follows a rigorous, step-by-step plan and has given good results. 
 Also a quarterly meeting of hospital staff and local residents was set up. This consultation platform ultimately became a core group of about fifteen volunteers, represented by people living in the vicinity of the hospital and hospital staff, as well as local politicians and the local police. This work is very destigmatising. 
 7 cities are organizing “hartelijke plekken”. (about 76 places in one city) 
 
 16 quarter makers work in different cities in Flanders.
 The “Flemish group quartermaking” is touring in Flanders and is attended by caregivers, citizens, experts by experience… 
 The second series of train the trainer quartermaking has started. 
 Learning for the international audience: Community mental health care is best organized in cooperation with existing social work or even as support of social work. This is the best way to avoid community work based on a biomedical model. 
 Next steps: 
 Supporting more communities and institutions in Flanders. 
 Schoolcourses for quartermakers.

Sport Nutrition Practice and Performance of Short Distance Runners: The Case of Oromia Athletics Clubs

The study was aimed to assess the impact of sport nutrition practice on performance of sprinters of Oromia selected athletics club. The athlete's diet affects his or her performance directly. Competitive athletes must eat a balanced diet containing all four food groups, and eating a variety of foods within each group is essential. However, no studies conducted on the impact of nutrition on Oromia short distance runners. A cross-sectional research design was employed. Out of eight (N=8) athletics clubs Oromia athletics club, five (n=5) of them were selected as target population namely; Adama, Nekemte, Asella, Dukam and Laga-Tafo Laga Dadhi athletics clubs. The clubs were selected by using a simple random sampling technique. The total population of athletes in selected clubs was (N=175) and sampled athletes were 120 Adama (23), Nekemte, (24) Asella, Dukam (26) and Laga-Tafo-Laga Dadhi (24) athletics) were selected using a stratified sampling technique. While coaches (N=5) were selected using census sampling techniques. Data collection instrument such as questionnaire, document analysis, interviews and observation were used. Analysis was performed using SPSS 25.0 (SPSS Inc., Chicago, IL) software. Frequency percentage and Simple regression was used quantitative data. Qualitative analysis was used to supplement the quantitative analysis. The result of this study shows that inadequate sprinters nutritional practice affects sprinters performance at p< 0.05. The finding of this study reveals that the majority of sprinters confirmed that sprinters did not get balanced sprinters diet due to this the sprinters performance was poor. As a recommendation, Oromia athletics club should plan for sport nutrition education and allocate enough budgets. Sprinters better extra meal apart from their clubs.

Undernutrition and its associated factors among pregnant women attending antenatal care at public health facilities in pastoral communities of Afar Regional State, northeast Ethiopia

BackgroundMaternal malnutrition during pregnancy increases the risk of miscarriages and foetal deaths, pre-term delivery, and maternal mortality. However, limited studies have been conducted in Ethiopia that may not represent the problem among pregnant women in pastoral communities like the Afar region. Therefore, this study assessed the prevalence and associated factors of undernutrition among pregnant women attending antenatal care at public health facilities in pastoral communities of the Afar region, northeast Ethiopia.A facility-based cross-sectional study design was employed from 20 September to 5 October 2020. A sample of 387 pregnant women attending antenatal care clinics in randomly selected public health facilities was included. The collected data were checked, cleaned, and entered using Epi-data version 3.1 and exported into Stata version 14.0 for further analysis. Binary logistic regression analysis was used to measure the association between undernutrition and its predictors among pregnant women. Finally, the statistical significance level was declared using an adjusted odds ratio with its corresponding 95% confidence interval.The overall prevalence of undernutrition among pregnant women was found to be 30.9% [95% CI 26.5%, 35.8%]. Being illiterate, living in rural, women’s substance usage during pregnancy, not receiving counselling on a balanced diet, having chronic medical problems, not taking extra meals within 24 h, having food restrictions during this pregnancy, and being HIV-positive were the independent predictors of undernutrition.ConclusionThis study indicated that nearly a third of pregnant women were undernourished. The regional and national governments should give due attention to women residing in rural areas to get access to education for women in pastoral communities. The health care providers should strengthen the screening of women with medical problems and interventions that improve maternal health during pregnancy. Besides the provision of prenatal dietary counselling on a balanced diet, avoiding food restrictions and encouraging them to take extra meal during pregnancy are recommended to avoid undernutrition among pregnant women in pastoral communities.

Magnitude and associated factors of low birth weight among term newborns delivered in Addis Ababa public hospitals, Ethiopia, 2021

Only 14% of births had information on birth weight available at the time of birth in Ethiopia. Hence, previous studies underestimate the magnitude and associated factors of low birth weight (LBW). As a result, the goal of this study is to fill those gaps in the previous studies. An institution-based cross-sectional study was employed. Binary logistic regression was used to identify the associated factors. In this study, the magnitude of LBW was 13.06%. History of chronic medical illness (AOR = 3; 95% CI: (1.02, 9.17)), haemoglobin level during pregnancy (AOR = 0.23; 95% CI: (0.10, 0.50)), iron/folic acid supplementation (AOR = 0.27; 95% CI: (0.10, 0.72)) and extra meal during pregnancy (AOR = 3.2; 95% CI: (1.52, 7.00)) were significantly associated with LBW. The magnitude of LBW in this study was comparable to the Ethiopian Demographic and Health Survey (EDHS) report from 2016. It is better to intervene in those identified factors in order to reduce LBW. Impact Statement What is already known on this subject? Low birth weight (LBW) accounts for 60–80% of all neonatal deaths each year. In developing countries like Ethiopia, LBW is a major public health concern. Almost half of the world's infants are not weighed at birth, a figure that is especially high in sub-Saharan Africa including Ethiopia. What do the results of this study add? Only 14% of births had information on birth weight available at the time of birth in Ethiopia. Hence, previous studies underestimate the magnitude and associated factors of LBW. To meet the Sustainable Development Goals (SDGs)-2030 targets for neonatal and child mortality, sufficient evidence on the magnitude of LBW and associated factors must be important in order to contribute to the development of timely interventions. A history of chronic medical illness, haemoglobin level, iron/folic acid supplementation and extra meal during pregnancy was associated with LBW. What are the implications of these findings for clinical practice and/or further research? The findings of this study will be useful in developing better health policies to prevent LBW as well as interventions that can target the identified factors.

Eating behaviours changes during COVID-19 lockdown due to gender and residential disparities amongst university students

This study aimed to determine the changes in the eating behaviours of university students during the lockdown due to COVID-19. A total of 118 students were invited to fill an electronic questionnaire regarding eating behaviour before and after the onset of the lockdown. Participants significantly scored higher “before” than “during” the lockdown for the item “consuming unhealthy food”. Moreover, “eating snacks between meals”, “eating irregular meals” and “soft drinks consumption” items increased significantly during the lockdown. Male participants showed a significant decrease in eating unhealthy food compared to female participants, while other eating patterns have similar trend. During the lockdown, city residents have significant increases in the frequency of eating regular meals, eating snacks between meals, frequency of soft drinks consumption and consuming 3 meals daily. City-outsiders have significant increases in consuming snacks between meals and significant decrease in soft drinks consumption. Generally, diet intake, irregular, extra meal and snacks have increased during the lockdown. Variations with regard to eating behaviours were dependant on gender. City residents eating behaviour was different may be due to availability of food items and variations in social life.

Hemoglobin Level and Associated Factors among Pregnant Women in Rural Southwest Ethiopia.

Background Anemia is a situation in which the number and size of red blood cells, or the concentration of hemoglobin, fall below established cut-off values. Low hemoglobin level during pregnancy favors the alteration of placental angiogenesis and resulted in restricting the availability of nutrients to the fetus and consequently causing fetal growth retardation and low weight at birth. This study is aimed at assessing the hemoglobin level and associated factors among pregnant women in rural communities of Jimma zone, Southwest Ethiopia. Methods A community-based cross-sectional study design was carried out among 367 pregnant women from June 1 to 30, 2020. Systematic random sampling was used to select study subjects. Hemoglobin level was measured by using HemoCue HB 301. An interviewer-administered structured questionnaire was used to collect the data. Descriptive statistics were used to describe the study subjects. A multivariable linear regression model was employed after the linearity, normality, multicollinearity, and homoscedasticity assumptions were checked. The unstandardized beta (β) coefficient along with a 95% confidence interval was computed to estimate the association between explanatory and dependant variables. Statistical significance was declared at P value < 0.05. Results The mean (± SD) hemoglobin level of the respondents was 12.66 (±1.44) g/dl. The overall magnitude of anemia (hemoglobin level < 11 g/dl) among pregnant women was found to be 85 [23.16%, (95% CI: 18.3%-27.5%)]. Meal frequency [β = 0.40, (95% CI: 0.12, 0.69), P = 0.005], interpregnancy interval [β = 0.08, (95% CI: 0.02, 0.15), P = 0.007], mid-upper arm circumference measurement [β = 0.13, (95% CI: 0.07, 0.20), P ≤ 0.001], own fruits/vegetable [β = 0.55, (95% CI: 0.79, 0.31), P ≤ 0.001], coffee consumption [β = −1.00, (95% CI: -1.31, -0.68), P ≤ 0.001], and having history of still birth [β = −0.63, (95% CI: -1.06, -0.20), P = 0.004] were significantly associated with the hemoglobin level of pregnant women. Conclusions Anemia was identified to be a moderate public health problem in the study area. Therefore, nutritional counseling should focus on the necessity of at least one extra meal, promotion of fruits/vegetable consumption, and improving the nutritional status of the women during antenatal care follow-up. Moreover, early screening and management of women with a history of stillbirth for anemia are also essential.

“Muita Galinha, Pouco Ovo”

“Muita Galinha, Pouco Ovo”

Prevalence and associated factors of anemia among pregnant women attending antenatal care at Felegehiwot Referral Hospital, Bahirdar City: Institutional based cross- sectional study

IntroductionAnemia is a major public health problem in the world. Various studies in Africa have reported a high prevalence of anemia among pregnant women. Even though it is routine to screen pregnant women for anemia during antenatal care, studies are done to assess the prevalence and associated factors of anemia among repeated antenatal care visitors in the study area are limited. ObjectiveTo assess the prevalence of anemia and its associated factors among pregnant women who had repeated antenatal care visits at Felegehiwot Referral Hospital from September-December 2019. MethodsHospital-based cross-sectional study was conducted in Amhara regional state, Felegehiwot Referral Hospital, Bahirdar city, Ethiopia. A total of 286 pregnant women were selected using a systematic random sampling technique. Structured and pretested questionnaires were used to collect data. Multivariable logistic regression analysis was fitted to identify factors associated with anemia during pregnancy. Adjusted odds ratio (AOR) with the corresponding 95% confidence interval (CI) was used to show the strength of associations and variables with p-values of < 0.05 were considered as statistically significant. ResultsThe overall prevalence of anemia among pregnant women who had repeated antenatal care visits at Felegehiwot Referral Hospital was 20.9%. Hookworm infection {AOR = 22.9: (95% CI (2.89, 181.57)), rural residence [AOR = 6.26; (95% CI 1.90, 20.71)), history of malarial attack [AOR = 19.62; (95% CI 3.93. 97.8)), lack of green leafy vegetables [AOR = 7.94; (95% CI 1.1, 56.4)) and ≥ one extra meal in ≤ 4 days per week [AOR = 15.7; (95% CI 4.26, 58.06)) were significantly associated with anemia during pregnancy. Conclusion and recommendationIn the present study anemia among pregnant women is found to be a moderate public health problem. Multiple factors including multiparty and living in rural areas were associated with anemia during pregnancy. Therefore, preventive strategies to prevent anemia during pregnancy particularly for multiparous mothers and mothers living in rural areas are imperative.

Knowledge and attitude on complementary feeding practices among parents or main care givers of children aged less than sixmonths admitted to Paediatric wards at TH/Jaffna

Lack of knowledge is an important barrier of successful complementary feeding practice. Inadequate Information Education Communication (IEC) activities in hospitals and welfare clinics and attractiveness towards the ready to made commercial weaning foods are also contributors of failure. The objective of the study was to determine the knowledge, attitude and practices of mothers or primary care givers regarding complementary feeding. An Institutional based descriptive study conducted in all three paediatric wards of Teaching Hospital Jaffna over a period of one year. A pretested questionnaire was administered to ascertain their knowledge, attitude and practices regarding complementary feeding. Various believes affecting their practices, knowledge on hygienic practices and feeding during illnesses was also assessed. A total of 302 mothers and primary care givers of children aged upto six months admitted to paediatric wards were recruited and 51.3% (n=155) were aware that complementary feeding (CF) had to be introduced at the end of six months. A total of 66 (21.9%) mothers had already started CF but only half of them (10.3%) followed a medical advice. Poor milk flow was the main reason for early CF without medical advice. Around 90% were aware of good hygienic practices while feeding the child. Mothers who strongly agreed to give extra meal for 2 weeks when the child recovered from acute illness and continued it for six months from the child started to gain weight when there was growth faltering were 1.7%(n=5) and 3.3%(n=10) respectively. Nearly 37 (12.3%) mothers strongly agreed that the child’s nutritional needs increased during the illness whereas 54% (n=163) strongly disagreed. Overall 22.8% (n=69) had good knowledge, 74.2% had average knowledge and 3% had poor knowledge about CF. Literacy level, economic status, type of family, marital status of the mother and the ability to read and understand the facts given in CHDR were significantly related (p&lt;0.05) with the knowledge of mothers regarding complementary feeding. Awareness needs to be generated through IEC activities in hospitals and primary care level regarding the benefits and importance of timely complementary feeding.

Undernutrition and Associated Factors among Lactating Women: Community-Based Cross-Sectional Study in Moyale District, Borena Zone, Southern Ethiopia

Background. Undernutrition is one of the most widespread public health problems that affect both developed and developing countries. In Ethiopia, it is one of the factors leading to unacceptable high morbidity and mortality among women. However, little is documented on undernutrition among lactating women particularly in such a purely pastoral community. Therefore, this study was designed to assess prevalence of undernutrition and its associated factors among lactating women living in pastoral community of Moyale District, Borena Zone, Southern Ethiopia, 2018. Methods. A community-based cross-sectional study was conducted. Data were collected from a random sampled 545 lactating women using structured interviewer-administered questionnaire. Height and weight measurements of the study participants were also taken to compute body mass index. Data were entered in to Epi info version 7 and then exported to SPSS version 21 software for analysis. Descriptive statistics like frequency, mean, and percentage were computed to describe characteristics of the sample. Multivariable analysis was carried out, association between independent and dependent variables were measured using adjusted odds ratios, and its 95% confidence interval and P value below 0.05 were considered statistically significant. Results. This study showed that prevalence of undernutrition among lactating women was 17.7%. Dietary diversity (AOR = 2.49, 95% CI: 1.43–4.36), monthly income (AOR = 5.22, 95% CI: 1.40–19.40), extra meal taking (AOR = 2.76, 95% CI: 1.43–5.29, delivery place (AOR = 2.65, 95% CI: 1.24–5.65), and household food insecurity (AOR = 6.57, 95% CI: 3.50–12.34) were independent variables showing statistically significant association with undernutrition of lactating women. Conclusion and recommendations. The study revealed that magnitude of undernutrition among lactating women was high. Dietary diversity, monthly income, extra meal, delivery place, and household food insecurity were found to be predictor of undernutrition. Finally, we recommend that governmental and nongovernmental organizations should organize timely interventions targeting lactating women.

A cross sectional study: knowledge and practices about diarrheal diseases and ORS in the mothers of under five years children

Background: Diarrhoea is one of themajorkillerin under five years children worldwide. But accurate knowledge and practices about diarrheal diseases and use of ORS as an important tool in the mothers remain low. This cross sectional study was conducted to find out the level of knowledge and practices about diarrhoea and ORS in the mothers of under five children. Material and Method: This cross-sectional study was conducted in 8 randomly selected colonies of semi urban and urban area of Indore district in the year 2017. Mothers who had at least one child under five years of age with one episode of diarrhoeain the past were included in the study. Results: Most of the mothers (61.4%) knew right description for diarrhoea. But very few mother had knowledge about causes (23.6%) of diarrhoea. Verysmall number (26.81%) knew about all danger signs. Majority (91.8%) of mothers knew of ORS though only half 54.5% of them knew correct method of ORS preparation. 81.7% mothers had some knowledge about use of home based fluid. About one third of mothers knew about Zinc tablets (34.6%) and Rotavirus vaccine (37.3%). 44.7% of mother used ORS while 73.4% used home based fluids. Post diarrheal episode only 26.36% of mothers gave extra meal to the children. Conclusion: A strong association is found between knowledge and practices regarding diarrhoea management. Hence health education should be used as a tool to promote knowledge and good practices and reduce morbidity and mortality related to acute diarrhoea.

Nutritional status, dietary intake, and health-related quality of life in outpatients with COPD.

BackgroundMalnutrition is common in patients with COPD; however, little is known about its impacts on health-related quality of life (QoL) among patients with COPD. This study aimed to explore the nutritional status and dietary intake among outpatients with COPD in Vietnam and its possible associations with QoL.MethodsA cross-sectional study was carried out in COPD outpatients visiting the COPD management unit at the National Lung Hospital, Hanoi, Vietnam between May 2017 and July 2017. Consecutive outpatients with a confirmed diagnosis of COPD were recruited with written inform consent. The nutritional status of participants was assessed using Subjective Global Assessment (SGA), and dietary intake via a 24-hour recall interview. The St George Respiratory Questionnaire (SGRQ) for COPD was used to investigate the participants’ QoL. Sociodemographic and clinical data were extracted from hospital records.ResultsOf 168 COPD outpatients involved in the study, three-quarters (74.4%) were diagnosed as malnourished (SGA B/C) and 81.5% reported unintentional weight loss. Most of the patients did not meet their estimated energy and protein requirements (85.7% and 89.9%, respectively). Malnutrition was significantly associated with disease severity (P=0.039) and ratio of protein intake to estimated requirement (P=0.005). QoL was low for all levels of malnutrition or disease severity, with well-nourished participants and those with less disease severity having better QoL (P=0.006 and P<0.001, respectively). With an extra meal per day, the odds of having malnutrition decreased 5.6 times (P<0.05) and the total SGRQ reduced 3.61 scores (P<0.05) indicating a better QoL.ConclusionMalnutrition and weight loss are prevalent among COPD outpatients. Most of the patients had inadequate dietary intake and low QoL. Nutrition counselling including increasing the number of meals per day with a focus on energy- and protein-rich foods may help improving nutritional status and QoL of patients with COPD in Vietnam.

A health facility based case-control study on determinants of low birth weight in Dassie town, Northeast Ethiopia: the role of nutritional factors

BackgroundLow birth weight remains a major public health problem affecting developing countries. Evidence shows that low birth weight has long lasting negative health consequences through its contribution to stunting, mental impairment and non-communicable chronic diseases in later life. Thus, it is worth investigating the role of nutritional factors as determinants of low birth weight to suggest nutritional interventions to curb its negative health outcomes. This study aimed to investigate the determinants of low birth weight with main focus on the role of nutritional factors in Ethiopia.MethodsA facility-based case-control study was conducted from 3 February to 29 April, 2017. The data were collected using structured, pretested interviewer-administered questionnaire in all public health facilities of Dessie Town. Anthropometric measurements were made following standard procedures for both mothers and their newborns. Consecutive live births of < 2500 g and two succeeding normal weight babies were selected as cases and controls, respectively. Data were entered in to Epi-data software version 3.1, and exported to SPSS version 21, and analyzed using frequency, mean and percentage. Factors with p < 0.25 during bivariate analyses were entered into a multivariable logistic regression model to determine significant determinants of LBW. Statistical significance was considered at p < 0.05. Results were reported with odds ratio and 95% CI.ResultsMean ± SD of birth weight (g) was 2138 ± 207 for cases and 3145 ± 415 for controls. After adjusting for potential confounders using multivariable logistic regression analysis, the absence of iron and folate supplementation, receiving no nutritional counseling and consuming no additional meal, maternal undernutrition, maternal anemia and inadequate dietary diversity during the current pregnancy were found to be significant determinants of low birth weight in our study.ConclusionLack of nutritional counseling, absence of additional meal intake and iron and folate supplementation during pregnancy, and maternal undernutrition, maternal anemia and inadequate maternal dietary diversity were significant determinants of low birth weight. The importance of nutritional counseling, improving iron and folate supplementation during pregnancy, and nutritional status of pregnant women need to be strengthened to reduce the incidence of LBW in Ethiopia. In addition, behavioral change communications targeting pregnant women to improve women dietary diversity and their extra meal intake practice need to be enhanced in Ethiopia.

Diet Quality of Clients of a Soup Kitchen

This study discerned the impact of a meal donation on the total diet quality of clients of a soup kitchen. A total of 110 adults were selected randomly from a soup kitchen in Central Texas. Participants completed a demographic questionnaire, food frequency questionnaire and a list of meal donations. Diet quality and food servings of the original diet, meal donation and total dietary intake were estimated via both the HEI-2010 and 2015 U.S. Dietary Guidelines. The soup kitchen provided a daily meal, which included fruit, cheese, egg, and bagel, but did not contain any vegetables or meat. Mean diet quality for their original diet was modest (HEI-2010 = 55.25). The extra meal donated by the soup kitchen increased the diet quality of the total diet by 10%, and added fat-soluble vitamins and essential minerals. Health professionals should support these soup kitchens, by volunteering and providing advice to the directors about the importance of offering a variety of healthy foods.

Improving Nepal's Female Community Health Volunteers’ (FCHV) Infant and Young Child Feeding (IYCF) Exposure and Knowledge: Results from Implementation Research on the Suaahara Program

Nepal has a cadre of thousands of Female Community Health Volunteers (FCHVs), whose primary responsibility is to deliver health and nutrition services to rural households. Suaahara, a program which integrates family planning, nutrition, water, sanitation and hygiene and homestead food production, aimed to use FCHVs to deliver information to improve the nutritional status of women and children &lt;2 years. Using mixed methods, we examined the effectiveness of the Suaahara program on improving FCHVs’ IYCF knowledge in the context of a quasi‐experimental impact and process evaluation. We surveyed the FCHVs of 120 wards in 8 districts, 60 in Suaahara (S) and 60 in comparison (C) areas, at baseline (2012) and follow‐up (2014). We used difference–in‐difference (DID) regression analysis, with adjustment for clustering and socio‐demographic characteristics, to analyze changes in IYCF knowledge between groups and over time. At follow‐up we also conducted a qualitative assessment using focus group discussions and observations of the same 60 FCHVs in Suaahara areas. We found that Suaahara had a positive impact on FCHVs’ knowledge of optimal complementary feeding: more Suaahara FCHVs became aware of the appropriate age (6–8.9 months) for introducing meat (S: 31% to 88%; C: 60% to 76%; P: 0.02 DID). Suaahara also had a positive influence on FCHVs’ knowledge relating to breastfeeding (BF) and what advice to give when a mother states that her child &lt;6 months of age does not breastfeed well: many more FCHVs in Suaahara areas reported that they discussed attachment (S: 10% to 70% vs. 15% to 40%; P: 0.06 DID) and discussed positioning (S: 20% to 83% vs. 30% to 54%; P: 0.09 DID). Many more FCHVs in Suaahara areas knew that if the mother had insufficient milk, she should BF more often, BF on demand, or BF by emptying 1 breast and switching to the other (S: 36% to 61% vs. 37% to 40%; P: 0.04 DID). Suaahara also had a positive influence on FCHVs’ understanding on the importance of giving more food or an extra meal to help a child recover from illness (S: 34% to 73%; C: 73% to 59%; P: 0.01 DID). These findings were consistent with qualitative findings in which the majority of FCHVs noted that although they had previously received health or nutrition training, the Suaahara training involved more detailed information including how to assist mothers with attachment and positioning and clarification that all foods, including animal source foods, should be introduced once a child is 6 months of age. Our study highlights the feasibility of improving FCHVs’ knowledge and skills. They are not only readily able to absorb more nuanced IYCF information rather than simple messages, but also report routinely incorporating the skills acquired during training, such as helping new mothers with positioning and attachment for successful breastfeeding.Support or Funding InformationFunding provided by the United States Agency for International Development, through Suaahara.

Prevalence of Anemia and Associated Factors among Pregnant Women in North Western Zone of Tigray, Northern Ethiopia: A Cross-Sectional Study.

Background. Anemia affects the lives of more than 2 billion people globally, accounting for over 30% of the world's population. Anemia is a global public health problem occurring at all stages of the life cycle but the burden of the problem is higher in pregnant women particularly in developing countries. The aim of this study was to determine the prevalence of anemia and associated factors among pregnant women attending antenatal clinics in north western zone of Tigray, northern Ethiopia. Methods. A facility based cross-sectional study was employed. A systematic random sampling procedure was employed to select 714 pregnant women who were attending antenatal clinics in health facilities found in the study area from April to May 2014. The data was entered and analyzed using Epi-info version 3.5.1 and SPSS version 20.0 statistical software, respectively. Logistic regression analysis was used to identify factors associated with anemia among the study participants. All tests were two-sided and p value < 0.05 was considered statistically significant. Results. The overall prevalence of anemia (hemoglobin < 11 g/dL) among the pregnant women was 36.1% (95% CI = 32.7%–39.7%) of which 58.5% were mildly, 35.7% moderately, and 5.8% severely anemic. In pregnant women, rural residence (AOR = 1.75, 95% CI = 1.01–3.04), no education/being illiterate (AOR = 1.56, 95% CI = 1.03–2.37), absence of iron supplementation during pregnancy (AOR = 2.76, 95% CI = 1.92–5.37), and meal frequency of less than two times per day (AOR = 2.28, 95% CI = 1.06–4.91) were the independent predictors for increased anemia among the pregnant women. Conclusions. Anemia was found to be moderate public health problem in the study area. Residence, educational status, iron supplementation during pregnancy, and meal frequency per day were statistically associated with anemia among the pregnant women. Awareness creation and nutrition education on the importance of taking iron supplementation and nutritional counseling on consumption of extra meal and iron-rich foods during pregnancy are recommended to prevent anemia in the pregnant women.

Co-occurrence of fumonisins and T-2 toxins in milling maize fractions under industrial conditions

Latest studies indicate frequent co-contamination of food and feed supplies. The aim of this study was to investigate the natural co-occurrence of fumonisins (FB) and T-2 toxins in maize milling fraction obtained under industrial conditions. Both mycotoxins were identified in all tested samples and the FB level was higher than T-2 toxin. This fact was reflected in the content of mycotoxins in milling end products (extra maize meal, superior maize meal, and maize flour) and in hominy feed fractions. Results revealed that mycotoxins are concentrated in the hominy feed fraction, while the lowest level of mycotoxins was identified in the extra maize meal that contains coarse particle, have uniform fineness and low fat content.

Daily profiles of energy and nutrient intakes: are eating profiles changing over time?

BACKGROUND/OBJECTIVES:Associations between timing of eating occasions and their nutrient composition and health have been described in interventional and cross-sectional studies. However, data from longitudinal data are limited. This study examined 17-year changes in energy and macronutrient intake across eating occasions in the 1946 British birth cohort.SUBJECTS/METHODS:Data were obtained from the 1946 British birth cohort. Cohort members completed 5d-estimated diaries at ages 36 (1982), 43 (1989) and 53 years (1999). Data from subjects who provided dietary data at all three time points were analysed (n=1253). Repeated-measures analysis of variance with post hoc Bonferroni's adjustment was used to examine changes in energy and macronutrient at breakfast, mid-morning, lunch, mid-afternoon, evening and extra meal slots between 1982 and 1999. Analyses were stratified by sex and social class.RESULTS:The proportion of energy and macronutrients consumed at lunch declined between 1982 and 1999, which was compensated by a greater intake in the mid-afternoon and evening. This trend was seen across sex and social class, although women and adults with a non-manual occupation reported greater energy, carbohydrate and non-starch polysaccharide intake at breakfast in 1982 and had a higher protein intake in the evening compared with men and adults with a manual occupation.CONCLUSIONS:The timing of energy and nutrient intake has shifted slightly over time, with a greater proportion of intake later in the day. The association between the observed sex and occupational social class differences in eating profiles and chronic disease warrants investigation.