Improve Micronutrient Intake Research Articles

Anaemia among schoolchildren; A narrative review

Anaemia is a significant problem in the developing world, such as Sub-Saharan Africa (SSA), with the greatest burden of disease experienced in children. Although extensive research on anaemia has been done among the pre-schoolers, less is documented about schoolchildren. Thus, the current review intends to summarise recent data on the prevalence and risk factors of anaemia among schoolchildren aged 5-18 years across SSA for planning mitigating interventions. A review was conducted on published English articles in Sub-Saharan countries providing estimates on anaemia prevalence and risk factors using databases from PubMed and Google Scholar from January 2010 to April 2021. A total of 41 articles were identified for review. Based on eligibility criteria, 18 articles were included in the current review. The review showed that the prevalence of anaemia among schoolchildren ranged from 11% (Ethiopia) to 83% (Nigeria). Generally, infection (56%), eating less protein and vegetables (33%), age (22%) and sex (16%) of the child were the significant risk factors for anaemia among schoolchildren. The current review established that anaemia is directly associated with infection, less consumption of protein and vegetables, age and sex of the child. Effective public health strategies such as biofortification of food are needed to improve micronutrient intake among older children.

Micronutrient intakes in the Dutch diet: foods, fortified foods and supplements in a cross sectional study

PurposeThis study investigates intakes of risk micronutrients from non-fortified foods, fortified foods and food supplements in different age and gender sub-groups of the Dutch population.MethodsThis is a secondary analysis of the Dutch National Food Consumption Survey (DNFCS 2012–2016, N = 4313, 1–79 years). The proportion of the population with Habitual Intakes below the Estimated Average Requirement (EAR) and above the Upper Level (UL) for calcium, iron, zinc, vitamin A, vitamin B6, folate, vitamin D and vitamin E from non-fortified foods, fortified foods and total intake including food supplements was calculated using Statistical Program to Assess Dietary Exposure (SPADE).ResultsMore than 50% of the population had an intake below the EAR for calcium, iron, vitamin D and folate. Intakes were inadequate for certain sub-groups for the other vitamins and minerals. Adolescents and women were the population sub-groups most likely to have an intake below the EAR. For zinc, vitamin A and folic acid, more than 1% of toddlers exceeded the UL from the total intake. A negligible proportion exceeded the UL for the other vitamins and minerals.ConclusionInadequate intakes were found for several micronutrients in various population sub-groups despite an apparently well-nourished population. Intakes of zinc, folic acid and vitamin A from food supplements in toddlers and preschoolers should be investigated further to ensure they do not exceed recommended amounts. These results can be used to inform policy makers and to design nutritional interventions to improve micronutrient intakes in the Netherlands.

EFFECTS OF SOAKING, BOILING, AND TOASTING PROCESSING TECHNIQUES ON NUTRIENT COMPOSITION OF PIGEON PEA FLOURS AND ORGANOLEPTIC ATTRIBUTES OF THEIR PUDDINGS AND BALLS.

This study evaluated the effects of soaking, boiling and toasting processing techniques on nutrient andphytochemical composition of pigeon pea flour and the organoleptic properties of their puddings and balls.Pigeon pea and cowpea seeds which served as control were purchased, processed into flour, used for thepreparation of puddings and balls. The pigeon pea flour samples were subjected to proximate, vitamin andmineral analysis using standard methods. The data generated from organoleptic evaluation, proximate,vitamins and minerals analyses respectively, were subjected to statistical analysis with descriptive statisticsSPSS version 20. One way ANOVA was used to compare mean at p<0.05 probability level. Findings showthat the processing techniques significantly improved the nutrient properties of the pigeon pea flours.However, toasted pigeon pea flour had the highest folate (vitamin B9) content of 644.530mcg/100g andphosphorus content. Boiled pigeon pea flour had the highest iron content of 2.205mcg/100g.. Boiled pigeonpea flour had the highest protein and iron content and soaked pigeon pea flour had the highest moisture,crude fiber and Vitamin B3 contents. Hence, to improve micronutrient intake such as folate and phosphorus,toasting processing technique is highly recommended

Challenges and obstacles implementing evidence-based food fortification policy in a high-income country.

The World Health Organization (WHO) recognizes food fortification as one of the most cost-effective and beneficial public health measures available. Mass fortification policies and regulations can reduce health disparities, including in high-income countries, by improving micronutrient intake among food-insecure or high-risk populations without changing their diet or behavior. While international health organizations have traditionally prioritized technical assistance and grants to medium and low-income countries, it is important to recognize that micronutrient deficiencies may also pose an important yet underappreciated public health problem in many high-income countries. Nevertheless, some high-income countries, including Israel, have been slow to adopt fortification, due to a variety of scientific, technological, regulatory, and political barriers. Overcoming these barriers requires an exchange of knowledge and expertise among the all stakeholders to achieve cooperation and broad public acceptance within countries. Similarly, sharing the experience of countries where the matter is in play may help inform efforts to advance fortification globally. Here we share a perspective on progress and barriers to achieve this goal in Israel, to inform efforts made to avoid the regrettable waste of unrealized human potential from prevalent yet preventable nutrient deficiency conditions, in Israel and beyond.

The Potential of Condiments, Seasonings, and Bouillon Cubes to Deliver Essential Micronutrients in Asia: Scenario Analyses of Iodine and Iron Fortification.

Micronutrient deficiencies are still highly prevalent in Asia. Fortification of cooking aids, such as condiments (fish and soy sauces), seasonings, and bouillon cubes, may be an additional strategy to improve micronutrient intake. The current study evaluated the potential impact of iodine and iron fortification of cooking aids on micronutrient intake in Asian countries. A systematic literature search was performed to collect consumption data from different countries in Asia. Data from 18 studies in nine Asian countries were included. Scenario analyses were performed using different fortification levels based on regulations and literature. Mean intake of cooking aids ranged from 3.2-15.9 g/day for condiments and 0.4-11.7 g/day for seasonings and bouillon cubes. When replacing salt with iodized salt (30 µg of iodine/g of salt), iodine intake would increase by 13-119 µg/day for soy and fish sauces (9-80% of the Nutrient Reference Value (NRV)), and 5-83 µg/day for bouillon cubes and seasonings (4-56% of the NRV). Fortification with iron 0.5 mg/g food product for condiments or 1 mg/g food product for bouillon cubes and seasonings improved iron intake for soy and fish sauces by 1.6-8.0 mg/day (11-57% of the NRV), and for bouillon cubes and seasonings by 0.4-5.6 mg/day (3-40% of the NRV). These results indicate that, depending on the consumption pattern, fortification of cooking aids can be a suitable strategy to increase intake of micronutrients.

Assessment of dietary intakes and feeding practices in children aged 6-23 months in a town in the Northeast region of Argentina.

An adequate quantity and quality of complementary feeding is essential during the first 2 years of life. The objective of this study was to assess dietary intakes and feeding practices in children aged 6-23 months in a town in the Northeast region of Argentina. Descriptive, crosssectional study (second semester of 2019). Intakes from 24-hour dietary recall interviews conducted among caregivers of children aged 6-23 months were assessed. Data were compared to dietary reference intakes. Feeding practices were assessed as per the World Health Organization's indicators. A total of 138 children aged 6-23 months were assessed. The mean adequacy ratio of energy and vitamins A, D, and E was below 100% for all ages, whereas the protein adequacy for children aged 7-12 and 13-23 months was 142.8% and 168.1%, respectively. A remarkable number of cases had energy and vitamin A intakes below the estimated average requirement. In relation to feeding practice indicators, 50.8% of infants received a minimum acceptable diet. There is a high prevalence of an inadequate level of energy and critical nutrient intake during complementary feeding of the children aged 6-23 months included in the study. Nutritional interventions that promote feeding practices to improve micronutrient intake would be highly important for children's current and future health.

Maternal Diet, Infection, and Risk of Cord Blood Inflammation in the Bangladesh Projahnmo Pregnancy Cohort.

Inflammation may adversely affect early human brain development. We aimed to assess the role of maternal nutrition and infections on cord blood inflammation. In a pregnancy cohort in Sylhet, Bangladesh, we enrolled 251 consecutive pregnancies resulting in a term livebirth from July 2016–March 2017. Stillbirths, preterm births, and cases of neonatal encephalopathy were excluded. We prospectively collected data on maternal diet (food frequency questionnaire) and morbidity, and analyzed umbilical cord blood for interleukin (IL)-1α, IL-1β, IL-6, IL-8 and C-reactive protein. We determined associations between nutrition and infection exposures and cord cytokine elevation (≥75% vs. <75%) using logistic regression, adjusting for confounders. One-third of mothers were underweight (BMI < 18.5 kg/m2) at enrollment. Antenatal and intrapartum infections were observed among 4.8% and 15.9% of the sample, respectively. Low pregnancy intakes of B vitamins (B1, B2, B3, B6, B9 (folate)), fat-soluble vitamins (D, E), iron, zinc, and linoleic acid (lowest vs. middle tertile) were associated with higher risk of inflammation, particularly IL-8. There was a non-significant trend of increased risk of IL-8 and IL-6 elevation with history of ante-and intrapartum infections, respectively. In Bangladesh, improving micronutrient intake and preventing pregnancy infections are targets to reduce fetal systemic inflammation and associated adverse neurodevelopmental outcomes.

Prevalence of vitamin-mineral supplement use and associated factors among Canadians: results from the 2015 Canadian Community Health Survey.

Vitamin/mineral supplements are used for improving micronutrient intake and preventing deficiencies, particularly for shortfall nutrients. We assessed the prevalence of vitamin/mineral supplement use and associated factors among a representative sample of Canadians aged ≥1 years. We used nationally representative data from the 2015 Canadian Community Health Survey (CCHS)-Nutrition. The prevalence of vitamin/mineral supplement use containing shortfall nutrients (vitamins: A, C, D, B6, B12 and folate; minerals: calcium, magnesium, and zinc) was examined in this study. Logistic regression models were performed to determine factors associated with vitamin/mineral supplement use among Canadian children (1-18 years) and adults (>19 years). The overall prevalence of vitamin/mineral supplement use was 38% among men and 53% among women. Males aged 14-18 years had the lowest prevalence (26.5%; 95% confidence interval (CI) = 21.9-31.0) and females aged ≥71 years had the highest prevalence (67.8%; 95% CI = 64.1-71.5) of vitamin/mineral supplement use. Female gender, older age, higher education level, higher income, living in urban areas, having chronic conditions, having a normal body mass index (BMI), and being non-smoker were independent positive predictors of vitamin/mineral supplement use among adults. Independent positive predictors of vitamin/mineral supplement use among Canadian children included younger age, having a normal BMI, and being food secure. Novelty: The overall prevalence of vitamin/mineral supplement use among Canadian men and women was 38% and 53%, respectively. Sociodemographic and lifestyle variables were associated with vitamin/mineral supplement use, especially among Canadian adults.

Strategies to Increase Micronutrient Intakes Among Laotian Women Adhering to Traditional Postpartum Dietary Restrictions

ObjectivesCulturally determined restrictive postpartum diets are common in Lao PDR, placing lactating women and breastfed infants at high risk of micronutrient deficiencies. The objective of this analysis was to explore if fortified condiments and supplements would be suitable strategies to improve micronutrient intakes among women adhering to dietary restrictions. MethodsMother-child (aged 21 days - <18 months) dyads (n = 680) were enrolled into a prospective cohort study in Lao PDR. Women were interviewed about foods and condiments that were consumed or restricted in weekly (for the first four weeks) and monthly intervals postpartum, and if they would be willing to take supplements during this time if provided to them. Data on minimum dietary diversity for women (MDD-W) and household food insecurity was collected. ResultsMean ± SD child and maternal age was 4.3 ± 3.3 mo and 24.7 ± 6.3 yr respectively, 95% of mothers were breastfeeding and 34% of households were moderately to severely food insecure. Almost all women (97%) reported adhering to food restrictions after childbirth for a median (IQR) length of time of 1 (1, 3) month (range 1 week to 36 months). White rice was consumed universally postpartum, however other diverse foods were highly restricted and consumed by < 32% of women in the first month. MDD-W was achieved by 10.4% of women currently restricting their diet and 16.4% who had resumed/were consuming their normal diet (p = 0.04). Of the women interviewed about condiments (n = 480), 99%, 43% and 53% habitually consumed salt, fish sauce and soy sauce respectively. During the period of dietary restrictions, 54% and 38% of habitual consumers restricted fish and soy sauces respectively, while all women continued to consume salt. Of the women asked about supplement use (n = 415), 87% reported that they would take supplements during the period of dietary restrictions. ConclusionsPostpartum dietary restrictions are widespread among women in Lao PDR. These highly restrictive diets and low dietary diversity likely contribute to micronutrient deficiencies in mothers that may have important consequences for their breastfed infants through reduced micronutrient content of breastmilk, which requires further exploration. Salt fortification and supplements could be viable strategies to increase micronutrient intakes among women. Funding SourcesBill & Melinda Gates Foundation.

The association between carbohydrate quality index and nutrient adequacy in Iranian adults

Purpose This paper aims to evaluate the association between carbohydrate quality index (CQI) and nutrient adequacy in Iranian adults. Design/methodology/approach A total of 268 men and women with ages ranged from 18 to 70 years were evaluated in a cross-sectional study. The CQI was calculated by adding together the three components, namely, the ratio of solid to total carbohydrate, dietary fiber and glycemic index. The scores of three components were summed to calculate the CQI, with a higher score indicating a higher dietary carbohydrate quality. The odds ratios (ORs) of nutrient adequacy ratio (NAR), defined as the ratio of intake of a nutrient to the age- and gender-specific recommended dietary allowance, for the intake of energy and 10 nutrients across quartiles of the CQI were calculated by logistic regression analysis and expressed with 95% confidence intervals (CIs). Findings CQI ranged between 3 to 15 (mean ± SD: 9 ± 1.9). Being in top versus bottom quartile of the CQI was associated with a higher NAR of folic acid (OR: 3.20, 95% CI: 1.06–9.62; P-trend: &lt;0.001), vitamin A (OR: 3.66; 95% CI: 1.46–9.17; P-trend: &lt;0.001), magnesium (OR: 5.94; 95% CI; 1.71–20.53; P-trend: &lt;0.001), vitamin C (OR: 7.85; 95% CI; 2.99–20.59; P-trend: &lt;0.001). Originality/value A higher CQI was associated with greater micronutrient consumption adequacy in Iranian adults. The results suggest that increasing the consumption of total fiber and solid carbohydrates and decreasing the glycemic index of the diet and liquid carbohydrates can improve micronutrient intake adequacy.

The effect of nutritional education program on micronutrient intake in children with chronic liver disease: A clinical trial.

BACKGROUND:Chronic liver disease (CLD) is one of the most common chronic diseases in the world that threatens the health of children due to its many complications such as malnutrition and problems related to growth and development. Paying attention to nutrition and lifestyle modification in these children is of special importance. Therefore, the aim of this study was to determine the effect of nutritional education program on micronutrient intake in children with CLD.MATERIALS AND METHODS:The present study is a two-group randomized clinical trial that was performed by available sampling and referred to Ghaem Children's Hospital in Mashhad in 2016. In this study, 77 children with CLD who met the inclusion criteria (45 children in the intervention group and 32 children in the control group) were studied. The intervention included six workshops and training on proper diet, post-workshop phone calls, and regular face-to-face counseling sessions (first 4 weeks once a week and second 4 weeks once every 2 weeks) on adherence to the above diet. Patients in the control group received routine care. The collection tools in the study included demographic information questionnaires, body composition device, and diet plan form in the form of 24-h recall forms. Data analysis was performed using descriptive statistical tests and Mann–Whitney and Wilcoxon statistical tests using SPSS software version 16.RESULTS:Based on the results of the study, the mean age of the research units was 7.8 ± 3.6 years. The mean duration of CLD was 4.6 ± 1.8 years in the intervention group and 5.1 ± 1.9 years in the control group. The mean crude intake of most minerals after the intervention was significantly higher than before the intervention, except for the crude intake of retinol, thiamine, riboflavin, folate, Vitamin C, iodine, and Vitamin B12. Furthermore, in relation to the modified intake of micronutrients, the mean modified intake of most micronutrients after the intervention showed a significant increase compared to before, except for retinol, Vitamin D, niacin, B12, and iodine.CONCLUSION:Considering the effect of providing a nutritional education program to improve micronutrient intake in children with CLD and emphasizing the importance of adequate micronutrient intake in improving the health of children, special nutrition programs should be provided to these children with special attention. In this regard, nurses can play an important role in improving the quality of nutrition of children by providing nutrition programs with appropriate follow-up.

Determinants of adherence to micronutrient powder use among young children in Ethiopia.

In Ethiopia, home fortification of complementary foods with micronutrient powders (MNPs) was introduced in 2015 as a new approach to improve micronutrient intakes. The objective of this study was to assess factors associated with intake adherence and drivers for correct MNP use over time to inform scale‐up of MNP interventions. Mixed methods including questionnaires, interviews and focus group discussions were used. Participants, 1,185 children (6–11 months), received bimonthly 30 MNP sachets for 8 months, with instruction to consume 15 sachets/month, that is, a sachet every other day and maximum of one sachet per day. Adherence to distribution (if child receives ≥14 sachets/month) and adherence to instruction (if child receives exactly 15[±1] sachets/month) were assessed monthly by counting used sachets. Factors associated with adherence were examined using generalized estimating equations. Adherence fluctuated over time, an average of 58% adherence to distribution and 28% for adherence to instruction. Average MNP consumption was 79% out of the total sachets provided. Factors positively associated with adherence included ease of use (instruction), child liking MNP and support from community (distribution and instruction) and mother's age >25 years (distribution). Distance to health post, knowledge of correct use (OR = 0.74, 95% CI = 0.66–0.81), perceived negative effects (OR = 0.73, 95% CI = 0.54–0.99) and living in Southern Nations, Nationalities and People Region (OR = 0.59, 95% CI = 0.52–0.67) were inversely associated with adherence to distribution. Free MNP provision, trust in the government and field staff played a role in successful implementation. MNP is promising to be scaled‐up, by taking into account factors that positively and negatively determine adherence.

Using formative research to design context-specific animal source food and multiple micronutrient powder interventions to improve the consumption of micronutrients by infants and young children in Tanzania, Kenya, Bangladesh and Pakistan.

Optimal complementary feeding practices including consumption of multiple micronutrient powders (MNP) are recommended to improve micronutrient intake by infants and young children (IYC) 6–23 months. Formative research was used to design the behaviour change strategy to improve IYC micronutrient intake for the multicountry ENRICH project in rural impoverished areas of Tanzania, Kenya, Bangladesh and Pakistan. Employing a qualitative approach with multiple methods and guided by a social ecological framework, the study was conducted in several phases: data collection in the community, household and health facilities, initial analysis and household trials (HHT). Results found limited use of animal source foods (ASF) for feeding IYC and MNP largely unavailable. Although cost constrained access to ASF, potential more affordable context‐specific ASF options were identified in each setting. Caregivers associated ASF with many positive attributes for IYC, but barriers to feeding them included lack of caregiver time and knowledge of specific preparation techniques, and limited advice from health workers. Feeding practices were identified that used time‐efficient, specific preparations for eggs and other ASF, and demonstrated good initial acceptability and feasibility during HHT. Testing MNP in HHT found good initial feasibility and acceptability and provided an understanding of the facilitators and constraints for preparing, feeding and promoting MNP. In conclusion, formative research led to the design of context‐specific ASF and MNP complementary feeding promotion strategies to improve IYC consumption of micronutrients by identifying the practices, benefits, motivations and alternative actions to overcome the barriers in each setting.

Dietary Patterns in Underprivileged Indian Children and Adolescents with Type 1 Diabetes

Background: Children with diabetes are likely to have different food and nutrient composition due to dietary restrictions. Studies on dietary intakes in Indian underprivileged children with Type1 diabetes are scarce. Objective: To study dietary patterns and nutrient intakes of underprivileged children and adolescents with type1 diabetes in comparison with their healthy siblings. Methods: Cross-sectional study, diet assessed by 24-h recall on 3-non-consecutive days in 120 children with type1 diabetes (11.2 ± 3.8 yrs) and 65-age-gender matched healthy siblings. Dietary patterns determined by cluster analysis. Nutrient composition was compared by one-way ANOVA. Results: Children with diabetes belonged to middle/lower economic class. Mean HbA1C of children with diabetes was 9.7 ± 2.0% with higher intakes of whole cereals, milk, fruits, vegetables and lower intakes of refined cereals, pulses, animal products than healthy siblings (P &lt;0.05). Four diet patterns were characterized on the basis of major foods: i) wheat, ii) millets, iii) rice and pulse and iv) milk and fruits. Though patterns were similar in both groups, significantly higher intakes of vitamin C (35 ± 23 vs. 24.7 ± 16.3 mg/d), zinc (5.6 ± 2 vs. 4.5 ± 2.3 mg/d), thiamin (812 ± 383 vs. 570 ± 254 μg/d), riboflavin (782 ± 341 vs. 352 ± 182 μg/d) and calcium (673 ± 272 vs. 461 ± 253 mg/d) noted in children with diabetes. Total energy, protein and carbohydrate intakes were comparable; fat consumption was significantly lower amongst children with diabetes, though above recommended daily allowance (RDA) 41.6 ± 14.1 gm vs. 47.4 ± 18.9 gm, P=0.029. Conclusion: Underprivileged children with diabetes and siblings had similar dietary patterns; children with diabetes consumed healthier diet than siblings, still glycemic control was not optimum. Dietary interventions are needed to improve micronutrient intake and reduce fat intake in underprivileged children with type1 diabetes to improve their glycemic control.

Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age.

Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age.

The role of fortified foods and nutritional supplements in the diets of older Irish adults

AbstractLow intakes and suboptimal status of vitamin D, riboflavin, vitamin B12, folate and calcium have been reported in older adults across Europe. Dietary strategies to improve micronutrient intakes and status could include food fortification (mandatory or voluntary) and/or the use of nutritional supplements. This study aims to examine the impact of fortified food consumption and nutritional supplement use on nutrient intakes and nutritional status of vitamin D, riboflavin, vitamin B12, dietary folate equivalents (DFE) and calcium in older Irish adults.Analyses were based on the National Adult Nutrition Survey (NANS) (2008–2010). A 4 day semi-weighed food record was used to collect food and beverage intake data (including nutritional supplement use) from a nationally representative sample of 1500 adults (226 older adults (≥ 65y)). Blood samples (n 1126 (n 145 ≥ 65y)) were collected, processed and analysed using standard operating procedures. Nutrient intakes were estimated using WISP© based on UK and Irish food composition data. Fortified foods were identified as those that had one or more micronutrients added in the ingredient list and a nutritional supplement was defined as a supplement containing vitamins and/or minerals (i.e. excludes herbal/non-nutritional supplements). A fortified food consumer or nutritional supplement user was defined as a participant who consumed a fortified food or took a nutritional supplement at any time over the 4-day recording period. Usual intakes of micronutrients were calculated via the NCI-method using SAS© Enterprise Guide and analyses of biomarker data were carried out using SPSS©.The consumption of fortified foods and/or use of nutritional supplements increased mean intakes of vitamin D (3.6 to 6.9μg/d), riboflavin (1.6 to 2.3mg/d), vitamin B12 (4.5 to 6.0μg/d), DFE (228 to 408μg/d) and calcium (784 to 947mg/d) in older Irish adults and reduced the prevalence of inadequate intakes of these micronutrients by up to 40%. Furthermore, consumers of fortified foods and/or nutritional supplements had improved biomarker status and reduced prevalence of low/deficient status for vitamin D (62 vs 16%), riboflavin (65 vs 11%), vitamin B12 (8 vs 0%) and folate (serum folate:18 vs 0%; red blood cell folate: 0% across all groups) when compared to non-consumers.This study has shown that fortified foods and/or nutritional supplements represent an opportunity to improve intakes and status of key micronutrients in older adults. The data presented in this study will serve to inform the development and implementation of updated dietary recommendations for older adults in Ireland.

Exploring agrobiodiversity for nutrition: Household on-farm agrobiodiversity is associated with improved quality of diet of young children in Vihiga, Kenya.

Due to their limited access to the external productive inputs and the dependency on rain-fed agricultural production, small scale farmers in sub-Saharan Africa have continued to face undernutrition despite the significant advancements in agriculture. They however often live in areas endowed with high agrobiodiversity which could contribute, if explored, to improved diets and nutrition. Few studies have linked the contribution of agrobiodiversity to the micronutrient adequacy of the diets of young children among smallholder farmers. The study explored this relationship and contributes to the growing body of literature linking agrobiodiversity to nutrition of young children. Two cross-sectional surveys were conducted as part of baseline assessment for an intervention study, one in the lean and a second in the plenty season in Vihiga county, Kenya. Household level interviews were administered to 634 households with children 12–23 months. Agrobiodiversity was defined as the number of crop species cultivated or harvested from the wild and the number of livestock maintained by the household across two agricultural seasons. Dietary data were collected using two-non-consecutive quantitative 24-hour recalls and analyzed using Lucille software. Diet quality was assessed using dietary diversity score based on seven food groups and mean probability of micronutrient adequacy computed for eleven micronutrients. A total of 80 species were maintained or harvested from the wild by the households. Mean household species richness was 9.9 ± 4.3. One in every four children did not meet the minimum dietary diversity score. The average mean probability of micronutrient adequacy was 68.11 ± 16.08 in plenty season compared to 56.37± 19.5% in the lean season. Iron, zinc and calcium were most limiting micronutrients in the diet, with less than 30% average probability of adequacy in both seasons. Household agrobiodiversity was positively associated with both dietary diversity score (r = 0.09, p = 0.029) and micronutrient adequacy (r = 0.15, p<0.000) in the pooled sample. One unit increase in species diversity was associated with 12.7% improvement in micronutrient adequacy. Despite the rich agrobiodiversity in the study area the diets were low in diversity and there is an unrealized opportunity to improve micronutrient intake through greater promotion and consumption of locally available agrobiodiversity.

Scaling-Up the Provision of Fortified Foods in Public Programs to Improve Micronutrient Intakes in Low-Income Populations (P10-034-19)

ObjectivesMicronutrient deficiencies adversely affect women and children, especially from low-income populations. The human costs are astronomical in terms of loss of energy, illness, reduced cognition and IQ, and loss in productivity. The objective was to assess whether table salt double fortified with iodine and iron (DFS), provided through a food security program, would increase intake of those nutrients in the target population. MethodsSubsidized DFS was supplied through the Public Distribution System (PDS) to address widely prevalent iron deficiency (51% in women, 64% in children) in Uttar Pradesh, India. Salt fortification levels were as per the Food Safety and Standards Authority of India (Iodine minimum 15 mg/kg, Iron 850–1100 mg/kg) to provide 100% DRI of Iodine and 30% DRI of iron for women in reproductive age group. Fortification regulations for labeling the salt packets were followed. The intervention reached 15 million people, with ∼4000 Tons of DFS every month for a whole year, without interruption, ensuring the full household table salt requirements. We assessed coverage and utilization of DFS through monthly exit survey at distribution shops selected by random sampling, followed by household visits in the shops catchment area. Between August to December 2018, data was collected from 2000 households every month. ResultsHigh purchase rate of DFS from the PDS shops (>90%) resulted from the ‘bundling’ of subsidized DFS with other food commodities. However, more than 80% of beneficiaries surveyed were unaware of the health benefits of DFS. Among those who purchased DFS, 51% reported regular use in daily cooking at the end of one year. Major reasons for non-regular use were: DFS giving a slightly dark appearance to cooked food (no difference in taste reported), pre-mix (coated iron) particles visible in the salt (perceived as impurities), and community preference for a specific popular brand. ConclusionsFood security programs provide a readily available platform to accelerate the scale-up of fortified food products among vulnerable and low-income populations. However, awareness of micronutrient deficiencies and a favorable attitude are prerequisites for uptake and compliance. Funding Sources1.Tata Trusts - The India Nutrition Initiative 2.Global Alliance for Improved Nutrition, Geneva (with support from the Bill and Melinda Gates Foundation).

Nutrient Intake and Adequacy Among Children 12–18 Months of Age in the Urban Slums of Mumbai, India (P11-093-19)

Objectivesa) To examine the mean nutrient intake among young children 12–18 months of age in urban slums of Mumbai, b) to determine the adequacy of micronutrient intake in their diet as per the National Institute of Nutrition (NIN) recommendations for optimum growth and development, and c) to determine if there is a difference in the nutrient intake of those randomized vs not randomized to the trial involving feeding of iron- and zinc-biofortified pearl millet complementary foods. MethodsA total of 407 children were screened of which dietary data was available for 359 children. Of the total randomized (n = 223), dietary data was available for 216 children who were randomized to one of the two study arms (Arm 1: n = 107, Arm 2: n = 109). A 24-hour dietary recall was performed, and nutrient intake was calculated using CS dietary software using the NIN food composition tables. ResultsThe average age of children was 14.81 months; 51% were males and 49% females. Majority of the children (81.64%) breastfed the previous day. The mean intake per day of calories, protein, iron, and zinc from complementary foods was found to be 598 kcal, 19.9 g, 3.25 mg, and 1.85 mg, respectively. On average, complementary feeding contributed to 89.6% of RDA for energy, 82.4% of calcium, 57.9% of iron, 58.8% of zinc, 51.9% vitamin A, 7.2% of vitamin B12, and 83.3% of dietary folate. All children had adequate caloric and protein intake. However, > 90% of children consumed inadequate iron, zinc, and folate according to the nutrient density of the complementary food, and > 50% of children consumed inadequate vitamin A and calcium. Overall, children randomized to the intervention were found to have a significantly higher intake of calories, protein, folate, and zinc. ConclusionsMajority of children living in the urban slums of Mumbai consumed diet inadequate for most micronutrients. Our findings confirm the suitability of this population for interventions aiming to improve micronutrient intake Funding SourcesHarvestPlus.

A Randomized Controlled Pilot Study to Assess Effects of a Daily Pistachio (Pistacia Vera) Afternoon Snack on Next-Meal Energy Intake, Satiety, and Anthropometry in French Women.

Including nuts in the diet improves appetite control and does not lead to weight gain. However, for pistachios, evidence from randomized intervention studies is limited and there are no data on the effect of pistachios on satiety. The objective of this study was to assess the effect of daily consumption of pistachios as an afternoon snack on satiety, self-reported energy, self-reported nutrient intake, body weight, and body composition. This randomized controlled pilot study included two parallel groups of 30 healthy French women, in a free-living setting. For four weeks, groups were instructed to consume either 56 g (1318 kJ) of pistachios or 56 g of isoenergetic/equiprotein savory biscuits as an afternoon snack. Evening energy intake, changes in anthropometric measures, and daily intake of energy and selected nutrients were assessed. Visual analogue scales (VAS) were used to rate hunger, fullness, desire to eat, and prospective consumption. Satiety effects were not different between groups, as assessed by evening energy intake or VAS scores. Consuming pistachios or biscuits had no impact on body weight. Thiamin, vitamin B6, copper, and potassium intakes were significantly higher in the pistachio group. Consuming pistachios or biscuits as an afternoon snack resulted in similar post-snack food intake and subjective feelings of satiety. A daily pistachio snack for a month did not affect body weight or composition but it did improve micronutrient intake.