Nutrition Program Research Articles

Prevalence and Implementation Characteristics of Weekend Food Assistance Programs in U.S. Schools

IntroductionAmid national efforts to align priorities for nutrition and food assistance programs, little is known about the implementation of community-led efforts for children. This study aimed to estimate U.S. public school participation in weekend backpack programs (WBPs), to document program structure, and to consider characteristics of programs with more nutritious food offerings. MethodsThe prevalence of WBP participation in 2022 was estimated using a state-stratified, random sample of n=413 public schools. Administrators from WBPs at 49 schools completed measures of implementation characteristics and nutritional quality of foods offered. In 2022-2023, using a multivariable-adjusted linear regression model, the authors explored the association between hypothesized implementation characteristics and Healthy Eating Index (HEI) 2015 scores of foods provided. ResultsHalf of public schools (53.7%, 95% CI: 46.8%, 60.7%) in the national sample reported participating in WBPs. Many WBPs in the subsample were affiliated with anti-hunger organizations (41%), led by school counselors and volunteers (55%), and funded by grants (51%). WBPs spent an average of $0.56 (sd=$0.36) per item. Foods provided averaged an HEI-2015 score of 58.4 (sd=12.3), similar to children's average diets. About half of WBPs (41%) reported accessing nutrition resources. ConclusionsDespite the decentralized structure and absence of dedicated funding mechanisms, WBPs were common in our national sample of schools, suggesting widespread perceptions of unmet food needs and extensive efforts from community members to mitigate weekend hunger. Further research on food procurement methods and program impacts on child nutrition outcomes is needed to advance national priorities for nutrition and food security.

Traditional Korean diet high in one-carbon nutrients increases global DNA methylation: implication for epigenetic diet.

DNA methylation is a major epigenetic phenomenon through which diet affects health and disease. This study aimed to determine the epigenetic influence of the traditional Korean diet (K-diet) on global DNA methylation via one-carbon metabolism. A crossover study was conducted on 52 women. Two diets, a K-diet, high in plant foods and low in calories and animal fat, and a control diet, similar to the diet currently consumed in Korea, were provided to all subjects alternately for 4weeks with a 4-week washout period. Clinical parameters were measured before and after each dietary intervention. Nutrient intake was calculated by using a computer-aided nutritional analysis program. One-carbon metabolites in the serum and global DNA methylation in peripheral mononuclear cells were determined using ultra-performance liquid chromatography-tandem mass spectrometry. The K-diet group consumed more folate (669.9 ± 6.7µg vs. 502.7 ± 3.0, p < 0.001), B6, B12, serine, and choline, and less methionine (992.6 ± 63 vs. 1048.3mg ± 34.1, p < 0.0001) than the control group did. In the K-diet group, the increment of plasma 5-methyltetrahydrofolate (0.08µg/mL ± 0.11 vs 0.02 ± 0.10, p < 0.009) and decrement of L-homocysteine (-70.7 ± 85.0 vs -39.3 ± 69.4, p < 0.0168) were greater than those of the control group. Global DNA methylation was significantly increased in the K-diet group (6.70 ± 3.02% to 9.45 ± 3.69, p < 0.0001) but not in the control group. A K-diet high in one-carbon nutrients can enhance the global DNA methylation status, suggesting an epigenetic mechanism by which the K-diet conveys health effects. Trial registration Korean Clinical Trial Registry (trial number: KCT0005340, 24/08/2020, retrospectively registered).

A Novel Summer Camp Integrating Physical, Psychological, and Educational Health in Youth: The THINK Program.

Numerous youth summer programs focus upon physical fitness, nutritional health, psychological well-being, or education. Few, however, have integrated all of these elements into a single program. The Translational Health in Nutrition and Kinesiology (THINK) program provides an integrative nutrition and exercise science curriculum that is interfaced with social emotional learning (SEL) and STEM education to enhance healthy behaviors in youth. The purpose of this study was to determine whether the THINK program could improve physical fitness, nutrition habits, SEL, and STEM education in a 6-week summer program covering a 3-year period. Participants from South Miami were enrolled in THINK (n = 108, 58 males, 50 females, 12.03 + 0.56 years). Physical fitness assessments, the Positive Youth Development Inventory (PYDI), the Students' Attitude Towards STEM Survey, and the Adolescent Food Habits Checklist (ADFH) were recorded at baseline and post-testing. Means and standard error values were evaluated for all dependent variables. Paired samples t-tests (SPSS version 27) were used to determine changes. Improvements in cardiorespiratory fitness (p < 0.001), power (p < 0.006), flexibility (p < 0.001), agility (p < 0.001), muscular endurance (p < 0.001), lean body mass (p < 0.001), ADFH (p < 0.001), and PYDI (p = 0.038) were found. An integrative summer fitness program can result in improvements in physical fitness, nutrition habits, and SEL in as little as six weeks.

Prevalence of Childhood Obesity and Overweight Among 6-12 Years of Children in Lucknow City and Its Association with Socio-Demographic Factors

Childhood obesity has reached pandemic levels in India. It is a significant contributing factor to various health conditions in children. There is a paucity of comprehensive data on obesity prevalence among elementary age group. Therefore, this study aims to find out the overweight and obesity prevalence among school going children of age group 6-12 years in Lucknow city. This was a cross-sectional study with a sample size of 509 students going to both private and government schools. Sample group was selected through systematic random sampling. Height, weight and BMI were measured. Respondents were categorized as obese, overweight and normal based on IAP BMI cut-offs. Socio-demographic data were systematically gathered through administration of structured questionnaires. Results were statistically analyzed using descriptive and chi-square test. The study determined that the combined prevalence rate of obesity and overweight in Luckow city was 29.7%. 13.6% of boys and 14.4% of girls were obese. Respondents related to lower and upper middle class (p &lt;.001) and having working parents (p =.001), especially mothers (p= 0.00), were the affected highest. It can be concluded that overweight and obesity rates are getting higher in children. To address these escalating rates the implementation of robust nutritional education programs is necessary that specifically target both children and parents. Keywords: Childhood, Obesity, Overweight, Prevalence, Body mass index, Children

Assessment of a Community-Based Nutrition Program for Women and Children in Nepal Using Demographic and Health Survey.

Undernutrition is a particularly acute problem in middle- and low-income countries. The "Suaahara" program is a 5-year community-focused program in Nepal, aimed at improving the health and nutrition of pregnant and lactating women and their children under the age of 2 years. This research contributes to evidence on the impact of the "Suaahara" program in 41 treated districts compared to 34 control districts. Using the difference-in-differences method, we found that the weight-for-height z-score and body mass index z-score of children under the age of 2 in the treated districts significantly increased by 0.223 standard deviations (SDs) and 0.236 SDs, respectively, compared with the control districts 5 years before and after the program. The number of antenatal care visits (at least four visits) and safe deliveries significantly increased for pregnant women by 10.4% and 9.1%, respectively, in the treated districts compared with the control districts. The prevalence of fever in children under 2 years of age was significantly reduced by 6.2% in the treated districts. The results show the significance of a policy evaluation with transparent indicators on public health, which is necessary for policymakers so that they can propose evidence-based policy.

Navigating intersectoral collaboration in nutrition programming: implementors’ perspectives from Assam, India

BackgroundThere is a growing interest in the use of intersectoral collaborative (ISC) approaches to address complex health-related issues. However, relatively little empirical research exists on the challenges of implementing, fostering and sustaining these approaches. Our study explores the perceptions and experiences of programme implementers regarding the implementation of an ISC approach, focusing on a case study of nutrition programming in Assam, India.MethodsWe conducted qualitative semi-structured face-to-face in-depth interviews with eleven programme implementers from two selected districts of Assam, India. These participants were purposefully sampled to provide a comprehensive understanding of the experiences of implementing intersectoral collaboration. Following the interviews, an inductive thematic analysis was performed on the collected data.ResultsThe study identified three main themes: operationalisation of ISC in daily practice, facilitators of ISC, and barriers to effective ISC. These were further broken down into six subthemes: defined sectoral mandates, leadership dynamics, interpersonal relationships and engagement, collective vision and oversight, resource allocation, and power dynamics. These findings highlight the complexity of ISC, focusing on the important structural and relational aspects at the macro, meso, and micro levels. Interpersonal relationships and power dynamics among stakeholders substantially influenced ISC formation in both the districts.ConclusionDespite challenges, there is ongoing interest in establishing ISC in nutrition programming, supported by political development agendas. Success relies on clarifying sectoral roles, addressing power dynamics, and engaging stakeholders systematically. Actionable plans with measurable targets are crucial for promoting and sustaining ISC, ensuring positive programme outcomes. The insights from our study provide valuable guidance for global health practitioners and policymakers dealing with similar challenges, emphasising the urgent need for comprehensive research given the lack of universally recognised policies in the realm of ISC in global health practice.

Differences in Farmers’ Market Patronage among Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

Differences in Farmers’ Market Patronage among Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

Effect of education and diet programs on changes in body mass index (BMI) and abdominal circumference in adult obesity

Obesity is a major risk factor for the emergence of degenerative diseases. Screening results for UHAMKA lecturers and education staff in 2021 showed that 31.1% and 57.2% were obese based on Body Mass Index (BMI) and waist circumference (WC). This study aims to analyze the effect of nutritional education and diet programs on weight loss, BMI, and WC. This is experimental research One Group Pretest Posttest Design. The intervention provided was nutritional education and a diet program in the form of reducing energy by 500 kcal/day and providing lunch for 6 consecutive days. The variables measured were body weight, BMI, WC, knowledge, attitudes, and behavior of balanced nutrition. Attitude and behavior variables on balanced nutrition were assessed using a questionnaire. A 24-hour recall was carried out to see the subjects' eating patterns before and after the intervention. The statistical tests used were the Wilxocon test and Paired t test to see differences in BMI, WC, attitudes, and behavior on balanced nutrition before and after the intervention. The research results showed that there was an average reduction in body weight, BMI, and WC. The results of statistical tests using the paired t test showed that there was a significant difference in WC before and after the intervention (p=0.000). Female subjects showed significant differences in body weight, BMI, and WC. It was found that there was an increase in knowledge scores, attitudes, and behavior of balanced nutrition. Education and diet programs influenced changes in the nutritional status of subjects.

Public Policy Analysis in Stunting Reduction: A Review of National Programs and Strategies

Stunting remains a severe problem in public health, including in Indonesia, and tackling it requires cross-sectoral efforts and integrated public policies. This study analyzes public policies on stunting reduction, especially national programs and strategies in Indonesia. The research method used is public policy analysis, including identifying, describing, and evaluating existing policies and factors influencing their implementation. The study collected data from various sources, including policy documents and academic literature. The results of the analysis show that the Indonesian government has implemented various national programs and strategies to reduce stunting. These programs include nutrition interventions, maternal and child health services, health education, and community empowerment. The national strategy adopted includes a cross-sectoral approach, active community participation, increased accessibility, and health system strengthening. Nevertheless, implementing public policies to stunt reduction is faced with various challenges. These challenges include budget constraints, suboptimal cross-sectoral coordination, public awareness, and environmental factors affecting child nutrition. In addition, evaluation of the impact and effectiveness of the program is also an essential focus in improving the success of stunting reduction efforts. The study suggests several policy recommendations to improve the effectiveness of stunting reduction in Indonesia. The recommendations include increasing budget allocations for nutrition programs, improving cross-sectoral coordination through establishing more effective coordination mechanisms, increasing community participation through a community-based approach, and strengthening regular program monitoring and evaluation.

Persistent Child Malnutrition in Dhaka: Integrating Political Considerations and Multisectoral Interventions for Solutions Moving Forward

One of the world’s most densely populated cities in the World, Dhaka continues to grapple with its persisting challenge of child malnutrition. While food shortages, food insecurity, and inadequate feeding practices contribute to child malnutrition, various social and economic determinants, including maternal education, family household income, and geographic residence further exacerbate the problem. While existing interventions like the Health Sector Support Project and National Nutrition Programme have made strides in reducing short-term and long-term child malnutrition, challenges such as insufficient coverage hamper its overall scope and effectiveness. In order to address issues hampering funding capacity and the breadth and quality of nutrition-related services, it is necessary to understand the factors affecting them, including political commitment toward child nutrition, policy alignment, program design and implementation, monitoring and evaluation, and intervention strategies and service delivery. Moving forward, comprehensive strategies taking into account political prioritization, multisectoral coordination, and targeted primary intervention strategies are crucial for tackling child malnutrition effectively in LMICs and cities like Dhaka and beyond.

Are children with disabilities more likely to be malnourished than children without disabilities? Evidence from the Multiple Indicator Cluster Surveys in 30 countries

IntroductionA key Sustainable Development Goal target is to eliminate all forms of malnutrition. Existing evidence suggests children with disabilities are at greater risks of malnutrition, exclusion from nutrition programmes and...

Diálogos entre educação popular e educação alimentar e nutricional: reflexões a partir das trajetórias de três docentes universitários

Abstract This essay explores the convergences and singularities of popular education and Food and Nutrition Education based on biographical fragments of the undergraduate training program in Nutrition of three university professors who established their academic and professional trajectories at these crossroads of knowledge and actions mediated by popular education. Inspired by the autobiographical method, the narratives revealed that the initial indignations with social inequalities were mobilizing the routes in the formative path toward understanding hunger, suffering, and human care. To this end, seeking spaces and opportunities to learn about and experience social work in contexts of vulnerabilities was a decisive factor in their personal and professional constructions, revealing the contradictions of traditional training models and the starting point for the genesis of critical thinking. Thus, clues are offered to understand the interfaces of Popular Education (PE) and Food and Nutrition Education (FNE) in the converging actions around the fight against hunger and the right to food without, however, reducing one to the other when food and Nutrition are projected on the horizon of practices.

Dialogues between popular education and food and nutritional education: reflections from the trajectories of three university professors.

This essay explores the convergences and singularities of popular education and Food and Nutrition Education based on biographical fragments of the undergraduate training program in Nutrition of three university professors who established their academic and professional trajectories at these crossroads of knowledge and actions mediated by popular education. Inspired by the autobiographical method, the narratives revealed that the initial indignations with social inequalities were mobilizing the routes in the formative path toward understanding hunger, suffering, and human care. To this end, seeking spaces and opportunities to learn about and experience social work in contexts of vulnerabilities was a decisive factor in their personal and professional constructions, revealing the contradictions of traditional training models and the starting point for the genesis of critical thinking. Thus, clues are offered to understand the interfaces of Popular Education (PE) and Food and Nutrition Education (FNE) in the converging actions around the fight against hunger and the right to food without, however, reducing one to the other when food and Nutrition are projected on the horizon of practices.

Cross-sectional associations of Special Supplemental Nutrition Program for Women, Infants, and Children benefit redemption and diet among children ages 1–4 years in California

BackgroundThe Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental healthy foods to children aged <5 y in low-income households. ObjectivesThe objectives of this study were to characterize WIC benefit redemption, identify associations between benefit redemption and child dietary intake, and whether child age modifies these associations. MethodsThe cross-sectional 2023 California Statewide WIC Survey, conducted with caregivers of WIC-participating children aged 1–4 y, was analyzed for this study. Included children had complete benefit redemption data, a complete National Health and Nutrition Examination Survey Dietary Screener Questionnaire (DSQ), and complete covariate data (weighted n = 2244). Monthly household category-specific benefit redemption percentage was averaged across 6 and 3 mo preceding survey completion. Associations between household redemption and child dietary intake (servings or amount/day) were assessed with multivariable linear regression and expressed as estimates and 95% confidence intervals (CI). ResultsTwenty-five percent higher redemption of breakfast cereal, whole grain bread, yogurt and whole milk in the 6 mo prior to the survey were associated with higher child intake frequency for cereal (0.02 servings/d; 95% CI: 0.00, 0.04), whole grain bread (0.02 servings/d; 95% CI: 0.00, 0.03), yogurt (0.04 servings/d; 95% CI: 0.02, 0.06), and whole milk (0.09 servings/d; 95% CI: 0.01, 0.16). Significant effect modification by child age (12 to <24 mo, 24–59 mo) was found for redemption of cheese/tofu and 100% juice (P-interaction = 0.02 and 0.001, respectively), and 25% higher redemption of these benefits were associated with lower intake frequency for cheese (−0.05 servings/d; 95% CI: −0.09, −0.02) and higher intake frequency for juice (0.12 servings/d; 95% CI: 0.06, 0.18), but only among children ages 12 to <24 mo. ConclusionsHigher redemption was associated with higher child intake of select WIC foods. Pairing the promotion of benefit redemption among program participants with nutrition education efforts may enhance dietary impacts of WIC participation.

TEMPORARY REMOVAL: Factors Affecting Anemia among Women of Reproductive Age in Mexico: A Mixed-Methods Country Case Study

BackgroundIn Mexico, anemia prevalence among women of reproductive age (WRA) decreased from 16.4% in 2006 to 11.6% in 2012, only to increase to 18.3% in 2016. The factors associated with this fluctuation are uncertain. ObjectiveWe conducted a systematic in-depth assessment of the quantitative and qualitative determinants of anemia among WRA in Mexico between 2006 and 2018. MethodsUsing multivariate stepwise linear regression, we analyzed Mexico’s Encuesta Nacional de Salud y Nutrición (ENSANUT) surveys from 2006, 2012, and 2018 to identify determinants of WRA anemia. We also conducted a review of anemia-relevant programs and policies, including financing documents, and conducted in-depth interviews and focus group discussions with key stakeholders in Mexico. ResultsAmong non-pregnant women (NPW) 15-49 years, mean hemoglobin (Hb) increased from 13.8 g/dL in 2006 to 14.0 g/dL in 2012, decreasing to 13.2 g/dL in 2018 (p<0.001). Inequities by geographical region and household wealth persisted throughout this period, with household wealth, urban residence and gravidity emerging as significant predictors of Hb among NPW. Qualitative analyses generally supported these findings. The most discussed program was Progresa-Oportunidades-Prospera (POP), where most resources for health were invested and most participants acknowledged that its cancellation in 2019 would lead to worsening in health and nutrition among the poor. Financing analyses showed a drop of funding for nutrition-related programs between 2014 and 2018. Cultural norms around gender roles were still prevalent, along with increasing rates of teenage pregnancy. ConclusionsAnemia prevention efforts need to refocus on poverty alleviation, continuity of adequate coverage and financing of nutrition programs, especially with safety nets, and increase in uptake of family planning, especially among adolescent girls.

TEMPORARY REMOVAL: Drivers of Anemia Reduction among Women of Reproductive Age in Senegal: A Country Case Study

BackgroundIn Senegal, anemia prevalence among women of reproductive age (WRA) decreased from 59% in 2005 to 54% in 2017. However, determinants of reduction in disease burden under challenging public health conditions have not been studied. ObjectiveTo conduct a systematic in-depth assessment of the quantitative and qualitative determinants of anemia reduction among WRA in Senegal between 2005 and 2017. MethodsStandard Exemplars in Global Health methodology was used for quantitative analyses using Senegal’s Demographic and Health Surveys. Qualitative analyses included a systematic literature review, program/policy analysis, and interviews with key stakeholders. A final Oaxaca-Blinder decomposition analysis (OBDA) evaluated the relative contribution of direct and indirect factors. ResultsAmong non-pregnant women (NPW), mean hemoglobin (Hb) increased from 11.4 g/dL in 2005 to 11.7 g/dL in 2017 (p<0.0001), corresponding to a 5%-point decline in anemia prevalence (58% to 53%). However, inequities by geographical region, household wealth, women’s educational attainment, urban compared to rural residence, and antenatal care (ANC) during last pregnancy continue to persist. During this time period, several indirect nutrition programs were implemented, with stakeholders acknowledging the importance of these programs, but agreeing there needs to be more consistency, evaluation, and oversight for them to be effective. Our OBDA explained 59% of the observed change in mean Hb, with family planning (25%), malaria prevention programs (17%), use of iron and folic acid (IFA) during last pregnancy (17%), and improvement in women’s empowerment (12%) emerging as drivers of anemia decline, corroborating our qualitative and policy analyses. ConclusionsDespite a reduction in anemia prevalence, anemia remains a severe public health problem in Senegal. To protect the gains achieved to date, as well as accelerate reduction in WRA anemia burden, focused efforts to reduce gender and social disparities, and improve coverage of health services, such as family planning, IFA, and antimalarial programs, are needed.

TEMPORARY REMOVAL: Drivers of Anemia Reduction among Women of Reproductive Age in the Philippines: A Country Case Study

BackgroundAnemia prevalence among women of reproductive age (WRA) in the Philippines was 25% in 2000, decreasing to 13% in 2018. To date, an in-depth assessment of the determinants associated with this decline has not been conducted. ObjectiveTo conduct a systematic in-depth assessment of the quantitative and qualitative determinants of anemia among WRA in the Philippines between 2008 and 2018. MethodsEmploying standard Exemplars methodology, we conducted quantitative analyses using the Philippines’ National Nutrition Survey, the Expanded National Nutrition Survey, and the Philippines National Demographic and Health Surveys. Qualitative analyses included a comprehnsive literature review, program/policy analysis, and interviews with stakeholders to understand country-level enablers and barriers to WRA anemia decline in the Philippines. A final Oaxaca-Blinder decomposition analysis (OBDA) evaluated the relative contribution of direct and indirect factors. ResultsAmong non-pregnant women (NPW), mean hemoglobin (Hb) increased from 12.7 g/dL in 2008 to 13.1 g/dL in 2018 (p<0.01), corresponding to an 11%-point decline in anemia prevalence (23% to 12%). Inequities by geographical region, household wealth, and women’s educational attainment narrowed considerably during this time. Important direct and indirect nutrition programs were introduced during our study period, including universal healthcare and food fortification. Country experts interviewed credited programs focused on alleviating micronutrient deficiencies and poverty, and improvements in women’s health and well-being, for the country's extraordinary success. OBDA explained ∼50% of the observed change in mean Hb among NPW, with family planning (35%), household socio-demographics (29%), and improvement in women’s nutrition (23%) emerging as critical drivers of anemia decline, corroborating our qualitative and policy analyses. ConclusionsTo protect these gains, WRA anemia prevention efforts in the Philippines should continue to focus on universal healthcare access, women’s empowerment, and poverty alleviation.

Multisectoral approaches for sustainable food and nutrition security actions in Ethiopia

Ethiopia has demonstrated a commitment to tackling the high burden of Food and Nutrition Security (FNS) challenges by developing and implementing various policies, strategies, and programs. Despite the efforts, the current FNS situation is of significant public health concern observed by various nutrition indices. The narrative review aimed to appraise multisectoral policy, strategic and programmatic initiatives aimed at addressing FNS challenges and identify entry points for enhancing coherent and integrated FNS approaches. The review involved broad literature research using Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. A total of 1,086 articles and grey literature were identified. Out of this, 47 full-text articles and documents met the selection criteria and were included in this review. Evidence was synthesized in themes to characterize the successes and challenges of key FNS policies, strategies, and programs and identify potential areas of improvement to enhance multisectoral actions and address FNS challenges. Overall, Ethiopia has made considerable progress in enhancing FNS through the implementation of a range of FNS policies, strategies, and programs such as the National Nutrition Program (NNP), Productive Safety Net Program (PSNP), and Agricultural Growth Program (AGP) among others. These efforts have resulted in notable achievements, such as the reduction of the prevalence of undernourishment from 47.0% in 2000 to 24.9% in 2020 and the reduction of stunting among children under five years from 57.4% to 35.2% over the same period. Nonetheless, the pace of progress has been hindered by various contextual and programmatic challenges such as climatic shocks, poverty, high inflation, political instability, limited access to production resources, inadequate coverage of FNS interventions, inadequate financing, and inadequate multisectoral coherence and integration. A comprehensive and integrated multisectoral FNS approach focusing on enhancing commitment, planning, coordination, financing, capacity building, and accountability across sectors and levels is imperative. Strengthening coherence across various sectors, alongside the operationalization of robust multisectoral monitoring and evaluation systems highlighted in the National Food and Nutrition Strategy, constitutes the most suitable entry points for ensuring sustainable advancement in mitigating the prevailing FNS challenges in Ethiopia. Key words: Food and nutrition security, policy and program, multisectoral approaches, Integration, Ethiopia

Promoting health and educational equity: Cross-disciplinary strategies for enhancing public health and educational outcomes

Promoting health and educational equity is a multifaceted challenge that requires cross-disciplinary strategies and collaborative efforts. This review explores various approaches aimed at enhancing public health and educational outcomes through integration and synergy between health and education disciplines. Addressing health and educational disparities is crucial for ensuring equitable opportunities and outcomes for all individuals. This review highlights the importance of interdisciplinary collaboration between health and education sectors in tackling complex issues such as socio-economic inequality, access to quality healthcare, and educational attainment. Key strategies include early childhood interventions that focus on nutrition, healthcare access, and early learning programs to support cognitive and physical development. Additionally, school-based health initiatives, including comprehensive wellness programs and mental health services, play a vital role in promoting student well-being and academic success. Furthermore, community engagement and partnerships between schools, healthcare providers, and local organizations are essential for creating supportive environments that foster health and educational equity. By working together, stakeholders can address the underlying social determinants of health and educational disparities, including poverty, discrimination, and inadequate resources. This review underscores the importance of evidence-based practices, data-driven decision-making, and policy advocacy to drive systemic change and improve health and educational outcomes for underserved populations. By adopting cross-disciplinary strategies and leveraging collective expertise, we can create healthier, more equitable communities where everyone has the opportunity to thrive.

Long-term impact of postnatal nutritional programming on cardiac sensitivity to ischemia-reperfusion injury in vivo and on glucose metabolism

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Fondation de France Introduction Nutritional environment during intra uterine and postnatal period has a major impact on health and disease in adulthood. The early programming of cardiometabolic risk through a postnatal overfeeding in rodents leads to a permanent increase in body weight, associated with alteration of left ventricular contractility, higher cardiac sensitivty to ischemic or chemo-toxic stresses and alterations of glucose métabolism in adulthood. However, these data have mainly obtained in young rodents and less is known for older animals. Purpose Our aim was to evaluate the impact of postnatal overfeeding (PNOF) on cardiac function, on cardiac sensitivity to ischemia-reperfusion (I-R) injury in vivo, on glucose metabolism and on metabolic profile of pericardial adipose tissue (PAT) in young (4 months), adult (6 months) and old (12 months) male mice. Methods PNOF was induced by the reduction of litter size of C57/BL6 mice immediately after birth: normally-fed group (NF) was composed of 9 male pups/mother and overfed group (PNOF) of 3 pups/mother. Echocardiography and blood sugar tests (glucose tolerance and insulin resistance) were performed at all ages. An in vivo ischemia-reperfusion injury was induced by the ligation of the left anterior descending coronary artery for 45 minutes followed by 24 h of reperfusion. PAT was harvested and weighted, in order to investigate by rt-qPCR its inflammatory status. All experiments were performed in 4-, 6- and 12-months aged mice. Results PNOF induced an early and permanent increase in body weight in PNOF group, independently of mice’s age (+23% at 24 days of life, +14% at 4 months, +23% at 6 and 12 months, compared to NF group). Echocardiographic measurements showed an alteration of left ventricular ejection fraction in mice aged from 4 months up to 12 months (-11 % on average, compared to NF groups). PNOF mice presented glucose intolerance and insulin resistance from 4 to 12 months of age. Moreover, PNOF mice had a higher PAT mass indexed to body weight with increased inflammatory status and decreased activin A mRNA expression at 6 and 12 months. Finally, PNOF induced a significant increase of infarct size at 4 months (+37%, p&amp;lt;0.01, n=8), 6 months (+32%, p&amp;lt;0.05, n=9) and 12 months (+38%, p&amp;lt;0,05, n=9) after cardiac surgery. Conclusion Nutritional programming through short-term PNOF induced an early and permanent overweight, an increase in pericardial fat mass with a greater inflammatory status, associated with alterations of glucose metabolism, alteration of systolic function and a higher sensitivity to ischemia reperfusion injury induced in vivo. The cellular mechanisms of these pathological modifications induced by PNOF need further exploration but could involve alterations in cardiomyocyte pathways and/or modification of global inflammatory status. Therefore, the PNOF mice model corresponds to a relevant experimental model of programmed metabolic syndrome as we known in humans.