Nutrition Program Research Articles

Acute malnutrition associated with MUAC among under-five children in tribal areas, India - A cross-sectional study.

For the past three decades, India has implemented several nutrition programs to address malnutrition in the under-fives. To understand the program's impact, this study assesses the prevalence of acute malnutrition, MAM, and SAM, using MUAC among tribal children. The survey was conducted in two tribal blocks (Desaiganj and Bhamragad) of the Gadchiroli district in Maharashtra to identify children registered in the 'Anganwadi' program. A community-based cross-sectional survey was carried out. The total sample size was 1055 children (aged 0-59 months). The overall prevalence of SAM and MAM was 1.4% (n=15) and 9.8% (n=103). A higher prevalence of MAM was found in males (38.5%, n= 40) and females (27.1%, n= 28) in below 6 months. Additionally, a higher prevalence of MAM was observed in females (10.7%, n=113) compared to males (9.0%, n=95). The prevalence of SAM was significantly (p<0.001) higher in females (1.7%, n=18) than in males (1.0%, n=11). Children aged between 12 and 17 months were sixteen times more likely (OR=16.9, p<0.001, CIs=4.8-59.6) to have MAM (MUAC<12.5cm) than children aged between 6 and 11 months. Children from the Desaiganj block were significantly less likely (OR=0.4, p<0.001, CIs= 0.2-0.7) to have MAM compared to children from Bhamragad. Approximately 4% (n=42) of children were classified as critically malnourished. There is an urgent need for block-level monitoring of MAM and SAM, as well as evaluation of existing nutrition programs, to address the disparity in the sex-specific prevalence of MAM and SAM in tribal areas.

Initial participant perspectives about participating in an online, semi-supervised, cirrhosis-specific nutrition and exercise intervention.

In chronic diseases, there have been issues with low levels of participant adherence and retention during well-supported lifestyle behaviour change interventional studies. Theoretically informed, the objective was to explore the types of challenges participants are experiencing to inform future designs. We conducted an exploratory descriptive study in an adult cirrhosis population after the first 4-6 weeks of a 12-week semi-supervised nutrition and exercise online program. Participants in the parent feasibility study, assessing the nutrition and exercise intervention (Heal-Me), were eligible for this nested study. Heal-Me is a multimodal program that is tailorable to a participant's abilities through regular interaction with the study's registered dietician and exercise specialist. Interviews (~60 min) with participants were recorded then analysed descriptively, guided by the capability, opportunity and motivational behaviour change model. The 20 participants preferred the expert-led group online nutrition and exercise classes over independent activities such as protein tracking and the exercise videos. Social gamification (e.g., weekly polls on favourite things like movies or sports teams) contributed to the group experience. All except one person required program tailoring to address preferences, abilities and new onset health events. Findings led to the inclusion of 4 behaviour change techniques to the initial 17, whereas 2 others were expanded. While program tailoring, awareness of cirrhosis nutrition and regular interactions with staff influenced participant retention and adherence in the first 4-6 weeks of the online program.

Nutrition management program for older adults in Ningxia nursing homes, China: Evidence-based practice and the Delphi method.

To construct an evidence-based practice program for the nutrition management of older adults in nursing homes. The program will provide a basis for improving or solving the nutrition management problems of older adults in nursing homes. Study based on guideline evidence and Delphi method. Comprehensively searched, assessed and summarized the evidence and aggregated best evidence and a preliminary program for nutrition management of older adults in nursing homes. Then used the Delphi method to assess the applicability of the preliminary program and the obstacle factors to modify, supplement and improve the nutrition management program. Baseline survey data were collected from three nursing homes in Ningxia, China, and guideline evidence was obtained through systematic searches of the Cochrane Library, PubMed and other scientific databases, as well as relevant official websites. A total of 350 older adults residing nursing homes and 160 nurses participated in the baseline survey. To ensure the program's applicability and identify potential implementation obstacles, 15 experts from local Grade-A hospitals, nursing homes, and community health centers were consulted for review. A 14-item, 56-best-evidence nutrition management program for older adults in nursing homes was developed based on five guideline evidences and baseline survey findings. This is a systematic and comprehensive nutritional management program for older adults in nursing homes based on guideline evidence, which can provide a standardized basis for the implementation of scientific nutritional management in nursing homes in Ningxia. Managers should promote the translation of evidence into practice in accordance with the specific circumstances of individual nursing homes.

Californian Schoolchildren’s Acceptance of and Preference for Pomegranate Compared to Two Lunch Fruit Standards

Specialty fruit crop species that are commonly served in school lunch programs include apples, citrus, and bananas. Among these three specialty crops, student food waste in primary and secondary schools in North America is enormous. In this postharvest sensory analysis study, schoolchildren were asked to rank and score for preference and acceptance of apples, oranges, and pomegranates. Minimally processed samples were used for each fruit type and the sensory analysis took place in classrooms in California, USA. ‘Red Delicious’ apple was generally less acceptable for multiple scored traits, and less preferred in consumer rankings, when compared with navel orange and ‘Wonderful’ pomegranate. Traits that were assessed by panelists included color, sweetness, tartness, texture, bitterness, and overall desirability. Both prepackaged arils and manually processed arils were used in the study and prepackaged arils were ranked lower when served alongside orange and apple compared with manually extracted, intact arils. Bitterness, color, tartness, and texture scores were significantly different among fruit types. This investigation indicates that Red Delicious is possibly a poor choice of apple cultivar for California schoolchildren and that pomegranate may be a possible alternative to apple, especially considering almost all apple cultivars develop brown flesh when cut. Whether pomegranate is feasible for school lunch programs remains to be seen; more research is needed to determine if pomegranate is a fruit that can be used to increase nutritive value and reduce food waste in public school nutrition programs.

Enhanced Nutrition Programs to Rehabilitate Freeze-stressed Citrus Trees in Subtropical Regions

Citrus spp. trees are not fully dormant during the winter months in the northern hemisphere; therefore, they are susceptible to sporadic freeze events of various magnitudes that could decline tree productivity or be lethal. In Feb 2021, winter storm Uri produced freezing air temperatures for nearly 72 hours, which created several degrees of injuries to citrus orchards in southern Texas. Producers in the area implemented combinations of multiple horticultural practices aimed at remediating injuries from the cold spell to stimulate root and tree recovery. However, there is a gap in our understanding of how practices such as compost application (CA) combined with varying rates of nitrogen (N) might facilitate tree recovery. Therefore, we conducted a 2-year field experiment using two CAs as soil amendments in combination with three N rates (112, 168, and 224 kg·ha−1 N) to evaluate fruit yield and internal quality, root growth, and recovery of ‘Rio Red’ grapefruits (Citrus ×paradisi Macf.) and ‘Marrs’ sweet oranges (Citrus sinensis). The yields of both crops exhibited modest improvement with CA in 2022; however, it was nonsignificant. Moreover, CA elicited more beneficial effects than N rates alone when rehabilitating trees and improving fruit internal quality after freezing events. Grapefruit brix was 4% higher in fruits harvested from trees treated with compost, and grapefruit roots exhibited a two-fold dry weight increment with CA. Sweet oranges from trees in the CA treatment had 22% lower acidity compared with that of untreated trees. Overall, our results indicate that citrus producers in southern Texas and other subtropical citrus-producing regions might facilitate the rehabilitation of tree injuries attributed to mild to moderate freeze events with moderate financial gains with the timely application of compost, which enhanced tree fitness and ameliorated fruit productivity declines during subsequent harvests.

Food, culture and health: An anthropological perspective

This article explores the complex interplay among food, culture, and health. It examines how dietary habits have evolved, from hunter‐gatherer societies to the globalization of Western diets, and their profound effects on cultural traditions and human health. While global markets reshape local diets, anthropological evidence suggests nutrition programmes work best when they build on cultural food knowledge rather than replace it. Our findings point to a pressing need for public health approaches that recognize food's role beyond mere sustenance – though implementing such culturally aware interventions remains challenging in practice.

Spatial variation, 20-year trends, and determinants of the double burden of wasting and stunting among under-five children in Ethiopia: a geo-spatial and multivariate decomposition analysis (2000–2019)

Despite extensive efforts, malnutrition persists as a critical public health concern, particularly in developing nations like Ethiopia. Concurrent occurrence of wasting and stunting poses severe consequences. Analyzing trends and factors contributing to this double burden is vital for evaluating and enhancing existing nutritional programs. Additionally, understanding the spatial distribution of malnutrition is crucial for targeted resource allocation, expediting progress towards optimal child growth. A 20-year trend and spatial analysis was conducted among 27,138 weighted samples of under-five children using EDHS (2000–2019). The data extraction was conducted between October 1 and November 1, 2023. STATA 18, ArcGIS Pro, and Sat Scan 9.6 were used for analysis. A logit-based multivariate decomposition analysis was used to identify contributing factors for the change in the double burden of wasting and stunting in the past 20 years. The statistical significance was declared at a P-value < 0.05. The double burden of wasting and stunting had shown a decline from 8.42% in 2000 to 3.31% in 2019. There is a clustered distribution of wasting and stunting (Moran’s I = 0.0712, p-value = 0.0290). Significant clustering is detected in the Somali, Afar, and Tigray regions. Among the changes in the effect of the characteristics (coefficient), maternal education level [β = −0.0012, 95% CI −0.0021, −0.0006], wealth level [β = −0.0049, 95% CI −0.0223, −0.0014], family size [β = −0.0014, 95% CI −0.0132, −0.0009] and media access [β = −0.0027, 95% CI −0.0039, −0.0014] were found to be significant contributors to the reduction of the double burden of wasting and stunting over the past 20 years. Despite the significant progress observed in the past 20 years, the problem still requires urgent attention. Thus, improving maternal education and household wealth levels is crucial. Furthermore, enhancing access to and utilization of family planning services and media coverage will help alleviate the burden and end malnutrition. Additionally, deploying additional resources in hotspot areas is also recommended.

Impact of Gestational Diabetes Mellitus on Fetal Growth and Nutritional Status in Newborns

Background: Gestational diabetes mellitus (GDM) is one of the most prevalent complications associated with pregnancy, exhibiting a gradual rise in prevalence worldwide. Given the potential for numerous short- and long-term complications for both mother and child, patients diagnosed with GDM require individualised treatment to compensate for metabolic abnormalities and ultimately reduce the risk of the known adverse consequences of impaired glucose tolerance. Methods and results: The manuscript presents a summary of the current knowledge on changes in maternal metabolism during physiological pregnancy and pregnancy complicated by gestational diabetes. Furthermore, the article provides a synthesis of the findings from recent research examining the impacts of gestational diabetes and the therapeutic modalities employed on the nutritional status of the fetus and neonate. Additionally, the review elucidates the function of the placenta and placental hormones in fetal development, as well as the impact of hyperglycemia, insulin resistance and adipokines on fetal and neonatal nutritional programming and predisposition to metabolic complications in adulthood. Conclusions: The metabolic environment, resulting from abnormal glucose tolerance during pregnancy, exerts a particularly significant impact on fetal growth and, consequently, on the birth weight and fat mass of the newborn infants. This is a pivotal factor influencing the nutritional and metabolic programming of the developing fetus, predisposing the individual to the development of metabolic complications throughout their lifetime.

Obesity paradox of sepsis in long-term outcome: The differential effect of body composition

BackgroundThe obesity paradox has been widely studied recently; however, its impact on the long-term prognosis of sepsis and the protective mechanism of body mass have not yet been sufficiently revealed. MethodsWe retrospectively evaluated the association between obesity and 1-year survival after sepsis in a single university-affiliated hospital and examined the differential effects of muscle mass and adiposity. ResultsAdult patients with sepsis or septic shock (n = 1492)were classified into obese (n = 300) and nonobese (n = 1192) groups. One-year mortality due to sepsis was lower in the obese than in the nonobese (52.0 % vs. 64.8 %; p < 0.001). In multivariate Cox analysis, one-year mortality due to sepsis was independently associated with body mass index (BMI) (hazard ratio 0.96). In the subgroup analysis, 705 were divided into four groups according to the psoas muscle index (PMI) and body fat percentage (BFP) to assess the differential impact of body fat and muscle mass on the one-year outcome of sepsis. One-year mortality was significantly different among the four groups (high BFP/low PMI, 60.6 %; high BFP/high PMI, 42.1 %; low BFP/high PMI, 34.8 %; low BFP/low PMI, 63.2 %; p = 0.002). The adjusted hazards ratio of one-year mortality of sepsis, which was normalized to the low BFP/high PMI group, were 1.2 (p = 0.585), 2.2 (p = 0.016), and 2.3 (p = 0.009) in groups of high BFP/high PMI, high BFP/low PMI, and low BFP/low PMI, respectively. ConclusionAn obesity paradox has been observed in the long-term outcomes of patients with sepsis, and muscle mass may be more critical than fat mass as a protective mechanism against obesity. Implications for clinical practiceA high BMI is linked to a more favorable long-term prognosis in sepsis, with muscle mass playing a more critical role than fat mass. A proactive nutritional and conditioning program may benefit patients anticipating major procedures and potential ICU admission. Such preparation could enhance their resilience and improve outcomes when facing critical illness, including sepsis.

Factors influencing provider deviation from national HIV and nutritional guidelines for HIV-exposed children in western Kenya: a qualitative study

BackgroundMalnutrition and HIV interact in a vicious cycle for HIV-exposed infants (HEIs), increasing vulnerability and the severity of each condition and contributing to poor health outcomes. We identified multi-level factors influencing provider adherence to Kenyan HIV and nutrition guidelines for HEIs.MethodsWe conducted six focus group discussions and seven in-depth interviews using a semi-structured question guide. Participants were selected through purposive maximum variation sampling of health workers involved in maternal and child health services and outpatient nutrition programs at two facilities in western Kenya. Data collection and analysis were guided by the Theoretical Domains Framework (TDF). Transcripts were coded by two primary coders using both deductive and inductive thematic analysis.ResultsTDF domains that drove guideline adherence included: environmental context and resources, beliefs about capabilities, and social influences. While participants praised attempts to integrate HIV and nutritional services through teamwork and service colocation, challenges in the successful referral of patients between services persisted. Participants described siloed HIV and nutrition-related knowledge across staff, leading to missed or delayed care if certain providers were unavailable. Participants emphasized understaffing as a major contributor to gaps in care. Inconsistent material resource availability also disrupted linkages between HIV and nutrition services for patients. While participants frequently expressed high intention and internal motivation to link children between services, they described minimal structured supervision or positive reinforcement from supervisors and feeling demoralized when resource constraints interfered with care provision. Lastly, participants described patient-level factors that made it challenging for families to seek or remain in care, including poverty and HIV and malnutrition-related stigma. Participants made several recommendations, including training multiple cadres in the fundamentals of both HIV and nutritional care to address siloed services and understaffing.ConclusionsThis study details the factors that facilitate or hinder health workers as they implement national guidelines and link HEIs between HIV and nutritional services, including the impact of physical integration of service sites, human and material resource constraints, and health worker motivation. Future interventions can address these challenges by expanding access to needed resources, task sharing, and testing implementation strategies that increase the efficiency of service delivery to improve linkages in care for vulnerable infants.

Nutrition-Focused Quality Improvement Programs in Pediatric Care

Nutrition is fundamental to a child’s growth and development. However, nutritional health is often compromised by acute and chronic conditions and treatments that can commonly result in malnutrition. Malnutrition encompasses undernutrition and overnutrition and may be exacerbated by food insecurity. Recent health policy efforts in the United States (US) include those focused on quality measurement and social determinants of health (SDOH) to reduce risks for malnutrition and food insecurity. Nutrition-focused quality improvement programs (QIPs) have emerged as a successful model for benchmarking current nutrition care in adult patients and creating pathways for establishing best practices for timely malnutrition screening, intervention, and appropriate follow-up and care coordination. However, less is known about opportunities for nutrition-focused QIPs in hospital pediatric malnutrition care. This Perspective helps fill the gap by discussing the problem of pediatric malnutrition and current US quality frameworks and child nutrition programs related to malnutrition and food insecurity. In addition, this Perspective summarizes how nutrition-focused QIPs can impact malnutrition, including how QIPs can link hospital care with patient discharge planning and outpatient interventions. Finally, the Perspective outlines specific opportunities for the implementation of pediatric nutrition-focused QIPs to reduce office visits and/or inpatient readmissions through appropriate nutrition screening, assessment, and interventions.

Food safety of fresh fruits and vegetables in the Philippines: challenges and prospects

Fruits and vegetables are high-value nutritious crops and are integral parts of food security and nutrition policies and programs. They are consumed fresh or partially processed and are often implicated in food safety problems. As food supply becomes increasingly globalized, food safety concerns have become multifarious, and impacts on lives and society have magnified, affecting both developed and developing countries. Reducing the risks of unsafe food involves preventing contamination throughout the food chain. This review draws the food safety situation of fruits and vegetables in the Philippines, particularly the prevalence of food safety hazards and issues in selected supply chains, and synthesizes the food safety gaps to lead the way forward, towards mainstreaming food safety and a safe food culture harnessing existing enabling ecosystems.

Ideas of Coherence Between Theory and Practice in the Training of Health Professionals: A Scoping Review

The main objective of this scoping review is to collect and systematically map research literature on pedagogical strategies and activities that target the relationship between theory and practice in clinical education within undergraduate healthcare programmes. We searched the Scopus and CINAHL databases for peer-reviewed papers in English, Swedish, Norwegian and Danish, published since 2016, and specific to professional undergraduate programmes in biomedical laboratory science, midwifery, nursing, nutrition and health, occupational therapy, physiotherapy, psychomotor therapy and radiography that explicitly refer to curriculum activities aiming to bridge the theory–practice gap. The process was guided by two research questions: (1) In connection with which undergraduate healthcare programmes are there published studies on pedagogical strategies and activities designed to help students integrate academic and clinical knowledge; how are they described; and what kind of clinical activities do they address? and (2) What epistemological assumptions underpin (explicitly and implicitly) these strategies and activities, as well as the definitions and the understanding of relationships between forms of knowledge? We identified 5,693 studies and found 24 eligible for inclusion. The studies employed different methodologies, with qualitative design the most frequent across all studies (n = 15). Most studies originated from North America and Australia (n = 11), and about a third were from Scandinavian countries. The 24 papers cover pedagogical strategies and activities ranging widely from technology-based models to peer support and tools for reflective learning. The vast majority (n = 18) referred to nursing programmes. The results show that the relationship between theory and practice is addressed mainly in clinical education in connection with nursing education. Definitions of central concepts and an outline of epistemological underpinnings are lacking. The pedagogical strategies and activities identified in clinical education can provide information for managers, policymakers, and academic and clinical educators, and guide future curriculum reforms. The review identifies a knowledge gap concerning pedagogical strategies and activities in clinical education within a range of healthcare programmes that extend beyond nursing.

A prospective observational study on maternal diet pre- and post-GDM diagnosis and pregnancy outcomes in individuals with/without GDM

AimsTo investigate (1) the association between maternal dietary choices during the first and second trimesters and the diagnosis of gestational diabetes mellitus (GDM), (2) the association between a GDM diagnosis and dietary choices during pregnancy, and (3) the differences in pregnancy outcomes between individuals with and without GDM.MethodsA prospective cohort study. Pregnant individuals with singleton pregnancy aged 19 ∼ 44 years, without severe pregnancy complications were enrolled in the study. Dietary data were collected at three time points during routine antenatal appointments: 8 ∼ 12 weeks gestation(n = 993), 20 ∼ 24 weeks gestation(n = 732), and 32 ∼ 36 weeks gestation(n = 536). GDM diagnosis and pregnancy outcomes were collected during follow-up from the electronic medical record (EMR).ResultsA total of 93 participants (12.9%) were diagnosed with GDM. Livestock and poultry meat intake during the second trimester were associated with an increased risk of developing GDM (aOR 1.371, 95%CI 1.070–1.756, P = 0.013), and a GDM diagnosis may lead to decreased intake of cereals and its products (P = 0.001), potatoes and its products (P < 0.001), and fruit (P = 0.002) and increased intake of fish, shrimp and shellfish (P = 0.001), eggs (P = 0.015), and milk and milk products (P = 0.011) in the third trimester. Individuals with GDM related to lower risk of excessive gestational weight gain (aOR 0.384, 95%CI 0.188–0.646, P = 0.001) but may increase the risk of fetal macrosomia (aOR 3.873, 95%CI 1.364–10.996, P = 0.011).ConclusionsUnderstanding maternal dietary choices around GDM diagnosis is crucial for accurate nutritional assessment and effective education programs. While our findings suggest dietary changes may occur post-diagnosis, further research is needed to confirm these patterns and the potential benefits of early dietary counseling for individuals with GDM.

Ragi Revolution: Enhancing Dietary Practices through Nutritional Education and Local Food Systems Implementation

Ragi (Eleusine coracana), commonly known as finger millet, is a nutrient-rich cereal that remains underutilized in modern diets despite its high calcium, iron, and dietary fiber content. This examines how ready-to-eat ragi-based supplementary foods, combined with effective nutrition education, can drive behavioral changes to incorporate ragi into daily diets and local food systems. The increasing availability of ready-to-eat ragi products offers an accessible solution for improving nutrition, but challenges remain in terms of consumer acceptance due to unfamiliarity and taste preferences. This paper focuses on the role of nutrition education in reshaping dietary behaviour, emphasizing case studies that demonstrate the effectiveness of targeted interventions in promoting ragi consumption. Additionally, it explores strategies for integrating ragi into public nutrition programs and sustainable food systems, highlighting the importance of community-driven efforts and public-private partnerships. The review also discusses the role of policy support and multi-stakeholder collaboration in fostering ragi’s cultivation and incorporation into local food systems. By examining behavioural change strategies such as social marketing and culturally sensitive approaches, this paper presents a roadmap for promoting ragi as a key component of sustainable diets and public health interventions.

Study protocol of an exercise and nutrition intervention for ovarian cancer patients during and after first-line chemotherapy (BENITA) - a randomized controlled trial

BackgroundIn ovarian cancer frequently reported side effects are muscle wasting and malnutrition, leading to frailty, decreased health-related quality of life (HRQoL), and cancer-related fatigue (CRF). Both often begin during first-line chemotherapy and develop progressively into a refractory state, if left untreated.MethodPrimary objective is to evaluate effectiveness of a newly developed app-based exercise and nutrition program under non-standardized conditions of clinical routine. We hypothize that patients who receive an individually tailored exercise and nutrition program for six months will have improved physical performance compared to patients who receive usual care. This is a multicenter randomized controlled open-label trial comparing an intervention group receiving a six-month exercise and nutrition intervention and a control group receiving usual care. Primary endpoint is the change in 6-Minute Walk Test (6MWT) from baseline to T2 (26 weeks after baseline) as a measure of physical functioning. Secondary endpoints include patients’ utilization and adherence to the nutrition program (MEDAS), their malnutrition risk (NRS2002), as well as patients’ HRQoL (see Table 1). Using the two-sample t-test with a two-sided type I error of 5% and 80% power, a medium effect size of Cohen’s d = 0.50 can be demonstrated with a minimum of 128 participants (64 per group). With a conservatively estimated dropout rate of 30%, 182 patients will be recruited. Patients who are included must be over 18 years of age, be diagnosed with ovarian cancer, cancer of fallopian tubes, or peritoneal cancer, FIGO stages II-IV, receive surgery and chemotherapy (adjuvant or neoadjuvant). Exclusion criteria are an ECOG status greater than 2, inadequate proficiency in German, or physical or mental impairments hindering the implementation of the program or execution of study procedures.DiscussionIn case of success, the project contributes in the long term to (i) improving medical care (diagnosis, psychoeducation, patient orientation, and empowerment), (ii) reducing the burden of disease and promoting physical autonomy for patients, and (iii) being incorporated into relevant guidelines.Trial registrationThe study was registered at ClinicalTrials.gov (NCT06250686).

Associations of linear growth with body composition of perinatally HIV-infected African adolescents.

The prevalence of poor linear growth among African children with perinatally acquired HIV remains high. There is concern that poor linear growth may to lead to later total and central fat deposition and associated non-communicable disease risks. We investigated associations between height-for-age Z score (HAZ) and total and regional fat and lean mass measured by dual-energy X-ray absorptiometry, expressed as internal population Z scores, among 839 Zimbabwean and Zambian perinatally HIV-infected male and female adolescents aged 11-19 years. Stunting (HAZ < -2) was present in 37 % of males and 23 % of females. HAZ was strongly positively associated with total, trunk, arm and leg fat mass and lean mass Z scores, in analyses controlling for pubertal stage, socio-economic status and HIV viral load. Associations of linear growth with lean mass were stronger than those with fat outcomes; associations with total and regional fat were similar, indicating no preferential central fat deposition. There was no evidence that age of starting antiretroviral therapy was associated with HAZ or body composition. Non-suppressed HIV viral load was associated with lower lean but not fat mass. The results do not support the hypothesis that poor linear growth or stunting are risk factors for later total or central fat deposition. Rather, increased linear growth primarily benefits lean mass but also promotes fat mass, both consistent with larger body size. Nutritional and/or HIV infection control programmes need to address the high prevalence of stunting among perinatally HIV-infected children in order to mitigate constraints on the accretion of lean and fat mass.

Nutritional guidance needs and influence factors for gastric cancer survivors in primary healthcare setting: a cross-sectional survey.

This study aimed to build a comprehensive understanding of the nutritional guidance needs of gastric cancer survivors in the primary healthcare setting that could be fulfilled by community health service centers as part of their primary healthcare services. Gastric cancer survivors were invited to participate in a questionnaire-based survey by convenience sampling method from the community health center. Relationships between nutritional demand and potential influence factors were examined by a multivariable logistic regression model. A total of 200 gastric cancer survivors were recruited from the community health service center in Shanghai, China, from whom we obtained 194 valid questionnaires, resulting in a 97.0% response rate. Of these gastric survivor participants, 48 individuals (24.7%) expressed a need for nutritional guidance administered by community health service centers, whereas 146 participants (75.3%) held the perspective that such guidance was unnecessary. Preferences for nutritional guidance included having a dietitian as the provider (68.8%), home-based engagement (72.9%), face-to-face consultation (68.8%), individual counseling (87.5%), and beginning immediately post-discharge (89.6%). A notable reluctance (66.7%) towards financial contribution was also observed. After adjusting for confounders, participants with higher income level (odds ratio (OR) = 4.45, 95% confidence interval (CI) = 1.39-15.50), history of food intake reduction (OR = 14.96, 95% CI = 3.49-82.28), and gastrointestinal symptoms (OR = 4.40, 95% CI = 1.35-14.33) were more likely to seek nutritional guidance. Gastric cancer survivors have a certain need for nutritional guidance administered by primary health service centers. Personal guidance by the primary health service center should be provided to gastric cancer survivors to support their dietary and nutritional intake needs. There is a need to develop and implement nutritional guidance programs in community health service centers as part of their primary healthcare services for gastric cancer survivors.

Moms &amp; Babies Feeling Better Together: Outcomes of a Technology-Assisted, Entertaining, CBT-Based Depression Treatment for Low-Income Perinatal People Served by a Rural Michigan WIC Clinic

Rural Americans experience higher rates of perinatal depression (PND) than urban peers yet are less likely to receive treatment. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a potential setting for offering PND treatment. This pilot study examines the impact of Moms &amp; Babies Feeling Better Together (MBFBT), a technology-assisted depression treatment, on perinatal WIC clients’ depressive symptoms, anxiety, and parenting self-efficacy. A one-group pre-/post-test design assessed changes in outcomes over time. Paired-samples t-test results show statistically significant decreases in depression and anxiety and increases in parenting self-efficacy between baseline and post-treatment. Repeated measures analysis of variance demonstrates significant patterns of difference in expected directions across three timepoints for each outcome. Findings provide preliminary support for MBFBT’s effectiveness and its promise for delivery within rural WIC settings.

Home Food Delivery to Address Food Insecurity Following Hospital Discharge.

Nearly 1 in 5 families with children in the United States are food insecure. Hospitalization of a child can exacerbate food insecurity, both during the hospitalization and after discharge. Although some hospitals provide free or subsidized meals during hospitalization, few address food insecurity in the immediate posthospitalization period. To address this gap, we developed an innovative Inpatient Food Pharmacy program. This program offers families of hospitalized children experiencing food insecurity a choice of 1 week of prepared meals, 6 months of monthly produce delivery, or both, after discharge. Our goals were to assess program enrollment, understand family preferences, and evaluate the program’s feasibility and acceptability. Among 120 eligible families, 71 (59%) enrolled. Fifty-five families (77%) chose both prepared meals and produce delivery, 13 (18%) chose prepared meals only, and 3 (4%) chose produce delivery only. The program successfully delivered 6972 prepared meals and 348 boxes of produce over 10 months. Follow-up calls reached 41 (58%) of enrolled families, all of whom reported that the program met their acute food needs. Feedback from families and resource navigators suggested the program was acceptable. We aim to advocate for sustainable funding for food delivery for children and families experiencing food insecurity at 3 levels (1) institutionally, through our hospital's community benefit spending, (2) statewide, through a proposed Medicaid Section 1115 waiver providing grocery delivery to Medicaid-insured pregnant and postpartum individuals and their families, and (3) federally, through the Special Supplemental Nutrition Program for Women, Infants, and Children and the Supplemental Nutrition Assistance Program.