Micronutrient Supplementation Research Articles

Personalized Ketogenic Diet Using AI for Optimal Brain Health

The ketogenic diet (KD) has demonstrated potential for treating neurological conditions like epilepsy, Alzheimer's disease, and cognitive decline as well as for enhancing brain health. Individual reactions to KD, however, differ because of things like lifestyle, metabolism, and heredity. It is difficult to achieve the best results with a one-size-fits-all dietary strategy because of this diversity. A new answer is provided by artificial intelligence (AI), which makes it possible to provide individualized nutritional advice that take individual characteristics into consideration. AI-driven models can forecast a person's reaction to KD and customize macronutrient ratios, calorie intake, and micronutrient supplementation by combining data from genomes, metabolomics, and clinical profiles. This individualized strategy can boost mitochondrial function, lower inflammation, increase neuroprotective advantages, and enhance cognitive function. This study investigates the application of AI to create a customized ketogenic diet that maximizes brain function.

Methyl Donor Micronutrients Orchestrate Lipid Metabolism: The Role of DNA Methylation Modification

DNA methylation, a key epigenetic modification, plays a crucial role in regulating lipid metabolism. Consistent correlations have been observed between aberrant DNA methylation patterns and lipid metabolic disorders. Emerging evidence indicates that methyl donor micronutrients could influence DNA methylation patterns, consequently exerting an influence on lipid metabolism. Specifically, the deficiency or excesses of methyl donor micronutrients (folate, choline, betaine, B vitamins and methionine) have been associated with altered DNA methylation patterns linked to lipid metabolism. These alteration in DNA methylation levels, occurring globally and within promoter regions, could affect gene expression related to lipid metabolism. However, the mechanisms through which methyl donor micronutrients regulate lipid metabolism via the DNA methylation modification and the role of methyl donor micronutrients supplementation on DNA methylation profiles remain unclear. In this review, we summarized the regulatory role of DNA methylation in lipid metabolism, and highlighted recent findings investigating the impact of methyl donor micronutrients on lipid metabolism, as well as DNA methylation-mediated adipogenesis and adipose deposition. Taken together, this review deepened our understanding of how the complex interplay between methyl donor micronutrients, DNA methylation, and lipid metabolism, and provides valuable information for accurately regulating lipid metabolism of livestock and poultry, thereby improving meat quality, and promoting the development of animal husbandry.

Associations of Maternal Nutritional Status and Supplementation with Fetal, Newborn, and Infant Outcomes in Low-Income and Middle-Income Settings: An Overview of Reviews

Background/Objectives: Despite advances in maternal nutritional knowledge, the effect of maternal diet, micronutrient status and undernutrition, and the effect of maternal supplementation on fetal, neonatal and infant outcomes still have gaps in the literature. This overview of reviews is intended to assess the available information on these issues and identify the main maternal nutritional factors associated with offspring outcomes in low- and middle-income countries as possible targets for public health interventions. Methods: The literature search was performed in Medline (PubMed) and Cochrane Library datasets in June 2024. Pre-specified outcomes in offspring were pooled using standard meta-analytical methods. Results: We found consistent evidence on the impact of maternal undernutrition indicated by low body mass index (BMI), mid-upper arm circumference (MUAC), and stature, but not of individual micronutrient status, on intrauterine-growth retardation, preterm birth, low birth weight, and small for gestational age, with research showing a possible effect of maternal undernutrition in later child nutritional status. Studies on micronutrient supplementation showed possible beneficial effects of iron, vitamin D, and multiple micronutrients on birthweight and/or decreasing small for gestational age, as well as a possible effect of calcium on preterm birth reduction. Interventions showing more consistent beneficial outcomes were balanced protein-energy and lipid base supplements, which demonstrated improved weight in newborns from supplemented mothers and a decreased risk of adverse neonatal outcomes. Conclusions: Further research is needed to identify the benefits and risks of maternal individual micronutrient supplementation on neonatal and further child outcomes.

Determinants of micronutrient supplementation during pregnancy among women in three sub-Saharan African countries: a multilevel logistic regression model

BackgroundPoor maternal nutrition during pregnancy is a common cause of poor maternal and infant outcomes. Micronutrient deficiencies are common among pregnant women in low- and middle-income countries, including sub-Saharan Africa. Pregnant women are recommended to take micronutrients like iron or folic acid and deworming medication during pregnancy. Therefore, this study was conducted to assess micronutrient intake and its associated factors among pregnant women in three countries using the most recent demographic and health survey.MethodsWe used data from the most recent demographic and health surveys, which were carried out between 2019 and 2022 in three sub-Saharan African countries. The study included a weighted sample of 13,568 reproductive-age women who had given birth within the five years prior to the survey. Utilizing multilevel logistic regression, the factors associated with the dependent variable were identified. Model comparison and fitness were assessed using the deviance (-2LLR), likelihood ratio test, median odds ratio, and intra-class correlation coefficient. Ultimately, factors were deemed statistically significant if they had a p-value less than 0.05.ResultsThe pooled prevalence of micronutrient intake among pregnant women during pregnancy of last birth was 77.56% (95% CI: 76.85%–78.25%). Factors like age [AOR = 1.78; 95% CI (1.14, 2.77)], educational status [AOR = 1.49; 95% CI (1.23, 1.79)], marital status [AOR = 0.66; 95% CI (0.58, 0.75)], working status [AOR = 1.17; 95% CI (1.01, 1.34)], media exposure [AOR = 1.20; 95% CI (1.05, 1.38)], preceding birth interval [AOR = 1.17; 95% CI (1.01, 1.34)], number of ANC visits [AOR = 1.65; 95% CI (1.29, 2.10)], and residence [AOR = 1.19; 95% CI (1.03, 1.37)] were significantly associated with micronutrient intake among pregnant women.ConclusionsMore than three-fourths of the study subjects were micronutrient supplemented during their pregnancy. Improving women's education, disseminating nutrition information through media, providing more attention to young pregnant women who live in rural areas, increasing the number of ANC visits, and women's empowerment are strongly recommended.

Expert consensus on major micronutrient supplementation during peri-conceptional period (2024)

Expert consensus on major micronutrient supplementation during peri-conceptional period (2024)

Enteral micronutrient supplementation and neurodevelopmental outcomes in preterm or low birth weight infants: A systematic review and meta-analysis.

The association of enteral micronutrient supplementation and the neurodevelopmental outcomes of preterm or low birth weight (LBW) infants is controversial. This research was prospectively registered (CRD42023454034). We searched MEDLINE, Embase, PsycInfo, ClinicalTrials. gov, and the Cochrane Library for randomised clinical trials (RCTs) or quasi-RCTs comparing any enteral micronutrients supplementation with placebo or no supplementation in preterm or LBW infants. The primary outcome was neurodevelopmental impairment (NDI), with secondary outcomes involving various neurodevelopmental tests and disabilities. There was no evidence of an association between enteral micronutrients supplementation and the risk of NDI (RR, 1.03; 95% CI, 0.93-1.14; moderate certainty evidence). There was no evidence that the supplemented groups enhanced cognitive (MD, 0.65; 95% CI, -0.37 to 1.67; low certainty evidence), language (SMD, -0.01; 95% CI, -0.11 to 0.09; moderate certainty evidence), or motor scores (SMD, 0.04; 95% CI, -0.06 to 0.15; very low certainty evidence) or IQ (SMD, -0.20; 95% CI, -0.53 to 0.13; very low certainty evidence). Subgroup analysis showed that multiple micronutrients supplementation improved expressive language score (MD, 1.42; 95% CI, 0.39-2.45), and zinc supplementation enhanced fine motor score (SMD, 1.70; 95% CI, 0.98-2.43). The overall heterogeneity was low. This study demonstrates that enteral micronutrient supplementation is associated with little or no benefits in neurodevelopmental outcomes for preterm or LBW infants. Well-designed RCTs are needed to further ascertain these associations.

Supplementation and Mitigating Cognitive Decline in Older Adults With or Without Mild Cognitive Impairment or Dementia: A Systematic Review.

This systematic literature review aims to answer the question of how micronutrients might influence the development and progression of dementia. In the present work, we focused on an overview of an updated review of relevant literature published in the last two decades. This review aims to delineate the relationship between micronutrient supplementation and cognitive decline in older subjects. In carrying out this review, we followed PRISMA, and our literature search was performed on PubMed. This systematic review includes only primary studies that have investigated the efficacy of nutritional interventions for the prevention of dementia and improvement of cognitive function in subjects aged 65 years or older with normal cognition, mild cognitive impairment (MCI), or Alzheimer's disease (AD). A gross heterogeneity of studies forbids the possibility of a direct comparison of the results. A review of the inclusion criteria and restrictions has been conducted to check the validity and reliability of the results. In this review, thirty-three primary studies were included. Results have shown that supplementation with vitamin D, probiotics, and PUFAs would most likely reduce cognitive decline, dementia, or AD compared with vitamins A, B, C, and E, which were seen to be relatively ineffective. Of note, when considering vitamin B supplementation, positive effects were only observed in non-aspirin users having high ω-3 fatty acid (ω-3 FA) plasma levels. In some cases, however, there were genotypic differences in subjects in response to vitamin B supplementation.

Exploring factors affecting adherence to multiple micronutrient supplementation during pregnancy in Cambodia: A qualitative analysis.

For decades, iron-folic acid (IFA) supplements have been provided to pregnant women in Cambodia through antenatal care (ANC) services. However, mounting evidence suggests that multiple micronutrient supplements (MMS) are superior to IFA supplements in achieving positive pregnancy outcomes. The possibility of transitioning from IFA supplements to MMS in government-run health centres is currently being assessed in Cambodia. A crucial component of this assessment involves identifying factors that can influence adherence to MMS, as low adherence can reduce supplement effectiveness. Consequently, this study aimed to explore the potential barriers and enablers to MMS adherence and identify the strengths and challenges of current ANC services. Data were collected through nine focus group discussions with pregnant women (n = 19), family members (n = 18) and midwives (n = 18) and three in-depth interviews with maternal and child health chiefs (n = 3) in Cambodia and analysed via content analysis. Factors found to influence MMS adherence included attitudes, perceptions and beliefs about MMS; knowledge related to supplementation; ANC counselling; family influence; physical health; access to ANC; supply of MMS; and supplementation norms. Noted strengths of ANC services were the quality of ANC materials, tailored patient education, midwife-patient relationships and flexibility of provided services. Primary challenges related to poor availability of ANC materials, inadequate midwife training, heavy workload, limited funding and suboptimal physical spaces for delivering ANC services. To effectively promote MMS adherence, strategies must involve pregnant women, family members and community leaders; seek to address knowledge gaps and misconceptions related to MMS; and enhance the availability and accessibility of ANC services.

Characteristics of Hospitalized Patients With and Without Celiac Disease on a Gluten-Free Diet.

Most people maintaining a gluten-free diet (GFD) do not have celiac disease (CD). Comorbidities and associated conditions in this population are largely unknown. This study identified demographics, dietary patterns, and diagnoses for patients prescribed a GFD during hospitalization and compared patients with CD to those without CD. We performed a retrospective cross-sectional study for hospital admissions with a GFD between Jan 1, 2010 and June 30, 2022, while excluding patients missing demographic data (n = 113). We compared patients with and without a CD diagnosis, including multivariable logistic regression to identify characteristics independently associated with a CD diagnosis. We analyzed 1527 hospitalized patients of all ages. A minority (n = 467, 30.6%) carried a CD diagnosis. Age, sex, body mass index, and Medicare/Medicaid enrollment and additional diagnoses associated with a GFD (e.g., IBS) were not significantly different. The CD cohort was more predominantly white (66.6% vs 58.4%, p = 0.007) and non-Hispanic (62.5% vs. 52.7%, p = 0.001). While hospitalized, patients with CD had fewer additional dietary restrictions (mean 0.33 vs 0.56, p < 0.001) and more frequent micronutrient supplementation (26.6% vs 21.4%, p = 0.03). CD was independently associated with malnutrition (OR 1.86, 95% CI 1.31-2.65) and inversely associated with a vegetarian diet (OR 0.35, 95% CI 0.15-0.81), reduced lactose diet (OR 0.25, 95% CI 0.13-0.50), and Hispanic ethnicity (OR 0.56, 95% CI 0.35-0.90) while controlling for other covariates. Two-thirds of hospitalized patients receiving a GFD do not have a diagnosis of CD. Among GFD inpatients, CD is associated with fewer dietary restrictions and independently associated with malnutrition.

Employing machine learning techniques for prediction of micronutrient supplementation status during pregnancy in East African Countries

Micronutrient deficiencies, known as “hidden hunger” or “hidden malnutrition,” pose a significant health risk to pregnant women, particularly in low-income countries like the East Africa region. This study employed eight advanced machine learning algorithms to predict the status of micronutrient supplementation among pregnant women in 12 East African countries, using recent demographic health survey (DHS) data. The analysis involved 138,426 study samples, and algorithm performance was evaluated using accuracy, area under the ROC curve (AUC), specificity, precision, recall, and F1-score. Among the algorithms tested, the random forest classifier emerged as the top performer in predicting micronutrient supplementation status, exhibiting excellent evaluation scores (AUC = 0.892 and accuracy = 94.0%). By analyzing mean SHAP values and performing association rule mining, we gained valuable insights into the importance of different variables and their combined impact, revealing hidden patterns within the data. Key predictors of micronutrient supplementation were the mother’s education level, employment status, number of antenatal care (ANC) visits, access to media, number of children, and religion. By harnessing the power of machine learning algorithms, policymakers and healthcare providers can develop targeted strategies to improve the uptake of micronutrient supplementation. Key intervention components involve enhancing education, strengthening ANC services, and implementing comprehensive media campaigns that emphasize the importance of micronutrient supplementation. It is also crucial to consider cultural and religious sensitivities when designing interventions to ensure their effectiveness and acceptance within the specific population. Furthermore, researchers are encouraged to explore and experiment with various techniques to optimize algorithm performance, leading to the identification of the most effective predictors and enhanced accuracy in predicting micronutrient supplementation status.

Ready-to-use therapeutic food as a promising therapy for the prevention and cure of undernutrition in pre-school children: A review

The nutritional status of pre-school children is a reflection of health of children in the world and forms the basis for the development of success-oriented interventional programs. This study indicates the prevalence of under-nutrition in under five children in the world, Africa and Nigeria. It also showed the prevalence of under-nutrition in the six geopolitical regions in Nigeria, with the Northern regions reported to have the highest burden of under-nutrition compared to the other regions due to several factors such as inadequate breast feeding, lack of access to healthcare, lack of clean water, armed conflict, inadequate dietary intake, inappropriate feeding, foetal growth restriction, inadequate sanitation, lack of parental education, large family size, incomplete vaccination, poverty and low socio-economic status and desire to have more children. Several nutritional interventions have been put in place to prevent and cure under-nutrition in pre-school children, which include Promotion of exclusive breastfeeding, Micronutrient supplementation, Food fortification, Nutrition education, Complimentary feeding, and Cash transfer programs, Ready-to-use therapeutics foods (RUTF), Nutritional rehabilitation centers, Parenteral nutrition, and Nutritional counseling and education. However, RUTF has been reported to have an effective intervention in the prevention and treatment of severe acute malnutrition (SAM) in pre-school children. It is an energy dense, shelf stable and ready to eat food which composed of peanut butter, sugar, full fat milk and mineral-vitamin premix. Other plant-based ingredients such as chickpea, soybean, sesame, maize, oats, sorghum and sunflower oil have also, been used in the production of RUTF and reported to be effective for complete recovery of SAM children.

Use of multiple micronutrient supplementation integrated into routine antenatal care: A discussion of research priorities.

Optimal maternal nutrition, including adequate intake and status of essential micronutrients, is important for the health of women and developing infants. Currently, the World Health Organization (WHO) Antenatal care recommendations for a positive pregnancy experience recommend daily iron and folic acid (IFA) supplementation as the standard of care. The use of multiple micronutrient supplements (MMSs) is recommended in the context of rigorous research as more evidence was needed regarding the impact of switching from IFA supplements to MMS, including evaluation of critical clinical maternal and perinatal outcomes, acceptability, feasibility, sustainability, equity and cost-effectiveness. WHO convened a technical consultation of key stakeholders to discuss research priorities with the objective of providing guidance and clarity to donors, implementers and researchers about this recommendation. The overarching principles of the research agenda include the use of clinical indicators and impact measures that are applicable across studies and settings and the inclusion of outcomes that are important to women. Future studies should consider using standardized protocols based on current best practices to measure critical outcomes such as gestational age (GA) and birthweight (BW) in studies. As GA and BW are influenced by multiple factors, more research is needed to understand the biological impact pathways, and how initiation and considerations for timing of MMS influence these outcomes. A set of core clinical indicators was agreed upon during the technical consultation. For implementation research, the Evidence-to-Decision framework was used as a resource for discussing components of implementation research. The implementation research questions, key indicators and performance measures will depend on country-specific context and bottlenecks that require further research and improved solutions to enable the successful implementation of iron-containing supplements.

Effect of heat stress in the first 1000 days of life on fetal and infant growth: a secondary analysis of the ENID randomised controlled trial

The intersecting crises of climate change, food insecurity, and undernutrition disproportionately affect children. Understanding the effect of heat on growth from conception to 2 years of age is important because of mortality and morbidity implications in the near term and over the life course. In this secondary analysis, we used longitudinal pregnancy cohort data from the Early Nutrition and Immunity Development (ENID) randomised controlled trial in West Kiang, The Gambia, which occurred between Jan 20, 2010, and Feb 10, 2015. The ENID trial assessed micronutrient supplementation in the first 1000 days of life starting from 20 weeks' gestation, during which anthropometric measurements were collected prospectively. We used multivariable linear regression to assess the effect of heat stress (defined by Universal Thermal Climate Index [UTCI]) on intrauterine growth restriction based on length-for-gestational age Z score (LGAZ), weight-for-gestational age Z score (WGAZ), and head circumference-for-gestational age Z score (HCGAZ) at birth, and assessed for effect modification of supplement intervention on the relationship between heat stress and infant anthropometry. We used multivariable, multilevel linear regression to evaluate the effect of heat stress on infant growth postnatally based on weight-for-height Z score (WHZ), weight-for-age Z score (WAZ), and height-for-age Z score (HAZ) from 0 to 2 years of age. Complete data were available for 668 livebirth outcomes (329 [49%] female infants and 339 [51%] male infants). With each 1°C increase in mean daily maximum UTCI exposure, in the first trimester, we observed a reduction in WGAZ (-0·04 [95% CI -0·09 to 0·00]), whereas in the third trimester, we observed an increase in HCGAZ (0·06 [95% CI 0·00 to 0·12]), although 95% CIs included 0. Maternal protein-energy supplementation in the third trimester was associated with reduced WGAZ (-0·16 [-0·30 to -0·02]) with each 1°C increase in mean daily maximum UTCI exposure, while no effect of heat stress on WGAZ was found with either standard care (iron and folate) or multiple micronutrient supplementation. For the postnatal analysis, complete anthropometric data at 2 years were available for 645 infants (316 [49%] female infants and 329 [51%] male infants). Postnatally, heat stress effect varied by infant age, with infants aged 6-18 months being the most affected. In infants aged 12 months exposed to a mean daily UTCI of 30°C (preceding 90-day period) versus 25°C UTCI, we observed reductions in mean WHZ (-0·43 [95% CI -0·57 to -0·29]) and mean WAZ (-0·35 [95% CI -0·45 to -0·26]). We observed a marginal increase in HAZ with increasing heat stress exposure at age 6 months, but no effect at older ages. Our results suggest that heat stress impacts prenatal and postnatal growth up to 2 years of age but sensitivity might vary by age. In the context of a rapidly warming planet, these findings could have short-term and long-term health effects for the individual, and immediate and future implications for public child health. Wellcome Trust.

Micronutrient supplementation and frequency of blood testing in vegan adults in Italy

Micronutrient supplementation and frequency of blood testing in vegan adults in Italy

Expert Consensus on an Open-Access UNIMMAP MMS Product Specification: 2024 revision.

The United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) of a multiple micronutrient supplement (MMS) for pregnant women is a proven evidence-based nutrition intervention and is listed on the World Health Organization (WHO) Model List of Essential Medicines. The 2024 revision of the Expert Consensus on an Open-Access UNIMMAP MMS Product Specification provides both purchasers and manufacturers with unified guidance on the production of UNIMMAP MMS. More specifically, it outlines the minimum requirements for the manufacture of UNIMMAP MMS and provides guidance on quality and regulatory standards based on whether the product is manufactured as a medicinal product or a dietary supplement. The product specification includes ingredients, excipients/food additives, and processing aids used in manufacturing UNIMMAP MMS; stability testing for different climatic zones; packaging and labeling considerations; pharmacopeial standards, manufacturing practices, certificates of analysis, change control, and quality agreement; finished product test specifications, including tablet characterization and purity/strength assay; analytical test methods; and storage and transportation requirements.

The Relevance of Plant-Based Diets and Micronutrient Supplementation for Body Composition: Data from the VeggieNutri Cross-Sectional Study

Objectives: This study aimed to compare the anthropometry and body composition of vegetarian and omnivorous adults living in Portugal, while exploring nutritional and health parameters underlying observed differences. Methods: 425 omnivorous (OMNI), lacto-ovo-vegetarian (LOV), or vegan (VEG) healthy adults were recruited. Anthropometry was measured, and bioelectrical impedance analysis was performed. Participants answered food frequency, sociodemographic, and lifestyle questionnaires. Serum iron, ferritin, and CRP were quantified by spectrophotometry, and serum B12 vitamin and homocysteine were quantified by chemiluminescent microparticle immunoassay. Results: Total protein intake significantly decreased with increasing strictness of vegetarian habits (median (P25; P75) in g/day: 98.6 (79.5; 123.1), 90.4 (65.9; 121.0), and 87.6 (59.8; 118.5) for OMNI, LOV and VEG, respectively; p = 0.020), and carbohydrate intake was the highest in LOV (median (P25; P75) in g/day: 231.5 (178.4; 287.9), 283.9 (227.3; 342.6), and 263.0 (222.0; 348.3) for OMNI, LOV and VEG, respectively; p = 0.001). VEG were the main users of B12 vitamin (93% in VEG vs. 17% in OMNI and 59% in LOV, p = 0.001), and LOV were the main users of iron supplements (29% in LOV vs. 14% in OMNI and 13% in VEG, p = 0.042), respectively. Blood levels of B12 vitamin correlated negatively with blood homocysteine (rs = −0.386, p &lt; 0.001) and positively with % muscle mass (rs = 0.136, p = 0.005). Participants using iron supplements presented higher C-reactive protein (CRP) (p = 0.014) and they had lower % MM (p = 0.003). Finally, when compared to being OMNI, being LOV independently associated with: (a) having +4.8% (p = 0.002) of fat mass, which could be due to higher carbohydrate intake, and (b) having −2.2% (p = 0.043) of muscle mass. Our data suggest that the association between diet and muscle mass could be attenuated in VEG due to B12 supplementation and/or aggravated in LOV due to iron supplementation-associated inflammation.

Micronutrient Supplementation: Need or Producing Costly Urine

Micronutrient Supplementation: Need or Producing Costly Urine

Vitabiotic: An alternative approach to diabetic foot.

Diabetic foot ulcers and infections are complications that can result in significant morbidity such as the need for amputations, especially in uncontrolled diabetes, thereby profoundly impacting quality of life. While traditional treatments like wound care and antibiotics are effective, there is growing interest in the role of micronutrients (such as vitamins C, D, E, zinc and magnesium) in improving outcomes. This study aims to evaluate how these micronutrients affect diabetic foot infections and the need for amputation, offering insights to enhance overall prognosis. Patients who were hospitalised with a diagnosis of diabetic foot infection in the Infectious Diseases Department of Ege University Faculty of Medicine Hospital between 1 April 2022, and 31 January 2023 were included in the study. The patients' socio-demographic information, characteristics of diabetic wounds, operation history, as well as their levels of micronutrients recorded on the case report form. A total of 202 patients were included in the study. The most common micronutrient deficiencies were vitamin D (69%), vitamin C (64%) and zinc (49%). The amputation rates were significantly higher in patients with deficiencies vitamin C, vitamin A and vitamin D (p < 0.005). Our research revealed a significant prevalence of vitamin deficiencies among the participants, and we observed a noteworthy correlation between amputation rates and these deficiencies. Although these findings show promise, it is essential to emphasise that micronutrient supplements should not replace traditional treatments but should rather be considered as a warning sign for preventing complications, particularly amputation or extremity loss.

Randomised control trial indicates micronutrient supplementation may support a more robust maternal microbiome for women with antenatal depression during pregnancy

Background and AimsWe investigated the effects of high dose dietary micronutrient supplementation or placebo on the human gut microbiome in pregnant women who had moderate symptoms of antenatal depression. There is a significant absence of well-controlled clinical studies that have investigated the dynamic changes of the microbiome during pregnancy and the relationship among diet, microbiome and antenatal depression. This research is among the first to provide an insight into this area of research. MethodsThis 12 - week study followed a standard double blinded randomised placebo-controlled trial (RCT) design with either high dose micronutrients or active placebo. Matching stool microbiome samples and mood data were obtained at baseline and post-treatment, from participants between 12 and 24 weeks gestation. Stool microbiome samples from 33 participants (17 in the placebo and 16 in the treatment group) were assessed using 16s rRNA sequencing. Data preparation and statistical analysis was predominantly performed using the QIIME2 bioinformatic software tools for 16s rRNA analysis. ResultsMicrobiome community structure became increasingly heterogenous with decreased diversity during the course of the study, which was represented by significant changes in alpha and beta diversity. This effect appeared to be mitigated by micronutrient administration. There were less substantial changes at the genus level, where Coprococcus decreased in relative abundance in response to micronutrient administration. We also observed that a higher abundance of Coprococcus and higher alpha diversity correlated with higher antenatal depression scores. ConclusionsMicronutrient treatment appeared to support a more diverse (alpha diversity) and stable (beta diversity) microbiome during pregnancy. This may aid in maintaining a more resilient or adaptable microbial community, which would help protect against decreases or fluctuations that are observed during pregnancy.

A review of the intersection between climate change, agriculture, health, and nutrition in Africa: costs and programmatic options

BackgroundClimate change adversely affects Africa’s agriculture which would worsen the widespread food insecurity and nutritional deficiencies. Vulnerable populations, especially female farmers, women, and children are disproportionately affected.MethodsThe paper synthesizes available peer-reviewed and grey literature on the intersections of climate change, food insecurity, agriculture, gender disparities, health, child nutrition, and micronutrient deficiencies in Africa. It explores the economic ramifications of these factors, particularly their impact on public health and economic stability. The work aggregates insights into the current and future challenges of agricultural sustainability and the expected human capital development and economic costs of climate variations.ResultsThe prevalence of hunger and undernourishment in Africa is notably higher compared to other regions. Climate change directly threatens agriculture, with anticipated reductions in crop and livestock yields, compounded by the negative impact of greenhouse emissions on the nutritional quality of staple foods. Female farmers contribute notably to agriculture, but their labor share is less dominant than previously assumed. Exposure to high temperatures, especially for outdoor workers and pregnant women, presents significant health risks, further impacting agricultural and economic output. These interdependencies are presented in a framework along with suggested interventions that could be contextualized to address the climate drivers and interconnectivity across agriculture, health, and livelihoods.ConclusionThe interdependence between food, agriculture, health, nutrition, and human productivity, all of which are exacerbated by the impacts of climate change in Africa, form a complex challenge with profound health and economic implications. A multifaceted strategy is needed, encompassing climate-resilient farming practices, gender-sensitive interventions, health-focused measures like micronutrient supplementation, and comprehensive economic policies.