scholarly journals Effects of Different Allotments of Avocados on the Nutritional Status of Families: A Cluster Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4021
Author(s):  
Lorena S. Pacheco ◽  
Ryan D. Bradley ◽  
Julie O. Denenberg ◽  
Cheryl A. M. Anderson ◽  
Matthew A. Allison
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Energy Intake ◽  
Controlled Trial ◽  
Plant Food ◽  
Primary Analysis ◽  
Intention To Treat ◽  
Calcium Magnesium ◽  
Cluster Randomized ◽  
The Impact

Avocados are a nutrient-dense plant-food, but limited trial-derived evidence exists about the effects of avocado intake on family nutritional status. We investigated the impact of two levels of avocado allotment, plus a standard nutrition education intervention on the nutritional status of Hispanic/Latino families. Seventy-two families consisting of at least three members of ≥5 years of age and residing in the same home, free of severe chronic disease, not on specific diets, and self-identified of Hispanic heritage, were randomized to one of two levels of avocado allotment (low = 3/week/family or high = 14/week/family) for 6 months plus 12 bi-weekly nutrition education sessions. The primary outcomes included change in a family’s total energy and macro- and micronutrient intakes. Primary analysis was intention-to-treat with unpaired, two-sided t-tests to assess mean changes between groups at 6 months. At 6 months, the high avocado allotment group had a significant reduction in energy intake, carbohydrate, animal and vegetable protein, saturated and polyunsaturated fat, calcium, magnesium, sodium, potassium, iron, and vitamin D intakes (all p < 0.05). A high allotment of avocados significantly reduced self-reported energy intake by 29% kcal/family/day, compared to a 3% kcal/family/day reduction in families who received a low allotment. Culturally-appropriate plant-food interventions may alter the nutritional status of at-risk families.

scholarly journals Scaled-Up Nutrition Education on Pulse-Cereal Complementary Food Practice in Ethiopia: A Cluster-Randomized Trial

2020 ◽  
Author(s):  
Getenesh Berhanu Teshome ◽  
Susan J. Whiting ◽  
Timothy J. Green ◽  
Demelash Mulualem ◽  
Carol J. Henry
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Weight Status ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Complementary Food ◽  
Control Group ◽  
Dietary Diversity Score ◽  
Cluster Randomized ◽  
The Impact

Abstract Background: Improving children's weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to assess the impact of a 9-month pulse-nutrition education program on improving mothers' knowledge, attitude, and practices (KAP) towards pulses, as well as its effect on children's diet diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods: A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midline, and endline. ANOVA and descriptive statistics were used to analyzed data. Results: At baseline and endline, maternal KAP and the dietary diversity score of the children (mean age at endline 18.8 ± 2.9 mo) were assessed. Intervention mothers’ KAP improved (p<0.001) at midline and endline compared to that of the control group, as did frequency of pulse consumption and Dietary Diversity Score (DDS) among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group (p=0.001). Conclusions: NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for complementary food may be an effective way to improve the health of children in Ethiopian communities. Trial Registration: Clinicaltrials.gov #NCT02638571

scholarly journals Determinants of Undernutrition among Young Children Living in Soth Nikum District, Siem Reap, Cambodia

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 685 ◽  
Author(s):  
Sonia Blaney ◽  
Lylia Menasria ◽  
Barbara Main ◽  
Chhea Chhorvann ◽  
Lenin Vong ◽  
...  
Keyword(s):  
Health Status ◽  
Nutritional Status ◽  
Controlled Trial ◽  
Baseline Data ◽  
Healthy Environment ◽  
Child Undernutrition ◽  
Degree Of Satisfaction ◽  
Cluster Randomized ◽  
Nutritional Status Of Children ◽  
The Impact

Background: Child undernutrition is of public concern in Cambodia. An understanding of factors influencing child nutritional status is essential to design programs that will reduce undernutrition. Using the UNICEF conceptual framework of causes of malnutrition, our research investigates the relationship between nutritional status of children aged 6–23 months and its immediate and underlying determinants. Methods: Baseline data from a cluster-randomized controlled trial aiming to assess the impact of the promotion of optimal feeding practices combined or not with the provision of local foods among 360 children 6–23 months of age were used. Anthropometry and biochemical measurements were performed at baseline. Data on each determinant of undernutrition were collected through interviews and direct observations. Results: Our results show that the degree of satisfaction of proteins and zinc requirements as well as the access to improved water sources and sanitation were positively associated with length-for-age, while having a better health status and a higher degree of satisfaction of energy, protein, zinc, and iron requirements were associated to an improved weight-for-length. Only child health status was associated to ferritin. Conclusion: Our results reiterate the importance of improving child diet and health status, but also the access to a healthy environment to ensure an optimal nutritional status.

scholarly journals Scaled-up nutrition education on pulse-cereal complementary food practice in Ethiopia: a cluster-randomized trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getenesh Berhanu Teshome ◽  
Susan J. Whiting ◽  
Timothy J. Green ◽  
Demmelash Mulualem ◽  
Carol J. Henry
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Complementary Food ◽  
Control Group ◽  
Dietary Diversity Score ◽  
End Point ◽  
Cluster Randomized ◽  
The Impact

Abstract Background Improving children’s weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to assess the impact of a 9-month pulse-nutrition education program on improving mothers’ knowledge, attitude, and practices (KAP) towards pulses, as well as its effect on children’s diet diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midpoint, and end point. ANOVA and descriptive statistics were used to analyzed data. Results At baseline and end point, maternal KAP and the dietary diversity score of the children (mean age at end point 18.8 ± 2.9 mo) were assessed. Intervention mothers’ KAP improved (p < 0.001) at midpoint and end point compared to that of the control group, as did frequency of pulse consumption and Dietary Diversity Score (DDS) among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group (p = 0.001). Conclusions NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for complementary food may be an effective way to improve the health of children in Ethiopian communities. Trial registration Clinicaltrials.gov #NCT02638571. Date of registration: 12/18/2015. Prospectively registered.

scholarly journals Impact of Protein Supplementation and Presumptive Treatment for Enteric Pathogens on Infant Growth from 6–12 Months of Age: Results of a Cluster-Randomized Controlled Trial

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 880-880
Author(s):  
Amanda Palmer ◽  
Hasmot Ali ◽  
Md Iqbal Hossain ◽  
Monica Pasqualino ◽  
Kaniz Ayesha ◽  
...  
Keyword(s):  
Nutrition Education ◽  
Controlled Trial ◽  
Infant Growth ◽  
Protein Supplementation ◽  
Enteric Pathogens ◽  
Presumptive Treatment ◽  
Anthropometric Indices ◽  
Cluster Randomized ◽  
Supplemental Protein ◽  
The Impact

Abstract Objectives Intake of high-quality protein may be insufficient to support growth in the context of high enteric pathogen carriage and environmental enteric dysfunction. Our objective was to test whether supplemental protein, with or without presumptive treatment for enteric pathogens, would improve infant growth from 6–12 months of age. Methods We conducted a 2 × 4 factorial cluster-randomized trial in rural Bangladesh. The first factor was azithromycin treatment (10 mg/kg * 3 days) or placebo at 6 & 9 months of age. The second factor, delivered from 6–12 months of age, consisted of: supplemental protein as daily porridge (125 kcal/d, with 10 g protein/day as egg white powder) or a daily egg; an isocaloric daily porridge; or nutrition education alone. The present aim tested the impact of the protein-rich porridge, with or without azithromycin treatment. All infants born in the study area over a 9-mo period were eligible and consented at ∼3 mo of age. Trained field workers measured infant size at 6, 9, and 12 mo of age using standardized protocols. We used linear regression with generalized estimating equations to test the interventions’ impact on anthropometric indices, respectively, at 12 mo of age, controlling for baseline measures. Analysis was intention-to-treat. Results Overall, 2205 infants were enrolled from 282 clusters and exposed to both nutrition (1074 in protein arm from 140 clusters; 1074 in the isocaloric arm from 142 clusters) and presumptive treatment interventions. At baseline, 18.7%, 16.9%, and 6.4% of infants were stunted, underweight, and wasted, respectively. There was no statistical interaction between protein supplementation and azithromycin treatment for any of the anthropometric indices, so groups were combined. In the analysis of main effects, added protein had no impact on mean length-for-age (β = 0.01; 95% CI: −0.06, 0.08), weight-for-age (β = −0.002; 95% CI: −0.06, 0.05), or weight-for-length (β = −0.04; 95% CI: −0.12, 0.05) Z-scores at 12 mo of age. Conclusions Supplemental protein from 6–12 mo of age had no effect on mean linear or ponderal growth measured at 12 mo of age, irrespective of presumptive treatment for enteric pathogens with azithromycin. Funding Sources The Bill and Melinda Gates Foundation.

scholarly journals Mitigated Impact of Provision of Local Foods Combined with Nutrition Education and Counseling on Young Child Nutritional Status in Cambodia

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1450 ◽  
Author(s):  
Lylia Menasria ◽  
Sonia Blaney ◽  
Barbara Main ◽  
Lenin Vong ◽  
Vannary Hun ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Controlled Trial ◽  
Local Foods ◽  
Mean Values ◽  
Degree Of Satisfaction ◽  
Iron And Zinc ◽  
Cluster Randomized ◽  
Child Nutritional Status ◽  
To Receive

Background: In Cambodia, stunting and wasting affect, respectively, 32% and 10% of children 0–59 months while 55% are anemic. Our research aims to assess the efficiency of two local foods combined with nutritional education and counseling (CEN) activities as compared to CEN alone on improving child nutritional status and dietary intake. Methods: A cluster-randomized controlled trial was conducted in Soth Nikum area over a six-month period among children 6–23 months (n = 360) assigned to receive either moringa +CEN, cricket +CEN or CEN alone. Anthropometric measurements were performed and hemoglobin and ferritin levels assessed. Results: Overall, no significant increase in the mean length/height-for-age z-score was observed, although a small increase of the weight-for-length/height was noted in intervention groups. Hemoglobin and ferritin mean values increased in all groups. The degree of satisfaction of energy, proteins, iron, and zinc requirements improved in all groups, but to a greater extent in the intervention groups and more children were healthy. Conclusion: Our research shows no significant impact of the provision of two local foods combined with CEN on the improvement of child nutritional status as compared to CEN alone. However, children consuming them better fulfilled their energy, iron, and zinc requirements and were healthier.

scholarly journals Protocol: Impact of nutrition education on nutrition capacity of caregivers and nutrition outcomes of indigenous Mbororo children in the West Region of Cameroon: cluster randomized controlled trial (Preprint)

2020 ◽  
Author(s):  
Florence Titu Manjong ◽  
Vincent Siysi Verla ◽  
Thomas Obinchemti Egbe ◽  
Dickson Nsagha
Keyword(s):  
Nutrition Education ◽  
Health Workers ◽  
Controlled Trial ◽  
Child Growth ◽  
Community Based ◽  
Cluster Randomized ◽  
And Control ◽  
The Impact ◽  
Knowledge Attitude And Practice ◽  
Child Caregiver

BACKGROUND Inadequate diets and life-threatening infections have profound adverse implications for child growth, development and survival, particularly among indigenous peoples. Evidence of the effectiveness of community-based nutrition education interventions in improving child feeding and nutrition outcomes among indigenous Mbororo population in Cameroon is scare. OBJECTIVE This study aims at investigating the impact of culturally-tailored community-based nutrition education intervention (Nu-WASHE) on caregivers’ knowledge, attitude and practice regarding complementary feeding, and nutrition outcomes of indigenous Mbororo children (3-59 months) in the Foumban and Galim health districts of the West region of Cameroon. METHODS A two-arm cluster randomized controlled trial will be conducted in the Foumban Health District and Galim Health District. The intervention and control arms will each comprise of 5 clusters with 121 child-caregiver pairs. Participants in the intervention arm will be organized into 5 caregivers’ peer-support platforms. A total of 12 educational sessions will be delivered to the intervention group by trained female Mbororo nutrition volunteers (6), and community health workers (6). The control arm will receive routine facility-based nutrition education. Data will be collected at 3 months and 6 months follow-up. Both descriptive statistics and multivariate logistic models will be used to estimate the effect of Nu-WASHE (independent variable) on outcome variables (caregivers’ knowledge, attitude and practice); child growth (weight, height/length, weight-for-age); and morbidity status (diarrhea, cough and fever) between both arms. Data assessors will be blinded to the group allocation. An approval (ref: 2019/1002-07/UB/SG/IRB/FHS) was obtained from the Faculty of Health Sciences-Institutional Review Board of the University of Buea. RESULTS Baseline data was collected in September 2019. In February 2020, 10 Mbororo communities (clusters) with 242 child-caregiver pairs were selected and allocated to the experimental and control arm in a 1:1 ratio. Community nutrition volunteers (6) and community health workers (6) were selected and trained. Data collection and analysis are ongoing, and statistical results will be available by the end of December 2020. CONCLUSIONS The findings of this study will provide evidence on the impact of culturally-tailored and Health belief model-based nutrition education for behavior change as a complementary strategy for strengthening health facility-based approaches to the reduction of malnutrition burden among the study population. CLINICALTRIAL The protocol was submitted to the Wealth Health Organization Pan Africa Clinical Trial Registry in South Africa for review. Feedback is still being awaited. The last correspondence was on July 4, 2020.

Zinc Depletion Increases Readmission in Older Patients: An Example of Interactions Between Nutrition and Disease

2017 ◽  
Vol 87 (1-2) ◽  
pp. 10-16 ◽  
Author(s):  
Salah Gariballa ◽  
Awad Alessa
Keyword(s):  
Nutritional Status ◽  
Inductively Coupled Plasma ◽  
Older Patients ◽  
Controlled Trial ◽  
Prognostic Indicators ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
Co Morbidity ◽  
The Impact ◽  
Poor Nutrition

Abstract. Background: ill health may lead to poor nutrition and poor nutrition to ill health, so identifying priorities for management still remains a challenge. The aim of this report is to present data on the impact of plasma zinc (Zn) depletion on important health outcomes after adjusting for other poor prognostic indicators in hospitalised patients. Methods: Hospitalised acutely ill older patients who were part of a large randomised controlled trial had their nutritional status assessed using anthropometric, hematological and biochemical data. Plasma Zn concentrations were measured at baseline, 6 weeks and at 6 months using inductively- coupled plasma spectroscopy method. Other clinical outcome measures of health were also measured. Results: A total of 345 patients assessed at baseline, 133 at 6 weeks and 163 at 6 months. At baseline 254 (74%) patients had a plasma Zn concentration below 10.71 μmol/L indicating biochemical depletion. The figures at 6 weeks and 6 months were 86 (65%) and 114 (70%) patients respectively. After adjusting for age, co-morbidity, nutritional status and tissue inflammation measured using CRP, only muscle mass and serum albumin showed significant and independent effects on plasma Zn concentrations. The risk of non-elective readmission in the 6-months follow up period was significantly lower in patients with normal Zn concentrations compared with those diagnosed with Zn depletion (adjusted hazard ratio 0.62 (95% CI: 0.38 to 0.99), p = 0.047. Conclusions: Zn depletion is common and associated with increased risk of readmission in acutely-ill older patients, however, the influence of underlying comorbidity on these results can not excluded.

Impact of an Amaranth-Sorghum Grains Product on Nutrient Intake of Children Aged 6-23 Months in Kiandutu Slums, Thika, Kenya

10.37512/700 ◽  
2020 ◽  
Keyword(s):  
Nutrition Education ◽  
Nutrient Intake ◽  
Controlled Trial ◽  
Poor Quality ◽  
Control Group ◽  
Composite Flour ◽  
Monthly Basis ◽  
Sorghum Flour ◽  
Baseline Characteristics ◽  
The Impact

Poor quality complementary foods contribute to undernutrition in children aged 6-23 months. Therefore, there is need to explore foods that will provide adequate nutrients for this age group. This study aimed at determining the impact of a sorghum-amaranth composite flour porridge on nutrient intake of children aged 6-23 months. A randomized controlled trial was conducted at Kiandutu slum, Thika, Kenya. Children in the control group (CG), received a maize-sorghum flour while those in the treatment group (TG) received an amaranth-sorghum flour. The sample size per study group was 73 mother-child pairs. The children in the TG received Kcal 1000 worth of porridge/day while those in the CG received Kcal 266.8/day. Mothers of children in both groups were given nutrition education at baseline, and monthly, for six months. Food intake data was taken at baseline, then monthly for six months. Descriptive statistics were used to describe nutrient intake. Chi square and Mann Whitney U test were was used to compare the baseline characteristics of the two groups and their nutrient intake, respectively. At baseline characteristics of the two groups were similar. On a monthly basis, nutrient intake in the TG was significantly higher for a majority of the nutrients than in the CG. The product can contribute to preventing under-nutrition in children aged 6-23 months.

scholarly journals Reduced exposure to malaria vectors following indoor residual spraying of pirimiphos-methyl in a high-burden district of rural Mozambique with high ownership of long-lasting insecticidal nets: entomological surveillance results from a cluster-randomized trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Joseph M. Wagman ◽  
Kenyssony Varela ◽  
Rose Zulliger ◽  
Abuchahama Saifodine ◽  
Rodaly Muthoni ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Indoor Residual Spraying ◽  
Malaria Vectors ◽  
Light Traps ◽  
High Burden ◽  
Randomized Controlled ◽  
Pirimiphos Methyl ◽  
Cluster Randomized ◽  
The Impact ◽  
Long Lasting Insecticidal Nets

Abstract Background The need to develop new products and novel approaches for malaria vector control is recognized as a global health priority. One approach to meeting this need has been the development of new products for indoor residual spraying (IRS) with novel active ingredients for public health. While initial results showing the impact of several of these next-generation IRS products have been encouraging, questions remain about how to best deploy them for maximum impact. To help address these questions, a 2-year cluster-randomized controlled trial to measure the impact of IRS with a microencapsulated formulation of pirimiphos-methyl (PM) in an area with high ownership of long-lasting insecticidal nets (LLINs) was conducted in a high-transmission district of central Mozambique with pyrethroid resistant vectors. Presented here are the results of the vector surveillance component of the trial. Methods The 2 year, two-armed trial was conducted in Mopeia District, Zambezia Province, Mozambique. In ten sentinel villages, five that received IRS with PM in October–November 2016 and again in October–November 2017 and five that received no IRS, indoor light trap collections and paired indoor-outdoor human landing collections catches (HLCs) were conducted monthly from September 2016 through October 2018. A universal coverage campaign in June 2017, just prior to the second spray round, distributed 131,540 standard alpha-cypermethrin LLINs across all study villages and increased overall net usage rates in children under 5 years old to over 90%. Results The primary malaria vector during the trial was Anopheles funestus sensu lato (s.l.), and standard World Health Organization (WHO) tube tests with this population indicated variable but increasing resistance to pyrethroids (including alpha-cypermethrin, from > 85% mortality in 2017 to 7% mortality in 2018) and uniform susceptibility to PM (100% mortality in both years). Over the entire duration of the study, IRS reduced An. funestus s.l. densities by 48% (CI95 33–59%; p < 0.001) in indoor light traps and by 74% (CI95 38–90%; p = 0.010) during indoor and outdoor HLC, though in each study year reductions in vector density were consistently greatest in those months immediately following the IRS campaigns and waned over time. Overall there was no strong preference for An. funestus to feed indoors or outdoors, and these biting behaviours did not differ significantly across study arms: observed indoor-outdoor biting ratios were 1.10 (CI95 1.00–1.21) in no-IRS villages and 0.88 (CI95 0.67–1.15) in IRS villages. The impact of IRS was consistent in reducing HLC exposures both indoors (75% reduction: CI95 47–88%; p = 0. < 0.001) and outdoors (68% reduction: CI95 22–87%; p = 0.012). While substantially fewer Anopheles gambiae s.l. were collected during the study, trends show a similar impact of IRS on this key vector group as well, with a 33% (CI95 7–53%; p = 0.019) reduction in mosquitoes collected in light traps and a non-statistically significant 39% reduction (p = 0.249) in HLC landing rates. Conclusion IRS with PM used in addition to pyrethroid-only LLINs substantially reduced human exposures to malaria vectors during both years of the cluster-randomized controlled trial in Mopeia—a high-burden district where the primary vector, An. funestus s.l., was equally likely to feed indoors or outdoors and demonstrated increasing resistance to pyrethroids. Findings suggest that IRS with PM can provide effective vector control, including in some settings where pyrethroid-only ITNs are widely used. Trial registrationclinicaltrials.gov, NCT02910934. Registered 22 September 2016, https://www.clinicaltrials.gov/ct2/show/NCT02910934.

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