Urban–Rural Disparities in Energy Intake and Contribution of Fat and Animal Source Foods in Chinese Children Aged 4–17 Years

Abstract Objectives Global intakes of animal source foods (ASFs) are important for several health outcomes─ broadly positive for maternal and child health outcomes (MCH) and broadly negative for some non-communicable diseases (NCDs). While ASFs represent an important source of key nutrients for many (particularly lower-income) consumers, the distributions of ASF intake is not well established. Our objective was to generate comprehensive estimates of daily intakes of milk, eggs, unprocessed red meat, and additional ASFs by country, age, sex, education and urban/rural location in 2015. Methods National and subnational surveys on dietary intake were identified through systematic searches of multiple electronic databases, and through personal communication with experts worldwide. Presently, the Global Dietary Database (GDD) includes 1137 survey-years of global data representing participants from 185 countries (97.5% of the world's population). Bayesian hierarchical modeling methods were used to combine individual-level intake data with country-level availability data and estimate mean intake and its statistical uncertainty for each country-, age-, sex-, education-, urban/rural- and year-specific stratum. Results In 2015, global milk intake was 95.0 g/day (95% uncertainty interval [UI] 70.1–134.7 g/day) with region-specific intakes ranging from 49.2 g/day in Asia to 155.9 g/day in high-income countries (Figure 1). Mean national milk intake was highest in Sweden (299.9 g/day) and lowest in China (23.4 g/day). Global egg intake was 25.0 g/day (13.5–54.1 g/day). Region-specific intake was highest in Latin American and the Caribbean (45.4 g/day) and lowest in Sub-Saharan Africa (13.9 g/day; Figure 2). Mean national egg intake was ≥1 serving per day (55 g) in 3 of the 185 countries. Global unprocessed red meat intake was 57.9 g/day (40.1–89.2 g/day) and intake was greatest in the Former Soviet Union (75.3 g) and Latin America and the Caribbean (69.4 g; Figure 3). National red meat intake was ≥1 serving per day (100 g) in 7 of the 185 countries. Additional findings for cheese, yogurt, reduced fat milk, whole milk, seafood and processed meat will be presented at the meeting. Conclusions Our findings highlight the substantial range of ASF intake worldwide. These data are valuable for dietary monitoring and the development of policies to prevent MCH and NCDs associated with both ASF insufficiency and surplus. Funding Sources Gates Foundation. Supporting Tables, Images and/or Graphs

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Trends and Urban-Rural Disparities of Energy Intake and Macronutrient Composition among Chinese Children: Findings from the China Health and Nutrition Survey (1991 to 2015)

Nutrients ◽

10.3390/nu13061933 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1933

Author(s):

Jian Zhao ◽

Lijun Zuo ◽

Jian Sun ◽

Chang Su ◽

Huijun Wang

Keyword(s):

Energy Intake ◽

Nutrition Transition ◽

Chinese Children ◽

Nutrition Status ◽

Nutrition Survey ◽

Macronutrient Composition ◽

Nutritional Interventions ◽

Balanced Diet ◽

Health And Nutrition ◽

Urban Rural

The nutrition status of children is gaining more attention with a rapid nutrition transition. This study aimed to investigate trends and urban-rural differences in dietary energy and macronutrient composition among Chinese children. A total of 7565 participants aged 6 to 17 years were obtained from three rounds (1991, 2004 and 2015) of the Chinese Health and Nutrition Survey (CHNS). The individual diet was evaluated via three consecutive 24-hour dietary recalls and compared with the Chinese Dietary Reference Intakes (DRIs). From 1991 to 2015, there was a significant increase in children’s fat intake, the proportion of energy intake from fat, and the proportion of children with more than 30% of energy from fat and less than 50% of energy from carbohydrates (p < 0.001). Compared with the DRI, the proportion with higher fat and lower carbohydrate intakes were, respectively, 64.7% and 46.8% in 2015. The urban-rural disparities in fat and carbohydrate intake gradually narrowed, while the gap in protein intake increased notably over time (p < 0.001). Chinese children experienced a rapid transformation to a low-carbohydrate and high-fat diet. Urban-rural disparities persistently existed; further nutritional interventions and education were of great significance, so as to ensure a more balanced diet for Chinese children.

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Animal source foods have a positive impact on the primary school test scores of Kenyan schoolchildren in a cluster-randomised, controlled feeding intervention trial

British Journal Of Nutrition ◽

10.1017/s0007114513003310 ◽

2013 ◽

Vol 111 (5) ◽

pp. 875-886 ◽

Cited By ~ 25

Author(s):

Judie L. Hulett ◽

Robert E. Weiss ◽

Nimrod O. Bwibo ◽

Osman M. Galal ◽

Natalie Drorbaugh ◽

...

Keyword(s):

Energy Intake ◽

Test Scores ◽

Primary Schools ◽

Average Energy ◽

Child Growth ◽

Control Group ◽

Animal Source Foods ◽

Cluster Randomised ◽

Animal Source ◽

The Impact

Micronutrient deficiencies and suboptimal energy intake are widespread in rural Kenya, with detrimental effects on child growth and development. Sporadic school feeding programmes rarely include animal source foods (ASF). In the present study, a cluster-randomised feeding trial was undertaken to determine the impact of snacks containing ASF on district-wide, end-term standardised school test scores and nutrient intake. A total of twelve primary schools were randomly assigned to one of three isoenergetic feeding groups (a local plant-based stew (githeri) with meat, githeri plus whole milk or githeri with added oil) or a control group receiving no intervention feeding. After the initial term that served as baseline, children were fed at school for five consecutive terms over two school years from 1999 to 2001. Longitudinal analysis was used controlling for average energy intake, school attendance, and baseline socio-economic status, age, sex and maternal literacy. Children in the Meat group showed significantly greater improvements in test scores than those in all the other groups, and the Milk group showed significantly greater improvements in test scores than the Plain Githeri (githeri+oil) and Control groups. Compared with the Control group, the Meat group showed significant improvements in test scores in Arithmetic, English, Kiembu, Kiswahili and Geography. The Milk group showed significant improvements compared with the Control group in test scores in English, Kiswahili, Geography and Science. Folate, Fe, available Fe, energy per body weight, vitamin B12, Zn and riboflavin intake were significant contributors to the change in test scores. The greater improvements in test scores of children receiving ASF indicate improved academic performance, which can result in greater academic achievement.

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Cash transfers and child nutritional outcomes: a systematic review and meta-analysis

BMJ Global Health ◽

10.1136/bmjgh-2020-003621 ◽

2020 ◽

Vol 5 (12) ◽

pp. e003621

Author(s):

James Manley ◽

Yarlini Balarajan ◽

Shahira Malm ◽

Luke Harman ◽

Jessica Owens ◽

...

Keyword(s):

Child Nutrition ◽

Social Protection ◽

Dietary Diversity ◽

Meta Analysis ◽

Cash Transfer ◽

Animal Source Foods ◽

Animal Source ◽

Z Scores ◽

Households With Children ◽

The Impact

BackgroundCash transfer (CT) programmes are implemented widely to alleviate poverty and provide safety nets to vulnerable households with children. However, evidence on the effects of CTs on child health and nutrition outcomes has been mixed. We systematically reviewed evidence of the impact of CTs on child nutritional status and selected proximate determinants.MethodsWe searched articles published between January 1997 and September 2018 using Agris, Econlit, Eldis, IBSS, IDEAS, IFPRI, Google Scholar, PubMed and World Bank databases. We included studies using quantitative impact evaluation methods of CTs with sample sizes over 300, targeted to households with children under 5 years old conducted in countries with gross domestic product per capita below US$10 000 at baseline. We conducted meta-analysis using random-effects models to assess the impact of CT programmes on selected child nutrition outcomes and meta-regression analysis to examine the association of programme characteristics with effect sizes.ResultsOut of 2862 articles identified, 74 articles were eligible for inclusion. We find that CTs have significant effects of 0.03±0.03 on height-for-age z-scores (p<0.03) and a decrease of 2.1% in stunting (95% CI −3.5% to −0.7%); consumption of animal-source foods (4.5%, 95% CI 2.9% to 6.0%); dietary diversity (0.73, 95% CI 0.28 to 1.19) and diarrhoea incidence (−2.7%, 95% CI −5.4% to −0.0%; p<0.05). The effects of CTs on weight-for-age z-scores and wasting were not significant (0.02, 95% CI −0.03 to 0.08; p<0.42) and (1.2%, 95% CI: −0.1% to 2.5%; p<0.07), respectively. We found that specific programme characteristics differentially modified the effect on the nutrition outcomes studied.ConclusionWe found that CT programmes targeted to households with young children improved linear growth and contributed to reduced stunting. We found that the likely pathways were through increased dietary diversity, including through the increased consumption of animal-source foods and reduced incidence of diarrhoea. With heightened interest in nutrition-responsive social protection programmes to improve child nutrition, we make recommendations to inform the design and implementation of future programmes.

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