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Babah OA, Akinajo OR, Beňová L, Hanson C, Abioye AI, Adaramoye VO, Adeyemo TA, Balogun MR, Banke-Thomas A, Galadanci HS, Sam-Agudu NA, Afolabi BB, Larsson EC. Prevalence of and risk factors for iron deficiency among pregnant women with moderate or severe anaemia in Nigeria: a cross-sectional study. BMC Pregnancy Childbirth 2024; 24:39. [PMID: 38182997 PMCID: PMC10768359 DOI: 10.1186/s12884-023-06169-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 12/03/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Anaemia during pregnancy causes adverse outcomes to the woman and the foetus, including anaemic heart failure, prematurity, and intrauterine growth restriction. Iron deficiency anaemia (IDA) is the leading cause of anaemia and oral iron supplementation during pregnancy is widely recommended. However, little focus is directed to dietary intake. This study estimates the contribution of IDA among pregnant women and examines its risk factors (including dietary) in those with moderate or severe IDA in Lagos and Kano states, Nigeria. METHODS In this cross-sectional study, 11,582 women were screened for anaemia at 20-32 weeks gestation. The 872 who had moderate or severe anaemia (haemoglobin concentration < 10 g/dL) were included in this study. Iron deficiency was defined as serum ferritin level < 30 ng/mL. We described the sociodemographic and obstetric characteristics of the sample and their self-report of consumption of common food items. We conducted bivariate and multivariable logistic regression analysis to identify risk factors associated with IDA. RESULTS Iron deficiency was observed among 41% (95%CI: 38 - 45) of women with moderate or severe anaemia and the prevalence increased with gestational age. The odds for IDA reduces from aOR: 0.36 (95%CI: 0.13 - 0.98) among pregnant women who consume green leafy vegetables every 2-3 weeks, to 0.26 (95%CI: 0.09 - 0.73) among daily consumers, compared to those who do not eat it. Daily consumption of edible kaolin clay was associated with increased odds of having IDA compared to non-consumption, aOR 9.13 (95%CI: 3.27 - 25.48). Consumption of soybeans three to four times a week was associated with higher odds of IDA compared to non-consumption, aOR: 1.78 (95%CI: 1.12 - 2.82). CONCLUSION About 4 in 10 women with moderate or severe anaemia during pregnancy had IDA. Our study provides evidence for the protective effect of green leafy vegetables against IDA while self-reported consumption of edible kaolin clay and soybeans appeared to increase the odds of having IDA during pregnancy. Health education on diet during pregnancy needs to be strengthened since this could potentially increase awareness and change behaviours that could reduce IDA among pregnant women with moderate or severe anaemia in Nigeria and other countries.
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Affiliation(s)
- Ochuwa Adiketu Babah
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Opeyemi Rebecca Akinajo
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lenka Beňová
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Claudia Hanson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ajibola Ibraheem Abioye
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Victoria Olawunmi Adaramoye
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Titilope A Adeyemo
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Haematology and Blood Transfusion, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Mobolanle Rasheedat Balogun
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Community Health, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Aduragbemi Banke-Thomas
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Global Maternal and Newborn Health Hub, Institute of Lifecourse Development, University of Greenwich, London, UK
| | - Hadiza S Galadanci
- African Center of Excellence for Population Health and Policy, Bayero University, Kano, Nigeria
- Department of Obstetrics and Gynaecology, College of Health Sciences Bayero University Kano/ Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Nadia A Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
| | - Bosede Bukola Afolabi
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
- Centre for Clinical Trials and Implementation Science (CCTRIS), College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Elin C Larsson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Choquenaira-Quispe C, Yucra Condori HR, Villanueva Salas JA, Gonzales-Condori EG. In vitro release of aluminum from the geophagic clay "Chacco" in the Peruvian highlands: Chemical characterization and health risk assessment. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART. B, PESTICIDES, FOOD CONTAMINANTS, AND AGRICULTURAL WASTES 2023; 58:294-303. [PMID: 36636021 DOI: 10.1080/03601234.2022.2161795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
In the altiplano zone of Latin America, "Chacco" is one of the clays widely consumed as part of geophagy. The objectives of the study were to chemically characterize "Chacco", determine the zero charge point, evaluate the release of aluminum in vitro, perform the kinetic study and evaluate the health risk. The results by ICP-OES showed that the elements with the highest concentration were Al, Ba, Ca, Fe, K, Mg, Mn, Na, Si, Sr, Ti and Zn. ATR-FTIR analysis showed the presence of Si-O (693 and 990 cm-1), Al-O (790 cm-1), Al-Al-OH bending vibration (912 cm-1), Si-H bond stretching (2100 to 2500 cm-1) and free -OH groups (3629 cm-1). SEM-EDX results indicate that Al is one of the main constituents of "Chacco" (7.35 wt%). The pHzpc of "Chacco" was 6.83. In the dissolution profiles, the highest Al release occurred at pH 6.8 and in intestinal juice simulated with pseudo-second order dissolution kinetics. The EDIAl and EWIAl were 20.24 and 142.66 respectively, comparing EWIAl with the PTWI established by JECFA (2 mg/kg bw), it is concluded that the weekly intake of "Chacco" represents an appreciable health risk. There are no reports of the carcinogenic factor of Al, so TRAl was not calculated.
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Affiliation(s)
- Celia Choquenaira-Quispe
- Escuela de Postgrado, Universidad Católica de Santa María, Urb. San José s/n Umacollo, Arequipa, Perú
| | - Harry R Yucra Condori
- Departamento Académico de Ingeniería de Industrias Alimentarias, Universidad Nacional de San Agustín, Arequipa, Perú
| | - José A Villanueva Salas
- Escuela de Postgrado, Universidad Católica de Santa María, Urb. San José s/n Umacollo, Arequipa, Perú
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Bundschuh J, Schneider J, Alam MA, Niazi NK, Herath I, Parvez F, Tomaszewska B, Guilherme LRG, Maity JP, López DL, Cirelli AF, Pérez-Carrera A, Morales-Simfors N, Alarcón-Herrera MT, Baisch P, Mohan D, Mukherjee A. Seven potential sources of arsenic pollution in Latin America and their environmental and health impacts. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 780:146274. [PMID: 34030289 DOI: 10.1016/j.scitotenv.2021.146274] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 06/12/2023]
Abstract
This review presents a holistic overview of the occurrence, mobilization, and pathways of arsenic (As) from predominantly geogenic sources into different near-surface environmental compartments, together with the respective reported or potential impacts on human health in Latin America. The main sources and pathways of As pollution in this region include: (i) volcanism and geothermalism: (a) volcanic rocks, fluids (e.g., gases) and ash, including large-scale transport of the latter through different mechanisms, (b) geothermal fluids and their exploitation; (ii) natural lixiviation and accelerated mobilization from (mostly sulfidic) metal ore deposits by mining and related activities; (iii) coal deposits and their exploitation; (iv) hydrocarbon reservoirs and co-produced water during exploitation; (v) solute and sediment transport through rivers to the sea; (vi) atmospheric As (dust and aerosol); and (vii) As exposure through geophagy and involuntary ingestion. The two most important and well-recognized sources and mechanisms for As release into the Latin American population's environments are: (i) volcanism and geothermalism, and (ii) strongly accelerated As release from geogenic sources by mining and related activities. Several new analyses from As-endemic areas of Latin America emphasize that As-related mortality and morbidity continue to rise even after decadal efforts towards lowering As exposure. Several public health regulatory institutions have classified As and its compounds as carcinogenic chemicals, as As uptake can affect several organ systems, viz. dermal, gastrointestinal, peptic, neurological, respiratory, reproductive, following exposure. Accordingly, ingesting large amounts of As can damage the stomach, kidneys, liver, heart, and nervous system; and, in severe cases, may cause death. Moreover, breathing air with high As levels can cause lung damage, shortness of breath, chest pain, and cough. Further, As compounds, being corrosive, can also cause skin lesions or damage eyes, and long-term exposure to As can lead to cancer development in several organs.
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Affiliation(s)
- Jochen Bundschuh
- UNESCO Chair on Groundwater Arsenic within the 2030 Agenda for Sustainable Development, University of Southern Queensland, West Street, Toowoomba 4350, Queensland, Australia.
| | - Jerusa Schneider
- Department of Geology and Natural Resources, Institute of Geosciences, University of Campinas, 13083-855 Campinas, SP, Brazil; Faculty of Agricultural Sciences, Federal University of Grande Dourados, João Rosa Góes St., 1761, Dourados, Mato Grosso do Sul, 79804-970, Brazil
| | - Mohammad Ayaz Alam
- Departamento de Geología, Facultad de Ingeniería, Universidad de Atacama, Avenida Copayapu 485, Copiapó, Región de Atacama, Chile
| | - Nabeel Khan Niazi
- Institute of Soil and Environmental Sciences, University of Agriculture Faisalabad, Faisalabad 38040, Pakistan
| | - Indika Herath
- UNESCO Chair on Groundwater Arsenic within the 2030 Agenda for Sustainable Development, University of Southern Queensland, West Street, Toowoomba 4350, Queensland, Australia
| | - Faruque Parvez
- Department of Environmental Health Sciences, Columbia University, 60 Haven Ave, B-1, New York, NY 10032, USA
| | - Barbara Tomaszewska
- AGH University of Science and Technology, Mickiewicza 30 Av., 30-059 Kraków, Poland
| | | | - Jyoti Prakash Maity
- Department of Earth and Environmental Sciences, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County 62102, Taiwan
| | - Dina L López
- Department of Geological Sciences, Ohio University, 316 Clippinger Laboratories, Athens, OH, USA
| | - Alicia Fernández Cirelli
- University of Buenos Aires, Faculty of Veterinary Sciences, Instituto de Investigaciones en Producción Animal (UBA-CONICET), Centro de Estudios, Transdiciplinarios del Agua (UBA), Av. Chorroarín 280, CABA C1427CWO, Argentina
| | - Alejo Pérez-Carrera
- University of Buenos Aires, Faculty of Veterinary Sciences, Centro de Estudios Transdiciplinarios del Agua (UBA), Instituto de Investigaciones en Producción Animal (UBA-CONICET), Cátedra de Química Orgánica de Biomoléculas, Av. Chorroarín 280, CABA C1427CWO, Argentina
| | - Nury Morales-Simfors
- UNESCO Chair on Groundwater Arsenic within the 2030 Agenda for Sustainable Development, University of Southern Queensland, West Street, Toowoomba 4350, Queensland, Australia; RISE Research Institutes of Sweden, Division ICT-RISE SICS East, Linköping SE-581.83, Sweden
| | - Maria Teresa Alarcón-Herrera
- Departamento de Ingeniería Sustentable, Centro de Investigación en Materiales Avanzados SC Unidad Durango, C. CIMAV # 110, Ejido Arroyo Seco, Durango, Dgo., Mexico
| | - Paulo Baisch
- Laboratório de Oceanografia Geológica, Instituto de Oceanografia, Universidade Federal do Rio Grande (FURG), Campus Carreiros, CP 474, CEP 96203-900 Rio Grande, RS, Brazil
| | - Dinesh Mohan
- UNESCO Chair on Groundwater Arsenic within the 2030 Agenda for Sustainable Development, University of Southern Queensland, West Street, Toowoomba 4350, Queensland, Australia; School of Environmental Sciences, Jawaharlal Nehru University, New Delhi 110067, India
| | - Abhijit Mukherjee
- Department of Geology and Geophysics, Indian Institute of Technology (IIT), Kharagpur, West Bengal 721302, India
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Geophagic clay around Uteh-Uzalla near Benin: mineral and trace elements compositions and possible health implications. SN APPLIED SCIENCES 2021. [DOI: 10.1007/s42452-021-04565-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AbstractGeophagic clay consumption, which is an age-long cultural practice by humans and animals in many parts of the world, and particularly in Nigeria, may have long time health effects on the consumers. This is particularly so because of the relatively high concentration of harmful minerals and toxic elements. This study sought to determine the mineralogical and trace element compositions of geophagic clay in Uteh-Uzalla area, which is underlain by the Benin Formation of Oligocene to Miocene age, in order to evaluate the potential health risk associated with the consumption of the clay. Sixteen clay samples were collected from mine face profiles of an open pit, analysed for mineral and trace element compositions, using x-ray diffraction technique and ultra-trace inductively coupled plasma mass spectrometry (ICP-MS) methods, respectively. The mean mineral concentration in % includes kaolinite, quartz and smectite (64.88, 19.98, and 9.54), respectively, among other minerals. And the mean concentrations in mg/kg for Cu (15.0), Pb (14.4), Zn (30.9), Co (8.9), Mn (39.4) and Th (10.5) among other elements were found in the clay. From the trace elements results when compared with health risk indices by Agency for Toxic Substances and Diseases Registry (ATSDR): Minimum Risk Level, recommended daily intake and estimated daily intake, it was found that the elements are far above the daily oral intake requirement. Also, considering the relatively low pH (acidic) values that were exhibited by the clays, harmful minerals and elements contained in the clay may be bioavailable in the internal system among those who are frequently involved in the consumption of the clay.
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Miller JD, Fitzgerald KG, Smith AL, Young SL. Geophagy among a Cohort of Kenyan Women with Mixed HIV Status: A Longitudinal Analysis. Am J Trop Med Hyg 2020; 101:654-660. [PMID: 31333167 DOI: 10.4269/ajtmh.19-0149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Geophagy, the craving and purposive consumption of earth, is commonly reported during pregnancy. To date, most studies of geophagy have been cross-sectional and have not assessed its relationship with HIV infection. Therefore, to concurrently examine proposed etiologies of geophagy, a cohort of 371 women with mixed HIV status from Nyanza region, Kenya were recruited in late pregnancy and interviewed about pica at nine time points, through 21 months postpartum. Nutritional status (hemoglobin concentration and food insecurity), physical health (HIV infection and gastrointestinal distress), and psychosocial health (depression and perceived stress) were also repeatedly assessed. Prevalence of geophagy was greatest during pregnancy and decreased significantly postpartum. In a two-level hierarchical linear model, a one-unit increase in average hemoglobin (g/dL) was associated with a 35% decrease in the odds of geophagy. The adjusted odds ratios (CI) of geophagy were 3.98 (2.99, 5.29), 2.54 (1.13, 5.69), and 1.68 (1.15, 2.44) times higher if a woman was pregnant, reported diarrhea in the prior 24 hours, or was HIV positive, respectively. The adjusted odds ratio of geophagy was 1.61 (1.06, 2.45) times higher if a woman reported geophagy during childhood. Our results lend greatest plausibility to the protection hypothesis (i.e., that geophagy occurs in response to compromised immunity and/or infection). Given the high prevalence of geophagy, clinicians should regularly screen for the behavior and measure inflammatory biomarkers before treating geophagy with iron supplements, which can exacerbate some infections.
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Affiliation(s)
- Joshua D Miller
- Department of Anthropology, Northwestern University, Evanston, Illinois
| | | | - Abigail L Smith
- Department of Statistics, Northwestern University, Evanston, Illinois
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, Illinois
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Gomes CDSF. Healing and edible clays: a review of basic concepts, benefits and risks. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2018; 40:1739-1765. [PMID: 28150053 DOI: 10.1007/s10653-016-9903-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 11/24/2016] [Indexed: 06/06/2023]
Abstract
The use of clay by humans for medicinal and wellness purposes is most probably as old as mankind. Within minerals, due to its ubiquitous occurrence in nature and easy availability, clay was the first to be used and is still used worldwide. Healing clays have been traditionally used by man for therapeutic, nutritional and skin care purposes, but they could impart some important health and skin care risks. For instance, clay particles could adsorb and make available for elimination or excretion any potential toxic elements or toxins being ingested or produced, but they could adsorb and make available for incorporation, through ingestion or through dermal absorption, toxic elements, e.g. heavy metals. Edible clays, a particular case of healing clays, have been traditionally used by man for nutritional and therapeutic purposes. Geophagy, the deliberate soil eating, earth eating, clay eating and pica (medical condition or eating disorder shown by individuals addicted to eat earth substances), has been observed in all parts of the world since antiquity, reflecting cultural practice, religious belief and physiological needs, be they nutritional (dietary supplementation) or as a remedy for disease. This paper pretends to review historical data, basic concepts and functions, as well as benefits and risks of the use of healing clays, in general, for therapeutic and cosmetic purposes, and of edible clays, in particular, for therapeutic purposes.
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Miller JD, Collins SM, Omotayo M, Martin SL, Dickin KL, Young SL. Geophagic earths consumed by women in western Kenya contain dangerous levels of lead, arsenic, and iron. Am J Hum Biol 2018; 30:e23130. [PMID: 29722093 DOI: 10.1002/ajhb.23130] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/25/2018] [Accepted: 04/07/2018] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Geophagy is commonly reported by pregnant women and children, yet its causes and consequences remain poorly understood. Therefore, we sought to determine if geophagy could contribute micronutrients and/or be a source of heavy metal exposure by examining the elemental composition of earths consumed in Kakamega, Kenya. METHODS Ten samples of earths commonly consumed during pregnancy were collected by study enumerators and analyzed using inductively coupled plasma-atomic emission spectroscopy. Samples were either collected at markets or from walls of participants' homes, based on where participants reported most commonly sourcing their consumed earths. RESULTS Based on estimated intakes (40 g/day), all samples had lead levels that exceeded the provisional maximum tolerable daily intake, and one sample exceeded the threshold for arsenic. Further, estimated intakes of iron for all samples were at least 8.9 times higher than the established threshold. Elemental concentrations were also compared by the site of sample collection (market vs. household wall); market samples had significantly higher iron concentrations and lower calcium concentrations than wall samples. CONCLUSIONS Geophagic earths in Kakamega may be harmful because of dangerously high levels of lead, arsenic, and iron. The prevalence of geophagy among vulnerable populations underscores the importance of understanding its causes and consequences for accurate public health messaging.
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Affiliation(s)
- Joshua D Miller
- Department of Anthropology, Northwestern University, Evanston, Illinois 60208
| | - Shalean M Collins
- Department of Anthropology, Northwestern University, Evanston, Illinois 60208
| | - Moshood Omotayo
- Program in International Nutrition, Cornell University, Ithaca, New York 14850.,Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York 14214
| | - Stephanie L Martin
- Department of Nutrition, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Katherine L Dickin
- Department of Nutritional Sciences, Cornell University, Ithaca, New York 14850
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, Illinois 60208
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