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Fleming LE, Landrigan PJ, Ashford OS, Whitman EM, Swift A, Gerwick WH, Heymans JJ, Hicks CC, Morrissey K, White MP, Alcantara-Creencia L, Alexander KA, Astell-Burt T, Berlinck RGS, Cohen PJ, Hixson R, Islam MM, Iwasaki A, Praptiwi RA, Raps H, Remy JY, Sowman G, Ternon E, Thiele T, Thilsted SH, Uku J, Ockenden S, Kumar P. Enhancing Human Health and Wellbeing through Sustainably and Equitably Unlocking a Healthy Ocean's Potential. Ann Glob Health 2024; 90:41. [PMID: 39005643 PMCID: PMC11243763 DOI: 10.5334/aogh.4471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 05/13/2024] [Indexed: 07/16/2024] Open
Abstract
A healthy ocean is essential for human health, and yet the links between the ocean and human health are often overlooked. By providing new medicines, technologies, energy, foods, recreation, and inspiration, the ocean has the potential to enhance human health and wellbeing. However, climate change, pollution, biodiversity loss, and inequity threaten both ocean and human health. Sustainable realisation of the ocean's health benefits will require overcoming these challenges through equitable partnerships, enforcement of laws and treaties, robust monitoring, and use of metrics that assess both the ocean's natural capital and human wellbeing. Achieving this will require an explicit focus on human rights, equity, sustainability, and social justice. In addition to highlighting the potential unique role of the healthcare sector, we offer science-based recommendations to protect both ocean health and human health, and we highlight the unique potential of the healthcare sector tolead this effort.
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Affiliation(s)
- Lora E Fleming
- European Centre for Environment and Human Health of the University of Exeter Medical School, Cornwall, UK
| | - Philip J Landrigan
- Instituto de Quimica de Sao Carlos, Universidade de Sao Paulo, Sao Carlos, SP, Brazil
| | | | - Ella M Whitman
- Program for Global Public Health and the Common Good, Boston College, Boston, Massachusetts, USA and the Centre Scientifique de Monaco, Monaco
| | - Amy Swift
- Ocean Program, at World Resources Institute, London, UK
| | - William H Gerwick
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, US
| | | | | | - Karyn Morrissey
- Department of Technology, Management and Economics, Technical University of Denmark, Denmark
| | | | - Lota Alcantara-Creencia
- College of Fisheries and Aquatic Sciences, Western Philippines University, Palawan, Philippines
| | - Karen A Alexander
- Marine Governance and Blue Economy at Heriot-Watt University, Orkney, UK
| | - Thomas Astell-Burt
- School of Architecture, Design and Planning, University of Sydney, Sydney, Australia
| | - Roberto G S Berlinck
- Instituto de Quimica de Sao Carlos, Universidade de Sao Paulo, Sao Carlos, SP, Brazil
| | - Philippa J Cohen
- Small-Scale Fisheries Research Program World Fish, Penang, Malaysia
| | - Richard Hixson
- Critical Care, County Durham and Darlington NHS Foundation Trust, Darlington, UK
| | - Mohammad Mahmudul Islam
- Department of Coastal and Marine Fisheries, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Arihiro Iwasaki
- Department of Applied Chemistry, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - Radisti A Praptiwi
- Research Center for Ecology and Ethnobiology, National Research and Innovation Agency (BRIN), Jakarta, Indonesia
| | | | - Jan Yves Remy
- Shridath Ramphal Centre, the University of the West Indies, St. Lucia/Barbados
| | - Georgina Sowman
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Eva Ternon
- Laboratoire d'Océanographie de Villefranche at Sorbonne Université, Paris, France
| | - Torsten Thiele
- Research Institute for Sustainability - Helmholtz Centre Potsdam (RIFS), Potsdam, Germany
| | - Shakuntala H Thilsted
- Nutrition, Health and Food Security Impact Area Platform Worldfish CGIAR, Penang, Malaysia
| | - Jacqueline Uku
- Kenya Marine and Fisheries Research Institute, Mombasa, Kenya
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Fetriyuna F, Purwestri RC, Jati IR, Setiawan B, Huda S, Wirawan NN, Andoyo R. Ready-to-use therapeutic/supplementary foods from local food resources: Technology accessibility, program effectiveness, and sustainability, a review. Heliyon 2023; 9:e22478. [PMID: 38046154 PMCID: PMC10686882 DOI: 10.1016/j.heliyon.2023.e22478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 12/05/2023] Open
Abstract
Ready-to-Use Therapeutic Food (RUTF) or Ready-to-Use Supplementary Food (RUSF) has been widely used in home-based treatment for severely and moderately acute malnourished children. These programs showed positive results in short term nutritional recovery in children, which were reported in some research settings. Nowadays, the RUTF/RUSF formulation has been improved using a variety of RUTF/RUSF from locally available food ingredients. This paper aims to review the essential aspects of the development and provision of RUTF/RUSF made from local food resources and monitor program effectiveness that warrants the program's sustainability. The modified recipes of RUTF/RUSF were developed following the international dietary guidelines for the rehabilitation of severely and moderately acute malnourished children. The local production of RUTF/RUSF provided some benefits that include empowering the local community, consideration of the common eating pattern, promoting the diversification of food consumption, strengthening food security, as well as supporting the sustainability of RUTF/RUSF production. Results of the PRISMA-based systematic literature review revealed various ingredient developments and processing techniques which could improve the product characteristics and sensory evaluation. RUTF/RUSF in local food production provided different food carriers (e.g., biscuits, wafers) and seemed to be more readily accepted by the children. Furthermore, the program sustainability of RUTF/RUSF depends on a continuous ingredients supply and support from the local government. The findings presented the importance of development of such food supplements based on the local food resources and with improved technology for prevention and rehabilitation of malnourished children.
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Affiliation(s)
- Fetriyuna Fetriyuna
- Department of Food Technology, Faculty of Agro-Industrial Technology, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
- Institute for Nutritional Science (140a), University of Hohenheim, Garbenstrasse 30, 70599, Stuttgart, Germany
- Study Center for the Development of Agro-Industrial Technology, Faculty of Agro-Industrial Technology, Universitas Padjadjaran, Jln. Raya Bandung-Sumedang Km. 21, Jatinangor, 45363, Indonesia
| | - Ratna Chrismiari Purwestri
- Institute for Nutritional Science (140a), University of Hohenheim, Garbenstrasse 30, 70599, Stuttgart, Germany
- Faculty of Forestry and Wood Sciences, Czech University of Life Sciences Prague, Kamycka 129, 16500, Praha-Suchdol, Czech Republic
| | - Ignasius R.A.P. Jati
- Department of Food Technology, Widya Mandala Surabaya Catholic University, Surabaya, 60265, Indonesia
| | - Budhi Setiawan
- Department of Pharmacology, Faculty of Medicine, Universitas Wijaya Kusuma, Surabaya, East Java, 60225, Indonesia
| | - Syamsul Huda
- Department of Food Technology, Faculty of Agro-Industrial Technology, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
- Study Center for the Development of Agro-Industrial Technology, Faculty of Agro-Industrial Technology, Universitas Padjadjaran, Jln. Raya Bandung-Sumedang Km. 21, Jatinangor, 45363, Indonesia
| | - Nia Novita Wirawan
- Department of Nutrition, Faculty of Health Sciences, Universitas Brawijaya, Veteran, Malang, East Java, 65145, Indonesia
| | - Robi Andoyo
- Department of Food Technology, Faculty of Agro-Industrial Technology, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
- Study Center for the Development of Agro-Industrial Technology, Faculty of Agro-Industrial Technology, Universitas Padjadjaran, Jln. Raya Bandung-Sumedang Km. 21, Jatinangor, 45363, Indonesia
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Urgell-Lahuerta C, Carrillo-Álvarez E, Salinas-Roca B. Interventions on Food Security and Water Uses for Improving Nutritional Status of Pregnant Women and Children Younger Than Five Years in Low-Middle Income Countries: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094799. [PMID: 34063195 PMCID: PMC8125397 DOI: 10.3390/ijerph18094799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/20/2022]
Abstract
Malnutrition is a global health issue concerning children and pregnant women in low- and middle-income countries (LMICs). The aim of this review was to assess the health-impact outcomes of interventions addressing food security, water quality and hygiene in order to address the improvement of the nutritional status in children below five years and pregnant women in LMICs. Using PRISMA procedures, a systematic review was conducted by searching in biomedical databases clinical trials and interventions for children and pregnant women. Full articles were screened (nf = 252) and critically appraised. The review included 27 randomized and non-randomized trials and interventions. Based on the analysis, three agents concerning nutritional status were identified. First, exclusive breastfeeding and complementary feeding were fundamental elements in preventing malnutrition. Second, provision of sanitation facilities and the promotion of hygienic practices were also essential to prevent infections spread and the consequent deterioration of nutritional status. Finally, seasonality was also seen to be a relevant factor to consider while planning and implementing interventions in the populations under study. In spite of the efforts conducted over last decades, the improvement in food insecurity rates has remained insufficient. Therefore, the development of global health programs is fundamental to guide future actions.
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Affiliation(s)
- Cristina Urgell-Lahuerta
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig 2, 25198 Lleida, Spain;
| | - Elena Carrillo-Álvarez
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla 326-332, 08025 Barcelona, Spain;
| | - Blanca Salinas-Roca
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig 2, 25198 Lleida, Spain;
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla 326-332, 08025 Barcelona, Spain;
- Correspondence: ; Tel.: +34-973-70-2469
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Borg B, Sok D, Mihrshahi S, Griffin M, Chamnan C, Berger J, Laillou A, Roos N, Wieringa FT. Effectiveness of a locally produced ready-to-use supplementary food in preventing growth faltering for children under 2 years in Cambodia: a cluster randomised controlled trial. MATERNAL & CHILD NUTRITION 2020; 16:e12896. [PMID: 31885221 PMCID: PMC7038903 DOI: 10.1111/mcn.12896] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 09/01/2019] [Accepted: 09/09/2019] [Indexed: 12/11/2022]
Abstract
This cluster randomised controlled trial tested the effectiveness of a locally produced, fish-based, ready-to-use supplementary food (RUSF) to prevent growth faltering (decline in z-scores). Cambodian infants (n= 485), aged 6 to 11 months, were randomised by site to receive the RUSF, Corn-Soy Blend++ (CSB++), micronutrient powders (MNP), or no supplement (control). The intervention was for 6 months. In unadjusted analysis, the control group had statistically significantly decreased weight-for-age z-scores (WAZ; -0.02, 95%CI = -0.03 - -0.01, P= 0.001) and height-for-age z-scores (HAZ; -0.07, 95%CI = -0.09 - -0.05, P < 0.001), and increased mid-upper arm-circumference (MUAC; 0.02cm, 95%CI = 0.01 - 0.04, P = 0.010), but no statistically significant change in weight-for-height z-scores (WHZ). The RUSF group did not differ significantly from the control for WAZ, HAZ or WHZ (in other words, WAZ and HAZ decreased and WHZ did not change), but had increased MUAC in comparison to the control (0.04cm, 95%CI = 0.01 - 0.06, P = 0.008). There were no statistically significant differences between the RUSF group and the CSB++ or MNP groups with respect to WAZ, HAZ, WHZ or MUAC. Interestingly, in adjusted analysis, low consumers of RUSF had increased WAZ, WHZ and MUAC (0.03, 95%CI = 0.01-0.06, P = 0.006; 0.04, 95%CI = 0.01-0.08, P = 0.026; and 0.05cm, 95%CI = 0.02-0.09, P = 0.004, respectively) compared with the control. The novel RUSF, particularly in small quantities, protected against ponderal growth faltering, but the improvements were of limited clinical significance.
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Affiliation(s)
- Bindi Borg
- School of Public Health, Faculty of MedicineUniversity of SydneySydneyAustralia
| | - Daream Sok
- Department of Nutrition, Exercise and Sports, Faculty of ScienceUniversity of CopenhagenCopenhagenDenmark
- Department of Fisheries Post‐Harvest Technologies and Quality Control, Fisheries AdministrationMinistry of Agriculture, Forestry and FisheriesPhnom PenhCambodia
| | - Seema Mihrshahi
- School of Public Health, Faculty of MedicineUniversity of SydneySydneyAustralia
| | - Mark Griffin
- School of Public Health, Faculty of MedicineUniversity of SydneySydneyAustralia
- School of Public HealthUniversity of QueenslandBrisbaneAustralia
| | - Chhoun Chamnan
- Department of Fisheries Post‐Harvest Technologies and Quality Control, Fisheries AdministrationMinistry of Agriculture, Forestry and FisheriesPhnom PenhCambodia
| | - Jacques Berger
- UMR‐204 NutripassInstitut de Recherche pour le Développement, IRD/UM/SupAgroMontpellierFrance
| | - Arnaud Laillou
- Child Survival and Development SectionUNICEFPhnom PenhCambodia
| | - Nanna Roos
- Department of Nutrition, Exercise and Sports, Faculty of ScienceUniversity of CopenhagenCopenhagenDenmark
| | - Frank T. Wieringa
- UMR‐204 NutripassInstitut de Recherche pour le Développement, IRD/UM/SupAgroMontpellierFrance
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Borg B, Mihrshahi S, Laillou A, Sigh S, Sok D, Peters R, Chamnan C, Berger J, Prak S, Roos N, Griffin M, Wieringa FT. Development and testing of locally-produced ready-to-use therapeutic and supplementary foods (RUTFs and RUSFs) in Cambodia: lessons learned. BMC Public Health 2019; 19:1200. [PMID: 31470824 PMCID: PMC6717373 DOI: 10.1186/s12889-019-7445-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 08/06/2019] [Indexed: 11/10/2022] Open
Abstract
Background Rates of childhood undernutrition are persistently high in Cambodia. Existing ready-to-use supplementary and therapeutic foods (RUSFs and RUTFs) have had limited acceptance and effectiveness. Therefore, our project developed and trialled a locally-produced, multiple micronutrient fortified lipid-based nutrient supplement (LNS) with therapeutic and supplementary versions. This ready-to-use food (RUF) is innovative in that, unlike many RUFs, it contains fish instead of milk. Development began in 2013 and the RUF was finalised in 2015. From 2015 until the present, both the RUTF and the RUSF versions were trialled for acceptability and effectiveness. Methods This paper draws on project implementation records and semi-structured interviews to describe the partnership between the Cambodian Ministries of Health and Agriculture, Forestry and Fisheries, UNICEF, the French National Research Institute for Sustainable Development (IRD), universities, and Vissot factory. It discusses the project implementation and lessons learned from the development and trialling process, and insights into positioning nutrition on the health agenda in low and middle-income countries. Results The lessons learned relate to the importance of project planning, management, and documentation in order to seize opportunities in the research, policy, advocacy, and programming environment while ensuring adequate day-to-day project administration and resourcing. Conclusions We conclude that projects such as ours, that collaborate to develop and test novel, locally-produced RUTFs and RUSFs, offer an exciting opportunity to respond to both local programmatic and broader research needs.
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Affiliation(s)
- Bindi Borg
- School of Public Health, Faculty of Medicine, University of Sydney, Sydney, Australia.
| | - Seema Mihrshahi
- School of Public Health, Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Arnaud Laillou
- Child Survival and Development Section, UNICEF, Phnom Penh, Cambodia
| | - Sanne Sigh
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Daream Sok
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.,Department of Fisheries Post-Harvest Technologies and Quality Control, Fisheries Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia
| | - Remco Peters
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Chhoun Chamnan
- Department of Fisheries Post-Harvest Technologies and Quality Control, Fisheries Administration, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia
| | - Jacques Berger
- UMR Nutripass, Institut de Recherche pour le Développement, IRD/UM/SupAgro, Montpellier, France
| | | | - Nanna Roos
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mark Griffin
- School of Public Health, Faculty of Medicine, University of Sydney, Sydney, Australia.,School of Public Health, University of Queensland, Brisbane, Australia
| | - Frank T Wieringa
- UMR Nutripass, Institut de Recherche pour le Développement, IRD/UM/SupAgro, Montpellier, France
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