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de Quadros VP, Balcerzak A, Allemand P, de Sousa RF, Bevere T, Arsenault J, Deitchler M, Holmes BA. Global Trends in the Availability of Dietary Data in Low and Middle-Income Countries. Nutrients 2022; 14:nu14142987. [PMID: 35889943 PMCID: PMC9324857 DOI: 10.3390/nu14142987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/06/2022] [Accepted: 07/12/2022] [Indexed: 02/05/2023] Open
Abstract
Individual-level quantitative dietary data can provide suitably disaggregated information to identify the needs of all population sub-groups, which can in turn inform agricultural, nutrition, food safety, and environmental policies and programs. The purpose of this discussion paper is to provide an overview of dietary surveys conducted in low- and middle-income countries (LMICs) from 1980 to 2019, analyzing their key characteristics to understand the trends in dietary data collection across time. The present study analyzes the information gathered by the Food and Agriculture Organization of the United Nations/World Health Organization Global Individual Food consumption data Tool (FAO/WHO GIFT). FAO/WHO GIFT is a growing repository of individual-level dietary data and contains information about dietary surveys from around the world, collected through published survey results, literature reviews, and direct contact with data owners. The analysis indicates an important increase in the number of dietary surveys conducted in LMICs in the past four decades and a notable increase in the number of national dietary surveys. It is hoped that this trend continues, together with associated efforts to validate and standardize the dietary methods used. The regular implementation of dietary surveys in LMICs is key to support evidence-based policies for improved nutrition.
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Affiliation(s)
- Victoria Padula de Quadros
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
- Correspondence:
| | - Agnieszka Balcerzak
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Pauline Allemand
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Rita Ferreira de Sousa
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Teresa Bevere
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Joanne Arsenault
- Intake—Center for Dietary Assessment, FHI Solutions, Washington, DC 20009, USA; (J.A.); (M.D.)
| | - Megan Deitchler
- Intake—Center for Dietary Assessment, FHI Solutions, Washington, DC 20009, USA; (J.A.); (M.D.)
| | - Bridget Anna Holmes
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
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Wable Grandner G, Dickin K, Kanbur R, Menon P, Rasmussen KM, Hoddinott J. Assessing statistical similarity in dietary intakes of women of reproductive age in Bangladesh. Matern Child Nutr 2020; 17:e13086. [PMID: 32990382 PMCID: PMC7988869 DOI: 10.1111/mcn.13086] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 08/28/2020] [Accepted: 09/01/2020] [Indexed: 01/28/2023]
Abstract
Women of reproductive age (WRA) need adequate nutrient intakes to sustain a healthy pregnancy, support fetal growth, and breastfeed after childbirth. However, data on women's dietary intake in low‐ and middle‐income countries (LMICs) are limited, and assessment of differences between dietary intakes of pregnant or lactating women compared with that of nonpregnant, nonlactating (NPNL) women is untested. Using single, multiple‐pass 24‐h dietary recall data from a sample of WRA residing in rural Bangladesh, we examined women's dietary intakes for energy, protein, calcium, iron, vitamin A, and dietary diversity for three groups: NPNL (n = 2,903), pregnant (n = 197), and lactating women (n = 944). We used equivalence testing to examine similarity in adjusted intakes for pregnant versus NPNL women and lactating versus NPNL women with a predetermined equivalence threshold based on recommendations specific for each reproductive stage. On average, both pregnant and lactating women had insufficient intakes for all dietary measures. Although statistically significant differences were observed between pregnant and NPNL women for energy intake and dietary diversity and between lactating and NPNL women for energy and protein intake, the magnitudes of these differences were too small to reject equivalence. Statistical similarity was also evident in all micronutrients and dietary diversity for both two‐group comparisons. Understanding statistical differences and similarities between dietary measures of women in distinct reproductive stages has important implications for the relevance, appropriateness, and evaluation of maternal diet‐enhancing interventions in LMICs, especially during pregnancy and lactation, when demand for macronutrients and micronutrients is elevated.
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Affiliation(s)
| | - Katherine Dickin
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Ravi Kanbur
- Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, New York, USA
| | - Purnima Menon
- Poverty Health and Nutrition Division, International Food Policy Research Institute, New Delhi, India
| | | | - John Hoddinott
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA.,Charles H. Dyson School of Applied Economics and Management, Cornell University, Ithaca, New York, USA
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Tang M, Frank DN, Tshefu A, Lokangaka A, Goudar SS, Dhaded SM, Somannavar MS, Hendricks AE, Ir D, Robertson CE, Kemp JF, Lander RL, Westcott JE, Hambidge KM, Krebs NF. Different Gut Microbial Profiles in Sub-Saharan African and South Asian Women of Childbearing Age Are Primarily Associated With Dietary Intakes. Front Microbiol 2019; 10:1848. [PMID: 31474951 PMCID: PMC6702451 DOI: 10.3389/fmicb.2019.01848] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/26/2019] [Indexed: 01/20/2023] Open
Abstract
Background To compare and characterize the gut microbiota in women of childbearing age from sub-Saharan Africa (the Democratic Republic of the Congo, DRC) and South Asia (India), in relation to dietary intakes. Methods Women of childbearing age were recruited from rural DRC and India as part of the Women First (WF) preconception maternal nutrition trial. Findings presented include fecal 16S rRNA gene-based profiling of women in the WF trial from samples obtained at the time of randomization, prior to initiation of nutrition intervention and to conception. Results Stool samples were collected from 217 women (DRC n = 117; India n = 100). Alpha diversity of the gut microbiota was higher in DRC than in India (Chao1: 91 ± 11 vs. 82 ± 12, P = 6.58E-07). The gut microbial community structure was not significantly affected by any demographical or environmental variables, such as maternal BMI, education, and water source. Prevotella, Succinivibrio, and Roseburia were at relatively high abundance without differences between sites. Bifidobacterium was higher in India (4.95 ± 1.0%) than DRC (0.3 ± 0.1%; P = 2.71E-27), as was Lactobacillus (DRC: 0.2 ± 0.0%; India: 1.2 ± 0.1%; P = 2.39E-13) and Faecalibacterium (DRC: 6.0 ± 1.7%; India: 8.4 ± 2.9%; P = 6.51E-7). Ruminococcus was higher in DRC (2.3 ± 0.7%) than in India (1.8 ± 0.4%; P = 3.24E-5) and was positively associated with consumption of flesh foods. Succinivibrio was positively associated with dairy intake in India and fish/insects in DRC. Faecalibacterium was positively associated with vitamin A-rich fruits and vegetables. Overall, these observations were consistent with India being primarily vegetarian with regular fermented dairy consumption and DRC regularly consuming animal-flesh foods. Conclusion Consumption of animal-flesh foods and fermented dairy foods were independently associated with the gut microbiota while demographic variables were not, suggesting that diet may have a stronger association with microbiota than demographic characteristics.
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Affiliation(s)
- Minghua Tang
- Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO, United States
| | - Daniel N Frank
- Division of Infectious Diseases, School of Medicine, University of Colorado Denver, Aurora, CO, United States
| | - Antoinette Tshefu
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Adrien Lokangaka
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Shivaprasad S Goudar
- KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belagavi, India
| | - Sangappa M Dhaded
- KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belagavi, India
| | - Manjunath S Somannavar
- KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Belagavi, India
| | - Audrey E Hendricks
- Department of Mathematical and Statistical Sciences, University of Colorado Denver, Aurora, CO, United States
| | - Diana Ir
- Division of Infectious Diseases, School of Medicine, University of Colorado Denver, Aurora, CO, United States
| | - Charles E Robertson
- Division of Infectious Diseases, School of Medicine, University of Colorado Denver, Aurora, CO, United States
| | - Jennifer F Kemp
- Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO, United States
| | - Rebecca L Lander
- Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO, United States
| | - Jamie E Westcott
- Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO, United States
| | - K Michael Hambidge
- Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO, United States
| | - Nancy F Krebs
- Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO, United States
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Lander RL, Hambidge KM, Westcott JE, Tejeda G, Diba TS, Mastiholi SC, Khan US, Garcés A, Figueroa L, Tshefu A, Lokangaka A, Goudar SS, Somannavar MS, Ali SA, Saleem S, McClure EM, Krebs NF, Group OBOTWFPNT. Pregnant Women in Four Low-Middle Income Countries Have a High Prevalence of Inadequate Dietary Intakes That Are Improved by Dietary Diversity. Nutrients 2019; 11:E1560. [PMID: 31295916 DOI: 10.3390/nu11071560] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 01/20/2023] Open
Abstract
Background: Up-to-date dietary data are required to understand the diverse nutritional challenges of pregnant women living in low-middle income countries (LMIC). To that end, dietary data were collected from 1st trimester pregnant women in rural areas of Guatemala, India, Pakistan, and Democratic Republic of the Congo (DRC) participating in a maternal lipid-based nutrient supplement (LNS) Randomized Controlled Trial to examine dietary diversity (DD), usual group energy and nutrient intakes, and prevalence of inadequate dietary intakes. Methods: Two 24-h dietary recalls were conducted in ~240 pregnant women/site (total n = 966) prior to 12-week gestation. Adequate DD was assessed, i.e., ≥5 major food groups consumed within the past 24 h. Median, Q1, Q3 intakes (without LNS) of energy, macronutrients, 12 micronutrients, and phytate were examined. The “at risk” prevalence of inadequate intakes were based on international guidelines for pregnant women. Results: Dietary patterns varied widely among sites, with adequate DD reported: 20% (Pakistan), 25% (DRC), 50% (Guatemala), and 70% (India). Significantly higher intakes of most key nutrients were observed in participants with adequate DD. More than 80% of women in all sites had inadequate intakes of folate, vitamin B12, and choline, and >80% of women in India and DRC also had inadequate intakes of calcium, thiamine, riboflavin, and vitamin B6. Conclusions: Our data highlight the likely need for micronutrient supplementation in pregnancy, specifically multi-micronutrient interventions, and support the value of increasing DD as part of sustainable long-term nutrition programs for women of reproductive age in these poor rural settings in LMIC.
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Shinozaki N, Murakami K, Masayasu S, Sasaki S. Development and simulated validation of a dish composition database for estimating food group and nutrient intakes in Japan. Public Health Nutr 2019; 22:2367-80. [PMID: 31092299 DOI: 10.1017/S1368980019000600] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To develop a dish composition database (DCD) and assess its ability to estimate dietary intake. DESIGN The DCD was developed based on 16 d dietary records (DR). We aggregated all reported dishes into 128 dish codes and calculated mean food group and nutrient contents for each code. These data were used to calculate dietary intake in a different population that completed a 4 d DR. The estimated values were compared with those estimated using the standard food composition database (FCD) of Japan. SETTING Japan. PARTICIPANTS A total 252 adults aged 31-81 years for the 16 d DR (3941 d in total) and 392 adults aged 20-69 years for the 4 d DR (1568 d in total) participated. RESULTS There were significant differences in median intakes between the DCD and the FCD for eighteen and twenty (of twenty-six) food groups and for twenty-nine and twenty-two (of forty-three) nutrients (including energy) in men and women, respectively. For food group intakes, Spearman correlation coefficients between the DCD and FCD ranged from 0·19 (animal fats) to 0·90 (fruits and alcoholic beverages) in men (median: 0·61) and from 0·25 (oils) to 0·89 (noodles) in women (median: 0·58). For nutrient intakes, the corresponding values ranged from 0·25 (retinol) to 0·90 (alcohol) in men (median: 0·60) and from 0·15 (retinol) to 0·74 (alcohol) in women (median: 0·53). CONCLUSIONS Whereas it is difficult to accurately estimate absolute dietary intake values using the present DCD, it has acceptable ability to rank the intakes of many food groups and nutrients.
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Abstract
BACKGROUND The growing appreciation of the multi-faceted importance of optimal maternal nutrition to the health and development of the infant and young child is tempered by incompletely resolved strategies for combatting challenges. OBJECTIVE To review the importance of maternal nutrition and strategies being employed to optimize outcomes. METHODS Selected data from recent literature with special focus on rationale for and currently published results of maternal nutrition supplements, including lipid based nutrition supplements. RESULTS 1) An impelling rationale for improving the maternal and in utero environment of low resource populations has emerged to achieve improved fetal and post-natal growth and development. 2) Based partly on population increases in adult height over one-two generations, much can be achieved by reducing poverty. 3) Maternal, newborn and infant characteristics associated with low resource environments include evidence of undernutrition, manifested by underweight and impaired linear growth. 4) Apart from broad public health and educational initiatives, to date, most specific efforts to improve fetal growth and development have included maternal nutrition interventions during gestation. 5) The relatively limited but real benefits of both iron/folic acid (IFA) and multiple micronutrient (MMN) maternal supplements during gestation have now been reasonably defined. 6) Recent investigations of a maternal lipid-based primarily micronutrient supplement (LNS) have not demonstrated a consistent benefit beyond MMN alone. 7) However, effects of both MMN and LNS appear to be enhanced by commencing early in gestation. CONCLUSIONS Poor maternal nutritional status is one of a very few specific factors in the human that not only contributes to impaired fetal and early post-natal growth but for which maternal interventions have demonstrated improved in utero development, documented primarily by both improvements in low birth weights and by partial corrections of impaired birth length. A clearer definition of the benefits achievable by interventions specifically focused on correcting maternal nutrition deficits should not be limited to improvements in the quality of maternal nutrition supplements, but on the cumulative quantity and timing of interventions (also recognizing the heterogeneity between populations). Finally, in an ideal world these steps are only a prelude to improvements in the total environment in which optimal nutrition and other health determinants can be achieved.
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Affiliation(s)
- K. Michael Hambidge
- Section of Nutrition, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E 19th Ave, MS C-225, Aurora, CO 80045 USA
| | - Nancy F. Krebs
- Section of Nutrition, Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E 19th Ave, MS C-225, Aurora, CO 80045 USA
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Mastiholi SC, Somannavar MS, Vernekar SS, Yogesh Kumar S, Dhaded SM, Herekar VR, Lander RL, Hambidge MK, Krebs NF, Goudar SS. Food insecurity and nutritional status of preconception women in a rural population of North Karnataka, India. Reprod Health 2018; 15:90. [PMID: 29945660 DOI: 10.1186/s12978-018-0535-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background As per the World Health Organization, the nutritional status of women of reproductive age is important, as effects of undernutrition are propagated to future generations. More than one-third of Indian women in the reproductive age group are in a state of chronic nutritional deficiency during the preconception period leading to poor health and likely resulting in low birth weight babies. This study was aimed to assess the food insecurity and nutritional status of preconception women in a rural population of north Karnataka. Methods A total of 770 preconception women were enrolled across a district in Karnataka from selected primary health centre areas by a cluster sampling method. Data on socioeconomic status, food insecurity and obstetric history were collected by trained research assistants, interviewing women at home. In half of the participants, a 1 day 24 –hour dietary recalls were conducted by dietary assistants to assess the dietary intakes. Anthropometric measurements and haemoglobin estimation were carried out at the health centres. Results In the present study, a majority of the participants (64.8%) belonged to the lower socio-economic classes and the prevalence of food insecurity was 27.4%. A majority of the participants had mild (15.5%) to moderate (78.6%) anaemia. About one-third of the participants (36.6%) were underweight. Significant associations were found between socio-economic status and anaemia (p = 0.0006) and between food insecurity and anaemia (p = 0.0001). Conclusion The nutritional status of preconception women was poor and anemia was more prevalent in low-socioeconomic and food insecure population.
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