Journal Articles

Household food production is positively associated with dietary diversity and intake of nutrient-dense foods for older preschool children in poorer families: Results from a nationally-representative survey in Nepal

Published: November 2017 Authors: Prajula Mulmi, William Masters, Shibani Ghosh, Grace Namirembe, Ruchita Rajbhandary, Swetha Manohar, Binod Shrestha, Keith West Jr. , Patrick Webb Publisher: Plos One
Nutrition-sensitive interventions supporting enhanced household food production have potential to improve child dietary quality. However, heterogeneity in market access may cause systematic differences in program effectiveness depending on household wealth and child age. Identifying these effect modifiers can help development agencies specify and target their interventions.

Understanding pathways to better nutrition at district level: Lessons from Uganda

Published: November 2017 Authors: Edgar Agaba, Jeffrey Griffiths Publisher: African Journal of Food, Ag, Nut & Dev.
For countries looking to implement multisectoral nutrition plans, it is critical to understand what works and how programs should be delivered and scaled-up in each context. Programs can learn from each other on how to adapt to new information, evidence and events related to scaling-up and district stakeholders can play important roles in implementation of this multisectoral plan. As part of “Pathways-to-Better Nutrition” (PBN) case study conducted by USAID/SPRING Project, this research set out to explore district leaders’ perceptions of the nutrition situation, programs and Continue reading →

Pre-earthquake national patterns of preschool child undernutrition and household food insecurity in Nepal in 2013 and 2014

Published: September 2017 Authors: Sudeep Shrestha, Andrew Thorne-Lyman, Swetha Manohar, Binod Shrestha, Sumanta Neupane, Ruchita Rajbhandary, Raman Shrestha, Rolf Klemm, Bareng Nonyane, Ramesh Adhikari, Patrick Webb, Keith West Jr. Publisher: Asia Pacific Journal of Clinical Nutrition
Preschool undernutrition remains a burden in Nepal. This paper reports results of surveys in 2013 and 2014, examining patterns of child nutritional status across the country, associations with household food insecurity and antecedent comparative national data for subsequent evaluations of nutritional status following the earthquake in Nepal in 2015.

Infant Nutritional Status and Markers of Environmental Enteric Dysfunction are Associated with Midchildhood Anthropometry and Blood Pressure in Tanzania

Published: August 2017 Authors: Lindsey Locks, Ramadhani Mwiru, Expeditho Mtisi, Karim Manji, Christine McDonald, Enju Lui, Roland Kupa, Rodick Kisenge, Said Aboud, Kerri Gosselin, Matthew Gillman, Andrew Gewirtz, Wafaie Fawzi, Christopher Duggan Publisher: Journal of Pediatrics
Children who participated in 2 randomized trials of micronutrient supplements in infancy were followed up in midchildhood (4.6-9.8 years of age). Anthropometry was measured at age 6 and 52 weeks in both trials, and blood samples were available from children at 6 weeks and 6 months from 1 trial. Linear regression was used for height-for-age z-score, body mass index-for-age z-score, and weight for age z-score, and blood pressure analyses; log-binomial models were used to estimate risk of overweight, obesity, and stunting in midchildhood.

Determinants of anemia among women and children in Nepal and Pakistan: An analysis of recent national survey data

Published: August 2017 Authors: Kassandra Harding, Victor Aguayo, Grace Namirembe, Patrick Webb Publisher: Maternal & Child Nutrition
Abstract: Anemia remains one of the most intractable public health challenges in South Asia. This paper analyzes individual-level and household-level determinants of anemia among children and women in Nepal and Pakistan. Applying multivariate modified Poisson models to recent national survey data, we find that the prevalence of anemia was significantly higher among women from the poorest households in Pakistan (adjusted prevalence ratio [95% CI]: 1.10 [1.04–1.17]), women lacking sanitation facilities in Nepal (1.22 [1.12–1.33]), and among undernourished women (BMI < 18.5 kg/m2) in both countries (Nepal: 1.10 [1.00–1.21] and Continue reading →

Prioritizing research for integrated implementation of early childhood development and maternal, newborn, child and adolescent health and nutrition platforms

Published: June 2017 Authors: Renee Sharma, Michelle Gaffey, Harold Alderman, Diego Bassani, Kimber Bogard, Gary Darmstadt, Jai Das, Jena Hamadani, Susan Horton, Julia Hussein, Stephen Lye, Rafael Perez-Escamilla, Kofi Marfo, Vanessa Mathews-Hanna, Atif Rahman, Karlee Silver, Patrick Webb, Zulfiqar Bhutta Publisher: Journal of Global Health
Existing health and nutrition services present potential platforms for scaling up delivery of early childhood development (ECD) interventions within sensitive windows across the life course, especially in the first 1000 days from conception to age 2 years. However, there is insufficient knowledge on how to optimize implementation for such strategies in an integrated manner. In light of this knowledge gap, we aimed to systematically identify a set of integrated implementation research priorities for health, nutrition and early child development within the 2015 to 2030 time Continue reading →

Vitamin B-12 status in infancy predicts development and cognitive functioning 5 years later in Nepalese children

Published: March 2017 Authors: Ingrid Kvestad, Mari Hysing, Merina Shrestha, Manjeswori Ulak, Andrew Thorne-Lyman, Sigrun Henjum, Per Ueland, Oyvind Midttun, Wafaie Fawzi, Ram Chandyo, Prakash Shrestha, Tor Strand Publisher: American Journal of Clinical Nutrition
We measured the associations between vitamin B-12 status in infancy (2–12 mo) and the development and cognitive functioning in Nepalese children 5 y later. Vitamin B-12 status was assessed in infancy with the use of plasma cobalamin, total homocysteine (tHcy), and methylmalonic acid (MMA). At 5 y of age, we measured development with the use of the Ages and Stages Questionnaire, 3rd edition (ASQ- 3), and cognitive functioning by using the Developmental Neuropsychological Assessment, 2nd edition (NEPSY II), in 320 children. In regression models, we estimated Continue reading →

Charting the cost of nutritionally-adequate diets in Uganda, 2000-2011

Published: March 2017 Authors: George Omiat, Gerald Shively Publisher: African Journ. of Food, Ag, Nutr, & Development
Although malnutrition rates have been on the decline in Uganda over the past two decades, they remain high. Challenges to achieving nutritional improvements result, in part, from high staple foods prices, which raise the cost of the food basket and increase the risk of food and nutrition insecurity, especially for poor households who are net buyers of staple foods. Nearly two-thirds of Ugandan households are net buyers of staples, a pattern that highlights the potential importance of food prices as a key driver of food Continue reading →

Erythrocyte fatty acid composition of Nepal breast-fed infants

Published: January 2017 Authors: Sigrun Henjum, Oyvind Lie, Manjeswori Ulak, Andrew Thorne-Lyman, Ram Chandyo, Prakash Shrestha, Wafaie Fawzi, Tor Strand, Marian Kjellevold Publisher: European Journal of Nutrition
Essential fatty acids play a critical role in the growth and development of infants, but little is known about the fatty acid status of populations in low-income countries. The objective was to describe the fatty acid composition of red blood cells (RBC) in breastfeed Nepali infants and a subsample of their mothers and to identify the main sources of fatty acids in the mother’s diet, as well as the fatty acid composition of breast milk.

Nutrition Smoothing: Can Proximity to Towns and Cities Protect Rural Children against Seasonal Variation in Agroclimatic Conditions at Birth?

Published: January 2017 Authors: Amelia F. Darrouzet-Nardi, Willliam A. Masters Publisher: Plos One
A large literature links early-life environmental shocks to later outcomes. This paper uses seasonal variation across the Democratic Republic of the Congo to test for nutrition smoothing, defined here as attaining similar height, weight and mortality outcomes despite different agroclimatic conditions at birth. We find that gaps between siblings and neighbors born at different times of year are larger in more remote rural areas, farther from the equator where there are greater seasonal differences in rainfall and temperature. For those born at adverse times in Continue reading →