All Publications

The Nutrition Innovation Lab provides support for research in Asia and Africa devoted to implementing effective interventions that integrate agriculture and nutrition activities to achieve a significant reduction in stunting among children less than 24 months of age and undernutrition in mothers. Our specific goals include: i) generation of empirical evidence of what works at scale (through applied research), and ii) support for enhanced institutional and human capacity to conduct research and implement effective nutrition activities at scale in future years.

Nutrition Innovation Lab Annual Report- Year 6

The following are the annual reports of the Feed the Future Innovation Lab for Nutrition for the fiscal year 2016 starting October 2015 through September 2016 (“Y6”). The Nutrition Innovation Lab seeks to discover how investments in agriculture can be enhanced to accelerate gains in nutrition, and how policy and program interventions can more effectively integrated to cost-effectively achieve improvements in maternal and child nutrition at scale. It also pursues innovative research at the frontiers of biology and policy, such as exploring the links between aflatoxins Continue reading →
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Chapter 2.2 The Economic Causes of Malnutrition

From the book Good Nutrition: Perspectives for the 21st Century
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Cross-sectional but not Longitudinal Measures of Food Insecurity are Associated with the Rate of Weight Gain during Pregnancy in Northern Uganda

Food insecurity (FI) during pregnancy may lead to adverse health outcomes for affected women. However, little is known on whether such effects are due to short-term within person changes (longitudinal effects) in FI or long-term between person differences (cross-sectional effects) in this exposure. Therefore, the aim of this study was to assess whether differences in cross-sectional measures of FI between women (defined as the mean prenatal IFIAS score) and/or longitudinal changes in FI within women
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Progression of antepartum depression differs by level of perceived social support and food insecurity

Antepartum depression (AD) is a risk factor for adverse pregnancy outcomes and may be worsened by food insecurity (FI) and lack of social support (SS). We studied the progression of AD from mid gestation to term and examined whether such progression differed by measures of SS and longitudinal measures of FI
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HIV-Infected Pregnant and Lactating Women have Higher Serum Aflatoxin levels than HIV–Uninfected Women and Aflatoxin Levels are Higher during Early Postpartum than during Pregnancy among HIV-Infected Women

Aflatoxins are carcinogenic and may affect linear growth. Prior cross-sectional data from Ghana have shown that aflatoxin levels are ~ 20% higher among HIV-infected than HIV-uninfected post-partum women. It is not known if HIV-infected pregnant women have elevated serum aflatoxin levels during pregnancy, or if aflatoxin levels change during the perinatal period. We therefore studied these relationships among a cohort of 246 women recruited in Gulu, Uganda, and followed through pregnancy and early infant life. All HIV-positive women received HIV antiretroviral therapy for free from Continue reading →
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HIV infection is associated with a lower rate of gestational weight gain and reduced neonatal length

Adequate gestational weight gain (GWG) and neonatal growth are important, respectively, for favorable birth outcomes and survival of infants through the first year. In sub-Saharan Africa, underlying infections, such as HIV, may adversely impact GWG and neonatal growth.
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High levels of food insecurity were observed among HIV, TB, and HIV/TB co-infected outpatients in northern Uganda

Food insecurity among individuals living with HIV is well-recognized globally. Since comorbidity with TB is common, particularly in sub-Saharan Africa, we examined the variation in the severity of food insecurity among people with either infection or both concurrently.
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Perinatal Exposure to Aflatoxins is Associated with a Lower Rate of Weight Gain Among HIV-Infected Pregnant Women and Reduced Linear Growth of HIV-Exposed Infants

Aflatoxins (AF) are carcinogens associated with poor linear growth in infants. AF serum levels have been reported to be higher in HIV infected (+) women. However, it is not known if maternal AF exposure affects gestational weight gain (GWG), or if relationship between in utero AF exposure and changes in perinatal anthropometry differs by maternal HIV or infant HIV exposure status. We enrolled 403 pregnant women (33.3% HIV (+), all on anti-retroviral treatment) at the antenatal clinic of Gulu Hospital, northern Uganda.
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Nutrition Innovation Lab Annual Reports- Year 5

The following are the annual reports of the Feed the Future Innovation Lab for Collaborative Research on Nutrition for the fiscal year 2015 starting October 2014 through September 2015 (“Y5”). The Nutrition Innovation Lab seeks to discover how investments in agriculture can be enhanced to accelerate gains in nutrition, and how policy and program interventions can more effectively integrated to cost-effectively achieve improvements in maternal and child nutrition at scale. It also pursues innovative research at the frontiers of biology and policy, such as exploring the Continue reading →
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To end malnutrition, we must step up to the plate with data on what people eat

Food systems are increasingly recognized as the driving force behind malnutrition in all its forms. Healthy diets are as fundamental to resolving stunting and vitamin and mineral deficiencies as they are to preventing obesity and diet-related non-communicable diseases. And healthy diets are made possible through healthy food systems.
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Risk Factors for Anemia in Non-pregnant Women across the Agroecological Zones of Nepal

Abstract- Objectives: Describe the prevalence of anemia in Nepali non-pregnant women of reproductive age by agroecological zone and potential risk factors.
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Building Strategic Capacities to Strengthen the Enabling Environment for Nutrition Policies and Programs in Four African Countries

Undernutrition has received significant attention at global and national levels in recent years but translating this attention into effective action at the country and district levels poses many challenges. We describe the observed national environments that support and challenge actors in moving national multisectoral nutrition policies and plans forward and how this on-going action research (AR) project seeks to strengthen strategic capacities and leadership in Burkina Faso, Mali, Ethiopia and Uganda.
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Alcohol Use Among Pregnant Ugandan Women of Mixed HIV Status is Associated with Social Environment and Food Insecurity

Antenatal alcohol use (AAU) is associated with poor health outcomes in maternal-infant dyads. However, AAU prevalence and risk factors are poorly understood, particularly in low-income settings. Therefore we studied correlates of any AAU among pregnant women receiving antenatal care in Gulu, Uganda.
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Combining public datasets to explore global trends in dietary quality, undernutrition and chronic disease 1980-2009

Combining public datasets to explore global trends in dietary quality, undernutrition and chronic disease 1980-2009 Agricultural production, commodity marketing and food consumption patterns have changed significantly over the past 30 years the world over, as have national epidemiological profiles.
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Understanding Pathways of Better Nutrition

This presentation is a result of Edgar Agaba’s ALE-(Applied Learning Experience) research work that was completed last year in Uganda’s 2 districts of Lira and Kisoro.  Collaborators included MPH- ALE, JSI/SPRING Project, and the Nutrition Innovation Lab. It was originally presented it to  Faculty and students on Wednesday, April 29th 2015: Sackler Room 316, 4:00 – 7:30 p.m as part of the ALE Presentations.
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Maternal HIV Infection, but not Food Insecurity, Predicts the Pattern of Weight Gain in Pregnant Women Attending Antenatal Services in Northern Uganda

In Sub-Saharan Africa, the differential impact of maternal HIV infection and/or food insecurity on the pattern of weight gain among pregnant women is unknown. To fill this gap, data on 402 pregnant women (33% HIV+ & participating in antiretroviral treatment) enrolled in a perinatal cohort study at Gulu Regional Referral Hospital in northern Uganda were analyzed.
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Social Support Modifies Bidirectional Linkages Between Food Insecurity and Prenatal Depressive Symptoms while Domestic Violence Alters the Unidirectional Impact of Food Insecurity on Prenatal Depressive Symptoms

To inform perinatal nutrition and mental health interventions, we used a cohort study to: 1) examine the directionality of relationships between maternal food insecurity (MFI) and prenatal depressive symptoms (PDS); and 2) see if social support (SS) or domestic violence (DV) modify this relationship. We enrolled 403 Ugandan pregnant women (33% HIV+ on antiretrovirals)) in mid-gestation and assessed them monthly through delivery for MFI (IFIAS) and the PDS (CES-D) using validated scales.
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Mycotoxin Exposure among Pregnant Women: Examining Knowledge, Practices, Diet Quality and Effects on Birth Outcomes in Banke, Nepal

The goal of aim 1 is to qualitatively assess existing agricultural and food storage knowledge and practices and quantitatively assess if knowledge and practices are associated with maternal aflatoxins exposure levels.
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Chapter 7: Childhood Threats to Adult Cognition in Sub- Saharan Africa: Malaria, Anemia, Stunting, Enteric Enteropathy, and the Microbiome of Malnutrition

Many common childhood conditions are associated with cognitive deficits. While some causes of impaired cognition, such as lead exposure, are well understood, other common conditions in countries such as Uganda – malnutrition, anemia and malaria – are not sufficiently recognized. In this chapter we discuss stunting and its root causes of undernutrition, a lack of sanitation and its relationship to environmental enteropathy and the intestinal microbiome. We also review information about iron-deficiency anemia and malaria, and their neurological and cognitive consequences. We believe that cognitive declines later in life, Continue reading →
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Nutrition Innovation Lab Annual Reports- Year 4

The following are the annual reports of the Feed the Future Innovation Lab for Collaborative Research on Nutrition for the fiscal year 2014 starting October 2013 through September 2014 (“Y4”). The Nutrition Innovation Lab seeks to discover how investments in agriculture can be enhanced to accelerate gains in nutrition, and how policy and program interventions can more effectively integrated to cost-effectively achieve improvements in maternal and child nutrition at scale. It also pursues innovative research at the frontiers of biology and policy, such as exploring the Continue reading →
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Challenges to Turning Nutrition & Agriculture Research into Action: A Case Study of NGO Research Uptake in Nepal

In Nepal, despite improvements in poverty reduction and health services, malnutrition persists. 41% of children under age five are stunted, 29% of children are underweight, and 18% of women of reproductive age are malnourished1. The Government of Nepal, research institutions, and local and international non-governmental organizations (NGOs) are working to improve nutrition through nutrition-specific and nutrition-sensitive interventions such as agricultural programs that increase production, productivity and income; improving water, sanitation, and hygiene practices; and encouraging more equitable food allocation within the household2. The involvement of Continue reading →
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A Qualitative Look at the Barriers to Interdisciplinary Collaboration in Agriculture and Nutrition Research in Nepal

Nepal’s burden of malnutrition and the dominance of agricultural livelihoods highlight the importance of understanding the pathways from agricultural production to nutritional outcomes and employing interventions that incorporate food production and consumption. A need for improved understanding of such pathways and the impacts of nutrition-sensitive interventions has encouraged related research initiatives in Nepal. Agriculture research has often been conducted separately from nutrition research, despite the inherent relationship between agriculture and nutrition in rural Nepal’s food-producing households and increasing recognition that agricultural production directly influences food Continue reading →
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Determinants of Nutritional Outcomes Among Children below Five Years of Age in Uganda

 This thesis presents findings of a study that sought to understand determinants of nutritional outcomes of children below five years of age in Uganda. Understanding these determinants was vital because in the Ugandan situation, most of the determinants are not ade8uately understood.  Even for those that are known, the magnitude of their impact and or the relative strengths of their impact on nutritional outcomes across regions is not well known.
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Factors Associated with Complementary Feeding Practices Among Children age 6-23 months in Pader District

Infant and young child feeding has been known to compromise the health of children among which complementary  feeding plays a major part. Even communities that have performed adequately in breast feeding have had  their  efforts undermined by complementary feeding hence causing malnutrition among their children.  This study was conducted with the aim of finding out factors that are associated with complementary feeding among the children in Pader district.
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Factors Associated with Dietary Diversity Among Women of Reproductive Age (15-49 yrs) in Agago District

Despite the internationally accepted recommendation that eating a diversity of foods leads to a healthy diet, and is associated with positive health outcomes such as reduced mortality, little information exists on what factors influence dietary diversity among women of reproductive age in Agago district.  The objective of this study is to determine dietary diversity among women of reproductive age (15-49 years) in Agago district.
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Maternal food insecurity, anemia, and social support are independently associated with prenatal depression among HIV-positive and -negative women attending antenatal services in northern Uganda

Limited data exist on prenatal depression in in high HIV burden resource-poor settings. Population: 403 pregnant clinic attendees at Gulu Hospital, Uganda. HIV (+) women were oversampled in a ratio of 1 HIV (+): 2 HIV
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Nutrition Innovation Lab Annual Reports- Year 3

The following are the annual reports of the Feed the Future Innovation Lab for Collaborative Research on Nutrition for the fiscal year 2013 starting October 2012 through September 2013 (“Y3”). The Nutrition Innovation Lab seeks to discover how investments in agriculture can be enhanced to accelerate gains in nutrition, and how policy and program interventions can more effectively integrated to cost-effectively achieve improvements in maternal and child nutrition at scale. It also pursues innovative research at the frontiers of biology and policy, such as exploring Continue reading →
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2nd Annual Scientific Symposium Proceedings, August 13-14, 2013

The Nutrition Innovation Lab‘s 2nd Annual Scientific Symposium held in Kathmandu, Nepal on August 13-14, 2013 under the theme “Science and Policy for Health, Agriculture and Economic Growth” facilitated the sharing of new research findings along the agriculture to nutrition pathway.
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Nutrition Innovation Lab Annual Reports- Year 2

The following are the annual reports of the Feed the Future Innovation Lab for Collaborative Research on Nutrition for the fiscal year 2012 starting October 2011 through September 2012 (“Y2”). The Nutrition Innovation Lab seeks to discover how investments in agriculture can be enhanced to accelerate gains in nutrition, and how policy and program interventions can more effectively integrated to cost-effectively achieve improvements in maternal and child nutrition at scale. It also pursues innovative research at the frontiers of biology and policy, such as exploring Continue reading →
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Risk Factors for Anemia in Non-Pregnant Women across the Agroecological Zones of Nepal

Objective: Describe the prevalence of anemia in Nepali non-pregnant women of reproductive age by agroecological zone and potential risk factors.
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Nutrition Innovation Lab Annual Reports- Year 1

The following are the annual reports of the Feed the Future Innovation Lab for Collaborative Research on Nutrition for the fiscal year 2011 starting October 2010 through September 2011 (“Y1”). The Nutrition Innovation Lab seeks to discover how investments in agriculture can be enhanced to accelerate gains in nutrition, and how policy and program interventions can more effectively integrated to cost-effectively achieve improvements in maternal and child nutrition at scale. It also pursues innovative research at the frontiers of biology and policy, such as exploring Continue reading →
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Association between household food insecurity and infant growth in rural Bangladesh

Food insecurity is a global concern, yet its association with child growth is not fully understood. This study in rural Bangladesh explored associations between household food insecurity, using standardized questions, and infant growth. We asked a published 10-item, 6-mo household food insecurity questionnaire at 6 and 12 mo postpartum to 6,333 mothers participating in an antenatal micronutrient supplementation trial.
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