Food Insecurity in Urban and Rural Areas in Central Brazil: Transition from Locally Produced Foods to Processed Items

Aiming to investigate the effect of diet and food consumption with regard to health, environment, and economy in light of nutrition ecology, we studied the dimensions of nutrition and food security in urban and rural settings in the region of Chapada dos Veadeiros, Central Brazil. We tracked diet and food consumption through carbon and nitrogen stable isotope ratios in fingernails of these inhabitants together with food intake data as a proxy for their diet patterns. We estimated household food insecurity by using the Brazilian Food Insecurity Scale. Nutrition and food insecurity was observed in both urban and rural areas, but was accentuated in rural settings. The diet pattern had high δ¹³C values in fingernails and low δ¹⁵N. Both urban and rural areas have diets with low diversity and relying on low-quality processed food staples at the same time that nutrition and food insecurity is quite high in the region.     

"I eat to be happy, to be strong, and to live." perceptions of rural and urban adolescents in Cameroon, Africa

OBJECTIVE: To investigate factors influencing rural and urban adolescents' food perceptions during a time of nutritional transition in Cameroon, Africa. DESIGN: Qualitative in-depth interviews. SETTINGS: Yaoundé urban and Bandja rural areas. PARTICIPANTS: Fifteen adolescents 12 to 15 years old purposely selected from schools in urban and rural areas. ANALYSIS: Interviews were audiotaped, transcribed, and analyzed using Grounded Theory method. FINDINGS: Factors influencing adolescents' food perceptions from the rural area were "to live" "health" and "poverty." Among adolescents from the urban poor area, "health," "beauty," and "not enough money" were factors. Among adolescents from the urban rich area, "pleasure" and "beauty" were factors. Rural girls liked "to be fat," whereas girls from the urban poor wanted "to be a little bit fat," and girls from the urban rich wanted "to be normal." CONCLUSIONS AND IMPLICATIONS: Food behavior is changing from a diet composed of traditional food in rural areas to a more westernized diet in urban areas. The relationship between socioeconomic factors and nutrition needs to be examined with a sufficiently large number of adolescents to investigate these factors in a quantitative survey. Healthful local food should be available at home and from vendors. Nutrition education about food and diet-related diseases is needed in school.     

Child Nutritional Status by Rural/Urban Residence: A Cross‐National Analysis

Purpose: Rural children in developing countries have poor health outcomes in comparison with urban children. This paper considers 4 questions regarding the rural/urban difference, namely: (1) do individual‐level characteristics account for rural/urban differences in child nutritional status; (2) do community‐level characteristics account for rural/urban differences net of individual‐level characteristics; (3) does type of residence alter the influence of individual characteristics; and (4) does the rural/urban difference vary across national contexts? Method: Analysis is based on Demographic and Health Survey data from 35 developing countries. Multilevel regression is used to examine rural/urban differences in nutritional status net of individual, community and national determinants of health status. Findings: Rural children have a substantially higher risk of poor nutrition. Much of this disadvantage is because of socioeconomic disadvantage, reproductive norms favoring early and more rapid childbearing, and lack of access to modern medicine. Rural residence also structures the nature of the relationships between socioeconomic status, access to medical care, and nutrition. Finally, the rural/urban gap declines as countries develop. Conclusion: Rural/urban differences in child nutritional status are substantial, and some—but not all—of the differences are attributable to socioeconomic status, access to medical care, and reproductive norms.     

Understanding determinants of nutrition, physical activity and quality of life among older adults: the Wellbeing, Eating and Exercise for a Long Life (WELL) study

ABSTRACT: BACKGROUND: Nutrition and physical activity are major determinants of health and quality of life; however, there exists little research focusing on determinants of these behaviours in older adults. This is important, since just as these behaviours vary according to subpopulation, it is likely that the determinants also vary. An understanding of the modifiable determinants of nutrition and physical activity behaviours among older adults to take into account the specific life-stage context is required in order to develop effective interventions to promote health and well-being and prevent chronic disease and improve quality of life. METHODS: The aim of this work is to identify how intrapersonal, social and environmental factors influence nutrition and physical activity behaviours among older adults living in urban and rural areas. This study is a cohort study of adults aged 55-65 years across urban and rural Victoria, Australia. Participants completed questionnaires at baseline in 2010 and will complete follow-up questionnaires in 2012 and 2014. Self-report questionnaires will be used to assess outcomes such as food intake, physical activity and sedentary behaviours, anthropometry and quality of life. Explanatory variables include socioeconomic position, and measures of the three levels of influence on older adults' nutrition and physical activity behaviours (intrapersonal, social and perceived environmental influences). DISCUSSION: Obesity and its determinant behaviours, physical inactivity and poor diet are major public health concerns and are significant determinants of the quality of life among the ageing population. There is a critical need for a better understanding of the determinants of nutrition and physical activity in this important target group. This research will provide evidence for the development of effective policies and programs to promote and support increased physical activity and healthy eating behaviours among older adults.     

Nutrition Information In Community Newspapers: Goal Framing,Story Origins,and Topics

Obesity rates are high in the rural United States. Because small communities often have few health care practitioners, nutrition news in community newspapers may be a useful source of information. This content analysis of a random sample of 164 nutrition stories from 10 community newspapers in the rural West North Central Midwest was guided by concepts from goal-framing theory. Locally generated stories comprised nearly half of the sample, suggesting that nutrition is a salient topic in many rural communities. Hedonic frames related to food enjoyment were twice as frequent as health improvement frames. Results suggest food promotion was the most common topic of nutrition stories, with guidelines for a healthy diet appearing about half as often. Stories about a healthy diet and food promotion were most often written locally. Findings are discussed with recommendations for improvement of community news coverage of nutrition.     

安徽省城乡居民膳食评价与建议

对１９９２年全国营养调查中我省城乡居民进行膳食营养评价,结果表明：城乡居民热能、蛋白质摄入充足,钙、核黄素及视黄醇供给不足,膳食结构不尽合理,与我国２０００年膳食目标相比仍有较大差距,城乡居民豆类、乳、蛋、水果等消费不足;居民膳食结构存在一定差异,市民膳食质量较好,农民膳食质量差,特别是蛋白质,来源于动物性食物及豆类的优质蛋白质仅占５．６％。建议促进大豆种植、畜禽养殖,提高大豆、奶、蛋、肉等动物性食物生产与消费,适当发展钙、铁强化食品,大力加强营养教育,指导平衡膳食,达到合理营养、促进健康的目的。     

1990～1998年中国食物消费与膳食结构

根据1990和1995年国家统计局七省市食物消费数据分析,居民豆类及豆制品消费减少,城市居民动物性食物消费过量,谷类消费下降,其提供热能比低于60％,农村居民食物消费以谷类为主,动物性食物、水果、植物油消费较低。1998年调查住户食物消费结果表明：城市居民动物性食物摄入量随收入增加而大,植物油消费持平,目前膳食结构相对合理,而农村居民仍需增加动物性食物、水果等的摄入量,其中贫困住户的营养状况需要注意。建议加强营养宣传教育,大力促进豆类的生产和消费以改善居民的膳食结构。     

Stunting and Anemia in Children from Urban Poor Environments in 28 Low and Middle-income Countries: A Meta-analysis of Demographic and Health Survey Data

Child malnutrition remains a global concern with implications not only for children’s health and cognitive function, but also for countries’ economic growth. Recent reports suggest that global nutrition targets will not be met by 2025. Large gaps are evident between and within countries. One of the largest disparities in child malnutrition within counties is between urban and rural children. Large disparities also exist in urban areas that have higher rates of child malnutrition in the urban poor areas or slums. This paper examines stunting and anemia related to an urban poverty measure in children under age 5 in 28 low and middle-income countries with Demographic and Health Survey data. We used the United Nations Human Settlements Programme (UN-HABITAT) definition to define urban poor areas as a proxy for slums. The results show that in several countries, children had a higher risk of stunting and anemia in urban poor areas compared to children in urban non-poor areas. In some countries, this risk was similar to the risk between the rural and urban non-poor. Tests of heterogeneity showed that these results were not homogeneous across countries. These results help to identify areas of greater disadvantage and the required interventions for stunting and anemia.     

安徽省部分农村地区中小学生营养与健康状况监测分析

目的了解和评价营养改善计划实施地区学生营养健康状况。方法在12个县抽取1 185所中小学校191 181名学生,监测学校食堂供餐模式、学生体格发育和微量营养素状况、学生膳食摄入等。结果 90%以上学校供餐模式为＂企业供餐＂;学生身高、体重指标略低于全省农村平均水平,营养不良率14.6%,贫血率9.1%;25%学生的肉、蛋、奶、豆类等富含优质蛋白质的食物摄入频率和每周食用量偏低。结论贫困农村地区中小学生存在营养健康问题,实施针对性的营养改善计划很有必要。     

Analysis of the current situation regarding the aging rural population in China and proposed countermeasures

China has become a country with an aging population. Compared with the aged in urban areas, the aged in rural areas have low income and are subject to social security deficiencies; the oldest among them are the most vulnerable group. If an effective mechanism for handling health risk is not available, the poor health of the rural elderly will cause an increase in their poverty level, which in turn will cause their health to become worse. Therefore, it is essential to analyze the current situation regarding rural population aging in China and to develop countermeasures. Data from 4 national health services surveys were used to analyze the differences between urban and rural populations. The results of the analysis revealed that the aged population in rural areas has poor health; economic security for the aged population is insufficient; and resources for the aged are lacking in rural areas. The Chinese government should improve medicare for the aged in rural areas, and establish a medical treatment subsidy system and a medical support system for the aged in rural areas.     

Rationale and Evidence for Menu-Labeling Legislation

Menu-labeling legislation is a proposed public health intervention for poor diet and obesity that requires chain restaurants to provide nutrition information on menus and menu boards. The restaurant industry has strongly opposed menu-labeling legislation. Using scientific evidence, this paper counters industry arguments against menu labeling by demonstrating that consumers want chain restaurant nutrition information to be disclosed; the current methods of providing nutrition information are inadequate; the expense of providing nutrition information is minimal; the government has the legal right to mandate disclosure of information; consumers have the right to know nutrition information; a lack of information reduces the efficiency of a market economy; and menu labeling has the potential to make a positive public health impact.     

鹤壁市45岁以上中老年居民膳食结构变迁趋势

目的了解鹤壁市居民膳食结构、营养和健康状况及其变化规律,揭示社会经济发展对居民营养和健康状况的影响。方法采用流行病学队列研究的方法进行居民营养研究。结果从1989年开始对同一样本人群的食物消费、营养状况及其相关的影响因素进行了9轮追踪研究,取得了鹤壁市居民过去20年膳食、营养和健康状况的变化状况,掌握了鹤壁居民20年来膳食结构和营养健康状况的变化趋势。结论本调查揭示了鹤壁市城乡居民膳食结构和营养水平及其相关慢性疾病的流行病学特点及变化规律。     

Health and Well-Being of Childbearing Women in Rural and Urban Contexts

As part of the national focus on women's health issues, it is important to identify those health-related characteristics of rural women that distinguish them from women living in urban settings. The aim of this study was to compare rural and urban childbearing women on socioeconomic characteristics, perceived stress, health-related practices, illness symptoms, parenting confidence, and body weight. One hundred sixty-five midwestern women responded to a health survey sent to them six months after childbirth. Rural women were younger and less educationally and economically advantaged compared to urban women. Before adjusting for these differences, rural women were less self-actualized, more interpersonally isolated, and reported less healthy nutrition than urban women. These differences disappeared when socioeconomic differences were adjusted. Rural and urban mothers did not differ in most other areas, including perceived stress, parenting confidence, and body weight. Compared to national norms, the perceived stress levels of both rural and urban mothers were significantly higher than a probability sample of U.S. women. Findings support the role of socioeconomic factors as contributing to risk of poor health promotion among rural childbearing women.     

Attraction and retention of qualified health workers to rural areas in Nigeria: a case study of four LGAs in Ogun State, Nigeria

INTRTODUCTION: A shortage of health workers is a major problem for Nigeria, especially in rural areas where more than 70% of the population live. At the primary care level, trained community health officers provide services normally reserved for doctors or medical specialists. The community health officers must therefore be supported and motivated to provide effective quality healthcare services. This study aimed to determine factors that will attract and retain rural and urban health workers to rural Nigerian communities, and to examine differences between the two groups. METHODS: A cross-sectional survey measured health workers' work experience, satisfaction with, and reasons for undertaking their current work; as well as reasons for leaving a work location. Data were also gathered on factors that attract health workers to rural settings and also retain them. RESULTS; Rural health workers were generally more likely to work in rural settings (62.5%) than their urban counterparts (16.5%). Major rural motivators for both groups included: assurances of better working conditions; effective and efficient support systems; opportunities for career development; financial incentives; better living conditions and family support systems. The main de-motivator was poor job satisfaction resulting from inadequate infrastructure. Rural health workers were particularly dissatisfied with career advancement opportunities. More urban than rural health workers expressed a wish to leave their current job due to poor job satisfaction resulting from poor working and living conditions and the lack of career advancement opportunities. CONCLUSIONS: Motivational factors for attraction to and retention in rural employment were similar for both groups although there were subtle differences. Addressing rural health manpower shortages will require the development of a comprehensive, evidence-based rural health manpower improvement strategy that incorporates a coordinated intersectoral approach, involving partnership with a range of stakeholders in rural health development.     

Nutrition Care Practices of Dietitians and Oral Health Professionals for Oral Health Conditions: A Scoping Review

Background: Oral health conditions, such as dental caries, pose a substantial burden worldwide. Although there are many risk factors for poor oral health, diet is often implicated as a cause of these issues. The purpose of this scoping review was to identify and map studies that have captured information on the “real-world” nutrition care practices of oral health professionals (OHPs) and dietitians to optimize oral health, and specifically the dentition and periodontium. Methods: A search of peer-reviewed articles was conducted using MEDLINE, CINAHL, and Embase. Articles that addressed the review objective and met the following criteria were included: English language, published since 2000, and study conducted in a high-income country. Results: Overall, 70 articles were included. Most articles reported on cross-sectional survey studies and provided self-reported data on OHP practices; few articles reported on dietitians. Most articles reported only general/unspecific information on assessment and intervention practices, such as dietary analysis, nutrition counselling, and diet advice, and lacked specific information about the care provided, such as the dietary assessment tools used, type of information provided, and time spent on these activities. Barriers to the provision of nutrition care by OHPs were common and included time and lack of remuneration. Few studies reported on collaboration between dietitians and OHPs. Conclusions: Several studies have captured self-reported information on nutrition care practices of OHPs related to oral health; however, there is limited information available on the details of the care provided. Few studies have examined the practices of dietitians.     

Improving enrollment and utilization of the Oportunidades program in Mexico could increase its effectiveness

Oportunidades, Mexico's most important antipoverty program, currently with 5 million enrolled households in all regions of the country, has been shown to significantly contribute to improving the nutrition, health, and education of the poor. Because the program has used different enrollment strategies in rural and urban areas and has both obligatory (e.g., health and nutrition education) and nonobligatory components (e.g., nutrition supplements for children younger than 2 y of age), it provides an excellent opportunity to study program enrollment and utilization of different program components. In urban areas enrollment was more complex, and hence enrollment was much lower then in rural areas where the process was quasiautomatic, and nearly all eligible households enrolled. Enrollment in urban areas was not associated with having a child younger than 2 y of age. Utilization was notably higher with the obligatory than with the nonobligatory program components, illustrated by the inadequate consumption of the nutrition program's supplement as compared with near-universal compliance with well-baby visits. Innovative approaches, some of which are currently being tested, are needed to further increase the program's impact.     

The burden of anemia among women in India

OBJECTIVE: This research investigates the prevalence and determinants of anemia among women in Andhra Pradesh. We examined differences in anemia related to social class, urban/rural location and nutrition status body mass index (BMI). We hypothesized that rural women would have higher prevalence of anemia compared to urban women, particularly among the lower income groups, and that women with low body mass index (BMI; <18.5 kg/m(2)) would have a higher risk compared to normal or overweight women. DESIGN: The National Family Health Survey 1998/99 (NFHS-2) provides nationally representative cross-sectional survey data on women's hemoglobin status, body weight, diet, social, demographic and other household and individual level factors. Ordered logit regression analyses were applied to identify socio-economic, regional and demographic determinants of anemia. SETTING: Andhra Pradesh, a southern Indian state. SUBJECTS: A total of 4032 ever-married women aged 15-49 from 3872 households. RESULTS: Prevalence of anemia was high among all women. In all 32.4% of women had mild (100-109.99 g/l for pregnant women, 100-119.99 for non-pregnant women), 14.19% had moderate (70-99.99 g/l), and 2.2% had severe anemia (<70 g/l). Protective factors include Muslim religion, reported consumption of alcohol or pulses, and high socioeconomic status, particularly in urban areas. Poor urban women had the highest rates and odds of being anemic. Fifty-two percent of thin, 50% of normal BMI, and 41% of overweight women were anemic. CONCLUSIONS: New program strategies are needed, particularly those that improve the overall nutrition status of women of reproductive ages. This will require tailored programs across socio-economic groups and within both rural and urban areas, but particularly among the urban and rural poor.     

Unravelling the extent of inequalities in health across urban and rural areas: Evidence from a national sample in England

Studies of inequalities in health between rural and urban settings have produced mixed and sometimes conflicting results, depending on the national setting of the study, the level of geographic detail used to define rural areas and the health indicators studied. By focusing on morbidity data from a national sample of individuals, this study aims to examine the extent of inequalities in health between urban and rural areas, as well as inequalities in health across rural areas of England. Multilevel analyses for poor self-rated health, overweight and obesity, and common mental disorders are reported for a sample of 30,776 individuals aged 18 years and older (obtained from the Health Survey for England years 2000–2003 combined) and distributed across 3645 small areas classed in four categories: two groups of urban areas (Greater London area or ‘other cities’) and two types of rural settings (semi-rural areas or villages). Results show that rural dwellers were significantly less likely than residents of urban areas to report their health as being fair or poor and to report common mental disorders, independent of their socio-demographic characteristics. However, as for urban settlements, there were significant variations in health across semi-rural areas and across villages, indicating the presence of health inequalities within rural settings in England. These inequalities were not fully explained by the individual composition of the areas or by the available measures of area socioeconomic conditions, indicating that in rural contexts more specific factors may have significance for health. Different policies and services for health promotion and care may need to be targeted to different types of rural areas.     

西部地区宁夏城乡老年人健康自我评价的对比研究

摘要:目的　了解西部宁夏地区老年人健康自评状况,分析影响老年人健康自评因素的城乡差异。方法　宁夏地区60岁及以上的城市和农村老年人各1 501名作为研究对象,内容包括社会人口学资料、健康自评、社会交往意愿、养老意愿、社会服务满意度等。结果　宁夏地区城乡老年人健康自评结果比较差异无统计学意义。年龄、外出频次是城乡老年人的共同影响因素,高龄、外出频次≤2次的老年人健康自评较差。另外,城市老年人健康自评还与社区服务满意度相关（χ2＝3.160,P＜0.001）,对社区服务满意的老年人要比不满意的健康自评好;农村老年人健康自评还与养老意愿相关（χ2＝9.658,P＜0.001）;有居家养老意愿的老年人比机构养老意愿的健康自评好。结论　西部宁夏地区老年人健康自评整体情况没有明显城乡差异,健康自评影响因素有一定不同。护理人员应根据实际情况为老年人提供不同的卫生服务,才能有效地提高老年人群的健康水平。     

中国学龄儿童营养健康状况及改善措施建议

学龄儿童处于生长发育和行为培养的关键时期.中国学龄儿童在营养健康状况逐步改善的同时,也面临超重肥胖迅速增加、营养不足依然存在、微量营养素摄入不足的多重挑战.不仅与膳食结构不合理、身体活动不足及行为生活方式不健康密切相关,也受到社会生活环境的影响.中国各部门陆续出台了一系列营养健康相关政策和行动,从贫困农村儿童营养改善、...