Vitamin A inadequacy observed in a group of 2- to 6-year-old children living in Kwangju, Republic of Korea

Dietary intakes and plasma concentrations of retinol and carotenoids were estimated in assessing the vitamin A status of young children in Kwangju, Republic of Korea. Three consecutive 24-hour food recalls and fasting blood samples were obtained from 123 healthy children (58 boys, 65 girls), aged 2-6 years. The daily vitamin A intake (mean +/- SD) was 355.9 +/- 178.1 microg retinol equivalents or 239.0 +/- 111.2 microg retinol activity equivalents. Provitamin A carotenoid intakes were 1211.2 +/- 840.0 microg/day beta-carotene, 234.6 +/- 231.7 microg/day alpha-carotene, and 149.1 +/- 160.7 microg/day beta-cryptoxanthin. Approximately 15-26% of subjects consumed < Korean Estimated Average Requirements (EAR) for vitamin A; whereas, 57-64% consumed < EAR for vitamin A for USA/Canadians. The mean plasma retinol concentration was 1.108 +/- 0.244 micromol/L. There were no significant correlations between intakes and plasma concentrations of retinol and carotenoids. Only 2.4% of children were vitamin A-deficient based on having plasma retinol concentrations <0.70 micromol/L. Plasma retinol concentrations of 42.3% of subjects were 0.70 - <1.05 micromol/L, which is considered indicative of potentially suboptimal vitamin A status. Therefore, some children may be at risk of inadequate vitamin A status in Kwangju, Republic of Korea.     

中国居民膳食维生素A的摄入状况调查

目的分析中国居民膳食维生素A的摄入状况及1982~2002年摄入量的变化趋势。方法利用2002年中国居民营养与健康状况调查数据进行分析。膳食调查包括23470户,共68965人。结果全国平均每标准人日视黄醇当量摄入量为469.2μg,摄入量达到RNI的居民占14.5%,达到60%RNI的占33.1%,不足20%RNI的居民占23.2%。6类地区中3类农村仅有9.7%的居民摄入量达到RNI。随着收入水平从低到高,视黄醇当量的摄入量总体呈上升趋势。从1982~2002年,居民视黄醇当量的平均摄入水平没有太大改善。结论中国居民膳食维生素A的总体摄入水平仍较低。     

Meeting requirements for vitamin A

When the intake of foods or pharmaceutical preparations containing sufficient nutrients of adequate bioavailability are consumed, nutrient requirements are met and optimal nutritional status is maintained. Recent studies have shown that the basis for describing vitamin A activity of carotenoids overestimates the bioavailability of provitamin A carotenoids and their bioconversion to retinol (vitamin A). It is therefore proposed that instead of 6 microg from a mixed diet, 21 microg beta-carotene are required to provide 1 microg of retinol or 1 RE (retinol equivalent) of vitamin A. Based on this assumption and on data from food balance sheets, estimates of daily per capita vitamin A intake expressed in RE in Africa, South America, and Asia are reduced from 895, 599, and 667, respectively, to 371, 372, and 258, respectively. Such intakes are well below the recommended daily intake of 600 RE for adult males. A new combination of approaches will therefore have to be used to combat vitamin A deficiency rather than that used up until now.     

1982年与2012年中国6~17岁学龄儿童膳食维生素A的摄入比较

  目的  了解中国6~17岁学龄儿童(以下简称学龄儿童)膳食维生素A、视黄醇和胡萝卜素摄入水平,为促进儿童营养改善和健康成长提供基础数据。  方法  通过分析1982年全国营养调查和2012年中国居民营养与健康状况监测中的膳食调查数据,计算学龄儿童每人每天各种食物及调味品摄入量。根据1982年与2012年的食物成分表,分别计算动物性食物来源的视黄醇和植物性食物来源的胡萝卜素摄入量,并将二者折合计算维生素A总量,与维生素A的推荐摄入量(recommended nutrient intake, RNI)进行比较。  结果  中国学龄儿童膳食维生素A摄入总量(μg RAE)从1982年的(333.3±15.9)μg RAE下降到2012年的(215.3±9.5)μg RAE(F=61.95, P < 0.001);其中,视黄醇摄入量从(28.4 ±2.0)μg增加到(107.6±4.8) μg(F=225.36, P < 0.001),胡萝卜素摄入量从(3 673.9±217.3)μg下降到(1 297.4±82.0)μg(F=214.98, P < 0.001)。1982年儿童膳食维生素A摄入总量为农村高于城市(F=5.28, P=0.022),2012年则为城市高于农村(F=14.85, P < 0.001)。2012年仅有四分之一的儿童膳食维生素A摄入量达到80%RNI以上。  结论  1982—2012年中国学龄儿童膳食维生素A摄入水平整体有所下降,动物性食物贡献率有所增加,植物性食物贡献率大幅度降低。建议加强膳食指导,丰富农村儿童食物供应的种类,改善儿童的维生素A营养状况。     

Small fish is an important dietary source of vitamin A and calcium in rural Bangladesh

Fish plays an important role in the Bangladeshi diet, constituting the main animal food in rural households. Fish consumption is dominated by wild small (length&lt;25 cm) indigenous fish species (SIS). A study was conducted to evaluate the dietary contribution of vitamin A and calcium from fish in rural Bangladesh. Seasonal fish consumption was surveyed in 84 rural households in Kishoreganj district using a 5 day recall method. Fifty-nine of the households practised aquaculture, producing carps and SIS in small ponds. The intra-household distribution of a standardised fish dish was surveyed in 20 households by weighing. The contribution of vitamin A and calcium from fish was calculated as a nutrient contribution ratio, expressing the nutrient intake from fish relative to the recommended intake at household level. The mean amount of fish consumed in all households was 37 g raw edible parts/person/day (median=27) in July 1997. 82 g raw edible parts/person/day (median=64) in October 1997, and 55 g raw edible parts/person/day (median=42) in February 1998. A total of 44 fish species was recorded in the diet. SIS contributed 84% of the total fish intake. Fish bought in the local markets was the most important source of fish in both fish-producing and non-fish-producing households. The intra-household fish distribution showed that the heads of the households (all males) were favoured over females and other males. In October, the; mean nutrient contribution ratio for vitamin A was 40% (median=23%) and for calcium was 32% (median=26%). SIS contributed more than 99% of vitamin A and calcium intakes from the total fish intake. Mola, a vitamin A-rich SIS, was produced in 34 of the fish-producing households. Mola harvested from the ponds and consumed in the households contributed, on average, 21% (median=18%) of the household recommended intake of vitamin A in a 7 month period. SIS is an important and perhaps irreplaceable dietary source of vitamin A and calcium, and promotion of the availability and accessibility of SIS for the population in rural Bangladesh should be given priority.     

Small fish is an important dietary source of vitamin A and calcium in rural Bangladesh

Fish plays an important role in the Bangladeshi diet, constituting the main animal food in rural households. Fish consumption is dominated by wild small (length<25 cm) indigenous fish species (SIS). A study was conducted to evaluate the dietary contribution of vitamin A and calcium from fish in rural Bangladesh. Seasonal fish consumption was surveyed in 84 rural households in Kishoreganj district using a 5 day recall method. Fifty-nine of the households practised aquaculture, producing carps and SIS in small ponds. The intra-household distribution of a standardised fish dish was surveyed in 20 households by weighing. The contribution of vitamin A and calcium from fish was calculated as a nutrient contribution ratio, expressing the nutrient intake from fish relative to the recommended intake at household level. The mean amount of fish consumed in all households was 37 g raw edible parts/person/day (median=27) in July 1997. 82 g raw edible parts/person/day (median=64) in October 1997, and 55 g raw edible parts/person/day (median=42) in February 1998. A total of 44 fish species was recorded in the diet. SIS contributed 84% of the total fish intake. Fish bought in the local markets was the most important source of fish in both fish-producing and non-fish-producing households. The intra-household fish distribution showed that the heads of the households (all males) were favoured over females and other males. In October, the; mean nutrient contribution ratio for vitamin A was 40% (median=23%) and for calcium was 32% (median=26%). SIS contributed more than 99% of vitamin A and calcium intakes from the total fish intake. Mola, a vitamin A-rich SIS, was produced in 34 of the fish-producing households. Mola harvested from the ponds and consumed in the households contributed, on average, 21% (median=18%) of the household recommended intake of vitamin A in a 7 month period. SIS is an important and perhaps irreplaceable dietary source of vitamin A and calcium, and promotion of the availability and accessibility of SIS for the population in rural Bangladesh should be given priority.     

Household Food Expenditure Patterns,Food Nutrient Consumption and Nutritional Vulnerability in Nigeria: Implications for Policy

The study examined the patterns of food spending, food nutrient consumption, and nutrient deficiency profiles of households in Nigeria using a cross-sectional nationwide household survey data. Food nutrients were estimated from food expenditure data while the nutrient deficiency profiles were assessed adapting Foster et al. (1984) poverty index. The study established widespread nutritional deficiencies with low-income household cohorts bearing a greater burden of the deficiencies. Protein-protein deficiency appears to be much more prevalent in urban than rural areas. However, the deficiency of micro-nutrients seems to diffuse across urban-rural divides of the country with deficiency of calcium, vitamin A, and vitamin C appearing to be more pronounced in rural areas while phosphorous, vitamin B1, vitamin B2, and vitamin B3 deficiencies seem to be higher in urban settings. Pro-poor income growth strategies and sensitively guided urban-rural food and nutrition interventions are advocated for improved food consumption and nutritional deficiency reduction.     

Predicting dietary intakes with simple food recall information: a case study from rural Mozambique

OBJECTIVE: Improving dietary status is an important development objective, but monitoring of progress in this area can be too costly for many low-income countries. This paper demonstrates a simple, inexpensive technique for monitoring household diets in Mozambique. DESIGN: Secondary analysis of data from an intensive field survey on household food consumption and agricultural practices, known as the Nampula/Cabo Delgado Study (NCD). SUBJECTS: In total, 388 households in 16 villages from a stratified random sample of rural areas in Nampula and Cabo Delgado provinces in northern Mozambique. METHODS: The NCD employed a quantitative 24-h food recall on two nonconsecutive days in each of the three different seasons. A dietary intake prediction model was developed with linear regression techniques based on NCD nutrient intake data and easy-to-collect variables, such as food group consumption and household size The model was used to predict the prevalence of low intakes among subsamples from the field study using only easy-to-collect variables. RESULTS: Using empirical data for the harvest season from the original NCD study, 40% of the observations on households had low-energy intakes, whereas rates of low intake for protein, vitamin A, and iron, were 14, 94, and 39, respectively. The model developed here predicted that 42% would have low-energy intakes and that 12, 93, and 35% would have low-protein, vitamin A, and iron intakes, respectively. Similarly, close predictions were found using an aggregate index of overall diet quality. CONCLUSIONS: This work demonstrates the potential for using low-cost methods for monitoring dietary intake in Mozambique.     

Reduction in estimated vitamin A intake induced by new food composition tables in Japan, where vitamin A is taken mostly from plant foods

A revised edition of the standard tables of food composition was implemented in Japan in 2005; one of the major revision points is the change of retinol activity equivalents for pro-vitamin A carotenoids. This preliminary analysis was conducted to examine whether the revision affects the estimation of vitamin A intake; and if so, to what extent. Accordingly, a field survey was conducted to collect 24-h duplicates of daily foods of citizens, and 26 adult women volunteered. Application of the procedures in the new and previous standard tables of food composition gave 537 microg retinol activity equivalent and 704 microg retinol equivalence, respectively, for daily vitamin A intake. Thus, the changes in retinol activity equivalents induced substantial reduction (by 24%) in estimation of vitamin A intake among the Japanese population, for whom pro-vitamin A carotenoids in plant foods are the major sources (76%) for vitamin A, and retinol accounts for only 35% (on the retinol activity equivalent basis).     

Dietary vitamin A intakes of Filipino elders with adequate or low liver vitamin A concentrations as assessed by the deuterated-retinol-dilution method: implications for dietary requirements

BACKGROUND: The vitamin A requirements of elderly humans have not been studied. OBJECTIVE: In a cross-sectional study of 60-88-y-old men (n = 31) and women (n = 31) in rural Philippines, we assessed the dietary intakes of elders with adequate (> or = 0.07 micromol/g) or low (< 0.07 micromol/g) liver vitamin A concentrations to estimate vitamin A requirements for this age group. DESIGN: Total-body vitamin A was assessed by the deuterated-retinol-dilution technique; liver vitamin A concentrations were assessed by assuming that liver weight is 2.4% of body weight and that, in this marginally nourished population, 70% of total-body vitamin A is in the liver; serum retinol was measured by HPLC; and dietary intakes were assessed with 3 nonconsecutive 24-h dietary recalls. The mean vitamin A intake + 2 SDs of subjects with adequate liver vitamin A concentrations was used to estimate an acceptable or sufficient vitamin A intake value for elders. RESULTS: The mean (+/- SD) vitamin A intakes of the men and women with adequate vitamin A in liver were 135 +/- 86 and 134 +/- 104 microg retinol activity equivalents (RAE)/d, respectively; intakes of the men and women with low vitamin A in liver were 75 +/- 53 and 60 +/- 27 microg RAE/d, respectively. Total-body vitamin A or liver vitamin A but not serum retinol correlated with dietary RAE, preformed vitamin A, beta-carotene, fat, and protein. An estimated acceptable or sufficient dietary vitamin A intake associated with adequate liver vitamin A concentrations in elders is 6.45 microg RAE/kg body wt; for a reference 76-kg man and a 61-kg woman, these values are approximately 500 and 400 microg RAE/d, respectively. CONCLUSION: The dietary vitamin A intakes of elders with adequate or low liver vitamin A concentrations as estimated by use of the deuterated-retinol-dilution technique are useful for assessing vitamin A requirements.     

Measuring Household Food Security Using Food Intake Indicators in Rural Kwazulu Natal,South Africa

Estimation of micronutrients intake in food consumption surveys has generally been ignored. Focusing on similar households, a household food consumption survey (n = 200) was carried out in November 2004 (period of less) and March 2005 (period of plenty) in rural KwaZulu Natal, South Africa. Diet diversity, energy, protein and micronutrient intakes were proxies of household food security. Principal Component Analysis was used to estimate household food adequacy and strength of the variables (nutrients) in determining household intake variation amongst the community. On average, variation in household intake was contributed by energy (62.8%), iron (20.2%), protein (11.8%), vitamin E (3.8%), vitamin A (1.0%), and dietary diversity (0.3%). Linking food intake to household variables can generate plausible variables for measuring household food security.     

A food-based approach introducing orange-fleshed sweet potatoes increased vitamin A intake and serum retinol concentrations in young children in rural Mozambique

Vitamin A deficiency is widespread and has severe consequences for young children in the developing world. Food-based approaches may be an appropriate and sustainable complement to supplementation programs. Orange-fleshed sweet potato (OFSP) is rich in beta-carotene and is well accepted by young children. In an extremely resource poor area in Mozambique, the effectiveness of introduction of OFSP was assessed in an integrated agriculture and nutrition intervention, which aimed to increase vitamin A intake and serum retinol concentrations in young children. The 2-y quasi-experimental intervention study followed households and children (n = 741; mean age 13 mo at baseline) through 2 agricultural cycles. In y 2, 90% of intervention households produced OFSP, and mean OFSP plot size in intervention areas increased from 33 to 359 m(2). Intervention children (n = 498) were more likely than control children (n = 243) to eat OFSP 3 or more d in the last wk (55% vs. 8%, P < 0.001) and their vitamin A intakes were much higher than those of control children (median 426 vs. 56 microg retinol activity equivalent, P < 0.001). Controlling for infection/inflammation and other confounders, mean serum retinol increased by 0.100 micromol/L (SEM 0.024; P < 0.001) in intervention children and did not increase significantly in control subjects. Integrated promotion of OFSP can complement other approaches and contribute to increases in vitamin A intake and serum retinol concentrations in young children in rural Mozambique and similar areas in Sub-Saharan Africa.     

Vitamin A status of 20- to 59-year-old adults living in Seoul and the metropolitan area,Korea

Dietary intakes and plasma concentrations of retinol and carotenoids were estimated in assessing the vitamin A status of Korean adults living in Seoul and the metropolitan area. Three consecutive 24-h food recalls were collected from 106 healthy subjects (33 males and 73 females) aged 20-59 years. Fasting blood samples of the subjects were obtained and plasma retinol and carotenoids were analyzed. The daily vitamin A intakes (mean ± SD) were 887.77 ± 401.35 µg retinol equivalents or 531.84 ± 226.42 µg retinol activity equivalents. There were no significant differences in vitamin A intakes among age groups. The retinol intake of subjects was 175.92 ± 129.87 µg/day. The retinol intake of the subjects in their 50''s was significantly lower than those in their 20''s and 30''s (P < 0.05). Provitamin A carotenoid intakes were 3,828.37 ± 2,196.29 µg/day β-carotene, 472.57 ± 316.68 µg/day α-carotene, and 412.83 ± 306.46 µg/day β-cryptoxanthin. Approximately 17% of the subjects consumed vitamin A less than the Korean Estimated Average Requirements for vitamin A. The plasma retinol concentration was 1.22 ± 0.34 µmol/L. There was no significant difference in plasma retinol concentrations among age groups. However, the concentrations of β-carotene, lycopene, and lutein of subjects in their 50''s were significantly higher than those of in their 20''s. Only one subject had a plasma retinol concentration < 0.70 µmol/L indicating marginal vitamin A status. Plasma retinol concentration in 30% of the subjects was 0.70- < 1.05 µmol/L, which is interpreted as the concentration possibly responsive to greater intake of vitamin A. In conclusion, dietary intakes and status of vitamin A were generally adequate in Korean adults examined in this study.     

The acute phase response and vitamin A status in malaria

Plasma retinol and 5 carotenes were assayed by high performance liquid chromatography in Thai rural and urban malaria patients and matched control subjects. Plasma retinol was lower in the rural than in the urban controls and both groups of malaria patients had lower serum retinol concentrations than their respective controls. 29% (6/21) of the rural patients were biochemically deficient in retinol (less than or equal to 0.35 mumol/litre), suggesting severely depleted liver stores of vitamin A. The carotene data suggest that the intake of total carotenoids may be 50 to 100% greater than in the UK and that a much higher proportion of dietary beta-carotene is converted to vitamin A than in British adults. The concentrations of non-pro-vitamin A carotenoids in both groups of malaria patients were not compatible with vitamin A deficiency. The differences between patient and control median concentrations of pro-vitamin A (PVA) carotenoids were greater than those of non-PVA carotenoids, suggesting increased utilization of vitamin A in malaria. There was no evidence of clinical vitamin A deficiency in either of the communities studied; therefore, severely depleted stores of retinol are very unlikely. There is an alternative explanation for low plasma retinol levels in malaria patients because retinol is bound to the negative acute phase proteins, retinol binding protein and transthyretin. We suggest that the behaviour of retinol during infection indicates a rapid distribution into extravascular fluids and an increased availability to the tissues; i.e., it may be another beneficial effect of the acute phase response.     

Elevated vitamin A intake and serum retinol in preadolescent children with cystic fibrosis

BACKGROUND: Persons with cystic fibrosis (CF) and pancreatic insufficiency (PI) are at risk of vitamin A deficiency because of steatorrhea, despite pancreatic enzyme replacement. Long-standing vitamin A supplementation may increase the risk of vitamin A toxicity. OBJECTIVE: The aim was to describe the vitamin A intake and serum retinol concentrations of preadolescent children with CF, PI, and mild-to-moderate pulmonary disease, who were cared for under current practice recommendations. DESIGN: This cross-sectional study evaluated children aged 8.0-11.9 y with CF and PI from 13 US CF centers. Dietary and supplemental vitamin A intakes were compared with the Dietary Reference Intakes (DRIs) for healthy children, CF recommendations, and data from the National Health and Nutrition Examination Survey (NHANES), 1999-2000. Serum retinol concentrations were compared with NHANES data. RESULTS: The 73 subjects with CF had a dietary vitamin A intake of 816 +/- 336 microg retinol activity equivalents (165 +/- 69% of the recommended dietary allowance), which was similar to the NHANES value. The supplement intake provided 2234 +/- 1574 microg retinol activity equivalents/d and exceeded recommendations in 21% of the subjects with CF. Total preformed retinol intake exceeded the DRI tolerable upper intake level in 78% of the subjects with CF. The serum retinol concentration was 52 +/- 13 microg/dL (range: 26-98 microg/dL), which was significantly higher than the NHANES value (37 +/- 10 microg/dL; range: 17-63 microg/dL; P < 0.001). CONCLUSION: Although supplementation helps to prevent vitamin A deficiency in children with CF and PI, their high vitamin A intakes and serum retinol concentrations suggest that usual care may result in excessive vitamin A intake and possible toxicity that would increase the risk of CF-associated liver and bone complications.     

Vitamin A, retinol, and carotenoids and the risk of gastric cancer: a prospective cohort study

BACKGROUND: Vitamin A may influence gastric carcinogenesis through its essential role in controlling cell proliferation and differentiation. However, epidemiologic studies of vitamin A, retinol (preformed vitamin A), and provitamin A carotenoids in relation to the risk of gastric cancer have documented inconsistent results. OBJECTIVE: The objective of the study was to examine the associations between intakes of vitamin A, retinol, and specific carotenoids and the risk of gastric cancer in a prospective population-based cohort study of Swedish adults. DESIGN: The study cohort consisted of 82 002 Swedish adults aged 45-83 y who had completed a food-frequency questionnaire in 1997. The participants were followed through June 2005. RESULTS: During a mean 7.2-y follow-up, 139 incident cases of gastric cancer were diagnosed. High intakes of vitamin A and retinol from foods only (dietary intake) and from foods and supplements combined (total intake) and of dietary alpha-carotene and beta-carotene were associated with a lower risk of gastric cancer. The multivariate relative risks for the highest versus lowest quartiles of intake were 0.53 (95% CI: 0.32, 0.89; P for trend = 0.02) for total vitamin A, 0.56 (95% CI: 0.33, 0.95; P for trend = 0.05) for total retinol, 0.50 (95% CI: 0.30, 0.83; P for trend = 0.03) for alpha-carotene, and 0.55 (95% CI: 0.32, 0.94; P for trend = 0.07) for beta-carotene. No significant associations were found for beta-cryptoxanthin, lutein and zeaxanthin, or lycopene intake. CONCLUSION: High intakes of vitamin A, retinol, and provitamin A carotenoids may reduce the risk of gastric cancer.     

中国南北方居民一年中营养素摄入量的变化趋势研究

目的　了解我国南北方居民一年内营养素摄入量的变化 ,判定营养素摄入是否具有季节性差异。方法　采用 2 4小时膳食回顾调查法对中国典型的北方农村和南方城乡三地合计约 30 0名健康成年居民进行膳食调查 ,一年内共调查 6次 ,两月一次 ,每次连续调查 3天。根据食物摄入量的调查结果 ,计算出每人每天能量和各种营养素的摄入量。结果　三地居民平均每天的能量、蛋白质以及脂肪的摄入量是充足的。我国典型南北方居民能量以及三大营养素 (蛋白质、脂肪和碳水化合物 )摄入量的季节性差异较小 ;硫胺素、核黄素、维生素E、烟酸以及锌的季节性变化也不大 ;视黄醇当量、抗坏血酸、钾和钙的摄入量则存在明显季节性差异。结论　通过对我国南北方三地一年多次的膳食调查结果分析 ,农村地区若避开 1月份的农闲季节和 7月份的农忙季节 ,其它月份进行的营养调查结果可以代表调查对象平常的膳食摄入情况 ;城市地区在一年的任何月份进行营养调查 ,对结果的影响都不大     

Household food security status measured by the US-Household Food Security/Hunger Survey Module (US-FSSM) is in line with coping strategy indicators found in urban and rural Indonesia

The food security assessment used by the United State's Food Security/Hunger Survey Module (US- FSSM) was used in five studies: these were in two urban and four rural areas in Indonesia between February 2004- August 2005. The number of households assessed was 3,704 and consisted of 45% urban and 55% rural. All households had children below five years. This paper aims to assess the applicability of US-FSSM for measuring household food-insecurity in Indonesia. Common coping-strategies discussed are to borrow money from the family, get an additional job, to lessen portion size of food, and to sell small assets. Although households in urban and rural areas were similar in size/number of children and male headed; the urban households were more income-secure, educated, and had better access to electrical appliances. A majority of the households was food-insecure (77% and 84% in urban and rural consecutively). More food-insecure households without and with hunger were found in rural areas. The number of affirmative responses to 17 out of 18 questions in the USFSSM was more in the rural households, showing less fortunate cases of food-insecurity. For a given coping strategy, as food-security status becomes more severe, the higher the percentage of households employing it. For a given food-security status, percentage of households was higher among lower-degree and less among higher-degree coping. Combining food-security and coping-strategy indicators may help to identify transient-food-secure households. Observing both indicators throughout different time of the year continuously may further identify adaptive mechanism by chronic-food-insecure households. Information on household food diversity could enrich findings on dietary intake modification, hence moving from food-security to nutrition-security.     

Household food insecurity and food expenditure in Bolivia, Burkina Faso, And the Philippines

This study examined the association between food insecurity, determined by a modified version of the U.S. Household Food Security Survey Module (US HFSSM), and total daily per capita (DPC) consumption (measured as household expenditures) in Bolivia, Burkina Faso, and the Philippines. Household food insecurity was determined by an adapted 9-item US HFSSM version. A short version of the World Bank's Living Standards Measurement Study (LSMS) consumption module measured household expenditures. Focus groups were used to adapt the survey instrument to each local context. The sample (n approximately 330 per country) includes residents of urban and rural areas. A 12-month food expenditure aggregate was generated as part of the total household expenditures calculation. DPC food expenditure, which represented over 60% of the total household consumption, as well as expenditures on specific food groups correlated with food insecurity both as a continuous Food Insecurity Score (FinSS) and a tricategorical food insecurity status variable. ANOVA and regression analysis were executed adjusting for social and demographic covariates. Food-secure households have significantly higher (P < 0.05) total DPC food expenditures as well as expenditures on animal source foods, vegetables, and fats and oils than moderately and severely food-insecure households. The results offer evidence that the US HFSSM is able to discriminate between households at different levels of food insecurity status in diverse developing world settings.     

Maternal nutritional status may be stressed by seasonal fluctuations in food availability: Evidence from rural women in Kenya

The effect of seasonal changes in household food availability on the dietary intakes and the nutritional status of 24 lactating women from smallholder rural households in Nakuru district Kenya, were investigated over a 15-month period in 1992/93 agricultural cycle. Dietary intakes and body weights were measured on monthly basis. Significant seasonal differences were found in intakes of calcium, vitamin A, vitamin C, riboflavin, and niacin respectively (P < 0.01), as well as in the intake of protein, iron, and thiamin (P < 0.05), but not with energy and fat intake. Large interseasonal weight losses of 5.6 kg (about 9%) at the rate of 1.1 kg/month, were observed between baseline measurements and the peak of the lean months when the energy intakes were 36.7 kcal/kg/day and protein at 1.1 g/kg/day. About 50% of the lost weight (2.8 kg) were recovered during the harvest months of January and February, when energy intakes improved to 41.0 kcal/kg/day, and protein to 1.2 g/kg/day. However, further weight losses of 1.6 kg or 0.5 kg/month occurred in the immediate postharvest months between March and June. While much of the weight loss may have been due to reduced energy intake during periods of food scarcity, part of the lost weight may have been due to increased energy requirement as a result of lactation and to increased physical activities. Further investigations are recommended.