Designing better input support programs: Lessons from zinc subsidies in Andhra Pradesh, India.

India has one of the largest agricultural input support programs in the world, delivered in the form of subsidies to farmers, raising concerns about its sustainability. This paper evaluates the performance of one such support, the micronutrient subsidy program in the state of Andhra Pradesh (AP) and presents a case for providing this support in the form of direct cash transfers. Under the program, key soil micronutrients- zinc, boron, and gypsum were distributed free of cost to farmers living in micronutrient-deficient areas, with identification and targeting managed entirely by the state. We survey 1621 farmers, 61 agriculture extension officers, and 78 agriculture input dealers to assess the efficacy of the program and to identify bottlenecks preventing effective targeting, with a focus on zinc. We find that use of non-subsidized zinc is high in AP, and awareness of benefits of zinc and physical access to input dealer shops are significant predictors of zinc use. We argue that the free provision of micronutrients may have created demand among farmers, but there is little justification to continue subsidizing such a program at such high rates or resorting to public distribution. We find that micronutrient procurement and distribution has become a burden on extension staff and crowds out the private sector. Our analysis shows that the subsidy can benefit more farmers if it is channeled through the network of private fertilizer dealers. We use administrative data on budgetary outlays and digital soil maps to suggest fiscal redistribution in the form of direct cash transfers that may ensure more effective targeting at a lower cost to the state.

Does Vitamin E Supplementation Enhance Growth Benefits of Breeding Helpers at No Oxidative Costs?

During early postnatal development, biomolecules are particularly exposed to the detrimental actions of unneutralized reactive oxygen species. These prooxidant molecules have been claimed to mediate the trade-off between growth and somatic maintenance. Vitamin E is a key exogenous antioxidant that plays an important role in protecting biological membranes against oxidative damage. However, evidence of the effect of vitamin E supplementation during early life on growth and oxidative status in wild populations is equivocal. We tested the effect of supplementing western bluebird nestlings (Sialia mexicana) with vitamin E on growth rate, antioxidant capacity, and oxidative damage to lipids. During the period of accelerated growth (5-8 d), bill growth rate was 21% higher in supplemented nestlings from nests with breeding helpers than in supplemented nestlings from unassisted nests. Vitamin E also boosted tarsus growth rate during the period of slow growth (11-18 d), and this effect was independent of the presence of breeding helpers. Differences in body size and mass, oxidative damage to lipids, and antioxidant capacity were not evident between supplemented and control nestlings at 18 d. Therefore, we conclude that vitamin E promoted faster bill and tarsus growth, but this transient effect disappeared as soon as the supplementation ceased. Our experimental study also supports the idea that tocopherols are rapidly metabolized, since we failed to detect any evident increase of vitamin E in supplemented nestlings at age 18 d. These results provide partial support for the hypothesis that growth rate is constrained by its costs in terms of increased susceptibility to oxidative stress.

Socio-demographic predictors and reasons for vitamin and/or mineral food supplement use in a group of outpatients in Skopje.

BACKGROUND: Vitamins and/or mineral food supplements (VMS) are mono- or multi-component products prepared in different pharmaceutical forms and categorized as food supplements. Numerous researchers have investigated the epidemiological predictors of use of VMS in population. Data of this kind in our setting are limited. AIMS: This survey aimed to gain information on the prevalence of use, certain sociodemographic predictors and reasons for VMS use in a group of 256 outpatients in Skopje. MATERIALS AND METHODS: This study was designed as an open-ended, cross-sectional survey. Data on VMS use were collected by survey method with a specially designed questionnaire as an instrument for this research. Appropriate statistical tests were used to analyse the data. RESULTS: Data from 256 outpatients from Skopje were analysed. Of them, one hundred and five (41.02%) reported using VMS. Female outpatients (p<0.01) and participants of Macedonian ethnicity (p<0.01), with a higher educational level (p<0.01) and those having their own income (p<0.05) reported significantly higher consumption of VMS. We found a statistically significant difference between the group of users and non-users of VMS regarding smoking status (p<0.05), alcohol consumption (p<0.05) and presence of a chronic disease (p<0.01). Physicians, magazines and friends were the most common source of information on VMS while maintaining good health and prevention of disease was the most common reasons for the use of these products. Only 63% of the users had disclosed the information on taking VMS to their physicians. CONCLUSION: This research provided an insight into VMS in our setting. Predictors on the use of VMS are of interest since these products contribute to total intake of vitamins and minerals in the population and they represent a source of valuable information when planning public health activities.

Transcriptome analysis in benefit-risk assessment of micronutrients and bioactive food components.

The establishment of functional effects due to variation in concentrations of micronutrients in our diet is difficult since they are often not immediately recognized as being healthy or unhealthy. Indeed, effects induced by micronutrients are hard to identify and therefore the establishment of the recommended daily intake, the optimal intake and the upper limit pose a challenge. For bioactive food components this is even more complicated. Whole-genome transcriptome analysis is highly suitable to obtain unbiased information on potential affected biological processes on a whole-genome level. Here, we will describe and discuss several aspects of transcriptome analysis in benefit-risk assessment, including effect size, sensitivity and statistical power, that have to be taken into account to faithfully identify functional effects of micronutrients and bioactive food components.

Effects of micronutrients on growth of children under 5 y of age: meta-analyses of single and multiple nutrient interventions.

BACKGROUND: Micronutrient interventions have received much attention as a cost-effective and promising strategy to improve child health, but their roles in improving child growth remain unclear. OBJECTIVE: Meta-analyses of randomized controlled trials were conducted to evaluate the effect of micronutrient interventions on the growth of children aged <5 y old. DESIGN: Eligible studies were identified by PubMed database searches and other methods. Weighted mean effect sizes and 95% CIs were calculated for changes in height, weight, and weight-for-height z scores (WHZ) by using random-effect models. Tests for publication bias were done by using funnel plots, heterogeneity, and stratified analyses by predefined characteristics. RESULTS: Interventions including iron (n = 27) or vitamin A (n = 17) only had no significant effects on growth. Interventions including zinc only (n = 43) had a small positive effect (effect size = 0.06; 95% CI: 0.006, 0.11) on change in WHZ but no significant effect on height or weight gain. Multiple micronutrient interventions (n = 20) improved linear growth (0.09; 95% CI: 0.008, 0.17). CONCLUSIONS: Our findings confirm earlier results of no benefits for interventions including iron and vitamin A only but differ from the earlier meta-analysis that found improvements in linear growth for zinc only interventions. This may be due to the improved nutritional status of children in the more recent studies. Multiple micronutrient interventions improve linear growth, but the benefits are small. Other strategies are needed to prevent stunting.

Effects of bovine serum concentrate, with or without supplemental micronutrients, on the growth, morbidity, and micronutrient status of young children in a low-income, peri-urban Guatemalan community.

OBJECTIVE: To determine the effects of dietary supplements containing bovine serum concentrate (BSC, a source of immunoglobulins) and/or multiple micronutrients (MMN) on children's growth velocity, rates of common infections, and MN status. DESIGN: Randomized, controlled, community-based intervention trial. SETTING: Low-income, peri-urban Guatemalan community. SUBJECTS: Children aged 6-7 months initially. INTERVENTIONS: Children received one of four maize-based dietary supplements daily for 8 months, containing: (1) BSC, (2) whey protein concentrate (WPC, control group), (3) WPC+MMN, or (4) BSC+MMN. RESULTS: There were no significant differences in growth or rates of morbidity by treatment group. Children who received MMN had lower rates of anemia and (in the group that received WPC+MMN) less of a decline in serum ferritin than those who did not, but there were no differences in other biochemical indicators of MN status by treatment group. CONCLUSIONS: MMN supplementation reduced anemia and iron deficiency in this population, but the MMN content and source of protein in the supplements did not affect other indicators of MN status, growth or morbidity.