The usefulness of nutrition and health videos displayed on mobile phones in rural Uganda: Experiences of community health workers and mothers.

Improvements in community health workers' (CHWs) knowledge and practices in low-income countries increasingly involve mobile phones and videos. However, little data exists on CHWs' and mothers' experiences of using such phones and videos. In this study, educational videos on nutrition, health and hygiene were downloaded onto mobile phones, which were given to 12 CHWs in rural Uganda. In 2018, these CHWs used the videos for a period of 3 months to support their work during their visits with families. We subsequently conducted individual interviews with eight CHWs and held four focus group discussions with 16 mothers. From the inductively analysed data, we identified four key themes: impact, competence, meaningfulness and choice, which are also dimensions of the Intrinsic Task Motivation Model. The model describes the motivation of workers and has previously been used in connection with CHWs. In our study, CHWs and mothers considered that the videos had more strongly impacted their learning than traditional teaching methods, and they felt the videos improved the child feeding and caring competence of both CHWs and mothers. Furthermore, the CHWs found that the videos enhanced the meaningfulness of their work, as they felt more greatly appreciated and necessary. In addition, they experienced more freedom of choice in their ability to influence their working routines. This study shows that educational videos are well received among CHWs and mothers. Educational videos are a promising method to maintain and improve the motivation of voluntary CHWs and influence correct child feeding and hygiene practices in Uganda.

Mothers' perceptions on and learning from infant and young child-feeding videos displayed in Mother and Child Health Centers in Kenya: a qualitative and quantitative approach.

OBJECTIVE: The objective was to explore mothers' perceptions on educational videos on infant and young child-feeding practices, and to assess whether viewing frequencies would influence maternal knowledge, attitudes and feeding practices (KAP). DESIGN: A set of forty-seven videos were displayed in health centres for 6 months. At 3 months, we conducted focus group discussions (FGD) with mothers and, at 6 months, administered KAP-questionnaire-based interviews to mothers. Using a quasi-experimental design, we compared groups according to video viewing frequencies. SETTING: The study was conducted in a slum in Nairobi and a rural area in Machakos, Kenya. We installed TV screens in waiting rooms of six Mother and Child Health Centers, where mothers could choose to watch them. PARTICIPANTS: Forty-three mothers with children aged 0­48 months participated in six FGD and 547 mothers of children aged 0­23 months in KAP interviews. RESULTS: The mothers from the FGD found the videos acceptable and beneficial. Videos enhanced mothers' learning and empowered them to support others in learning. The KAP data showed that after adjustments, breast-feeding (P = 0·06), complementary feeding knowledge (P = 0·01), complementary feeding attitudes (P = 0·08) and hygiene knowledge and practices (P = 0·003) were better among mothers who had seen videos three to four times, or five or more times, compared with mothers who had seen the videos once or twice. CONCLUSIONS: Videos were an accepted form of education and were beneficial when watched repeatedly. The videos could be a good addition to current infant and young child-feeding education efforts in Kenya.

Urban and rural dietary patterns are associated with anthropometric and biochemical indicators of nutritional status of adolescent Mozambican girls.

OBJECTIVE: The objective of the present study was to explore whether dietary patterns (DP) are associated with nutritional status indicators among adolescent Mozambican girls. Design/Setting/Subjects In this population-based cross-sectional study we used the FFQ data of 547 girls aged 14-19 years from Central Mozambique to derive dietary patterns by means of principal component analysis. We used two-level linear regression models to examine the associations between the DP and anthropometric and biochemical indicators of nutritional status. RESULTS: We identified three DP: 'Urban bread and fats', 'Rural meat and vegetables' and 'Rural cassava and coconut'. The 'Urban bread and fats' DP was positively associated with BMI-for-age Z-score (BMIZ), mid-upper arm circumference (MUAC), triceps skinfold (P for all<0·001) and blood Hb (P=0·025). A negative association was observed between the 'Urban bread and fats' DP and serum folate (P<0·001). The 'Rural meat and vegetables' DP and the 'Rural cassava and coconut' DP were associated negatively with BMIZ, MUAC and triceps skinfold (P for all<0·05), but the 'Rural meat and vegetables' DP was associated positively with serum ferritin (P=0·007). CONCLUSIONS: Urban and rural DP were associated with nutritional status indicators. In a low-resource setting, urban diets may promote body fat storage and blood Hb concentrations but compromise serum folate concentration. It is important to continue valuing the traditional, rural foods that are high in folate.

Associations of dietary diversity scores and micronutrient status in adolescent Mozambican girls.

PURPOSE: In low-income settings, dietary diversity scores (DDSs) often predict the micronutrient adequacy of diets, but little is known about whether they predict levels of biochemical indicators of micronutrient status. METHODS: In 2010, we studied two samples of non-pregnant 14- to 19-year-old girls in central Mozambique, the first in January-February ('hunger season'; n = 227) and the second in May-June (harvest season; n = 223). In this paper, we examined whether a low Women's Dietary Diversity Score (WDDS) predicts a low concentration of haemoglobin, serum ferritin, zinc, and folate, and plasma retinol in adolescent Mozambican girls. We constructed three scores: WDDS based on 24-h recalls, WDDS15g based on 24-h recall and employing a 15 g limit, and 7dWDDS based on 7-day food frequency questionnaires. Logistic regression models, stratified by season, were used to estimate the odds of having a low concentration of a status indicator (≤25th percentile of the season-specific distribution or cut-off from the literature) in those with a low score compared to those with a higher score. RESULTS: In January-February, after adjusting for confounders, a low (≤3) WDDS and a low (≤5) 7dWDDS were each associated with higher odds of having low serum zinc compared to having a higher score, regardless of which of the two types of cut-offs for serum zinc was used. These associations were not present in May-June. CONCLUSIONS: Our data from Mozambique suggest that dietary diversity is associated with serum zinc, but this association seems to be limited to the hunger season.

Is competence enough to enable Kenyan mothers to make good infant and young child feeding decisions?

The aim of this study was to explore factors associated with maternal infant and young child feeding motivation in urban and rural Kenya. We conducted 18 focus group discussions with mothers of children 0 to 23 months of age and healthcare workers. The data were transcribed, translated, and explored following the principles of content analysis. We first explored and coded the data inductively and categorized it according to emerging themes representing the most relevant topics for young child feeding. After this, these themes were theorized into an explanatory framework. Finally, the results yielded seven themes integrated into self-determination theory's three basic motivation-building pillars: autonomy, competence, and relatedness. We found that maternal intrahousehold autonomy on child feeding was substantial. However, this autonomy was lost for a period of time while in close contact with the healthcare staff. The authority of the healthcare workers was at its peak when the child was born and faded gradually as the child grew. Building maternal competence is important for child-feeding outcomes, but our data showed that the health education methods used by the healthcare workers were inadequate to improve maternal to improve the motivation. The competence of Kenyan healthcare workers should be improved in the area of complementary feeding counseling, and they should be trained to provide practical and emotional support as a way of increasing maternal motivation on infant and child feeding.

Essential fatty acid intake and serum fatty acid composition among adolescent girls in central Mozambique.

Many African diets are low in fat but are currently changing because of nutrition transition. We studied fat and fatty acid (FA) intake and the essential fatty acid (EFA) status of adolescent girls (aged 14-19 years, n 262) in Zambezia Province, central Mozambique. A cross-sectional study was carried out in a city as well as in the towns and rural villages of a coastal and an inland district. Dietary intake and FA sources were studied in a 24 h dietary recall. FA compositions of cholesteryl esters and phospholipids of non-fasting serum samples were analysed by GLC. Fat intake was low (13-18 % of energy) in all areas. Coconut and palm oil were the main sources of fat, and soyabean oil and maize were the main sources of PUFA. Compared to Food and Agriculture Organization/WHO 2010 recommendations, intake of linoleic acid (LA, 18 : 2n-6) was inadequate in the coastal district, and intakes of n-3 PUFA were inadequate in all areas. FA compositions of serum lipids differed between areas. The proportions of LA tended to be highest in the city and lowest in the rural areas. The phospholipid mead (20 : 3n-9):arachidonic acid (20 : 4n-6) ratio did not indicate EFA insufficiency. LA proportions in phospholipids were low, but those of long-chain n-6 and n-3 PUFA were high in comparison with Western adolescents. To conclude, fat sources, FA intake and EFA status differed between adolescent girls living in different types of communities. Fat intake was low, but EFA insufficiency was not indicated.

Plant sterol feeding induces tumor formation and alters sterol metabolism in the intestine of Apc(Min) mice.

Dietary plant sterols reduce the absorption of cholesterol and therefore increase intraluminal cholesterol concentration. We examined how plant sterol esters from functional foods affect intestinal tumorigenesis in tumor-prone adenomatous polyposis coli (Apc)(Min) mice. Feeding plant sterols at 0.8% increased the number of intestinal adenomas, and the effect was significant in female mice. The concentration of mucosal free sitosterol increased by eightfold in plant sterol males and by threefold in plant sterol females when compared with respective controls. The concentration of mucosal free cholesterol was significantly lower in plant sterol males than in control males, and the decrease in free cholesterol was accompanied with a significant increase in nuclear sterol regulatory element binding protein-2. No difference was found in the levels of ß-catenin, cyclin D1, epidermal growth factor receptor, extracellular signal-regulated kinase 1/2, or caveolin-1 in either gender after plant sterol feeding. Among all measured parameters, higher levels of estrogen receptor ß and free cholesterol in the mucosa were among the strongest predictors of increased intestinal tumorigenesis. In addition, gene expression data showed significant enrichment of up-regulated genes of cell cycle control and cholesterol biosynthesis in plant sterol females. The results indicate that high intake of plant sterols accelerates intestinal tumorigenesis in female Apc (Min)mice; however, the mechanism behind the adverse effect remains to be discovered.

Food photographs in portion size estimation among adolescent Mozambican girls.

OBJECTIVE: To assess the validity of food photographs in portion size estimation among adolescent girls in Mozambique. The study was carried out in preparation for the larger ZANE study, which used the 24 h dietary recall method. DESIGN: Life-sized photographs of three portion sizes of two staple foods and three sauces were produced. Participants ate weighed portions of one staple food and one sauce. After the meal, they were asked to estimate the amount of food with the aid of the food photographs. SETTING: Zambezia Province, Mozambique. SUBJECTS: Ninety-nine girls aged 13­18 years. RESULTS: The mean differences between estimated and actual portion sizes relative to the actual portion size ranged from 219% to 8% for different foods. The respective mean difference for all foods combined was 25% (95% CI 212, 2 %). Especially larger portions of the staple foods were often underestimated. For the staple foods, between 62% and 64% of the participants were classified into the same thirds of the distribution of estimated and actual food consumption and for sauces, the percentages ranged from 38% to 63%. Bland­Altman plots showed wide limits of agreement. CONCLUSIONS: Using life-sized food photographs among adolescent Mozambican girls resulted in a rather large variation in the accuracy of individuals' estimates. The ability to rank individuals according to their consumption was, however, satisfactory for most foods. There seems to be a need to further develop and test food photographs used in different populations in Sub-Saharan Africa to improve the accuracy of portion size estimates.

Mothers' knowledge and practices on breastfeeding and complementary feeding in an urban slum area and rural area in Kenya: A cross-sectional interview study.

Maternal breastfeeding and complementary feeding knowledge is an important determinant of childrens' long-term health and development. This study aims to account for associations between knowledge and practices in Kenya and report the food consumption of children from birth to 18 months. In 2015 mother-child pairs were recruited from Mother-and-Child Health Centers; 415 in an urban slum in Nairobi and 364 in rural Machakos. Knowledge and practice scores were calculated from questionnaire variables and 24-h food frequency questionnaire. The associations of knowledge and practices were studied with regression analysis. Breastfeeding knowledge (Nairobi 6.3/9, Machakos 5.9/9) and practices (Nairobi 7.5/8, Machakos 7.2/8) were good in both areas. Complementary feeding knowledge was not as good (Nairobi 7.5/14, Machakos 7.1/14). Minimum meal frequency was reached by almost 80% of the children but dietary diversity was low (Nairobi 2.7 [SD 1.4], Machakos 2.4. [SD 1.3]). Only 27% of children in Nairobi and 13% in Machakos were fed a minimum acceptable diet. The complementary feeding knowledge score was associated only with minimum dietary diversity in Nairobi (OR: 1.29; 95% CI: 1.105-1.514). Infant and young child feeding knowledge and practices were on a similar level in both areas. Future interventions should focus on improving dietary diversity.

Genetic mapping of Mom5, a novel modifier of Apc(Min)-induced intestinal tumorigenesis.

The initial purpose of this study was to assess the role of estrogen receptor beta (ERbeta) in intestinal tumorigenesis by examining the effects of an ERbeta knockout (ERbeta(-/-)) on Apc(Min) mice. In order to accomplish this goal on a uniform genetic background, we were required to backcross the ERbeta knockout from the 129P2 genetic background to the B6 genetic background for 10 generations. Midway through this process, we performed a test cross in which mice from the N(5) backcross generation of the ERbeta knockout strain were intercrossed with Apc(Min/+) mice to obtain Apc(Min/+) ERbeta(+/+), Apc(Min/+) ERbeta(+/-) and Apc(Min/+) ERbeta(-/-) mice. Intestinal tumorigenesis in the N(5)F(2) mice was evaluated at 14 weeks of age. The analysis of the impact of ERbeta in the N(5) cross was complicated by segregating 129P2-derived alleles that affected tumor number and were unlinked to ERbeta. Genetic linkage analysis of this cross permitted the localization of a single genetic modifier of tumor number in Apc(Min/+) mice. This locus, Modifier of Min 5 (Mom5), maps to proximal mouse chromosome 5; the 129P2 allele of this locus is associated with a 50% reduction in mean intestinal tumor number. Through in silico analysis and confirmatory sequencing, we have identified the Rad50-interacting protein-1 gene as a strong candidate for Mom5.

Disruption of estrogen receptor signaling enhances intestinal neoplasia in Apc(Min/+) mice.

Estrogen receptors (ERs) [ERalpha (Esr1) and ERbeta (Esr2)] are expressed in the human colon, but during the multistep process of colorectal carcinogenesis, expression of both ERalpha and ERbeta is lost, suggesting that loss of ER function might promote colorectal carcinogenesis. Through crosses between an ERalpha knockout and Apc(Min) mouse strains, we demonstrate that ERalpha deficiency is associated with a significant increase in intestinal tumor multiplicity, size and burden in Apc(Min/+) mice. Within the normal intestinal epithelium of Apc(Min/+) mice, ERalpha deficiency is associated with an accumulation of nuclear beta-catenin, an indicator of activation of the Wnt-beta-catenin-signaling pathway, which is known to play a critical role in intestinal cancers. Consistent with the hypothesis that ERalpha deficiency is associated with activation of Wnt-beta-catenin signaling, ERalpha deficiency in the intestinal epithelium of Apc(Min/+) mice also correlated with increased expression of Wnt-beta-catenin target genes. Through crosses between an ERbeta knockout and Apc(Min) mouse strains, we observed some evidence that ERbeta deficiency is associated with an increased incidence of colon tumors in Apc(Min/+) mice. This effect of ERbeta deficiency does not involve modulation of Wnt-beta-catenin signaling. Our studies suggest that ERalpha and ERbeta signaling modulate colorectal carcinogenesis, and ERalpha does so, at least in part, by regulating the activity of the Wnt-beta-catenin pathway.

Lactobacillus rhamnosus LC705 together with Propionibacterium freudenreichii ssp shermanii JS administered in capsules is ineffective in lowering serum lipids.

OBJECTIVE: The aim of this study was to examine the effect of the administration of Lactobacillus rhamnosus strain LC705 and Propionibacterium freudenreichii ssp shermanii strain JS in capsules on serum cholesterol and triglyceride levels in mildly or moderately hypercholesterolemic men. METHODS: Thirty-eight basically healthy men, mean age 42 years (range 24-55), mean cholesterol 6.2 mmol/L (5.3-8.2 mmol/L), participated in this double-blind, randomised, placebo-controlled, two-period crossover study with 4-week treatment periods. The subjects consumed daily two probiotic capsules containing viable Lactobacillus rhamnosus LC705 and Propionibacterium freudenreichii ssp shermanii JS (2 x 10(10) colony forming units of each strain daily) or two placebo capsules. Serum lipids were assessed before the intervention, at the end of both 4-week treatment periods, and 2 weeks after the second treatment period. Dietary and lifestyle habits were carefully monitored. RESULTS: All the subjects completed the study, and the probiotic capsules were well tolerated. Dietary habits and the intake of energy and nutrients, such as saturated fatty acids and cholesterol, did not differ between the treatment groups. No changes in total cholesterol, HDL cholesterol, LDL cholesterol or triglyceride levels were observed during the consumption of the probiotics compared to placebo. CONCLUSIONS: The administration of Lactobacillus rhamnosus LC705 and Propionibacterium freudenreichii ssp shermanii JS did not affect serum lipids.

Western diet enhances intestinal tumorigenesis in Min/+ mice, associating with mucosal metabolic and inflammatory stress and loss of Apc heterozygosity.

Western-type diet (WD) is a risk factor for colorectal cancer, but the underlying mechanisms are poorly understood. We investigated the interaction of WD and heterozygous mutation in the Apc gene on adenoma formation and metabolic and immunological changes in the histologically normal intestinal mucosa of ApcMin/+ (Min/+) mice. The diet used was high in saturated fat and low in calcium, vitamin D, fiber and folate. The number of adenomas was twofold higher in the WD mice compared to controls, but adenoma size, proliferation or apoptosis did not differ. The ratio of the Min to wild-type allele was higher in the WD mice, indicating accelerated loss of Apc heterozygosity (LOH). Densities of intraepithelial CD3ε+ T lymphocytes and of mucosal FoxP3+ regulatory T cells were higher in the WD mice, implying inflammatory changes. Western blot analyses from the mucosa of the WD mice showed suppressed activation of the ERK and AKT pathways and a tendency for reduced activation of the mTOR pathway as measured in phosphoS6/S6 levels. The expression of pyruvate dehydrogenase kinase 4 was up-regulated in both mRNA and protein levels. Gene expression analyses showed changes in oxidation/reduction, fatty acid and monosaccharide metabolic pathways, tissue organization, cell fate and regulation of apoptosis. Together, our results suggest that the high-risk Western diet primes the intestine to tumorigenesis through synergistic effects in energy metabolism, inflammation and oxidative stress, which culminate in the acceleration of LOH of the Apc gene.

The plant lignans matairesinol and secoisolariciresinol administered to Min mice do not protect against intestinal tumor formation.

The lignans matairesinol (MAT) and secoisolariciresinol (SECO) were fed to Min mice at 0.02% (w/w) in diet to study their effects on intestinal tumor development. The mean number (67 vs. 51, P=0.052) and size (1.4 vs. 1.2 mm, P=0.011) of tumors in the MAT group was elevated when compared with the control group. Tumor formation of the SECO group did not differ from the control group. Intake of MAT increased the level of both MAT and enterolactone in the plasma while SECO feeding increased SECO, enterodiol, and enterolactone (P=0.001). These results showed that MAT or SECO do not prevent intestinal carcinogenesis in Min mice and that MAT may have adverse effects.

Determinants of plasma phospholipid arachidonic and docosahexaenoic acids among adolescent girls in central Mozambique - possible roles of iron and zinc.

We explored if linoleic acid (LA) and alpha-linolenic acid (ALA) will be efficiently converted to arachidonic acid (AA) and docosahexaenoic acid (DHA) in the adolescent girls (aged 15-18 years, n=145) in Mozambique consuming habitually low fat diet and if low iron and/or zinc status predicts the conversion. Total fat, LA and ALA intakes were 15-19%, 1.2-3.5% and 0.2-0.3% of energy, respectively in three areas. Iron and zinc intake varied between 9.6-12.3mg/day and 3.6-5.0mg/day. Significant negative association of plasma AA was found with plasma LA and ALA and significant positive association with serum ferritin. Plasma DHA associated, negatively with plasma LA and ALA. We showed that in a population with low intakes of LA and ALA, the proportions of phospholipid LA and ALA determines the relative proportions of AA and DHA and low iron status probably attenuates the conversion of LA to AA.

Mid-upper arm circumference is associated with biochemically determined nutritional status indicators among adolescent girls in Central Mozambique.

Biochemically determined nutritional status measurements in low-income countries are often too expensive. Therefore, we hypothesized that some anthropometrical or functional measurements (handgrip) could reflect nutritional status measured by specific biochemical indicators. We did a population-based study from 1 urban area and 2 rural districts in Zambézia Province of Mozambique. The participants (n=386) were non-pregnant adolescent girls between 15 and 18 years of age. 96% had a normal BMI-for-age score. Weight and mid-upper arm circumference (MUAC) were highly correlated (r>0.8) with each other and with total body muscle mass, body mass index (BMI), and with waist circumference, as well as with skinfolds (r>0.6). Upper and total arm lengths were correlated (r>0.7) with height and with each other, and right and left handgrip were correlated only with each other, as were triceps and subscapular skinfolds (r>0.7). Serum albumin correlated negatively with waist circumference (P<.001) and positively with MUAC (P=.007). Stepwise regressions showed that waist circumference, MUAC, weight, and handgrip were important nutritional status indicators in the models using hemoglobin, serum albumin, ferritin, zinc, and plasma retinol concentrations as dependent variables. MUAC could be a valuable anthropometric marker of the overall nutritional status of adolescent girls in low-income countries. When nutrition transition proceeds, waist circumference together with MUAC could form tools for the prediction of worsening of nutritional status.

Ellagitannin-rich cloudberry inhibits hepatocyte growth factor induced cell migration and phosphatidylinositol 3-kinase/AKT activation in colon carcinoma cells and tumors in Min mice.

Berries have been found to inhibit colon carcinogenesis in animal models, and thus represent a potential source of compounds for prevention and treatment of colorectal cancer. The mechanistic basis for their effects is not well understood. We used human colon carcinoma cells and Min mice to investigate the effects of ellagitannin-rich cloudberry (Rubus chamaemorus) extract on cancer cell migration and underlying cell signaling. Intrinsic and hepatocyte growth factor (HGF) -induced cell motility in human HT29 and HCA7 colon carcinoma cells was assessed carrying out cell scattering and scratch wound healing assays using time-lapse microscopy. Activation of Met, AKT, and ERK in cell lines and tumors of cloudberry-fed Min mice were determined using immunoprecipitation, Western blot and immunohistochemical analyses. Cloudberry extract significantly inhibited particularly HGF-induced cancer cell migration in both cell lines. Cloudberry extract inhibited the Met receptor tyrosine phosphorylation by HGF and strongly suppressed HGF-induced AKT and ERK activation in both HT29 and HCA7 cells. Consistently, cloudberry feeding (10% w/w freeze-dried berries in diet for 10 weeks) reduced the level of active AKT and prevented phosphoMet localization at the edges in tumors of Min mice. These results indicate that cloudberry reduces tumor growth and cancer cell motility by inhibiting Met signaling and consequent activation of phosphatidylinositol 3-kinase/AKT in vitro and in tumors in vivo. As the Met receptor is recognized to be a major target in cancer treatment, our results suggest that dietary phytochemicals may have therapeutic value in reducing cancer progression and metastasis.

Changes in intestinal immunity, gut microbiota, and expression of energy metabolism-related genes explain adenoma growth in bilberry and cloudberry-fed ApcMin mice.

We showed previously that ellagitannin-rich cloudberries and anthocyanin-rich bilberries reduce the number of intestinal adenomas in multiple intestinal neoplasia/+ (ApcMin) mice. We also found that cloudberries decreased the size of adenomas, whereas bilberries increased it. Here we hypothesized that the difference in adenoma growth could be explained by dissimilar effects of the berries on intestinal immune responses and gut microbiota, potentially driven by the distinct polyphenol compositions of the 2 berries. Our objectives were to investigate lymphocyte subtypes and the predominant cecal bacterial diversity in mice fed with bilberries and cloudberries, and to analyze global gene expression profiles in the intestinal mucosa. Immunostainings of CD3+ T lymphocytes, FoxP3+ regulatory T lymphocytes, and CD45R+ B lymphocytes revealed a smaller ratio of intraepithelial to all mucosal CD3+ T lymphocytes in the cloudberry-fed mice compared with controls, suggesting an attenuation of inflammation. Bilberry feeding induced no changes in the density of any of the lymphocyte subtypes. The predominant bacterial diversity in cecal contents, analyzed using polymerase chain reaction-denaturating gradient gel electrophoresis, was higher in the bilberry group than in the control or cloudberry groups. The microbial profiles of cloudberry-fed mice clustered together and were associated with small adenoma size. Pathway analyses of gene expression data showed that cloudberry down-regulated and bilberry up-regulated the expression of energy metabolism-related genes in the intestinal mucosa. In conclusion, attenuation of intestinal inflammation, changes in microbial profiles, and down-regulation of mucosal energy metabolism may account for the smaller adenoma size in cloudberry-fed mice in comparison to bilberry-fed mice.

Promotion of adenoma growth by dietary inulin is associated with increase in cyclin D1 and decrease in adhesion proteins in Min/+ mice mucosa.

We have earlier shown that dietary fructo-oligosaccharide inulin enhances adenoma growth in multiple intestinal neoplasia (Min/+) mice. To further explore inulin-induced early biochemical changes in the normal-appearing mucosa, Min/+ mice were fed from the age of 5 weeks to the ages of 8 and 15 weeks a control diet or an inulin-enriched diet (10% w/w). In addition, the wild-type littermates were fed with the same diets until the age of 8 weeks, in order to determine whether similar changes happen both in the wild-type and Min/+ mice. The mucosa without adenomas was collected and fractionated to nuclear, cytosolic and membrane pools. The protein levels of beta-catenin, cyclin D1 and E-cadherin were determined by Western blotting at both time points, and immunohistochemical stainings were done for 8-week-old mice. The promotion of adenoma growth by inulin (week 15, 1.3-fold increase, P=.0004) was associated with accumulation of cytosolic and nuclear beta-catenin, and increased amount of cytosolic cyclin D1 (1.5-fold increase, P=.003) in the normal-appearing mucosa of the Min/+ mice. Furthermore, inulin feeding reduced the membranous pools of beta-catenin and E-cadherin. Also in the wild-type mice the drop in membranous beta-catenin was clear (P=.015), and, moreover, a subset of crypts had enhanced nuclear beta-catenin staining. These data indicate that dietary inulin can already activate in the normal-appearing mucosa beta-catenin signaling, which in the presence of Apc mutation induces adenoma growth and even in the wild-type mice direction of the changes is similar.

Poor micronutrient intake and status is a public health problem among adolescent Mozambican girls.

Micronutrient deficiencies can damage the health of adolescent girls and their offspring. There is a lack of population-based data on the micronutrient status of adolescents in Sub-Saharan Africa. We conducted a cross-sectional, population-based study to examine the biochemical status, prevalence of deficiency, dietary intake, and food sources of selected micronutrients among adolescent girls in Central Mozambique. Separate groups of study participants were recruited in 2 seasons in 2010. The participants were girls between 14 and 19 years of age (n = 551) from 1 urban area and 2 rural districts. Micronutrient status indicators were analyzed from blood and urine samples. Twenty-four-hour dietary recalls were also carried out. The overall prevalence with 95% confidence interval (calculated using sampling weights) among nonpregnant girls was 42.4% (37.2%-47.8%; n = 466) for anemia, 27.4% (23.1%-32.2%; n = 427) for low serum ferritin, 32.7% (27.7%-38.1%; n = 423) for low serum zinc, 14.7% (11.2%-19.0%; n = 426) for low plasma retinol, and 4.1% (2.9%-5.8%; n = 448) for low serum folate. The selenium status was considered sufficient. Mild to moderate iodine deficiency was found in the rural districts, whereas the iodine status of urban girls was adequate. Significantly lower serum folate concentrations were found in the urban area compared to the rural districts. The seasonal differences in vitamin A intake were significant. The intakes of micronutrients from animal source foods were small. In summary, adolescent Mozambican girls are at risk of several micronutrient deficiencies. This raises concern especially because adolescent motherhood is common in the region. Actions need to be taken to prevent and control micronutrient deficiencies.