Government strategies to ensure the human right to adequate and healthy food facing the Covid-19 pandemic in Brazil. / Estratégias governamentais para a garantia do direito humano à alimentação adequada e saudável no enfrentamento à pandemia de Covid-19 no Brasil.

The Covid-19 pandemic revealed a concrete and immediate threat to food and nutrition security (FNS), especially for vulnerable groups. This study aimed to identify government strategies implemented in Brazil to provide the Human Right to Adequate and Healthy Food in high social vulnerability contexts during the Covid-19 pandemic. A cross-sectional study was carried out, with analysis of official documents published between March 20 and July 30, 2020, by the Federal Government, Federal District, Brazilian states, and capitals, focusing on measures to ensure availability and physical or financial access to food. Strategies implemented mainly involve food distribution and minimum income assurance. The following were implemented: Basic Emergency Income (Federal Government); Food Acquisition Program (PAA), and emergency financial aid (states); emergency food donation programs (states and municipalities). Existing measures were adapted to the pandemic, such as the National School Food Program (PNAE), the National Food Acquisition Program (PAA), and the distribution of food and staple food baskets. While essential, these strategies have limited scope and are insufficient to ensure FNS.

A pandemia de Covid-19 revelou a existência de ameaça concreta e imediata à segurança alimentar e nutricional (SAN), em especial de grupos vulnerabilizados. O estudo buscou identificar as estratégias governamentais implementadas no Brasil para prover o Direito Humano à Alimentação Adequada e Saudável em contextos de elevada vulnerabilidade social frente à Covid-19. Foi realizado um estudo transversal, com análise de documentos oficiais publicados entre 20 de março e 30 de julho de 2020 pela União, Distrito Federal, estados e capitais brasileiras, com foco em medidas que assegurem disponibilidade e acesso físico ou financeiro a alimentos. As estratégias implementadas envolvem fundamentalmente distribuição de alimentos e garantia de renda mínima. Foram instituídas: Renda Básica Emergencial (União); Programa de Aquisição de Alimentos (PAA) e auxílio financeiro emergencial (estados); programas de doação emergencial de alimentos (estados e municípios). Medidas existentes foram adaptadas frente à pandemia, como o Programa Nacional de Alimentação Escolar (PNAE), o Programa de Aquisição de Alimentos (PAA) nacional, a distribuição de alimentos e de cestas básicas. Embora importantes, essas estratégias têm alcance limitado e são insuficientes para assegurar a SAN.

Estratégias governamentais para a garantia do direito humano à alimentação adequada e saudável no enfrentamento à pandemia de Covid-19 no Brasil / Government strategies to ensure the human right to adequate and healthy food facing the Covid-19 pandemic in Brazil

Resumo A pandemia de Covid-19 revelou a existência de ameaça concreta e imediata à segurança alimentar e nutricional (SAN), em especial de grupos vulnerabilizados. O estudo buscou identificar as estratégias governamentais implementadas no Brasil para prover o Direito Humano à Alimentação Adequada e Saudável em contextos de elevada vulnerabilidade social frente à Covid-19. Foi realizado um estudo transversal, com análise de documentos oficiais publicados entre 20 de março e 30 de julho de 2020 pela União, Distrito Federal, estados e capitais brasileiras, com foco em medidas que assegurem disponibilidade e acesso físico ou financeiro a alimentos. As estratégias implementadas envolvem fundamentalmente distribuição de alimentos e garantia de renda mínima. Foram instituídas: Renda Básica Emergencial (União); Programa de Aquisição de Alimentos (PAA) e auxílio financeiro emergencial (estados); programas de doação emergencial de alimentos (estados e municípios). Medidas existentes foram adaptadas frente à pandemia, como o Programa Nacional de Alimentação Escolar (PNAE), o Programa de Aquisição de Alimentos (PAA) nacional, a distribuição de alimentos e de cestas básicas. Embora importantes, essas estratégias têm alcance limitado e são insuficientes para assegurar a SAN.

Abstract The Covid-19 pandemic revealed a concrete and immediate threat to food and nutrition security (FNS), especially for vulnerable groups. This study aimed to identify government strategies implemented in Brazil to provide the Human Right to Adequate and Healthy Food in high social vulnerability contexts during the Covid-19 pandemic. A cross-sectional study was carried out, with analysis of official documents published between March 20 and July 30, 2020, by the Federal Government, Federal District, Brazilian states, and capitals, focusing on measures to ensure availability and physical or financial access to food. Strategies implemented mainly involve food distribution and minimum income assurance. The following were implemented: Basic Emergency Income (Federal Government); Food Acquisition Program (PAA), and emergency financial aid (states); emergency food donation programs (states and municipalities). Existing measures were adapted to the pandemic, such as the National School Food Program (PNAE), the National Food Acquisition Program (PAA), and the distribution of food and staple food baskets. While essential, these strategies have limited scope and are insufficient to ensure FNS.

What is the cost of integration? Evidence from an integrated health and agriculture project to improve nutrition outcomes in Western Kenya.

Integrated nutrition and agricultural interventions have the potential to improve the efficiency and effectiveness of investments in food security and nutrition. This article aimed to estimate the costs of an integrated agriculture and health intervention (Mama SASHA) focused on the promotion of orange-fleshed sweet potato (OFSP) production and consumption in Western Kenya. Programme activities included nutrition education and distribution of vouchers for OFSP vines during antenatal care and postnatal care (PNC) visits. We used expenditures and activity-based costing to estimate the financial costs during programme implementation (2011-13). Cost data were collected from monthly expense reports and interviews with staff members from all implementing organizations. Financial costs totalled US$507 809 for the project period. Recruiting and retaining women over the duration of their pregnancy and postpartum period required significant resources. Mama SASHA reached 3281 pregnant women at a cost of US$155 per beneficiary. Including both pregnant women and infants who attended PNC services with their mothers, the cost was US$110 per beneficiary. Joint planning, co-ordination and training across sectors drove 27% of programme costs. This study found that the average cost per beneficiary to implement an integrated agriculture, health and nutrition programme was substantial. Planning and implementing less intensive integrated interventions may be possible, and economies of scale may reduce overall costs. Empirical estimates of costs by components are critical for future planning and scaling up of integrated programmes.

Spring onion seed demand forecasting using a hybrid Holt-Winters and support vector machine model.

Demand for spring onion seeds is variable and maintaining its supply is crucial to the success of seed companies. Spring onion seed demand forecasting, which can help reduce the high operational costs increased by long-period propagation and complex logistics, has not previously been investigated yet. This paper provides a novel perspective on spring onion seed demand forecasting and proposes a hybrid Holt-Winters and support vector machine (SVM) forecasting model. The model uses dynamic factors, including historical seed sales, seed inventory, spring onion crop market price and weather data, as inputs to forecast spring onion seed demand. Forecasting error, i.e. the difference between actual and forecasted demand, is assessed. Two advanced machine learning models are trained on the same dataset as benchmark models. Numerical experiments using actual commercial sales data for three spring onion seed varieties show the proposed hybrid model outperformed the statistical-based models for all three forecasting errors. Seed inventory, spring onion crop market price and historical seed sales are the most important dynamic factors, among which seed inventory has short-term influence while other two have mid-term influence on seed demand forecasting. The absolute minimum temperature is the only factor having long-term influence. This study provides a promising spring onion seed demand forecasting model that helps understand the relationships between seed demand and other dynamic factors and the model could potentially be applied to demand forecasting of other crop seeds to reduce total operational costs.

Inter-brand competition in the convenience store industry, store density and healthcare utilization.

We investigate the impact of access to convenience stores and competition between convenience store chains on the use of medical care in Taiwan. Using insurance claims from 0.85 million individuals and administrative data on store sales, we find that greater store density and more inter-brand competition reduced expenditures on outpatient medical services and prescription drugs. In support of these findings, we demonstrate that convenience store competition was associated with greater consumption of healthy foods and lower obesity rates. Our estimates suggest that the rise in convenience store competition from 2002 to 2012 reduced outpatient expenditures in Taiwan by 0.44 percent and prescription drug expenditures by 0.85 percent.

Exploring Food Guidance Approaches for Seniors in Antigonish, NS: Is There Still Gold at the End of the Rainbow?

Purpose: As Canada rethinks approaches to food guidance, insights into the needs of seniors in rural communities are important to ensure their nutrition issues are addressed. This study aimed to explore the food guidance needs and wants of a group of seniors living in Antigonish, Nova Scotia. Methods: Three focus groups were held with a total of 12 participants over the age of 65 years, living independently in the community. Seniors were asked about their views on Canada's Food Guide (CFG) and the Brazilian Dietary Guidelines (BDG). Results: Participants identified CFG as a trusted source of information and related well to the food groups and directive statements. Portion sizes were confusing and advice on food choices was not seen as being realistic in terms of cost and availability. The holistic nature of the BDG was appealing but guidance on processed food and social eating was not seen as relevant. Neither guidance tool addressed concerns about sustainability and environmental issues. Point of purchase nutrition information was preferable to receiving it from health professionals. Conclusion: CFG was seen as a trusted source of advice; however, locally accessible guidance on affordability and environmental issues related to food choice is needed for this group.

The palm oil industry and noncommunicable diseases.

Large-scale industries do not operate in isolation, but have tangible impacts on human and planetary health. An often overlooked actor in the fight against noncommunicable diseases is the palm oil industry. The dominance of palm oil in the food processing industry makes it the world's most widely produced vegetable oil. We applied the commercial determinants of health framework to analyse the palm oil industry. We highlight the industry's mutually profitable relationship with the processed food industry and its impact on human and planetary health, including detrimental cultivation practices that are linked to respiratory illnesses, deforestation, loss of biodiversity and pollution. This analysis illustrates many parallels to the contested nature of practices adopted by the alcohol and tobacco industries. The article concludes with suggested actions for researchers, policy-makers and the global health community to address and mitigate the negative impacts of the palm oil industry on human and planetary health.

Les grandes industries ne fonctionnent pas en vase clos; elles ont des effets tangibles sur la santé des individus et de la planète. Un acteur souvent négligé dans la lutte contre les maladies non transmissibles est l'industrie de l'huile de palme. Étant donné sa prédominance dans l'industrie alimentaire, l'huile de palme est l'huile végétale la plus largement produite au monde. Nous avons appliqué les déterminants commerciaux de la santé pour analyser l'industrie de l'huile de palme. Nous mettons en évidence la relation mutuellement profitable entre cette industrie et l'industrie des aliments transformés ainsi que ses effets sur la santé des individus et de la planète, et notamment des pratiques culturales néfastes liées à des maladies respiratoires, la déforestation, la diminution de la diversité biologique et la pollution. Cette analyse établit de nombreux parallèles avec la nature contestée de pratiques adoptées par les industries de l'alcool et du tabac. L'article se conclut par des propositions d'action pour que les chercheurs, les responsables politiques et la communauté mondiale de la santé examinent et atténuent les effets négatifs de l'industrie de l'huile de palme sur la santé des individus et de la planète.

Las industrias a gran escala no operan de forma aislada, sino que tienen un impacto tangible en la salud humana y del planeta. Un agente que a menudo se ignora en la lucha contra las enfermedades no contagiosas es la industria del aceite de palma. El predominio del aceite de palma en la industria del procesamiento de alimentos lo convierte en el aceite vegetal más producido del mundo. Se han aplicado los determinantes comerciales del marco de la salud para analizar la industria del aceite de palma. Cabe destacar la relación mutuamente beneficiosa de la industria con la industria de los alimentos procesados y su impacto en la salud humana y del planeta, incluidas las prácticas de cultivo perjudiciales que están relacionadas con las enfermedades respiratorias, la deforestación, la pérdida de biodiversidad y la contaminación. Este análisis ilustra muchos paralelismos con la naturaleza controvertida de las prácticas adoptadas por las industrias del alcohol y el tabaco. El artículo concluye con varias sugerencias de posibles medidas para que los investigadores, los responsables de la formulación de políticas y la comunidad mundial de la salud aborden y mitiguen los impactos negativos de la industria del aceite de palma en la salud humana y del planeta.

"We need good nutrition but we have no money to buy food": sociocultural context, care experiences, and newborn health in two UNHCR-supported camps in South Sudan.

BACKGROUND: Determinants of newborn health and survival exist across the reproductive life cycle, with many sociocultural and contextual factors influencing outcomes beyond the availability of, and access to, quality health services. In order to better understand key needs and opportunities to improve newborn health in refugee camp settings, we conducted a multi-methods qualitative study of the status of maternal and newborn health in refugee camps in Upper Nile state, South Sudan. METHODS: In 2016, we conducted 18 key informant interviews with health service managers and front-line providers and 13 focus group discussions in two Sudanese refugee camps in Maban County, South Sudan. Our focus group discussions comprised 147 refugee participants including groups of mothers, fathers, grandmothers, traditional birth attendants, community health workers, and midwives. We analysed our data for content and themes using inductive and deductive techniques. RESULTS: We found both positive practices and barriers to newborn health in the camps throughout the reproductive lifecycle. Environmental and contextual factors such as poor nutrition, lack of livelihood opportunities, and insecurity presented barriers to both general health and self-care during pregnancy. We found that the receipt of material incentives is one of the leading drivers of utilization of antenatal care and facility-based childbirth services. Barriers to facility-based childbirth included poor transportation specifically during the night; insecurity; being accustomed to home delivery; and fears of an unfamiliar birth environment, caesarean section, and encountering male health care providers during childbirth. Use of potentially harmful traditional practices with the newborn are commonplace including mixed feeding, use of herbal infusions to treat newborn illnesses, and the application of ash and oil to the newborn's umbilicus. CONCLUSIONS: Numerous sociocultural and contextual factors impact newborn health in this setting. Improving nutritional support during pregnancy, strengthening community-based transportation for women in labour, allowing a birth companion to be present during delivery, addressing harmful home-based newborn care practices such as mixed feeding and application of foreign substances to the umbilicus, and optimizing the networks of community health workers and traditional birth attendants are potential ways to improve newborn health outcomes.

Designing programs to improve diets for maternal and child health: estimating costs and potential dietary impacts of nutrition-sensitive programs in Ethiopia, Nigeria, and India.

Improving maternal and child nutrition in resource-poor settings requires effective use of limited resources, but priority-setting is constrained by limited information about program costs and impacts, especially for interventions designed to improve diet quality. This study utilized a mixed methods approach to identify, describe and estimate the potential costs and impacts on child dietary intake of 12 nutrition-sensitive programs in Ethiopia, Nigeria and India. These potential interventions included conditional livestock and cash transfers, media and education, complementary food processing and sales, household production and food pricing programs. Components and costs of each program were identified through a novel participatory process of expert regional consultation followed by validation and calibration from literature searches and comparison with actual budgets. Impacts on child diets were determined by estimating of the magnitude of economic mechanisms for dietary change, comprehensive reviews of evaluations and effectiveness for similar programs, and demographic data on each country. Across the 12 programs, total cost per child reached (net present value, purchasing power parity adjusted) ranged very widely: from 0.58 to 2650 USD/year among five programs in Ethiopia; 2.62 to 1919 USD/year among four programs in Nigeria; and 27 to 586 USD/year among three programs in India. When impacts were assessed, the largest dietary improvements were for iron and zinc intakes from a complementary food production program in Ethiopia (increases of 17.7 mg iron/child/day and 7.4 mg zinc/child/day), vitamin A intake from a household animal and horticulture production program in Nigeria (335 RAE/child/day), and animal protein intake from a complementary food processing program in Nigeria (20.0 g/child/day). These results add substantial value to the limited literature on the costs and dietary impacts of nutrition-sensitive interventions targeting children in resource-limited settings, informing policy discussions and serving as critical inputs to future cost-effectiveness analyses focusing on disease outcomes.

Incorporating orange-fleshed sweet potato into the food system as a strategy for improved nutrition: The context of South Africa.

Orange-fleshed sweet potato (OFSP) is considered the single most successful example of biofortification of a staple crop, and presents a feasible option to address vitamin A deficiency. Though initially promoted as part of a crop-based approach focusing on production and consumption at household level, it evolved into small-scale commercial production, predominantly in Sub-Saharan Africa. This paper reviews OFSP initiatives in relation to the South African food environment and food supply systems, also identifying opportunities for scaling out OFSP in a situation where sweet potato is not eaten as a staple. Current per capita consumption of sweet potato is low; the focus is thus on increasing consumption of OFSP, rather than replacing cream-fleshed varieties. For the major OFSP variety, Bophelo, 66g consumption can be sufficient to meet the recommended daily allowance for 1-3year old children (300µRE vitamin A). Despite a national Vitamin A supplementation programme and fortified staple foods in South Africa, 43.6% of children under 5years of age were reported to be vitamin A deficient in 2012, indicating a stronger need to promote the consumption of Vitamin A-rich foods, such as OFSP. To increase availability of and access to OFSP, all aspects of the food supply system need to be considered, including agricultural production, trade, food transformation and food retail and provisioning. Currently, small-scale commercial OFSP producers in South Africa prefer to deliver their produce to local informal markets. To enter the formal market, small-scale producers often have difficulties to meet the high standards of the retailers' centralised procurement system in terms of food quality, quantity and safety. Large retailers may have the power to increase the demand of OFSP, not just by improving availability but also by developing marketing strategies to raise awareness of the health benefits of OFSP. However, currently the largest scope for scaling out is through a number of public sector programmes such as the National School Nutrition Programme, Community Nutrition and Development Centres, Small-holder Farmer programmes and Agriparks. Though the major approach is focused on unprocessed, boiled OFSP, there are unexploited opportunities for processing of OFSP. However, the nutritional quality of products should be a main consideration within the context of the co-existence of undernutrition, overnutrition and micronutrient deficiencies in the country.

Status report - FoodReach Toronto: lowering food costs for social agencies and community groups. / Rapport d'étape - FoodReach Toronto : réduire le coût des aliments pour les organismes sociaux et les groupes communautaires.

Toronto has the largest absolute number of food insecure households for any metropolitan census area in Canada: of its 2.1 million households, roughly 252 000 households (or 12%) experience some level of food insecurity. Community organizations (including social agencies, school programs, and child care centres) serve millions of meals per year to the city's most vulnerable citizens, but often face challenges accessing fresh produce at affordable prices. Therefore in 2015, Toronto Public Health, in collaboration with public- and private-sector partners, launched the FoodReach program to improve the efficiency of food procurement among community organizations by consolidating their purchasing power. Since being launched, FoodReach has been used by more than 50 community organizations to provide many of Toronto's most marginalised groups with regular access to healthy produce.

RÉSUMÉ: Toronto compte plus de ménages en situation d'insécurité alimentaire que les autres régions métropolitaines de recensement au Canada : sur 2,1 millions de ménages, environ 252 000 (soit 12 %) vivent dans une certaine forme d'insécurité alimentaire. Les organismes communautaires (organismes sociaux, programmes scolaires, garderies) servent des millions de repas par année aux citoyens les plus vulnérables de la ville, mais rencontrent souvent des difficultés à obtenir des produits frais à prix abordable. C'est dans ce contexte, afin d'améliorer l'efficience de l'approvisionnement alimentaire des organismes communautaires en consolidant leur pouvoir d'achat, que le Bureau de santé publique de Toronto, en collaboration avec des partenaires des secteurs public et privé, a créé en 2015 le programme FoodReach. Depuis sa création, FoodReach a permis à plus d'une cinquantaine d'organismes communautaires d'obtenir un accès régulier à des produits sains pour de nombreux groupes parmi les plus marginalisés de Toronto.

Local foods can meet micronutrient needs for women in urban Burkina Faso, but only if rarely consumed micronutrient-dense foods are included in daily diets: A linear programming exercise.

Women of reproductive age are at nutritional risk due to their need for nutrient-dense diets. Risk is further elevated in resource-poor environments. In one such environment, we evaluated feasibility of meeting micronutrient needs of women of reproductive age using local foods alone or using local foods and supplements, while minimizing cost. Based on dietary recall data from Ouagadougou, we used linear programming to identify the lowest cost options for meeting 10 micronutrient intake recommendations, while also meeting energy needs and following an acceptable macronutrient intake pattern. We modeled scenarios with maximum intake per food item constrained at the 75th percentile of reported intake and also with more liberal maxima based on recommended portions per day, with and without the addition of supplements. Some scenarios allowed only commonly consumed foods (reported on at least 10% of recall days). We modeled separately for pregnant, lactating, and nonpregnant, nonlactating women. With maxima constrained to the 75th percentile, all micronutrient needs could be met with local foods but only when several nutrient-dense but rarely consumed items were included in daily diets. When only commonly consumed foods were allowed, micronutrient needs could not be met without supplements. When larger amounts of common animal-source foods were allowed, all needs could be met for nonpregnant, nonlactating women but not for pregnant or lactating women, without supplements. We conclude that locally available foods could meet micronutrient needs but that to achieve this, strategies would be needed to increase consistent availability in markets, consistent economic access, and demand.

Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States.

It is the position of the Academy of Nutrition and Dietetics that systematic and sustained action is needed to achieve food and nutrition security in the United States. To achieve food security, effective interventions are needed, along with adequate funding for, and increased utilization of, food and nutrition assistance programs; inclusion of nutrition education in such programs; strategies to support individual and household economic stability; and research to measure impact on food insecurity- and health-related outcomes. Millions of individuals living in the United States experience food insecurity. Negative nutritional and non-nutritional outcomes are associated with food insecurity across the lifespan, including substandard academic achievement, inadequate intake of key nutrients, increased risk for chronic disease, and poor psychological and cognitive functioning. Registered dietitian nutritionists and nutrition and dietetics technicians, registered, play key roles in addressing food insecurity and are uniquely positioned to make valuable contributions through competent and collaborative practice, provision of comprehensive food and nutrition education and training, innovative research related to all aspects of food insecurity, and advocacy efforts at the local, state, regional, and national levels.

Gluten-Free Foods in Rural Maritime Provinces: Limited Availability, High Price, and Low Iron Content.

We investigated the price difference between gluten-free (GF) and gluten-containing (GC) foods available in rural Maritime stores. GF foods and comparable GC items were sampled through random visits to 21 grocery stores in nonurban areas of Nova Scotia, New Brunswick, and Prince Edward Island, Canada. Wilcoxon rank tests were conducted on price per 100 g of product, and on the price relative to iron content; 2226 GF foods (27.2% staple items, defined as breads, cereals, flours, and pastas) and 1625 GC foods were sampled, with an average ± SD of 66 ± 2.7 GF items per store in rural areas and 331 ± 12 in towns. The median price of GF items ($1.76/100 g) was more expensive than GC counterparts ($1.05/100 g) and iron density was approximately 50% less. GF staple foods were priced 5% higher in rural stores than in town stores. Although the variety of GF products available to consumers has improved, higher cost and lower nutrient density remain issues in nonurban Maritime regions. Dietitians working in nonurban areas should consider the relative high price, difficult access, and low iron density of key GF items, and work together with clients to find alternatives and enhance their food literacy.

Lean-Season Food Transfers Affect Children's Diets and Household Food Security: Evidence from a Quasi-Experiment in Malawi.

Background: There is evidence that social transfers increase food consumption, improving the quantity and quality of food consumed by poor households. Questions remain on how to improve the effectiveness of social programs.Objective: The aim was to assess the impact of a lean-season food transfer on household food security, diet, and nutrition status of young children during the lean season in Malawi and to understand processes through which transfers operated.Methods: This was a longitudinal, quasi-experimental study based on 2 survey rounds in the Zomba district in Malawi. Data were collected from 60 communities randomly selected among food-insecure villages. Twenty households were randomly selected for interviews within each community. Study outcomes included household expenditures and food consumption (measured by using 7-d recall) and child-level dietary diversity (measured by using 24-h recall) and nutritional status (anthropometric measurements). We followed a mixed-methods approach involving child- and household-level assessments, as well as interviews with community stakeholders. We estimated program impact by combining propensity score matching and difference-in-difference methods.Results: The per capita effect of food transfers on food expenditure was estimated at 36 Malawian kwachas/d, corresponding to an increase of 19% from baseline. There was evidence of increased iron availability in household intake. Highly significant effects were found on children's dietary diversity score, corresponding to an increase of 15%, as well as a positive effect on weight-for-height z scores (WHZs) of >0.25 SDs. Effects on food expenditure and dietary diversity were robust to alternative matching specifications, although the effect on WHZs was not. Examination of the targeting of the transfer showed evidence of large errors of inclusion and exclusion.Conclusion: During the lean season in food-insecure settings, where important declines in food insecurity, diet quality, and nutrition status are present, food transfers may have a protective effect on household food security and diets of young children.

The Prevalence of Micronutrient Deficiencies and Inadequacies in the Middle East and Approaches to Interventions.

Micronutrient deficiencies and inadequacies constitute a global health issue, particularly among countries in the Middle East. The objective of this review is to identify micronutrient deficits in the Middle East and to consider current and new approaches to address this problem. Based on the availability of more recent data, this review is primarily focused on countries that are in advanced nutrition transition. Prominent deficits in folate, iron, and vitamin D are noted among children/adolescents, women of childbearing age, pregnant women, and the elderly. Reports indicate that food fortification in the region is sporadic and ineffective, and the use of dietary supplements is low. Nutrition monitoring in the region is limited, and gaps in relevant information present challenges for implementing new policies and approaches to address the problem. Government-sponsored initiatives are necessary to assess current dietary intakes/patterns, support nutrition education, and to reduce food insecurity, especially among vulnerable population groups. Public-private partnerships should be considered in targeting micronutrient fortification programs and supplementation recommendations as approaches to help alleviate the burden of micronutrient deficiencies and inadequacies in the Middle East.

Community-based grain banks using local foods for improved infant and young child feeding in Ethiopia.

The first thousand days of a child's life are critical for ensuring adequate nutrition to enable optimal health, development and growth. Inadequate infant and young child feeding (IYCF) practices likely contribute to Ethiopia's concerning malnutrition situation. Development partners in four regions of Ethiopia implemented community production of complementary food with women's groups processing local grains and legumes at grain banks to improve availability, accessibility, dietary diversity and timely introduction of complementary foods. The objective of this study was to establish the acceptability, perceived impact, feasibility and required inputs to sustain local grain bank interventions to improve IYCF. A subsidized barter system was used by mothers in the rural communities, and flour was sold in the semi-urban context. Purposive sampling guided the qualitative study design and selection of project stakeholders. A total of 51 key informant interviews and 33 focus group discussions (n = 237) were conducted. The grain bank flour was valued for its perceived diverse local ingredients; while the project was perceived as creating labour savings for women. The grain bank flour offered the potential to contribute to improved IYCF; however, further dietary modification or fortification is needed to improve the micronutrient content. Dependence upon external inputs to subsidize the barter model and the reliance on volunteer labour from women's groups in the rural context are the greatest risks to sustainability. This intervention illustrates how integrated agricultural and health interventions leveraging local production can appeal to diverse stakeholders as an acceptable approach to improve IYCF.

Potential application of microalga Spirulina platensis as a protein source.

The high protein level of various microalgal species is one of the main reasons to consider them an unconventional source of this compound. Spirulina platensis stands out for being one of the richest protein sources of microbial origin (460-630 g kg-1 , dry matter basis), having similar protein levels when compared to meat and soybeans. The use of S. platensis in food can bring benefits to human health owing to its chemical composition, since it has high levels of vitamins, minerals, phenolics, essential fatty acids, amino acids and pigments. Furthermore, the development of new protein sources to supply the shortage of this nutrient is an urgent need, and protein from S. platensis plays an important role in this scenario. In this sense, extraction processes that allow maximum protein yield and total utilization of biomass is an urgent need, and ultrasonic waves have proven to be an effective extraction technique. The number of scientific papers related to protein fraction from S. platensis is still limited; thus further studies on its functional and technological properties are needed. © 2016 Society of Chemical Industry.