Community-based interventions targeting multiple forms of malnutrition among adolescents in low-income and middle-income countries: protocol for a scoping review.

BACKGROUND: Adolescent malnutrition is a significant public health challenge in low-income and middle-income countries (LMICs), with long-term consequences for health and development. Community-based interventions have the potential to address multiple forms of malnutrition and improve the health outcomes of adolescents. However, there is a limited understanding of the content, implementation and effectiveness of these interventions. This scoping review aims to synthesise evidence on community-based interventions targeting multiple forms of malnutrition among adolescents in LMICs and describe their effects on nutrition and health. METHODS AND ANALYSIS: A comprehensive search strategy will be implemented in multiple databases including MEDLINE (through PubMed), Embase, CENTRAL (through Cochrane Library) and grey literature, covering the period from 1 January 2000 to 14 July 2023. We will follow the Participants, Concept and Context model to design the search strategy. The inclusion criteria encompass randomised controlled trials and quasi-experimental studies focusing on adolescents aged 10-19 years. Various types of interventions, such as micronutrient supplementation, nutrition education, feeding interventions, physical activity and community environment interventions, will be considered. Two reviewers will perform data extraction independently, and, where relevant, risk of bias assessment will be conducted using standard Cochrane risk-of-bias tools. We will follow the PRISMA Extension for Scoping Reviews checklist while reporting results. ETHICS AND DISSEMINATION: The scope of this scoping review is restricted to publicly accessible databases that do not require prior ethical approval for access. The findings of this review will be shared through publications in peer-reviewed journals, and presentations at international and regional conferences and stakeholder meetings in LMICs. SCOPING REVIEW REGISTRATION: The final protocol was registered prospectively with the Open Science Framework on 19 July 2023 (https://osf.io/t2d78).

Micronutrient Supplementation for Pregnant and Lactating Women to Improve Maternal and Infant Nutritional Status in Low- and Middle-Income Countries: Protocol for a Systematic Review and Meta-analysis.

BACKGROUND: Two billion people in low- and middle-income countries (LMICs) are deficient in key nutrients. Nutritional deficiencies worsen during pregnancy, causing adverse outcomes for the mother and the fetus, with consequences after pregnancy. These effects may be mitigated by providing micronutrient supplementation to women during pregnancy and lactation. However, the effects of micronutrient supplementation on the nutritional status of pregnant and lactating women and that of their infants remain largely unclear in LMICs. OBJECTIVE: The purpose of this systematic review and meta-analysis is to determine the effects of single, double, or multiple micronutrient supplements during pregnancy or lactation on maternal and infant nutritional status in LMICs. METHODS: Randomized controlled trials of single, double, or combinations of micronutrients assessing effects on the maternal (serum, plasma, and breastmilk) and infant (serum and plasma) nutritional status will be included. MEDLINE (through PubMed), EMBASE, CENTRAL (through Cochrane Library), and the World Health Organization (WHO) library database will be used to identify relevant published studies, starting from the inception of each database until February 28, 2022. The Cochrane Risk of Bias Tool will be used to assess the risk of bias in the included studies. The selection of studies, data extraction, and risk of bias assessment will be carried out independently by 2 reviewers. A narrative summary will be provided of all the included studies. Meta-analyses will be performed whenever possible, and the heterogeneity of effects will be evaluated using I2, subgroup analyses, and metaregression. The certainty of the evidence for each outcome will be assessed using the GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach. RESULTS: We will conduct meta-analyses using Stata software (version 16, StataCorp) and present both a narrative and systematic summary of all studies included in this review in text and table form. For continuous outcomes, effect estimates will be expressed as mean differences and standardized mean differences, while for binary outcomes, they will be expressed as risk ratios, rate ratios, hazards ratios, or odds ratios, all with 95% CIs and comparing the intervention group with the control group. When studies for an outcome are adequately consistent with respect to intervention, comparator, and definition of the outcome, a random-effects, inverse variance-weighted meta-analysis will be conducted. We will provide a narrative synthesis for outcomes with insufficient data or extreme heterogeneity. CONCLUSIONS: This review will provide evidence upon which to base policy and programming for women in LMICs to supplement micronutrients in pregnancy and lactation. Detailed results disaggregated by variables such as maternal age, sex of infant, duration, and dose of intervention may also help policy makers, researchers, practitioners, and government agencies to adopt more effective maternal and child health policies and programs in LMICs. The review will also identify any gaps in the existing evidence. TRIAL REGISTRATION: PROSPERO CRD42022308715; https://tinyurl.com/y33cxekr. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/40134.

Association of iron supplementation and dietary diversity with nutritional status and learning outcomes among adolescents: Results from a longitudinal study in Uttar Pradesh and Bihar, India.

BACKGROUND: Poor nutritional status and educational outcomes are associated with adverse health consequences throughout the life course. OBJECTIVES: We examined the associations of sex, iron and folic acid (IFA) supplementation, deworming, and dietary diversity with nutritional status and learning outcomes among Indian adolescents. METHODS: Data of 12 035 adolescents from two rounds (2015-16 and 2018-19) of the Understanding the Lives of Adolescents and Young Adults surveys in Uttar Pradesh and Bihar, India were used. Multivariate linear and logistic regression models were used to estimate the prospective relationships of explanatory variables in the first round of the survey with nutritional status (ie, hemoglobin, BMI- and height-for-age z-scores, and incidence of anemia, stunting, and underweight) and learning outcomes (ie, reading proficiency, math proficiency, and school dropout) in the second round of the survey. The multivariable models were adjusted for a range of confounders, clustering by the population sampling unit and sampling weights. RESULTS: Girls had a lower hemoglobin (adjusted mean difference (aMD) = -2.07; 95% confidence interval (CI) = -2.20, -1.94; P < 0.001) and height-for-age z-score (aMD = -0.45; 95% CI = -0.53, -0.38; P < 0.001) and higher BMI-for-age z-score (aMD = 0.36; 95% CI = 0.27, 0.44; P < 0.001) compared to boys. Girls had poorer reading (adjusted odds ratio (aOR) = 0.81; 95% CI = 0.70, 0.95; P = 0.01) and math proficiency (adjusted odds ratio aOR = 0.36; 95% CI = 0.31, 0.42; P < 0.001), and increased risk of school dropout (aOR = 1.65; 95% CI = 1.40, 1.95; P < 0.001) than boys. Receiving IFA tablets was not significantly associated with hemoglobin levels of adolescents overall, however we noted a significant beneficial relationship among girls (aMD = 0.41; 95% CI = 0.00, 0.82) but not among boys (aMD = 0.02; 95% CI = -0.38, 0.43) (P for interaction = 0.09). Receiving IFA tablets was positively associated with reading proficiency (aOR = 1.47; 95% CI = 1.07, 2.01; P = 0.02), math proficiency (aOR = 1.51; 95% CI = 1.16, 1.98; P < 0.001) and a reduced risk of school dropout (aOR = 0.72; 95% CI = 0.54, 0.96; P = 0.03). Deworming was not associated with nutritional status and learning outcomes. Diverse dietary intake was positively associated with hemoglobin, height-for-age z-score and math proficiency, and a reduced risk of school dropout in adolescents. CONCLUSION: Integrated nutritional and health interventions and strengthening the existing nutrition supplementation program are critical to address adolescents' nutritional needs and improve educational outcomes.

Green synthesis of biocompatible carbon dots using aqueous extract of Trapa bispinosa peel.

We are reporting highly economical plant based method for the production of luminescent water soluble carbon dots (C-dot) using Indian water plant Trapa bispinosa peel extract without adding any external oxidizing agent at 90 °C. C-dots ranging from 5 to 10nm were found in the solution with a prominent green fluorescence under UV-light (λex=365 nm). UV-vis spectra recorded at different time intervals (30-120 min) displayed signature absorption of C-dots between 400 and 600 nm. Fluorescence spectra of the dispersion after 120 min of synthesis exhibited characteristic emission peaks of C-dots when excited at 350, 400, 450 and 500 nm. C-dots were further analyzed using X-ray diffraction (XRD), Raman Spectroscopy and Thermo-Gravimetric Analysis (TGA). Structure of the C-dots was found to be turbostratic when studied using XRD. C-dots synthesized by our method were found to be exceptionally biocompatible against MDCK cells.