Point-of-use micronutrient fortification: lessons learned in implementing a preschool-based pilot trial in South Africa.

This current pilot trial assessed the feasibility of implementing a point-of-use (PoU) micronutrient fortification in preschool settings. Preschool children (n = 151) aged 36-79 months were randomized into intervention (n = 76) and control (n = 75) groups, both receiving breakfast maize-porridge with added micronutrient or placebo powder for 52 school days. Process evaluation and early childhood development indicators were used to assess trial feasibility. Process evaluation results showed that the implementation components were feasible and could be delivered with high fidelity. The improvement in hemoglobin concentration in intervention and control groups were not significantly different (P = 0.250). There was medium likelihood for practical significance for the two global cognitive scores assessed: non-verbal index (intervention effects: 7.20; 95% confidence interval: 2.60, 11.81; P = 0.002, effect size: 0.55) and mental processing index (intervention effects: 2.73; 95% confidence interval: 0.25, 5.70; P = 0.072, effect size: 0.36) on the Kaufman Assessment Battery for Children, Second Edition. The lessons from this trial could help in planning/implementing future PoU micronutrient fortification trial among South African preschool children.

Harvesting time and roasting effects on colour properties, xanthophylls, phytates, tannins and vitamin C contents of orange maize hybrid.

Biofortified maize varieties form an essential part of a nutritious diet; available evidence suggests that different processing methods may affect the final food products. The study aimed to evaluate the effects of processing (roasting) and harvesting time on the bioactive components (lutein, zeaxanthin, ß-cryptoxanthin, phytate, tannin and vitamin C) and colour properties (L*, a*, b*), of biofortified orange maize. The orange maize hybrids used for the study were obtained from the International Institute of Tropical Agriculture (IITA) diverse lines with high provitamin A (PVA) content. The results showed that harvesting time and roasting methods significantly (P ≤ 0.001) affected the colour properties. The positive values of ∆b* 30.7, 36.0 and 38.1 at 20 days after pollination (DAP), 27DAP and 34DAP, respectively showed that the intensity of orange colour increased with delay in harvesting time. In unprocessed freshly harvested orange hybrid maize; lutein, zeaxanthin, ß-cryptoxanthin, tannin and vitamin C increased with an increase in harvesting time. For roasted hybrid, the mean concentrations of all the bioactive components increased with increases in harvesting time except for tannin and vitamin C that showed a decrease at 20DAP and 27DAP. The results revealed that processing and time of harvest affect the levels of non-provitamin A carotenoids, tannins, phytic acid, Vitamin C and the colour properties of biofortified maize genotypes.

Prevalence and correlates of depression among black and Latino stroke survivors with uncontrolled hypertension: a cross-sectional study.

OBJECTIVE: To examine the prevalence and correlates of depression in a cohort of black and Hispanic stroke survivors with uncontrolled hypertension. SETTING: Baseline survey data from 10 stroke centres across New York City. PARTICIPANTS: Black and Hispanic stroke survivors with uncontrolled hypertension (n=450). OUTCOME MEASURES: Depressive symptoms were assessed with the 8-item Patient Reported Outcomes Measurement Information System (PROMIS) measure. Depression was defined as a PROMIS score ≥55. Other data collected included clinical factors, health-related quality of life (EuroQoL five dimensions (EQ-5D)), functional independence (Barthel Index, BI), stroke-related disability (Modified Rankin Score), physical function (PROMIS Physical Function) and executive functioning (Frontal Assessment Battery). RESULTS: The mean age was 61.7±11.1 years, 44% of participants were women and 51% were black. Poststroke depression was noted in 32% of the cohort. Examining bivariate relationships, patients with depression were observed to have poorer function and quality of life as evidenced by significantly lower PROMIS physical function scores (36.9±8.32 vs 43.4±10.19, p<0.001); BI scores (79.9±19.2 vs 88.1±15.1, p<0.001); EQ-5D scores (0.66±0.24 vs 0.83±0.17, p<0.001) and higher Rankin scores (2.10±1.00 vs 1.46±1.01, p<0.001) compared with those without depression. Multivariate (model adjusted) significant correlates of depression included lower self-reported quality of life (OR=0.02 (CI 0.004 to 0.12) being younger (OR=0.94; 95% CI 0.91 to 0.97); not married (OR=0.46; CI 0.24 to 0.89)); and foreign-born (OR=3.34, 95% CI 1.4 to 7.97). There was a trend for higher comorbidity to be uniquely associated with depression (≥3 comorbid conditions, OR=1.49, 95% CI 1.00 to 2.23). CONCLUSIONS: Poststroke depression is common among black and Hispanic stroke survivors with higher rates noted among foreign-born patients and those with high comorbidity. These findings highlight the importance of screening for depression in minority stroke survivors. TRIAL REGISTRATION NUMBER: http://www.clinicaltrials.gov. Unique identifier: NCT01070056.