A Decision Framework for Selecting Critically Important Nutrients from Aquatic Foods.

PURPOSE OF REVIEW: Aquatic foods are increasingly being recognized as a diverse, bioavailable source of nutrients, highlighting the importance of fisheries and aquaculture for human nutrition. However, studies focusing on the nutrient supply of aquatic foods often differ in the nutrients they examine, potentially biasing their contribution to nutrition security and leading to ineffective policies or management decisions. RECENT FINDINGS: We create a decision framework to effectively select nutrients in aquatic food research based on three key domains: human physiological importance, nutritional needs of the target population (demand), and nutrient availability in aquatic foods compared to other accessible dietary sources (supply). We highlight 41 nutrients that are physiologically important, exemplify the importance of aquatic foods relative to other food groups in the food system in terms of concentration per 100 g and apparent consumption, and provide future research pathways that we consider of high importance for aquatic food nutrition. Overall, our study provides a framework to select focal nutrients in aquatic food research and ensures a methodical approach to quantifying the importance of aquatic foods for nutrition security and public health.

Healthy home food environments of pregnant Black women are shaped by food outlet access and participation in nutrition assistance programs.

OBJECTIVES: Improving access to healthy food in Black communities is imperative to combat intergenerational health disparities. Pregnant Black women represent an especially vulnerable population to multiple (and overlapping) sources of socioeconomic and political disenfranchisement and thus for whom maternal nutrition is crucial. This study aimed to (1) define household food environment types, (2) determine whether the distribution of community food outlets is associated with these household food environment types, and (3) determine whether the community-household food environment relationship differs by maternal education or participation in nutrition assistance programs. METHODS: Cross-sectional data for pregnant Black women in North Carolina (n = 429) come from the Mothers & Others study, an obesity-prevention randomized control trial, with linked spatial data on all community food outlets (n = 6312) in the study area in 2015. Factor analysis was used to define household food environment types. These factor scores were regressed on access metrics to community food outlets. Adjusted linear regressions tested interaction by maternal education and nutrition assistance programs. RESULTS: Four household food environment types were defined: Factor 1 (fresh fruits and vegetables (F/V), low snack), Factor 2 (canned F/V, sweet drinks), Factor 3 (dried/frozen F/V, candy), and Factor 4 (low F/V, soda). Having more convenience stores within 0.25 miles was associated with higher Factor 4 scores. No food outlets were associated with higher Factor 1 scores overall. However, SNAP or WIC participating households saw higher Factor 1 scores with increased access to supermarkets, convenience stores, and dollar stores. CONCLUSIONS: Nutrition assistance programs play an important role as buffers against unhealthy community food environments which influence household food environments and maternal nutrition.

Examining the trade-offs of palm oil production and consumption from a sustainable diets perspective: lessons learned from Myanmar.

OBJECTIVE: The aim of this study was to examine the trade-offs related to the production and consumption of palm oil in Myanmar from a sustainable diets perspective. DESIGN: We used an enhanced value chain analysis approach that included semi-structured interviews with key stakeholders; market analyses to assess edible oils in markets and focus groups as well as surveys with consumers to ascertain their perceptions and practices related to edible oils. SETTING: Four settings in Myanmar (upper income urban; lower income urban; middle-income urban; lower income rural). PARTICIPANTS: Key stakeholders (n 12) from government, trade bodies and civil society organisations were included in the interviews. Women from each of the regions participated in four focus groups (n 32), and a convenience sample of male and female consumers participated in the surveys (n 362). RESULTS: We found mistrust of the oil sector overall. Poor production practices, leading to low yields, limit the economic viability of oil palm production in Myanmar and contribute to negative environmental (e.g. deforestation) and social outcomes (e.g. land conflicts). Consumers demonstrated low preferences for palm oil as compared with traditional oils from a taste, health and transparency perspective; however, they indicated that its relative low cost led to its purchase over other oils. CONCLUSIONS: The Burmese example suggests that there may be limited benefits, and significant costs, of investing in palm oil production in regions where there are coordinating disincentives from a sustainable diets perspective. However, if oil palm cultivation is to continue, there are opportunities to improve its economic viability and environmental sustainability.

Climate anomalies and childhood growth in Peru.

Climate change has been linked to poor childhood growth and development through maternal stress, nutritional insults related to lean harvests, and exposure to infectious diseases. Vulnerable populations are often most susceptible to these stressors. This study tested whether susceptibility to linear growth faltering is higher among Peruvian children from indigenous, rural, low-education, and low-income households. High-resolution weather and household survey data from Demographic and Health Survey 1996-2012 were used to explore height-for-age z-scores (HAZ) at each year of life from 0 to 5. Rural, indigenous children at age 0-1 experience a HAZ reduction of 0.35 units associated with prenatal excess rainfall which is also observed at age 4-5. Urban, non-indigenous children at age 4-5 experience a HAZ increase of 0.07 units associated with postnatal excess rainfall, but this advantage is not seen among rural, indigenous children. These findings highlight the need to consider developmental stage and social predictors as key components in public health interventions targeting increased climate change resilience.

Water Security in the Galápagos: Socioecological Determinants and Health Implications.

Water security is strongly associated with important health outcomes and has many socioecological determinants. Several studies have documented the social determinants of water security and impacts of water security on health, independently. Yet few have examined both components in one setting. Using data from Ecuador's nationally representative health survey (ENSANUT-ECU), we proposed a new methodological framework for assessing water security in the Galápagos and assessed the relationship between socioecological indicators and water security among 2701 individuals in 693 households. We then tested the link between water security and childhood stunting using multilevel mixed effects logistic regressions controlling for household clustering. We found that being higher income in rural settings is significantly protective of water quality (OR 7.35) and increasing household size is associated with reduced water access (OR 0.44). We found no impact of water insecurity on childhood stunting. We observed a marked divergence in water security between islands and discussed potential underlying structural determinants. Understanding the structural predictors of water security and health is a necessary step in improving local health outcomes in the Galápagos. The social and physical factors leading to this water security environment may also be shared by similar locations, broadening the application of these findings.

Water, food, and the dual burden of disease in Galápagos, Ecuador.

OBJECTIVE: Rapid development in low- and middle-income countries (LMIC) has led to changes in diet that have outpaced water and sanitation improvements, contributing to a dual burden of overweight and noncommunicable disease risk factors (OWT/NCD) and undernutrition and infectious disease symptoms (UND/ID) within individuals and households. Yet, little work has examined the joint impact of water and food exposures on the development of the dual burden. METHODS: We use data from Ecuador's nationally representative Encuesta Nacional de Salud y Nutrición (ENSANUT-ECU) to test whether water access and quality and diet quality and security are associated with OWT/NCD and UND/ID among 1119 children and 1582 adults in Galápagos. Adjusted multinomial and logistic models were used to test the separate and joint associations between water and food exposures and the dual burden and its components at the individual and household levels. RESULTS: The prevalence of the dual burden of OWT/NCD and UND/ID was 16% in children, 33% in adults, and 90% in households. Diet quality was associated with a higher risk of dual burden in individuals and households. Mild food insecurity was positively associated with the risk of dual burden at the household level. No water variable separately predicted the dual burden. Joint exposure to poor water access and food insecurity was associated with greater odds of dual burden in households. CONCLUSION: Our results suggest that unhealthy diets and poor water quality contribute to the dual burden at the individual and household levels. Addressing both food and water limitations is important in LMIC.

Palm Oil in Myanmar: A Spatiotemporal Analysis of the Effects of Industrial Farming on Biodiversity Loss.

BACKGROUND: Palm oil consumption is potentially deleterious to human health, and its production has resulted in 11 million hectares of deforestation globally. Importing roughly 394,000 metric tons of palm oil in 2012 alone, the Burmese government has recently pushed for intensive oil palm development to sate domestic demand for consumption and become international market players. Given well-studied linkages between biodiversity loss and ecosystem instability, this study aims to characterize the nature of deforestation for oil palm production in Myanmar, its relationship to increased biodiversity loss, and contextualize the potential impacts of this loss on diets and human health in rural Myanmar. METHODS: First, a GIS land suitability analysis overlaying spatial data on rainfall, elevation, and slope was conducted in order to identify areas of Myanmar best suited to oil palm tree growth. Second, after narrowing the geographic range, vegetation indices using varying spectral band models in ENVI (Environment for Visualizing Images) allowed a more granular examination of changes in vegetation phenology from 1975 to 2015. Lastly, ground truthing permitted an in-person verification of GIS and ENVI results and provided contextual understanding of oil palm development in Myanmar. RESULTS: GIS analysis revealed that the Tanintharyi Region, one of the most biodiverse regions in Myanmar, is highly suitable for oil palm growth. Next, vegetation indices revealed a progressive shift from smallholder farming, with little observable deforestation between 1975 and 1990, to industrial oil palm plantations all throughout Tanintharyi starting around 2000-a shift concomitant with biodiversity loss of primary forestland. Ground truthing indicated that plantation development has advanced rapidly, though not without barriers to growth. CONCLUSIONS: If these trends of Burmese oil palm intensification continue, 4 key outcomes may follow: (1) even higher levels of biodiversity loss, (2) increased access and affordability of edible palm oil, (3) decreased importing of palm oil, and (4) large profits made from selling excess palm oil on the international market. Although the first 2 outcomes may adversely affect low-income Burmese populations, the latter 2 may bode well for the domestic economy and international trade partners, thus encouraging competing interests. This increased domestic access and affordability of palm oil may increase consumption and cause increased prevalence of cardiovascular disease, diabetes, and obesity. Finally, this biodiversity loss concurrent with industrial deforestation may disproportionately impact vulnerable, rural communities.