Relationship of dietary intake between children aged 12-59 months and their mothers in rural Kenya: a cross-sectional study in two seasons.

OBJECTIVE: The aim of the study was to investigate the quantitative association between the dietary intakes of children and their caregivers. METHOD: In this cross-sectional study, a non-consecutive 2-day 24-h dietary recall was conducted in two seasons. Participants comprised 142 pairs of 12-59-month-old children and their female caregivers from rural areas of Kenya. Energy and micronutrient adequacy, food group intakes and food allocation were assessed. Differences and correlations between caregiver and child diets were examined, and multiple regression analysis was used to investigate the relationship between the children's and caregivers' dietary intakes. RESULTS: The child's diet was significantly lower in energy and higher in micronutrient adequacy than was the caregiver's diet (p < 0.001). Specifically, the child's diet contained more fruits, dairy products, sugar and confectionaries per 4184 kj. Children were allocated relatively more dishes containing nutrient-rich foods than staple foods. The correlation coefficients between the dietary intake of caregivers and children were stronger among 24-59-month-old children. After controlling with covariates, caregiver energy intake was significantly associated with child energy intake (standardised beta [ß] = 0.512, p < 0.001), and caregiver micronutrient adequacy was associated with child micronutrient adequacy (ß = 0.679 and ß = 0.262 after energy adjustment, p < 0.001). CONCLUSIONS: The dietary intakes of caregivers and children were closely related. The children had a more nutrient-rich diet compared to that of their caregivers. Differences in food group intakes and food allocation may contribute to the higher nutrient adequacy of children. There is a need to improve the diet of caregivers, which would contribute to improving the diet of children.

Dietary Lactobacillus-Derived Exopolysaccharide Enhances Immune-Checkpoint Blockade Therapy.

Microbes and their byproducts have been reported to regulate host health and immune functions. Here we demonstrated that microbial exopolysaccharide produced by Lactobacillus delbrueckii subsp. bulgaricus OLL1073R-1 (EPS-R1) induced CCR6+ CD8+ T cells of mice and humans. In mice, ingestion of EPS-R1 augmented antitumor effects of anti-CTLA-4 or anti-PD-1 monoclonal antibody against CCL20-expressing tumors, in which infiltrating CCR6+ CD8+ T cells were increased and produced IFNγ accompanied by a substantial immune response gene expression signature maintaining T-cell functions. Of note, the antitumor adjuvant effect of EPS-R1 was also observed in germ-free mice. Furthermore, the induction of CCR6 expression was mediated through the phosphorylated structure in EPS-R1 and a lysophosphatidic acid receptor on CD8+ T cells. Overall, we find that dietary EPS-R1 consumption induces CCR6+ CD8+ T cells in Peyer's patches, favoring a tumor microenvironment that augments the therapeutic effect of immune-checkpoint blockade depending on CCL20 production by tumors. SIGNIFICANCE: Gut microbiota- and probiotic-derived metabolites are attractive agents to augment the efficacy of immunotherapies. Here we demonstrated that dietary consumption of Lactobacillus-derived exopolysaccharide induced CCR6+ CD8+ T cells in Peyer's patches and improved the tumor microenvironment to augment the therapeutic effects of immune-checkpoint blockade against CCL20-producing tumors. See related commentary by Di Luccia and Colonna, p. 1189. This article is highlighted in the In This Issue feature, p. 1171.

High Adherence to the Food Pyramid's Recommendations Avoids the Risk of Insufficient Nutrient Intake among Farmers in Peri-Urban Kenya.

This study aimed to investigate whether the Kenyan Food Pyramid (FP) can evaluate excess or insufficient nutrient intake. Participants were farmers (56 men and 64 women, aged 18-60 years) in Wangige Village, Kiambu County-a peri-urban area of Kenya. Cross-sectional data were collected for demographic characteristics, physical measurements, and 2-day and 24-h dietary recalls. The average adherence level to the FP (hereafter, "FP score") was 25.0 out of 50.0, with a minimum and maximum of 14.1 and 41.5, respectively. Energy and protein % energy ratio were significantly higher (p for trend < 0.05) in the higher FP score group. A higher FP score was also associated with a higher energy-adjusted micronutrient intake, and it was more likely to meet nutrient requirements. However, the higher FP score group had a higher risk of excess sodium intake (p for trend < 0.001). The Kenyan FP could be a useful tool for avoiding the risk of insufficient nutrient intake, but not for avoiding high energy and sodium intake. It is necessary to include appropriate evaluations to limit energy, sugar, and salt. Food groups and recommendations of the FP should be optimised according to the dietary environment of the target population so as to promote their health.

Nitrogen stock and farmer behaviour under rice policy change in Japan.

Mitigating the environmental impact of nitrogen (N) derived from agricultural production is a significant issue in our progression towards a sustainable society. This study aims to estimate the N stock (i.e., as the accumulation of N input into farmland that is neither taken up by the crops nor discharged into the environment, but rather remains in the soil) related to rice production in Japan and to identify the relationship between the economic behaviour of rice farmers and N stock. The results indicate a persistent reduction in N stock since the early 1990s, caused mainly by the change in N input by a change in government policy away from production subsidies to more extensive use of market mechanisms. It seems clear that production subsidy policies provide little incentive for farmers to reduce their N input; however, even if the introduction of market mechanisms, farmers may not properly evaluate the contribution of N stock to agricultural production. Consequently, it may be difficult to achieve the optimal level of N stock from an environmental impact perspective. To achieve the optimal N stock, the relationship between farmer behaviour and N stock needs to be better understood.

Information flow to increase support for tidal energy development in remote islands of a developing country: agent-based simulation of information flow in Flores Timur Regency, Indonesia.

BACKGROUND: Public awareness is crucial for successful deployment of tidal energy, a renewable energy source that can provide clean electricity to remote islands. However, considering public attitudes on tidal energy are not well known, especially in developing countries, a barrier exists in implementing public engagement strategies. This study aims to contribute by identifying strategies for information provision-the initial step in public engagement-and estimate how these can be engaged to enhance support for tidal energy among the local public in a remote area of a developing country, in this case, Flores Timur Regency, Indonesia, considering their socio-cultural background. METHODS: In this paper, we employ statistical analyses using multinomial probit modelling to identify the key variables that shape information flow. The aptness of the variables is then verified using post-estimation techniques for their use as input parameters for the simulation of the information flow in the field study area. Agent-based simulation (ABS) is employed to replicate the actual conditions in Flores Timur Regency, Indonesia, and simulate the flow of information through the local community. RESULTS: According to the multinomial probit estimations, the people belonging to the top hierarchical group show a higher probability to support tidal energy compared to the members belonging to the lower groups. Understandably, around twice as many information flow cycles are needed to disseminate information to the members of the lowest hierarchical group, compared to the members of the top hierarchical group. The results also show that increasing the amount of available information has a positive impact on information dissemination. CONCLUSIONS: This study demonstrated that information provision is highly effective with propagation of information that specifically highlights the individual benefits, rather than the community benefits of tidal energy. Additionally, savings in terms of costs, time, and efforts can be realized if the most influential members of the local community are targeted initially before including all other stakeholders. The study also indicated that locals absorb more information and increase their support for tidal energy when additional data is made available. Finally, as long-term strategy, information provision becomes most effective when the local population gains higher educational capabilities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13705-021-00302-8.

Groundwater salinization and associated co-contamination risk increase severe drinking water vulnerabilities in the southwestern coast of Bangladesh.

Household drinking water security is one of the major issues among coastal communities in Bangladesh. To examine the groundwater quality and social consequences, groundwater samples and household questionnaires were administered across the study area. Instrumental and statistical tools were used to analyze the water quality and social survey data. The average concentrations of electrical conductivity (EC) (7135.67 µS/cm), total dissolved solids (TDS) (3691 mg/L), Na+ (1569.51 mg/L), Ca2+ (289.5 mg/L), Mg2+ (340.51 mg/L), Cl- (2940.78 mg/L), F- (11.85 mg/L), NO3- (54.44 mg/L), NO2- (162.95 mg/L), PO43- (105.19 mg/L), Fe (4.9 mg/L), Mn (1.22 mg/L), As (16.55 µg/L), B (833.28 µg/L), and Pb (34.22 µg/L) were observed in groundwater, and exceeded the drinking water standards from 30% to 100% depending on the sampling location. Thus, the remarkably high contents of EC, TDS, Cl-, and Na+ represented possible saltwater intrusion along the coastal aquifer. The positive correlations between EC and trace and toxic elements indicated the potential influence of groundwater salinization on the dissolution of more chemical contaminants in the aquifer. These results showed that 100% of samples were unsuitable for drinking purposes. Severe drinking water scarcity is a serious issue, and local people have been affected by water-related diseases owing to the long-term consumption of contaminated water. Salinity problems in drinking water and related health diseases have increased significantly in the past several years. In addition, climate change and its associated hazards, including sea-level rise, cyclonic storm surges, flooding, and resulting inundation problems, have intensified the drinking water scarcity and health problems at the community level. To ensure household water security, environmental exposure, hydrogeology, and anthropogenic interventions must be considered to determine future sustainable water policies.

Severe salinity contamination in drinking water and associated human health hazards increase migration risk in the southwestern coastal part of Bangladesh.

Bangladesh is a deltaic country and is highly vulnerable to climate change and sea level rise. This study explores population migration risk in relation to communal crisis due to socioeconomic vulnerability, drinking water scarcity, and health threats caused by salinity hazards. For this, we conducted a household questionnaire survey as well as, focus group discussions, key informant interviews, and field observations. To identify the drinking water salinity and migration risk, our theoretical process hypothesizes a new composite indexing approach. Salinity hazards and potable water crises have increased the spread of human diseases and treatment costs, while socioeconomic crisis and poverty are inseparable risks of coastal communities because of frequent cyclone hits. Recently, salinity hazards have added a new dimension to health insecurities and household financial instability. Results showed a high migration risk in the unions of Gabura, Munshigonj, Atulia, Burigoaliny, and Padmapukur (from highest risk to lowest), as these areas exhibit worsening situations with respect to drinking water scarcity, salinity hazards, and health hazards, and their adaptive capacities are significantly low. Furthermore, socioeconomic vulnerabilities to cyclone hits, salinity hazards, and severe drinking water scarcity may soon contribute to increased population migration in response to climate change, sea level rise, and the associated impacts of these trends. To tackle the future mass population migration problem, urgent action is required to improve socioeconomic conditions, and provide alternative sources of potable water and health care facilities. Hard and soft measures must be ensured to reconstruct vulnerable areas impacted by riverbank erosion, flooding, and waterlogging. Additionally, action should be taken to enhance local awareness of coastal disasters, their associated hazardous consequences, and possible mitigation and adaptation measures.

Development and Validation of a Data-Based Food Frequency Questionnaire for Adults in Eastern Rural Area of Rwanda.

This study aimed to develop and evaluate the validity of a food frequency questionnaire (FFQ) for rural Rwandans. Since our FFQ was developed to assess malnutrition, it measured energy, protein, vitamin A, and iron intakes only. We collected 260 weighed food records (WFRs) from a total of 162 Rwandans. Based on the WFR data, we developed a tentative FFQ and examined the food list by percent contribution to energy and nutrient intakes. To assess the validity, nutrient intakes estimated from the FFQ were compared with those calculated from three-day WFRs by correlation coefficient and cross-classification for 17 adults. Cumulative contributions of the 18-item FFQ to the total intakes of energy and nutrients reached nearly 100%. Crude and energy-adjusted correlation coefficients ranged from -0.09 (vitamin A) to 0.58 (protein) and from -0.19 (vitamin A) to 0.68 (iron), respectively. About 50%-60% of the participants were classified into the same tertile. Our FFQ provided acceptable validity for energy and iron intakes and could rank Rwandan adults in eastern rural area correctly according to their energy and iron intakes.

Geographical accessibility to healthcare and malnutrition in Rwanda.

The prevalence of stunting in children less than five years of age is elevated in Rwanda. It is one of the main health challenges upon which the government is struggling to achieve progress. Health centers and district hospitals in Rwanda are expected to provide a package of health services including nutrition related activities, nutritional rehabilitation, education, and growth monitoring. They can hence play a potent role in alleviating malnutrition and stunting in Rwanda. This study tested whether travel time from household clusters to the nearest health center was significantly and negatively associated with the distribution of height-for-age z-scores of younger than five year old children in the eastern province of Rwanda. Data for 974 children was extracted from the Rwanda Demographic and Health Survey (DHS) database. However, since DHS does not contain any information on travel time to health centers, the latter was simulated using AccessMod 4.0, an extension to ArcGIS 9.3.1 that simulates health facilities' catchment areas and travel times to health facilities. Travel time was found to be negatively associated with height-for-age z-scores at the 5% level in a stepwise regression analysis that controlled for wealth index, mother's primary and secondary education, sex of the child, preceding birth interval, and birth order of the child. Field measurements are needed to validate travel time. If validated, results point to the importance of improved access to healthcare facilities as a potential pathway in reducing stunting in Rwanda.