Is nutritional functional diversity in the rural food and nutrition system associated with food security and nutrient adequacy? A case study of rural areas of Zahedan district, Iran.

BACKGROUND: An overlooked problem in food and nutrition system analysis is assuring adequate diversity for a healthy diet. Little is known about nutrient diversity in food and nutrition systems and how it transmits to dietary diversity. Nutritional functional diversity (NFD) is a metric that describes diversity in providing nutrients from farm to market and the consumption level. The objective of this study is to determine the NFD score at different stages of the rural food and nutrition system, including household's agricultural and home production, domestic food processing, purchased food, and diet. It also aims to explore the association between NFD and nutrient adequacy, food security, and anthropometric indicators. METHODS: A cross-sectional study was conducted on 321 households in 6 villages of Zahedan district. The NFD score was measured at three subsystems (production, processing, and consumption) of the food and nutrition system. Household food security, mean adequacy ratio (MAR), and anthropometrics of the household's head were measured to assess the association between NFD and food and nutrition indicators. Linear and bivariate statistical techniques were applied to study the associations between variables. RESULTS: In the rural food and nutrition system, the food purchased from the city plays the main role in the households NFD score. Their contribution to total NFD was twice that of the food items purchased from the village. The NFD score of homestead production and households food processing was found to be five times less than those of food purchased from cities. The food insecure households had significantly lower NFD scores for food purchased from the city and higher NFD scores for purchased food items from the rural market and native wild vegetable consumption. A strong and positive relationship was observed between NFD of food items purchased from the city and households'MAR. No significant association was found between the NFD score of homestead production, processing, and dependent variables, i.e. food insecurity, MAR, and household head anthropometrics. CONCLUSION: NFD score, as a relatively new metric, could help in determining diversity from farm to diet and identifying the gaps to plan appropriate interventions for improving diversity in the local food system.

The national health program for vitamin D supplementation in a developing country.

BACKGROUND: Previous studies have reported a high frequency of vitamin D deficiency (VDD) among different age groups in Iran. AIMS: In this study, the current coverage, status of vitamin D supplement taking, and program efficacy have been evaluated by the Office of Nutrition Department Society in Iran since 2014. METHODS: This study was conducted in collaboration with the International UNESCO center for Health-Related Basic Sciences and Human Nutrition and the Office of Nutrition Department Society. Sixty three medical universities were included in the current study to calculate the availability, accessibility and acceptability coverages. Furthermore, 3 medical universities including Mashhad (MUMS), Qom (QUMS) and Zahedan (ZAUMS) University of Medical Sciences were selected based on the results of the National Integrated Micronutrient Survey 2012 (NIMS-II study), in order to assess the status of vitamin D supplement intake in all age ranges. RESULTS: Quantitative analysis showed that availability coverage was 74.96% and 77.56% and accessibility was 80.70% and 83.26% in elderly and middle-aged subjects, respectively in 2018. The acceptability was approximately 43.7% and 43.9% among elderly and middle-aged participants, respectively. The availability and acceptability coverage was 80.99% and 85.0% among students in high schools. The mean vitamin D supplement uptake frequency was 27.0% (n = 387); 20.7% and 29.2% in rural and urban area, respectively (P = 0.001). The results showed that there was no significant difference in serum vitamin D levels between urban (20.41 ± 6.43 ng/ml) and rural areas, (P = 0.887). There was no significant difference in the serum vitamin D concentrations between men and women (P = 0.461). CONCLUSIONS: The frequency of taking vitamin D supplements was 27.0% in Iran in 2018. The frequency of taking of vitamin D supplements among vitamin D deficient group (serum vitamin D levels <19.99 ng/ml) was 43.6%. Lack of knowledge was the most important reason for not taking vitamin D supplement. Moreover, the serum vitamin D levels have increased in subjects aged 18-30 years old after the implementation of the vitamin D supplementary program.

WHO Ending Childhood Obesity and Iran-Ending Childhood Obesity Programs Based on Urban Health Equity Indicators: A Qualitative Content Analysis.

BACKGROUND: The childhood obesity epidemic is one of the most serious global health challenges, and many relevant policies have been designed and implemented. Regarding health equity policy-making, it is important to adopt proper interventional strategies, including childhood obesity policies. The purpose of this study is to assess compliance with the WHO Ending Childhood Obesity (ECHO), and the Iran-Ending Childhood Obesity (IRAN-ECHO) program draft in terms of Urban Health Equity Indicators (UHEIs) in Iran. METHODS: This is a descriptive study, using a directed quantitative content analysis approach to analyze the ECHO report and IRAN-ECHO program draft, based on Iranian UHEI. The UHEI consist of 52 indicators in 5 domains. The frequency of each code in the ECHO report and IRAN-ECHO draft was calculated and analyzed. RESULTS: In total, 148 and 84 phrases or words in ECHO and IRAN-ECHO were encoded with UHEI concepts. The results showed that the physical activity indicator was the most frequent among indicators in both ECHO (n = 48, 32.43%) and IRAN-ECHO (n = 41, 48.80%). Indicators 28 (prevalence of underweight in children under 5, n = 14, 9.45%) and 19 (use of primary care services, n = 21, 25%) were the next most frequent in ECHO and IRAN-ECHO, respectively. CONCLUSION: In this study, ECHO and IRAN-ECHO had high compliance with some UHEI, especially indicators placed in domain 3 (social and human development). It indicates that social and human development plays an important role in preventing and controlling childhood obesity.

Assessing the micronutrient and macronutrient intakes in female students and comparing them with the set standard values.

BACKGROUND: Healthy nutrition particularly the energy intake and the essential nutrients in female students is very important. This study aims to assess micro- and macronutrient intakes in female students of Isfahan University of Medical Sciences, Iran. MATERIALS AND METHODS: This cross-sectional study involved 100 female students aged between 18 and 25 years in 2008-2009. Anthropometrics measures were performed and two 24-hours food recalls were used to collect the dietary information and were analyzed using food processor 2 and compared with the dietary reference intakes (DRIs) 2008. FINDINGS: As many as 61.1% of subjects resided in dormitories; 12.7% were married. Prevalence of overweight or obesity and abdominal obesity in the subjects studied were 6.9% and 46.1%, respectively. The mean (±SD) systolic blood pressure was 105.2 ± 15.6 mmHg and the diastolic was 62.2 ± 10.4 mmHg. Totally, 3.9% of the subjects had hypertension. Food intake analysis indicated that B12, folate, magnesium, potassium, and calcium were below the recommended level, and vitamin C, E, pantothenic acid, B1, B3, phosphate, and zinc were above, and energy intake, macronutrient, vitamin A, pyridoxine, iron, and selenium were, in general, adequate. CONCLUSION: The findings of the study indicated that macronutrients intake was appropriate, but the problem mainly existed in the consumption of micronutrients. It is recommended to increase the intakes of important food groups such as dairy, vegetable, and fruit that are proper sources of micronutrients, and it is also suggested to improve strategies and the competence in this area of nutrition.