Severe acute malnutrition (SAM) affects up to 50 % of children with HIV, especially those who reside in resource-constrained healthcare setting like Ethiopia. During subsequent follow-up of children factors related to incidence of SAM after antiretroviral therapy (ART) is set on, however, there is no prior evidence. An institution-based retrospective cohort study was employed among 721 HIV-positive children from 1 January to 30 December 2021. Data were entered using Epi-Data version 3.1 and exported to STATA version 14 for analysis. Bi-variable and multivariable Cox-proportional hazard models were employed at 95 % confidence intervals to identify significant predictors for SAM. According to this result, the overall mean (±sd) age of the participants was found to be 9⋅83 (±3⋅3) years. At the end of the follow-up period, 103 (14⋅29 %) children developed SAM with a median time of 30⋅3 (13⋅4) months after ART initiation. The overall incidence density of SAM was found to be 5⋅64 per 100 child (95 % CI 4⋅68, 6⋅94). Children with CD4 counts below the threshold [AHR 2⋅6 (95 % CI 1⋅2, 2⋅9, P = 0⋅01)], disclosed HIV status [AHR 1⋅9 (95 % CI 1⋅4, 3⋅39, P = 0⋅03)] and Hgb level ≤10 mg/dl [AHR 1⋅8 (95 % CI 1⋅2, 2⋅9, P = 0⋅03)] were significant predictors for SAM. Significant predictors of acute malnutrition were having a CD4 count below the threshold, children who had previously reported their HIV status, and having haemoglobin <10 mg/dl. To ensure better health outcomes, healthcare practitioners should improve earlier nutritional screening and consistent counselling at each session of care.

Alcohol abuse among women is a public health importance that may impair prenatal and postnatal growth. Tella is among the most common homemade alcoholic beverages in rural Ethiopia, but little is known about the magnitude of tella intake during pregnancy and lactation or its effects on child growth. The present study investigated associations between maternal tella intake and the growth of their children. A cross-sectional mixed-methods study was conducted with mothers (n 228) and their 12–36-month-old children and with key informants (n 12). Tella intake during most recent pregnancy and lactation was estimated retrospectively by glasses per drinking event and frequency of events. Nearly 80 % of mothers had consumed some amount of tella during their most recent pregnancy and lactation. Furthermore, 72 % of children had tasted or drunk tella at some time during their life. Stunting was 42 % and was significantly associated with maternal tella consumption at least every other day during pregnancy (adjusted odds ratio (AOR) 4⋅97, 95 % confidence interval (CI) 2⋅20, 11⋅25), male sex (AOR 2⋅31, 95 % CI 1⋅27, 4⋅19), two or more under-5-year-old children in the household (AOR 3⋅52, 95 % CI 1⋅49, 8⋅33) and family size >5 (AOR 1⋅84, 95 % CI 1⋅01, 3⋅36). Underweight was 24⋅6 % and was associated with the child drinking tella with their mother (AOR 4⋅23, 95 % CI 1⋅99, 8⋅97), being male (AOR 3⋅73, 95 % CI 1⋅73, 7⋅94), having ≥3 diarrhoeal episodes in the last 3 months (AOR 11⋅83, 95 % CI 4⋅22, 33⋅14) and being in the older age group (AOR 2⋅98, 95 % CI 1⋅09, 8⋅13). The associations between tella intake and child growth suggest the need to mitigate the effects of tella on child anthropometry.

Despite the well-documented role of carbohydrate (CHO) in promoting endurance exercise performance, endurance athletes typically fail to meet current recommendations in competition. Adequate nutrition knowledge is key to drive athletes’ behaviour, but the current level of knowledge in this population is not known. The present study assessed knowledge of CHO for competition in an international cohort of endurance athletes using the Carbohydrates for Endurance Athletes in Competition Questionnaire (CEAC-Q). The CEAC-Q was completed by 1016 individuals (45 % female), from the United Kingdom (40 %), Australia/New Zealand (22 %), the United States of America/Canada (18 %) and other countries (21 %). Total CEAC-Q scores were 50 ± 20 % (mean ± sd), with no differences in scores between the five subsections (10 ± 5 points, P < 0⋅001). Based on typical knowledge and frequency of correct answers, we defined questions with low (0–39 %), moderate (40–69 %) and high (70–100 %) knowledge at a population level. Knowledge deficiencies were identified in questions related to CHO metabolism (Low: 2 out of 5 questions (2/5), Moderate: 3/5), CHO-loading (Low: 2/5, Moderate: 1/5), pre-event CHO (Low: 2/5, Moderate: 2/5), CHO during exercise (Moderate: 4/5) and CHO for recovery (Low: 3/5, Moderate: 1/5). Current CHO amounts recommendations were identified correctly for CHO-loading, pre-competition meal, during competition >2⋅5 h) and post-competition recovery by 28% (Low), 45 % (Moderate), 48 % (Moderate), and 29 % (Low), respectively. Our findings indicate that endurance athletes typically have limited knowledge of carbohydrate guidelines for competition, and we identify specific knowledge gaps that can guide targeted nutrition education to improve knowledge as an initial step towards optimal dietary practice.

Coenzyme Q10 (CoQ10), a lipid involved in ATP synthesis, exhibits very limited oral absorption, and its endogenous production decreases with ageing and with the occurrence of oxidative stress. Our group previously showed that monoglycerides omega-3 (MAG-OM3) increase OM3 plasma concentrations. Since CoQ10 is liposoluble, we hypothesised that its 48 h pharmacokinetics is higher when provided with MAG-OM3 compared to CoQ10 alone (in powder form) or added to rice oil (a neutral triacylglycerol oil). A randomised triple-blind crossover study was performed with fifteen men and fifteen women consuming the three supplements providing 200 mg of CoQ10 in a random order. Blood samples were collected before (t = 0) and 1, 3, 5, 6, 7, 8, 10, 11, 24 and 48 h after the supplement intake. Plasma total CoQ10 concentrations were analysed on ultrahigh-performance liquid chromatography coupled to a tandem mass spectrometer (UPLC-MS/MS). Participants were 26⋅1 ± 4⋅8 years old. When CoQ10 was provided with rice or MAG-OM3 oils, the 48 h area under the curve (AUC 0–48 h) was approximately two times higher compared to when provided without an oil. The delta max concentration (ΔCmax) of plasma CoQ10 was, respectively, 2 (MAG-OM3) and 2⋅5 (rice oil) times higher compared to CoQ10 alone. There was a significant sex by treatment interaction (P = 0⋅0250) for the AUC 0–6 h supporting that in postprandial, men and women do not respond the same way to the different supplement. Women had a higher CoQ10 concentration 48 h after the single-dose intake compared to men. We conclude that CoQ10 supplements must be provided with lipids, and their kinetics is different between men and women.

Concurrent wasting and stunting (WaSt) is a serious form of malnutrition among young children, particularly vulnerable groups affected by the conflict. Understanding the prevalence and risk factors of WaSt among vulnerable children is important to develop effective intervention measures to reduce the burden of WaSt. The present study aimed to identify the prevalence of and risk factors for WaSt among marginalised children aged 6–59 months in Sana’a city, Yemen. A community-based cross-sectional design was conducted on a total sample size of 450 marginalised children aged 6–59 months who lived at home with their mothers. Multivariable logistic regression analysis was performed and the prevalence of WaSt was found to be 10⋅7 %. Children aged 24–59 months were protected from WaSt (adjusted odds ratio (AOR) 0⋅40, 95 % confidence interval (CI) 0⋅21, 0⋅75). A higher prevalence of WaSt was associated with male sex (AOR 2⋅31, 95 % CI 1⋅13, 4⋅71), no history of being breastfed (AOR 3⋅57, 95 % CI 1⋅23, 10⋅39), acute diarrhoea (AOR 2⋅12, 95 % CI 1⋅12, 4⋅02) and family income sources of assistance from others (AOR 2⋅74, 95 % CI 1⋅08, 6⋅93) or salary work (AOR 2⋅22, 95 % CI 1⋅10, 4⋅47). Continued breast- and bottle-feeding were not associated with WaSt in children aged 6–23 months. Mothers’ age, education and work status, family size and drinking water source were not associated with WaSt. Overall, we found that the prevalence of WaSt among marginalised children remained high. Interventions to improve household income, hygienic conditions and child feeding practices are necessary to promote child growth.

Consumers intending to eat healthily should consult available information on the energy, salt, sugar and saturated fat content of foods. Some consumers, however, do this more than others do. The objective of this research was to identify distinct subgroups within the group of consumers who intend to eat healthily, segmented according to the timing and frequency of their use of information about energy, salt, sugar and saturated fat. Furthermore, we analysed whether consulting this information actually led to healthier food choices. Data on use of specific nutritional information in a computerised task in which participants made multiple dichotomous food choices (e.g. high-fat v. low-fat cheese) were recorded from 240 participants using process tracing software. Participants could view nutritional information by hovering the mouse over specific areas of the screen. We found three clusters of participants based on use of information about energy, salt, sugar and saturated fat: low, medium and high information users. There was a between-clusters difference in how often the healthy option was chosen (88·95 % with high information v. 67·17 % with low information usage). Presence in the medium and high information clusters was partially predicted by perceived self-efficacy in making healthy choices. It appears that some consumers are very confident of their ability to make healthy choices, which is a reason for making less use of nutritional information prior to making food choices and may result in unhealthy choices. Our findings improve understanding of the conditions needed to develop effective interventions targeted at health-conscious consumers.

The objective was to investigate which predictive equations provide the best estimates of resting energy expenditure (REE) in postpartum women with overweight and obesity. Lactating women with overweight or obesity underwent REE measurement by indirect calorimetry, and fat-free mass (FFM) was assessed by dual-energy X-ray absorptiometry at three postpartum stages. Predictive equations based on body weight and FFM were obtained from the literature. Performance of the predictive equations were analysed as the percentage of women whose REE was accurately predicted, defined as a predicted REE within ±10 % of measured REE. REE data were available for women at 10 weeks (n 71), 24 weeks (n 64) and 15 months (n 57) postpartum. Thirty-six predictive equations (twenty-five weight-based and eleven FFM-based) were validated. REE was accurately predicted in ≥80 % of women at all postpartum visits by six predictive equations (two weight-based and four FFM-based). The weight-based equation with the highest performance was that of Henry (weight, height, age 30–60 years) (HenryWH30−60), with an overall mean of 83 % accurate predictions. The HenryWH30−60 equation was highly suitable for predicting REE at all postpartum visits (irrespective of the women's actual age), and the performance was sustained across changes in weight and lactation status. No FFM-based equation was remarkably superior to HenryWH30−60 for the total postpartum period.

The effects of purslane consumption on anthropometric measurements and blood pressure have been studied in numerous experiments. However, the research findings conflict with one another. In order to assess the impact of purslane on weight, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP), this meta-analysis was carried out. Up until February 2023, PubMed, Web of Science, Scopus, Google Scholar, and the reference lists of the identified pertinent randomised controlled trials (RCTs) were all searched. The random-effects model was used to calculate the effect size and then to describe it as a weighted mean difference (WMD) and 95 % confidence interval (CI) (CRD42023427955). The systematic review was able to incorporate seven RCTs. Meta-analysis showed that purslane significantly decreased body weight (WMD): −0⋅73 kg, 95 % confidence interval (CI): −1⋅37, −0⋅09, P=0⋅025), BMI (WMD: −0⋅35 kg/m2, 95 % CI: −0⋅64, −0⋅07, P=0⋅016), and SBP (WMD: −3⋅64 mmHg, 95 % CI: −6⋅42, −0⋅87, P = 0⋅01), and for WC, there was no discernible effect (WMD: −0⋅86 cm; 95 % CI, −1⋅80 to 0⋅07; P = 0⋅06) and DBP (WMD: −0⋅36 mmHg; 95 % CI, −1⋅75 to 1⋅03; P = 0⋅61). Purslane consumption, especially in participants with a BMI of <30, might play a role in decreasing SBP, body weight, BMI, and WC. Purslane consumption significantly reduced body weight, BMI, and SBP; however, WC and DBP did not experience a reduction. More investigation is needed to verify the impact of purslane consumption on anthropometric parameters and blood pressure.

Sound general and sports nutrition knowledge in athletes is essential for making appropriate dietary choices. Assessment of nutrition knowledge enables evaluation and tailoring of nutrition education. However, few well-validated tools are available to assess nutrition knowledge in athletes. The objective of the present study was to establish the validity of the Platform to Evaluate Athlete Knowledge Sports – Nutrition Questionnaire (PEAKS-NQ) for use in the United Kingdom and Irish (UK-I) athletes. To confirm content validity, twenty-three sports nutritionists (SNs) from elite, UK-I sports institutes provided feedback on the PEAKS-NQ via a modified Delphi method. After minor changes, the UK-I version of the PEAKS-NQ was administered to UK-I SN from the British Dietetic Association Sport and Exercise Nutrition Register, and elite athletes (EA) training at elite sports institutes in the UK and Ireland. Independent samples t-test and independent samples median tests were used to compare PEAKS-NQ total and subsection scores between EA and SN (to assess construct validity). Cronbach's alpha (good ≥ 0⋅7) was used to establish internal consistency. The SN achieved greater overall [SN (n 23) 92⋅3 (9⋅3) v. EA (n 154): 71⋅4 (10⋅0)%; P < 0⋅001] and individual section scores (P < 0⋅001) except Section B, Identification of Food Groups (P = 0⋅07). Largest knowledge differences between SN and EA were in Section D, Applied Sports Nutrition [SN: 88⋅5 (8⋅9) v. EA: 56⋅7 (14⋅5)%; P < 0⋅00]. Overall ES was large (2⋅1), with subsections ranging from 0⋅6 to 2⋅3. Cronbach's alpha was good (0⋅83). The PEAKS-NQ had good content and construct validity, supporting its use to assess nutrition knowledge of UK-I athletes.

Epidemiological and intervention studies have reported negative health effects of sucrose intake, but many of these studies were not representative of typical dietary habits. In this pilot study, we aimed to test the effect of increasing sucrose intakes for 1 week on body composition and blood pressure and explore the feasibility of consuming high intakes of sucrose in addition to a habitual diet. In a randomised crossover design study, twelve healthy participants (50 % female, age 28⋅4 ± 10 years, BMI 25 ± 3 kg/m2), consumed either 40, 80 or 120 g sucrose in 500 ml water in addition to their habitual diet every day for 1 week, with a 1-week washout between treatment periods. Body composition (assessed using bioelectrical impedance) and blood pressure measurements were taken before and after each intervention phase. All participants reported no issues with consuming the sucrose dose for the intervention period. There was a significant increase in systolic blood pressure following 120 g sucrose intake (P = 0⋅006), however there was no significant changes to blood pressure, body weight, BMI, percentage protein, fat or water (P > 0⋅05) when comparing change from baseline values. There was also no effect of sucrose intakes on energy or macronutrient intakes during the intervention (P > 0⋅05). We show here that varying doses of sucrose over a 1-week period have no effect on body composition or blood pressure. The amounts of sucrose used were an acceptable addition to the habitual diet and demonstrate the feasibility of larger-scale studies of chronic sucrose supplementation.

The present study examined the association of contextual factors (social and food preparation location) with the energy density of meals and snacks consumed in a sample of young Australian adults (18–30 years old) identified using wearable camera technology. Over three consecutive days, a subsample of young adults wore a wearable camera that captured images in 30 s intervals. Eating episodes from 133 participants were annotated for preparation location and social context (covering social interaction and screen use). Over the same period, participants completed daily 24 h recalls. The nutritional composition of meals and snacks was calculated by matching the items identified in the camera to the 24 h recall using time and date stamps. Self-reported data (weight and height) was used to calculate body mass index and (residential postcode) to assign socio-economic status. The association of context and demographic factors with energy density was determined using a mixed linear regression model employing the bootstrap method with bias-corrected and accelerated. In total, 1817 eating episodes were included in the analysis (n 8 preparation unclear and n 15 food components could not be identified excluded). Food prepared within the home was 1⋅1 kJ/g less energy-dense than other preparation locations. Lunches (CI −1⋅7 to −0⋅3) and dinners (CI −1⋅6 to −0⋅5) were both 1⋅0 kJ/g lower in energy density than breakfasts. Snacks were 3⋅5 kJ/g (CI 2⋅8–4⋅1) more energy-dense than breakfasts. Food prepared outside the home and food consumption during snacking appear to be adversely contributing to energy-dense food intake.

The transition of foods during toddlerhood and the suboptimal diets consumed in the Middle East make children susceptible to malnutrition and micronutrient deficiencies. Based on international recommendations, coupled with the merits of clinical studies on the application of young child formula (YCF), a group of fourteen experts from the Middle East reached a consensus on improving the nutritional status of toddlers. The recommendations put forth by the expert panel comprised twelve statements related to the relevance of YCF in young children; the impact of YCF on their nutritional parameters and functional outcomes; characteristics of the currently available YCF and its ideal composition; strategies to supply adequate nutrition in young children and educational needs of parents and healthcare professionals (HCPs). This consensus aims to serve as a guide to HCPs and parents, focusing on improving the nutritional balance in toddlers in the Middle Eastern region. The panellists considere YCF to be one of the potential solutions to improve the nutritional status of young children in the region. Other strategies to improve the nutritional status of young children include fortified cow's milk and cereals, vitamin and mineral supplements, early introduction of meat and fish, and the inclusion of diverse foods in children's diets.

Lipid-based nutrient supplements (LNS) may be beneficial for malnourished HIV-infected patients starting antiretroviral therapy (ART). We assessed the effect of adding vitamins and minerals to LNS on body composition and handgrip strength during ART initiation. ART-eligible HIV-infected patients with BMI <18·5 kg/m2 were randomised to LNS or LNS with added high-dose vitamins and minerals (LNS-VM) from referral for ART to 6 weeks post-ART and followed up until 12 weeks. Body composition by bioelectrical impedance analysis (BIA), deuterium (2H) diluted water (D2O) and air displacement plethysmography (ADP), and handgrip strength were determined at baseline and at 6 and 12 weeks post-ART, and effects of LNS-VM v. LNS at 6 and 12 weeks investigated. BIA data were available for 1461, D2O data for 479, ADP data for 498 and handgrip strength data for 1752 patients. Fat mass tended to be lower, and fat-free mass correspondingly higher, by BIA than by ADP or D2O. At 6 weeks post-ART, LNS-VM led to a higher regain of BIA-assessed fat mass (0·4 (95 % CI 0·05, 0·8) kg), but not fat-free mass, and a borderline significant increase in handgrip strength (0·72 (95 % CI −0·03, 1·5) kg). These effects were not sustained at 12 weeks. Similar effects as for BIA were seen using ADP or D2O but no differences reached statistical significance. In conclusion, LNS-VM led to a higher regain of fat mass at 6 weeks and to a borderline significant beneficial effect on handgrip strength. Further research is needed to determine appropriate timing and supplement composition to optimise nutritional interventions in malnourished HIV patients.

The present study aimed to develop an isotope protocol to achieve equilibrium of 13CO2 in breath of cats during carbon oxidation studies using L-[1-13C]-Phenylalanine (L-[1-13C]-Phe), provided orally in repeated meals. One adult male cat was used in two experiments. In each experiment, three isotope protocols were tested in triplicate using the same cat. During carbon oxidation study days, the cat was offered thirteen small meals to achieve and maintain a physiological fed state. In experiment 1, the isotope protocols tested (A, B and C) had a similar priming dose of NaH13CO3 (0⋅176 mg/kg; offered in meal 6), but different priming [4⋅8 mg/kg (A) or 9⋅4 mg/kg (B and C); provided in meal 6] and constant [1⋅04 mg/kg (A and B) or 2⋅4 mg/kg (C); offered in meals 6–13] doses of L-[1-13C]-Phe. In experiment 2, the isotope protocols tested (D, E and F) had similar priming (4⋅8 mg/kg; provided in meal 5) and constant (1⋅04 mg/kg; provided in meals 5–13) doses of L-[1-13C]-Phe, but increasing priming doses of NaH13CO3 (D: 0⋅264, E: 0⋅352, F: 0⋅44 mg/kg; provided in meal 4). Breath samples were collected using respiration chambers (25-min intervals) and CO2 trapping to determine 13CO2:12CO2. Isotopic steady state was defined as the enrichment of 13CO2, above background samples, remaining constant in at least the last three samples. Treatment F resulted in the earliest achievement of 13CO2 steady state in the cat's breath. This feeding and isotope protocol can be used in future studies aiming to study amino acid metabolism in cats.

To gain knowledge on the precision of an in vitro method for characterisation of the fermentability of dietary fibres, this study aimed to evaluate the repeatability and reproducibility of such a method. Substrates used were citrus pectin (CP), fructo-oligosaccharides (FOS), guar gum (GG), sugar beet pulp (SBP) and wheat middlings (WM). Each substrate was incubated with faecal inoculum from five cats with three replicates for each substrate–cat combination. Gas production was measured continuously during the 48 h incubation and SCFA and organic matter disappearance (only SBP and WM) were determined after incubation. Four consecutive runs were performed. The within-run variability (repeatability) was generally lower for the more simple and pure substrates (CP, FOS, GG) than for the more complex substrates containing mixtures of fibres (SBP, WM). Replicates showed high variability, in particular for SCFA profiles and parameters of gas production kinetics. The between-run CV (reproducibility) for the measured parameters were, in general, below 10 % for CP, FOS and GG and higher values were obtained for SBP and WM. It is concluded that for precise dietary fibre characterisation, the number of replicates should be multiple and adjusted according to the variability of the parameters of interest and the complexity of fibres. The method yielded reproducible results with some variation in absolute values obtained, which may have an impact on the significance level of the differences among substrates.

Previous studies on the relationship between dairy consumption and hip fracture risk have reported inconsistent findings. Therefore, we aimed to conduct an algorithmically driven non-linear dose-response meta-analysis of studies assessing dairy intake and risk of developing incident hip fracture. Meta-analysis from PubMed and Google Scholar searches for articles of prospective studies of dairy intake and risk of hip fracture, supplemented by additional detailed data provided by authors. Meta-regression derived dose-response relative risks, with comprehensive algorithm-driven dose assessment across the entire dairy consumption spectrum for non-linear associations. Review of studies published in English from 1946 through December 2021. A search yielded 13 studies, with 486 950 adults and 15 320 fractures. Non-linear dose models were found to be empirically superior to a linear explanation for the effects of milk. Milk consumption was associated with incrementally higher risk of hip fractures up to an intake of 400 g/d, with a 7 % higher risk of hip fracture per 200 g/d of milk (RR 1⋅07, 95 % CI 1⋅05, 1⋅10; P < 0⋅0001), peaking with 15 % higher risk (RR 1⋅15, 95 % CI 1⋅09, 1⋅21, P < 0⋅0001) at 400 g/d versus 0 g/d. Although there is a dose-risk attenuation above 400 g/d, milk consumption nevertheless continued to exhibit elevated risk of hip fracture, compared to zero intake, up to 750 g/d. Meanwhile, the analysis of five cohort studies of yoghurt intake per 250 g/d found a linear inverse association with fracture risk (RR 0⋅85, 95 % CI 0⋅82, 0⋅89), as did the five studies of cheese intake per 43 g/d (~1 serving/day) (RR 0⋅81, 95 % CI 0⋅72, 0⋅92); these studies did not control for socioeconomic status. However, no apparent association between total dairy intake and hip fracture (RR per 250 g/d of total dairy = 0⋅97, 95 % CI 0⋅93, 1⋅004; P = 0⋅079). There were both non-linear effects and overall elevated risk of hip fracture associated with greater milk intake, while lower risks of hip fracture were reported for higher yoghurt and cheese intakes.

Malnutrition remains one of the most common causes of morbidity and mortality among children, particularly in Ethiopia. The present study aimed to assess determinants of severe acute malnutrition among children aged 6–59 months in the pastoral community of Liban District, Southeastern Ethiopia. A case–control study design was conducted on 89 cases and 177 controls from 1–30 December 2020. A simple random sampling technique was used to select study participants. Data collected using interviewer-administered structured questionnaire were used, and anthropometric measurements were done by standardised calibrated instruments to collect data. Data were entered into EPI data version 3.1 and then exported to SPSS version 25.0 software for analysis. All candidate variables with P < 0⋅25 in bivariate analysis were then entered into multivariable logistic regression. Associated factors were identified at P < 0⋅05 and 95 % CI. A total of 266 (89 cases and 177 controls) having a response rate of 96⋅6 % being underweight [adjusted odds ratio (AOR) = 11⋅8, 95 % CI 3⋅17, 43⋅89], illness previous 2 weeks (AOR = 3⋅47, 95 % confidence interval (CI) 1⋅34, 8⋅99), family member with malnutrition (AOR = 4⋅52, 95 % CI 1⋅45, 14⋅01), greater than five family size, (AOR = 5⋅33, 95 % CI 2⋅08, 13⋅66), mothers unable to read and write (AOR = 3⋅66, 95 % CI 1⋅27, 10⋅56), mothers with low decision autonomy (AOR = 5⋅67, 95 % CI 2⋅26, 14⋅27), not handwashing at all critical time (AOR = 7⋅23, 95 % CI 2⋅74, 19⋅07), not feeding child animal source (AOR = 7⋅13, 95 % CI 1⋅98, 25⋅59), bottle feeding (AOR = 7⋅06, 95 % CI 2⋅34, 21⋅28) and being married (AOR = 0⋅05, 95 % CI 0⋅02, 0⋅19) were significantly associated with acute malnutrition. The present study has confirmed the association of acute malnutrition with maternal education, underweight, family size and inappropriate infant caring practices.

Dietary supplements can be used to compensate for an inadequate diet. However, some studies indicate that supplement users consume healthier diets than non-users, although such data are lacking in Japanese children. The aim of the present study was to investigate the food and nutrient intake of dietary supplement users among school-aged children in Japan. A nationwide school dietary survey was conducted at fourteen elementary schools and thirteen junior high schools in twelve prefectures in Japan. Three-day non-consecutive semi-weighed dietary records were obtained on two weekdays and one weekend day. Analysis of covariance was performed to investigate differences in food and nutrient intake from meals consumed at school and outside of school between dietary supplement users and non-users, adjusted for socio-demographic and health-related characteristics. Of the 910 children included in this analysis, 80 (8⋅8 %) reported supplement use. Based on 3-d dietary records, dietary supplement users consumed higher mean amounts of oils and lower amounts of fruits and vegetables than non-users. In school lunches, users consumed significantly higher amounts of oils and lower amounts of protein than non-users. In meals consumed outside of school, dietary supplement users consumed significantly higher amounts of confectioneries and lower amounts of fruits and vegetables, folate, vitamin C and dietary fibre than non-users. Collectively, our findings indicate that dietary supplement users consumed less healthy diets than non-users. Additional studies are warranted to confirm these results and identify factors contributing to poorer dietary habits in supplement users.

Maternal size, weight gain in pregnancy, fetal gender, environment and gestational age are known determinants of birth weight. It is not clear which component of maternal weight or gained weight during pregnancy influences birth weight. We evaluated the association of maternal total body water measured by the deuterium dilution technique (TBW-D2O) at 17 and 34 weeks of gestation with birth weight. A secondary aim was to examine the utility of bioimpedance spectroscopy (BIS) to determine total body water (TBW-BIS) in pregnancy. At 17 and 34 weeks of pregnancy, ninety-nine women (fifty-one rural and forty-eight urban) from Pune, India had measurements of body weight, TBW-D2O, TBW-BIS and offspring birth weight. At 17 weeks of gestation, average weights for rural and urban women were 45⋅5 ± 4⋅8 (sd) and 50⋅7 ± 7⋅8 kg (P < 0⋅0001), respectively. Maternal weight gains over the subsequent 17 weeks for rural and urban women were 6⋅0 ± 2⋅2 and 7⋅5 ± 2⋅8 kg (P = 0⋅003) and water gains were 4⋅0 ± 2⋅4 and 4⋅8 ± 2⋅8 kg (P = 0⋅092), respectively. In both rural and urban women, birth weight was positively, and independently, associated with gestation and parity. Only for rural women, between 17 and 34 weeks, was an increase in dry mass (weight minus TBW-D2O) or a decrease in TBW-D2O as a percentage of total weight associated with a higher birth weight. At both 17 and 34 weeks, TBW-BIS increasingly underestimated TBW-D2O as the water space increased. Differences in body composition during pregnancy between rural and urban environments and possible impacts of nutrition transition on maternal body composition and fetal growth were demonstrated.