evidence-based blog of Filippo Dibari

Posts Tagged ‘food’

WFP: foods and food supplements for preventing and treating malnutrition in children

In Under-nutrition on June 4, 2012 at 2:23 pm

Original title: “Current and potential role of   specially formulated foods and food supplements for   preventing malnutrition among 6-23 months old and   treating moderate malnutrition among 6-59 months old children”

by Saskia de Pee and Martin W Bloem (2008) – WFP



Reducing child malnutrition requires nutritious food, breastfeeding, improved hygiene, health services, and (prenatal) care. Poverty and food insecurity seriously constrain accessibility of nutritious diets, including high protein quality, adequate micronutrient content and bioavailability, macro-minerals and essential fatty acids, low anti-nutrient content, and high nutrient density. Largely plant-source-based diets with few animal source and fortified foods do not meet these requirements and need to be improved by processing (dehulling, germinating, fermenting), fortification, and adding animal source foods, e.g. milk, or other specific nutrients. Options include using specially formulated foods: fortified blended foods (FBFs), commercial infant cereals, ready-to-use foods i.e. pastes/compressed bars/biscuits, or complementary food supplements (CFS): micronutrient powders (MNP); powdered CFS containing (micro)nutrients, protein, amino acids and/or enzymes; or lipid-based nutrient supplements (LNS), 120-500 kcal/d, typically containing milk powder, high-quality vegetable oil, peanut-paste, sugar, (micro)nutrients. Most supplementary feeding programs for moderately malnourished children supply FBFs, such as corn soy blend, with oil and sugar, which has shortcomings: too many anti-nutrients, no milk (important for growth), suboptimal micronutrient content, high bulk and viscosity. Thus, for feeding young or malnourished children, FBFs need to be improved or replaced. Based on success with ready-to-use therapeutic foods (RUTF) for treating severe acute malnutrition, modifying that recipe is also considered. Commodities for reducing child malnutrition should be chosen based on nutritional needs, program circumstances, availability of commodities, and likelihood of impact. Data are urgently required to compare impact of new or modified commodities to current (FBFs) and to RUTF developed for treating severe acute malnutrition.

Eating Maps: Places, Times, and People in Eating Episodes

In Over-nutrition, Under-nutrition on May 27, 2012 at 7:17 am

by Jeffery Sobala, Christine Blakeb, Margaret Jastrana, Amanda Lyncha, Carole A. Bisognia & Carol M. Devinea

Ecology of Food and Nutrition, Volume 51, Issue 3, 2012


“This project developed a method for constructing eating maps that portray places, times, and people in an individual’s eating episodes. Researchers used seven consecutive days of qualitative eating recall interviews from 42 purposively sampled U.S. adults to draw a composite eating map of eating sites, meals, and partners for each person on a template showing home, work, automobile, other homes, and other places. Participants evaluated their own maps and provided feedback. The eating maps revealed diverse places, times, and partners. Eating maps offer a flexible tool for eliciting, displaying, validating, and applying information to visualize eating patterns within contexts.”

Comment: this tool was applied in a western country. However, the same may be interesting also when adapted to food and nutrition surveys in low-resource settings.

WFP: new Executive Director – Ertharin Cousin

In Under-nutrition on May 25, 2012 at 9:02 am

IFPRI says:

“How can the World Food Programme (WFP) better meet the urgent needs of the poorest and most vulnerable while building the capacity of nations and peoples to feed themselves? As the WFP’s new Executive Director, Ertharin Cousin is leading the world’s largest food assistance agency at a time of complex new challenges and unprecedented opportunities. Come hear her vision and plans for a WFP that is more agile, accountable and transparent, with policies, programs and partnerships that are evidence-based, results-focused and responsive to local experience and expertise.”

Organic foods. Good for your health? We do not know, today. Maybe tomorrow…

In Under-nutrition on May 18, 2012 at 11:58 am

This morning, a friend of mine has solicited some insight about the relation between organic food and public health nutrition impact. I looked into the available systematic reviews from peer-reviewed journals. These are the results from the found studies – I could not find much more out there.

There are at least two ways to interpret these controversial papers* written by researchers from the London School of Hygiene and Tropical Medicine and other institutions, and whose abstracts are reported beneath.

  • The first interpretation is that “there is not sufficient evidence that eating organic may have a positive impact on human health“. Painful as it is, that is a matter of fact. However, there is more that can be learnt.
  • The second interpretation is that “the state of the art of the quality of research in the field of organic food and nutrition is (very?) poor“. Therefore, there is need not only for more research, but also with much higher quality standards.

Is there a third perspective about this topic? Other papers available?


* The papers retrieved are:

Nutrition-related health effects of organic foods: a systematic review

Alan D DangourKaren LockArabella HayterAndrea Aikenhead,Elizabeth Allen, and Ricardo Uauy

Am J Clin Nutr July 2010vol. 92 no. 1 203-210


Background: There is uncertainty over the nutrition-related benefits to health of consuming organic foods.

Objective: We sought to assess the strength of evidence that nutrition-related health benefits could be attributed to the consumption of foods produced under organic farming methods.

Design: We systematically searched PubMed, ISI Web of Science, CAB Abstracts, and Embase between 1 January 1958 and 15 September 2008 (and updated until 10 March 2010); contacted subject experts; and hand-searched bibliographies. We included peer-reviewed articles with English abstracts if they reported a comparison of health outcomes that resulted from consumption of or exposure to organic compared with conventionally produced foodstuffs.

Results: From a total of 98,727 articles, we identified 12 relevant studies. A variety of different study designs were used; there were 8 reports (67%) of human studies, including 6 clinical trials, 1 cohort study, and 1 cross-sectional study, and 4 reports (33%) of studies in animals or human cell lines or serum. The results of the largest study suggested an association of reported consumption of strictly organic dairy products with a reduced risk of eczema in infants, but the majority of the remaining studies showed no evidence of differences in nutrition-related health outcomes that result from exposure to organic or conventionally produced foodstuffs. Given the paucity of available data, the heterogeneity of study designs used, exposures tested, and health outcomes investigated, no quantitative meta-analysis was justified.

Conclusion: From a systematic review of the currently available published literature, evidence is lacking for nutrition-related health effects that result from the consumption of organically produced foodstuffs.

Nutritional quality of organic foods: a systematic review

Alan D Dangour,  Sakhi K Dodhia,  Arabella Hayter,  Elizabeth AllenKaren Lock, and Ricardo Uauy

Am J Clin Nutr September 2009 vol. 90 no. 3 680-685


Background: Despite growing consumer demand for organically produced foods, information based on a systematic review of their nutritional quality is lacking.

Objective: We sought to quantitatively assess the differences in reported nutrient content between organically and conventionally produced foodstuffs.

Design: We systematically searched PubMed, Web of Science, and CAB Abstracts for a period of 50 y from 1 January 1958 to 29 February 2008, contacted subject experts, and hand-searched bibliographies. We included peer-reviewed articles with English abstracts in the analysis if they reported nutrient content comparisons between organic and conventional foodstuffs. Two reviewers extracted study characteristics, quality, and data. The analyses were restricted to the most commonly reported nutrients.

Results: From a total of 52,471 articles, we identified 162 studies (137 crops and 25 livestock products); 55 were of satisfactory quality. In an analysis that included only satisfactory-quality studies, conventionally produced crops had a significantly higher content of nitrogen, and organically produced crops had a significantly higher content of phosphorus and higher titratable acidity. No evidence of a difference was detected for the remaining 8 of 11 crop nutrient categories analyzed. Analysis of the more limited database on livestock products found no evidence of a difference in nutrient content between organically and conventionally produced livestock products.

Conclusions: On the basis of a systematic review of studies of satisfactory quality, there is no evidence of a difference in nutrient quality between organically and conventionally produced foodstuffs. The small differences in nutrient content detected are biologically plausible and mostly relate to differences in production methods.

A third paper tackles the topic more indirectly, but does not add much to the reported impact on the public health nutrition issue.

Taste preferences and food intake

In Over-nutrition on May 16, 2012 at 8:03 am

Annual Review of Nutrition, Vol. 17: 237-253

Drewnowski A. (1997).


“Sensory responses to the taste, smell, and texture of foods help determine food preferences and eating habits. However, sensory responses alone do not predict food consumption. The view that a “sweet tooth” leads to obesity through excess sugar consumption is overly narrow. In reality, there are multiple links between taste perceptions, taste preferences, food preferences, and food choices and the amount of food consumed. Taste responses are influenced by a range of genetic, physiological, and metabolic variables. The impact of taste factors on food intake further depends on sex and age and is modulated by obesity, eating disorders, and other pathologies of eating behavior. Food preferences and food choices of populations are further linked to attitudinal, social, and—probably most important—economic variables such as income. Nutrition education and intervention strategies aimed at improving population diets ought to consider sensory pleasure response to foods, in addition to a wide range of demographic and socio-cultural variables.”

My comment: this paper has profoundly influenced my understanding of how taste preferences may increase or decrease the intake of lipid based, ready-to-use food in the management of undernutrition, chronic, acute, and/or due to infections (HIV/TB).

Film Trailer: “The Weight of the Nation”

In Over-nutrition on May 10, 2012 at 8:12 pm

In the US, IOM and CDC say: “…this may be the first generation of children who will have a shorter life expectancy than their parents…”.

The Politics of Food / conversation with history – Michael Pollan (free Video – 58m)

In Over-nutrition on May 8, 2012 at 12:31 pm

From Keen Talks you can watch this video.

Michael Pollan discusses the agricultural industrial complex that dominates consumer choices about what to eat. He explores the origins, evolution and consequences of this system for the nations health and environment. He highlights the role of science, journalism, and politics in the development of a diet that emphasizes nutrition over food.

“Pollan also sketches a reform agenda and speculates on how a movement might change Americas eating habits. He also talks about science writing, the rewards of gardening, and how students might prepare for the future.”

Sourdough home baking. Seriously

In Over-nutrition on May 8, 2012 at 7:04 am

Sometime you may also long for a good home made bread, crunchy and fruity. But you may happen to live in the anonymous outskirts of a large town in the western world or work in… a refugee camp in Africa or Asia (I am a humanitarian nutritionist). Well, or something in between.

While I was living in the Amazon jungle, I learnt how to bake using industrial yeasts as a starter. The habit of baking did not abandon me, when I moved back to more civilized worlds. So, with the usual ups and downs, friends were still offered the fruits of my kneading exercises.

However, recently the use of sourdough starter revamped my jungle-based enthusiasm for home bread baking. Making a sourdough is not as easy as buying industrial yeasts. However dozens, maybe hundreds of blogs and web sites help you in this endeavour. This is my favourite one, written by a Dutch couple with a pretty scientific approach. I was impressed and I hope to visit them in the next months.

Already experienced? You like challenges? Make people happy around you: give it a try with the sourdough croissant.

Linear Programming in Nutrition: easy! Yes, but…only if somebody would have told me how to do it.

In Under-nutrition on May 3, 2012 at 11:40 am

This week I am working again for Valid International creating new formulations for feeding programmes in emergency settings. The software to create the theoretical formulation is a simple MS Excel sheet, using the add-in Solver. However the technique is based on linear programming : something very mysterious until few years ago for me, now much more accessible. Basically it is a mathematical approach to solve multi-factorial equations – scary isn’t it?

However, the potential use of Linear Programming (also) in nutrition is huge! You can design and assess diets and formulate new foods. Not only. As an example see this economic assessment of food prices using Linear Programming (Briend et al.). Or for the ones interested in therapeutic feeding, do not miss this paper.

For some simple theory  have a look at this UN document about  Linear Programming in nutrition, prepared by Andre’ Briend: very well done. If you are specifically interested on ready-to-use therapeutic food, see this recent paper. If you are looking for a simple software, try Nutrisurvey (the picture is from this software): a marvel work by Juergen Erhardt.

Question: are you a nutritionist or a food technologist? Did you receive a training in this amazing tool during your education? If not, why is it so? Do you think there is market out there for this?

My opinion – I had to learn myself… Interesting, but time demanding. As a nutritionist, or food technologist, my point is that this tool should be a compulsory part of our formal education (MSc, bachelor, etc.), just as much we learn about food and nutrient composition.

What is your point about it?



Find more information about LP also here.

Adding kiwi and grape seeds to burgers to reduce the meat bad effect

In Over-nutrition on April 30, 2012 at 3:31 pm

Dr Greger: “Dietary interventions, including increasing fruit and vegetable intake and decreasing meat intake, may not only help slow the progression of chronic obstructive pulmonary disease, but may actually improve lung function.”

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