Food recovery and produce distribution as a system strategy for increasing access to healthy food among populations experiencing food insecurity: lessons for post-pandemic planning.

Using data from an intercept survey of 428 adults who received free surplus produce at five distribution sites and qualitative data from 15 interviews with site personnel, we examined facilitators (e.g. community partnerships, coalition support) and challenges (e.g. limited refrigerated storage, lack of transportation infrastructure) to operating a food recovery and distribution program in Los Angeles County. Overall, this food system intervention appeared to fill an unmet need for recipients, nearly 80% of whom were food insecure and 60% visited a site several months/year or monthly. For many living in this county's underserved communities, this effort was instrumental in increasing access to healthy food before and during the COVID-19 pandemic. To sustain/expand this program's reach, local governments and food assistance programs should provide greater coordination and oversight, and invest more resources into this food recovery and distribution infrastructure.

Do food distribution and competitor density affect agonistic behaviour within and between clans in a high fission-fusion species?

According to the ecological model of female social relationships (EMFSR), within-group competition and between-group competition in female-bonded species are shaped by food distribution. Strong between-group contests are expected over large, monopolizable resources and high population density, but not when low-quality food is distributed across large, undefended home ranges. Within-group contests are expected to be more frequent with increasing heterogeneity among feeding sites and with group size. We tested these predictions in female Asian elephants, which show traits associated with infrequent contests-graminivory, high fission-fusion and overlapping home ranges. We examined how food distribution and competitor density affected agonistic interactions within and between female elephant clans (social groupings) in the Kabini grassland, southern India. We found stronger between-clan contest in the grassland than that known from neighbouring forests, and more frequent agonism between females between clans than within clans. Such strong between-clan contest was attributable to the grassland being a food-rich habitat patch, thus supporting the EMFSR. Within-clan agonism was also frequent, but did not increase with food heterogeneity, contradicting the EMFSR. Contrary to recent claims, increasing within-clan agonism with group size suggested ecological constraints on large groups despite high fission-fusion. High population density may explain such frequent contests despite graminivory and fission-fusion.

Infant and child mortality in the Netherlands 1935-47 and changes related to the Dutch famine of 1944-45: A population-based analysis.

Precise estimates of the impact of famine on infant and child mortality are rare due to lack of representative data. Using vital statistics reports on the Netherlands for 1935-47, we examine the impact of the Dutch famine (November 1944 to May 1945) on age-specific mortality risk and cause of death in four age groups (stillbirths, <1 year, 1-4, 5-14) in the three largest famine-affected cities and the remainder of the country. Mortality during the famine is compared with the pre-war period January 1935 to April 1940, the war period May 1940 to October 1944, and the post-war period June 1945 to December 1947. The famine's impact was most visible in infants because of the combined effects of a high absolute death rate and a threefold increase in proportional mortality, mostly from gastrointestinal conditions. These factors make infant mortality the most sensitive indicator of famine severity in this setting and a candidate marker for comparative use in future studies.

Use of food distribution resources among military families with young children since the COVID-19 pandemic.

OBJECTIVE: The present study examined military families' use of food distribution resources and military (e.g. rank) and non-military (e.g. race/ethnicity) characteristics associated with using food distribution resources. DESIGN: Secondary data analyses from a cross-sectional survey in the first 6 months of 2021. SETTING: A national sample of eligible families completed an online survey. PARTICIPANTS: 8326 enlisted military families with an active duty service member in the United States Army or Air Force who applied for supplemental childcare funding distributed by National Military Family Association. RESULTS: 13·2 % of the families reported utilising a food distribution resource in the past 12 months. Those with lower financial well-being were more likely to utilise such resources. Older (OR = 1·04, 95 % CI = 1·02, 1·05, P < 0·001), single-earner (OR = 0·73, 95 % CI = 0·61, 0·89, P = 0·001) families with a lower rank (OR = 0·69, 95 % CI = 0·64, 0·75, P < 0·001) and Army affiliation (compared with Air Force) (OR = 2·31, 95 % CI = 2·01, 2·67, P < 0·001) were more likely to utilise food distribution resources. Members of certain racial/ethnic minority groups were more likely to utilise food distribution resources than White respondents (OR from 1·47 for multi-racial to 1·69 for Asians), as were families with more dependent children (OR = 1·35, 95 % CI = 1·25, 1·47, P < 0·001). CONCLUSIONS: These results identify the extent of food distribution resource utilisation in military families with young children approximately 1 year into the COVID-19 pandemic. The results also identify characteristics associated with their use of food distribution resources. Findings are discussed with an emphasis on prevention and intervention implications for military families.

Tailored Informational Interventions for Reducing Surplus and Waste of Fruits and Vegetables in a Food Market: A Pilot Study.

This pilot study explored the effectiveness of tailored informational interventions to reduce the surplus and waste of fruits and vegetables at the distribution level in Chile. Stalls from a fresh food market were randomized to intervention (n = 5 selling fruits, n = 5 selling vegetables) or control (n = 4 selling fruits, n = 4 selling vegetables) groups. The causes of surplus and waste were estimated by questionnaires. Surplus, avoidable waste, and unavoidable waste were measured using direct quantification before and after the intervention, and were expressed relative to the initial stock. Before the intervention, the surplus was (median [25th-75th percentile]) 46.2% [33.3-51.2] for fruits and 51.5% [41.3-55.0] for vegetables; avoidable waste was 0.1% [0.0-0.8] for fruits and 1.8% [0.7-5.3] for vegetables; and unavoidable waste was 0.0% [0.0-1.0] for fruits and 0.0% [0.0-1.3] for vegetables. Planning and storage represented the main causes explaining surplus and waste. After the intervention, the intervention group decreased the surplus of fruits compared to the control group (-17.8% [-29.0--11.0] vs. 5.8% [-0.6-7.8], respectively; p = 0.016), without other differences. In conclusion, tailored informational interventions based on the causes of surplus and waste may reduce the surplus of fruits in a fresh food market. Interventions might also include management strategies for the surplus to improve grocers' business operations.

Evaluation of US Department of Agriculture Foods Programs for Households Using Nutrition Guidelines for the Charitable Food System.

BACKGROUND: US Department of Agriculture (USDA) Foods programs for households (ie, The Emergency Food Assistance Program, Food Distribution Program on Indian Reservations, and Commodity Supplemental Food Program) are designed to provide nutritious foods at no cost to income-eligible individuals in the United States. OBJECTIVE: Our aim was to evaluate the nutritional quality of the foods available from 3 USDA Foods programs for households (ie, The Emergency Food Assistance Program, Food Distribution Program on Indian Reservations, and Commodity Supplemental Food Program) according to the Healthy Eating Research (HER) Guidelines for the Charitable Food System. DESIGN: Review of the nutritional information of the foods available from USDA Foods programs for households was performed. Using the HER Guidelines, foods were categorized into a 3-tiered system (ie, choose often/green; choose sometimes/yellow; choose rarely/red) based on levels of saturated fat, sodium, and added sugar per serving, and presence of whole grains. SETTING: All unique foods available from The Emergency Food Assistance Program, Food Distribution Program on Indian Reservations, and Commodity Supplemental Food Program (n = 152) for fiscal year 2022 were evaluated. MAIN OUTCOME MEASURES: Nutritional quality of the foods available from USDA Foods programs for households according to the HER guidelines was measured. Foods were ranked green, yellow, red, or not ranked. STATISTICAL ANALYSES PERFORMED: The proportion of foods in each HER Guidelines' rank was calculated across the 3 USDA Foods programs for households and by each program. RESULTS: The majority of USDA Foods were ranked green (57.3%) or yellow (35.5%). A small number of items were ranked red (3.3%) or were unranked condiments or cooking staples (3.9%). CONCLUSIONS: The USDA Foods available in the household programs were primarily fruits and vegetables; lean proteins; whole grains; and low-fat dairy products that were consistent with national dietary guidelines. There is some room for improvement, and adjustments in the specifications for certain items are recommended to strengthen the nutritional value of the foods provided through these important federal programs.

Global Food Production and Distribution Analysis using Data Mining and Unsupervised Learning.

BACKGROUND: Today's food industry is extensive and complicated, encompassing anything from subsistence agriculture to multinational food corporations. The mobility of food and food elements in food systems has a major impact on biodiversity preservation and the overall sustainability of our fragile global ecosystem. Identifying the human and livestock consumption patterns across regions and territories will optimize the dietary standards of the habitually undernourished and the expanding population without substantially increasing the amount of land under cultivation. Food preservation is the basis for economic advancement and social sustainability, so the food industry, both local and global, is fundamental to everyone. As a primary mechanism for ensuring global food preservation, there is currently a strong emphasis on accelerating food supply and decreasing waste. Thus, analyzing the production and distribution of food supply will boost economic sustainability. METHODOLOGY: In this paper, we present a quantitative analysis of global and regional food supply to reveal the flow of food and feed products in various parts of the world. Using data mining and machine learning-based approaches, we seek to quantify the production and distribution of food elements. The study aims to employ artificial intelligence-based methods to comprehend the shift and change in supply and consumption patterns with timely distribution to meet the global food instability. The method involves using statistical-based approaches to identify the hidden factors and variables. Feature engineering is used to uncover the interesting features in the dataset, and various clustering-based algorithms, like K-Means, have been utilized to group and identify the similar and most notable features. RESULT AND DISCUSSION: The concept of data mining and machine learning-based algorithms has helped us in identifying the global food production and distribution subsystem. The identified elements and their relationship can help stakeholders in regulating various external and internal factors, including urbanization, urban food needs, the economic, political and social framework, food demand, and supply flows. The exploratory analysis helps in establishing the efficiency and dynamism of food supply and distribution systems. CONCLUSION: The outcome demonstrates a pattern indicating the flow of currently grown crops into various endpoints. Few countries with massive populations have shown tremendous growth in their production capacity. Despite the fact that only a few countries produce a large portion of food and feed crops, still it is insufficient to feed the estimated global population. Significant changes in many people's socioeconomic conditions, as well as radical dietary changes, will also be required to boost agricultural credit and economic foundations.

Nutritional Status and Intra-household Food Distribution Among Reproductive-Age-Group Women in a Slum Area of Hooghly District, West Bengal: A Mixed-Methods Approach.

Introduction Malnutrition among women of reproductive age (WRA), especially those living in slum areas, is one of the most concerning nutritional issues because of the extreme nutritional stress they face in the form of inequitable intra-household food distribution (IHFD). This study aimed to assess the nutritional status (NS) and its association with IHFD among reproductive-age-group women along with exploring the perspectives of the stakeholders regarding inequitable food distribution. Materials and methods The quantitative part of the convergent parallel mixed-methods design study was conducted among 150 WRA, selected by cluster random sampling from 15 slum areas of Hooghly District, between December 2020 and May 2021. Data were collected using a predesigned pretested schedule with anthropometric measurements. IHFD was quantified by the relative dietary energy adequacy ratio (RDEAR). Ordinal logistic regression was performed to obtain adjusted-proportional odds ratios (aPOR) for higher categories of NS (underweight: reference category). Stratified subgroup analysis was done to assess the influencers of IHFD. For the qualitative part, in-depth interviews were conducted with eight purposively selected in-laws of study participants, and the data were interpreted by thematic analysis. Results The mean age of the study participants was 28.6±6.3 years. The proportion of malnutrition and inequitable IHFD (RDEAR<1) among them was 50% and 46%, respectively. Higher categories of NS were found to be significantly associated with an increase in RDEAR (aPOR=22.6, 95% CI: 2.75-185.45, p-value=0.004). Among underweight and normal NS women, those who were earning members and directly involved in food preparation/production had a greater allocation of food within their households. Physiological intolerance, incapacity of earning, and traditional customs were the most recurring themes transcribed as the barriers to equitable food distribution. Conclusion A high magnitude of malnutrition and its association with inequitable IHFD among WRA warrant policy-level support to increase women's employment opportunities and address gender-based inequities through comprehensive information education communication (IEC) techniques as well.

Agroecological producers shortening food chains during Covid-19: opportunities and challenges in Costa Rica.

The Covid-19 pandemic has compounded the global food insecurity crisis, disproportionately affecting the consumers, farmers, and food workers (UN in Policy brief: impacts of COVID-19 on food security and nutrition, 2020, https://www.un.org/sites/un2.un.org/files/sg_policy_brief_on_covid_impact_on_food_security.pdf). The significant disruptions caused by Covid-19 have called international attention to food security and sparked conversations about how to better support food production and trade. Our paper contributes to a small but growing literature on the impacts and responses of agroecological farmers to Covid-19 in Costa Rica. Specifically, we interviewed 30 agroecological farmers about (1) livelihood disruptions during Covid-19, (2) the areas of food production and sales most affected during this pandemic, and (3) how farmers and consumers are adapting during this crisis. Our findings reveal multiple impacts on agroecological farmers including: economic hardships of lower incomes and inability to pay loans, changes in purchasing and consumption patterns, market disruptions, changes in sales, a decrease in agrotourism, and a shortage of farmworkers. Furthermore, we also report the following farmer adaptation strategies: (1) minimizing distance with consumers to facilitate direct delivery, (2) establishing e-commerce platforms. Based on our findings, we recommend the following: (1) building farmer networks for knowledge sharing, (2) increasing technological support for farmers, and (3) providing government support to ensure that such crises do not increase unemployment among farmers and exacerbate food insecurity.

The Impact of the COVID-19 Pandemic on Food Distribution at Emergency Food Assistance Organizations in the Southwestern United States: A Qualitative Investigation.

This study aimed to identify changes in food distribution operations at emergency food assistance organizations (EFAOs) during the COVID-19 pandemic. EFAOs across the Houston metro area, TX (human service centers and food pantries) as well as the Houston Food Bank (HFB) participated in the qualitative study. Data were collected via individual semi-structured interviews and focus group (December 2020-February 2021), and coded using semi-structured thematic analysis. Categories were pre-identified based on the interview questions. Direct quotes supported subcategories. Directors from 18 EFAOs were interviewed; 8 HFB leadership staff participated in a focus group. Four major categories of change due to COVID-19 included new safety measures, changes in food distribution process, changes in volunteerism and staffing, and changes in amounts of food distributed. This study helps identify susceptibilities in EFAOs' food distribution chain should be addressed to manage future emergency food insecurity crises more effectively. An understanding of the changes/challenges incurred by EFAOs during the COVID-19 pandemic can inform policymakers to ensure local food distribution organizations are prepared to fill the needs during future a crisis of food insecurity.

Comparative Analysis of Energy Use and Greenhouse Gas Emission of Diesel and Electric Trucks for Food Distribution in Gowanus District of New York City.

New York City's food distribution system is among the largest in the United States. Food is transported by trucks from twelve major distribution centers to the city's point-of-sale locations. Trucks consume large amounts of energy and contribute to large amounts of greenhouse gas emissions. Therefore, there is interest to increase the efficiency of New York City's food distribution system. The Gowanus district in New York City is undergoing rezoning from an industrial zone to a mix residential and industrial zone. It serves as a living lab to test new initiatives, policies, and new infrastructure for electric vehicles. We analyze the impact of electrification of food-distribution trucks on greenhouse gas emissions and electricity demand in this paper. However, such analysis faces the challenges of accessing available and granular data, modeling of demands and deliveries that incorporate logistics and inventory management of different types of food retail stores, delivery route selection, and delivery schedule to optimize food distribution. We propose a framework to estimate truck routes for food delivery at a district level. We model the schedule of food delivery from a distribution center to retail stores as a vehicle routing problem using an optimization solver. Our case study shows that diesel trucks consume 300% more energy than electric trucks and generate 40% more greenhouse gases than diesel trucks for food distribution in the Gowanus district.

Food-trade-associated COVID-19 outbreak from a contaminated wholesale food supermarket in Beijing.

The re-emerging outbreak of COVID-19 in Beijing, China, in the summer of 2020 originated from a SARS-CoV-2-infested wholesale food supermarket. We postulated that the Xinfadi market outbreak has links with food-trade activities. Our Susceptible to the disease, Infectious, and Recovered coupled Agent Based Modelling (SIR-ABM) analysis for studying the diffusion of SARS-CoV-2 particles suggested that the trade-distancing strategy effectively reduces the reproduction number (R0). The retail shop closure strategy reduced the number of visitors to the market by nearly half. In addition, the buy-local policy option reduced the infection by more than 70% in total. Therefore, retail closures and buy-local policies could serve as significantly effective strategies that have the potential to reduce the size of the outbreak and prevent probable outbreaks in the future.

The effects of foods available through the Food Distribution Program on Indian Reservations (FDPIR) on inflammation response, appetite and energy intake.

OBJECTIVE: To compare the effects of a typical Food Distribution Program on Indian Reservations (FDPIR) diet with an FDPIR diet that meets Dietary Guidelines for Americans (DGA) on inflammation response, appetite and energy intake on a combination of American Indian (AI) and non-AI individuals. DESIGN: A within-subjects, randomised, crossover design was used to compare two dietary conditions: (1) a FDPIR diet that met DGA and (2) a FDPIR diet that did not meet DGA. Each participant served as their own control and was exposed to both dietary conditions. Repeated-measures ANOVA and t tests assessed significance between the two dietary conditions. SETTING: This took place in the Montana State University Nutrition Research Laboratory in the USA. PARTICIPANTS: Female and male participants (n 13) aged 18-55 years from the university and local community. RESULTS: There were no significant differences in inflammatory response and appetite sensations between the two dietary conditions. Findings indicated that participants ate 14 % more (P < 0·01) kcal on a typical FDPIR diet compared with a FDPIR diet that met DGA. CONCLUSIONS: Higher energy intake during a typical FDPIR diet compared with a FDPIR diet that meets DGA may increase risk for obesity and nutrition-related diseases, including type 2 diabetes and other chronic inflammatory conditions.

Impact of Dietary Interventions during Pregnancy on Maternal, Neonatal, and Child Outcomes in Low- and Middle-Income Countries.

Optimal nutrition plays a crucial role in pregnancy. Maternal malnutrition is a risk factor for maternal, fetal, and neonatal complications and is more prevalent in low and middle-income countries (LMICs). This review aims to study the effectiveness of antenatal macronutrient nutritional interventions on maternal, neonatal, and child outcomes. We searched the CENTRAL, PubMed, Embase, and other databases for randomized controlled trials and quasi-experimental designs on healthy pregnant women in LMICs. We also searched grey literature and reports from Google Scholar, Web of Science, and websites of different organizations. Title/abstract screening, full-text screening, and data extraction filtered 15 studies for inclusion. Balanced energy protein (BEP) supplementation (n = 8) studies showed a reduced incidence of perinatal mortality, stillbirths, low birth weight (LBW) infants, small for gestational age (SGA) babies and increased birth weight. Food distribution programs (FDPs) (n =5) witnessed reduced rates of SGA, stunting, wasting, and increased birth weight and birth length. Studies on intervention for obesity prevention (n = 2) showed reductions in birth weight. Other findings were statistically insignificant. Subgroup analyses were conducted to study the effectiveness of supplementation between regions, location, the timing of supplementation and nutritional status; however, there were a limited number of studies in each subgroup. Data from our review supports the antenatal supplementation of BEP and FDP for the prevention of adverse maternal, neonatal, and child outcomes that can be utilized for future policymaking. However, more research is required before recommending obesity prevention programs.

Measuring Caenorhabditis elegans Spatial Foraging and Food Intake Using Bioluminescent Bacteria.

For most animals, feeding includes two behaviors: foraging to find a food patch and food intake once a patch is found. The nematode Caenorhabditis elegans is a useful model for studying the genetics of both behaviors. However, most methods of measuring feeding in worms quantify either foraging behavior or food intake, but not both. Imaging the depletion of fluorescently labeled bacteria provides information on both the distribution and amount of consumption, but even after patch exhaustion a prominent background signal remains, which complicates quantification. Here, we used a bioluminescent Escherichia coli strain to quantify C. elegans feeding. With light emission tightly coupled to active metabolism, only living bacteria are capable of bioluminescence, so the signal is lost upon ingestion. We quantified the loss of bioluminescence using N2 reference worms and eat-2 mutants, and found a nearly 100-fold increase in signal-to-background ratio and lower background compared to loss of fluorescence. We also quantified feeding using aggregating npr-1 mutant worms. We found that groups of npr-1 mutants first clear bacteria from within the cluster before foraging collectively for more food; similarly, during large population swarming, only worms at the migrating front are in contact with bacteria. These results demonstrate the usefulness of bioluminescent bacteria for quantifying feeding and generating insights into the spatial pattern of food consumption.

Where and what? Frugivory is associated with more efficient foraging in three semi-free ranging primate species.

Foraging in seasonal environments can be cognitively challenging. Comparative studies have associated brain size with a frugivorous diet. We investigated how fruit distribution (where) and preference (what) affect foraging decisions in three semi-free ranging primate species with different degrees of frugivory: Macaca tonkeana (N indiv = 5; N trials = 430), M. fascicularis (N indiv = 3; N trials = 168) and Sapajus apella (N indiv = 6; N trials = 288). We used 36 boxes fixed on trees and filled with highly and less preferred fruits with different (weekly) spatio-temporal distributions. Individuals were tested in two conditions: (1) same fruit provided concurrently in the same quantity but in a scattered and in a clumped distribution, (2) highly preferred fruit was scattered while the less preferred was clumped. Generally, primates preferred feeding first on the boxes of the clumped distribution in both conditions, with the more frugivorous species at a higher degree than the less frugivorous species in condition (1), but not (2). Therefore, what fruit was available changed the foraging decisions of the more frugivorous species who also engaged more in goal-directed travel. When feeding on preferred fruit, primates probably maximized foraging efficiency regardless of their degree of frugivory. Our findings emphasize that the food type and distribution may be a preponderant driver in cognitive evolution.

Perceptions of What Is Important for Appetite-An Interview Study With Older People Having Food Distribution.

The proportion of older people in the population increases and more and more continue living in their own homes. Appetite among the elderly people is important to their nutrition and health. The increased risk of unintended weight loss and malnutrition is linked to food distribution among home-living elderly people. The aim was to describe experiences and perceptions of what matters to appetite among home-living elderly people having food distribution. The design was qualitative where interview data were collected among 13 interviewees in 2017 to 2018. Data were analyzed using qualitative content analysis. The results are presented in three domains: the food, the meal situation, and the adaptation to meal service with categories and themes responding to each domain. The six themes related to appetite among the elderly people concerned the following: eating tasty, savory, and culturally adapted food; eating healthy and sustainable food; eating alone or together with others; eating in a pleasant meal environment; having choices to make about the meal; and last, accepting disabilities and increased dependency. One conclusion is that many aspects should be taken into consideration when promoting appetites of people who also get food distribution. It is highly individual and an understanding of which aspects are relevant must be considered; consequently, person-centered care is suggested to promote appetite.

Life cycle assessment of waste prevention in the delivery of pasta, breakfast cereals, and rice.

Waste prevention is the top priority of the European waste management strategy. In fact, as indicated in the latest Waste Framework Directive, the best option to deal with waste is not to generate it at all. In this framework, the distribution of loose dry food products through self-dispensing systems (so-called "loose distribution") is being considered worldwide as a practice to reduce the generation of packaging waste. This life cycle assessment (LCA) evaluates the environmental convenience of the loose distribution of dry pasta, breakfast cereals, and rice, in comparison with the traditional method of distribution. For each product, several baseline scenarios based on single-use packaging were compared with different waste prevention scenarios in which the product is distributed loose. The comparison addressed waste generation, 13 impact categories on the environment and human health, and the Cumulative Energy Demand (CED) indicator. The results are significantly different for the 3 products. The loose distribution of pasta allows a 50% waste reduction and a decrease in the potential impacts only when compared with single-use cartonboard boxes. Conversely, when the comparison is made with single-use polypropylene bags, the loose distribution can even cause an increase in waste generation (up to 15%) and in the potential life cycle impacts. For breakfast cereals, the loose distribution allows a significant reduction in both the amount of waste (up to 84%) and the potential impacts, compared to the sale of traditional single-use bag-in-box packages. Finally, the loose distribution of rice permits a reduction in both waste generation (up to 86%) and most of the potential impacts. In particular, the impact reduction is higher when the reference single-use packaging that is replaced includes a cartonboard box. Integr Environ Assess Manag 2016;12:445-458. © 2016 SETAC.

Relationship between intra-household food distribution and coexistence of dual forms of malnutrition.

BACKGROUND/OBJECTIVES: The relationship between food intake and nutritional status has been clearly established. Yet, there are only limited studies on food intake among family members and their nutritional status. The study examined the relationship between intra-household food distribution and coexistence of dual forms of malnutrition (DFM) in the same household. SUBJECTS/METHODS: Households with a malnourished child and overweight mother were categorized as DFM. Intra-household food distribution among family members was reported using ratios, which are a measure of individual intakes as compared to all household member intakes adjusted to RDA. RESULTS: A 1,899 families were included in the study. The prevalence of DFM was 29.8% (95%CI 26.5-31.2). Children consumed lower amounts of energy (OR 1.34; 95%CI 1.06-1.69, P = 0.011), carbohydrates (OR 1.2; 95%CI1.03-1.61, P = 0.022), protein (OR 1.3; 95%CI 1.03-1.64, P = 0.026), and fat (OR 1.3; 95%CI 1.05-1.66, P = 0.016) than their mothers and other family members. In contrast, mothers consumed more carbohydrates than children and other family members (OR1.24; 95%CI 1.02-1.51, P = 0.03). CONCLUSIONS: This study is the first to report on the food distribution among family members and its relationship with occurrence of DFM in Indonesia. The results confirm the occurrence of an unequal food distribution between children and mothers, which increases risk of DFM in the household. The results also demonstrate that nutritional education at the household level is important to increase awareness of the impact of DFM.

Relationship between intra-household food distribution and coexistence of dual forms of malnutrition

BACKGROUND/OBJECTIVES: The relationship between food intake and nutritional status has been clearly established. Yet, there are only limited studies on food intake among family members and their nutritional status. The study examined the relationship between intra-household food distribution and coexistence of dual forms of malnutrition (DFM) in the same household. SUBJECTS/METHODS: Households with a malnourished child and overweight mother were categorized as DFM. Intra-household food distribution among family members was reported using ratios, which are a measure of individual intakes as compared to all household member intakes adjusted to RDA. RESULTS: A 1,899 families were included in the study. The prevalence of DFM was 29.8% (95%CI 26.5-31.2). Children consumed lower amounts of energy (OR 1.34; 95%CI 1.06-1.69, P = 0.011), carbohydrates (OR 1.2; 95%CI1.03-1.61, P = 0.022), protein (OR 1.3; 95%CI 1.03-1.64, P = 0.026), and fat (OR 1.3; 95%CI 1.05-1.66, P = 0.016) than their mothers and other family members. In contrast, mothers consumed more carbohydrates than children and other family members (OR1.24; 95%CI 1.02-1.51, P = 0.03). CONCLUSIONS: This study is the first to report on the food distribution among family members and its relationship with occurrence of DFM in Indonesia. The results confirm the occurrence of an unequal food distribution between children and mothers, which increases risk of DFM in the household. The results also demonstrate that nutritional education at the household level is important to increase awareness of the impact of DFM.