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1. How prices and income influence global patterns in saturated fat intake by age, sex and world region: a cross-sectional analysis of 160 countries

Author

Albertino Damasceno, Cristina Palacios, Anoop Misra, Parvin Mirmiran, Nizal Sarrafzadegan, Simon Anderson, Ingibjorg Gunnarsdottir, Yanping Li, Anand Krishnan, Yu Chen, Alireza Esteghamati, Farshad Farzadfar, Giuseppe Grosso, Reza Malekzadeh, Sumathi Swaminathan, Patricio Lopez-Jaramillo, Noushin Mohammadifard, Jean-Michel Gaspoz, Pedro Marques-Vidal, Idris Guessous, Tal Shimony, Lital Keinan-Boker, Carukshi Arambepola, Antonia Trichopoulou, Dariush Mozaffarian, Marialaura Bonaccio, Simona Costanzo, Licia Iacoviello, Andrew Muhammad, Wen-Harn Pan, Manami Inoue, Peter Vollenweider, Luz Maria Sanchez-Romero, Carl Lachat, Demosthenes Panagiotakos, Sangita Sharma, Eva Roos, Milton Severo, Safiah Yusof, Nuno Lunet, Roya Kelishadi, Frederick Cudhea, Anuradha Khadilkar, Cho-il Kim, Veena Ekbote, Masoud Mirzaei, Inge Huybrechts, Lluis Serra-Majem, Anjum Memon, Simón Barquera, Aminul Haque, Katia Castetbon, Saeed Dastgiri, Victoria Miller, Julia Reedy, Peilin Shi, Jianyi Zhang, Abla M. Sibai, Xia Cao, Pascal Bovet, Pamela Abbott, Karen Charlton, Hsing-Yi Chang, Yasuhiro Matsumura, Yoonsu Cho, Puneet Misra, Morteza Abdollahi, Suad Al-Hooti, Anahita Houshiar-rad, Eda Koksal, Abdulrahman Musaiger, Gulden Pekcan, Sahar Zaghloul, Yves Martin-Prevel, Kyungwon Oh, Meei-Shyuan Lee, Sirje Vaask, Shu Wen Ng, Simon Forsyth, Dimitrios Trichopoulos, Erkki Vartiainen, Christian Haerpfer, Carla Lopes, Foong Ming Moy, Tor Strand, Mohammadreza Pakseresht, Yi Ma, Androniki Naska, Dorothy Gauci, Ibrahim Elmadfa, Wilbur Hadden, Hajah Masni Ibrahim, Lars Johansson, Hae-Jeung Lee, Nur Indrawaty Lipoeto, Balakrishna Nagalla, Stefka Petrova, Noppawan Piaseu, Laufey Steingrimsdottir, Lucjan Szponar, Holmfridur Thorgeirsdóttir, Inga Thorsdottir, Aida Turrini, Anna Waskiewicz, Gábor Zajkás, Harikumar Rachakulla, Heléne Enghardt Barbieri, Nattinee Jitnarin, Le Tran Ngoan, Jaana Lindström, Kalyana Sundram, Ranil Jayawardena, Irina Kovalskys, Noël Barengo, Zaleha Abdullah Mahdy, Maryam Hashemian, Duarte Torres, Angélica Ochoa, Pulani Lanerolle, Chandrashekar Janakiram, Fatemeh Vida Zohoori, Parvin Abedi, Suvi Virtanen, Amelia Ahles, Jacqueline N Yenerall, Josh Erndt-Marino, Mustafa Arici, Amy Luke, Suhad Abumweis, Mohannad Al Nsour, Iftikhar Alam, Nasser Al-Daghri, Shaun Sabico, alHamad Nawal Ai, Eman Alissa, Sameer Al-Zenki, Karim Anzid, Joanne Arsenault Hacettepe, Renzo Asciak, Lajos Biró, Juan Rivera Dommarco, Daniel Illescas-Zarate, Sonia Rodriguez Ramirez, Ivonne Ramirez Silva, Per Bergman, Anna Karin Lindroos, Jessica Petrelius Sipinen, Sesikeran Boindala, Mauricio T. Caballero, FNeville Calleja, Mario Capanzana, Jan Carmikle, Michelle Castro, Corazon Cerdena, Shashi Chiplonkar, Khun-Aik Chuah, IRCCS INM Neuromed, Stefaan De Henauw, Karin DeRidder, Eric Ding, Rokiah Don, Charmaine Duante, Vesselka Duleva, Samuel Duran Aguero, Jalila El Ati, Alison Eldridge, Tatyana El-kour, Laetitia Nikiema, Zohreh Etemad, Fariza Fadzil, Mei Fen Chan, Anne Fernandez, Dulitha Fernando, Regina Fisberg, Edna Gamboa Delgado, J Brahmam Ginnela, Aida Hadziomeragic, Jemal Haidar Ali, Rubina Hakeem, Rajkumar Hemalatha, Avula Laxmaiah, Indrapal Meshram, Nimmathota Arlappa, Sigrun Henjum, Hristo Hinkov, Zaiton Hjdaud, Daniel Hoffman, Beth Hopping, Shu-Yi Hung Yao-Te Hsieh, Nahla Chawkat Hwalla, Nayu Ikeda, Olof Jonsdottir, Rajesh Jeewon, Ola Kally, Mirnalini Kandiah, Tilakavati Karupaiah, Rebecca Goldsmith, Jurgen Konig, Liisa Korkalo, Riitta Freese, Jeremy Koster, Herculina Kruger, Rebecca Kuriyan-Raj, Sanghui Kweon, Sihyun Park, Yuen Lai, Indu Waidyatilaka, Catherine Leclercq, J Lennert Veerman, Lydia Lera Marques, Annie Ling, Widjaja Lukito, Elisabette Lupotto, Stefania Sette, Raffaela Piccinelli, Wan Manan, Dirce Marchioni, Angie Mathee, Paramita Mazumdar, Gert Mensink, Alexa Meyer, Claudette Mitchell, David Balfour, Moses Mwangi, Maryam Maghroun, Fatemeh Mohammadi-Nasrabadi, Zalilah Mohd Shariff, Elizabeth Mwaniki, Jannicke Myhre, Augustin Nawidimbasba Zeba, Sina Noshad, Marga Ocke, Jillian Odenkirk, Mariana Oleas, Sonia Olivares, Johana Ortiz-Ulloa, Johanna Otero, Rajendra Parajuli, Luz Posada, Farhad Pourfarzi, Alan Martin Preston, Ingrid Rached, Ali Reza Rahbar, Colin Rehm, Makiko Sekiyama, Rusidah Selamat, Khadijah Shamsuddin, Harri Sinkko, Milton Fabian Suarez-Ortegon, Elzbieta Sygnowska, Maria Szabo, Ilse Khouw, Swee Ai Ng, Heli Tapanainen FrieslandCampina, Reema Tayyem, Bemnet Tedla, Coline van Oosterhout, Marieke Vossenaar, Eva Warensjo Lemming, Lothar Wieler, Mabel Yap, Maria Elisa Zapata, Khairul Zarina, Zipporah Bukania, Yeri Kombe, Julie Long, K. Michael Hambidge, Tshilenge S. Diba, Umber S. Khan, Gabriela Tejeda, Cornelia Tudorie, Anca Nicolau, Amanda de Moura Souza, Alan de Brauw, Mourad Moursi, Alicia Rovirosa, Carol Henry, Getahun Ersino, Gordon Zello, Chanthaly Luangphaxay, Daovieng Douangvichit, Latsamy Siengsounthone, Christine Hotz, Constance Rybak, Corina Aurelia Zugravu, Donka Baykova, Elizabeth Yakes-Jimenez, Gudrun B. Keding, Lydiah M. Waswa, Irmgard Jordan, J.V. Meenakshi, Laila Eleraky, Wolfgang Stuetz, Lalka Rangelova, Lilian Aluso, Julia Boedecker, Francis Oduor, Tamene Taye Asayehu, Veronika Janská, Ward Siamusantu, and Ken Brown

Subjects
Medicine
Abstract

Objective When considering proposals to improve diets, it is important to understand how factors like price and income can affect saturated fat (SF) intake and demand. In this study, we examine and estimate the influence of price and income on intake across 160 countries, by age and sex, and derive sensitivity measures (price elasticities) that vary by age, sex and world region.Design We econometrically estimate intake responsiveness to income and prices across countries, accounting for differences by world region, age and sex. Intake data by age, sex and country were obtained from the 2018 Global Dietary Database. These data were then linked to global price data for select food groups from the World Bank International Comparison Programme and income data from the World Development Indicators Databank (World Bank).Results Intake differences due to price were highly significant, with a 1% increase in price associated with a lower SF intake (% energy/d) of about 4.3 percentage points. We also find significant differences across regions. In high-income countries, median (age 40) intake reductions were 1.4, 0.8 and 0.2 percentage points, given a 1% increase in the price of meat, dairy, and oils and fats, respectively. Price elasticities varied with age but not sex. Intake differences due to income were insignificant when regional binary variables were included in the analysis.Conclusion The results of this study show heterogeneous associations among prices and intake within and across countries. Policymakers should consider these heterogeneous effects as they address global nutrition and health challenges.

Published
2024
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2. Determination of Vitamin A Total Body Stores in Children from Dried Serum Spots: Application in a Low- and Middle-Income Country Community Setting

Author

Mario Capanzana, M F Dolly Reario, Carl Cabanilla, Ame Stormer, Georg Lietz, Marjorie J Haskell, Anthony Oxley, Reina Engle-Stone, and Jody C Miller

Subjects
0301 basic medicine, Serum, Male, liquid chromatography tandem mass spectrometry, Retinyl Esters, Philippines, Medicine (miscellaneous), Indicator Dilution Techniques, Retinyl acetate, chemistry.chemical_compound, Plasma, 0302 clinical medicine, Isotopes, Refrigeration, Tandem Mass Spectrometry, Medicine, 030212 general & internal medicine, Vitamin A, Methodology and Mathematical Modeling, dried serum spots, Pediatric, Chromatography, Liquid, Nutrition and Dietetics, Spots, Vitamin A Deficiency, Retinol, Temperature, Total body, total body stores, Liver, dried blood spots, Community setting, Female, Diterpenes, retinol isotope dilution, Vitamin, Clinical Trials and Supportive Activities, Nutritional Status, stable isotopes, 03 medical and health sciences, AcademicSubjects/MED00060, Animal science, Food Sciences, Paired samples, children, Animal Production, Clinical Research, Humans, Developing Countries, Nutrition, 030109 nutrition & dietetics, Nutrition & Dietetics, business.industry, Prevention, Reproducibility of Results, Infant, vitamin A status, Nutrition Assessment, chemistry, AcademicSubjects/SCI00960, Low and middle income, business, Digestive Diseases, Chromatography, Liquid
Abstract

Author(s): Oxley, Anthony; Engle-Stone, Reina; Miller, Jody C; Reario, MF Dolly; Stormer, Ame; Capanzana, Mario V; Cabanilla, Carl VD; Haskell, Marjorie J; Lietz, Georg | Abstract: BackgroundThe retinol isotope dilution (RID) method has been used to evaluate vitamin A (VA) status in healthy adults and children in low- and middle-income countries (LMIC) and to assess the efficacy of various VA interventions.ObjectiveThe study was designed to examine whether dried serum spots (DSS) can be applied to RID when conducting VA total body store (TBS) assessments in community settings.MethodsFour days after an oral dose of 0.4nmg [13C10]retinyl acetate was administered to Filipino children (12-18nmo), a single blood draw was divided to isolate both serum and plasma. Serum (40 μL) was spotted and dried on Whatman 903 cards and shipped at ambient temperature whereas liquid plasma (LP) was frozen at -80°C and shipped on dry ice. The VA tracer to tracee ratio from DSS and LP was quantified by LC-MS/MS. Comparisons between DSS and LP paired samples (nn=n72) were made for [13C10]retinol specific activity (SAp) by Pearson's correlation and for VA TBS by Bland-Altman analysis.ResultsThe sum of 3 coextracted DSS were required to consistently detect [13C10]retinol above the LC-MS/MS limit of quantitation (LOQ). [13C10]retinol SAp from DSS was highly correlated with SAp from LP (rn=n0.945; P ln0.01). A comparison of methods for TBS determination using Bland-Altman analysis indicated agreement with an intraindividual difference of 24.7nμmol (4.6%). Mean total liver reserve (TLR) values from DSS and LP were 1.7nμmol/g (± 0.6 SD) and 1.6nμmol/g (± 0.6 SD), respectively.ConclusionsVA TBS can be determined from DSS thereby reducing the logistics and cost of maintaining a cold chain by shipping samples at ambient temperature and, thus, making the RID technique more feasible in LMIC community settings. This trial was registered at https://clinicaltrials.gov as NCT03030339.

Published
2021

3. Development of a Screening Tool to Estimate Vitamin A Intake and Comparison with Detailed Dietary Assessment Methods

Author

Jody C Miller, Mario Capanzana, Carl Cabanilla, Ame Stormer, Marjorie J Haskell, Georg Lietz, Jennifer Lynn Ford, Reina Engle-Stone, and Dolly Reario

Subjects
Nutrition and Dietetics, Dietary assessment, business.industry, Medicine (miscellaneous), Physiology, Powder dose form, Micronutrient, Community and Public Health Nutrition, Vitamin A intake, Medicine, Screening tool, business, Breast feeding, Food Science
Abstract

OBJECTIVES: We aimed to develop and validate a tool to estimate vitamin A (VA) intake and identify children at risk of intake above the tolerable upper intake level (UL). METHODS: We developed, pilot-tested, and refined a screening tool to estimate VA intake among Filipino children 12–18 mo of age. Data were entered into tablets with pre-loaded food composition data to calculate VA intake immediately. The screening tool was used to identify children likely to have “adequate” (one group: 200–500 µg retinol activity equivalents, RAE/d) or “high” (two groups: >600 µg retinol/d) intake. Interviewers administered four 24-h recalls, one 12-h observed weighed record with 12-h recall, and a 30-d supplement questionnaire. Breastmilk intake and VA concentration were measured among breastfeeding children. We compared the screening tool and detailed dietary assessment (DDA) results for primary VA sources, group mean usual intake, and prevalence of intakes above the UL. RESULTS: Major VA sources were similar between methods: fortified milk powders, multivitamin supplements, and breastmilk; contributions from intervention programs (e.g., micronutrient powders, fortified staple foods) were low. Mean usual retinol intakes for the high groups (n = 47 and 39, respectively) were 1218 and 1313 µg/d by screening tool vs. 1096 and 931 by DDA; 70 and 77% had usual intake above 600 µg/d. In the adequate group (n = 37), mean total VA intake was 375 and 559 µg RAE/d by screening and DDA, respectively. CONCLUSIONS: This screening tool provides a reasonably good rapid estimate of VA intake among Filipino children and can be useful for identifying groups with adequate to excessive intakes. FUNDING SOURCES: Bill & Melinda Gates Foundation.

Published
2020

4. Assessment of Vitamin A (VA) Total Body Stores (TBS) Using Dried Derum Spots (DSS)

Author

Jody C Miller, Carl Cabanilla, Marjorie J Haskell, Georg Lietz, Mario Capanzana, Dolly Reario, Anthony Oxley, Ame Stormer, and Reina Engle-Stone

Subjects
Vitamin, Global Nutrition, Nutrition and Dietetics, Spots, business.industry, Medicine (miscellaneous), Total body, Serum specimen, chemistry.chemical_compound, Animal science, chemistry, Medicine, Radioisotope dilution technique, Bland–Altman plot, business, Food Science
Abstract

OBJECTIVES: The retinol isotope dilution method has been successfully applied to assess the efficacy of VA interventions in low and middle-income countries. However, the current method is limited in its applicability because it relies on keeping serum samples in the cold chain. To overcome that limitation, we assessed the feasibility of using DSS for assessing TBS in Filipino children 12–18 months of age. METHODS: Serum (40 µL) from Filipino children, who had received an oral dose of [,(13)C(10)]-retinyl acetate was spotted and dried on Whatman 903 cards then stored at −20°C before shipment at room temperature; aliquots of liquid serum were kept frozen at −80°C until analysis. DSS and liquid serum were extracted by established methods and then analysed by LC-MS/MS to quantify the [,(13)C]/[,(12)C] retinol ratio and TBS. RESULTS: Mean ± SD TBS of 57 Filipino infants aged 12–18 mo were 507.6 ± 185.8 µmol and 495.5 ± 170.1 µmol from either serum or DSS samples, respectively. Comparison of methods using Bland-Altman analysis indicated agreement between both methods with an intra-individual mean difference for TBS of 22.1 µmol (4.5%). CONCLUSIONS: TBS can be determined using serum spot samples in field settings, thus reducing the costs and limitations of shipping serum samples on dry ice and reducing the need for −80C storage in field stations. FUNDING SOURCES: Medical Research Council UK; Bill and Melinda Gates Foundation.

Published
2020

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