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International audience; In the Lower Mekong Basin, paddy fields often appear as mosaics, with soil mounds covered by trees or other plants in a spotty distribution. These soil mounds are commonly named termite ‘lenticular mounds’ because termite bioturbation is considered to be at their origin. Termite mounds host a large diversity of animals and plants, increasing landscape patchiness. Because the preservation of these islands of biodiversity is threatened by modern agricultural practices, the aim of this study was to quantify their abundance and the services they provide to the local population. The abundance of mounds and their use by the population were quantified in a catchment in Cambodia. We found that mounds density reached ~2 mounds ha−1. Interviews carried out within the catchment showed that most of the interviewees used mounds for increasing the fertility of their field and for the cultivation of rice and other plants (e.g. sponge gourd and pumpkin). In addition to their potential to increase plant productivity, the survey revealed that animals (rats and snakes), mushrooms and 13 plant species found on or in mounds were consumed by the population. In addition to potentially contributing to an increase in food diversity, mounds also impacted farmers' health by allowing access to 20 medicinal plant species and indirectly via a reduction in pesticide use. In conclusion, this study is the first attempt to quantify the large number of services provided by termite mounds in Cambodia. This increase in the knowledge of the diversity of environmental and socioeconomic services provided by termite mounds is likely to contribute to their preservation and provide a basis for the sustainable management of biodiversity in paddy fields in the Lower Mekong Basin region

The utilization of termite mounds for the improvement of soil fertility is a worldwide practice and usually explained by the specific properties of this biogenic material. In Cambodia, farmers also use termite mound soils as amendments with the aim to improve the fertility of paddy fields. The first objective of this study was, therefore, to describe the physical and chemical properties of this material and, consequently, to determine its potential for improving soil fertility. A second objective was to consider farmer’s perception and to quantify the diversity of services provided by termite mounds. We confirmed the specific soil properties of termite mounds but showed that their positive influence on soil chemical fertility and water retention are only significant in very sandy soil (>80% sand) while they remain limited in less sandy soil (~40 and 60% of sand). However, termite mounds are considered useful by farmers independently of the soil condition, mostly because this soil material is considered to positively increase soil fertility but also because they host a specific biodiversity which can be used for medicinal purposes or because consumed, then increasing population livelihood. Our work shows the discrepancy between the perception of farmers and the real impact of termite mounds on soil fertility as well as the diversity of services delivered by biodiversity in paddy fields.

Background: The establishment of staff canteens is expected to improve the nutritional situation of Cambodian garment workers. The objective of this study is to assess the nutritive value of low-price model lunch sets provided at a garment factory in Phnom Penh, Cambodia. Methods: Exemplary lunch sets were served to female workers through a temporary canteen at a garment factory in Phnom Penh. Dish samples were collected repeatedly to examine mean serving sizes of individual ingredients. Food composition tables and NutriSurvey software were used to assess mean amounts and contributions to recommended dietary allowances (RDAs) or adequate intake of energy, macronutrients, dietary fiber, vitamin C (VitC), iron, vitamin A (VitA), folate and vitamin B12 (VitB12). Results: On average, lunch sets provided roughly one third of RDA or adequate intake of energy, carbohydrates, fat and dietary fiber. Contribution to RDA of protein was high (46% RDA). The sets contained a high mean share of VitC (159% RDA), VitA (66% RDA), and folate (44% RDA), but were low in VitB12 (29% RDA) and iron (20% RDA). Conclusions: Overall, lunches satisfied recommendations of caloric content and macronutrient composition. Sets on average contained a beneficial amount of VitC, VitA and folate. Adjustments are needed for a higher iron content. Alternative iron-rich foods are expected to be better suited, compared to increasing portions of costly meat/fish components. Lunch provision at Cambodian garment factories holds the potential to improve food security of workers, approximately at costs of

Background: Concerns about the nutritional status of Cambodian garment workers were raised years ago but data are still scarce. The objectives of this study are to examine the nutritional, hemoglobin and micronutrient status of female workers in a garment factory in Phnom Penh, Cambodia, and to assess if body mass index is associated with hemoglobin and/or micronutrient status. Methods: A cross-sectional survey was conducted among 223 female workers (nulliparous, non-pregnant) at a garment factory in Phnom Penh. Anthropometric measurements were performed and blood samples were taken to obtain results on hemoglobin, iron, vitamin A, vitamin B12 and inflammation status (hemoglobinopathies not determined). Bivariate correlations were used to assess associations. Results: Overall, 31.4% of workers were underweight, 26.9% showed anemia, 22.1% showed iron deficiency, while 46.5% had marginal iron stores. No evidence of vitamin A or vitamin B12 deficiency was found. Body mass index was associated with serum ferritin (negative) and serum retinol-binding protein (positive) concentrations, but not strongly. A comparison between underweight and not underweight workers resulted in distinctions for iron deficiency and iron deficiency anemia, with a higher prevalence among not underweight. Conclusions: The prevalence of underweight, anemia and poor iron status was high. Young and nulliparous female garment workers in Cambodia might constitute a group with elevated risk for nutritional deficiencies. Strategies need to be developed for improving their nutritional, micronutrient and health status. The poor iron status seems to contribute to the overall prevalence of anemia. Low hemoglobin and iron deficiency affected both underweight and those not underweight. Despite the fact that body mass index was negatively associated with iron stores, true differences in iron status between underweight and not underweight participants cannot be confirmed.

Malnutrition is locked in a vicious cycle of increased mortality, poor health, impaired cognitive development, slow physical growth, reduced learning capacity, inferior performance, and ultimately lower adult work performance and productivity. The consensus of global scientific evidence indicates that lowering the rates of malnutrition will be an indispensable component of any successful program to raise the quality of human capital and resources. This study used a “consequence model” to apply the coefficient risk-deficit on economic losses, established in the global scientific literature, to Cambodian health, demographic, and economic data to develop a national estimate of the value of economic losses due to malnutrition. The impact of the indicators of malnutrition analyzed represent a burden to the national economy of Cambodia estimated at 266 million USD annually (1.7% of GDP). Stunting is reducing the Cambodian economic output by more than 120 million USD, and iodine deficiency disorders alone by 57 million USD. This economic burden is too high in view of Cambodia’s efforts to drive economic development. The government should rapidly expand a range of low-cost effective nutrition interventions to break the current cycle of increased mortality, poor health and ultimately lower work performance, productivity, and earnings.

Vitamin A has an important role to play in vision, bone growth, reproduction, cell division, and cell differentiation. With the focus on Vitamin A and Carotenoids, this book includes the latest research in these areas and starts with an overview putting the compounds in context with other vitamins, supplementation and discussing the importance of beta-carotene. Details of the chemistry, structure and biochemistry of the compounds begins with nomenclature followed by information on encapsulation, thermal degradation and occurrence. Developments in analytical and bioanalytical techniques concerning these compounds in plant, milk and human tissue systems are covered in detail. Finally, the book covers the extensive functions and effects of Vitamin A on eg developmental growth, immune function, cancer risk, the brain and lungs as well as vision. Delivering high quality information, this book will be of benefit to anyone researching this area of health and nutritional science. It will bridge scientific disciplines so that the information is more meaningful and applicable to health in general. Part of a series of books, it is specifically designed for chemists, analytical scientists, forensic scientists, food scientists, dieticians and health care workers, nutritionists, toxicologists and research academics. Due to its interdisciplinary nature it could also be suitable for lecturers and teachers in food and nutritional sciences and as a college or university library reference guide.

Parturition triggers an acute phase response, but its magnitude, duration and predictors are not well described. We determined serum alpha1-antichymotrypsin (ACT) and C-reactive protein (CRP) among 216 women attending postpartum services in south-eastern Zimbabwe. Serum CRP peaked during the first week and serum ACT around 9 days postpartum. Serum ACT, but not serum CRP, was lower among HIV infected women. Multiparity was a negative, and preterm delivery and caesarean section were positive predictors of both serum ACT and CRP. There is a need for a better understanding of the acute phase response to parturition.

Micronutrient deficiencies remain prevalent in low- and middle-income countries and disproportionately affect young children and women of reproductive age (WRA). Although the impact of food fortification on the micronutrient status of populations has been demonstrated beyond doubt, this impact potential is constrained in practice by critical gaps in program design and implementation. These are partly linked to suboptimal collection and use of data for decision making. The overall aim of this thesis was to evaluate methods for assessing performance and potential for impact of large-scale food fortification programs and provide guidance on evidence-based decision making for effective program design and delivery. We quantified apparent micronutrient intakes from fortified foods among WRA in subnational (Nigeria [n=1461], South Africa [n=419]) and national (Tanzania [n=957], Uganda [n=719]) cross-sectional, clustered household surveys. Additionally, we compared two simplified dietary assessment methods (i.e., a food acquisition and purchase questionnaire (FAPQ) and a 7-d semi-quantitative food frequency questionnaire [SQ-FFQ]) against 24-h recalls for estimating consumption of fortifiable foods among 116 children (12-18 mo) and their mothers (18-49 y) in Mandaluyong City, Philippines. Finally, we applied the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Evidence to Decision (EtD) framework for health system and public health decisions to the Nigerian fortification program to explore its utility for decision making in food fortification programs.In the household surveys, we found that, despite inconsistent fidelity of program implementation, fortified foods were major contributors to vitamin A and iodine intakes, but not iron, among WRA. These indicators helped identify program improvements needed to minimize risk of low or excessive intakes. In the comparison study, we found that the SQ-FFQ, but not the FAPQ, generated useful information on fortifiable food consumption patterns that can inform decisions related to fortification program design and monitoring. The FAPQ method needs to be strengthened to capture prepared foods and minimize under- and over-estimation. The GRADE EtD framework is a practical tool to facilitate and document the use of evidence to inform decisions to start, strengthen, sustain, or continue fortification programs. This tool could help policymakers strengthen fortification decision-making processes.Good program design and continual collection and use of performance monitoring data throughout the fortification program cycle are essential to ensure that impact potential is realized, and risk are mitigated. Findings from this research provide evidence on appropriate tools and methods for collecting and using such data to inform policy decision making processes necessary to improve program design, delivery, and ultimately health impacts.; Les carences en micronutriments restent prévalentes dans les pays à revenu faible et intermédiaire et touchent de manière disproportionnée les jeunes enfants et les femmes en âge de procréer (FAP). Malgré le fait que l'impact de l’enrichissement des aliments sur le statut en micronutriments de populations ait été démontré de manière incontestable, ce potentiel d'impact est limité dans la pratique en raison de lacunes importantes dans la conception et la mise en œuvre des programmes. Ces lacunes sont en partie liées à une collecte et une utilisation non optimale des données employées pour les prises de décision. L'objectif général de cette thèse était d'évaluer les méthodes d'évaluation de la performance et du potentiel d'impact des programmes d’enrichissement des aliments à grande échelle, et de fournir des conseils sur la prise de décision en se fondant sur des données probantes afin de favoriser la conception et la mise en œuvre efficaces de programmes. Nous avons quantifié les apports apparents en micronutriments provenant d'aliments enrichis chez les FAP dans le cadre d'enquêtes transversales auprès de ménages infranationales (Nigeria [n=1461], Afrique du Sud [n=419]) et nationales (Tanzanie [n=957], Ouganda [n=719]). De surcroît, nous avons comparé deux méthodes d'évaluation diététique simplifiées (un questionnaire sur l'acquisition et l'achat d'aliments (QAAA) et un questionnaire semi-quantitatif sur la fréquence de consommation alimentaire (SQ-FCA)) avec des rappels de 24 heures pour estimer la consommation d'aliments fortifiables chez 116 enfants (12-18 mois) et leurs mères (18-49 ans) à Mandaluyong City, aux Philippines. Enfin, nous avons appliqué le cadre analytique GRADE (en anglais Grading of Recommendations Assessment, Development, and Evaluation) de preuves à la décision pour les décisions relatives aux systèmes de santé et à la santé publique dans le cadre du programme d’enrichissement nigérian, afin d'explorer son utilité pour la prise de décision dans les programmes d’enrichissement des aliments.Dans les enquêtes auprès des ménages, nous avons constaté que, malgré un manque de rigueur en termes de mise en œuvre du programme, les aliments enrichis ont largement contribué aux apports en vitamine A et en iode, mais pas en fer, chez les FAP. Ces indicateurs ont permis d'identifier les améliorations nécessaires à apporter au programme afin de minimiser le risque d'apports faibles ou excessifs. Dans l'étude comparative, nous avons constaté que le SQ-FCA, mais pas le QAAA, a permis de récolter des informations utiles sur les habitudes de consommation d'aliments enrichissants pouvant servir à la prise de décisions relatives à la conception et au suivi des programmes d’enrichissement. La méthode QAAA doit être renforcée pour prendre en compte les aliments préparés et minimiser les sous-estimations et les surestimations. Le cadre analytique GRADE de preuves à la décision est un outil pratique pour faciliter et documenter l'utilisation des données qui servent à la prise décisions relatives au lancement, au renforcement, au maintien ou à la poursuite des programmes d’enrichissement. Cet outil pourrait aider les décideurs à renforcer les processus de prise de décision en matière d’enrichissement.Une bonne conception du programme ainsi qu’un processus continu de collecte et utilisation de données de suivi des performances tout au long du cycle du programme d’enrichissement des aliments, sont essentiels pour s'assurer que le potentiel d'impact est réalisé et que les risques sont atténués. Les résultats de cette recherche fournissent des preuves sur les outils et les méthodes appropriés pour la collecte et l'utilisation de ces données afin d'informer les processus de prise de décision politique nécessaires pour améliorer la conception du programme, sa mise en œuvre et, en fin de compte, son impact sur la santé.

The thesis examines nutritional and environmental determinants of childhood stunting in East Africa. I will examine stunting by using epidemiologic analysis of secondary data (i.e. DHS data) and the analysis of biochemical data related to micronutrient and enteropathy status. During the 2015-2016 academic year, I published three manuscripts related to stunting in Ethiopia, collected stool samples as part of a case-control study in Tanzania, and received funding to analyze these samples. Laboratory analysis will be done in November-December 2016. This research study in Tanzania will examine both the nutritional and environmental factors associated with linear growth.; La thèse examine les déterminants nutritionnels et environnementaux de retard de croissance aux enfants en Afrique de l'Est. Je vais examiner le retard de croissance en utilisant une analyse épidémiologique des données secondaires (e.g. données de DHS) et l'analyse des données biochimiques liés à micronutriments et l'état de l'entéropathie. Pendant l'année scolaire 2015-2016, j'ai publié trois manuscrits liés à un retard de croissance en Ethiopie, a recueilli des échantillons de selles dans le cadre d'une étude cas-témoins en Tanzanie, et a reçu un financement pour analyser ces échantillons. Les analyses de laboratoire se fera en Novembre-Décembre 2016. Cette étude en Tanzanie examinera à la fois les facteurs nutritionnels et environnementaux associés à la croissance linéaire.