Results of The Sackler Institute for Nutrition Science Research Award Call for Proposals 2017
Dr. Joaquin Barnoya, Washington University, St Louis
The effect of occupations and school attendance on rural adolescent girls' nutritional status in Guatemala: a mixed methods study
Obesity rates are increasing among women in Latin America. More than half (52%) of Guatemalan women are overweight and rates are higher among adolescent girls from low-socioeconomic status (SES)1. In order to design effective obesity prevention strategies among adolescent girls, it is important to understand the risk factors.
Guatemala is one of the most unequal countries worldwide. Poverty is more prevalent in rural areas and income inequality is high, especially among women. While in urban areas, school attendance is relatively high (74.9%), in rural areas it can be as low as 42.8%. In addition, 23% of children and adolescents are employed. Compared to adolescent boys (32.1%) girls, are less likely to be enrolled in school (20.7%) and less likely to work. Instead, adolescent girls are more likely to perform household chores and care for younger siblings2. Increasing school access and quality for girls in rural areas remain important challenges in Guatemala.
School absenteeism and lower educational attainment are positively associated with adolescent poor nutritional status and household food insecurity3. However, the school environment in Guatemala does not foster a nutritionally adequate environment4 and facilities for physical activity are less than optimal and prioritized for boys5. To the best of our knowledge, there is no study in Guatemala to examine association between nutritional status and occupation in rural adolescent girls. With this study, we seek to inform future interventions to reduce disparity and improve nutritional status among rural adolescents in Guatemala.
Dr. Kathryn Dewey, University of California at Davis
Effects of a pre- and postnatal nutritional intervention among pregnant Bangladeshi adolescents on growth, development and morbidity of their infants during the first two years of life
We examined the birth outcomes of pregnant Bangladeshi adolescent women in the Rang Din Nutrition Study (RDNS) in the first phase of our Sackler-funded work. In addition to the birth outcomes, we have extensive data on growth, development and morbidity of the children at 18-24 months, and we now propose to examine these outcomes within the subgroup of adolescent mothers. In the RDNS, there were only two groups during pregnancy and the first 6 months postpartum (maternal lipid-based nutrient supplement [LNS] vs iron and folic acid [IFA]), but at 6-24 months postpartum there were four groups, with about 1000 mother-infant pairs in each group in the total sample (~40% of whom were adolescents). In the maternal LNS group, the infants received child LNS from 6 to 24 months. The maternal IFA group became three groups: a) maternal IFA + child LNS from 6 to 24 months; b) maternal IFA + child micronutrient powder from 6 to 24 months; and c) maternal IFA + no child supplement (Control group). We have shown that in the overall sample provision of pre- and postnatal LNS increased children’s linear growth and head circumference at 24 months and reduced stunting at 18 months, compared to children who received no supplement (Dewey et al 2017), and that all three interventions (pre- and postnatal LNS, postnatal LNS and postnatal MNP) had beneficial effects on motor and language development (Matias et al 2017). For these proposed analyses we would compare infant growth, development and morbidity across all four groups, within the subset of adolescent mothers. Given that the effect of maternal LNS on birth outcomes was greatest in the adolescent mothers (Mridha et al 2016), we expect that we may find a similar pattern with regard to later child outcomes.
Dr. Sophie Goudet, Loughborough University
Impact of garment work on food security among young women in poor urban areas, Yangon, Myanmar
The research will be conducted by the lead researcher in partnership with potential organisations such as the World Food Programme (WFP), the United Nations Children's Fund (UNICEF) and/or the International Labour Organisation (ILO). These organizations have conducted assessment in urban areas of Myanmar which informed the design of the proposed research. WFP and UNICEF conducted appraisal work in 2014 to explore qualitatively the food security situation and its related factors (economic, social, and political) in urban areas (WFP 2014 unpublished) and was complemented in 2016 by a review of existing evidence of food security and undernutrition in poor urban communities done by the lead researcher (WFP / UNICEF 2016 unpublished). ILO Yangon has conducted a rapid assessment of the child labour situation in an industrial area of Yangon (Hlang Thayar) (ILO 2015) and has been pursuing other projects aiming to empower women in Myanmar by improving labour relations, social dialogue and gender equality in the garment industry. While this work provides a rich contextual framework of the urban poor, food security issues related to garment work was so far underexplored.
The study uses a mixed method approach and it is expected to generate robust evidence on critical issues related to food security and nutrition related to garment work in this vulnerable group of young women and inform policy recommendations related to food security and productivity.
Dr. Paul Hewett, The Population Council
Assessment of the impact of schooling, household work and employment on nutrition outcomes of adolescent girls and young women and their children in Zambia
The study will use a prospective cohort of urban and rural Zambian adolescent girls aged 10–19 in 2013 who were followed annually for four years. The information on adolescents, and their children, was collected as part of a rigorous cluster-randomized evaluation of a DFID-funded, nutrition-sensitive, adolescent girls’ empowerment intervention conducted between 2013-2015. The primary objective of the intervention was to empower vulnerable adolescent girls by providing them social, health and economic assets to be drawn upon to reduce vulnerabilities and expand opportunities and improve their nutritional and general health. At the core of the program were mentor-led, weekly girls’ group meetings conducted over the course of two years. Three curricula were used to guide discussions in the meetings, specifically: 1) health and life skills, 2) financial education, and 3) a nutritional curriculum tailored for adolescent girls. The weekly girls’ group meetings were complemented by two additional components: 1) a health voucher to enhance access to sexual and reproductive health services and 2) a bank account to provide girls’ access to formal savings mechanisms.
Dr. Whitney Schott, University of Pennsylvania
Dietary and Weight-Related Behaviors, Overweight, and Dietary Diversity by Employment Status Among Peruvian Young Women
In this study we aim to characterize key weight-related behaviors (e.g., consumption of sugary beverages and “junk” foods, physical activity, time spent sitting), overweight status, and dietary diversity within the context of categories of varying occupational status (e.g., student, working for wages, agricultural work, or work-student combination), time use (e.g. time spent on domestic chores and caregiving behaviors, for example), and food environments (e.g. availability, affordability and reliance on pre-packaged or pre-prepared and high-caloric foods versus healthy, nutritional alternatives), and how these relations may differ by sex and urban versus rural residence.
We also aim to assess how weight-related behaviors, overweight status, and dietary diversity changes relate to changes in occupational status (for example, dropping out of school, or entering into wage-employment from school), and how these relations may differ by sex and by urban versus rural residence.
Dr. Andrew Thorne-Lyman, Johns Hopkins University
Does adolescent dietary quality vary by occupation and time use in South Asia? A study of 30,000 pubescent children in rural Bangladesh
This study will analyze data collected repeatedly throughout a 12-month period in a rural population-based sample of »30,000 8-14 year olds living in an area of rural northwest Bangladesh. Recognizing that work activities, schooling and time use, and diet are all likely to exhibit seasonal patterns, data was collected on these topics following standardized procedures by the same cadre of trained staff during three main (post-monsoon/early dry; cool-warm dry; and late dry/early-mid monsoon) seasons of Bangladesh.
As they age, we hypothesize that adolescents will increasingly spend time engaged in work activities (initially non-formal then formal), and that their diets will increasingly include snack foods as they spend more time away from their households for school and for work. We expect to see gender differences emerge for occupational engagement, with girls more focused on domestic unpaid household work and boys increasingly seeking work outside the home, perhaps seasonally, for pay as they get older. We hypothesize that household food security and socioeconomic status will likely mediate activity patterns, such that poor/food insecure adolescents will tend to have poorer diets (possibly lacking both diversity and higher in junk food) and more likely to engage in work outside the house, possible on a seasonal basis when casual laborers are hired for agriculture.
Scientific Advisory Group
Dr. Zulfiqar Bhutta
The Hospital For Sick Children, Toronto
Dr. Ann Blanc
The Population Council
Dr. Robert Black
Johns Hopkins University
Dr. Inge D. Brouwer
Dr. Satvika Chavasani
Dr. Sara Elder
Dr. Lynnda Kiess
The World Food Program
Dr. Marie Ruel