Trends and inequities in adequacy of micronutrient intakes in rural Bangladesh

Background Micronutrient deficiencies pose a significant public health challenge, yet limited evidence exists on micronutrient intakes over time in Bangladesh. Objective We assessed trends and adequacies in micronutrient intakes and examined the changes in inequities by age group, sex, and expenditure quintile. Methods We used panel data from the 2011 and 2018 Bangladesh Integrated Household Survey (n =21,475 and 21,589 household members aged ≥2y, respectively). Food consumption data were collected using a household dietary recall. Changes in micronutrient intakes were assessed using non-parametric Mann-Whitney-Wilcoxon rank sum test. Inequities in outcomes were examined using the Slope Index of Inequality and Concentration Index. Results Micronutrient intakes remained suboptimal across 2011 and 2018, with low adequacy (<0.50) for all nutrients except niacin. While vitamin A intake increased across various demographics, trends for other micronutrient intakes differed by age. Intakes improved for 10 micronutrients among children aged 2-<5y, but increased for only half of examined micronutrients among children aged 5-9y. For adolescents and adults, most micronutrient intakes slightly declined, with greater inadequacies observed among females versus males. Pregnant women experienced sharper declines in adequacy of micronutrient intakes than lactating women. The mean probability of adequacy (MPA) was low (around one-third) for all age groups with lower MPA among poorer compared to richer households across age, sex and survey years. Inequity gaps in MPA mostly declined, except for females ≥50y and pregnant women. Conclusions Micronutrient intakes and adequacies remain suboptimal and have decreased marginally over time for many nutrients and MPA across most age groups. Inequities in micronutrient intakes persist by age, sex, and income levels, disproportionately affecting the poor, adults, and women. Our study calls for evidence-based policies and programs that incorporate a range of proven approaches and tailored solutions to effectively tackle persisting inequities and ensure access to healthy diets for all.

Diets, fruit and vegetables consumption, and nutritional status in Benin: A scoping review

Unhealthy diets, including low fruit and vegetables (F&V) intake, contribute to morbidity and mortality related to non-communicable diseases. Designing culturally appropriate interventions to improve diets and F&V intake requires an in-depth understanding of individual-level dietary patterns, household consumption patterns, and nutritional status resulting from inadequate F&V intake. In this scoping review, we summarised the literature on diets, F&V intake, and nutritional status in Benin. We searched PubMed from 2012 to August 2024 to identify articles on diets and nutritional status, and from 2002 to August 2024 to identify articles on F&V intake. We included 36 articles on diets, 27 on F&V intake, and 16 on nutritional status. Existing literature demonstrated that Beninese diets are cereal-based and monotonous, characterised by low diversity and low F&V intake across all population groups. Available evidence indicated a high burden of undernutrition in children <5 years of age, a rising prevalence of overnutrition in women of reproductive age, and a high prevalence of overnutrition in adults. Evidence on how diets and F&V intake vary by urban/rural location, season, and socioeconomic characteristics was limited and inconsistent. Two evaluations of garden irrigation programmes assessed impacts on women's dietary diversity and F&V consumption. Additional research is needed to improve our understanding of diets, F&V intake, and diet-related nutritional challenges and how they evolve over time and across different population groups. Understanding these gaps can help identify entry points and targets for interventions to improve diet quality and F&V intake in Benin.

Rethinking responses to the world’s water crises