Nutrition Intervention Strategies in National Development

Contributors

Foreword

Preface

I Nutrition Interventions in General


1. Some Elements of Successful Nutrition Intervention Strategies

Conceptualization

Commitment

Multisectorial, Visible, and Stable Infrastructure

Feedback for Program Adjustments

Needs Oriented

Community Participation

Conclusion

References


2. Nutrition Interventions: Basic Concepts

Text

Reference

II Socioeconomic Strategies


3. The Economic Effects of Early Malnutrition: Economic Considerations for Nutrition Intervention Programs

Justification for Investment in Alleviating Early Malnutrition

Resource Savings Effect

Human Capital Effect

Approaches to Study the Economic Effects of Early Malnutrition

The Case of Latin America

Conclusion

Reference


4. Socioeconomic Development and Nutritional Status: Efficiency of Intervention Programs

Text

General Comments

References


5. Integrating Nutrition into Agricultural Policy

Text

References


6. Comments on Economic Growth, Income Distribution, and Human and Social Development in Latin America

Growth, Distribution, and Poverty

Factors Determining Distributive Inequality

Magnitude and Difficulty of Redistribution

The Free Market: Does It Solve the Distributive Inequalities?

Areas of State Intervention


7. Role of the Government in Income Distribution and Nutritional Improvement: The Chilean Case

Text

Reference

III Supplementary Feeding Programs


8. Success or Failure of Supplementary Feeding Programs as a Nutritional Intervention

Supplementary Feeding Programs as Nutritional Intervention

Nature of Supplementary Feeding

Justification for Supplementary Feeding Programs

Types of Supplementary Feeding Programs

Evidence of Success in Reducing the Prevalence of Malnutrition

Conclusions

References


9. Supplementary Feeding Program in Pregnancy and Lactation: Consideration for Intervention Programs

Introduction

The Limits of Adaptation

Pregnancy and Lactation as a Continuum

Maternal Weight and Weight Gain as Indices of Risk

Does Maternal Nutrition Affect Fetal Growth?

Would Nutrition Intervention Be Expected to Increase Birth Weight?

What Else Might Be Affected? What Else Should Be Measured?

Conclusions

References


10. Supplementary Feeding during Pregnancy: Impact on Mother and Child in Bogota, Colombia

Initial Nutritional State

Actual Level of Supplementation

Impact of Supplementary Feeding during Pregnancy on Mothers and Children in Bogota

References


11. Nutrition Intervention Programs in Chile for Pregnant Women and Nursing Mothers: The Issues

Selection of Recipient Populations

Assessment of Nutritional Status

Selection of Type of Supplement

When to Supplement

Evaluation of Program Effectiveness

Supplementation during Lactation

References


12. Effectiveness of Supplementary Feeding Programs in Chile

Description of Intervention Programs with Nutritional Impact

General Comments

References


13. Comments on the Supplementary Feeding Programs in Chile

Text


14. Case Study of a National Supplementary Feeding Program: The WIC Program in the United States

Introduction

History

What WIC Does

WIC in the Future—Expansion, Stabilization, or Extinction?

Conclusion

References


15. School Feeding Programs in the Philippines

Introduction

Applied Nutrition Program (ANP)

Cooperative for American Relief Everywhere (CARE)

Catholic Relief Services (CRS)

World Food Program Assisted Project

Future Plans and Conclusions

References

IV Strategies for Treatment of Protein Energy Malnutrition


16. Rehabilitation of Protein Energy Malnutrition in Young Infants: Hospital and Community Based Programs in Chiang Mai, Thailand

Experience with Hospital Rehabilitation of Severe PEM at Chiang Mia

Fluid and Electrolyte Imbalance Therapy

Therapy for Infection

Dietary Therapy

References


17. Nutrition Recovery Centers: The Chilean Experience

General Background

The Need of a Strategy of Direct Protection to the Infant

Creation of the Chilean Nutrition Foundation (CONIN)

Recovery of the Impoverished Family

Summary

References


18. Comments on Nutrition Rehabilitation Center Programs

Text

References

V Nutrition-Infection Cycle as Related to Intervention Techniques


19. Importance of Infection and Immunity in Nutrition Intervention Programs and Priorities for Interventions

Introduction

Priorities for Interventions on the Nutrition-Infection Complex in Developing Countries

References


20. Evaluating the Health Benefits of Improved Water Supply through Assessment of Nutritional Status in Developing Countries

Introduction

Water Supply and Health Benefits

Water and Nutrition Relationships

Tubewell Water and Cholera in Rural Bangladesh

Discussion

References


21. Environmental Sanitation: A Nutrition Intervention

Introduction

Experimental Design

Evaluation of Bacterial Contamination of Feeding Bottles

Evaluation of Seasonal Diarrhea Episodes

Evaluation of Nutritional Status

Changes of Attitudes, Habits, and Quality of Life

Final Comments

References

VI Nutrient-Specific Interventions


22. Iron Deficiency: Methods to Measure Prevalence and Evaluate Interventions

Text

References


23. Prevalence of Nutritional Anemias among Pregnant Women in Chile

Prevalence of Iron Deficiency

Prevalence of Folic Acid Deficiency

Conclusion

References


24. Evaluation of Iron Status and Prevalence of Iron Deficiency in Infants in Chile

Normal Hematological Values in Infants

Prevalence of Iron Deficiency in Infants

Iron Deficiency Redefined

Conclusion

References


25. Iron Fortification: What Must Be Considered?

Text


26. Prevention of Iron Deficiency by Means of Iron Fortification of Sugar

Introduction

Background Characteristics of Central American Populations

Selection of the Iron Salt

Other Considerations

Objectives of the Fortification Study

Design of the Study

Results of 20 Months of Fortification and Discussion

References


27. Prevention of Iron Deficiency in Infants by Milk Fortification

Text

References


28. Interventions for the Prevention of Endemic Goiter

Methods of Intervention

Components of a Successful Intervention Program for Endemic Goiter

References


29 The Use of Food Fortification to Prevent Folate Deficiency

Pilot Survey of Folate Deficiency

Preliminary Trial of Folate-Fortified Maize Meal

Properties of Folic Acid Relevant to Food Fortification

Effects of Different Levels of Fortification in Pregnant Women

Target Groups for a Folate Fortification Program

The Antimegaloblastic Effect of Folate-Fortified Foods

Pilot Field Trial of Folate-Fortified Food

Possible Hazards of Food Fortification with Folate

Technological and Economic Considerations

References


30. Interventions for the Prevention of Vitamin A Deficiency: A Summary of Experiences

Events Leading to Coordinated Intervention

Selection of Intervention Strategies

Summarization of Experience in Vitamin A Interventions

Central America—Sugar Fortification

Philippines—Monosodium Glutamate

Indonesia—Monosodium Glutamate

Horticultural Approach

Combined Interventions

Summary

References

VII Nutrition Education


31. Why Teach Nutrition and to Whom?

Text

References


32. Some Problems in the Implementation and Evaluation of Food and Nutrition

Text


33. Nonformal Education: An Instrument for Nutrition Intervention Education Programs

Introduction

Conceptual Basis

Methodological Aspects

Case Study

Conclusions

References

Index