Olney DK et al. · Jul 1, 2026
Improving diets can improve nutrition and health outcomes. In this supplement, evidence from five low-and-middle-income countries on the country specific dietary (including F&V) intake patterns, nutrition issues and evaluated solutions to improve diets across population groups is presented. Based on this evidence, the final paper offers perspectives and future priorities.
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Herrera-González A et al. · Jul 1, 2026
Context Obesity and micronutrient deficiencies in the pediatric population of Mexico pose significant public health challenges. However, the relationship between these two conditions is still being studied. Objective To systematically review evidence on the association between overweight and obesity and micronutrient deficiencies among Mexican children and adolescents. Data sources A systematic search was conducted in 13 databases and one search engine. Data analysis Sixteen studies met the eligibility criteria and were included in this review. A total of 20 043 participants were included across the included studies, and the results were highly varied, as not all micronutrients showed a significant deficit in the presence of obesity. Calcium, phosphorus, magnesium, and vitamin E deficiencies were noted among participants with obesity; however, these did not significantly differ from those of individuals with normal weight. Current evidence suggests that Mexican children who have overweight or obesity are more likely to have zinc, iron, and vitamins D and B6 deficiency. A random-effects meta-analysis of 4 studies showed that children who have overweight or obesity were significantly more likely to have a deficit of vitamin D (odds ratio [OR], 1.84; 95% CI, 1.46-2.32), which was stronger for school-aged children (OR, 1.99; 95% CI, 1.56-2.55). Conclusion Current evidence suggests that Mexican children and adolescents who have overweight or obesity are more likely to experience vitamin D deficiency, and some evidence suggests that they are also prone to zinc, iron, and vitamin B6 deficiencies. For this reason, health-promotion and -prevention efforts must be comprehensive and address micronutrient deficiencies, common risk factors, and broader social determinants linked to noncommunicable diseases. Systematic review registration PROSPERO registration no. CRD42019154132.
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Martin-Cañavate R et al. · Jul 1, 2026
Stunting remains highly prevalent in Angola. Multisectoral interventions are essential to prevent this public health issue, and while economic evaluations have assessed the costs and consequences of these interventions, they have largely overlooked costs incurred by participants. The MuCCUA trial evaluates the cost-effectiveness of three interventions to prevent stunting during the first 1000 days: standard of care (SOC), SOC plus nutritional supplementation (SOC + NS), and SOC plus cash transfers (SOC + CT). This study aimed to estimate participants' opportunity costs and to explore women's experiences. After 12 months of implementation, data were collected from participant women through focus group discussions, interviews and questionnaires on travel and waiting times, and transport costs for attending health posts and community sessions in the SOC arm, and for quarterly distribution visits in the SOC + NS and SOC + CT arms. Total opportunity costs per participant were estimated by intervention arm and community category (close/far from services and/or distribution points). The total opportunity cost of participants over 1 year were US$9373.91 for SOC, US$16,142.09 for SOC + NS and US$18,231.38 for SOC + CT, corresponding to US$1.69, US$2.80 and US$3.17 per participant per month respectively. Value of travel and waiting times accounted for 75%-85% of opportunity costs, with women in remote villages facing substantially higher burdens. These findings highlight the importance of accounting for opportunity costs, especially time and geographic accessibility, when designing maternal and child health and nutrition interventions. Incorporating a societal perspective in economic evaluations is essential to capture unintended participant burdens and promote equitable, effective participation. Trial Registration: NCT05571280. Registered 7 October 2022.
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Worku M et al. · Jul 1, 2026
Ethiopia has one of the highest rates of undernutrition among children under five (U5) and women of reproductive age (WRA) globally, alongside rising overweight/obesity, particularly in urban areas. Poor diet is a shared driver of multiple forms of malnutrition. We used a participatory photography (Photovoice) approach to explore the lived experiences of WRA and their children U5 in adopting healthy diets across lower- and higher- socio-economic status (SES) groups in Addis Ababa. Women took photographs illustrating challenges to healthy diets, and five focus groups (n = 31 women) were conducted to discuss challenges and solutions, with separate sessions held for different SES groups. A hybrid thematic analysis, combining deductive and inductive approaches, identified themes/subthemes, with comparisons across SES groups. Financial and physical barriers to accessing healthy foods, time constraints and perceived poor food safety were major contributors to poor diets. In lower SES groups, women also reported limited knowledge about healthy diets, inadequate family support and poor home food environments. In higher SES groups, unhealthy food preferences coupled with easy access to and aggressive promotion of unhealthy foods were key challenges. Proposed government-level solutions included job creation, nutrition education, affordable healthy food, investment in household infrastructure, expanded childcare and restrictions on unhealthy food availability and promotion. Societal-level solutions included gender equality, strengthened community-based loan schemes and support for urban agriculture. These findings highlight that women recognise their needs and who should support them, and emphasise the importance of including women's voices in decision-making processes. Findings also underscore the need for integrated interventions targeting individual, food environment and socio-economic drivers to improve diets among women and children in urban Ethiopia.
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