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We argue that the research agenda should embrace the whole nutritional contribution of the multiple dietary components of cereals towards addressing the triple burden of undernutrition, micronutrient malnutrition, overweight/obesity and non-communicable diseases. Agri-nutrition and development communities need to adopt a multidisciplinary and food systems research approach from farm to metabolism. Agriculture researchers should collaborate with other food systems stakeholders on nutrition-related challenges in cereal production, processing and manufacturing, and food waste and losses. Cereal and food scientists should also collaborate with social scientists to better understand the impacts on diets of the political economy of the food industry, and the diverse factors which influence local and global dietary transitions, consumer behavioural choices, dietary change, and the assessment and acceptance of novel and nutritious cereal-based products.
ကုန်စည်အမျိုးအစားအားလံုးအား လွပ်လပ်စွာ စီးဆင်းခွင့ ်ေပးြခင်း- တည် ငိမ်ေသာ အစားအစာစိုက်ပျိုးထုတ်လုပ် ေရးစနစ်သည် အစားအစာအမျိုးအမည်အစံု (အနည်းလိုအာဟာရများ ကယ်ဝသည့် သစ်သီးဝလံများ၊ ဟင်းသီး ဟင်းရွက်များ၊ တိရစ ာန်များမှရေသာ အစားအစာများ အပါအဝင်) ှင့ ်အတူ မ ှိမြဖစ်လိုအပ်ေသာ စားစရာမဟုတ်သည့်ကုန်စည်များပါ လွပ်လပ်စွာ စီးဆင်းမ ှိေစရန် လိုအပ်ပါသည်။ ြပဿနာများေပါ်ေပါက်လာပါက ၎င်းတိုကိုေြဖ ှင်း ိုင်ရန် အစားအစာေစျးကွက်များ ှင ့ ့ ် တန်ဖိုးကွင်းဆက်များကို ြဖစ် ိုင်သမ နီးကပ်စွာ ေစာင့ ် ကည့်ြခင်း ြမန်မာ ိုင်ငံအတွင်း ှိ အစားအစာေရာင်းချသည့်ေစျးများတွင် သန် ှင်းမ ကိုြမ ့ င့ ်တင်ြခင်းြဖင့ ် COVID-19ပျံ ှံ ိုင်မ အ ရာယ်ကို ့ ေလ ာချ ့ ြခင်း ကုန်စည်စီးဆင်းမ ကို မတားဆီးေစရန် ရဲ၊စစ်တပ် ှင့ ်အြခားေဒသအာဏာပိုင်များသို ှင်းလင်းေသာ န် ကားချက်များ ထု ့ တ်ြပန် ထားြခင်း ြမန်မာအစိုးရသည် ဤ ပ်ေထွးေသာ ကျန်းမာေရး ှင့ ်လူမ စီးပွားေရးအကျပ်အတည်းကာလတေလ ာက် အချိန်တိုင်းတွင် အေြခခံအစားအစာ ှင့ ်အာဟာရဖူလံုမ ကို ထိန်းသိမ်းရမည်ြဖစ်ေ ကာင်း အိ ိယ ှင့ ်အြခားဖွံ ဖိုးဆဲ ိုင်ငံများ၏ အမှားအယွင်းများမှ သင်ခန်းစာရယူသင့ ်ပါသည်။
Through an analysis of 89 studies, identified through a systematic search, on rural areas of low and middle-income countries, we observe three findings. First, women play a key role in agriculture, as reflected in their time commitments. Second, evidence from a very limited set of studies suggests that agricultural interventions tend to increase time commitments in agriculture of the household members for whom impact is measured. Third, while changing time use tends to change nutritional outcomes, it does so in a range of complex ways and there is no agreement on the impact. Nutritional impacts are varied because households and household members respond to increased time burden and workload in different ways.
Methods Adherence data were collected prospectively from a double blind randomized controlled trial in rural Vietnam. Five thousand eleven women of reproductive age were randomized to receive preconception supplements for weekly consumption containing either: Folic Acid, Iron and Folic Acid (IFA), or Multiple Micronutrients. Women who became pregnant received prenatal IFA supplements for daily consumption through delivery. Village health workers visited participants’ homes every two weeks to deliver supplements and record consumption and side effects. Multivariate logistic regression was used to assess individual, household, and programmatic predictors of supplement adherence.
Results Adherence was high with 78 and 82% of the women consuming more than 80% of the preconception and prenatal supplements, respectively. Women of minority ethnicity (OR = 0.78 95% CI = 0.67, 0.91) and farmers (OR = 0.71 95% CI = 0.58, 0.88) were less likely to consume >80% of the preconception supplements while socioeconomic status (SES) (OR = 2.71 highest vs. lowest quintile; 95% CI = 2.10, 3.52) was positively associated with >80% adherence in the entire preconception sample with available information (n = 4417). Women in their first pregnancy had lower prenatal adherence compared to multiparous women. At the programmatic level, each village health worker visit was associated with higher odds of >80% adherence by 3–5% before pregnancy and 18% during pregnancy.
Conclusions Key determinants of adherence included SES, ethnicity, occupation (farmer) and parity which may be helpful for targeting women for counseling on supplement adherence. Increased contact with village health workers was positively associated with adherence to micronutrient supplementation both before conception and during pregnancy indicating the need for resources to support community outreach to women of reproductive age.
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