Nutrition

Adjustment for energy intake in nutritional research: a causal inference perspective

1 month ago   |   By American Journal of Clinical Nutrition

AbstractBackgroundFour models are commonly used to adjust for energy intake when estimating the causal effect of a dietary component on an outcome; 1) the “standard model” adjusts for total energy intake, 2) the “energy partition model” adjusts for remaining energy intake, 3) the “nutrient density model” rescales the exposure as a proportion of total energy, and 4) the “residual model” indirectly adjusts for total energy by using a residual. It remains underappreciated that each approach evaluates a different estimand and only partially accounts for confounding by common dietary...
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Perspective: When the cure might become the malady: the layering of multiple interventions with mandatory micronutrient fortification of foods in India

1 month ago   |   By American Journal of Clinical Nutrition

ABSTRACTWhen public health programs with single nutrients are perceived to have a poor impact on the target health outcome, the policy response can be to supply more, by layering additional mandatory programs upon the extant programs. However, we argue for extreme caution, because nutrients are beneficial in the right dose, but potentially harmful when ingested in excess. Unnecessary motivations for the reactionary layering of multiple intervention programs emerge from incorrect measurements of the risk of nutrient inadequacy in the population, or incorrect biomarker cutoffs to evaluate...
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Impact of scaling up prenatal nutrition interventions on human capital outcomes in low- and middle-income countries: a modeling analysis

1 month ago   |   By American Journal of Clinical Nutrition

ABSTRACTBackgroundPrenatal nutrition interventions can lead to improved birth outcomes, which in turn are associated with better education and human capital outcomes later in life.ObjectiveWe estimated the impact of scaling up iron-folic acid , calcium, multiple micronutrient , and balanced energy protein supplementation for pregnant women, on human capital outcomes in low- and middle-income countries .MethodsWe used mathematical modeling with proportional reductions in adverse birth outcomes to estimate the potential gains in school years and lifetime income due to scaling up each...
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