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2013

Grillenberger, M; Murphy, SP; BNO, Neumann CG;, Neumann CG;, Bwibo NO.  2013.  High prevalence of inadequate iron intake in rural Kenyan school children.
Neumann, CG, Jiang L, Weiss RE, Grillenberger M, Gewa CA, Siekmann JH, Murphy SP, Bwibo NO.  2013.  Meat supplementation increases arm muscle area in Kenyan schoolchildren., 2013 Apr. The British journal of nutrition. 109(7):1230-40. Abstractmeat_supplementation_increases_arm_muscle_area_in_kenyan_schoolchildren.pdf

The present study examines the effect of animal-source-food (ASF) intake on arm muscle area growth as part of a larger study examining causal links between ASF intake, growth rate, physical activity, cognitive function and micronutrient status in Kenyan schoolchildren. This randomised, controlled feeding intervention study was designed with three isoenergetic feeding interventions of meat, milk, and plain traditional vegetable stew (githeri), and a control group receiving no snack. A total of twelve elementary schools were randomly assigned to interventions, with three schools per group, and two cohorts of 518 and 392 schoolchildren were enrolled 1 year apart. Children in each cohort were given feedings at school and studied for three school terms per year over 2 years, a total of 9 months per year: cohort I from 1998 to 2000 and cohort II from 1999 to 2001. Food intake was assessed by 24 h recall every 1-2 months and biochemical analysis for micronutrient status conducted annually (in cohort I only). Anthropometric measurements included height, weight, triceps skinfold (TSF) and mid-upper-arm circumference (MUAC). Mid-upper-arm muscle area (MAMA) and mid-upper-arm fat area (MAFA) were calculated. The two cohorts were combined for analyses. The meat group showed the steepest rates of gain in MUAC and MAMA over time, and the milk group showed the next largest significant MUAC and MAMA gain compared with the plain githeri and control groups (P< 0·05). The meat group showed the least increase in TSF and MAFA of all groups. These findings have implications for increasing micronutrient intake and lean body mass in primary schoolchildren consuming vegetarian diets.

Neumann, CG, Bwibo NO, Jiang L, Weiss RE.  2013.  School snacks decrease morbidity in Kenyan schoolchildren: a cluster randomized, controlled feeding intervention trial., 2013 Mar 28. Public health nutrition. :1-12. Abstractschool_snacks_decrease_morbidity_in_kenyan_schoolchildren.pdf

OBJECTIVE: To examine the effects of three different school snacks on morbidity outcomes. DESIGN: Twelve schools were randomized to either one of three feeding groups or a Control group. There were three schools per group in this cluster randomized trial. Children in feeding group schools received school snacks of a local plant-based dish, githeri, with meat, milk or extra oil added. The oil used was later found to be fortified with retinol. Physical status, food intake and morbidity outcomes were assessed longitudinally over two years. SETTING: Rural Embu District, Kenya, an area with high prevalence of vitamin A deficiency. SUBJECTS: Standard 1 schoolchildren (n 902; analytic sample) enrolled in two cohorts from the same schools one year apart. RESULTS: The Meat and Plain Githeri (i.e. githeri + oil) groups showed the greatest declines in the probability of a morbidity outcome (PMO) for total and severe illnesses, malaria, poor appetite, reduced activity, fever and chills. The Meat group showed significantly greater declines in PMO for gastroenteritis (mainly diarrhoea) and typhoid compared with the Control group, for jaundice compared with the Plain Githeri group, and for skin infection compared with the Milk group. The Milk group showed the greatest decline in PMO for upper respiratory infection. For nearly all morbidity outcomes the Control group had the highest PMO and the least decline over time. CONCLUSIONS: The intervention study showed beneficial effects of both animal-source foods and of vitamin A-fortified oil on morbidity status.

2012

Long, JK, Murphy SP, Weiss RE, Nyerere S, Bwibo NO, Neumann CG.  2012.  Meat and milk intakes and toddler growth: a comparison feeding intervention of animal-source foods in rural Kenya., 2012 Jun. Public health nutrition. 15(6):1100-7. AbstractMeat and milk intakes and toddler growth

To examine the effects of animal-source foods on toddler growth.

2011

Omwami, EM, Neumann C, Bwibo NO.  2011.  Effects of a school feeding intervention on school attendance rates among elementary schoolchildren in rural Kenya., 2011 Feb. Nutrition (Burbank, Los Angeles County, Calif.). 27(2):188-93. Abstracteffects_of_a_school_feeding_intervention.pdf

A randomized controlled school feeding intervention offered an opportunity to determine whether school feeding resulted in improved school attendance among elementary schoolchildren in a rural district of Kenya.

2009

Gewa, CA, Weiss RE, Bwibo NO, Whaley S, Sigman M, Murphy SP, Harrison G, Neumann CG.  2009.  Dietary micronutrients are associated with higher cognitive function gains among primary school children in rural Kenya., 2009 May. The British journal of nutrition. 101(9):1378-87. Abstractdietary_micronutrients.pdf

With the exception of iodine and Fe, there is still very limited information on the effect of micronutrients on cognitive function, especially among school-age children. The present analysis evaluates the relationship between dietary Fe, Zn and B vitamins (B12, B6, folate and riboflavin) and gains in cognitive test scores among school children in rural Kenya. Data for the present study were obtained from The Child Nutrition Kenya Project, a 2-year longitudinal, randomised controlled feeding intervention study using animal source foods. Dietary nutrient values were based on monthly and bimonthly 24 h recall data collected during the study period. In longitudinal regression analyses, available Fe, available Zn, vitamin B12 and riboflavin showed significant relationships with improved cognitive test scores, after controlling for confounders such as energy intake, school, socio-economic status and morbidity. Available Fe intake was associated with significantly higher gains in Raven's Coloured Progressive Matrices test scores over time. Available Zn intake was associated with significantly higher gains in digit span-total test scores over time, while vitamin B12 and riboflavin intakes were each associated with significantly higher gains in digit span-forward test scores over time. This analysis demonstrates the influence of improved dietary micronutrient status on school children's cognitive function.

2008

Neumann, CG, Bwibo NO, Siekmann JH, McLean ED, Browdy B, Drorbaugh N.  2008.  Comparison of blood smear microscopy to a rapid diagnostic test for in-vitro testing for P. falciparum malaria in Kenyan school children. Abstractcomparison_of_blood_smear_microscopy.pdfWebsite

OBJECTIVE:
To compare the diagnostic performance of microscopy using Giemsa-stained thick and thin blood smears to a rapid malaria dipstick test (RDT) in detecting P. falciparum malaria in Kenyan school children.
DESIGN:
Randomised, controlled feeding intervention trial from 1998-2001.
SETTING:
Rural Embu district, Kenya. The area is considered endemic for malaria, with four rainy seasons per year. Chloroquine resistance was estimated in 80% of patients. Children had a spleen rate of 45%.
SUBJECTS:
A sample of 515 rural Kenyan primary school children, aged 7-11 years, who were enrolled in a feeding intervention trial from 1998-2001.
MAIN OUTCOME MEASURES:
Percent positive and negative P. falciparum malaria status, sensitivity, specificity and positive and negative predictive values of RDT
RESULTS:
For both years, the RDT yielded positive results of 30% in children compared to microscopy (17%). With microscopy as the "gold standard", RDT yielded a sensitivity of 81.3% in 1998 and 79.3% in 2000. Specificity was 81.6% in 1998 and 78.3% in 2000. Positive predictive value was 47.3% in 1998 and 42.6% in 2000, and negative predictive value was 95.6% in 1998 and 94.9% in 2000.
CONCLUSION:
Rapid diagnostic testing is a valuable tool for diagnosis and can shorten the interval for starting treatment, particularly where microscopy may not be feasible due to resource and distance limitations

O, PROFBWIBONIMROD.  2008.  Dietary micronutrients are associated with higher cognitive function gains among primary school children in rural Kenya. Gewa CA, Weiss RE, Bwibo NO, Whaley S, Sigman M, Murphy SP, Harrison G, Neumann CG.Br J Nutr. 2008 Sep 30:1-10. [Epub ahead of print]. Br J Nutr. 2008 Sep 30:1-10. [Epub ahead of print]. : Anim. Hlth. Prod. Afr. 2008 AbstractDietary micronutrients.pdf

With the exception of iodine and Fe, there is still very limited information on the effect of micronutrients on cognitive function, especially among school-age children. The present analysis evaluates the relationship between dietary Fe, Zn and B vitamins (B12, B6, folate and riboflavin) and gains in cognitive test scores among school children in rural Kenya. Data for the present study were obtained from The Child Nutrition Kenya Project, a 2-year longitudinal, randomised controlled feeding intervention study using animal source foods. Dietary nutrient values were based on monthly and bimonthly 24 h recall data collected during the study period. In longitudinal regression analyses, available Fe, available Zn, vitamin B12 and riboflavin showed significant relationships with improved cognitive test scores, after controlling for confounders such as energy intake, school, socio-economic status and morbidity. Available Fe intake was associated with significantly higher gains in Raven's Coloured Progressive Matrices test scores over time. Available Zn intake was associated with significantly higher gains in digit span-total test scores over time, while vitamin B12 and riboflavin intakes were each associated with significantly higher gains in digit span-forward test scores over time. This analysis demonstrates the influence of improved dietary micronutrient status on school children's cognitive function.

2007

O, PROFBWIBONIMROD.  2007.  Designing snacks to address micronutrient deficiencies in rural Kenyan schoolchildren. J Nutr . 2007 Apr; 137 ( 4 ): 1093-6 . Review. PMID: 17374685 [PubMed - indexed for MEDLINE] Murphy SP, Gewa C, Grillenberger M, Bwibo NO, Neumann CG.. J Nutr . 2007 Apr; 137 ( 4 ): 1093-6 . Review. PMID: 17374685 [PubMed - indexed for MEDLINE]. : Anim. Hlth. Prod. Afr. 2008 Abstractdesigning_snacks_to_address_micronutrient.pdf

University of Hawaii, Honolulu, HI 96813, USA. suzanne@crch.hawaii.edu

Three snacks were designed to improve nutrient intakes among school-age children living in rural Kenya. Snacks containing animal-source foods (milk and meat) provided more nutrients than an equicaloric vegetarian snack. The vegetarian snack provided extra vitamin A (primarily from fortified cooking fat; the milk snack was rich in calcium, vitamin A, and vitamin B-12; and the meat snack supplied vitamin B-12, iron, and zinc. When changes in intakes from baseline to the feeding period were compared across the 4 groups, total energy intake increased the most for children in the meat group and the least for children in the control group. Differences in energy intakes across the 3 feeding groups were primarily caused by decreases in home intake for the vegetarian and milk snack groups. It is important to evaluate the change in home intakes as well as intakes from the foods provided by the study when evaluating the effect of feeding programs on nutrient adequacy.

PMID: 17374685 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD.  2007.  Low plasma vitamin B-12 in Kenyan school children is highly prevalent and improved by supplemental animal source foods. J Nutr . 2007 Mar; 137 ( 3 ): 676-82 . PMID: 17311959 [PubMed - indexed for MEDLINE] McLean ED, Allen LH, Neumann CG, Peerson JM, Siekm. J Nutr . 2007 Mar; 137 ( 3 ): 676-82 .. : Anim. Hlth. Prod. Afr. 2008 Abstractlow_plasma_vitamin_b-12.pdf

Department of Nutritional Biology, University of California, Davis, CA 95616, USA.

The high prevalence of vitamin B-12 deficiency in many regions of the world is becoming recognized as a widespread public health problem, but it is not known to what extent this deficiency results from a low intake of the vitamin or from its malabsorption from food. In rural Kenya, where a previous study identified a high prevalence of inadequate vitamin B-12 intakes, this study examined whether plasma vitamin B-12 concentrations were associated with dietary sources of the vitamin at baseline and could be increased by supplementation with animal source foods (ASF). The 4 experimental groups in 503 school children were: 1) control (no food provided); 2) githeri (a maize and bean staple with added oil); 3) githeri + meat (githeri + minced beef); or 4) githeri + milk (githeri + milk). Feedings were isocaloric. Dietary data were collected at baseline, and biochemical data at baseline and after 1 and 2 y of feeding. Baseline plasma vitamin B-12 concentration was 193.6 +/- 105.3 pmol/L and correlated with % energy from ASF (r = 0.308, P < 0.001). The odds ratio for low plasma vitamin B-12 (<148 pmol/L), which occurred in 40% of children, was 6.28 [95% CI: 3.07-12.82] for the lowest vs. highest ASF intake tertile (P < 0.001). Feeding ASF (meat or milk) greatly reduced the prevalence of low plasma vitamin B-12 (P < 0.001). The high prevalence of low plasma vitamin B-12 concentrations in these children is predicted by a low intake of ASF, and supplemental ASF improves vitamin B-12 status.

PMID: 17311959 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD.  2007.  The potential of increased meat intake to improve iron nutrition in rural Kenyan schoolchildren. Int J Vitam Nutr Res . 2007 May; 77 ( 3 ): 193-8 . PMID: 18214020 [PubMed - indexed for MEDLINE] Grillenberger M, Murphy SP, Neumann CG, Bwibo NO, Verhoef H,. Int J Vitam Nutr Res . 2007 May; 77 ( 3 ): 193-8 .. : Anim. Hlth. Prod. Afr. 2008 Abstractthe_potential_of_increased_meat_intake_to_improve_iron_nutrition.pdf

Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.

Schoolchildren in developing countries often have inadequate intakes of iron, due primarily to poor bioavailability. Increasing meat in the diet could improve both the amount of iron consumed and its availability. The effect of increases in intakes of meat and ascorbic acid on absorbed iron was investigated by theoretically modifying the habitual diet of rural Kenyan schoolchildren. The projected changes in the amount of absorbed iron and prevalence of inadequate iron intakes were calculated for 78 children (6-9 years of age). The prevalence of inadequate iron intakes decreased from 77% to 54% through the theoretical addition of 50 g beef or 100 mg ascorbic acid and to 23% through the addition of both to dinner each day. To reduce the prevalence of inadequate iron intake to 5%, the addition of 100 g meat plus 150 mg ascorbic acid would be necessary. The combined addition of meat and ascorbic acid to a meal has the potential to reduce the projected prevalence of inadequate iron intakes among these schoolchildren.

PMID: 18214020 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD.  2007.  Meat supplementation improves growth, cognitive, and behavioral outcomes in Kenyan children. J Nutr . 2007 Apr; 137 ( 4 ): 1119-23 . PMID: 17374691 [PubMed - indexed for MEDLINE] Neumann CG, Murphy SP, Gewa C, Grillenberger M, Bwibo NO.. J Nutr . 2007 Apr; 137 ( 4 ): 1119-23 .. : Anim. Hlth. Prod. Afr. 2008 Abstractmeat_supplementation_improves_growth.pdf

Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, CA 90095, USA. cneumann@mednet.ucla.edu

A randomized, controlled school feeding study was conducted in rural Embu District, Kenya to test for a causal link between animal-source food intake and changes in micronutrient nutrition and growth, cognitive, and behavioral outcomes. Twelve primary schools were randomly assigned to 1 of 4 groups. Children in Standard I classes received the local plant-based dish githeri as a midmorning school snack supplemented with meat, milk, or fat added to equalize energy content in all feedings. The Control children received no feedings but participated in data collection. Main outcome measures assessed at baseline and longitudinally were 24-h food intake recall, anthropometry, cognitive function, physical activity, and behaviors during school free play. For cognitive function, the Meat group showed the steepest rate of increase on Raven's Progressive Matrices scores and in zone-wide school end-term total and arithmetic test scores. The Plain githeri and Meat groups performed better over time than the Milk and Control groups (P < 0.02-0.03) on arithmetic tests. The Meat group showed the greatest increase in percentage time in high levels of physical activity and in initiative and leadership behaviors compared with all other groups. For growth, in the Milk group only younger and stunted children showed a greater rate of gain in height. The Meat group showed near doubling of upper midarm muscle area, and the Milk group a smaller degree of increase. This is the first randomized, controlled feeding study to examine the effect of meat- vs. milk- vs. plant-based snacks on functional outcomes in children.

PMID: 17374691 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD, N PROFWEREFREDRICK.  2007.  Neonatal nutrition and later outcomes of very low birth weight infants at Kenyatta national hospital Afr Health Sci. 2007 June; 7 (2) : 108. Afr Health Sci. : Anim. Hlth. Prod. Afr. 2008 Abstractneonatal_nutrition.pdf

Extensive research in developed countries has established that very low birth weight (VLBW) infants are particularly vulnerable to the effects of early nutritional deficiencies. There is, however, little information from poor countries on the long-term effects of these deficiencies in such infants.

Determine the association between neonatal feeding regimens and post-discharge morbidity/ mortality and neurological abnormalities at the age of two years for a cohort of VLBW infants.

One hundred and seventy five VLBW infants were recruited over a consecutive period of one year and followed up to the age of two years corrected for gestation. With neonatal feeding regimes as the exposure variable, post-discharge re-hospitalization, mortality and Saigal and Rosenbaum's functional disability assessment scores were compared as the outcome variables.

2006

Grillenberger, M;, Neumann CG;, Murphy SP;, Bwibo NO;, Weiss RE;, Jiang L;, Hautvast JG;, West CE.  2006.  Intake of micronutrients high in animal-source foods is associated with better growth in rural Kenyan school children. Abstractintake_of_micronutrients_high_in_animal-source_foods.pdf

Observational studies have shown that children in developing countries consuming diets containing high amounts of bioavailable nutrients, such as those found in animal-source foods, grow better. The present study investigated which specific nutrients from the diet of Kenyan school children predicted their growth. The children (n 544, median age 7 years) participated in a 2-year long food supplementation study with animal-source foods. Height gain during the intervention period was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B12. Weight gain was positively predicted by average daily intakes of energy from animal-source foods, haem Fe, preformed vitamin A, Ca and vitamin B12. Gain in mid-upper-arm muscle area was positively predicted by average daily intakes of energy from animal-source foods and vitamin B12. Gain in mid-upper-arm fat area was positively predicted by average daily intakes of energy from animal-source foods. Gain in subscapular skinfold thickness was not predicted by any of the nutrient intakes. Negative predictors of growth were total energy and nutrients that are contained in high amounts in plant foods. The study shows that growth was positively predicted by energy and nutrients that are provided in high amounts and in a bioavailable form in meat and milk, and their inclusion into the diets of children in developing countries should be part of all food-based programmes in order to improve micronutrient status and growth

Grillenberger, M;, Neumann CG;, Murphy SP;, Bwibo NO.  2006.  Impact of supplementation with animal source foods on morbidity of rural Kenyan school children.
Bwibo, NO;, Acham JM.  2006.  Health education in Kenya- an overview.
O, PROFBWIBONIMROD, N PROFWEREFREDRICK.  2006.  Early growth of very low birth weight infants. East Afr Med J. 2006 Mar;83(3):84-9. Were FN, Bwibo NO.. East Afr Med J. 2006 Mar;83(3):84-9.. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD.  2006.  Grillenberger M, Neumann CG, Murphy SP, Bwibo NO, Weiss RE, Jiang L, Hautvast JG, West CE.Intake of micronutrients high in animal-source foods is associated with better growth in rural Kenyan school children. Br J Nutr. 2006 Feb;95(2):379-90.. Br J Nutr. 2006 Feb;95(2):379-90.. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD, N PROFWEREFREDRICK.  2006.  Two year neurological outcomes of Very Low Birth Weight infants. East Afr Med J. 2006 May;83(5):243-9. Were FN, Bwibo NO.. East Afr Med J. 2006 May;83(5):243-9.. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Nutritional Biology, University of California, Davis, CA 95616, USA.

The high prevalence of vitamin B-12 deficiency in many regions of the world is becoming recognized as a widespread public health problem, but it is not known to what extent this deficiency results from a low intake of the vitamin or from its malabsorption from food. In rural Kenya, where a previous study identified a high prevalence of inadequate vitamin B-12 intakes, this study examined whether plasma vitamin B-12 concentrations were associated with dietary sources of the vitamin at baseline and could be increased by supplementation with animal source foods (ASF). The 4 experimental groups in 503 school children were: 1) control (no food provided); 2) githeri (a maize and bean staple with added oil); 3) githeri + meat (githeri + minced beef); or 4) githeri + milk (githeri + milk). Feedings were isocaloric. Dietary data were collected at baseline, and biochemical data at baseline and after 1 and 2 y of feeding. Baseline plasma vitamin B-12 concentration was 193.6 +/- 105.3 pmol/L and correlated with % energy from ASF (r = 0.308, P < 0.001). The odds ratio for low plasma vitamin B-12 (<148 pmol/L), which occurred in 40% of children, was 6.28 [95% CI: 3.07-12.82] for the lowest vs. highest ASF intake tertile (P < 0.001). Feeding ASF (meat or milk) greatly reduced the prevalence of low plasma vitamin B-12 (P < 0.001). The high prevalence of low plasma vitamin B-12 concentrations in these children is predicted by a low intake of ASF, and supplemental ASF improves vitamin B-12 status.

PMID: 17311959 [PubMed - indexed for MEDLINE]

2005

O, PROFBWIBONIMROD.  2005.  Sigman M, Whaley SE, Neumann CG, Bwibo N, Guthrie D, Weiss RE, Liang LJ, Murphy SP.Diet quality affects the playground activities of Kenyan children. Food Nutr Bull. 2005 Jun;26(2 Suppl 2):S202-12.. Food Nutr Bull. 2005 Jun;26(2 Suppl 2):S202-12. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

2004

O, PROFBWIBONIMROD.  2004.  Neumann CG, Gewa C, Bwibo NO.Child nutrition in developing countries. Pediatr Ann. 2004 Oct;33(10):658-74.. Pediatr Ann. 2004 Oct;33(10):658-74. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

2003

O, PROFBWIBONIMROD.  2003.  The impact of dietary intervention on the cognitive development of Kenyan school children. J Nutr . 2003 Nov; 133 ( 11 Suppl 2 ): 3965S-3971S . PMID: 14672297 [PubMed - indexed for MEDLINE] Whaley SE, Sigman M, Neumann C, Bwibo N, Guthrie D, Weiss RE, Alb. J Nutr . 2003 Nov; 133 ( 11 Suppl 2 ): 3965S-3971S .. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Psychiatry and Psychology, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. swhaley@mednet.ucla.edu

Previous observational studies in developing countries have suggested that diet quality, particularly increased animal source food (ASF) consumption, is positively associated with child cognitive development. This report presents findings from a study in rural Kenya, designed to test the impact of three different diets on the cognitive development of school children. Twelve schools with a total of 555 Standard 1 children (equivalent to U.S. Grade 1) were randomized to one of four feeding interventions: Meat, Milk, Energy or Control (no feeding). Feeding continued for seven school terms (21 mo), and cognitive tests were administered before the commencement of feeding and during every other term of feeding. Hierarchical linear random effects models and associated methods were used to examine the effects of treatment group on changes in cognitive performance over time. Analyses revealed that children receiving supplemental food with meat significantly outperformed all other children on the Raven's Progressive Matrices. Children supplemented with meat, and children supplemented with energy, outperformed children in the Control group on tests of arithmetic ability. There were no group differences on tests of verbal comprehension. Results suggest that supplementation with animal source food has positive effects on Kenyan children's cognitive performance. However, these effects are not equivalent across all domains of cognitive functioning, nor did different forms of animal source foods produce the same beneficial effects. Implications of these findings for supplementation programs in developing countries are discussed.

PMID: 14672297 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD.  2003.  Bwibo NO, Neumann CG.The need for animal source foods by Kenyan children. J Nutr. 2003 Nov;133(11 Suppl 2):3936S-3940S. Review.. J Nutr. 2003 Nov;133(11 Suppl 2):. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD.  2003.  Kenyan school children have multiple micronutrient deficiencies, but increased plasma vitamin B-12 is the only detectable micronutrient response to meat or milk supplementation. J Nutr . 2003 Nov; 133 ( 11 Suppl 2 ): 3972S-3980S . PMID: 14672298 [PubMed -. J Nutr . 2003 Nov; 133 ( 11 Suppl 2 ): 3972S-3980S .. : Anim. Hlth. Prod. Afr. 2008 Abstract

Program in International Nutrition, University of California, Davis, CA 95616, USA.

Animal source foods (ASF) can provide micronutrients in greater amounts and more bioavailable forms compared to plant source foods, but their intake is low in many poor populations. However, the impact of ASF on micronutrient status of undernourished populations has not been assessed. Supplemental meat (60-85 g/d), milk (200-250 mL/d) or energy (isocaloric with the meat and milk, 240-300 kcal/d) were randomly assigned to 555 undernourished school children aged 5-14 y in a rural malaria-endemic area of Kenya, at one school meal daily for one school year. Blood and stool samples were collected at baseline and after 1 y to assess stool parasites, malaria, hemoglobin, serum or plasma C-reactive protein, ferritin, iron, zinc, copper, vitamin B-12, folate and retinol, and erythrocyte riboflavin. At baseline, there was a high prevalence of micronutrient deficiencies (iron, zinc, vitamins A and B-12 and riboflavin), yet plasma ferritin was low in few children, and none had low serum copper. At the end of the year of supplementation, plasma vitamin B-12 concentrations were significantly increased in children fed the Meat or Milk meal; prevalence of severe plus moderate deficiency fell from 80.7% at baseline to 64.1% in the Meat group and from 71.6 to 45.1% in the Milk group, respectively. No significant improvement was observed in the status of other micronutrients compared to the Energy and Control groups, although malaria and other infections may have obscured effects. Supplementation with small amounts of meat or milk reduced the high prevalence of vitamin B-12 deficiency in these children.

PMID: 14672298 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD.  2003.  Murphy SP, Gewa C, Liang LJ, Grillenberger M, Bwibo NO, Neumann CG.School snacks containing animal source foods improve dietary quality for children in rural Kenya. J Nutr. 2003 Nov;133(11 Suppl 2):3950S-3956S.. J Nutr. 2003 Nov;133(11 Suppl 2):3950S-3956S.. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD.  2003.  Neumann CG, Bwibo NO, Murphy SP, Sigman M, Whaley S, Allen LH, Guthrie D, Weiss RE, Demment MW.Animal source foods improve dietary quality, micronutrient status, growth and cognitive function in Kenyan school children: background, study design and baselin. J Nutr. 2003 Nov;133(11 Suppl 2):3941S-3949S.. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD.  2003.  Whaley SE, Sigman M, Neumann C, Bwibo N, Guthrie D, Weiss RE, Alber S, Murphy SP. he impact of dietary intervention on the cognitive development of Kenyan school children. J Nutr. 2003 Nov;133(11 Suppl 2):3965S-3971S.. J Nutr. 2003 Nov;133(11 Suppl 2):3965S-3971S.. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, P.O. Box 20956-00202, Nairobi, Kenya. BACKGROUND: Early growth in very low birth weight (VLBW) infants has been found predictive of their later outcomes. This has led to increased interest in establishing measures to optimise such growth. In facilities without the resources required to undertake long-term audits for all the high risk infants they graduate, these growth parameters may also be used as selection criteria for those meriting such follow up reducing costs. OBJECTIVES: To describe early growth patterns among a cohort of VLBW infants and determine some of the factors associated with poor growth among them. DESIGN: Cross section survey. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: One hundred and seventy five neonatal survivors. RESULTS: Of the 175 infants recruited, the male/female ratio was 4:6, sixty four (36.6%) were intrauterine growth retarded while significant illnesses during the neonatal period were reported in 109 (62.3%). Forty seven percent of the infants had been fed on exclusive breast milk, 33% on mixed feeds while 20% received exclusive preterm formula. The mean neonatal weight gain for the whole cohort was 13.5 (3.9) g/kg/day, length of 0.34 (0.11) cm/week and head circumference of 0.32 (0.71) cm/week. By term only 33 (18.9%), 37 (21.1%) and 48 (28%) had reached the expected (the 3rd percentile) weight, length and head circumference respectively. Sixty percent of the infants gained weight at <15 g/kg/day while 70% and 78% grew in head circumference and length at < 0.5 cm/week respectively. At term weight, head and linear growth faultering were recorded in 81%, 72% and 79% respectively. The factors that were associated with better growth at this stage included feeding on preterm formula (P < 0.001) and absence of neonatal morbidity (P < 0.001). Infants who were appropriate for gestational age at birth also had better catch up growth at term compared to those born small for gestation (P < 0.001) but their neonatal growth itself was not significantly better. CONCLUSION: The mean neonatal growth in all anthropometric measures was less than expected and by the time of their expected delivery, less than 30% of these infants had reached the 3rd percentile of the expected measurement in all the three growth parameters. Choice of milk and neonatal morbidity influenced these growth patterns. RECOMMENDATIONS: Routine fortification of mother's milk or addition of preterm formula and reorganised care of sick newborns is recommended to improve early growth. PMID: 16771104 [PubMed - indexed for MEDLINE]

2002

2001

2000

Neumann, CG; Bwibo, NO.  2000.  Malaria and micronutrient status of Kenyan schoolers.

1997

O, PROFBWIBONIMROD.  1997.  Bwibo N O Child Abuse and Neglect, Chapter 27 In: child Health . AMREF. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Psychiatry and Psychology, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. swhaley@mednet.ucla.edu

Previous observational studies in developing countries have suggested that diet quality, particularly increased animal source food (ASF) consumption, is positively associated with child cognitive development. This report presents findings from a study in rural Kenya, designed to test the impact of three different diets on the cognitive development of school children. Twelve schools with a total of 555 Standard 1 children (equivalent to U.S. Grade 1) were randomized to one of four feeding interventions: Meat, Milk, Energy or Control (no feeding). Feeding continued for seven school terms (21 mo), and cognitive tests were administered before the commencement of feeding and during every other term of feeding. Hierarchical linear random effects models and associated methods were used to examine the effects of treatment group on changes in cognitive performance over time. Analyses revealed that children receiving supplemental food with meat significantly outperformed all other children on the Raven's Progressive Matrices. Children supplemented with meat, and children supplemented with energy, outperformed children in the Control group on tests of arithmetic ability. There were no group differences on tests of verbal comprehension. Results suggest that supplementation with animal source food has positive effects on Kenyan children's cognitive performance. However, these effects are not equivalent across all domains of cognitive functioning, nor did different forms of animal source foods produce the same beneficial effects. Implications of these findings for supplementation programs in developing countries are discussed.

PMID: 14672297 [PubMed - indexed for MEDLINE]

1995

O, PROFBWIBONIMROD.  1995.  R.N. Musoke, Care of the newborn. Chapter 2 in Primary Health Care. A manual for medical students and other health workers Ed. K. Mukelabai, N.O. Bwibo, F.E. Onyango, Second edition 1995, UNICEF.. manual for medical students and other health workers Ed. K. Mukelabai, N.O. Bwibo, F.E. Onyango, Second edition 1995, UNICEF.. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Psychiatry and Psychology, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. swhaley@mednet.ucla.edu

Previous observational studies in developing countries have suggested that diet quality, particularly increased animal source food (ASF) consumption, is positively associated with child cognitive development. This report presents findings from a study in rural Kenya, designed to test the impact of three different diets on the cognitive development of school children. Twelve schools with a total of 555 Standard 1 children (equivalent to U.S. Grade 1) were randomized to one of four feeding interventions: Meat, Milk, Energy or Control (no feeding). Feeding continued for seven school terms (21 mo), and cognitive tests were administered before the commencement of feeding and during every other term of feeding. Hierarchical linear random effects models and associated methods were used to examine the effects of treatment group on changes in cognitive performance over time. Analyses revealed that children receiving supplemental food with meat significantly outperformed all other children on the Raven's Progressive Matrices. Children supplemented with meat, and children supplemented with energy, outperformed children in the Control group on tests of arithmetic ability. There were no group differences on tests of verbal comprehension. Results suggest that supplementation with animal source food has positive effects on Kenyan children's cognitive performance. However, these effects are not equivalent across all domains of cognitive functioning, nor did different forms of animal source foods produce the same beneficial effects. Implications of these findings for supplementation programs in developing countries are discussed.

PMID: 14672297 [PubMed - indexed for MEDLINE]

O, PROFBWIBONIMROD.  1995.  Bwibo NO. Breastfeeding: past, present and future. East Afr Med J. 1995 Mar;72(3):145-6.. East Afr Med J. 1995 Mar;72(3):145-6.. : Anim. Hlth. Prod. Afr. 2008 Abstract

Department of Psychiatry and Psychology, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. swhaley@mednet.ucla.edu

Previous observational studies in developing countries have suggested that diet quality, particularly increased animal source food (ASF) consumption, is positively associated with child cognitive development. This report presents findings from a study in rural Kenya, designed to test the impact of three different diets on the cognitive development of school children. Twelve schools with a total of 555 Standard 1 children (equivalent to U.S. Grade 1) were randomized to one of four feeding interventions: Meat, Milk, Energy or Control (no feeding). Feeding continued for seven school terms (21 mo), and cognitive tests were administered before the commencement of feeding and during every other term of feeding. Hierarchical linear random effects models and associated methods were used to examine the effects of treatment group on changes in cognitive performance over time. Analyses revealed that children receiving supplemental food with meat significantly outperformed all other children on the Raven's Progressive Matrices. Children supplemented with meat, and children supplemented with energy, outperformed children in the Control group on tests of arithmetic ability. There were no group differences on tests of verbal comprehension. Results suggest that supplementation with animal source food has positive effects on Kenyan children's cognitive performance. However, these effects are not equivalent across all domains of cognitive functioning, nor did different forms of animal source foods produce the same beneficial effects. Implications of these findings for supplementation programs in developing countries are discussed.

PMID: 14672297 [PubMed - indexed for MEDLINE]

1993

O, PROFBWIBONIMROD.  1993.  Children and accidents. Epidemiology and prevention. Trop Geogr Med . 1993; 45 ( 5 ): 223-6 . No abstract available. PMID: 8279063 [PubMed - indexed for MEDLINE] Bwibo NO.. Trop Geogr Med . 1993; 45 ( 5 ): 223-6 .. : Anim. Hlth. Prod. Afr. 2008 Abstract

No abstract available

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