Medicine and Health Sciences Commons^™

"Fueling For A Healthy Life:" A Cooking Class For Adolescent And Young Adult Childhood Cancer Survivors, Hope Dominique

Senior Theses

Following cancer treatment, childhood cancer survivors (CCS) are at an increased risk of developing chronic diseases and face an increased risk of health-related death during adulthood. Recent literature demonstrates that modifying lifestyle factors such as nutrition can reduce the risk of late mortality in survivors, suggesting that interventions promoting a healthy lifestyle may improve quality and quantity of life for CCS. However, many adolescent and young adult (AYA) CCS do not adhere to national dietary guidelines and face both real and perceived barriers to adopting healthier eating habits while in a critical period for establishing behaviors that contribute to lifelong …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

Food Insecurity Screening In People With Cystic Fibrosis, Rebecca Edwards, Lauren Tate, Ana Cairns, Cheryl Coyne, Kathleen Walker, Kim Violette, Ann Ladner, Jessica D'Amico

Costas T. Lambrew Research Retreat 2023

Background: Adequate nutrition is a cornerstone in the management of cystic fibrosis (CF). Malabsorption secondary to pancreatic insufficiency and increased energy demands related to lung disease can increase energy requirements over twofold for a person with CF. Food insecurity (FI) affects approximately 10% of Mainers (1). Per the Cystic Fibrosis Foundation, there may be up to a threefold increase in the prevalence of FI in the CF population (2). To address this issue, we implemented FI screening in the adult and pediatric CF programs to identify the prevalence of FI within our population and to offer immediate interventions.

The Rising Rates Of Pediatric Health Conditions Due To Lack Of Nutrition Education, Amanda Healy

Nursing | Student Research Posters

Statistics show that there is an increase in childhood health conditions related to nutrition. Throughout the United States, the rates of childhood obesity have drastically increased along with the rates of type two diabetes. There is correlation between these two chronic problems in pediatric patients, but not all pediatrics diagnosed with DM2 are obese. Furthermore, there is a correlation between this increase of obesity/DM2 and the lack of nutrition education in schools. The public school system in the United States does not have the funding to provide adequate nutrition education to the children which is leading to substantial health consequences. …

Exploring Modern Trends And Prevention Strategies For Childhood Obesity: A Comprehensive Literature Review, Anya E. Bogen

Honors Theses

This literature review seeks to provide an overview of the current research on childhood obesity. The study examines the prevalence and causes of childhood obesity, including genetic, environmental, and behavioral factors. The review also discusses the health consequences associated with childhood obesity, such as the increased risk for chronic diseases and psychological and social problems. Additionally, the review explores the effectiveness of interventions designed to prevent childhood obesity, including individual lifestyle modifications, education from health practitioners and school programs, and global, national, and state programs to promote wellness. The literature review concludes that childhood obesity is a complex and multifactorial …

Nutritional Management Of The Infant With Chronic Kidney Disease Stages 2-5 And On Dialysis., Vanessa Shaw, Caroline Anderson, An Desloovere, Larry A. Greenbaum, Dieter Haffner, Christina L. Nelms, Fabio Paglialonga, Nonnie Polderman, Leila Qizalbash, José Renken-Terhaerdt, Stella Stabouli, Jetta Tuokkola, Johan Vande Walle, Bradley A. Warady, Rukshana Shroff

Manuscripts, Articles, Book Chapters and Other Papers

The nutritional management of children with chronic kidney disease (CKD) is of prime importance in meeting the challenge of maintaining normal growth and development in this population. The objective of this review is to integrate the Pediatric Renal Nutrition Taskforce clinical practice recommendations for children with CKD stages 2-5 and on dialysis, as they relate to the infant from full term birth up to 1 year of age, for healthcare professionals, including dietitians, physicians, and nurses. It addresses nutritional assessment, energy and protein requirements, delivery of the nutritional prescription, and necessary dietary modifications in the case of abnormal serum levels …

Aa And Dha Are Decreased In Paediatric Ad/Hd And Inattention Is Ameliorated By Increased Plasma Dha, John J. Miklavcic, Ellen Ivity, Ian M. Macdonald, Liana Urichuk, Vera C. Mazurak, Christina Rinaldi, Michael T. Clandinin

Food Science Faculty Articles and Research

The purpose of this study was to assess long chain polyunsaturated fatty acid (LCPUFA) status in relation to socio-behavioral outcomes in children with Attention Deficit/Hyperactivity Disorder (AD/HD). In a case-control design, plasma phospholipid fatty acid content was assessed in children aged 5–12 years with AD/HD and in typically functioning children. Dietary intakes of LCPUFAs arachidonic acid (AA; 20:4n6) and docosahexaenoic acid (DHA; 22:6n3) were quantified using a four-day food record, polymorphisms were determined in FADS1 and FADS2, and socio-behavioral outcomes were assessed using the Conners 3 Parent Rating Scales in a cross section of children with AD/HD. Compared to …

Alleviating Hidden Hunger: An Infallible Bridge To Improved Health And Nutrition, Jai K. Das, Zahra Ali Padhani

Department of Paediatrics and Child Health

No abstract provided.

Covid-19, Nutrition, And Gender: An Evidence-Informed Approach To Gender-Responsive Policies And Programs, Anna Kalbarczyk, Noora-Lisa Aberman, Bregje S M Van Asperen, Rosemary Morgan, Zulfiqar Ahmed Bhutta, Bianca Carducci, Rebecca Heidkamp, Saskia Osendarp, Neha Kumar, Anna Lartey

Department of Paediatrics and Child Health

In addition to the direct health impacts of COVID-19, government and household mitigation measures have triggered negative indirect economic, educational, and food and health system impacts, hitting low-and middle-income countries the hardest and disproportionately affecting women and girls. We conducted a gender focused analysis on five critical and interwoven crises that have emerged because of the COVID-19 crisis and exacerbated malnutrition and food insecurity. These include restricted mobility and isolation; reduced income; food insecurity; reduced access to essential health and nutrition services; and school closures. Our approach included a theoretical gender analysis, targeted review of the literature, and a visual …

Oral Drug Dosing Following Bariatric Surgery: General Concepts And Specific Dosing Advice, Jurjen S. Kingma, Desirée M. T. Burgers, Valerie M. Monpellier, Marinus J. Wiezer, Heleen J. Blussé Van Oud‐Alblas, Janelle D. Vaughns, Catherine M. T. Sherwin, Catherijne A. J. Knibbe

Pediatrics Faculty Publications

Bariatric or weight-loss surgery is a popular option for weight reduction. Depending on the surgical procedure, gastric changes like decreased transit time and volume and increased pH, decreased absorption surface in the small intestine, decreased exposure to bile acids and enterohepatic circulation, and decreased gastrointestinal transit time may be expected. In the years after bariatric surgery, patients will also substantially lose weight. As a result of these changes, the absorption, distribution, metabolism and/or elimination of drugs may be altered. The purpose of this article is to report the general influence of bariatric surgery on oral drug absorption, and to provide …

Decreased Physical Activity Among Youth Resulting From Covid-19 Pandemic-Related School Closures: Natural Experimental Study., Amanda Grimes, Joseph S. Lightner, Katlyn Eighmy, Chelsea Steel, Robin P. Shook, Jordan A. Carlson

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The COVID-19 pandemic has resulted in the closure of schools and may have inadvertently resulted in decreased physical activity for youth. Emerging evidence suggests that school closures due to the COVID-19 pandemic could have hastened the inactivity of youth, possibly due to a lack of structure outside of school and increased access to sedentary activities.

OBJECTIVE: The purpose of this study was to assess changes in physical activity from pre-school closure (before the pandemic) to post-school closure (during the pandemic) among youth in spring 2020.

METHODS: This study used a natural experimental design; youth were enrolled in a physical …

Distance From Healthcare Facilities Is Associated With Increased Morbidity Of Acute Infection In Pediatric Patients In Matiari, Pakistan, Elise Corden, Saman Hasan Siddiqui, Yash Sharma, Sheraz Ahmed, Fayyaz Umrani, Najeeb Rahman, Rafey Ali, Najeeha Talat Iqbal, Syed Asad Ali, Sana Syed

Department of Paediatrics and Child Health

The relationship between environmental factors and child health is not well understood in rural Pakistan. This study characterized the environmental factors related to the morbidity of acute respiratory infections (ARIs), diarrhea, and growth using geographical information systems (GIS) technology. Anthropometric, address and disease prevalence data were collected through the SEEM (Study of Environmental Enteropathy and Malnutrition) study in Matiari, Pakistan. Publicly available map data were used to compile coordinates of healthcare facilities. A Pearson correlation coefficient (r) was used to calculate the correlation between distance from healthcare facilities and participant growth and morbidity. Other continuous variables influencing these …

The Good Food For Learning Universal Curriculum-Integrated Healthy School Lunch Intervention: Protocol For A Two-Year Matched Control Pre-Post And Case Study, Rachel Engler-Stringer, Jennifer Black, Nazeem Muhajarine, Wanda Martin, Jason Gilliland, Janet Mcvittie, Sara Kirk, Hannah Wittman, Amin Mousavi, Sinikka Elliott, Brent Hills, Gordon Androsoff, Debbie Field, Brit Macdonald, Chelsea Belt, Hassan Vatanparast

Paediatrics Publications

Background: Good nutrition affects children's health, well-being, and learning, and schools offer an important setting to promote healthy behaviors that can last a lifetime. Once children reach school age, they spend more of their waking hours in school than in any other environment. Children's eating habits may be easier to influence than those of adults. In Canada, households with children are more likely to experience food insecurity, and school food programs that are universally available to all children can support the development of healthy eating patterns across groups of varying socioeconomic status. There is a significant gap in the rigorous …

Association Of Maternal Prenatal Selenium Concentration And Preterm Birth: A Multicountry Meta-Analysis, Nagendra Monangi, Huan Xu, Waqasuddin Khan, Furqan Kabir, Muhammad Imran Nisar, Aneeta Hotwani, Usma Mehmood, Ambreen Nizar, Javairia Khalid, Fyezah Jehan

Department of Paediatrics and Child Health

Background: Selenium (Se), an essential trace mineral, has been implicated in preterm birth (PTB). We aimed to determine the association of maternal Se concentrations during pregnancy with PTB risk and gestational duration in a large number of samples collected from diverse populations.
Methods: Gestational duration data and maternal plasma or serum samples of 9946 singleton live births were obtained from 17 geographically diverse study cohorts. Maternal Se concentrations were determined by inductively coupled plasma mass spectrometry analysis. The associations between maternal Se with PTB and gestational duration were analysed using logistic and linear regressions. The results were then combined using …

Delivering Nutrition Interventions To Women And Children In Conflict Settings: A Systematic Review, Shailja Shah, Zahra Ali Padhani, Daina Als, Mariella Munyuzangabo, Michelle F. Gaffey, Wardah Ahmed, Fahad J. Siddiqui, Sarah Meteke, Jai K. Das, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Low/middle-income countries (LMICs) face triple burden of malnutrition associated with infectious diseases, and non-communicable diseases. This review aims to synthesise the available data on the delivery, coverage, and effectiveness of the nutrition programmes for conflict affected women and children living in LMICs.
Methods: We searched MEDLINE, Embase, CINAHL, and PsycINFO databases and grey literature using terms related to conflict, population, and nutrition. We searched studies on women and children receiving nutrition-specific interventions during or within five years of a conflict in LMICs. We extracted information on population, intervention, and delivery characteristics, as well as delivery barriers and facilitators. Data …

Assessment Of Nutritional Status In Children With Kidney Diseases-Clinical Practice Recommendations From The Pediatric Renal Nutrition Taskforce., Christina L. Nelms, Vanessa Shaw, Larry A. Greenbaum, Caroline Anderson, An Desloovere, Dieter Haffner, Michiel J S Oosterveld, Fabio Paglialonga, Nonnie Polderman, Leila Qizalbash, Lesley Rees, José Renken-Terhaerdt, Jetta Tuokkola, Johan Vande Walle, Rukshana Shroff, Bradley A. Warady

Manuscripts, Articles, Book Chapters and Other Papers

In children with kidney diseases, an assessment of the child's growth and nutritional status is important to guide the dietary prescription. No single metric can comprehensively describe the nutrition status; therefore, a series of indices and tools are required for evaluation. The Pediatric Renal Nutrition Taskforce (PRNT) is an international team of pediatric renal dietitians and pediatric nephrologists who develop clinical practice recommendations (CPRs) for the nutritional management of children with kidney diseases. Herein, we present CPRs for nutritional assessment, including measurement of anthropometric and biochemical parameters and evaluation of dietary intake. The statements have been graded using the American …

Early Enteral Feeding In Preterm Infants: A Narrative Review Of The Nutritional, Metabolic, And Developmental Benefits, Melissa K. Thoene, Ann Anderson-Berry

Journal Articles: Pediatrics

Enteral feeding is the preferred method of nutrient provision for preterm infants. Though parenteral nutrition remains an alternative to provide critical nutrition after preterm delivery, the literature suggests that enteral feeding still confers significant nutritional and non-nutritional benefits. Therefore, the purpose of this narrative review is to summarize health and clinical benefits of early enteral feeding within the first month of life in preterm infants. Likewise, this review also proposes methods to improve enteral delivery in clinical care, including a proposal for decision-making of initiation and advancement of enteral feeding. An extensive literature review assessed enteral studies in preterm infants …

Differences In Adolescent Activity And Dietary Behaviors Across Home, School, And Other Locations Warrant Location-Specific Intervention Approaches., Adrian Ortega, Carolina M. Bejarano, Christopher C. Cushing, Vincent S. Staggs, Amy Papa, Chelsea Steel, Robin P. Shook, Debra K. Sullivan, Sarah C. Couch, Terry L. Conway, Brian E. Saelens, Karen Glanz, Lawrence D. Frank, Kelli L. Cain, Jacqueline Kerr, Jasper Schipperijn, James F Sallis, Jordan A. Carlson

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Investigation of physical activity and dietary behaviors across locations can inform "setting-specific" health behavior interventions and improve understanding of contextual vulnerabilities to poor health. This study examined how physical activity, sedentary time, and dietary behaviors differed across home, school, and other locations in young adolescents.

METHODS: Participants were adolescents aged 12-16 years from the Baltimore-Washington, DC and the Seattle areas from a larger cross-sectional study. Participants (n = 472) wore an accelerometer and Global Positioning Systems (GPS) tracker (Mean days = 5.12, SD = 1.62) to collect location-based physical activity and sedentary data. Participants (n = 789) completed 24-h …

Impact Of Conflict On Maternal And Child Health Service Delivery: A Country Case Study Of Afghanistan, Mohammed Shafiq Mirzazada, Zahra Ali Padhani, Sultana Jabeen, Malika Fatima, Arjumand Rizvi, Uzair Ansari, Jai K. Das, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction: Since decades, the health system of Afghanistan has been in disarray due to ongoing conflict. We aimed to explore the direct effects of conflict on provision of reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) services and describe the contextual factors influencing these services.
Method: We conducted a quantitative analysis of secondary data on RMNCAH&N indicators and undertook a supportive qualitative study to help understand processes and contextual factors. For quantitative analysis, we stratified the various provinces of Afghanistan into minimal-, moderate- and severe conflict categories based on battle-related deaths from Uppsala Conflict Data Program (UCDP) and …

Understanding The Factors Affecting The Humanitarian Health And Nutrition Response For Women And Children In Somalia Since 2000: A Case Study, Zahra Ahmed, Anushka Ataullahjan, Michelle F. Gaffey, Mohamed Osman, Chantal Umutoni, Zulfiqar Ahmed Bhutta, Abdirisak A. Dalmar

Woman and Child Health

Background: Somalia has been ravaged by more than two decades of armed conflict causing immense damage to the country's infrastructure and mass displacement and suffering among its people. An influx of humanitarian actors has sought to provide basic services, including health services for women and children, throughout the conflict. This study aimed to better understand the humanitarian health response for women and children in Somalia since 2000.
Methods: The study utilized a mixed-methods design. We collated intervention coverage data from publically available large-scale household surveys and we conducted 32 interviews with representatives from government, UN agencies, NGOs, and health facility …

Impact Of Conflict On Maternal And Child Health Service Delivery - How And How Not: A Country Case Study Of Conflict Affected Areas Of Pakistan, Jai K. Das, Zahra Ali Padhani, Sultana Jabeen, Arjumand Rizvi, Uzair Ansari, Malika Fatima, Ghulam Akbar, Wardah Ahmed, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction: In conflict affected countries, healthcare delivery remains a huge concern. Pakistan is one country engulfed with conflict spanning various areas and time spans. We aimed to explore the effect of conflict on provision of reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) services and describe the contextual factors influencing the prioritization and implementation in conflict affected areas of Pakistan (Balochistan and FATA).
Method: We conducted a secondary quantitative and a primary qualitative analysis. For the quantitative analysis, we stratified the various districts/agencies of Balochistan and FATA into the conflict categories of minimal-, moderate- and severe based on …

Deprivation Matters: Understanding Associations Between Neighbourhood Deprivation, Unhealthy Food Outlets, Unhealthy Dietary Behaviours And Child Body Size Using Structural Equation Modelling., Victoria Egli, Matthew Hobbs, Jordan A. Carlson, Niamh Donnellan, Lisa Mackay, Daniel Exeter, Karen Villanueva, Caryn Zinn, Melody Smith

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Children residing in neighbourhoods of high deprivation are more likely to have poorer health, including excess body size. While the availability of unhealthy food outlets are increasingly considered important for excess child body size, less is known about how neighbourhood deprivation, unhealthy food outlets and unhealthy dietary behaviours are interlinked.

METHODS: This study involves children aged 8-13 years (n=1029) and resided in Auckland, New Zealand. Unhealthy dietary behaviours (frequency of consumption of unhealthy snacks and drinks) and food purchasing behaviour on the route to and from school were self-reported. Height and waist circumference were measured to calculate waist-to-height ratio …

The Dietary Management Of Calcium And Phosphate In Children With Ckd Stages 2-5 And On Dialysis-Clinical Practice Recommendation From The Pediatric Renal Nutrition Taskforce., Louise Mcalister, Pearl Pugh, Laurence Greenbaum, Dieter Haffner, Lesley Rees, Caroline Anderson, An Desloovere, Christina Nelms, Michiel Oosterveld, Fabio Paglialonga, Nonnie Polderman, Leila Qizalbash, José Renken-Terhaerdt, Jetta Tuokkola, Bradley A. Warady, Johan Vande Walle, Vanessa Shaw, Rukshana Shroff

Manuscripts, Articles, Book Chapters and Other Papers

In children with chronic kidney disease (CKD), optimal control of bone and mineral homeostasis is essential, not only for the prevention of debilitating skeletal complications and achieving adequate growth but also for preventing vascular calcification and cardiovascular disease. Complications of mineral bone disease (MBD) are common and contribute to the high morbidity and mortality seen in children with CKD. Although several studies describe the prevalence of abnormal calcium, phosphate, parathyroid hormone, and vitamin D levels as well as associated clinical and radiological complications and their medical management, little is known about the dietary requirements and management of calcium (Ca) and …

The Nutritional Status Of Children Living Within Institutionalized Care: A Systematic Review, Emily Delacey, Cally Tann, Nora Groce, Maria Kett, Michael Quiring, Ethan Bergman, Caryl Garcia, Marko Kerac

All Faculty Scholarship for the College of the Sciences

Background. There are an estimated 2.7 million children living within institutionalized care worldwide. This review aimed to evaluate currently available data on the nutrition status of children living within institutionalized care.

Methods. We searched four databases (Pubmed/Medline, CINHAL Plus, Embase and Global Health Database) for relevant articles published from January 1990 to January 2019. Studies that included information on anthropometry or micronutrient status of children living within institutionalized care were eligible for inclusion. The review is registered on PROSPERO: CRD42019117103.

Results. From 3,602 titles screened, we reviewed 98 full texts, of which 25 papers were eligible. Two (8%) studies reported …

Raising Awareness About The Vermont Donor Milk Center, Rosie Friedman, Emi Eakin

Family Medicine Clerkship Student Projects

The Vermont Donor Milk Center (VDMC) is an emerging community resource that provides donated, pasteurized breast milk to new parents for their infants. Upon questioning, we identified that many providers did not know about the VDMC or how to prescribe milk. In addition, VDMC expressed that they have not been able to complete the community outreach they had initially hoped for. We chose to dedicate our project to disseminating information about VDMC to perinatal care providers in Vermont.

Health Effects Of A Vegan Diet And Pediatric Cancer Prevention, Lindsay Wisehart

Senior Honors Theses

Veganism is a diet which excludes consumption of all animal products. With proper planning and vitamin supplementation to ensure adequate intake of protein, fat, calcium, zinc, iron, and vitamins D and B12, a vegan diet is widely accepted as suitable for growing and developing children. The decreased levels of dairy, red and processed meats, fat, and protein, and increased levels of fruits and vegetables characteristic of a vegan diet have been shown to reduce risk of mortality and a number of diseases including adult and childhood cancer. Childhood cancer is the second leading cause of childhood death in Western society. …

Integrating Nutrition Into Health Systems: What The Evidence Advocates, Rehana Salam, Jai K. Das, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

There is considerable evidence of positive health and nutrition outcomes resulting from integrating nutrition-specific interventions into health systems; however, current knowledge on establishing and sustaining effective integration of nutrition into health systems is limited. The objective of this review is to map the existing types of integration platforms and review the evidence on integrated health and nutrition programmes' impacts on specific nutrition outcomes. A literature search was conducted, and integrated nutrition programmes were examined through the lens of the six World Health Organization (WHO) building blocks, including the demand side. Forty-five studies were included in this review, outlining the integration …

A Time-Friendly, Feasible Measure Of Nutrition Knowledge In Type 1 Diabetes: The Electronic Nutrition And Carbohydrate Counting Quiz (Encq)., Arwen M. Marker, Amy E. Noser, Nicole Knecht, Mark A. Clements, Susana R. Patton

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Greater knowledge about nutrition and carbohydrate counting are associated with improved glycemic control and quality of life in youth with type 1 diabetes (T1D). However, limited assessments of nutrition and carbohydrate knowledge have been developed, and existing measures can be time-consuming, overly broad, or not conducive to routine clinical use. To fill this gap, we developed and examined the feasibility of administering the electronic Nutrition and Carbohydrate Counting Quiz (eNCQ).

METHOD: Ninety-two caregivers and 70 youth with T1D (mean age 12.5 years; mean time since diagnosis 5 years; English speaking) completed the 19-item eNCQ via tablet during a routine …

Association Between Systemic Inflammation And Nutritional Compounds In Maternal-Infant Dyads, Jessica N. Snowden

Theses & Dissertations

Many events during pregnancy and early infancy can affect infant brain development. Inflammation during pregnancy, around delivery and during early infancy appears to adversely affect infant brain development. As the brain is rapidly growing and developing from conception through early childhood, it is particularly vulnerable during this time to inflammatory insults, which may be exacerbated or ameliorated by nutritional factors. Inflammatory compounds, as well as many nutritional compounds, can be either pro- or anti-inflammatory. These compounds are of particular importance in preterm infants, who are at risk of deficiency in anti-inflammatory micronutrients typically stored as a result of prenatal maternal …

Effect Of Life Skills Building Education And Micronutrient Supplements Provided From Preconception Versus The Standard Of Care On Low Birth Weight Births Among Adolescent And Young Pakistani Women (15–24 Years): A Prospective, Population-Based Cluster-Randomized Trial, Jo-Anna B. Baxter, Yaqub Wasan, Sajid Bashir Soofi, Zamir Suhag, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one’s own well-being, as well as future pregnancy outcomes and the health of the next generation.
Methods: The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate …