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Author

Esi K Colecraft

Other affiliations: Iowa State University
Bio: Esi K Colecraft is an academic researcher from University of Ghana. The author has contributed to research in topics: Nutrition Education & Animal source foods. The author has an hindex of 13, co-authored 47 publications receiving 708 citations. Previous affiliations of Esi K Colecraft include Iowa State University.


Papers
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Journal ArticleDOI
TL;DR: By focusing on undernutrition and overweight, the GNR puts malnutrition in a new light and identifies bottlenecks in the scale-up of nutrition-specific and nutrition-sensitive approaches and highlights actions to accelerate coverage and reach.
Abstract: In 2013, the Nutrition for Growth Summit called for a Global Nutrition Report (GNR) to strengthen accountability in nutrition so that progress in reducing malnutrition could be accelerated. This article summarizes the results of thefirst GNR. By focusing on undernutrition and overweight, the GNR puts malnutrition in a new light. Nearly every country in the world is affected by malnutrition, and multiple malnutrition burdens are the ‘‘new normal.’’ Unfortunately, the world is off track to meet the 2025 World Health Assembly (WHA) targets for nutrition. Many countries are, however, making good progress on WHA indicators, providing inspiration and guidance for others. Beyond the WHA goals, nutrition needs to be more strongly represented in the Sustainable Development Goal (SDG) framework. At present, it is only explicitly mentioned in 1 of 169 SDG targets despite the many contributions improved nutritional status will make to their attainment. To achieve improvements in nutrition status, it is vital to scale up nutrition programs. We identify bottlenecks in the scale-up of nutrition-specific and nutrition-sensitive approaches and highlight actions to accelerate coverage and reach. Holding stakeholders to account for delivery on nutrition actions requires a well-functioning accountability infrastructure, which is lacking in nutrition. New accountability mechanisms need piloting and evaluation, financial resource flows to nutrition need to be made explicit, nutrition spending targets should be established, and some key data gaps need to be filled. For example, many UN member states cannot report on their WHA progress and those that can often rely on data >5 y old. The world can accelerate malnutrition reduction substantially, but this will require stronger accountability mechanisms to hold all stakeholders to account. JN utrdoi: 10.3945/jn.114.206078.

261 citations

Journal ArticleDOI
01 Feb 2008
TL;DR: The links between nutrition and HIV/AIDS amplify the negative effects of HIV infection on human development at individual, household, community and national levels and is impeding progress towards achieving the UN millennium development goals.
Abstract: HIV/AIDS is associated with biological and social factors that affect the individual's ability to consume and utilize food and to acquire food. These biological and social factors lead to poor nutritional status and weight loss, which are an important cause of morbidity in individuals infected with HIV, resulting in a poor quality of life; weight loss is an important predictor of death from AIDS. The links between nutrition and HIV/AIDS amplify the negative effects of HIV infection on human development at individual, household, community and national levels. For many developing countries the incidence of HIV/AIDS and malnutrition is impeding progress towards achieving the UN millennium development goals. Aggressive interventions to curb the spread of HIV continue to be needed. Concurrent efforts to improve nutrition for populations living with HIV/AIDS should also be given priority.

64 citations

Journal ArticleDOI
TL;DR: Physical inactivity is a modifiable independent determinant of overweight or obesity among Ghanaian school-aged children and promoting and supporting a physically active lifestyle in this population is likely to reduce risk of childhood overnutrition.
Abstract: Childhood overnutrition is a serious public health problem, with consequences that extend into adulthood. The aim of this study was to determine the prevalence and determinants of overweight and obesity among school-age children in two urban settings in Ghana. This cross-sectional study involved 3089 children (9–15 years) recruited between December 2009 and February 2012 in Accra and Kumasi, Ghana. Socio-demographic, dietary, and physical activity data were collected using pretested questionnaires. BMI-for-age z-scores were used to categorize anthropometric data of the children as thin, normal, or overweight/obese. Determinants of overweight were examined using multiple logistic regressions. Seventeen percent of children were overweight or obese. Children who reported lower participation (< 3 times/week) in sports activity were 44% more likely to be overweight or obese (AOR = 1.44; 95% CI: 1.07, 1.94). Maternal tertiary education (AOR = 1.91, 95% CI: 1.07, 3.42), higher household socioeconomic status (AOR = 1.56, 95% CI: 1.18, 2.06), and attending private school (AOR = 1.74, 95% CI: 1.31, 2.32) were also associated with elevated risk of overweight and obesity. Physical inactivity is a modifiable independent determinant of overweight or obesity among Ghanaian school-aged children. Promoting and supporting a physically active lifestyle in this population is likely to reduce risk of childhood overnutrition.

56 citations

Journal ArticleDOI
TL;DR: In this article, the least expensive ASF was fish, which was easy to preserve and consumed by all communities, and interventions that increase income may be most successful in improving Ghanaian children's diets.
Abstract: Micronutrient deficiencies limit child health and development. Although animal source foods (ASF) provide highly bioavailable micronutrients, Ghanaian preschoolers consume little. Participatory rapid appraisal methods identified constraints to the availability, accessibility, and utilization of ASF. Stakeholders working with or living in six communities in three agro-ecological zones reported constraints including low income, lack of access to technology and markets, inequitable household food allocation, inadequate knowledge, and beliefs. The least expensive ASF was fish, which was easy to preserve and consumed by all communities. Since ASF was primarily purchased, interventions that increase income may be most successful in improving Ghanaian children's diets.

54 citations

Journal ArticleDOI
TL;DR: Integrated interventions that increase access to high-quality foods and nutrition education improve child nutrition and Sensitivity analyses with random-effects and mixed-effects models and as-treated analysis were consistent with the findings.
Abstract: Stunting in Ghana is associated with rural communities, poverty, and low education; integrated agricultural interventions can address the problem. This cluster randomized controlled trial tested the effect of a 12-month intervention (inputs and training for poultry farming and home gardening, and nutrition and health education) on child diet and nutritional status. Sixteen clusters were identified and randomly assigned to intervention or control; communities within clusters were randomly chosen, and all interested, eligible mother-child pairs were enrolled (intervention: 8 clusters, 19 communities, and 287 households; control: 8 clusters, 20 communities, and 213 households). Intention-to-treat analyses were used to estimate the effect of the intervention on endline minimum diet diversity (≥4 food groups), consumption of eggs, and length-for-age (LAZ)/height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length (WLZ)/weight-for-height (WHZ) z-scores; standard errors were corrected for clustering. Children were 10.5 ± 5.2 months (range: 0-32) at baseline and 29.8 ± 5.4 months (range: 13-48) at endline. Compared with children in the control group, children in the intervention group met minimum diet diversity (adjusted odds ratio = 1.65, 95% CI [1.02, 2.69]) and a higher LAZ/HAZ (β = 0.22, 95% CI [0.09, 0.34]) and WAZ (β = 0.15, 95% CI [0.00, 0.30]). Sensitivity analyses with random-effects and mixed-effects models and as-treated analysis were consistent with the findings. There was no group difference in WLZ/WHZ. Integrated interventions that increase access to high-quality foods and nutrition education improve child nutrition.

47 citations


Cited by
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Journal ArticleDOI
TL;DR: This Commission outlines the opportunities and challenges for investment in adolescent health and wellbeing at both country and global levels (panel 1).

1,976 citations

Journal ArticleDOI
TL;DR: It is shown that stunting is the best overall indicator of children's well‐being and an accurate reflection of social inequalities and the challenge is to prevent linear growth failure while keeping child overweight and obesity at bay.
Abstract: Childhood stunting is the best overall indicator of children's well-being and an accurate reflection of social inequalities. Stunting is the most prevalent form of child malnutrition with an estimated 161 million children worldwide in 2013 falling below -2 SD from the length-for-age/height-for-age World Health Organization Child Growth Standards median. Many more millions suffer from some degree of growth faltering as the entire length-for-age/height-for-age z-score distribution is shifted to the left indicating that all children, and not only those falling below a specific cutoff, are affected. Despite global consensus on how to define and measure it, stunting often goes unrecognized in communities where short stature is the norm as linear growth is not routinely assessed in primary health care settings and it is difficult to visually recognize it. Growth faltering often begins in utero and continues for at least the first 2 years of post-natal life. Linear growth failure serves as a marker of multiple pathological disorders associated with increased morbidity and mortality, loss of physical growth potential, reduced neurodevelopmental and cognitive function and an elevated risk of chronic disease in adulthood. The severe irreversible physical and neurocognitive damage that accompanies stunted growth poses a major threat to human development. Increased awareness of stunting's magnitude and devastating consequences has resulted in its being identified as a major global health priority and the focus of international attention at the highest levels with global targets set for 2025 and beyond. The challenge is to prevent linear growth failure while keeping child overweight and obesity at bay.

762 citations

Journal ArticleDOI
TL;DR: The United States participated at the World Food Summit: Five Years Later meeting held at FAO headquarters June 10-13, 2002, to discuss progress towards attaining the 1996 World Food summit target of reducing the world’s number of hungry and malnourished by half by 2015 as discussed by the authors.
Abstract: Food and Agriculture Organization (FAO) The Food and Agriculture Organization (FAO), established in 1945, is a UN specialized agency that provides global data and expertise on agri­ culture and nutrition, fisheries, forestry, and other food and agriculture– related issues. FAO is the UN system’s largest autonomous agency, with headquarters in Rome, 78 country offices and 15 regional, sub–regional, and liaison offices, including one located in Washington, D.C. FAO’s highest policy–making body, the biennial General Conference, comprises all 183 FAO member countries plus the European Commission. The General Conference determines FAO policy and approves FAO’s reg­ ular program of work and budget. The 31st Conference, meeting in November 1999, re–elected Director–General Jacques Diouf (Senegal) to a second six–year term through December 2005. Each biennial Confer­ ence elects a 49–member Council that meets semi–annually to make rec­ ommendations to the General Conference on budget and policy issues. The North America region, which comprises the United States and Can­ ada, is allocated two seats on the Council and one seat each on FAO’s Program, Finance, and Constitutional and Legal Matters (CCLM) Com­ mittees. The United States holds the North American seats on the Finance and Joint Staff Pension Committees through December 2003. Canada holds the North American seat on the CCLM and Program Committees through December 2003. The United States participated at the World Food Summit: Five Years Later meeting held at FAO headquarters June 10–13, 2002, to discuss progress towards attaining the 1996 World Food Summit target of reduc­ ing the world’s number of hungry and malnourished by half by 2015. The United States presented new initiatives to improve agriculture productivity as a significant contribution toward meeting that goal. U.S. Secretary of Agriculture Ann Veneman, leading the U.S. delegation, joined other min­ isters and heads of state and government in adopting a Declaration, “The International Alliance Against Hunger,” which reiterated the goals of the 1996 World Food Summit and stated, inter alia, “we are committed to

683 citations

Journal ArticleDOI
TL;DR: It is suggested that increasing on-farm diversity is not always the most effective way to improve dietary diversity in smallholder households and should not be considered a goal in itself.
Abstract: Undernutrition and micronutrient malnutrition remain problems of significant magnitude in large parts of the developing world. Improved nutrition requires not only better access to food for poor population segments, but also higher dietary quality and diversity. Because many of the poor and undernourished people are smallholder farmers, diversifying production on these smallholder farms is widely perceived as a useful approach to improve dietary diversity. However, empirical evidence on the link between production and consumption diversity is scarce. Here, this issue is addressed with household-level data from Indonesia, Kenya, Ethiopia, and Malawi. Regression models show that on-farm production diversity is positively associated with dietary diversity in some situations, but not in all. When production diversity is already high, the association is not significant or even turns negative, because of foregone income benefits from specialization. Analysis of other factors reveals that market access has positive effects on dietary diversity, which are larger than those of increased production diversity. Market transactions also tend to reduce the role of farm diversity for household nutrition. These results suggest that increasing on-farm diversity is not always the most effective way to improve dietary diversity in smallholder households and should not be considered a goal in itself. Additional research is needed to better understand how agriculture and food systems can be made more nutrition-sensitive in particular situations.

481 citations

Journal ArticleDOI
TL;DR: In this paper, a conceptual framework that highlights the role of complementary feeding within the layers of contextual and causal factors that lead to stunted growth and development and the resulting short and long-term consequences is presented.
Abstract: An estimated 165 million children are stunted due to the combined effects of poor nutrition, repeated infection and inadequate psychosocial stimulation. The complementary feeding period, generally corresponding to age 6-24 months, represents an important period of sensitivity to stunting with lifelong, possibly irrevocable consequences. Interventions to improve complementary feeding practices or the nutritional quality of complementary foods must take into consideration the contextual as well as proximal determinants of stunting. This review presents a conceptual framework that highlights the role of complementary feeding within the layers of contextual and causal factors that lead to stunted growth and development and the resulting short- and long-term consequences. Contextual factors are organized into the following groups: political economy; health and health care systems; education; society and culture; agriculture and food systems; and water, sanitation and environment. We argue that these community and societal conditions underlie infant and young child feeding practices, which are a central pillar to healthy growth and development, and can serve to either impede or enable progress. Effectiveness studies with a strong process evaluation component are needed to identify transdisciplinary solutions. Programme and policy interventions aimed at preventing stunting should be informed by careful assessment of these factors at all levels.

458 citations