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Over the past decade, there has been growing interest in the development and production of plant-based and cell-based alternatives to farmed meat. Although promoted for their capacity to avoid or reduce the environmental, animal welfare, and, in some cases, public health problems associated with farmed meat production and consumption, little research has critically evaluated the broader potential public health and food systems implications associated with meat alternatives. This review explores key public health, environmental, animal welfare, economic, and policy implications related to the production and consumption of plant-based meat substitutes and cell-based meats, and how they compare to those associated with farmed meat production. Based on the limited evidence to date, it is unknown whether replacing farmed meats with plant-based substitutes would offer comparable nutritional or chronic disease reduction benefits as replacing meats with whole legumes. Production of plant-based substitutes, however, may involve smaller environmental impacts compared to the production of farmed meats, though the relative impacts differ significantly depending on the type of products under comparison. Research to date suggests that many of the purported environmental and health benefits of cell-based meat are largely speculative. Demand for both plant-based substitutes and cell-based meats may significantly reduce dependence on livestock to be raised and slaughtered for meat production, although cell-based meats will require further technological developments to completely remove animal-based inputs. The broader socioeconomic and political implications of replacing farmed meat with meat alternatives merit further research. An additional factor to consider is that much of the existing research on plant-based substitutes and cell-based meats has been funded or commissioned by companies developing these products, or by other organizations promoting these products. This review has revealed a number of research gaps that merit further exploration, ideally with independently funded peer-reviewed studies, to further inform the conversation around the development and commercialization of plant-based substitutes and cell-based meats.

The Sundarbans, prone to cyclones and tidal surges, witnessed 13 cyclones (1961-2020), causing widespread water and vector-borne diseases, injuries, deaths, crop and livestock loss, and long-term health issues. This study investigates the impact of multi-purpose cyclone shelters on the health outcomes of the Sundarbans population, focusing on epidemic-prone diseases caused by these natural disasters. The study used secondary data from the Health Management Information System (HMIS) portal, Census of India, International Best Track Archive for Climate Stewardship (IBTracs), Department of Disaster Management, and Environmental Systems Research Institute, Inc (ESRI) India, to understand the association of environmental, social, demographic, geographic, and economic factors on water and vector-borne diseases and cyclonic events for 19 census development (CD) blocks. Maps were prepared using ArcGIS Pro v.2.8. A literature review was undertaken to assess the effectiveness of cyclone shelters and potential shortcomings in addressing and mitigating these unintended health outcomes post-disaster. Data analysis in SPSS used the chi-square test and Student's t-test. The study found that the prevalence of waterborne diseases across the CD blocks in Sundarbans was significantly higher in the cyclonic years compared to the non-cyclonic years (t = 6.69), regardless of the seasons. Prevalence of vector-borne diseases was also significantly higher in the cyclonic years compared to the non-cyclonic years (t = 2.55). It was also found that the existing literature lacks detailed accounts of shelter residents' experiences, illnesses, and pre-existing health issues, particularly addressing the needs of vulnerable populations like women, children, and the elderly. The study highlights gaps in India's research on evacuee experiences in cyclone shelters, particularly for vulnerable populations like women, children, and the elderly and sick. Future research should focus on primary studies focusing on evacuee experiences, material innovation, and climate-resilient design of cyclone shelters.

Child stunting is associated with poor child development and increased mortality. Our aim was to determine the effect of length of maternal and paternal education on stunting in children under the age of 5 years. Data for indicators of child growth and of parental education and socioeconomic status were gathered from 590 570 families in Indonesia and 395 122 families in Bangladesh as part of major nutritional surveillance programmes. The prevalence of stunting in families in Indonesia was 33·2%, while that in Bangladesh was 50·7%. In Indonesia, greater maternal formal education led to a decrease of between 4·4% and 5% in the odds of child stunting (odds ratio per year 0·950, 95% CI 0·946–0·954 in rural settings; 0·956, 0·950–0·961 in urban settings); greater paternal formal education led to a decrease of 3% in the odds of child stunting (0·970, 0·967–0·974). In Bangladesh, greater maternal formal education led to a 4·6% decrease in the odds of child stunting (0·954, 0·951–0·957), while greater paternal formal education led to a decrease of between 2·9% and 5·4% in the odds of child stunting (0·971, 0·969–0·974 in rural settings; 0·946, 0·941–0·951 in urban settings). In Indonesia, high levels of maternal and paternal education were both associated with protective caregiving behaviours, including vitamin A capsule receipt, complete childhood immunisations, better sanitation, and use of iodised salt (all p<0·0001). Both maternal and paternal education are strong determinants of child stunting in families in Indonesia and Bangladesh.

BackgroundClimate change adversely affects Africa’s agriculture which would worsen the widespread food insecurity and nutritional deficiencies. Vulnerable populations, especially female farmers, women, and children are disproportionately affected.MethodsThe paper synthesizes available peer-reviewed and grey literature on the intersections of climate change, food insecurity, agriculture, gender disparities, health, child nutrition, and micronutrient deficiencies in Africa. It explores the economic ramifications of these factors, particularly their impact on public health and economic stability. The work aggregates insights into the current and future challenges of agricultural sustainability and the expected human capital development and economic costs of climate variations.ResultsThe prevalence of hunger and undernourishment in Africa is notably higher compared to other regions. Climate change directly threatens agriculture, with anticipated reductions in crop and livestock yields, compounded by the negative impact of greenhouse emissions on the nutritional quality of staple foods. Female farmers contribute notably to agriculture, but their labor share is less dominant than previously assumed. Exposure to high temperatures, especially for outdoor workers and pregnant women, presents significant health risks, further impacting agricultural and economic output. These interdependencies are presented in a framework along with suggested interventions that could be contextualized to address the climate drivers and interconnectivity across agriculture, health, and livelihoods.ConclusionThe interdependence between food, agriculture, health, nutrition, and human productivity, all of which are exacerbated by the impacts of climate change in Africa, form a complex challenge with profound health and economic implications. A multifaceted strategy is needed, encompassing climate-resilient farming practices, gender-sensitive interventions, health-focused measures like micronutrient supplementation, and comprehensive economic policies.

Background Cash transfer (CT) programs are an important type of social protection meant to reduce poverty. Whether CT programs increase the risk of overweight and obesity is unclear. The objective was to characterize the relationship between CT programs and the risk of overweight and obesity in children and adults. Methods We searched articles in PubMed, Embase, Cochrane, EconLit, Global Health, CINAHL Plus, IBSS, Health & Medical Collection, Scopus, Web of Science, and WHO Global Index Medicus in August 2021. Studies involving CT as the intervention, a control group, body mass index, overweight, or obesity as an outcome, and sample size > 300 were included. The Newcastle–Ottawa Scale was used for quality assessment. Results Of 2355 articles identified, 20 met the inclusion criteria. Because of marked heterogeneity in methodology, a narrative synthesis was used to present results. Thirteen of the studies reported that CT programs were associated with a significantly lower risk of overweight and obesity, eight studies showed no significant association, and one study reported a significantly increased risk of obesity in women. Quality assessment showed that most studies lacked sample size and power calculations, validation of exposure, descriptions of non-respondents or those lost to follow-up, and blinded outcome assessment. Conclusions Overall, the studies were suggestive that CT programs either have no impact or decrease the risk of overweight and/or obesity in children, adolescents, and adults, but no firm conclusions can be drawn from the available evidence. This review demonstrated limitations in the available studies of CT programs and overweight/obesity.

Retention in care and adherence to antiretroviral treatment (ART) are critical elements of HIV care interventions and are closely associated with optimal individual and public health outcomes and cost effectiveness. This literature review was conducted to analyse how the roles of clients in HIV care and treatment are discussed, from terminology used to measurement methods to consequences of a wide range of patient-related factors impacting client adherence to ART and retention in care. Unfortunately, data suggests that clients find it hard to follow recommended behaviour. For HIV, the greatest loss to follow-up occurs before starting treatment, though each step of the continuum of care is affected. Measurement approaches can be divided into ‘direct’ and ‘indirect’ methods; in practice, a combination is often considered the best strategy. Inadequate retention and adherence lead to decreased health outcomes (morbidity, mortality, drug resistances, risk of transmission) and cost effectiveness (increased costs and lower productivity).

Socioeconomic costs of HIV and TB and the difficulty of maintaining optimal treatment are well documented. Social protection measures such as food assistance may be required to offset some of the treatment related costs as well as to ensure food security and maintain good health of the affected individual and household. Programmes have started placing greater emphasis on treatment adherence and are looking for proven interventions that can optimize it. This paper looks at the effect of food assistance for enabling treatment adherence and reviews studies that used food assistance to promote adherence. Eight of ten studies found that provision of food can improve adherence and/or treatment completion for HIV care and treatment, ART and TB-DOTS. This indicates that food provision is not only a biological, but also a behavioural intervention, and underscores that unresolved food insecurity can be an impediment to treatment adherence and consequently to good treatment outcomes.

To determine whether children in India who have a low intake of vitamin A–rich foods are at higher risk of malnutrition, anemia, and not receiving child health interventions. We analyzed data from the India National Family Health Survey, 2005–2006. Of 17 847 children (41.9%), aged 12–35 months, 7020 did not receive vitamin A–rich foods, based on 24-h recall. The prevalence of stunting, severe stunting, underweight, and severe underweight among children who did and did not receive vitamin A–rich foods was, respectively, 52.5% versus 59.0%, 26.7% versus 32.9%, 43.8% versus 48.5%, and 17.9% versus 21.6% (all P < 0.0001). Children who did not receive vitamin A–rich foods were more likely to be anemic, not have completed childhood immunizations, and not to have received vitamin A supplementation in the previous 6 mo (all P < 0.0001). Maternal education of ≥10, 7–9, and 1–6 y, respectively, compared with no formal education was associated with the child receiving vitamin A–rich foods (odds ratio 1.41, 95% confidence interval 1.20–1,67, P < 0.0001; odds ratio 1.20, 95% confidence interval 1.04–1.37, P = 0.01; odds ratio 1.16, 95% confidence interval 1.02–1.32, P = 0.02) in a multivariate logistic regression model adjusting for maternal age, household size, socioeconomic status, and location. Children who did not receive vitamin A–rich foods were more likely to be malnourished and to have missed basic child health interventions, including vitamin A supplementation. Children were more likely to receive vitamin A–rich foods if their mothers had previously achieved higher primary or secondary education levels.

To determine the most effective method for analysing haemoglobin concentrations in large surveys in remote areas, and to compare two methods (indirect cyanmethaemoglobin and HemoCue) with the conventional method (direct cyanmethaemoglobin). Samples of venous and capillary blood from 121 mothers in Indonesia were compared using all three methods. When the indirect cyanmethaemoglobin method was used the prevalence of anaemia was 31-38%. When the direct cyanmethaemoglobin or HemoCue method was used the prevalence was 14-18%. Indirect measurement of cyanmethaemoglobin had the highest coefficient of variation and the largest standard deviation of the difference between the first and second assessment of the same blood sample (10-12 g/l indirect measurement vs 4 g/l direct measurement). In comparison with direct cyanmethaemoglobin measurement of venous blood, HemoCue had the highest sensitivity (82.4%) and specificity (94.2%) when used for venous blood. Where field conditions and local resources allow it, haemoglobin concentration should be assessed with the direct cyanmethaemoglobin method, the gold standard. However, the HemoCue method can be used for surveys involving different laboratories or which are conducted in relatively remote areas. In very hot and humid climates, HemoCue microcuvettes should be discarded if not used within a few days of opening the container containing the cuvettes.

We investigated the relation between parental tobacco use and malnutrition in children <5 y of age and compared expenditures on foods in households with and without tobacco use. Tobacco use, child anthropometry, and other factors were examined in a stratified, multistage cluster sample of 77 678 households from the Bangladesh Nutrition Surveillance Project (2005–2006). Main outcome measurements were stunting, underweight, and wasting, and severe stunting, severe underweight, and severe wasting. Secondary outcomes included the proportion of household expenditures spent on food. The prevalence of parental tobacco use was 69.9%. Using the new World Health Organization child growth standards, prevalences of stunting, underweight, and wasting were 46.0%, 37.6%, and 12.3%, respectively. After adjusting for potential confounders, parental tobacco use was associated with an increased risk of stunting (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.12–1.21, P < 0.0001), underweight (OR 1.17, 95% CI 1.12–1.22, P < 0.0001), and wasting (OR 1.10, 95% CI 1.03–1.17, P = 0.004), and severe stunting (OR 1.16, 95% CI 1.10–1.23, P < 0.0001), severe underweight (OR 1.21, 95% CI 1.13–1.30, P < 0.0001), and severe wasting (OR 1.14, 95% CI 0.98–1.32, P = 0.09). Households with tobacco use spent proportionately less per capita on food items and other necessities. In Bangladesh parental tobacco use may exacerbate child malnutrition and divert household funds away from food and other necessities. Further studies with a stronger analytic approach are needed. These results suggest that tobacco control should be part of public health strategies aimed at decreasing child malnutrition in developing countries.