To compare infant and young child feeding practices in children aged 0–23 months across nine East and Southeast Asian countries.

Secondary analyses of cross-sectional data from available Demographic and Health Surveys (DHS; Indonesia, Philippines, Timor-Leste, Cambodia and Vietnam), Multiple Indicator Country Surveys (Lao People's Democratic Republic (Lao PDR) and Myanmar) and national nutrition surveys (Democratic People’s Republic of Korea (DPR Korea) and Mongolia) conducted between 2000 and 2005.

Seven countries from Southeast Asia and two from East Asia.

Children aged 0–23 months with samples ranging from 826 to 5610 for DHS, and from 477 to 5860 for non-DHS data.

More than 93 % of infants were ever breast-fed, and over 75 % were currently breast-fed except in the Philippines. Timely initiation of breast-feeding varied from 32 % in Indonesia to 46 % in Timor-Leste. Exclusive breast-feeding (EBF) rate in infants under 6 months of age ranged from 11 % in Myanmar to 60 % in Cambodia. EBF rates were also low in Vietnam (15·5 %) and Lao PDR (23 %), and varied between 30 % and 40 % in Indonesia, Philippines and Timor-Leste. The proportion of infants under 6 months of age who were given breast milk with non-milk liquids was high except in Indonesia and Timor-Leste. Bottle-feeding rates were lower in DPR Korea (3 %), Lao PDR (6 %) and Myanmar (6 %) and higher in the Philippines (49 %) and Mongolia (31 %). Timely complementary-feeding rate varied widely across countries (6–99 %).

All the countries studied should make greater efforts to improve timely initiation of breast-feeding and EBF for 6 months. Measures should be taken to reduce high bottle-feeding rate in the Philippines, Mongolia, Indonesia and Vietnam, and improve complementary-feeding rate in Lao PDR, Myanmar, DPR Korea and Philippines.

To assess whether persistent micronutrient deficiencies in Mongolian children identified in our earlier biochemical study are associated with inadequacies in quantity and/or quality in their complementary diets.

A cross-sectional study of breast-fed children aged 6–23 months, randomly selected from four districts in Ulaanbaatar and four provincial capitals.

Weight and length were measured, and sociodemographic status, feeding practices and nutrient adequacy of complementary foods for children aged 6–8 months (n 26), 9–11 months (n 29) and 12–23 months (n 73) were assessed via questionnaire and in-home interactive 24 h recalls.

No geographic differences existed so data were combined. Adherence to WHO infant and young child feeding practices was poor: few children were exclusively breast-fed up to 6 months of age or received the recommended number of feedings containing the recommended number of food groups. Nevertheless, energy intakes from complementary diets, primarily from cereals and non-nutritious snacks, were above WHO-estimated needs; <1 % of energy was from meat and eggs or fruits and vegetables. Median intakes and densities of most nutrients (except protein, thiamin and riboflavin) failed to meet WHO recommendations for at least two age groups, assuming average breast milk intake; greatest density deficits were for Fe > vitamin C > vitamin A > Zn > Ca.

Complementary feeding in Mongolia is compromised by deficits in several micronutrients but not energy, in part because of frequent consumption of non-nutritious snacks. The latter may interfere with breast-feeding and should be avoided. Instead, wheat-based complementary foods should be enriched with affordable cellular animal foods and fruits rich in vitamin C to combat existing micronutrient deficits.

To obtain baseline pre-intervention prevalence levels of iodine deficiency and parasitic and helminth infections in school-going children in Bie Province, Angola.

A cross-sectional study conducted in randomly selected schools. The target population was children aged 6–10 years.

Bie Province, Angola.

A total of 1029 children sampled, with 791 stool samples and 826 urine samples collected from twenty-four schools.

Widespread severe and moderate deficiencies in iodine. Children in five schools were severely iodine deficient. All sampled schoolchildren were iodine deficient to a greater or lesser extent. In all, 80 % of all children across the twenty-four schools were infected with one or a combination of intestinal helminths and intestinal protozoa.

These findings have serious implications for the cognitive development of Angolan children, as well as for Angola’s development in terms of productivity and economic potential. It is strongly recommended that the provincial and national Ministries of Health, in collaboration with international health agencies, immediately plan and implement a strategy to provide sufficient iodine through iodised oil capsules and iodised salt to the iodine-deficient population. National coalitions need to be strengthened among the government, partners and salt producers. It is also recommended that all the children in schools be de-wormed for multiple helminth species at least twice a year.

Fe supplementation has been used to prevent anaemia in China; however, high Fe intake and body Fe stores may increase diabetes risk. The present study aimed to prospectively examine the association between Fe intake/stores and hyperglycaemia, and to assess the joint effects on anaemia.

We followed 1056 healthy adults aged 20 years and older from 2002 to 2007. Body Fe stores were measured. Dietary data were collected using a 3 d food record and FFQ. Hyperglycaemia was defined as fasting plasma glucose >5·6 mmol/l.

Of the participants, 28·8 % were anaemic at baseline. During the 5 years of follow-up, we documented 125 incident cases of hyperglycaemia, among them twenty-three were diabetic. Haem Fe intake was positively associated with the risk of hyperglycaemia in men and women: the OR (95 % CI) across increasing quartiles of haem Fe intake was 1·00 (referent), 1·49 (0·74, 3·01), 2·16 (1·06, 4·42) and 3·48 (1·71, 7·11), respectively (P for trend <0·001). Comparing the fourth quartile of serum ferritin with the others, the age- and gender-adjusted OR (95 % CI) was 1·54 (1·01, 2·34), P for trend = 0·043. The association between total Fe intake and the risk of hyperglycaemia was significant in men (P for trend = 0·002). Anaemia added additional risk of hyperglycaemia on haem Fe intake. Comparing extreme quartiles of haem Fe intake, the OR (95 % CI) was 5·67 (1·43, 22·49) and 3·44 (1·51, 7·85) for hyperglycaemia among anaemic and non-anaemic participants (P for trend = 0·008 and 0·010, respectively).

The present cohort study suggests that high haem Fe intake, anaemia and high ferritin are associated with an increased risk of hyperglycaemia in Chinese men and women. There was a joint effect between anaemia and haem Fe intake on the risk of hyperglycaemia.

To estimate the prevalence of malnutrition among free-living elderly in a rural population of south India.

Cross-sectional study. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) questionnaire, which is an eighteen-item nutritional screening instrument used in the elderly.

Kaniyambadi block, a rural development block in the state of Tamil Nadu, south India.

Community-dwelling elderly (aged 60 years and above).

As evaluated by the MNA, 14 % of the 227 subjects were malnourished and 49 % were at risk of malnourishment. No significant difference was found between men and women. The majority of the elderly were living with their children, had no income and consumed three meals per day. Older age (P < 0·001), decreased food intake (P < 0·001) and consuming fewer meals (P < 0·001) were independently associated with lower MNA scores.

More than 60 % of the subjects had low MNA scores (<23·5) indicating that deficient protein–energy intake is common among rural elderly of south India and requires more attention.

Few studies have examined recent shifts in meat consumption (MC), differences among US population groups, and the influence of psychosocial–behavioural factors.

Nationally representative data collected for US adults aged ≥18 years in the 1988–1994 and 1999–2004 National Health and Nutrition Examination Survey (NHANES) and the 1994–1996 Continuing Survey of Food Intakes by Individuals (CSFII) and Diet and Health Knowledge Survey (DHKS) were used.

We found a U-shaped trend in MC, a decrease between 1988–1994 and 1994–1996, and an increase from 1994–1996 to 1999–2004. NHANES 1988–1994 and 1999–2004 indicate that MC did not change significantly, particularly for all meat, red meat, poultry and seafood. Between 1994–1996 and 1999–2004, average MC, including red meat, poultry, seafood and other meat products, increased in men. Women’s total MC decreased, mainly due to decreased red meat and other meat products, except for increased seafood. Noticeable differences existed in the changes across population groups. Black men had the largest increase in consumption of total meat, poultry and seafood; Mexican American men had the smallest increase in poultry, seafood and other meat products. In 1999–2004, ethnic differences in MC became greater in women than among women in 1994–1996. Associations between MC and energy intake changed over time. Perceived benefit of dietary quality and food label use were associated with reduced red MC.

Noticeable differences exist in the shifts in MC across population groups and surveys. MC increased in men but decreased in women in recent years.

To evaluate time trends in the availability of soft drinks, to identify food choices associated with their consumption and to assess the relationship between socio-economic status and daily soft drink availability in a wide range of European countries.

Data on food and beverage availability collected through the national household budget surveys and harmonized in the DAFNE (Data Food Networking) project were used. Averages and variability of soft drink availability were estimated and tests for time trends were performed. The daily availability of food groups which appear to be correlated with that of soft drinks was further estimated. Multivariate logistic and linear regression models were applied to evaluate the association between socio-economic status and the acquisition of soft drinks.

Twenty-four European countries.

Nationally representative samples of households.

The availability of soft drinks is steadily and significantly increasing. Households in West and North Europe reported higher daily availability of soft drinks in comparison to other European regions. Soft drinks were also found to be correlated with lower availability of plant foods and milk and higher availability of meat and sugar products. Lower socio-economic status was associated with more frequent and higher availability of soft drinks in the household.

Data collected in national samples of twenty-four European countries showed disparities in soft drink availability among socio-economic strata and European regions. The correlation of soft drinks with unfavourable dietary choices has public health implications, particularly among children and adolescents.

The traditional Mediterranean food pattern is more easily preserved when meals are eaten at home; however, as a result of recent socio-economic changes, away-from-home meal consumption has increased rapidly in Mediterranean countries. Little research has been conducted so far to investigate the long-term health effects of these changes in the Mediterranean area.

In a prospective Spanish dynamic cohort of 9182 university graduates (the SUN Study; Seguimiento Universidad de Navarra, University of Navarra Follow-up) with a mean age of 37 years, followed up for an average of 4·4 years, we assessed the association between the frequency of eating out of home and weight gain or incident overweight/obesity. Dietary habits were assessed with an FFQ previously validated in Spain.

During follow-up, eating-out consumers (two times or more per week) had higher average adjusted weight gain (+129 g/year, P < 0·001) and higher adjusted risk of gaining 2 kg or more per year (OR = 1·36; 95 % CI 1·13, 1·63) than non-eating-out consumers. Among participants with baseline BMI < 25 kg/m2, we observed 855 new cases of overweight/obesity. Eating away-from-home meals was significantly associated with a higher risk of becoming overweight/obese (hazard ratio = 1·33; 95 % CI 1·13, 1·57).

A higher frequency of meals eaten out of home may play a role in the current obesity epidemic observed in some Mediterranean countries.

To evaluate the reproducibility of a semi-quantitative FFQ used in the Seguimiento Universidad de Navarra (SUN) project.

The data that were analysed were collected from an FFQ answered twice by a 326-participant subsample of the SUN project (115 men, 35·3 %; 211 women, 64·7 %), with either less than 1 year or more than 1 year between responses. The questionnaire included 136 items. Pearson correlation coefficients (r) were calculated to evaluate the magnitude of the association between both measures after energy adjustment and correcting for within-person variability. We also evaluated misclassification by quintiles distribution.

The highest corrected correlations among participants who answered before 1 year were found for PUFA (r = 0·99). Among participants who answered after 1 year between both questionnaires, olive oil had the highest corrected correlation (r = 0·99). The highest percentage of gross misclassification, lowest quintile in FFQ1 and highest quintile in FFQ2 or highest quintile in FFQ1 and lowest quintile in FFQ2 was for cereals, fish or seafood, and n-3 fatty acids (7·6 %). Alcoholic drinks had the highest percentage of reasonable classification, same or adjacent quintile, in FFQ1 and FFQ2 (86·4 %).

Our study suggests that FFQ reproducibility is acceptable for participants who answered the same questionnaire twice less than 1 year apart. Participants who answered FFQ more than 1 year apart showed worse values on reproducibility. We consider this Spanish FFQ as an important, valid and reproducible tool in nutritional epidemiology.

To determine whether the Mini Nutritional Assessment (MNA) can screen and diagnose for malnutrition in the Iranian elderly.

The MNA was administered to all volunteers. Each patient underwent anthropometric and serum albumin measurements. Reliability, validity, sensitivity, specificity, positive- and negative-predictive values were estimated. To identify optimal threshold values for predicting malnutrition, receiver-operating characteristic curve analysis was performed for MNA scores.

Kahrizak Charity Foundation (Tehran, Iran).

Two hundred and twenty-one consecutive elderly patients entered into the cross-sectional study. Amputees and patients with liver or renal disorders, oedema or any end-stage diseases were excluded.

According to MNA score, 3·2 % were malnourished, 43·4 % were at risk of malnutrition and 53·4 % were well nourished. The proportions in these categories according to ideal body weight and serum albumin were 2·3 %, 17·1 % and 80·6 %, respectively. Cronbach’s α coefficient (reliability) was 0·61. The correlations between total MNA score, anthropometric values and serum albumin (criterion-related validity) were all significant. There were significant differences in total MNA score between two BMI groups but not between two categories according to serum albumin and skin ulcers (construct validity). The sensitivity and specificity of the MNA according to its established cut-off points were 82 % and 63 %, respectively. Positive-predictive value was 35 % and negative-predictive value was 93 %. By using the best cut-off point (MNA score of 22 according to Youden index), the sensitivity, specificity, positive-predictive value and negative-predictive value were 88 %, 62 %, 57 % and 89 %, respectively.

The MNA with its established cut-off points may not be a good fit for Asian populations, including Iranian elderly.

To estimate the phytate intake and molar ratio of phytate to zinc in the diet of the people in the United Kingdom.

Tables of the phytate content of foods were developed from twenty-eight published and unpublished studies. They were then applied to the nutrient databank of the National Diet and Nutrition Survey (NDNS). The study is a retrospective analysis of data on daily consumption of foods and drinks from the NDNS of children, adolescents, adults and the elderly based on 4–7 d weighed intakes.

A total of 6786 British participants aged 1·5 years and above, who participated in the NDNS, 1992–2001.

England, Scotland and Wales.

The median daily intakes of phytate for children, adolescents, adults and the elderly population were 496, 615, 809 and 629 mg/d, respectively. Although there were differences in phytate intakes between men and women, and for children, adolescents and elderly populations, after adjusting for differences in energy intake, there was no significant variation. The median phytate-to-zinc molar ratios for children, adolescents, adults and the elderly population were 11·8, 10·4, 9·7 and 8·7, respectively. Overall, the main sources of phytate were cereal and cereal products (e.g. breakfast cereals and breads), vegetables, potatoes and savoury snacks (e.g. chips and crisps), hot drinks and miscellaneous foods (e.g. commercial toddler foods and drinks, chocolate and soups), fruits and nuts.

The present study estimated the dietary intake of phytate and the phytate-to-zinc molar ratio of the diet of the UK population, which can be used for estimating the average requirement of zinc. Further research should focus on the completion and validation of the tables of phytate content of UK foods, to assess (and if necessary improve) the accuracy and precision of these findings.

To our knowledge, only a few Iranian studies have investigated factors associated with obesity among men. The aims of the present study were to explore the associations between sociodemographic factors, smoking and obesity in Iranian men and compare these associations between Iranian men and women.

We used data from the National Health Survey in Iran. A generalised estimating equations model included 11 697 men and 14 854 women aged 20–69 years (12 850 households). Body weight and height were objectively measured. BMI was calculated as kg/m2, and subjects were classified into obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2).

Among men, adjusted obesity OR were 0·62 (95 % CI 0·52, 0·74), 1·09 (95 % CI 0·90, 1·32), 1·003 (95 % CI 1·00, 1·007) and 0·57 (95 % CI 0·40, 0·81) for smokers, married, economic index and active workforce groups, respectively. Using low education as the reference group, the obesity OR for men were 1·06 (95 % CI 0·89, 1·26) and 0·75 (95 % CI 0·57, 0·99) for the moderate and high education groups, respectively. Using rural as the reference group, the obesity OR was 1·87 (95 % CI 1·56, 2·26) for urban men.

Our findings may point towards a better understanding of the social and cultural mechanisms of obesity in Iranian men. The above sociodemographic factors are large contributors to obesity and provide the greatest opportunity for actions and interventions designed for prevention and treatment.

Although recent studies have shown an inverse relationship between dairy consumption and metabolic abnormalities, we are aware of no study evaluating the association between dairy consumption and circulating levels of inflammatory markers. The current study was undertaken to assess the association between the consumption of high-fat and low-fat dairy products and circulating levels of inflammatory markers among Tehrani women aged 40–60 years.

In a cross-sectional study of 486 apparently healthy women aged 40–60 years, we assessed usual dietary intakes by means of an FFQ. Anthropometric measurements were made and fasting blood samples were taken for measuring inflammatory markers.

The reported mean (sd) daily intake of low- and high-fat dairy consumption was 85 (sd 23) and 101 (sd 29) g/d, respectively. After control for age, BMI, waist circumference and other potential confounders, low-fat dairy consumption was inversely associated with C-reactive protein (β = −0.04), IL-6 (β = −0.02) and soluble vascular cell adhesion molecule-1 (β = −0.06); with further adjustment for dietary intakes, the associations remained significant just for soluble vascular cell adhesion molecule-1 (β = −0.03). High-fat dairy intake was positively associated with log-transformed values of serum amyloid A (β = 0.08) and soluble vascular cell adhesion molecule-1 (β = 0.05), both before and after adjustment for all potential confounding variables. No overall significant associations were found between total dairy consumption and inflammation.

The current study indicates an independent relationship between high-fat as well as low-fat dairy consumption, not total dairy intake, and some markers of inflammation and endothelial dysfunction. Further studies are required to identify responsible components of dairy products and related mechanisms of action.

Dietary flavonoids and their metabolites may have neuroprotective effects against age-associated neurodegenerative disorders such as Alzheimer’s and related dementias (dementia). There is a lack of population studies, however, on correlations between flavonoid intake and dementia. The main objective of the present study was to analyse such a relationship at a large-scale population level.

Based on global data (FAO, WHO), databases were generated for: (i) flavonoid content of foods; (ii) per capita national dietary intakes of flavonoids and other dietary factors; and (iii) disability-adjusted life years – a measure of burden and death – due to dementia. Five major flavonoid subclasses were examined. To minimize influences due to accuracy and reliability of the disease source data, twenty-three developed countries were selected after statistical evaluation.

Flavonols and combined flavonoids (all five combined) intakes were the only two parameters with significant (P < 0·05) negative dementia correlations. Multiple linear regression models confirmed this relationship, and excluded confounding from some other dietary and non-dietary factors. Similar analyses with non-dementia, neurological/psychiatric diseases did not yield significant correlations.

At a global level, and in the context of different genetic backgrounds, our results suggest that higher consumption of dietary flavonoids, especially flavonols, is associated with lower population rates of dementia in these countries.

In the context of the nutrition transition and associated changes in the food retail sector, to examine the socio-economic characteristics and motivations of shoppers using different retail formats (large supermarkets (LSM), medium-sized supermarkets (MSM) or traditional outlets) in Tunisia.

Cross-sectional survey (2006). Socio-economic status, type of food retailer and motivations data were collected during house visits. Associations between socio-economic factors and type of retailer were assessed by multinomial regression; correspondence analysis was used to analyse declared motivations.

Peri-urban area around Tunis, Tunisia, North Africa.

Clustered random sample of 724 households.

One-third of the households used LSM, two-thirds used either type of supermarket, but less than 5 % used supermarkets only. Those who shopped for food at supermarkets were of higher socio-economic status; those who used LSM were much wealthier, more often had a steady income or owned a credit card, while MSM users were more urban and had a higher level of education. Most households still frequently used traditional outlets, mostly their neighbourhood grocer. Reasons given for shopping at the different retailers were most markedly leisure for LSM, while for the neighbourhood grocer the reasons were fidelity, proximity and availability of credit (the latter even more for lower-income customers).

The results pertain to the transition in food shopping practices in a south Mediterranean country; they should be considered in the context of growing inequalities in health linked to the nutritional transition, as they differentiate use and motivations for the choice of supermarkets v. traditional food retailers according to socio-economic status.

To describe food habits and associated sociodemographic factors.

Cross-sectional survey in 2005.

Ninety-six school classes in Ramallah, Nablus and Hebron governorates, Occupied Palestinian Territory.

Grade 8 and 9 students aged 13–15 years (n 2952).

Self-administered student and parent questionnaires.

High standard of living (STL) index and residence in Ramallah were positively associated with intake of animal foods, Western-style foods, dairy products, fruits and vegetables, sweets and salty snacks. Only 26·1 % of the students ate three main meals daily; 26·2 % of the boys and 51·0 % of the girls had breakfast one to two times per week or less often (P < 0·001). Only one-quarter of students drank milk daily (32·9 % of boys and 18·3 % of girls, P < 0·001). The majority of students, boys and girls in similar proportions, consumed vegetables daily (72·8 % v. 73·8 %, respectively). Daily fruit consumption was also equally common among boys and girls (58·9 % v. 55·2 %, respectively), but with clear differences by STL, region and parents’ education. Daily intake of sweets and salty snacks was common among girls, and daily intake of soft drinks was common among boys.

Irregular meal patterns were common among Palestinian adolescents. High STL and residence in Ramallah were associated with frequent intake of foods high in sugar and fat, but also with frequent intake of fruits and vegetables. Effective interventions are needed to establish healthy dietary habits.

To determine associations of diet, physical activity and television (TV) viewing time with obesity among aboriginal and non-aboriginal youth in conjunction with socio-economic variables.

Cross-sectional study of differences between aboriginal and non-aboriginal groups and associations between lifestyle and socio-economic factors with obesity were examined.

Population data from the Canadian Community Health Survey Cycle 2·2 conducted in 2004 in the ten provinces of Canada.

A total of 198 aboriginal and 4448 non-aboriginal Canadian youth aged 12–17 years.

Compared to non-aboriginal youth, physical activity participation among aboriginal youth was higher, but consumption of vegetables and dairy products was lower, and more aboriginal youth were ‘high’ TV watchers. Low income adequacy was associated with decreased odds for obesity among aboriginal youth in contrast to higher odds among non-aboriginal youth. Non-aboriginal ‘high’ TV watchers consumed more soft drinks and non-whole-grain products than did ‘low’ TV watchers. Physical activity participation did not differ between ‘high’ and ‘low’ TV watchers for both groups, and was associated with lowered odds for obesity only among aboriginal youth.

Sociodemographic and lifestyle risk factors associated with obesity differ between aboriginal and non-aboriginal youth. These findings may be useful for guiding intervention efforts.

The purpose of the present paper is to assess the relationship between food insecurity and food consumption patterns, anthropometric measures and serum micronutrient levels in rural Kilimanjaro, Tanzania.

A population-based cross-sectional study was carried out between March and May of 2005.

Rural Kilimanjaro, Tanzania.

Analysis was restricted to 1014 adults aged 15–44 years with children and complete data.

A large majority of the participants (91 %) reported some kind of food insecurity. Food insecurity was significantly associated with age, marital status and occupation. Participants reporting food insecurity were significantly less likely to frequently consume animal products, fruits and vegetables compared with participants categorized as food secure. Women categorized as experiencing individual food insecurity had a larger waist circumference than food-secure women (P = 0·026) while the mean BMI of women appeared to decline if they had a child who was food insecure (P = 0·038). There were no observed differences in serum micronutrient levels by food insecurity status.

Food insecurity is highly prevalent and associated with food consumption patterns, waist circumference and BMI of women in rural Tanzania. Further studies should apply self-report measures in assessing food insecurity to larger and more diversified populations.

To assess the impact of an integrated community-based micronutrient and health (MICAH) programme on anaemia (Hb < 120 g/l) among non-pregnant rural Malawian women aged 15–49 years from communities that participated in the 1996–2005 MICAH programme.

Prospective study of two large-scale cross-sectional surveys conducted in 2000 and 2004 as part of programme evaluation in MICAH and Comparison areas.

Rural areas across Malawi. The MICAH programme implemented a comprehensive package of interventions to reduce anaemia, based on a broad range on direct and indirect causes in Malawi. The project approaches included: Fe supplementation; dietary diversification and modification; food fortification; and strengthening primary health care.

Non-pregnant women of childbearing age (15–49 years old, n 5422), from randomly selected households that responded to a household questionnaire, had their Hb measured from finger-prick blood samples using the HemoCue®.

In 2000, there was no significant difference in Hb concentration between MICAH and Comparison areas (mean (se): 117·4 (0·4) v. 116·8 (0·5) g/l, P > 0·05) and the corresponding prevalence of anaemia (53·5 % v. 52·9 %, P > 0·05). By 2004, Hb concentration had increased significantly in MICAH but not in Comparison areas (mean (se): 121·0 (0·4) v. 115·7 (0·6) g/l, P < 0·001), and the prevalence of anaemia had declined significantly in MICAH areas (53·5 % to 44·1 %, χ2 = 28·2, P < 0·0001) but not in Comparison areas (52·8 % to 54·0 %, χ2 = 0·3, P = 0·6).

The MICAH programme was an effective public health nutrition programme that was associated with significant reductions in the prevalence of anaemia among non-pregnant rural Malawian women.