***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Indonesia 's economic crisis of late 1990s lowered consumption of micronutrient-rich foods , which increased the prevalence of micronutrient deficiencies , including anemia . As a postcrisis response , 5 nongovernmental organizations ( NGOs ) implemented Food for Work ( FFW ) programs to protect food consumption levels and nutritional status by providing rice , sometimes combined with oil and /or pinto beans . An independent evaluation assessed the effect of the FFW programs on nutrition outcomes , particularly anemia . A quasi-experimental design was used in which 1500 beneficiary and 1500 control households were r and omly selected and followed in each of 3 urban and 2 rural sites . Baseline data were collected before program implementation and subsequently at approximately 6-mo intervals for 2.5 y. The poor were found to be appropriately targeted , and program participation ranged from 4 to 18 mo . The proportion of households with debts ranged from 32 to 70 % ; although it was higher among beneficiaries than controls , it increased among controls , but not beneficiaries . However , only among urban poor mothers in Surabaya were the odds of anemia at endline lower when participating in the FFW program ( 0.60 , 95%CI [ 0.40 - 0.89 ] ) . Other risk factors for  anemia in mothers and children included nutritional status ( anemia at baseline , low  BMI , receipt of vitamin A capsule , child age ) and socioeconomic status ( maternal education , having official residency in the area , income level ) . Thus , postcrisis FFW programs had limited effect on anemia , the main identified nutritional problem . Closer attention is required to the potential for affecting nutritional outcomes through FFW , including food aid quality and quantity and complementary nonfood interventions . Micronutrient deficiencies should be addressed directly via supplements and fortified foods The cash component of Oportunidades , a large conditional cash transfer ( CCT ) program in Mexico , has previously been shown to be associated with better outcomes for child growth and development . The objective of this analysis was to determine whether the cash transfers were also associated with positive outcomes for adult health .  Oportunidades  was originally r and omized across 506 rural ( < 2500 inhabitants ) communities assigned to immediate incorporation into the program in 1997 or incorporation 18 mo later . Adults ( n = 1649 early , n = 2039 late intervention ) aged 18 - 65 y were then assessed in 2003 . All of the households included in the analysis reported here complied with Oportunidades 's requirements for the entire period , but some received higher cumulative cash transfers because they were living in communities r and omized to begin receiving transfers earlier and /or they accumulated cash at a faster rate because they had more school-aged children at baseline . Our primary findings were that a doubling of cumulative cash transfers to the household was associated with higher BMI ( beta = + 0.83 , 95 % CI 0.46 , 1.20 ; P < 0.0001 ) , higher diastolic blood pressure ( beta = + 1.19 , 95 % CI 0.09 , 2.29 ; P = 0.03 ) , and higher prevalence of overweight [ odds ratio ( OR ) = 1.41 , 95 % CI 1.18 , 1.67 ; P < 0.0001 ) , grade I obesity ( OR = 1.41 , 95 % CI 1.14 , 1.75 ; P = 0.002 ) , and grade II obesity ( OR = 1.57 , 95 % CI 1.05 , 2.36 ; P = 0.03 ) , while controlling for a wide range of covariates , including household composition at baseline . Oportunidades has been portrayed as a model for CCT programs worldwide , but the results reported here support the notion that the cash component of Oportunidades may be negatively associated with some adult health outcomes Objectives : Food insecurity and HIV/AIDS outcomes are inextricably linked in sub-Saharan Africa . We report on health and nutritional outcomes of a multisectoral agricultural intervention trial among HIV-infected adults in rural Kenya . Design : This is a pilot cluster r and omized controlled trial . Methods : The intervention included a human-powered water pump , a microfinance loan to purchase farm commodities , and education in sustainable farming practice s and financial management .  Two health facilities in Nyanza Region , Kenya were r and omly assigned as intervention or control .  HIV-infected adults 18 to 49 years ’ old who were on antiretroviral therapy and had access to surface water and l and were enrolled beginning in April 2012 and followed quarterly for 1 year . Data were collected on nutritional parameters , CD4 + T-lymphocyte counts , and HIV RNA . Differences in fixed-effects regression models were used to test whether patterns in health outcomes differed over time from baseline between the intervention and control arms . Results : We enrolled 72 and 68 participants in the intervention and control groups , respectively . At 12 months follow-up , we found a statistically significant increase in CD4 + cell counts ( 165 cells/&mgr;l , P < 0.001 ) and proportion virologically suppressed in the intervention arm compared with the control arm ( comparative improvement in proportion of 0.33 suppressed , odds ratio 7.6 , 95 % confidence interval : 2.2–26.8 ) . Intervention participants experienced significant improvements in food security ( 3.6 scale points higher , P < 0.001 ) and frequency of food consumption ( 9.4 times per week greater frequency , P = 0.013 ) compared to controls . Conclusion : Livelihood interventions may be a promising approach to tackle the intersecting problems of food insecurity , poverty and HIV/AIDS morbidity β-Carotene-rich orange sweet potato ( OSP ) has been shown to improve vitamin A status of infants and young children in controlled efficacy trials and in a small-scale effectiveness study with intensive exposure to project inputs . However , the potential of this important food crop to reduce the risk of vitamin A deficiency in deficient population s will depend on the ability to distribute OSP vines and promote its household production and consumption on a large scale . In rural Mozambique , we conducted a r and omised , controlled effectiveness study of a large-scale intervention to promote household-level OSP production and consumption using integrated agricultural , dem and creation/behaviour change and marketing components . The following two intervention models were compared : a low-intensity ( 1 year ) and a high-intensity ( nearly 3 years ) training model . The primary nutrition outcomes were OSP and vitamin A intakes by children 6 - 35 months and 3 - 5·5 years of age , and women . The intervention result ed in significant net increases in OSP intakes ( model 1 : 46 , 48 and 97 g/d ) and vitamin A intakes ( model 1 : 263 , 254 and 492 μg retinol activity equivalents/d ) among the younger children , older children and women , respectively . OSP accounted for 47 - 60 % of all sweet potato consumed and , among reference children , provided 80 % of total vitamin A intakes . A similar magnitude of impact was observed for both models , suggesting that group-level trainings in nutrition and agriculture could be limited to the first project year without compromising impact . Introduction of OSP to rural , sweet potato-producing communities in Mozambique is an effective way to improve vitamin A intakes Céline Langendorf and colleagues conducted a pragmatic intervention  study in Niger to assess whether distributions of supplementary foods in addition to household support by cash transfer effectively reduced malnutrition in children aged 6 to 23 months . Please see later in the article for the Editors ' BACKGROUND In sub-Saharan Africa , ~ 40 % of children < 5 y old are stunted , with levels that have remained largely unchanged over the past 2 decades . Although the complex determinants of undernutrition are well recognized , few studies have evaluated strategies that combine nutrition-specific , health-based approaches with food system- and livelihood-based interventions . OBJECTIVE We examined changes in childhood stunting and its determinants after 3 y of exposure to an integrated , multisector intervention and compared these changes with national trends . DESIGN A prospect i ve observational trial was conducted across rural sites in 9 sub-Saharan African countries with baseline levels of childhood stunting > 20 % . A stratified r and om sample of households and resident children < 2 y old from villages exposed to the program were enrolled in the study . Main outcome measures included principal determinants of undernutrition and childhood stunting , which was defined as a height-for-age z score less than -2 . National trends in stunting were generated from demographic and health surveys . RESULTS Three years after the start of the program in 2005 - 2006 , consistent improvements were observed in household food security and diet diversity , whereas coverage with child care and disease-control interventions improved for most outcomes . The prevalence of stunting in children < 2 y old at year 3 of the program ( 2008 - 2009 ) was 43 % lower ( adjusted OR : 0.57 ; 95 % CI : 0.38 , 0.83 ) than at baseline . The average national stunting prevalence for the countries included in the study had remained largely unchanged over the past 2 decades . CONCLUSION These findings provide encouraging evidence that a package of multisector interventions has the potential to produce reductions in childhood stunting Vitamin A deficiency ( VAD ) persists in Ug and a and the consumption of β-carotene-rich orange sweet potato ( OSP ) may help to alleviate it . Two large-scale , 2-y intervention programs were implemented among Ug and an farmer households to promote the production and consumption of OSP . The programs differed in their inputs during year 2 , with one being more intensive ( IP ) and the other being reduced ( RP ) . A r and omized , controlled effectiveness study compared the impact of the IP and RP with a control on  OSP  and  vitamin A intakes among children aged 6 - 35 mo ( n = 265 ) and 3 - 5 y ( n = 578 ) , and women ( n = 573 ) , and IP compared with control on vitamin A status of 3- to 5-y-old children ( n = 891 ) and women ( n = 939 ) with serum retinol < 1.05 μmol/L at baseline . The net OSP intake increased in both the IP and RP groups ( P < 0.01 ) , accounting for 44 - 60 % of vitamin A intake at follow-up . The prevalence of inadequate vitamin A intake was reduced in the IP and RP groups compared with controls among children 6 - 35 mo of age ( > 30 percentage points ) and women ( > 25 percentage points ) ( P < 0.01 ) , with no differences between the IP and RP groups of children ( P = 0.75 ) or women ( P = 0.17 ) . There was a 9.5 percentage point reduction in prevalence of serum retinol < 1.05 μmol/L for children with complete data on confounding factors ( n = 396 ; P < 0.05 ) . At follow-up , vitamin A intake from OSP was positively associated with vitamin A status ( P < 0.05 ) . Introduction of OSP to Ug and an farming households  increased vitamin A intakes among children and women and was associated with improved vitamin A status among children Inventory of all agricultural tasks depicted l and preparation by women farmers as one of the most drudgery prone task with high energy cost , thereby , making it amenable to ergonomic interventions in terms of improved technologies ( clod breaker , improved plough/'danella ' ) to relieve women from high energy dem and s , time spent and associated drudgery . The study was conducted in two hill states of India viz . Himachal Pradesh ( 35 villages and 900 representative sample s ) and Uttrakh and ( 10 villages and 900 representative sample s ) . Experimental data were conducted on representative sub sample of 60 hill farm women of both the states to assess physiological workload and musculo-skeletal problems both while working with traditional tools along with improved tools by employing selected parameters viz . physical fitness level , physiological parameters etc . The results showed that heart rate values were more than acceptable limits for task performed with the traditional tools as compared with improved tools . Significant reduction in the heart rate was observed while working with improved tools . Analysis of MSDs showed that the postural stress and severity of pain in various body parts was reduced by adopting new technology . Hence , the use of improved l and preparation tools is recommended over the existing ones for drudgery reduction OBJECTIVE To determine whether a cash-for-work programme during the annual food insecurity period in Bangladesh improved nutritional status in poor rural women and children . METHODS The panel study involved a r and om sample of 895 households from over 50,000 enrolled in a cash-for-work programme between September and December 2007 and 921 similar control households . The height , weight and mid-upper arm circumference of one woman and child aged less than 5 years from each household were measured at baseline and at the end of the study ( mean time : 10 weeks ) . Women reported 7-day household food expenditure and consumption on both occasions . Changes in parameters were compared between the two groups . FINDINGS At baseline , no significant difference existed between the groups . By the study end , the difference in mean mid-upper arm circumference between women in the intervention and control groups had widened by 2.29 mm and the difference in mean weight , by 0.88 kg . Among children , the difference in means between the two groups had also 
    Output:
    
Primary outcome measures tended to focus on undernutrition .
Intensive agricultural interventions were associated with improved calorie , vitamin , fruit and vegetable intake .
However , positive impacts were reliant on participant 's l and ownership , infection status and limited in generalisability .
Though many interventions addressing poverty and development have great potential to impact on NCD prevalence and risk , most fail to measure or report these outcomes .
Current evidence is limited to behavioural risk factors , namely diet and suggests a positive impact of agricultural-based food security programmes on dietary indicators .
However , studies investigating the impact of improved income on obesity tend to show an increased risk .