Marlene Perignon - Academia.edu (original) (raw)

Papers by Marlene Perignon

PLoS ONE, 2014

Background: Nutrition is one of many factors affecting the cognitive development of children. In ... more Background: Nutrition is one of many factors affecting the cognitive development of children. In Cambodia, 55% of children ,5 y were anemic and 40% stunted in 2010. Currently, no data exists on the nutritional status of Cambodian school-aged children, or on how malnutrition potentially affects their cognitive development. Objective: To assess the anthropometric and micronutrient status (iron, vitamin A, zinc, iodine) of Cambodian schoolchildren and their associations with cognitive performance. Methods: School children aged 6-16 y (n = 2443) from 20 primary schools in Cambodia were recruited. Anthropometry, hemoglobin, serum ferritin, transferrin receptors, retinol-binding protein and zinc concentrations, inflammation status, urinary iodine concentration and parasite infection were measured. Socioeconomic data were collected in a subgroup of children (n = 616). Cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM) and block design and picture completion, two standardized tests from the Wechsler Intelligence Scale for Children (WISC-III). Results: The prevalence of anemia, iron, zinc, iodine and vitamin A deficiency were 15.7%; 51.2%, 92.8%, 17.3% and 0.7% respectively. The prevalence of stunting was 40.0%, including 10.9% of severe stunting. Stunted children scored significantly lower than non-stunted children on all tests. In RCPM test, boys with iron-deficiency anemia had lower scores than boys with normal iron status (21.46, p,0.05). In picture completion test, children with normal iron status tended to score higher than iron-deficient children with anemia (20.81; p = 0.067) or without anemia (20.49; p = 0.064). Parasite infection was associated with an increase in risk of scoring below the median value in block design test (OR = 1.62; p,0.05), and with lower scores in other tests, for girls only (both p,0.05). Conclusion: Poor cognitive performance of Cambodian school-children was multifactorial and significantly associated with long-term (stunting) and current nutritional status indicators (iron status), as well as parasite infection. A life-cycle approach with programs to improve nutrition in early life and at school-age could contribute to optimal cognitive performance.

Nutrients

Background: Within Cambodia, micronutrient deficiencies continue to be prevalent in vulnerable gr... more Background: Within Cambodia, micronutrient deficiencies continue to be prevalent in vulnerable groups, such as women and children. Fortification of staple foods such as rice could be a promising strategy for Cambodia to improve micronutrient status. Objective: Our objective was to investigate the impact of multiple-micronutrient fortified rice (MMFR), distributed through a World Food Program school-meals program (WFP-SMP) on serum zinc concentrations and folate status in a double-blind, cluster-randomized, placebo-controlled trial. Methods: Sixteen schools were randomly assigned to receive one of three different types of extruded-fortified rice (UltraRice Original (URO), UltraRice New (URN), or NutriRice) or unfortified rice (placebo) six days a week for six months. A total of 1950 schoolchildren (6–16 years old) participated in the study. Serum zinc (all groups) and folate (only in NutriRice and placebo group) concentrations were assessed from morning non-fasting antecubital blood ...

Data in Brief

The dataset concerns the environmental impacts of water consumption and land use caused by 1 kg o... more The dataset concerns the environmental impacts of water consumption and land use caused by 1 kg of food item supplied to two Mediterranean countries: France and Tunisia. The dataset takes into account the food items available in France and Tunisia (identified in two national dietary surveys) and their origin. Water consumption and land use surfaces were extracted from existing databases and from national data for animal feed description. Upto-date available evaluation methods were used to assess the associated impacts. The origin of ingredients was considered to compute impacts on all countries of the world. These data were used in Perignon et al., 2019 [1]. Q 2

European Journal of Clinical Nutrition

Background/objectives It is not known whether dietary changes able to simultaneously achieve nutr... more Background/objectives It is not known whether dietary changes able to simultaneously achieve nutritional adequacy and reduce diet-related greenhouse gas emissions (GHGE) are similar across Europe when cultural and gender specificities are taken into account. Subjects/methods Starting from each mean observed diet in five European countries (France, UK, Italy, Finland, and Sweden) and for each gender, nutritionally adequate diets departing the least from observed diet were designed with linear programming by applying stepwise 10% GHGE reductions. Other models directly minimized GHGE. Results For most countries and whatever the gender, achieving nutritional adequacy implied between-food-group subtitutions (i.e., replacing items from the sugar/fat/alcohol food-group with items from the fruit and vegetables and starchy foodgroups), but increased GHGE. Once nutritional adequacy was met, to decrease GHGE, the optimization process further induced within-food-groups substitutions that were reinforced by stepwise GHGE reductions. Diet modeling results showed the need for changes in consumption of animal-based products but those changes differed according to country and gender, particularly for fish, poultry, and non-liquid milk dairy. Depending on country and gender, maximal GHGE reductions achievable ranged from 62% to 78% but they induced large departures from observed diets (at least 2.8 kg/day of total absolute weight change) by modifying the quantity of at least 99% of food items. Conclusions Setting nutritional goals with no consideration for the environment may increase GHGE. However, diet sustainability can be improved by substituting food items from the sugar/fat/alcohol food group with fruit, vegetables, and starches, and country-specific changes in consumption of animal-based products. Standardized surveys and individual diet modeling are promising tools for further exploring ways to achieve sustainable diets in Europe.

Public health nutrition, 2018

Even though current policy is strongly focused on the crucial first '1000 days', it might... more Even though current policy is strongly focused on the crucial first '1000 days', it might be still possible to enhance cognitive function during the pre-adolescent and adolescent years by improving micronutrient status. In Cambodia, nutritional status is poor. Provision of rice fortified with micronutrients through a school meal programme (SMP) could be a cost-effective strategy to help improve health and school performance. The present study aimed to evaluate the effect of three different micronutrient-fortified rice formulations on cognitive function in Cambodian children. Sixteen Cambodian schools receiving SMP. The FORISCA-UltraRice®+NutriRice® study was a randomized, double-blind, placebo-controlled trial. Four groups of four schools were randomly allocated to receive normal rice, UltraRice®Original, UltraRice®New or NutriRice®. Within each school, 132 children were randomly selected. Data on cognitive performance (picture completion, block design and Raven's colour...

Acta tropica, Jan 24, 2018

American Journal of Tropical Medicine and Hygiene, 2016

Soil-transmitted helminth (STH) infection has been associated with lower cognitive performance of... more Soil-transmitted helminth (STH) infection has been associated with lower cognitive performance of schoolchildren. To identify pathways through which STH infection might affect school performance, baseline data from a large rice-fortification trial in Cambodian schoolchildren were used to investigate associations between STH infection, micronutrient status, anemia, and cognitive performance. Complete data on anthropometry, cognitive performance, and micronutrient status were available for 1,760 schoolchildren, 6-16 years of age. STH infection was identified using Kato-Katz, whereas cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM), block design, and picture completion. STH infection was found in 18% of the children; almost exclusively hookwork infection. After adjusting for age and gender, raw cognitive test scores were significantly lower in hookworminfected children (−0.65; −0.78; −2.03 points for picture completion, RCPM, and block design, respectively; P < 0.05 for all). Hookworm infection was associated with iron status (total body iron), but not with vitamin A and zinc status, nor with inflammation or anthropometry. Body iron was negatively associated with increased intensity of hookworm infection (R = 0.22, P < 0.001). Hookworm infection in Cambodian schoolchildren was associated with lower cognitive performance, an effect most likely mediated through lower body iron. Interventions that are more effective against hookworm infection are needed to contribute to better health and improvement of cognitive performance.

The Journal of nutrition, Jan 14, 2016

Dietary guidelines are designed to help meet nutritional requirements, but they do not explicitly... more Dietary guidelines are designed to help meet nutritional requirements, but they do not explicitly or quantitatively account for food contaminant exposures. In this study, we aimed to test whether dietary changes needed to achieve nutritional adequacy were compatible with acceptable exposure to food contaminants. Data from the French national dietary survey were linked with food contaminant data from the French Total Diet Study to estimate the mean intake of 204 representative food items and mean exposure to 27 contaminants, including pesticides, heavy metals, mycotoxins, nondioxin-like polychlorinated biphenyls (NDL-PCBs) and dioxin-like compounds. For each sex, 2 modeled diets that departed the least from the observed diet were designed: 1) a diet respecting only nutritional recommendations (NUT model), and 2) a diet that met nutritional recommendations without exceeding Toxicological Reference Values (TRVs) and observed contaminant exposures (NUTOX model). Food, nutrient, and cont...

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Public Health Nutrition, 2016

ObjectiveTo assess the compatibility between reduction of diet-related greenhouse gas emissions (... more ObjectiveTo assess the compatibility between reduction of diet-related greenhouse gas emissions (GHGE) and nutritional adequacy, acceptability and affordability dimensions of diet sustainability.DesignDietary intake, nutritional composition, GHGE and prices were combined for 402 foods selected among those most consumed by participants of the Individual National Study on Food Consumption. Linear programming was used to model diets with stepwise GHGE reductions, minimized departure from observed diet and three scenarios of nutritional constraints: none (FREE), on macronutrients (MACRO) and for all nutrient recommendations (ADEQ). Nutritional quality was assessed using the mean adequacy ratio (MAR) and solid energy density (SED).SettingFrance.SubjectsAdults (n1899).ResultsIn FREE and MACRO scenarios, imposing up to 30 % GHGE reduction did not affect the MAR, SED and food group pattern of the observed diet, but required substitutions within food groups; higher GHGE reductions decreased ...

PLOS ONE, 2016

Background Early identification of children <5 yrs with acute malnutrition is a priority. Acute m... more Background Early identification of children <5 yrs with acute malnutrition is a priority. Acute malnutrition is defined by the World Health Organization as a mid-upper-arm circumference (MUAC) <12.5 cm or a weight-for-height Z-score (WHZ) <-2. MUAC is a simple and low-cost indicator to screen for acute malnutrition in communities, but MUAC cutoffs currently recommended by WHO do not identify the majority of children with weight-for-height Z-score (<-2 (moderate malnourished) or r<-3 (severe malnourished). Also, no cutoffs for MUAC are established for children >5 yrs. Therefore, this study aimed at defining gender and age-specific cutoffs to improve sensitivity of MUAC as an indicator of acute malnutrition. Methods To establish new age and gender-specific MUAC cutoffs , pooled data was obtained for 14,173 children from 5 surveys in Cambodia (2011-2013). Sensitivity, false positive rates, and areas under receiver-operator characteristic curves (AUC) were calculated using wasting for children <5yrs and thinness for children 5yrs as gold standards. Among the highest values of AUC, the cutoff with the highest sensitivity and a false positive rate 33% was selected as the optimal cutoff. Results Optimal cutoff values increased with age. Boys had higher cutoffs than girls, except in the 8-10.9 yrs age range. In children <2yrs, the cutoff was lower for stunted children compared to non stunted children. Sensitivity of MUAC to identify WHZ<-2 and <-3 z-scores increased from 24.3% and 8.1% to >80% with the new cutoffs in comparison with the current WHO cutoffs .

PloS one, 2016

Fortification of staple foods is considered an effective and safe strategy to combat micronutrien... more Fortification of staple foods is considered an effective and safe strategy to combat micronutrient deficiencies, thereby improving health. While improving micronutrient status might be expected to have positive effects on immunity, some studies have reported increases in infections or inflammation after iron supplementation. To study effects of micronutrient-fortified rice on hookworm infection in Cambodian schoolchildren. A double-blinded, cluster-randomized trial was conducted in 16 Cambodian primary schools partaking in the World Food Program school meal program. Three types of multi-micronutrient fortified rice were tested against placebo rice within the school meal program: UltraRice_original, UltraRice_improved and NutriRice. Four schools were randomly assigned to each study group (placebo n = 492, UltraRice_original n = 479, UltraRice_improved n = 500, NutriRice n = 506). Intestinal parasite infection was measured in fecal samples by Kato-Katz method at baseline and after thr...

European Journal of Nutrition & Food Safety, 2015

Frontiers in Nutrition

Mediterranean countries are undergoing dietary and nutritional changes that affect their inhabita... more Mediterranean countries are undergoing dietary and nutritional changes that affect their inhabitants' health, while facing massive environmental challenges. The increasing demand of water in agriculture, the capacity to maintain local food production, and the growing dependence on food imports are interconnected issues that must be addressed to ensure food security and nutrition in the Mediterranean region. Here, we present the conceptual framework and methodologies developed by the MEDINA-Study Group for rethinking food systems toward sustainable consumption and production modes. Based on its multidisciplinary expertise, the MEDINA-Study Group designed a "fork-to-farm" multi-scale approach, stemming from current dietary habits and examining how some options to nutritionally improve these habits might affect the food systems. This approach was developed for research activities in the South of France and Tunisia, two areas with very different diet-agriculture-environment nexus. The conceptual framework is based on the analysis of elements of the food systems (from consumption to production) at different levels (individual, household, regional and national levels). The methods include: (i) modeling options of dietary changes at different scales, in order to nutritionally optimize food consumption-production without increasing the environmental impact, (ii) translating the best-choice changes into possible policy actions, (iii) testing the acceptability and feasibility of these actions with several stakeholders, and (iv) producing guidelines for sustainable food choices and production. The MEDINA-Study Group identified additional issues that could be included in a future framework to help designing ambitious agricultural, food and health policies in the Mediterranean region.