Heather C Hamner's research while affiliated with Centro Nacional De Investigaciones En Salud Materno Infantil (Cenismi) and other places

Publications (81)

Article
The American Academy of Pediatrics (AAP) recommends introducing complementary foods (i.e., any solid or liquid other than breast milk or infant formula) to infants at approximately age 6 months (1). Although a consensus on ideal timing is lacking, most experts agree that introduction of complementary foods before age 4 months is too early because o...
Article
Infants younger than 4 months are not ready for complementary foods/drinks (any solid or liquid other than breast milk or infant formula). Almost half of US infants participate in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which provides nutrition education and support to low-income families. We describe the p...
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Introduction: Many Americans exceed the dietary recommendations for added sugars. Healthy People 2030 set a population target mean of 11.5% calories from added sugars for persons aged ≥2 years. This paper describes the reductions needed in population groups with varying added sugars intake to meet this target using 4 different public health approa...
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Good nutrition in early childhood supports optimal growth, development, and health (1). Federal guidelines support a dietary pattern with daily fruit and vegetable consumption and limited added sugars, including limited consumption of sugar-sweetened beverages (1). Government-published dietary intake estimates for young children are outdated at the...
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Background: Expressing milk (i.e., human milk) is common in the United States, but practices are unknown among families in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This study of a WIC population explores the practice of and reasons for expressing milk in the first year postpartum. Methods: We analyzed da...
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Background: High consumption of added sugars is related to adverse health consequences. Objective: The objective of this study was to examine characteristics of US youth who report high intakes of added sugars, as well as the eating occasions and top sources of added sugars that contributed to intakes among consumers with high added sugars intak...
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The 2020–2025 Dietary Guidelines for Americans (DGA) recommends less than 10% of total daily calories come from added sugars. However, many adults overconsume added sugars putting them at risk for poor health outcomes. We examined characteristics of high added sugars consumers among US adults (≥20 years) and described their top 10 sources of added...
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Objective Characterize feeding guidance mothers recall receiving from their child's health care provider (HCP). Design Cross-sectional study of mothers participating in the 2017–2019 National Survey of Family Growth. Participants US mothers reporting (n = 1,302) information about their youngest child (aged 6 months to 5 years). Variables Measure...
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Iron deficiency and the more severe sequela, iron deficiency anemia, are public health problems associated with morbidity and mortality, particularly among pregnant women and younger children. The 1998 Centers for Disease Control and Prevention recommendations for prevention and control of iron deficiency in the United States is old and does not re...
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The first 1000 days begins with pregnancy and ends at the child’s second birthday. Nutrition throughout the life course, and especially during the first 1000 days, supports maternal health and optimal growth and development for children. We give a high-level summary of the state of nutrition in the first 1000 days in the United States. We provide e...
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Background High consumption of added sugars is associated with adverse health. The Dietary Guidelines for Americans 2015–2020 (DGA) recommends no more than 10% of total daily calories from added sugars. Objective We examined characteristics of high added sugars consumers among US children aged 2–19 years and described top 5 sources of added sugars...
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Among pregnant women, anemia, a condition of low hemoglobin concentration, can increase risk for maternal and fetal morbidity and mortality, including premature delivery, and other adverse outcomes (1). Iron deficiency is a common cause of anemia, and during pregnancy, iron requirements increase (2). Surveillance of anemia during pregnancy in the U...
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BACKGROUND Maternity care practices have been linked with higher chances of meeting breastfeeding intentions, but this relationship has not been examined using national data on US low-income women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). METHODS Using data from the WIC Infant and Toddler Feedin...
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Objective To examine infant food preparation practices at age 7, 9, 11, and 13 months overall and by sociodemographic characteristics. Design Data from a longitudinal study from the US Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2) wer...
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Background: Returning to work can impact breastfeeding duration; limited data exist on how this may impact a lower income population. Methods: Data from U.S. Department of Agriculture's longitudinal study WIC Infant and Toddler Feeding Practices Study-2 were used to assess breastfeeding duration (<12 versus ≥12 months) by age of the baby when women...
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Objectives Delayed cord clamping (DCC) allows transfusion of placental blood to a newborn after birth and is recommended by the American College of Obstetricians and Gynecologists. DCC can increase hemoglobin levels and iron stores in term infants, preventing or delaying iron deficiency in young children. This study describes the prevalence of DCC...
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The American Academy of Pediatrics (AAP) recommends introducing complementary foods (i.e., any solid or liquid other than breast milk or infant formula) to infants at approximately age 6 months (1). Although a consensus on ideal timing is lacking, most experts agree that introduction of complementary foods before age 4 months is too early because o...
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Full-text available
Prenatal breastfeeding intentions impact breastfeeding practices. Racial/ethnic disparities exist in breastfeeding rates; it is unknown if prenatal intentions and meeting intentions differ by race/ethnicity. A longitudinal cohort of USDA's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) which enrolled participants begi...
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Objectives: To describe the iron content of commercially available infant and toddler foods. Methods: Nutrition Facts label data were used from a 2015 database of 1037 commercial infant and toddler food and drink products. Products were grouped into food categories on the basis of name, ingredients, target age, and reference amounts customarily...
Article
Background: Limited information is available on added sugars consumption in US infants and toddlers. Objectives: To present national estimates of added sugars intake among US infants and toddlers by sociodemographic characteristics, to identify top sources of added sugars, and to examine trends in added sugars intake. Design: Cross-sectional a...
Article
Objective: Assess pediatrician practices around growth and nutrition for children under 2 years. Design: 2017 cross-sectional survey of a national random sample of the American Academy of Pediatrics members. Setting: US. Participants: Practicing primary care pediatricians and residents (n = 698). Main outcome measures: World Health Organiz...
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Background: The US Dietary Guidelines for Americans provide dietary recommendations for individuals aged ≥2 y and metrics exist to assess alignment. Nonfederal feeding recommendations exist for children <2 y, but limited metrics and assessment of dietary quality are available. Objective: We aimed to assess dietary quality of children aged 6 mo-4...
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Surveillance of U.S. breastfeeding duration and exclusivity has historically reported estimates among all infants, regardless of whether they had initiated breastfeeding. These surveillance estimates have consistently shown that non-Hispanic black (black) infants are less likely to breastfeed, compared with other racial/ethnic groups.* Less is know...
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Background: To describe the availability and nutrient composition of U.S. commercially available squeeze pouch infant and toddler foods in 2015. Materials and methods: Data were from information presented on nutrition labels for 703 ready-to-serve, pureed food products from 24 major U.S. infant and toddler food brands. We described nutritional c...
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An understanding of the source of children’s foods and drinks is needed to identify the best intervention points for programs and policies aimed at improving children’s diets. The mean number and type of eating occasions and the relative proportions of foods and drinks consumed from different sources were calculated among children aged 1–4 years (n...
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: media-1vid110.1542/5984243449001PEDS-VA_2018-2274Video Abstract BACKGROUND: In 2009, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) revised its food packages to align with updated nutrition science. Understanding how these revisions may impact current consumption patterns could be important. Methods: Dietary d...
Article
Purpose: As part of wellness efforts, employers may seek to improve the nutritional quality of foods offered and consumed in cafeterias and vending machines. However, little is known about who consumes food from these venues and the types and dietary quality of the foods consumed. Design: Cross-sectional. Setting: Nonschool cafeterias and vend...
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Background Hospitals that provide maternity care can play an important role in providing or directing mothers to postdischarge breastfeeding support, which improves breastfeeding duration especially when providing multiple support modes. This study described 2007‐2015 national trends in postdischarge breastfeeding supports among United States mater...
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Background: Mother-infant skin-to-skin contact (SSC) immediately after birth helps transition infants to the post-uterine environment and increases the likelihood of breastfeeding initiation and duration. This study examines trends in U.S. maternity practices related to SSC, and variations by facility demographics. Methods: Data were from the Ma...
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Background: Although there has been inconsistency in recommendations regarding the optimal time for introducing complementary foods, most experts agree that introduction should not occur before 4 months. Despite recommendations, studies suggest that 20% to 40% of US infants are introduced to foods at younger than 4 months. Previous studies focused...
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Breast milk is the recommended nutrition for infants. For preterm infants, when mother's milk is not available, pasteurized donor milk is recommended (1). Non-Hispanic black mothers are at increased risk for having a preterm birth and for not breastfeeding (2,3); however, it is not known whether demographic disparities exist in the use of breast mi...
Article
Background: Total-body iron stores (TBI), which are calculated from serum ferritin and soluble transferrin receptor concentrations, can be used to assess the iron status of populations in the United States.Objective: This analysis, developed to support workshop discussions, describes the distribution of TBI and the prevalence of iron deficiency (ID...
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Early dietary patterns can have long-term health consequences. This study describes food consumption patterns among US children ≤23 months. We used one 24 h dietary recall from the National Health and Nutrition Examination Survey 2009–2014 to estimate the percentage of children ≤23 months who consumed selected food/beverage categories on any given...
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Objectives: To describe the prevalence and secular trends of high weight-for-length among infants (ages, 3-23 months) in the biennial US Department of Agriculture Women, Infants, and Children Program and Participants Characteristic (WIC-PC) Survey from 2000 through 2014 (n = 16 927 120). Methods: Weight-for-length was considered to be "high" if...
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Background: Folate cutoffs for risk of deficiency compared with possible deficiency were originally derived differently (experimental compared with epidemiologic data), and their interpretations are different. The matching of cutoffs derived from one assay with population-based data derived from another assay requires caution. Objective: We asse...
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Iron, calcium, and zinc are important nutrients for the young, developing child. This study describes the usual intake of iron, calcium, and zinc among US children in the second year of life using two days of dietary intake data from the National Health and Nutrition Examination Survey 2003-2012. Estimates were calculated using PC-SIDE to account f...
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Objective: We explored how Americans aged ≥2 years who consumed the recommended amount of fruits and vegetables on a given day incorporated fruits and vegetables into their diet compared with those who did not consume recommended amounts. Design: We used 1 d of dietary recall data from the National Health and Nutrition Examination Survey (NHANES...
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Serum and erythrocyte (RBC) total folate are indicators of folate status. No nationally representative population data exist for folate forms. We measured the serum folate forms (5-methyltetrahydrofolate (5-methylTHF), unmetabolised folic acid (UMFA), non-methyl folate (sum of tetrahydrofolate (THF), 5-formyltetrahydrofolate (5-formylTHF), 5,10-met...
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Red blood cell (RBC) folate concentrations are a potential biomarker of folate-sensitive neural tube defect (NTD) risk in the population. The purpose of this analysis was to describe women in the U.S. population with RBC folate concentrations below those associated with optimal NTD prevention. We used data from the 2007 to 2012 National Health and...
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Folate is found naturally in foods or as synthetic folic acid in dietary supplements and fortified foods. Adequate periconceptional folic acid intake can prevent neural tube defects. Folate intake impacts blood folate concentration; however, the dose-response between natural food folate and blood folate concentrations has not been well described. W...
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The methylenetetrahydrofolate reductase (MTHFR) 677C>T polymorphism is a risk factor for neural tube defects. The T allele produces an enzyme with reduced folate-processing capacity, which has been associated with lower blood folate concentrations. We assessed the association between MTHFR C677T genotypes and blood folate concentrations among healt...
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Hispanic women have higher rates of neural tube defects and report lower total folic acid intakes than non-Hispanic white (NHW) women. Total folic acid intake, which is associated with neural tube defect risk reduction, has been found to vary by acculturation factors (i.e. language preference, country of origin, or time spent in the United States)...
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Introduction: Neural tube defects such as anencephaly, spina bifida, and encephalocele are congenital anomalies of the central nervous system. Data on the prevalence of neural tube defects in Kenya are limited. This study characterizes and estimates the prevalence of spina bifida and encephalocele reported in a referral hospital in Kenya from 2005-...
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Introduction: Neural tube defects such as anencephaly, spina bifida, and encephalocele are congenital anomalies of the central nervous system. Data on the prevalence of neural tube defects in Kenya are limited. This study characterizes and estimates the prevalence of spina bifida and encephalocele reported in a referral hospital in Kenya from 2005-...
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Corn masa flour, used to make products such as corn tortillas, is a staple food for Hispanic populations residing in the United States, particularly among Mexican Americans and Central Americans. Research has indicated that Hispanic women in the United States continue to be at a higher risk of having a neural tube defect-affected pregnancy than wom...
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Whether folic acid fortification and supplementation at the population level have led to a higher prevalence of vitamin B-12 deficiency in the absence of anemia remains to be examined among a nationally representative sample of older U.S. adults. We assessed the prevalence of low vitamin B-12 status in the absence of anemia or macrocytosis before a...
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Hispanics in the US have a higher prevalence of neural tube defect (NTD) -affected pregnancies than non-Hispanic whites, and lower median total folic acid (FA) intake. FA fortification of corn masa flour (CMF) is a policy-level intervention for NTD prevention; however, the impact on NTD prevalence has not been estimated. We developed a model to est...
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The Institute of Medicine set a tolerable upper intake level (UL) for usual daily total folic acid intake (1,000 µg). Less than 3% of US adults currently exceed the UL. The objective of this study was to determine if folic acid fortification of corn masa flour would increase the percentage of the US population who exceed the UL. We used dietary int...
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Objective: Hispanics with lower acculturation may be at higher risk for neural tube defects compared with those with higher acculturation due to lower total folic acid intake or other undetermined factors. Modelling has indicated that fortification of corn masa flour with folic acid could selectively target Mexican Americans more than other race/e...
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Obesity is associated with an increased risk of having a pregnancy affected by a neural tube defect (NTD). It is not clear whether the amount of folic acid required by obese women to protect against NTDs is the same as that for nonobese women. We analyzed data from the National Health and Nutrition Examination Survey, representative of the noninsti...
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The USA currently fortifies enriched cereal grain products (ECGP) with folic acid at 140 μg/100 g. In addition, folic acid can be voluntarily added to ready-to-eat cereals (RTEC) up to 400 μg/serving and it is found in many dietary supplements, most often at a dose of 400 μg. We sought to model folic acid intake under various fortification and supp...
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Folic acid can prevent neural tube defects (NTD). Hispanic women have a higher prevalence of NTD than non-Hispanic white (NHW) women and consume less folic acid. Among Hispanics, acculturation has been associated with lower intakes of natural folate. It is unknown if this same relationship is seen for fortified foods. This article describes the ass...
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Acculturation factors have been found to affect dietary intakes of folate among older Mexican Americans (MAs) (≥60 years). The association of acculturation with folate biomarkers is unknown. We determined whether acculturation factors were associated with folate biomarkers (e.g., serum folate, red blood cell [RBC] folate, and total homocysteine con...
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Previous studies have shown that acculturation factors are associated with dietary patterns of older Mexican Americans (MAs), but the association of these factors with post-fortification folate intake is unknown. We estimated usual folate intakes for U.S. MAs aged ≥60 years (N = 712) by acculturation factors using data from the National Health and...
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The neural tube defects (NTDs) anencephaly and spina bifida, are serious birth defects of the brain and spine that affect about 3000 pregnancies per year in the United States. Research has found a strong link between periconceptional folic acid consumption and NTD prevention. Because Hispanic women have higher rates of NTD-affected births, targeted...
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US adults have access to multiple sources of folic acid. The contribution of these sources to usual intakes above the tolerable upper intake level (UL) (1000 microg/d) and to folate and vitamin B-12 status is unknown. The objective was to estimate usual folic acid intake above the UL and adjusted serum and red blood cell folate, vitamin B-12, methy...
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The incidence of neural tube defects (NTDs), serious birth defects of the brain and spine that affect approximately 3,000 pregnancies in the United States each year, can be reduced by 50-70% with daily periconceptional consumption of the B vitamin folic acid. Two studies were designed to assess college women's reactions to and perceptions of potent...
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The MTHFR 677C-->T variant is associated with reduced enzyme activity, abnormalities of folate metabolism, and potential increase in folate requirement. The effect of this variant on the Recommended Dietary Allowance (RDA) for folate is unclear. The aim of this study was to assess the effect of the MTHFR 677C-->T polymorphism on the current folate...
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Folic acid can prevent up to 70% of neural tube defects (NTDs) if taken before pregnancy. Compared with other race-ethnicities, Hispanic women have higher rates of NTDs, lower rates of folic acid supplement use, and lower total folic acid intakes. The objective was to assess potential effects of fortifying corn masa flour with folic acid on Mexican...
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This article focuses on the development and implementation of the Science Ambassador (SA) Program, which targets adolescents by working directly with science teachers who write and implement lesson plans that feature public health topics. The main goals of the program are to develop science lesson plans on public health topics, expose adolescents t...
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Neural tube defects (NTDs) are serious birth defects of the brain and spine that affect approximately 3,000 pregnancies in the United States each year and affected 404 pregnancies in Puerto Rico from 1996 to 2002. Consuming the B vitamin folic acid can reduce the incidence of NTDs 50%-70%, and recent efforts to reduce NTD rates have focused on incr...
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Background: US adults have access to multiple sources of folic acid. The contribution of these sources to usual intakes above the tolerable upper intake level (UL) (1000 lg/d) and to folate and vitamin B-12 status is unknown. Objective: The objective was to estimate usual folic acid intake above the UL and adjusted serum and red blood cell folate,...

Citations

... Despite the benefits of FVC, very few children consume the recommended amounts of fruits and vegetables [3][4][5]. For example, in the United States (U.S.), 88% of children do not meet the recommendations for vegetable intake and 50% fall short of the recommendations for whole fruit consumption [6]. Therefore, in recent years, increasing children's FVC has been a common primary objective for public health nutrition interventions [7,8]. ...
... Given its numerous benefits, the American Academy of Pediatrics recently changed its recommendation for breastfeeding duration from ≥1 year to ≥2 years [2]. One recent study indicated only 7% of U.S. children experiencing prolonged breastfeeding for ≥2 years [3], but research examining modifiable risk factors that affect breastfeeding duration beyond 1 year is lacking. It is well-known that unindicated formula supplementation during maternity stay could disrupt early breastfeeding by reducing stimulation of maternal milk production and altering infant gut development, however its effects on long-term breastfeeding duration is unknown. ...
... The presence of toxic metals in vegetables is a concern for human health as ingestion of these metals can have adverse effects on various bodily functions, which may be including cancer, developmental anomalies, hematological and reproductive effects, kidney and liver damage, cardiovascular diseases and nervous system disorders [16,17]. In recent years, numerous studies conducted worldwide by researchers have focused on investigating the potential risks of HMs on human health through the consumption of vegetables [18][19][20][21][22][23]. These studies analyze the levels of toxic metals in vegetables, such as lead, cadmium, arsenic, and mercury, and assess the potential health implications for individuals who consume them. ...
... In the present study, 14.9% of adults reported eating sweet foods ≥2 times/day, and 29.9% reported drinking SSB ≥2 times/day during the COVID-19 pandemic in 2021. Although our findings cannot be directly compared to those of the NHANES, based on 2015-2018 NHANES data, about 30% of US adults were classified as high added sugars consumers (i.e., consuming > 15% of total energy from added sugars), and the top sources of added sugars were SSB and sweet bakery products among high consumers [19]. Although we were unable to find any published peer-reviewed studies reporting solely high sweet food intake (without beverage sources) among US adults, a US Department of Agriculture (USDA) study reported that 61% of US adults aged ≥20 years consumed any sweet foods (without beverage sources) on a given day using the 2015-2018 NHANES data [20]. ...
... Although ID is a leading cause of anemia, ID, IDA, and anemia should not be conflated [6,27]. The largest amount of circulating iron (~80%) is used for hemoglobin (Hb) synthesis; therefore, the absence of anemia is assumed to imply adequate iron stores [9,28]. ...
... For example, less than 60% of eligible people in the U.S. participated in W.I.C., in part because of barriers including difficulty taking time off work to apply, lack of understanding of W.I.C., language and cultural barriers, transportation issues, the difficulty of the W.I.C. shopping process, and dietary issues [2][3][4]. Reducing barriers to W.I.C. enrollment may improve food security, increase food access, and reduce adverse maternal and child health outcomes [15][16][17][18][19]. However, there is limited research examining barriers to W.I.C. in detail and less evidence concerning the relationship between these barriers and health outcomes [19]. ...
... In singleton pregnancies, patients with anemia may experience more postpartum hemorrhage, cesarean delivery, preeclampsia and PPROM than patients without anemia (Kanu et al., 2022;Smith et al., 2019). However, compared to twin pregnant women without anemia, we did not find increased rates of these complications among anemic patients. ...
... Breastfeeding counseling during pregnancy has been linked to an increase in the likelihood of meeting breastfeeding intentions and practices during the postnatal period. Women who experienced supportive antenatal care practices were more likely to fulfill their prenatal breastfeeding intentions mainly initiation of breastfeeding within one hour and giving only breast milk in the first six months [19]. ...
... Most of the protocols are low burden requiring <15 minutes to administer and little or no specialized training. The wealth protocol from the Panel Study of Income Dynamics 30,31,40 was an exception. Despite the length of administration, resulting in a higher burden for investigators and participants, the WG selected it because disparities in wealth are key to understanding SES and racial disparities in studies with this goal. ...
... In a cross-sectional survey in the USA, around 73-79% obstetricians waited for at least 30 seconds for CC in preterm vaginal birth [17]. In another study DCC rate in caesarean delivery varied from 37% to 61% and the practice was influenced by hospital annual CS rates [18]. Recently, Pauley and team successfully implemented ACOG recommendation into clinical practice through a QI study and achieved 96% DCC rate over 6 weeks with a single PDSA cycle [19]. ...