This is the first of two posts I’ll be writing based on today. The other one probably won’t be ready until tomorrow. This one is from my attendance at an afternoon panel focused on nutrition: Nutritional Supplements and Complementary Feeding Practices.

Unfortunately, Zhang was unable to attend, so Labbok read her abstract and presented some of her own thoughts+experience on complementary feeding practices.

The session was organized around three evaluations of nutrition interventions: 1) an education and iron folate supplement program in northern Bangladesh, 2) Ultra Rice in Andhra Pradesh (India), and 3) a education program using health workers in northwest China. Ultra Rice was the primary reason I came to this session. If you don’t know, Ultra Rice is a micronutrient supplement that takes the size, shape, and other characteristics of rice. It is mixed in with regular rice at a ratio of roughly 1:100. More from PATH.

The overarching theme that I pulled from the session – as one of the few nutrition outsiders in the room – was an emphasis on what the field of nutrition needs,  in terms of interventions, research, and resources. Here’s the detailed view:

Continuum of interventions: Labbook did an excellent job of moderating, providing a global view of the presentations – including Zhang’s – throughout. She spoke of a “continuum of interventions”, which she presented in two different ways. First, in terms of target age: infants (Zhang), adolescents (Talukder), and women/children (Galloway). Second, in terms of approach: clinical – delayed cord clamping to increase the flow of nutrients to infants at birth; behavioral – via various education programs; and systemic – food-based solutions such as Ultra Rice.

Food-based solutions: In addition to Galloway (Ultra Rice), Talukder advocated for food-based solutions based on his study. Instead of iron folate tablets, he recommended food fortification, homestead food production, and dietary modifications. Talukder said, “We have to think about people and culture with interventions”, to which Galloway agreed, “We need more food-based solutions”.

Understanding behaviors (1): A Nepali in the audience asked a question about the impact of grinding Ultra Rice into rice flour (Ultra Rice Flour?) on micronutrient levels for the “end user”. This has not been studied, but it seems that it should be, particularly for areas that grind their own rice flour and use it significantly in cooking. I’m not a food expert, but I would guess that South Indian and Bengali cuisine qualify.

Understanding behaviors (2): In the Ultra Rice study, the “excess” method of boiling rice, where the extra water is poured off, resulted in levels of iron content more than 2x lower than the “absorption” method. Galloway, however, indicated that the excess method is preferred in many areas in India. The challenge becomes reconciling food culture with behavior change. (I wonder if the cookstove people and the nutrition people talk much.)

More studies: There were a variety of studies suggested by the panel and audience members that have not been conducted. Among these were rigorous, comparative studies of the various micronutrient innovations, such as Ultra Rice, Sprinkles, and Nutributter.

This is a report from the Global Health Council’s annual conference in Washington, DC. This year’s conference, Dateline 2010: Global Health Goals & Metrics, was held June 14-18, 2010. GHC37 is a reference to the Twitter hashtag used for the meeting. Make sure to check out the Council’s own conference blog coverage for more depth. This is our third year covering the meeting (2008 posts, 2009 posts).