Christine P Stewart
Biographic Data
| ID | 3466496 |
|---|---|
| NAME | Christine P Stewart |
| GIVEN NAMES | Christine P |
| FAMILY NAME | Stewart |
| SIGNATURE | STEWART C P |
| AFFILIATIONS | University of California, Davis |
| ORCID | 0000-0003-4575-8571 |
| VERIFIED | Yes |
| TOTAL WORKS | 43 |
| TOTAL CITATIONS | 65 |
| AUTHOR COUNT | 43 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2007 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Haemoglobin concentration thresholds that discriminate functional outcomes among children aged 6–30 months in eight countries: A pooled analysis of individual participant data
Introduction The WHO cut-offs to define anaemia among children (haemoglobin, Hb <105 g/L in 6–23 months and <110 g/L in 24–59 months) are based on the distribution of Hb concentrations in a healthy population. Our objective was to identify Hb values that best discriminate functional outcomes among children aged 6–30 months. Methods We used previously compiled datasets from an individual participant data meta-analysis of effects of small quantity …
Food vendor characteristics in and around junior high schools and the relationship with adolescent diet quality in Ghana
Objective: Aspects of the school food environment can influence food purchasing and consumption among adolescents, particularly those without access to a school meal programme. Our objective was to describe and compare food vendors of junior high schools (JHS) in Ghana. Design: We conducted structured observations of food vendors within a 0·25-km radius of eight JHSs. We compared foods sold and hygiene practices by vendor and community characteri…
Identifying priority countries for scaling up small-quantity lipid-based nutrient supplements
INTRODUCTION: Undernutrition is a cause of nearly half of all deaths among children under 5 years old. Small-quantity lipid-based nutrient supplements (SQ-LNS) have been shown to prevent child wasting, stunting, anaemia and mortality among children 6-23 months of age in low- and middle-income countries (LMICs). Scaling up effective preventive interventions is urgent given the current global food insecurity and nutrition crisis. METHOD: To priorit…
Adolescent and Parental Perspectives of Food Insecurity at Home and at School Among Adolescents Attending Junior High Schools in Cape Coast, Ghana
Adolescent food insecurity (FI) is associated with negative health and development outcomes, but parents may be unaware of these experiences. In Ghana, adolescents without access to school meals may be at risk of FI and poor diet. We described adolescent FI at home/school, assessed parents' abilities to report on them, and determined how FI relates to diet quality. We randomly selected 187 adolescent (11-17 years)/parent pairs from 8 schools in C…
Dietary intake and micronutrient adequacy among adults engaged in agriculture in rural Sri Lanka: Findings from a cross-sectional baseline survey
Objective: To characterise food group consumption, assess the contribution of food groups to energy and micronutrient intake, and estimate usual nutrient intake among adults in rural Sri Lanka. Design: A baseline survey (December 2020–February 2021) was conducted as part of an agriculture-based, nutrition-sensitive resilience program evaluation. Dietary intake was assessed using telephone-based 24-h recalls ( n 1283), with repeat recalls from 769…
A Cross-Cultural Analysis of Infants' Spatial Attention on the Infant Orienting With Attention (Iowa) Task
Research with Western samples has uncovered the rapid development of infants' visual attention. This study evaluated spatial attention in 6- to 9-month-old infants living in rural Malawi (N = 511; nBoys = 255, nYao = 427) or suburban California, United States (N = 57, nBoys = 29, nWhite = 37) in 2018–2019. Using the Infant Orienting With Attention (IOWA) task, results showed that infants were faster and more accurate to fixate a target when a cue…
Associations of fish and meat intake with iron and anaemia in Malawian children
Animal flesh foods are rich in bioavailable iron but infrequently consumed by young children. We aimed to determine whether flesh food intake was associated with iron and anaemia status among 585 Malawian infants enroled in a 6-month egg-feeding trial. The percentage of days of small fish, large fish and meat consumption were assessed through weekly 7-day animal-source food screeners. Grams of intake were assessed through 24-h recalls conducted a…
Estimating minimum dietary diversity for children aged 6–23 months: A comparison of agreement and cost of two recall methods in Cambodia and Zambia
Objective: To compare the agreement and cost of two recall methods for estimating children’s minimum dietary diversity (MDD). Design: We assessed child’s dietary intake on two consecutive days: an observation on day one, followed by two recall methods (list-based recall and multiple-pass recall) administered in random order by different enumerators at two different times on day two. We compared the estimated MDD prevalence using survey-weighted l…
The cost-effectiveness of small-quantity lipid-based nutrient supplements for prevention of child death and malnutrition and promotion of healthy development: Modelling results for Uganda
Objective: Recent meta-analyses demonstrate that small-quantity lipid-based nutrient supplements (SQ-LNS) for young children significantly reduce child mortality, stunting, wasting, anaemia and adverse developmental outcomes. Cost considerations should inform policy decisions. We developed a modelling framework to estimate the cost and cost-effectiveness of SQ-LNS and applied the framework in the context of rural Uganda. Design: We adapted costs …
The association between plasma choline, growth and neurodevelopment among Malawian children aged 6–15 months enroled in an egg intervention trial
Choline is an essential micronutrient that may influence growth and development; however, few studies have examined postnatal choline status and children's growth and development in low- and middle-income countries. The aim of this observational analysis was to examine associations of plasma choline with growth and development among Malawian children aged 6-15 months enrolled in an egg intervention trial. Plasma choline and related metabolites (b…
Preventive small-quantity lipid-based nutrient supplements reduce severe wasting and severe stunting among young children: An individual participant data meta-analysis of randomized controlled trials
Including SQ-LNSs in preventive interventions to promote healthy child growth and development is likely to reduce rates of severe wasting and stunting. This meta-analysis was registered at www.crd.york.ac.uk/PROSPERO as CRD42019146592.
Impacts of an egg intervention on nutrient adequacy among young Malawian children
Eggs are a rich source of multiple nutrients that support child growth and development. Provision of eggs as a complementary food may improve dietary adequacy among young children at risk for undernutrition. Our objective was to test the impact of an egg intervention on the adequacy of total nutrient intakes and micronutrient density among 6- to 15-month-old Malawian children. Children 6 to 9 months old, living in Mangochi District, Malawi, were …
Small-quantity lipid-based nutrient supplements for children age 6–24 months: A systematic review and individual participant data meta-analysis of effects on developmental outcomes and effect modifier…
Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child growth: An individual participant data meta-analysis of randomized controlled trials
Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child anemia and micronutrient status: An individual participant data meta-analysis of randomized contr…
Small-quantity lipid-based nutrient supplements for the prevention of child malnutrition and promotion of healthy development: Overview of individual participant data meta-analysis and programmatic im…
Impacts of an egg complementary feeding trial on energy intake and dietary diversity in Malawi
Complementary feeding diets in low- and middle-income countries are generally inadequate to meet requirements for growth and development. Food-based interventions may prevent nutrient inadequacies provided that they do not displace other nutrient-rich foods. We conducted a randomized controlled trial in rural Malawi in which 660 children aged 6 to 9 months were provided an egg a day for 6 months or assigned to a control group. Dietary intake of c…
Snack food consumption among Bangladeshi children, supplementary data from a large RCT
Childhood obesity has been associated with consumption of energy-dense foods such as caloric beverages and fast foods. Many low- and middle-income countries like Bangladesh are now experiencing a rising problem of noncommunicable diseases along with the long-standing problem of stunting and undernutrition. WASH Benefits Bangladesh was a large community-based cluster randomized controlled trial conducted in rural Bangladesh. Study clusters were ra…
Association between Malaria Infection and Early Childhood Development Mediated by Anemia in Rural Kenya
Malaria is a leading cause of morbidity and mortality among children under five years of age, with most cases occurring in Sub-Saharan Africa. Children in this age group in Africa are at greatest risk worldwide for developmental deficits. There are research gaps in quantifying the risks of mild malaria cases, understanding the pathways linking malaria infection and poor child development, and evaluating the impact of malaria on the development of…
Lipid-based nutrient supplements and all-cause mortality in children 6–24 months of age: A meta-analysis of randomized controlled trials
The Wash Benefits and SHINE trials: Interpretation of Wash intervention effects on linear growth and diarrhoea
Child stunting is a global problem and is only modestly responsive to dietary interventions. Numerous observational studies have shown that water quality, sanitation, and handwashing (WASH) in a household are strongly associated with linear growth of children living in the same household. We have completed three randomised efficacy trials testing improved household-level WASH with and without improved infant and young child feeding (IYCF) on stun…
Egg intervention effect on linear growth no longer present after two years
The Lulun Project, a randomized controlled trial conducted in 2015, found that one egg per day for 6 months during early complementary feeding reduced stunting by 47% and increased linear growth by 0.63 length-for-age Z (LAZ). This follow-up cohort study (Lulun Project II) aimed to test whether the growth effect remained in the egg intervention group compared with the control group after approximately 2 years. Mothers or caregivers from the Lulun…
Reply to S Rahman and S Ireen
Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: A cluster-randomised controlled trial
Background Poor nutrition and exposure to faecal contamination are associated with diarrhoea and growth faltering, both of which have long-term consequences for child health. We aimed to assess whether water, sanitation, handwashing, and nutrition interventions reduced diarrhoea or growth faltering. Methods The WASH Benefits cluster-randomised trial enrolled pregnant women from villages in rural Kenya and evaluated outcomes at 1 year and 2 years …
Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Bangladesh: A cluster randomised controlled trial
BACKGROUND: Diarrhoea and growth faltering in early childhood are associated with subsequent adverse outcomes. We aimed to assess whether water quality, sanitation, and handwashing interventions alone or combined with nutrition interventions reduced diarrhoea or growth faltering. METHODS: The WASH Benefits Bangladesh cluster-randomised trial enrolled pregnant women from villages in rural Bangladesh and evaluated outcomes at 1-year and 2-years' fo…
Contextualising complementary feeding in a broader framework for stunting prevention
An estimated 165 million children are stunted due to the combined effects of poor nutrition, repeated infection and inadequate psychosocial stimulation. The complementary feeding period, generally corresponding to age 6-24 months, represents an important period of sensitivity to stunting with lifelong, possibly irrevocable consequences. Interventions to improve complementary feeding practices or the nutritional quality of complementary foods must…
Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child growth: An individual participant data meta-analysis of randomized controlled trials
Preventive small-quantity lipid-based nutrient supplements reduce severe wasting and severe stunting among young children: An individual participant data meta-analysis of randomized controlled trials
Including SQ-LNSs in preventive interventions to promote healthy child growth and development is likely to reduce rates of severe wasting and stunting. This meta-analysis was registered at www.crd.york.ac.uk/PROSPERO as CRD42019146592.
Preterm delivery but not intrauterine growth retardation is associated with young maternal age among primiparae in rural Nepal
Pregnancy during adolescence is associated with adverse birth outcomes, including preterm delivery and low birthweight. The nutrient availability to the fetus may be limited if the mother is still growing. This research aims to study the effects of pregnancy during adolescence in a nutritionally poor environment in rural Nepal. This study utilized data from a randomized controlled trial of micronutrient supplementation during pregnancy in south-e…
A cross-sectional study of the prevalence and risk factors for hypertension in rural Nepali women
Although the prevalence of hypertension was low in this cohort, it was more prevalent among the poorer women and was strongly associated with other cardiovascular risks. These associations at a relatively young age may confer greater risk for cardiovascular disease among women in later life, indicating the need for interventions to reduce the progression from pre-hypertension to hypertension
Contextualising complementary feeding in a broader framework for stunting prevention
An estimated 165 million children are stunted due to the combined effects of poor nutrition, repeated infection and inadequate psychosocial stimulation. The complementary feeding period, generally corresponding to age 6-24 months, represents an important period of sensitivity to stunting with lifelong, possibly irrevocable consequences. Interventions to improve complementary feeding practices or the nutritional quality of complementary foods must…
The Courts, the Churches, the Witches and their Killers
Evaluation of a Novel Single-administration Food Frequency Questionnaire for Assessing Seasonally Varied Dietary Patterns among Women in Rural Nepal
Novel dietary assessment methods are needed to study chronic disease risk in agrarian cultures where food availability is highly seasonal. In 16,320 rural Nepalese women, we tested a novel food frequency questionnaire, administered once, to assess past 7-day intake and usual frequency of intake throughout the year for year-round foods and when in season for seasonal foods. Spearman rank correlations between usual and past 7-day intakes were 0.12-…
Adherence to recommendations on lipid‐based nutrient supplement and iron and folic acid tablet consumption among pregnant and lactating women participating in a community health programme in northwest…
Limited knowledge exists on sustained adherence to small-quantity lipid-based nutrient supplements for pregnant and lactating women (LNS-PL) and how this compares with that of other prenatal supplements. To address these gaps, a random subsample of women (n = 360) during pregnancy, early (6- to 12-week post-partum) and late (12- to 24-week post-partum) lactation, from an ongoing effectiveness trial in Bangladesh, was selected for in-home intervie…
Maternal plasma cholesterol and duration of pregnancy: A prospective cohort study in Ghana
Low plasma cholesterol may be associated with preterm birth; however, results are mixed and limited primarily to high-income countries. Our objective was to determine whether maternal plasma lipid concentrations are associated with pregnancy duration. We performed a nested cohort (n = 320) study of pregnant Ghanaian women enrolled in a randomized controlled trial. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipopr…
A cluster-randomized, controlled trial of nutritional supplementation and promotion of responsive parenting in Madagascar: The Mahay study design and rationale
Current Controlled Trials ISRCTN14393738 . Registered June 23, 2015
Trends and predictors of appropriate complementary feeding practices in Nepal: An analysis of national household survey data collected between 2001 and 2014
There is evidence that suboptimal complementary feeding contributes to poor child growth. However, little is known about time trends and determinants of complementary feeding in Nepal, where the prevalence of child undernutrition remains unacceptably high. The objective of the study was to examine the trends and predictors of suboptimal complementary feeding in Nepali children aged 6-23 months using nationally representative data collected from 2…
Risk factors of poor complementary feeding practices in Pakistani children aged 6–23 months: A multilevel analysis of the Demographic and Health Survey 2012–2013
Appropriate feeding practices are crucial for survival, growth, and development in childhood. This paper analyzes Pakistan's Demographic and Health Survey 2012-2013 to fill the knowledge gap in risk factors of poor complementary feeding practices in Pakistani children. Multilevel models were applied to fit the multistage cluster sample of 2,827 children aged 6-23 months from 489 communities. Introduction of solid, semi-solid, or soft foods (intro…
Eating down or simply eating less? The diet and health implications of these practices during pregnancy and postpartum in rural Bangladesh
Objective To: (i) determine the prevalence of self-reported eating less and eating down during early and late pregnancy and postpartum, and explore risk factors associated with eating less; (ii) examine the association between eating less and diet quality; and (iii) determine the association between eating less and weight gain during pregnancy. Design Data were collected longitudinally from a cohort of women participating in a community health pr…
Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: A cluster-randomised controlled trial
Background Poor nutrition and exposure to faecal contamination are associated with diarrhoea and growth faltering, both of which have long-term consequences for child health. We aimed to assess whether water, sanitation, handwashing, and nutrition interventions reduced diarrhoea or growth faltering. Methods The WASH Benefits cluster-randomised trial enrolled pregnant women from villages in rural Kenya and evaluated outcomes at 1 year and 2 years …
Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Bangladesh: A cluster randomised controlled trial
BACKGROUND: Diarrhoea and growth faltering in early childhood are associated with subsequent adverse outcomes. We aimed to assess whether water quality, sanitation, and handwashing interventions alone or combined with nutrition interventions reduced diarrhoea or growth faltering. METHODS: The WASH Benefits Bangladesh cluster-randomised trial enrolled pregnant women from villages in rural Bangladesh and evaluated outcomes at 1-year and 2-years' fo…
The Lulun Project's social marketing strategy in a trial to introduce eggs during complementary feeding in Ecuador
The Lulun Project incorporated a social marketing strategy that accompanied a randomized controlled trial (RCT) of a food-based intervention that introduced eggs into the complementary feeding diet of Ecuadorian infants. This strategy was designed to promote behaviour change, in this case, egg consumption, through voluntary prosocial behaviour, empowerment, and brand loyalty. A three-phase social marketing strategy (design, campaigns, and evaluat…
Complementary feeding practices among rural Bangladeshi mothers: Results from Wash Benefits study
Inappropriate complementary feeding contributes to linear growth faltering in early childhood. Behaviour change interventions have been effective at improving practice, but few studies have investigated the effects of multicomponent integrated interventions. We conducted a cluster-randomized controlled trial in rural Bangladesh in which geographic clusters were randomized into seven arms: water treatment (W), sanitation (S), handwashing (H), wate…
The potential of a simple egg to improve maternal and child nutrition
Evidence is mounting about the benefits of eggs for child nutrition and potential benefits for women during pregnancy and birth outcomes. Maternal consumption of eggs during lactation may also enhance the breast-milk composition of certain nutrients, thus contributing to the nutrition and potentially also to the development of breastfed children. Relative to single nutrient supplements, eggs deliver nutrients and other hormone or immune factors i…
Co‐causation of reduced newborn size by maternal undernutrition, infections, and inflammation
More than 20 million babies are born with low birthweight annually. Small newborns have an increased risk for mortality, growth failure, and other adverse outcomes. Numerous antenatal risk factors for small newborn size have been identified, but individual interventions addressing them have not markedly improved the health outcomes of interest. We tested a hypothesis that in low-income settings, newborn size is influenced jointly by multiple mate…
A behaviour change intervention with lipid‐based nutrient supplements had little impact on young child feeding indicators in rural Kenya
Poor infant and young child feeding (IYCF) practices are associated with linear growth faltering. Our objective was to evaluate the impact of a nutrition and water and sanitation for health intervention on three IYCF indicators-minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) in Kenyan children. Households were randomized into one of eight groups: (a) active control; (b) passive control; (c) water q…
Predictors of complementary feeding practices in Afghanistan: Analysis of the 2015 Demographic and Health Survey
Despite improvements over the past 20 years, high burdens of child mortality and undernutrition still coexist in Afghanistan. Global evidence indicates that complementary feeding (CF) practices predict child survival and nutritional status. Our study aims to describe CF practices in Afghanistan and to discern underlying predictors of CF by analysing data from Afghanistan's 2015 Demographic and Healthy Survey. Multilevel models were constructed co…
Stagnating trends in complementary feeding practices in Bangladesh: An analysis of national surveys from 2004‐2014
Bangladesh has experienced steady socio-economic development. However, improvements in child growth have not kept pace. It is important to document complementary feeding (CF) practices-a key determinant of children's growth-and their trends over time. The study aims to examine trends in CF practices in children aged 6-23 months using data from Bangladesh Demographic and Health Surveys conducted in 2004, 2007, 2011, and 2014. Multilevel logistic r…
The Wash Benefits and SHINE trials: Interpretation of Wash intervention effects on linear growth and diarrhoea
Child stunting is a global problem and is only modestly responsive to dietary interventions. Numerous observational studies have shown that water quality, sanitation, and handwashing (WASH) in a household are strongly associated with linear growth of children living in the same household. We have completed three randomised efficacy trials testing improved household-level WASH with and without improved infant and young child feeding (IYCF) on stun…
Egg intervention effect on linear growth no longer present after two years
The Lulun Project, a randomized controlled trial conducted in 2015, found that one egg per day for 6 months during early complementary feeding reduced stunting by 47% and increased linear growth by 0.63 length-for-age Z (LAZ). This follow-up cohort study (Lulun Project II) aimed to test whether the growth effect remained in the egg intervention group compared with the control group after approximately 2 years. Mothers or caregivers from the Lulun…
Reply to S Rahman and S Ireen
Impacts of an egg complementary feeding trial on energy intake and dietary diversity in Malawi
Complementary feeding diets in low- and middle-income countries are generally inadequate to meet requirements for growth and development. Food-based interventions may prevent nutrient inadequacies provided that they do not displace other nutrient-rich foods. We conducted a randomized controlled trial in rural Malawi in which 660 children aged 6 to 9 months were provided an egg a day for 6 months or assigned to a control group. Dietary intake of c…
Snack food consumption among Bangladeshi children, supplementary data from a large RCT
Childhood obesity has been associated with consumption of energy-dense foods such as caloric beverages and fast foods. Many low- and middle-income countries like Bangladesh are now experiencing a rising problem of noncommunicable diseases along with the long-standing problem of stunting and undernutrition. WASH Benefits Bangladesh was a large community-based cluster randomized controlled trial conducted in rural Bangladesh. Study clusters were ra…
Medicine (31 works) · Child Nutrition and Water Access (29 works) · Environmental health (22 works) · Demography (12 works) · Food Security and Health in Diverse Populations (12 works) · Demography (11 works) · Internal Medicine (11 works) · Pediatrics (10 works) · Poverty, Education, and Child Welfare (9 works) · Psychological intervention (9 works)