Researchers at Cornell University with an interest in international nutrition are studying multiple aspects of global health, agriculture, food systems, and nutrition. World–class research, in collaboration with global partners, is leading to discoveries that bring us closer to solving challenging problems. The Program in International Nutrition collaborates with governments around the world, international and national non-governmental organizations, research institutes and universities, community-based organizations, and donors to bring together the knowledge and skills needed to improve nutrition and well-being.  We work across sectors such as public health, agriculture, water and sanitation, gender, education, health systems, and economics to find interdisciplinary answers to complex questions.

Dr. David Sahn speaking with village members while out on field work

Dr. David Sahn speaking with village residents while doing field research

Grants and Awards

National Scientific Achievement Awards

2019 Kellogg Prize for Lifetime Achievements in International Nutrition Supported by Kellogg Company: Marie Ruel, PhD, '90;  International Food Policy Research Institute

2019 Pfizer Consumer Healthcare Nutritional Sciences Award Supported by Pfizer: Katherine L. Tucker, PhD, '86; University of Massachusetts Lowell

Engaged Curriculum Grants fund teams who are integrating community engagement into new and existing majors, minor and course - putting community-engaged learning at the very heart of the university.

2018-2019 awardees: Tashara Leak, Julia Finkelstein, Jeanne Moseley, David Pelletier, Rebecca Seguin, Kate Dickin for the Global and Public Health Sciences Major: Reaching under-served communities with health prevention and treatment information through a major that promotes cultural sensitivity and community engagement.

The purpose of the Engaged Graduate Students Grant is to enable PhD students to initiate or build research or scholarship that is community-engaged, or to develop strategies for incorporating community engagement into existing research and scholarship.

2018-2019 awardees:

Elizabeth Centento Tablante (special committee chair: Saurabh Mehta) for Zika During the First 1,000 Days of Life

Ibukun Owoputi (special committee chair; Kate Dickin) for Gender Influences on Maternal and Child Nutrition

Dr. Mehta is presented with the Rainer Gross Award by Dr. Ursula Gross Dr. Saurabh Mehta is presented with the 4th Rainer Gross Prize, awarded during the Micronutrient Forum on “Positioning Women’s Nutrition at the center of Sustainable development”, held in Cancún, Mexico and presented by Dr. Ursula Gross, widow of the late Rainer Gross. Dr. Mehta received the prize for the “Cornell NutriPhone”, an INSiGHT project.

 

Cornell PIN is a leader in research, policy, and action to improve nutrition and health in low and middle-income countries around the world. Listed below are profiles of our ongoing research.

Consuming Iron Biofortified Beans Increases Iron Status in Rwandan Women after 128 Days in a Randomized Controlled Feeding Trial.

This project sought to examine nutrition problems of women with a primary emphasis on iron deficiency in developing countries. A feeding trial with iron-biofortified beans, supported by HarvestPlus, was completed in 2014 in Rwanda through collaboration with scientists at the University of Rwanda at Huye, the University of Oklahoma, and Pennsylvania State University. This 4 month-long feeding study tested the efficacy of consuming iron-biofortified beans on improved iron status, physical performance, and neurocognitive function in university women. Other collaborators included the International Food Policy Research Institute (IFPRI) and the Center for Tropical Agriculture (CIAT) in Cali, Colombia. This research showed that “biofortification” strategies, the process by which the micronutrient quality of staple food crops is improved through agronomic practices, conventional plant breeding, or modern biotechnology, can improve the micronutrient status of human subjects at risk of deficiencies in developing countries. This study confirms previous findings by the Haas research group of the efficacy of iron-biofortification of pearl millet, rice, and beans in India, Philippines, and Mexico.

Investigator(s): Jere Haas, Sarah Luna, Mercy Lung’aho, Michael J Wenger, Laura Murray-Kolb, Steve Beebe, Jean-Bosco Gahutu, and Inez Egli

In The Incidence of Recent Child Health Improvements in Africa, (Sahn, David E., and Stephen D. Younger, forthcoming in Review of Development Economics), we examined the extent to which health and education improvements are equitably shared or “inclusive.” We propose a descriptive method for this analysis that is analogous to growth incidence curves and apply it to nine developing countries. We find that health improvements often have a distribution more likely to be relatively pro-poor than income growth. Improvements in school attainment are more neutral in most countries. We do not see clear patterns in terms of the within-country relationship between improvements in income, health, and education. 

Investigator(s)David E. Sahn & Stephen D. Younger

In Household Shocks and Education Investment in Madagascar, (Glick, Peter J., David E. Sahn, and Thomas Walker, forthcoming, Oxford Bulletin of Economics and Statistics), we measured the extent to which households in Madagascar adjust children’s school attendance in order to cope with exogenous shocks to household income, assets, and labor supply. Our analysis was based on a unique data set with 10 years of recall data on school attendance and household shocks. We found that the probability of a child dropping out of school increased significantly when the household experienced an illness, death, or asset shock. We proposed a test to distinguish whether the impact of shocks on school attendance could be attributed to credit constraints, labor market rigidities, or a combination of the two. The results of the test suggested that credit constraints, rather than labor market rigidities, explain the inability of households in Madagascar to keep their children in school during times of economic distress.

Investigator(s): Peter J. Glick, David E. Sahn, & Thomas Walker

In Schooling, Marriage, and Age of First Birth in Madagascar  (Peter J. Glick, Christopher Handy, and David E. Sahn. 2015. Population Studies 69(2): 219–236), we jointly estimated the determinants of educational attainment, marriage age, and age of first birth among females 12 to 25 years of age in Madagascar, explicitly accounting for the endogeneities that arose from modeling these related outcomes simultaneously. Low female schooling attainment, early marriage, and low age at first birth are major policy concerns in developing countries. We find that an additional year of schooling resulted in a delay of marriage by 1.5 years. Marrying one year later delayed the age of first birth by 0.5 years. Parental education and wealth also had important effects on schooling, marriage, and age at first birth: among other findings, a woman’s first birth was delayed by 0.75 years for four additional years of schooling of her mother. Overall, the results provided rigorous evidence for the critical role of education— both own education and that of parents—in delaying marriage and fertility of young women.

Investigator(s): Peter J. Glick, Christopher Handy, & David E. Sahn

Female secondary school attendance has recently increased in Sub-Saharan Africa; however, the higher likelihood of attending school after puberty has put girls at risk of becoming pregnant while attending school. In The Impact of Early Childbearing on Schooling and Cognitive Skills among Young Women in Madagascar, (Herrera, Catalina, and David E. Sahn, under review, Demography), we used a panel survey, designed to capture the transition from adolescence to early adulthood, to analyze whether teenage pregnancy contributes to lower school attainment and cognitive skills among young women in Madagascar. We addressed the endogeneity between fertility and education decisions and controlled for an extensive set of community social infrastructure characteristics. We found that having a child increases by 42% the likelihood of dropping out of school and decreases by 44% the chances of completing lower secondary school. This school-pregnancy related dropout is associated with a reduction of 1.1 standard deviations in the Math and French test scores.

Investigator(s): Catalina Herrera (Northeastern University) & David E. Sahn (Cornell University)

Calcium supplementation during pregnancy can prevent preeclampsia, a major cause of maternal mortality globally. The World Health Organization (WHO) recently issued guidelines recommending prenatal calcium supplementation in populations where dietary calcium intake is low, but there is a dearth of experience with delivering this intervention. Cornell researchers conducted formative research in Ethiopia and Kenya on acceptability of calcium and iron-folic acid supplements among end users and behavior change communication strategies to support adherence.  In Kenya, we also tested a model for delivering supplements through community-level antenatal care to assess feasibility and factors that influence adherence. This included a cluster randomized trial comparing two dosing regimens. The results in both countries will inform recommendations for national policies and implementation of this evidence-based intervention to save maternal and newborn lives.

Martin SL, Wawire V, Ombunda H, Li T, Sklar K, Tzehaie H, Wong A, Pelto GH, Chapleau GM, Omotayo MO, Stoltzfus RJ, Dickin KL. Integrating calcium supplementation into antenatal care services in western Kenya: A qualitative process evaluation to examine the implementation of evidence-based guidelines.  Current Developments in Nutrition 2018; 2(11)

Tesfaye B, Sinclair K, Wuehler SE Moges T, De-Regil LM, Dickin KL. Applying international guidelines for calcium supplementation to prevent preeclampsia: Simulation of recommended dosages suggests risk of excess intake in Ethiopia. Public Health Nutrition 2018.

Birhanu Z, Chapleau GM, Ortolano SE, Mamo G, Martin SL, Dickin KL. Ethiopian women’s perspectives on antenatal care and iron-folic acid supplementation: Insights for translating global antenatal calcium guidelines into practice. Maternal & Child Nutrition 2018;14(S2): e12424.

Omotayo MO, Dickin KL, Pelletier DL, Martin SL, Kung’u JK, Stoltzfus RJ. Feasibility of integrating calcium and iron-folate supplementation to prevent preeclampsia and anemia in pregnancy in primary healthcare facilities in Kenya. Maternal & Child Nutrition 2018;14(S2): e12437.

Omotayo MO, Martin SL, Stoltzfus RJ. Ortolano SE, Mwanga E, Dickin KL. With adaptation, the WHO guidelines on calcium supplementation for prevention of preeclampsia are adopted by pregnant women. Maternal & Child Nutrition, 2017. doi:10.1111/mcn.12521.

Martin SL, Omotayo MO, Pelto GH, Chapleau GM, Stoltzfus RJ, Dickin KL. Adherence-specific social support enhances adherence to calcium supplements among pregnant women in Kenya. Journal of Nutrition 2017; 147:688-696. doi:10.3945/jn.116.242503.

Omotayo MO, Dickin KL, Pelletier DL, Mwanga E, Kung’u JK, Stoltzfus RJ. A simplified regimen compared to who guidelines decreases antenatal calcium supplement intake for prevention of preeclampsia in a cluster-randomized non-inferiority trial in rural Kenya. Journal of Nutrition 2017; 147 (10): 1986-1991. doi: 10.3945/jn.117.251926.

Martin SL, Omotayo MO, Chapleau GM, Stoltzfus RJ, Birhanu Z, Ortolano S, Pelto GH, Dickin KL. Adherence partners are an acceptable behavior change strategy to support calcium and iron-folic acid supplementation among pregnant women in Ethiopia and Kenya. Maternal & Child Nutrition 2016.

Omotayo MO, Dickin KL, O’Brien KO, Neufeld LM, De-Regil LM, Stoltzfus RJ. Translating guidelines for calcium supplementation to prevent preeclampsia into policy. Advances in Nutrition: An International Review Journal. 2016 Mar 1;7(2):275-8.

Investigators (DNS): Katherine Dickin, Rebecca Stoltzfus, Lanre Omotayo, Stephanie Martin, Zewdie Birhanu (Ethiopia), Stephanie Ortolano, Gina Chapleau

Partners: Implementing partners include Jimma University, Ethiopian Public Health Institute, Micronutrient Initiative Ethiopia Office, Micronutrient Initiative Kenya Office, University of Nairobi, AMREF Health Africa

Acknowledgement: This research is funded by the Micronutrient Initiative

Boundary‐spanning actors in complex adaptive governance systems: The case of multisectoral nutrition

Fifty-four countries are attempting to use a multisectoral approach to reduce chronic malnutrition, and a single boundary crossing-agent may be one of the things they need to succeed. A team of Cornell researchers is testing this notion in Ethiopia, Uganda, Mali and Burkina Faso. The work is based on the idea (so far unexamined in nutrition circles) that the dozens of organizations needed for a multisectoral approach are best viewed as Complex Adaptive Systems and, as such, a boundary-crossing agent can play a catalytic role in facilitating convergence, information flows, strategic relationships, critical decisions and other soft system components. Cornell action-researchers are embedded and playing these roles in the national nutrition policy communities in these four countries, documenting the processes and outcomes and sharing the findings with nutrition organizations at the regional, continental and global levels.

Investigators (All DNS): David Pelletier and Suzanne Gervais (Ithaca Campus), Hajra Hafeez-ur-Rehman (Ethiopia), Dia Sanou (Burkina Faso and Mali), Jackson Tumwine (Uganda).

Funding: UNICEF and European Union.

This project seeks to explicate the potential causal link between mycotoxins, gut dysfunction and stunting in young children. Mycotoxins, produced by molds that contaminate staple foods such as maize, are a source of widespread environmental contamination, especially in sub-Saharan Africa. This project seeks to describe the prevalence and severity of multiple mycotoxin exposures in a large representative sample of pregnant women in rural Zimbabwe. This project explores biomarkers of mycotoxin exposure in women and children and evidence of mycotoxin contamination in their staple food sources. In doing so, this project will inform the development of more effective child health interventions.

Investigators/ Research Team: Cornell University, Zvitambo

Funded by: the Bill & Melinda Gates Foundation

Evidence to Action: Highlights From Transform Nutrition Research (2012-2017)

Recent reviews have shown that social protection programmes in developing countries have, generally, strong impacts on household food security but little impact on chronic undernutrition. This two year study seeks to assess whether the form of transfer – food or cash – affects chronic undernutrition and whether these effects are larger when the transfer is combined with high quality nutrition behavior change communication activities. The intervention was fielded in rural Bangladesh between 2012 and 2014.

Investigators/Research Team: Professor John Hoddinott is a member of the research team which also includes other researchers based in Bangladesh and the United States.

Funding: Government of Bangladesh, as well Switzerland, Germany, the United Nations Development Programme, the UK’s Department for International Development through its Transform Nutrition research programme, and the United States of America.

There is growing evidence that non–cognitive skills affect economic, behavioral, and demographic outcomes in the developed world. However, there is little such evidence in developing country contexts. In The Role of Personality, Cognition, and Shocks in Determining Labor Outcomes of Young Adults in Madagascar (David E. Sahn and Kira Villa), we estimated the joint effect of five specific personality traits and cognition measured through achievement test scores on the age of entry into the labor market, labor market sectoral selection, and within sector earnings for a sample of young adults in Madagascar. The personality traits that we examined are known as the “Big Five Personality Traits”: Openness to Experience, Conscientiousness, Extraversion, Agreeableness, and Neuroticism. Additionally, we looked at how these traits interact with household-level shocks in determining their labor market entry decisions. We found that personality, as well as cognitive test scores, have an effect on these outcomes of interest, and that their impact on labor supply is, in part, a function of how individuals respond to exogenous shocks.

Investigator(s): David E. Sahn & Kira Villa

With the third highest stunting rate in Africa, Tanzania faces significant problems of poor child growth and associated risks of mortality, cognitive deficits, poor school performance and adult productivity. A project led by IMA World Health aims to build capacity and implement multisectoral interventions to prevent stunting in five regions around Lake Victoria. Cornell is involved in operations research to guide and assess intervention activities. Trials of improved practices (TIPs) and interviews will evaluate exclusive breastfeeding and complementary feeding practices, and identify how fathers and family members can support mothers to overcome barriers such as time constraints. Other research will assess the scale-up of mentoring for district nutrition officers and other key implementation stakeholders and the acceptability and feasibility of community-level implementation of nutrition-specific and nutrition-sensitive interventions. ASTUTE works closely with the Government of Tanzania on innovative approaches to support household, community and local government actions promoting healthy growth and development of children.

Matare CR, Craig HC, Martin SL, Kayanda RA, Chapleau GM, Bezner Kerr R, Dearden KA, Nnally LP, Dickin KL. Barriers and Opportunities for Improved Exclusive Breastfeeding Practices in Tanzania: Household Trials with Mothers and Fathers. Food and Nutrition Bulletin (on-line May 2019) https://doi.org/10.1177/0379572119841961

Cornell Investigator(s): Kate Dickin, Rebecca Stoltzfus, Rachel Bezner-Kerr, Cynthia Matare, Stephanie Martin, Ibukun Owoputi, Gina Chapleau, Hope Craig (Ithaca campus), Luitfrid Nnally, Kirk Dearden, Rosemary Kayanda (Tanzania)

Partners: IMA World Health, Tanzania Food and Nutrition Centre (TFNC), Partnership for Nutrition in Tanzania (PANITA), Development Media International (DMI)

Singida Nutrition and Agroecology Project (SNAP)

Can peer farmer mentors improve food security and child health in rural Tanzania?

This project in Singida district, central Tanzania supports peer mentoring on agroecological farming practices, improved infant and young child feeding (IYCF) practices, and gender equality. Expected outcomes are to improve agricultural output, especially legume yields, household food security, and infant diet. This project contributes to our understanding of solutions to undernutrition in SSA because of its emphasis on linking improved agricultural output to changes in feeding practices and nutrition and will allow deep exploration of the role of household gender dynamics in agriculture-nutrition linkages.

Investigator(s): Sera L Young (Department of Population Medicine and Diagnostic Sciences), Rachel B Kerr (Development Sociology), Elias Mtinda (ActionAid Tanzania), Vicky Santoso (Nutritional Sciences), Hijab Khan (Biology)

We gratefully acknowledge the McKnight Foundation, the Atkinson Center for Sustainable Future, and the National Institutes of Health.

hands holding maize

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Contact us at intl_nutrition@cornell.edu

Kate Dickin, PhD; Associate Research Professor, Director of Cornell PIN