Evidence is growing that human-associated early-life microbial diversity modulates health over the long term, via effects in the infant termed 'immune and metabolic education'. Documenting high microbial diversity contexts, such as in Africa, thus, has rich potential for understanding this aspect of the landscape of health. Yet, change on the continent is occurring rapidly, and microbial communities are shifting as behaviors and diets are altered, and antibiotic use expands; we may be losing the opportunity to obtain relevant data. After introducing what is known about the effects of early life microbial diversity on late life health, we provide an overview of what is known of the current, and expected future, trajectory of human-associated microbial diversity in Africa, introducing data on the core drivers. We argue that critical insights may be lost if better understanding of infant microbial communities in Africa is not obtained soon.

A barrier analysis study was carried out in Mwenezi and Chiredzi Districts of Zimbabwe, to guide the development of a community-based behaviour change program. The aim of the barrier analysis was to identify factors that influenced a woman’s infant feeding and care practices. This paper reports the findings for one behaviour, exclusive breastfeeding. The study was based on the methodology from “A Practical Guide to Conducting a Barrier Analysis” (Kittle 2013). Structured in-depth interviews were administered to 91 women who were mothers of infants under the age of six months, 46 of whom who were exclusively breastfeeding and 45 who were not. Issues pertaining to self-efficacy, social support and perceived risks and benefits, as well as cultural and community norms and rules were identified. The qualitative analysis included sorting and identifying themes. Common barriers for exclusive breastfeeding were influence from the mother-in-law, high maternal workload, and perceived breast milk insufficiency. The main enablers were breastfeeding knowledge, the presence of a spouse/partner who assisted with chores and nurses who provided breastfeeding information. The insights gained from this study were used by Nutrition Action Zimbabwe to develop a behaviour change programme that was implemented from 2018-2020.

Introduction: Breast milk contains a wide range of hormones, nutrients, and bioactive compounds. Chrononutrition looks at the interaction between food, both meal timing and meal composition, and circadian rhythms.Method: This review is a continuation on series on chrononutrition and breast milk. All human studies published in English were included regardless of location or year of publication.Results: This review identifies the hormonal circadian variation researched in breast milk to date for melatonin, cortisol, cortisone, leptin, and insulin.Conclusion: The circadian variation observed in some hormones reinforces the superiority of breast milk over formula milk. Melatonin has been the most studied, but more research for all the hormones is needed due to various gaps in the literature and varying levels of study quality. There is insufficient evidence to make recommendations specifically targeting the lactating mother, but we identify and recommend several ideas for future research.

This study utilised a structural equation model to examine the relationship between diet quality, socioeconomic status, and cardiovascular disease (CVD) risk in South African learners. Confirmatory factor analysis was used to test the indirect effects model for diet, socioeconomic status, diet quality and cardiovascular risk using pre-existing cross-sectional data. The structural equation model was fit using Lavaan version 0.6–5 in R version 3.6.1. Data were analysed from 178 children and adolescents, aged 6–18 years, from five rural schools in Cofimvaba, South Africa. Latent variables were created for dietary quality, dyslipidaemia and the socioeconomic status of participants. A negative association was observed between socioeconomic status and dyslipidaemia in school-aged children (p = 0.029).

Objective: The objective of this literature review was to identify and summarize the current knowledge on the circadian variation of breast milk nutrients and the implications of these findings.Method: A review of literature was conducted, including all relevant studies regardless of location and year of publication.Results: The amino acids tyrosine, histidine, aspartic acid and phenylalanine and energy were observed to be higher during the day. Fat and the vitamins B-1, B-2, B-3, B-6, and B-12 were higher at night. Other studies have shown conflicting results or no circadian variation for certain nutrients. Poor reproducibility and small sample sizes affect the quality of existing research.Conclusion: More research is needed, and longitudinal studies would help assess the effect of breast milk chrononutrition on the long-term health outcomes of infants.

Background: Breastfed infants have a reduced risk of infections and allergies. The study of chrononutrition in human milk seeks to understand the circadian variation of various human milk immune factors.Methods: Empirical studies on human milk, chrononutrition, and immune factors were searched through PUBMED, Google Scholar, and SCOPUS. Keywords included “chrononutrition,” “breastmilk composition,” “human milk,” “day-night cycles,” “sleep-wake cycles” and the names of various immune factors. After excluding duplicate articles, animal studies, studies looking at other human milk components, studies that did not collect human milk samples over a 24 hour period, and studies that were not in English, eleven studies on the topic remained and ten studies were included in the review. The excluded study had a sample size of two.Results: This review identified the circadian variation of certain immune factors found in human milk such as antibodies, complement proteins, cytokines, by-products of phagocyte activity, nucleotides, microRNAs, and antioxidants.Conclusion: The circadian variation observed in some human milk components highlights the unique ability of human milk to vary in composition based on the circadian rhythms of mothers and infants. The limited number of studies makes it difficult to make conclusive recommendations and creates an opportunity for further research in this growing field.