Menopause is associated with significant hormonal and reproductive changes in women. Evidence documents interindividual differences in the signs and symptoms associated with menopause, including cognitive decline. Hypothesized reasons for the cognitive decline include changes in hormone levels, especially estrogen, but study findings have been inconsistent. Hormone replacement therapies (HRTs) are often recommended to alleviate menopause-related symptoms in both peri- and postmenopausal women. However, the North American Menopause Society does not recommend the use of HRT for the management of cognitive complaints in perimenopausal women due to lack of evidence. Additionally, there are many women for which the use of HRT is contraindicated. As such, it would be helpful to have an alternative method for alleviating symptoms, including declines in cognition, during the menopause transition. Iron supplementation may be a promising candidate as it has been associated with improved cognitive performance in premenopausal women with iron deficiency and iron deficiency anemia. Because many women will experience heavy blood losses during perimenopause, they are at risk of becoming iron deficient and/or anemic. The use of iron supplementation in women with iron deficiency may serve to not only improve iron status but also to alleviate many of the signs and symptoms associated with perimenopause (lethargy, depressed affect, etc.), including cognitive decline. However, evidence to inform treatment protocols is lacking. Well-designed studies of iron supplementation in perimenopausal women are needed in order to understand the potential of such supplementation to alleviate the cognitive decline associated with perimenopause.

Due to the nutrition transition, adolescent diets globally appear to be shifting to increased consumption of fast foods and snacks high in sodium, added sugar, and saturated fat. In urban informal settlements in Kenya, limited evidence suggests adolescents consume 1–2 meals per day, have low dietary diversity, and consume foods from roadside stalls. We characterized the diets of adolescent girls in an urban informal settlement in Kenya and assessed the factors associated with diet quality and decision‐making. We used a convergent mixed methods design to simultaneously analyze survey, dietary intake, structured interview, and focus group discussion data. Participants were recruited via a community‐based participatory‐development organization. We assessed diet quality from 24‐h recall using the Global Diet Quality Project's Global Dietary Recommendations score—combining dietary risk factors for non‐communicable disease (NCD‐risk) with dietary factors protective of non‐communicable disease (NCD‐protect). We tested associations between diet quality, household hunger, sociodemographic variables, and food behaviors. Focus group discussion (FGD) and interview data were transcribed, translated, and analyzed thematically according to the factors that influenced diet. Adolescent girls predominately consumed food from grains, dark leafy greens, sweet tea or coffee, and deep‐fried foods (predominately samosas, mandazi [doughnuts], and fries). Adolescent girls with moderate or severe household hunger had higher diet quality scores—driven by a lower consumption of dietary risk factors for non‐communicable disease (NCD risk)—compared to girls with little to no household hunger. This relationship was driven by the consumption of red meat, by girls with less household hunger. In qualitative data, finances were the main decision‐making factor with skipping meals as a common coping strategy. Adolescent girls were aware of what foods constitute a healthy diet, but their diet quality and decision‐making were driven by household hunger, finances, and food safety.

Local health departments (LHDs) in Indiana are experiencing simultaneous changes in state and federal public health funding. The objective of this work was to understand LHDs' experiences with the impact of recent state and federal funding reductions on their operations, service delivery, and ability to advance federal and state health priorities. Of the 48 invited local health department staff from Indiana's District 4, 22 completed the online survey. Respondents represented a wide range of positions, including environmental health specialists, vital records staff, administrative staff, health officers, and more. LHDs in our sample experienced significant state and federal cuts, with most participants estimating that approximately 61%–80% of their department's entire operating budget had been or was expected to be reduced. A majority reported that at least 1 core health program had been cut or was at risk of being cut. Ultimately, the types of cuts experienced by LHDs led to reductions in personnel and programming, jeopardized key programs, and limited access for high-risk populations, thus reducing capacity for progress toward key federal and state priorities, including chronic disease prevention.