We investigate the impacts of access to piped water on drinking water quality, sanitation, hygiene and health outcomes in marginalized rural households of north-western Bangladesh, using a quasi-experimental setup. A government organization – the Barindra Multipurpose Development Authority (BMDA) – established a piped water network to connect rural households with the deep ground water resources and improve their access to potable water. Using propensity score matching, the study compares a treatment and a control group of households to identify gains in water-sanitation, hygiene and health outcomes. In terms of water safety, we find no improvement in the quality of drinking water, measured by E. coli count per 100 ml of water at the point of use (i.e. the pots and jars used to store it). Food utensils tested positive for E. coli in both the control and treatment group, thus showing no improvement through the BMDA intervention. Hygiene behavior such as handwashing with soap after defecation or before feeding children also does not improve. Finally, we do not find evidence of health benefits, such as decreased diarrhea incidence of under-five children or improved nutritional outcomes such as stunting, underweight and wasting. Although access to BMDA piped water in the premises is subject to a fee, it seems this incentive mechanism is not strong enough to improve water behavior or its outcomes: treated households are as poor as the non-treated in terms of maintaining hygiene and water quality, possibly because of lack of information.

Due to the harmful effects of veterinary antibiotics (VAs) residues in food on children's health, urine samples from 31 preschool and primary school children were analyzed for 13 common VAs. Samples of raw and cooked pork, chicken, fish, milk and drinking water from the children's living areas were also analyzed for residual VAs. Urinalysis revealed one to four target antibiotics in 77.4% of the sample group, with concentrations as high as 0.36ng/mL. Norfloxacin and penicillin had the highest detection rates (48.4% and 35.5%, respectively), with median concentrations of 0.037 and 0.13ng/mL, respectively. The VA burden of children in HK was lower than that in Shanghai. Enrofloxacin, penicillin, and erythromycin were the most detected VAs in raw and cooked food. Only oxytetracycline was detected in terminal tap water, and none were detected in milk. Tetracycline and doxycycline hyclate were detected in organic eggs (up to 7.1ng/g) and regular eggs (up to 6.6ng/g), which were common in children's diets. Traditional Chinese cooking processes did not completely eliminate VAs, and the concentrations of some VAs increased, especially after frying and roasting. The estimated daily intake (EDI) results show that the contribution of dietary intake and that based on the urine concentrations of VAs were far below the acceptable daily intake (ADI). The EDIs from urine were significantly lower than those based on cooked foods. The highest level of achievement percentage (LAP) based on dietary consumption and urine concentrations were 39.7% and 1.79%, respectively, and thus current levels of exposure to VAs would not seem to pose a risk to children's health. However, harmful effects of residual VAs during developmental periods may occur with exposure to much lower doses than those considered harmful to adults, and further investigation of these emerging pollutants is urgently encouraged.

Contaminated water and food are major causes of malnutrition and mortality in the developing world, particularly among children. Infants are most vulnerable to diarrheal illnesses when introduced to fluids and foods as they are weaned from breastfeeding to a mixed diet. There is scant literature about the role of nutrition professionals in addressing this problem. Considerable progress has been made in identifying strategies to prevent diarrhea in children. Strategies include implementing low-technology methods of sanitizing water, emphasizing the benefits of breastfeeding, protecting prepared foods from unclean environments, and educating and motivating food preparers. Resolution of water and food safety problems requires a collaborative interdisciplinary approach among health professionals and involvement of community leaders. Dietetic professionals have the training to empower individuals and communities with skills to create a safe water and food environment.

Children in developing countries often face multiple micronutrient deficiencies. Introduction of zinc‐fortified water can increase zinc intake, but additional recommendations are required to address overall diet nutrient adequacy. We developed and tested food‐based recommendations (FBRs) that included zinc‐fortified water for children aged between 4 and 6 years from rural Kenya to achieve the best possible nutrient adequacy. Dietary intakes of 60 children aged 4–6 years, from Kisumu West district, Kenya, were assessed using a quantitative multipass 24‐hr recall. Linear programming model parameters were derived, including a list of foods consumed, median serving sizes, and distribution of frequency of consumption. By using the Optifood linear programming tool, we developed FBRs for diets including zinc‐fortified water. FBRs with nutrient levels achieving ≥70% recommended nutrient intake (RNI) of the World Health Organization/Food and Agriculture Organization of the United Nations RNI for most of the 12 considered nutrients were selected as the final recommendations for the children. With no FBRs and no zinc‐fortified water, percent RNI coverage range was between 40% and 76% for zinc, improving to 66–101% after introduction of zinc‐fortified water. The final set of FBRs achieved nutrient adequacy for all nutrients except for vitamin A (25% RNI) and folate (68% RNI). Introduction of zinc‐fortified water combined with FBRs will likely improve the nutrient adequacy of diets consumed by children in Kenya but needs to be complemented with alternative interventions to ensure dietary adequacy.