1
|
Mesfin S, Abebe D, Jiru HD, Sori SA. Only two in five pregnant women have adequate dietary diversity during antenatal care at Hiwot Fana Specialized University Hospital in Eastern Ethiopia. J Nutr Sci 2024; 13:e17. [PMID: 38572370 PMCID: PMC10988145 DOI: 10.1017/jns.2024.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/11/2024] [Accepted: 02/09/2024] [Indexed: 04/05/2024] Open
Abstract
Dietary diversification is a sustainable and appealing strategy for pregnant women to ensure a balanced dietary intake. In Ethiopia, despite the implementation of various nutritional initiatives, inadequate dietary diversity remains a significant factor contributing to adverse birth outcomes. Thus, this study aimed to assess the dietary diversity and associated characteristics among pregnant women attending antenatal care in Eastern Ethiopia. Institution-based cross-sectional study was conducted from April 28 to May 28, 2021. A total of 420 pregnant women were selected using a systematic random sampling technique. We used the adjusted odds ratio (AOR) and a 95% confidence interval to estimate the strength of the association. We used a p-value of 0.05 to declare statistical significance. Only 35.0% (95% CI: 30.5, 39.5) of the 420 pregnant women involved in this study received appropriate dietary diversity. Having an educational level of college and above (AOR 3.01, 95% CI: 1.19-7.5), being an urban dweller (AOR = 3.57, 95% CI: 1.68-7.52), eating three meals and above (AOR = 7.62, 95% CI: 2.88-9.03), and having ≤4 family sizes (AOR = 9.33, 95% CI: 4.06-10.4) were significantly associated with an adequate dietary diversity score among pregnant women. This study found that pregnant women had inadequate overall consumption of a diversified diet. Increasing meal frequency, enhancing women's education, raising awareness of dietary diversity among rural inhabitants, and offering counselling on family planning utilisation during ANC services are all beneficial in promoting dietary diversity among pregnant women.
Collapse
Affiliation(s)
- Sinetibeb Mesfin
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Abebe
- School of Nursing and Midwifery, College of Health and Medical Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Hirut Dinku Jiru
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Seboka Abebe Sori
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| |
Collapse
|
2
|
Gebreegziabher T, Sidibe S. Determinants of household-, maternal- and child-related factors associated with nutritional status among children under five in Mali: evidence from a Demographic and Health Survey, 2018. Public Health Nutr 2024; 27:e58. [PMID: 38311339 PMCID: PMC10882532 DOI: 10.1017/s1368980024000363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE The current study aims to determine household-, maternal- and child-related factors influencing nutritional status among children under five in Mali. DESIGN Quantitative cross-sectional study using secondary data extracted from Mali DHS-VI 2018. SETTING Urban and rural areas of Mali. PARTICIPANTS A total of 8908 children participated, with 3999 in the younger age group (0-24 months) and 4909 in the older age group (25-59 months). RESULTS In the younger age group, the prevalence of stunting, wasting and underweight was 18·8 % (95 % CI%: 17·5, 20·0), 24·6 % (95 % CI: 23·2, 26·0) and 13·2 % (95 % CI: 12·1, 14·3), respectively, while in the older age group, it was 24·9 % (95 % CI: 23·7, 26·2), 22·7 % (95 % CI: 21·5, 24·0) and 5·7 % (95 % CI: 5·0, 6·5), respectively. Being average or large size at birth, having piped source of water, receiving Zn, deworming, high maternal BMI, receiving Fe during pregnancy, higher maternal education and being rich were associated with lower odds of one or more form of undernutrition in both groups. On the other hand, children who were anaemic, drank from a bottle, maternal anaemia, current pregnancy of mothers and living in rural areas were associated with higher odds of stunting, wasting or underweight. Interestingly, children who received Fe supplementation had a higher odds of wasting in the younger group but lower odds of all forms of undernutrition in the older group. CONCLUSIONS This study emphasised the potential risk factors associated with undernutrition in children. Children who consume non-potable water, have mothers with lower levels of education and BMI and reside in rural areas are more likely to experience undernutrition.
Collapse
Affiliation(s)
- Tafere Gebreegziabher
- Food Science and Nutrition, Department of Health Sciences, Central Washington University, 400 E University Way, Ellensburg, WA98926, USA
| | - Saran Sidibe
- Food Science and Nutrition, Department of Health Sciences, Central Washington University, 400 E University Way, Ellensburg, WA98926, USA
| |
Collapse
|
3
|
Traoré F, Omolo M, Beal T, Nordhagen S, Codjia P, Kiige L, Kamudoni P, Arimi C, Kirogo V, Ortenzi F, Wouabe ED. Modelling policies to improve affordability and consumption of nutritious foods for complementary feeding in Kenya. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 3:e13519. [PMID: 38204288 PMCID: PMC10782137 DOI: 10.1111/mcn.13519] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/09/2023] [Accepted: 03/23/2023] [Indexed: 01/12/2024]
Abstract
In Kenya 26% of children under age 5 experience stunted growth, 4% are wasted and 11% are underweight. In pregnant women, the prevalence of iron deficiency is 36% and iron-deficiency anaemia prevalence is 26%. Previous studies have identified affordability as a key barrier to the intake of nutrients, particularly from animal-source foods (ASFs). Thus, this study analyzes to what extent the affordability of ASF in Kenya can be improved. It focuses on four ASFs: eggs, milk, chicken and beef. Using a computable general equilibrium model, three policy simulations were undertaken to establish the impact of potential changes on nutritious ASF availability and affordability: a 20% increase in total factor productivity (TFP) for the four products; a 20% TFP increase plus a 25% reduction in trade and transportation margins; and a 20% TFP increase for ASF and maize (a key input in animal feed). Simulations suggest increasing the productivity of the four ASF products would increase their availability and lower consumer prices (up to 17% lower). Household consumption of the four commodities would increase, resulting in improved household dietary diversity. Rural households would gain more compared with urban households. Poor households (the lowest 40%) would register larger welfare (Equivalent Variation) gains than other households in both urban and rural areas. The richest 20% of the population would neither lose nor gain following the policy changes. Reducing transportation costs and trade margins and increasing maize productivity could further reduce the price of ASFs through lower production costs and increased consumption.
Collapse
Affiliation(s)
| | - Miriam Omolo
- The African Policy Research InstituteNairobiKenya
| | - Ty Beal
- Global Alliance for Improved NutritionWashingtonDistrict of ColumbiaUSA
| | | | | | | | | | | | | | | | - Eric Djimeu Wouabe
- Global Alliance for Improved NutritionWashingtonDistrict of ColumbiaUSA
- Present address:
Results for DevelopmentWashingtonDistrict of ColumbiaUSA
| |
Collapse
|
4
|
Venter C. Immunonutrition: Diet Diversity, Gut Microbiome and Prevention of Allergic Diseases. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:545-561. [PMID: 37827976 PMCID: PMC10570780 DOI: 10.4168/aair.2023.15.5.545] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 10/14/2023]
Abstract
Allergic diseases are increasing both in morbidity and mortality. Genetic, environmental, and dietary factors may all be involved in this increase. Nutrition during pregnancy, breastfeeding, and early life may play a particularly important role in preventing allergic diseases. Based on current systematic reviews, the intake of specific nutrients has failed to prevent allergic disease. Prevention strategies have shifted their focus to the overall diet which can be described using diet diversity. Infant and maternal diet diversity in pregnancy has been associated with reduced allergy outcomes in childhood. Overall, diet also seems to have a marked effect on the microbiome compared to single foods. Factors that may negate the allergy-preventative effect of overall diet diversity include the addition of emulsifiers, advanced glycation end-product content, and overuse of commercial baby foods. There is a need to perform randomized controlled trials using overall dietary intake to support international food allergy guidelines. These studies should ideally be conducted by multi-professional teams.
Collapse
Affiliation(s)
- Carina Venter
- Section of Allergy & Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
| |
Collapse
|
5
|
Petrone BL, Aqeel A, Jiang S, Durand HK, Dallow EP, McCann JR, Dressman HK, Hu Z, Tenekjian CB, Yancy WS, Lin PH, Scialla JJ, Seed PC, Rawls JF, Armstrong SC, Stevens J, David LA. Diversity of plant DNA in stool is linked to dietary quality, age, and household income. Proc Natl Acad Sci U S A 2023; 120:e2304441120. [PMID: 37368926 PMCID: PMC10319039 DOI: 10.1073/pnas.2304441120] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/10/2023] [Indexed: 06/29/2023] Open
Abstract
Eating a varied diet is a central tenet of good nutrition. Here, we develop a molecular tool to quantify human dietary plant diversity by applying DNA metabarcoding with the chloroplast trnL-P6 marker to 1,029 fecal samples from 324 participants across two interventional feeding studies and three observational cohorts. The number of plant taxa per sample (plant metabarcoding richness or pMR) correlated with recorded intakes in interventional diets and with indices calculated from a food frequency questionnaire in typical diets (ρ = 0.40 to 0.63). In adolescents unable to collect validated dietary survey data, trnL metabarcoding detected 111 plant taxa, with 86 consumed by more than one individual and four (wheat, chocolate, corn, and potato family) consumed by >70% of individuals. Adolescent pMR was associated with age and household income, replicating prior epidemiologic findings. Overall, trnL metabarcoding promises an objective and accurate measure of the number and types of plants consumed that is applicable to diverse human populations.
Collapse
Affiliation(s)
- Brianna L. Petrone
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
- Medical Scientist Training Program, Duke University School of Medicine, Durham, NC27710
| | - Ammara Aqeel
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Sharon Jiang
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Heather K. Durand
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Eric P. Dallow
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Jessica R. McCann
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Holly K. Dressman
- Duke Microbiome Core Facility, Center for Genomic and Computational Biology, Duke University, Durham, NC27710
| | - Zhengzheng Hu
- Duke Microbiome Core Facility, Center for Genomic and Computational Biology, Duke University, Durham, NC27710
| | | | - William S. Yancy
- Duke Lifestyle and Weight Management Center, Durham, NC27710
- Department of Medicine, Duke University School of Medicine, Durham, NC27710
| | - Pao-Hwa Lin
- Department of Medicine, Nephrology Division, Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC27705
| | - Julia J. Scialla
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA22903
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA22903
| | - Patrick C. Seed
- Division of Pediatric Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL60611
| | - John F. Rawls
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
- Duke Microbiome Center, Duke University School of Medicine, Durham, NC27710
| | - Sarah C. Armstrong
- Department of Pediatrics, Duke University School of Medicine, Durham, NC27710
| | - June Stevens
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC27599
| | - Lawrence A. David
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
- Duke Microbiome Center, Duke University School of Medicine, Durham, NC27710
| |
Collapse
|
6
|
Mahal SS, Kucha C, Kwofie EM, Ngadi M. Design and Development of 'Diet DQ Tracker': A Smartphone Application for Augmenting Dietary Assessment. Nutrients 2023; 15:2901. [PMID: 37447227 DOI: 10.3390/nu15132901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
The purpose of the current study was to describe the design, development, and validation of the 'Diet DQ Tracker'. The 'Diet DQ Tracker' is the first self-administered smartphone app designed to collect dietary data for diet diversity indicators. The main objective of the app was to replace the traditional methods of dietary data collection, such as in-person or telephone 24 h recall via pen and paper questionnaire or tablets. The real-time meal recording, extensive food database, and automatic score calculations and visualizations for MDD-W, IYCF-MDD, and HDDS have the potential to overcome the drawbacks of 24 h recalls. Recall depends on respondent memory, food expertise, and time consumption and demands skilled interviewers. Further, SAIN, LIM recommendations in the app prompt users to diversify diets with healthy foods. The pilot study determined the acceptability, feasibility, and relative validity of the 'Diet DQ Tracker' with a 24 h dietary recall. The results demonstrated minimal differences in dietary scores by both methodologies. The app, being convenient, easy to use, less time-consuming, and enjoyable, was preferred by the entire study sample over 24 h recall. The app will be continually updated with foods from different cultures for validating in large-scale studies. The future studies will help to improve the subsequent versions of the app.
Collapse
Affiliation(s)
- Subeg Singh Mahal
- Department of Bioresource Engineering, McGill University, Macdonald Campus, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada
| | - Christopher Kucha
- Department of Bioresource Engineering, McGill University, Macdonald Campus, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada
- Department of Food Science and Technology, University of Georgia, 100 Cedar St., Athens, GA 30602, USA
| | - Ebenezer M Kwofie
- Department of Bioresource Engineering, McGill University, Macdonald Campus, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada
| | - Michael Ngadi
- Department of Bioresource Engineering, McGill University, Macdonald Campus, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada
| |
Collapse
|
7
|
Hearst MO, Wells L, Hughey L, Makhoul Z. Household Dietary Diversity among Households with and without Children with Disabilities in Three Low-Income Communities in Lusaka, Zambia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2343. [PMID: 36767710 PMCID: PMC9914986 DOI: 10.3390/ijerph20032343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this manuscript is to describe household dietary diversity (HDDS) in Lusaka, Zambia between households with and without a child with a disability living in the same communities. Cross-sectional data were collected in three low-income compounds in September 2021. Participants included households with a child with a disability enrolled in Kusamala+, a community-based program, (n = 444) and a convenience sample of adults living in the same area without a child with a disability (n = 1027). The HDDS tool asked about food groups consumed in the past 24 h by people in the household. The responses were summed (yes = 1, no = 0), range 0-12. Individual dietary diversity scores (IDDSs) were calculated for children (0-8 items). Analysis included descriptive statistics and linear regression. Mean HDDS for the households with a child with a disability was 4.8 (SD 2.1) vs. 6.1 (SD = 2.2) among households without a child with a disability (p < 0.001). The individual score for children (IDDS) for households with children with disabilities was 2.6 (SD = 1.4) vs. 3.7 (SD = 1.6) for households without a child with a disability. Households with a child with a disability had a significantly lower HDDS and IDDS in unadjusted and adjusted models (p < 0.001). National policy must assure the most vulnerable populations, and often hidden, receive focused financial and food support.
Collapse
Affiliation(s)
- Mary O. Hearst
- School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA
| | - Leah Wells
- Public Health Department, St. Catherine University, St. Paul, MN 55105, USA
| | | | | |
Collapse
|
8
|
Fongar A, Linderhof V, Ekesa B, Dijkxhoorn Y, Nalweyiso MD. Impact of healthy food and diet information on household food security: A randomized control trial in Kampala, Uganda. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2023. [DOI: 10.3389/fsufs.2022.1063331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Healthy diets are unaffordable for almost 3.1 billion people worldwide, and in 2018, already 43% of the African population were urban dwellers. Our food systems are changing rapidly, coupled with rising dietary aspirations. What are healthy diets and how can healthy diets be reached and increased in an urban context was the question of project NOURICITY. Looking into different information channels to deliver information on healthy diets in a low-income area in urban Kampala, Uganda, two packages of interventions were developed based on information on the selected focus group discussions with parish representatives. The first package consisted of a flier including graphic information on healthy diets and three food groups (treatment group 1). The second included the same flier plus interactive voice responses (IVRs) as a phone call to deliver the flier information in a different format (treatment group 2). For the study, we targeted 450 randomly selected households, which were randomly assigned into three groups (control, treatment group 1, and treatment group 2). Respondents from Kanyanya (a low-income parish of Kampala city) were randomly selected. They were visited two times in March as well as in December of the year 2021, while the intervention was rolled out in the period from September to November 2021. Healthy diets are measured using the Household Dietary Diversity Score and the food variety score is based on a 7-day food consumption recall, while dietary quality is measured for a subsample of women and the minimum dietary diversity for all of the selected women. The results indicated statistically significant changes per group at household food consumption in March 2021 compared to December 2021. However, the results of the difference-in-difference method between the control and the treatment groups did not display any significant difference at the household level. However, increased dairy and meat consumption in the treatment groups was observed. Over 90% of the households in treatment group 2 listened to any type of IVR message. Although no significant treatment effects were found, almost all households receiving intervention package 2 mentioned that the IVR calls were easy to follow, while almost 80% indicated sharing the information with their neighbors and 92% enjoyed receiving the message. However, the intervention has potential but needs to be improved upon.
Collapse
|
9
|
Charters TJ, Kaufman JS, Nandi A. A Causal Mediation Analysis for Investigating the Effect of a Randomized Cash-Transfer Program in Nicaragua. Am J Epidemiol 2023; 192:111-121. [PMID: 36130208 DOI: 10.1093/aje/kwac165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/22/2022] [Accepted: 09/15/2022] [Indexed: 01/14/2023] Open
Abstract
Mediation analysis can be applied to data from randomized trials of health and social interventions to draw causal inference concerning their mechanisms. We used data from a cluster-randomized trial in Nicaragua, fielded between 2000 and 2002, to investigate whether the impact of providing access to a conditional cash-transfer program on child nutritional outcomes was mediated by child health check-ups and household dietary diversity. In a sample of 443 children 6-35 months old, we estimated the controlled direct (CDE) effect of random assignment on measured height-for-age z scores had we intervened so that all children received a health check-up and had the same level of household dietary diversity, using inverse-probability weighted marginal structural models to account for mediator-outcome confounding. Sensitivity analyses corrected the CDE for potential nondifferential error in the measurement of dietary diversity. Treatment assignment increased height-for-age z score by 0.37 (95% CI: 0.05, 0.69) standard deviations. The CDE was 0.20 (95% CI: -0.17, 0.57) standard deviations, suggesting nearly one-half of the program's impact on child nutrition would be eliminated had we intervened on these factors, although estimates were relatively imprecise. This study provides an illustration of how causal mediation analysis can be applied to examine the mechanisms of multifaceted interventions.
Collapse
|
10
|
Le HN, Nguyen KV, Phung H, Hoang NTD, Tran DT, Mwanri L. Household Dietary Diversity among the Ethnic Minority Groups in the Mekong Delta: Evidence for the Development of Public Health and Nutrition Policy in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:932. [PMID: 36673687 PMCID: PMC9859100 DOI: 10.3390/ijerph20020932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Poor household dietary diversity has been linked to malnutrition in individuals, households, and cumulatively in populations. High rates of malnutrition among Khmer ethnic children aged five years and younger have been reported in Tri Ton district, Vietnam. This paper aims to further investigate household dietary diversity and associated factors among Khmer ethnic minority populations in Vietnam. A cross sectional study was conducted from October 2018 to April 2019 in Tri Ton District, An Giang Province. By employing a multistage sampling technique, a total of 402 (99.8% response rate) participants were interviewed to measure household dietary diversity using a structured and validated questionnaire developed by FAO. Both bivariate and multivariate logistic regression analyses were carried out to identify factors associated with household dietary diversity. The results showed that the prevalence of low, medium and high dietary diversity scores were 21.4%, 70.4% and 8.2%, respectively. Male-headed households, literacy level, household income, exposure to mass media on nutrition and health information, and frequency of eating were positively associated with household dietary diversity (p < 0.05). However, owning a vegetable and rice farm was not statistically related to households’ dietary diversification. The paper concludes that the magnitude of household diversified dietary intakes was essentially low to medium in participants’ households. These findings have provided evidence to inform the development of the National Nutrition Strategy—2021−2030 in Vietnam, to be revised in 2045. This national strategy proposes appropriate interventions, programs and policies to improve socioeconomic status in ethnic groups and in mountainous areas to enhance populations’ health and well-being including controlling childhood malnutrition. In order to improve population health and wellbeing in Tri Ton District, further actions to address effective dietary practices including strengthening nutrition and health communication about the need to improve household dietary diversity to high levels are recommended.
Collapse
Affiliation(s)
- Hiep N. Le
- Department of Food Technology, An Giang University, Long Xuyên 880000, Vietnam
- Center for Educational Testing and Quality Assessment, Vietnam National University HCMC, Ho Chi Minh City 700000, Vietnam
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222, Australia
- Health & Agricultural Policy Research Institute, University of Economics Ho Chi Minh City, Ho Chi Minh City 72516, Vietnam
| | - Kien V. Nguyen
- Health & Agricultural Policy Research Institute, University of Economics Ho Chi Minh City, Ho Chi Minh City 72516, Vietnam
- Climate Change Institute, An Giang University, Long Xuyên 880000, Vietnam
- Research School of Management, College of Business and Economics, The Australian National University, 26 Kingsley St., Acton, Canberra, ACT 2601, Australia
| | - Hai Phung
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222, Australia
| | - Ngan T. D. Hoang
- National Institute of Nutrition, 48B Tang Bat Ho, Pham Dinh Ho Ward, Hai Ba Trung District, Hanoi 100000, Vietnam
| | - Duong T. Tran
- National Institute of Nutrition, 48B Tang Bat Ho, Pham Dinh Ho Ward, Hai Ba Trung District, Hanoi 100000, Vietnam
| | - Lillian Mwanri
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide Campus, Adelaide, SA 5000, Australia
| |
Collapse
|
11
|
A Low-Diet Diversity Score Is Associated With Increased Risk of Growth Failure Among Children. TOP CLIN NUTR 2023. [DOI: 10.1097/tin.0000000000000302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
12
|
Wondemagegn AT, Tsehay B, Mebiratie AL, Negesse A. Effects of dietary diversification during pregnancy on birth outcomes in east Gojjam, northwest Ethiopia: A prospective cohort study. Front Public Health 2022; 10:1037714. [PMID: 36544806 PMCID: PMC9760662 DOI: 10.3389/fpubh.2022.1037714] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/08/2022] [Indexed: 12/08/2022] Open
Abstract
Introduction Adequate nutrient intake during pregnancy is an important key factor affecting fetal growth and birth outcomes, as well as maternal health, as demonstrated by experimental animal studies. However, the few human studies available, especially those conducted in the least developed countries (LDCs), are much less consistent. Therefore, this study aimed to investigate the association between dietary diversification during pregnancy and birth outcomes in Gojjam, Ethiopia. Methodology A facility-based prospective cohort study was conducted on 416 pregnant mothers (exposed and non-exposed) from December 2019 to January 2020. Information about the Women's Dietary Diversity Score (WDDS) was collected using the Food and Agricultural Organization's guidelines. Data were collected through interviewer-administered questionnaires and measurements. Log-binomial regression analysis was performed to estimate the relative risk of adverse birth outcomes. Energy, macronutrient, and micronutrient amounts were calculated using the nutrition survey software version 2007. The differences between groups were noticed using analysis of variance. Eta squared was estimated in the current study. Results The overall magnitude of low birth weight, preterm birth, and stillbirth in the study area, respectively, was 41%, 38%, and 4%. After adjustment for baseline characteristics, this study revealed that pregnant women in the inadequate WDDS group were at increased risk of LBW (ARR = 6.4; 95% CI: 3.4, 12) and PTD (ARR = 6.3; 95% CI: 3.3, 11.95) as compared with their counterparts but no difference in the occurrence of stillbirth (ARR = 1.08; 95% CI: 0.20, 5.79). Conclusion Overall, this study found a large magnitude of low birth weight and preterm birth. Inadequate intake of dietary diversity during pregnancy significantly increased the rate of low birth weight and preterm birth. Thus, we recommend the concerned body to work on improving the feeding practices of pregnant mothers in the study area.
Collapse
Affiliation(s)
- Amsalu Taye Wondemagegn
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia,*Correspondence: Amsalu Taye Wondemagegn
| | - Binalfew Tsehay
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Akiloge Lake Mebiratie
- Department of Obstetrics and Gynecology, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Ayenew Negesse
- Department of Human Nutrition and Food Sciences, Health Science College, Debre Markos University, Debre Markos, Ethiopia
| |
Collapse
|
13
|
Milliron BJ, Klobodu C, Gunen B, Bahruddinov M, Klassen AC. Household and Nutrition-Related Characteristics Associated with Water, Sanitation and Hygiene (WASH) Practices in Tajikistan. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2150109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Brandy-Joe Milliron
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Cynthia Klobodu
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Bengucan Gunen
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | - Ann C. Klassen
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| |
Collapse
|
14
|
Amadou A, Sighoko D, Coulibaly B, Traoré C, Kamaté B, Mallé BS, de Seze M, Kemayou Yoghoum FN, Biyogo Bi Eyang S, Bourgeois D, Curado MP, Bayo S, Gormally E, Hainaut P. Decrease in liver cancer incidence rates in Bamako, Mali over 28 years of population-based cancer registration (1987-2015). World J Hepatol 2022; 14:1767-1777. [PMID: 36185725 PMCID: PMC9521454 DOI: 10.4254/wjh.v14.i9.1767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/20/2021] [Accepted: 09/14/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary liver cancer is common in West Africa due to endemic risk factors. However, epidemiological studies of the global burden and trends of liver cancer are limited. We report changes in trends of the incidence of liver cancer over a period of 28 years using the population-based cancer registry of Bamako, Mali.
AIM To assess the trends and patterns of liver cancer by gender and age groups by analyzing the cancer registration data accumulated over 28 years (1987-2015) of activity of the population-based registry of the Bamako district.
METHODS Data obtained since the inception of the registry in 1987 through 2015 were stratified into three periods (1987-1996, 1997-2006, and 2007-2015). Age-standardized rates were estimated by direct standardization using the world population. Incidence rate ratios and the corresponding 95% confidence intervals (CI) were estimated using the early period as the reference (1987-1996). Joinpoint regression models were used to assess the annual percentage change and highlight trends over the entire period (from 1987 to 2015).
RESULTS Among males, the age-standardized incidence rates significantly decreased from 19.41 (1987-1996) to 13.12 (1997-2006) to 8.15 (2007-2015) per 105 person-years. The incidence rate ratio over 28 years was 0.42 (95%CI: 0.34-0.50), and the annual percentage change was -4.59 [95%CI: (-6.4)-(-2.7)]. Among females, rates dropped continuously from 7.02 (1987-1996) to 2.57 (2007-2015) per 105 person-years, with an incidence rate ratio of 0.37 (95%CI: 0.28-0.45) and an annual percentage change of -5.63 [95%CI: (-8.9)-(-2.3)].
CONCLUSION The population-based registration showed that the incidence of primary liver cancer has steadily decreased in the Bamako district over 28 years. This trend does not appear to result from biases or changes in registration practices. This is the first report of such a decrease in an area of high incidence of liver cancer in Africa. This decrease may be explained by the changes and diversity of diet that could reduce exposure to aflatoxins through dietary contamination in this population.
Collapse
Affiliation(s)
- Amina Amadou
- Institute for Advanced Biosciences, Grenoble 38700, France
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon 69008, France
| | - Dominique Sighoko
- Department of Medicine, University of Chicago, Chicago, IL 60611, United States
| | - Bourama Coulibaly
- Department of Pathological Anatomy and Cytology, University Hospital of Point G, Bamako BP333, Mali
| | - Cheick Traoré
- Department of Pathological Anatomy and Cytology, University Hospital of Point G, Bamako BP333, Mali
| | - Bakarou Kamaté
- Department of Pathological Anatomy and Cytology, University Hospital of Point G, Bamako BP333, Mali
| | - Brahima S Mallé
- Department of Pathological Anatomy and Cytology, University Hospital of Point G, Bamako BP333, Mali
| | - Maëlle de Seze
- Université Paris 1 Panthéon-Sorbonne, Paris 75005, France
| | | | - Sandrine Biyogo Bi Eyang
- Department of Pathological Anatomy and Cytology, University Hospital of Point G, Bamako BP333, Mali
| | - Denis Bourgeois
- Health, Systemic, Process, UR 4129 Research Unit, Université Claude Bernard Lyon 1, Villeurbanne 69100, France
| | - Maria Paula Curado
- Epidemiology and Statistics Nucleus, ACCamargo Cancer Center, Sao Paulo 01508-010, Brazil
| | - Siné Bayo
- Department of Pathological Anatomy and Cytology, University Hospital of Point G, Bamako BP333, Mali
| | - Emmanuelle Gormally
- Sciences and Humanities Confluence Research Center, Université Catholique de Lyon, Lyon 69288, France
| | - Pierre Hainaut
- Institut pour l’Avancée des Biosciences, Grenoble 38700, France
| |
Collapse
|
15
|
Parvin T, Endres K, Hasan MT, Uddin IM, Bhuyian MSI, Zohura F, Coglianese N, Biswas SK, Alam M, Faruque ASG, Gittelsohn J, Perin J, George CM. Low Fruit and Vegetable Consumption Associated with Linear Growth Faltering among Children in Urban Bangladesh. Am J Trop Med Hyg 2022; 106:tpmd211124. [PMID: 35576951 PMCID: PMC9209935 DOI: 10.4269/ajtmh.21-1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/31/2022] [Indexed: 11/07/2022] Open
Abstract
The objective of this study was to examine the association between dietary diversity and child growth among children 6 to 23 months of age in urban slums of Bangladesh. This prospective cohort study enrolled 192 participants 6 to 23 months of age in Dhaka, Bangladesh. A total of 170 children with follow-up anthropometric data were included in the analysis. To collect dietary intake information for children 6 to 23 months of age, consumption of five or more of the following eight minimum dietary diversity food groups was recorded using 24-hour dietary recall at enrollment provided by the child's caregiver: 1) breast milk; 2) grains, roots, and tubers; 3) legumes and nuts; 4) dairy products; 5) flesh foods; 6) eggs; 7) vitamin A-rich fruits and vegetables; and 8) other fruits and vegetables. Height and weight were measured at baseline and at a 12-month follow-up. Fifty-five percent of children (106 of 192) consumed five or more of the eight minimum dietary diversity food groups during their first visit to assess dietary intake. Eighty-two percent of children (157 of 192) had a report of consuming an animal source of food (e.g., eggs, diary, flesh foods) in the past 24 hours, 85% (164 of 192) consumed any source of protein (e.g., eggs, diary, flesh foods, nuts, and legumes), and 65% of children (125 of 192) were reported to consume any fruits and vegetables. Child consumption of fruits and vegetables was associated positively with change in length-for-age z-scores from baseline to the 12-month follow-up (coefficient, 0.86; 95% CI, 0.03-1.68). Inadequate fruit and vegetable consumption was associated with linear growth faltering among the young children residing in urban Dhaka, Bangladesh. These findings demonstrate the need for effective interventions to increase fruit and vegetable consumption in this susceptible pediatric population.
Collapse
Affiliation(s)
- Tahmina Parvin
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Kelly Endres
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - M. Tasdik Hasan
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Ismat Minhaj Uddin
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Fatema Zohura
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | | | - Munirul Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Abu S. G. Faruque
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jamie Perin
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Christine Marie George
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
16
|
Spatial Differences in Diet Quality and Economic Vulnerability to Food Insecurity in Bangladesh: Results from the 2016 Household Income and Expenditure Survey. SUSTAINABILITY 2022. [DOI: 10.3390/su14095643] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The study explored the spatial differences in diet quality and economic vulnerability to food insecurity with the association of sociodemographic characteristics at the household level in Bangladesh. This study was a secondary data analysis of Household Income and Expenditure Survey (HIES) data of 2016. Both statistical and spatial analyses were applied while assessing diet qualities in terms of the household dietary diversity score (HDDS), percentage of food energy from staples (PFES), and percentage of expenditure on food (PEF) as an indicator of the economic vulnerability to food insecurity (EVFI). The study’s findings revealed that the quality of people’s diets worsened as they moved from urban to rural area, and EVFI increased as they moved from the center to the periphery of the country. Nationally, the average HDDS was about 6.3, and the average PFES per household per day was about 70.4%. The spatial distribution of HDDS and PFES showed that rural regions in terms of settlements and the north, northwest and southeast regions had mostly low diet diversity. Besides, the average PEF per household per day was about 54%, with the highest in Mymensingh (57.4%) and the lowest in Dhaka division (50.2%). The average PEF in the households illustrated was highest in rural (55.2%) and lowest in the city (45.7%). Overall, based on the PEF at the sub-district level, the medium level of vulnerability comprised the highest share (69%) in Bangladesh. Age, gender, literacy, educational qualification and religion of the household’s head along with the number of earners, monthly income, area of settlements and divisions were significantly correlated with HDDS, PFES and EVFI. The study findings suggest that targeted interventions, including access to education, women empowerment and employment generation programs should be implemented in peripheral areas (north, northwest and southeast) to increase diet quality and minimize economic vulnerability to achieve sustainable food and nutrition security in Bangladesh.
Collapse
|
17
|
Determinants of Household Nutrition Security in Countries in Protracted Crisis: Evidence from South Sudan. SUSTAINABILITY 2022. [DOI: 10.3390/su14084793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Undernutrition is a considerable challenge in sub-Saharan Africa, especially in countries affected by a protracted crisis, but the literature lacks information on the underlying mechanisms influencing micro- and macronutrients, and appropriate analytical tools are needed to assist policymakers and implementers. The paper contributes to filling this gap, focusing on the Western Bahr el Ghazal state in South Sudan and using primary data collected in May–June 2019 for a statistically representative sample of households. The literature typically uses one micro- or macronutrient as a proxy of nutritional status. On the contrary, the study applied a MANCOVA with an artificial dependent variable, including protein, vitamin A, and heme iron, in a single experiment to discover the variables that better explain household nutritional status. Dietary diversity explains the largest proportion of variance in household nutritional status. The importance of the variables in explaining the variance in the specific micro- and macronutrients depends on the explanatory variable. Therefore, the results suggest the possible misinterpretation of undernutrition using one nutrient. Moreover, they highlight the importance of a multisectoral approach to the problem with a central role played by agriculture and the urgency of the reinforcement of the humanitarian–development–peace nexus to improve household nutrition security in South Sudan.
Collapse
|
18
|
Determinants of food security status with reference to women farmers in rural Kenya. SCIENTIFIC AFRICAN 2022. [DOI: 10.1016/j.sciaf.2022.e01114] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
19
|
Gassara G, Chen J. Household Food Insecurity, Dietary Diversity, and Stunting in Sub-Saharan Africa: A Systematic Review. Nutrients 2021; 13:4401. [PMID: 34959953 PMCID: PMC8707760 DOI: 10.3390/nu13124401] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The significant public health problem in Sub-Saharan Africa of household food insecurity is an underlying cause of malnutrition in Sub-Saharan Africa. This study aims to systematically study the association between household food insecurity, dietary diversity, and stunting. METHODS This review was carried out based on the recommendations of PRISMA (2015). We searched the literature in six bibliographic databases: PubMed, EMBASE, Science Direct, Web of Science, Google Scholar, and Scopus. The research was based on studies conducted in Sub-Saharan Africa about household food insecurity, dietary diversity, and stunting and was published between 2009 and 2020. RESULTS Out of 2398 original articles identified, only 21 articles met the specific requirements of this review. Two-thirds of the articles selected showed that stunting was linked to household food insecurity and dietary diversity. CONCLUSIONS This study found that household food insecurity and dietary diversity are significantly associated with stunting in Sub-Saharan Africa. This review recommends that in order to yield a sustainable fight against childhood malnutrition in Sub-Saharan Africa, reliable guidelines and strategies are needed to address these factors related to malnutrition.
Collapse
Affiliation(s)
| | - Jihua Chen
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410008, China;
| |
Collapse
|
20
|
Alaba OA, Hongoro C, Thulare A, Lukwa AT. Leaving No Child Behind: Decomposing Socioeconomic Inequalities in Child Health for India and South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7114. [PMID: 34281051 PMCID: PMC8296912 DOI: 10.3390/ijerph18137114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/01/2021] [Accepted: 06/26/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The United Nations' 2030 Agenda for Sustainable Development argues for the combating of health inequalities within and among countries, advocating for "leaving no one behind". However, child mortality in developing countries is still high and mainly driven by lack of immunization, food insecurity and nutritional deficiency. The confounding problem is the existence of socioeconomic inequalities among the richest and poorest. Thus, comparing South Africa's and India's Demographic and Health Surveys (DHS) of 2015/16, this study examines socioeconomic inequalities in under-five children's health and its associated factors using three child health indications: full immunization coverage, food insecurity and malnutrition. METHODS Erreygers Normalized concentration indices were computed to show how immunization coverage, food insecurity and malnutrition in children varied across socioeconomic groups (household wealth). Concentration curves were plotted to show the cumulative share of immunization coverage, food insecurity and malnutrition against the cumulative share of children ranked from poorest to richest. Subsequent decomposition analysis identified vital factors underpinning the observed socioeconomic inequalities. RESULTS The results confirm a strong socioeconomic gradient in food security and malnutrition in India and South Africa. However, while full childhood immunization in South Africa was pro-poor (-0.0236), in India, it was pro-rich (0.1640). Decomposed results reported socioeconomic status, residence, mother's education, and mother's age as primary drivers of health inequalities in full immunization, food security and nutrition among children in both countries. CONCLUSIONS The main drivers of the socioeconomic inequalities in both countries across the child health outcomes (full immunization, food insecurity and malnutrition) are socioeconomic status, residence, mother's education, and mother's age. In conclusion, if socioeconomic inequalities in children's health especially food insecurity and malnutrition in South Africa; food insecurity, malnutrition and immunization in India are not addressed then definitely "some under-five children will be left behind".
Collapse
Affiliation(s)
- Olufunke A. Alaba
- Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa;
| | - Charles Hongoro
- Developmental, Capable and Ethical State, Human Sciences Research Council, Pretoria 0001, South Africa;
- School of Health Systems and Public Health (SHSPH), Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Aquina Thulare
- National Department of Health, Pretoria 0001, South Africa;
| | - Akim Tafadzwa Lukwa
- Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa;
| |
Collapse
|
21
|
Al-Zabir A, Wongnaa CA, Islam MA, Mozahid MN. Food security status of farming households in Bangladesh: A comparison of recipients and non-receivers of institutional support. AFRICAN JOURNAL OF SCIENCE, TECHNOLOGY, INNOVATION AND DEVELOPMENT 2021. [DOI: 10.1080/20421338.2020.1804100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Abdullah Al-Zabir
- Department of Agricultural Statistics, Sylhet Agricultural University, Bangladesh
| | - Camillus Abawiera Wongnaa
- Department of Agricultural Economics, Agribusiness and Extension, Kwame Nkrumah University of Science and Technology, Ghana
| | - Md. Ariful Islam
- Faculty of Veterinary and Animal Science, Sylhet Agricultural University, Bangladesh
| | - Md. Nur Mozahid
- Department of Agricultural Economics and Policy, Sylhet Agricultural University, Bangladesh
| |
Collapse
|
22
|
Shiferaw YF, Engidaw MT, Kedir M, Tsegaye AT. Wealth index is significantly associated with the early phase of fracture healing among fractured patients at the University of Gondar Specialized Hospital, Northwest Ethiopia. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01559-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
23
|
Abstract
BACKGROUND Nutritional status has important implications for labor productivity, lifetime earnings, and country-wide economic development. Dietary diversity is an important contributor to nutrition. OBJECTIVE To identify how patterns of food consumption are related to dietary diversity and to measure the potential for policy interventions to influence diet complexity. METHODS Household dietary diversity scores were constructed using data from 11 809 rural and urban households surveyed in Nepal between 2013 and 2016. Diversity scores were based on 7-day recall information on food purchases and food consumed directly from agricultural production. Reported consumption from 14 food groups was mapped into 4 distinct dietary patterns via latent class analysis. Ordered probit regressions were used to identify factors associated with observed diet patterns. RESULTS Diets are heterogeneous and map into 4 clusters along a continuum of complexity. Three identified diets are vegetarian and 1 is nonvegetarian. Diet complexity is associated with geography and socioeconomic features of the sample. On average, poor and agricultural households have less complex diets and households receiving remittances have more complex and higher quality diets. Road density is positively correlated with diet complexity. We find evidence of modest reductions in diet quality over the sample period. CONCLUSIONS Results confirm heterogeneous dietary behavior of Nepalese households. The identified patterns could be used to more effectively target policies directed at nutrition education or efforts to improve health by diversifying and improving the nutritional quality of household diets, for example, through supplemental feeding programs, home garden promotion, or targeted food assistance programs.
Collapse
Affiliation(s)
| | - Alecia Evans
- 311308Purdue University, West Lafayette, IN, USA
| |
Collapse
|
24
|
Saaka M, Mutaru S, Osman SM. Determinants of dietary diversity and its relationship with the nutritional status of pregnant women. J Nutr Sci 2021; 10:e14. [PMID: 33889397 PMCID: PMC8057399 DOI: 10.1017/jns.2021.6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 12/23/2022] Open
Abstract
There is little information regarding factors that determine dietary diversity among pregnant women in Ghana. The present study, therefore, sought to assess the independent predictors of dietary diversity and its relationship with nutritional status of pregnant women in the Northern Region of Ghana. The present study was an analytical cross-sectional survey involving 423 pregnant women in different stages of gestation. The 24-h dietary recall method was used to assess minimum dietary diversity for women (MDD-W), and nutritional status was assessed using mid-upper arm circumference (MUAC) measurements. Binary logistic regression was performed to assess the association between maternal dietary diversity and maternal thinness and a P value of <0⋅05 was considered statistically significant. Of the 423 women, 79⋅9 % (95 % CI 76⋅1, 83⋅7) met the MDD-W and the prevalence of undernutrition among the pregnant women was 26⋅0 %. The analysis showed that women of low household wealth index were 48 % less likely (AOR 0⋅52, CI 0⋅31, 0⋅88) of meeting the MDD-W, whereas women from households of poor food insecurity were 88 % less likely (AOR 0⋅12, CI 0⋅05, 0⋅27) of achieving the MDD-W. Women of low household size were three times more likely of meeting the MDD-W (AOR 3⋅07, CI 1⋅13, 8⋅39). MDD-W was not associated with maternal underweight during pregnancy. In conclusion, the results of the present study showed that food insecurity and not low MDD-W, associated with mothers' thinness (underweight) during pregnancy in peri-urban setting of Northern Ghana.
Collapse
Affiliation(s)
- Mahama Saaka
- University for Development Studies, School of Allied Health Sciences, P O Box 1883, Tamale, Ghana
| | - Sofo Mutaru
- Ghana Health Service, Northern Region, Tamale, Ghana
| | - Shaibu Mohammed Osman
- University for Development Studies, School of Allied Health Sciences, P O Box 1883, Tamale, Ghana
| |
Collapse
|
25
|
Impact of improved small-scale livestock farming on human nutrition. Sci Rep 2021; 11:191. [PMID: 33420257 PMCID: PMC7794515 DOI: 10.1038/s41598-020-80387-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 12/10/2020] [Indexed: 11/20/2022] Open
Abstract
Micronutrient deficiencies and stunting rates are high in many low-income countries. Increasing and diversifying food intake are often challenging for small-scale farmers in lowland areas as flooding often results in crop losses and drowning of livestock. A cluster-randomised controlled trial was conducted over 12-months in Bangladesh, involving 150 small-scale duck rearing households, including 50 control, and 50 households each in two intervention arms. Interventions focussing on improving duck health and duck nutrition were applied on a village level. Data analysis focussed on assessing the impact of interventions on duck mortality, sales and consumption, and on dietary diversity of household members. Improved duck rearing increased the consumption and the sales of ducks. Household selling more ducks were more likely to purchase and consume milk products, contributing to an improved households’ dietary diversity. Our results suggest that improving duck rearing can provide a suitable and sustainable alternative to maintain and improve dietary diversity of households in flood-prone areas.
Collapse
|
26
|
Understanding Dietary Diversity, Dietary Practices and Changes in Food Patterns in Marginalised Societies in Sri Lanka. Foods 2020; 9:foods9111659. [PMID: 33202762 PMCID: PMC7696452 DOI: 10.3390/foods9111659] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/26/2020] [Accepted: 10/31/2020] [Indexed: 01/04/2023] Open
Abstract
Micronutrient malnutrition is a serious public health problem in developing countries, including Sri Lanka. Most frequently, micronutrient malnutrition is experienced by the poorest households due to cereal-based, monotonous diets that lack dietary diversity. Sri Lankan traditional food system is changing day by day. In parallel, nutrition deficiencies, malnutrition, and noncommunicable diseases are the most significant problems today in Sri Lanka. Therefore, understanding dietary diversity and dietary changes in Sri Lanka must be studied to address related public health issues. This study investigates nutrition adequacy, dietary diversity, dietary practice, and traditional food pattern changes in different marginalised areas in Sri Lanka. A cross-sectional survey was done using 24 h food recall and an administrative questionnaire for 400 women of reproductive age (WRA) (18-49 years old) in marginalised areas in Sri Lanka. The random sampling method was used for data collection. The research confirmed that different areas had poor dietary practices, with macronutrient imbalance and alarmingly low intakes of micronutrients. Interestingly, the diversity of food was higher in rural areas than in urban areas. Approximately 83% of women in urban areas did not meet minimum dietary diversity (MDD-W). Overall, about 63% of reproductive age women did not meet MDD-W and food security. The mean MDD-W for both areas was low. Significant differences in MDD-W levels were found in the two areas (F = 90.483, p < 0.05). The sample showed a significant positive correlation between MDD-W and area, monthly income, educational level, food source, BMI level and health status (R2 = 360; p < 0.01). This sample did not find that the consumption of traditional varieties of foods and agrobiodiversity are decreasing. Additionally, the study confirmed that low dietary diversity impacts nutrition status and health. The results highlight that the leading causes for low diet diversity are decreased dependence on own production, increased purchasing food at markets, lack of suitable lands to cultivate, agro-commercialisation, less knowledge of food and nutrition, loss of traditional food culture, low income and high prices of food. Inappropriate food patterns, nutrition policies and governance in Sri Lanka are the main factors to the nutrition findings. The study finding will help the decision-making authorities or policymakers to design suitable nutrition programs for vulnerable people in marginalised areas and to use these to strengthen a sustainable food and nutrition system in Sri Lanka.
Collapse
|
27
|
Mank I, Vandormael A, Traoré I, Ouédraogo WA, Sauerborn R, Danquah I. Dietary habits associated with growth development of children aged < 5 years in the Nouna Health and Demographic Surveillance System, Burkina Faso. Nutr J 2020; 19:81. [PMID: 32772913 PMCID: PMC7416397 DOI: 10.1186/s12937-020-00591-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 07/21/2020] [Indexed: 02/06/2023] Open
Abstract
Background Knowing which dietary habits are associated with child growth could lead to better long-term health outcomes and improve the design of food-based interventions. We aimed to identify dietary habits that are associated with the growth development of children aged < 5 years living in rural Burkina Faso. Methods This study used cross-sectional baseline data from 514 children (8–59 months) within the Nouna Health and Demographic Surveillance System (HDSS) in 2018. Household socio-demographics and child dietary habits, height and weight were assessed. We constructed scores for dietary diversity (DDS) and food variety (FVS), and extracted exploratory dietary pattern scores (DPS) using principal component analysis (PCA). Child growth was measured using height-for-age (HAZ) and weight-for-height z-scores (WHZ). We used multiple-adjusted linear regressions considering for socio-economic factors to quantify associations. Results In this study population (median 36 ± 14 months old), stunting (HAZ < − 2) was seen in 26% and wasting (WHZ < − 2) in 7%. The DDS (median 7 ± 2 food groups) was positively associated with WHZ, while the FVS (median 13 ± 8 food items) was inversely associated with HAZ. We identified 4 dietary patterns: leaves-based, beans and poultry-based, maize and fish-based, and millet and meat-based diets. Only the maize and fish-based diet showed a statistically significant and here positive trend for associations with WHZ. Conclusion Growth development of children aged < 5 years continues to be a health problem in the Nouna HDSS. A higher dietary diversity and food variety and dietary patterns characterized by maize and fish and beans and poultry intake appear to be beneficial for growth of young children in this area.
Collapse
Affiliation(s)
- Isabel Mank
- Heidelberg Institute of Global Health (HIGH), Medical Faculty, Heidelberg University, Heidelberg, Germany.
| | - Alain Vandormael
- Heidelberg Institute of Global Health (HIGH), Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Issouf Traoré
- Centre de Recherche en Santé de Nouna (CRSN), Institut National de Santé Publique (INSP), Nouna, Burkina Faso.,Institut Universitaire de Formations Initiale et Continue (IUFIC), Université Ouaga II (UO2), Ouagadougou, Burkina Faso
| | | | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Medical Faculty, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
28
|
Miller V, Webb P, Micha R, Mozaffarian D. Defining diet quality: a synthesis of dietary quality metrics and their validity for the double burden of malnutrition. Lancet Planet Health 2020; 4:e352-e370. [PMID: 32800153 PMCID: PMC7435701 DOI: 10.1016/s2542-5196(20)30162-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Achieving most of the UN Sustainable Development Goals requires a strong focus on addressing the double burden of malnutrition, which includes both diet-related maternal and child health (MCH) and non-communicable diseases (NCDs). Although, the most optimal dietary metric for assessing malnutrition remains unclear. Our aim was to review available global dietary quality metrics (hereafter referred to as dietary metrics) and evidence for their validity to assess MCH and NCD outcomes, both separately and together. A systematic search of PubMed was done to identify meta-analyses or narrative reviews evaluating validity of diet metrics in relation to nutrient adequacy or health outcomes. We identified seven dietary metrics aiming to address MCH and 12 for NCDs, no dietary metrics addressed both together. Four NCD dietary metrics (Mediterranean Diet Score, Alternative Healthy Eating Index, Healthy Eating Index, and Dietary Approaches to Stop Hypertension) had convincing evidence of protective associations with specific NCD outcomes, mainly mortality, cardiovascular disease, type 2 diabetes, and total cancer. The remaining NCD dietary metrics and all MCH dietary metrics were not convincingly validated against MCH or NCD health outcomes. None of the dietary metrics had been validated against both MCH and NCD outcomes. These findings highlight major gaps in assessing and addressing diet to achieve global targets and effective policy action.
Collapse
Affiliation(s)
- Victoria Miller
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Patrick Webb
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| |
Collapse
|
29
|
Osama M, Khan AA, Syed SH, Mohiuddin O, Hassan A, Zaidi SR, Sami N. Non-Adherence to WHO Recommendations Regarding Infant Feeding Practices Results in Dilemma of Malnourishment: A Community-Based Prospective Cohort Study Conducted in Karachi, Pakistan. Cureus 2020; 12:e8507. [PMID: 32656023 PMCID: PMC7346294 DOI: 10.7759/cureus.8507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/08/2020] [Indexed: 11/05/2022] Open
Abstract
Background The prevalence of chronic malnutrition and its associated morbid outcomes has been a significant cause of health loss globally, affecting millions of children hampering their mental, physical, social, and immune system development. World Health Organization's (WHO) recommendations presenting infant feeding guidelines have largely controlled this burden. However, developing countries including Pakistan have failed to promote these guidelines and still succumb to a huge burden of morbidity and mortality secondary to malnourishment among infants. Methodology Our study is a prospective cohort including 300 infants without predisposing congenital anomaly, followed from 6 months to 18 months of age. The primary outcome involved was classifying patients as malnourished based on anthropometric measurements, assessing the prevalence of co-morbidities and comparison of results in compliance with WHO guidelines. Results A total of 276 infants were included and the rest were lost to follow-up. Stratification on socioeconomic status was done; 53% of infants were diagnosed as malnourished, either due to stunted growth, underweight, or both. The odds of development of malnourishment based on non-adherence to WHO guidelines on breastfeeding were 2.87 (p=0.001). The incidence of morbid complications was higher in the malnourished group, including gastrointestinal and respiratory tract infections. Conclusion The implementation of WHO recommendations on infant feeding techniques can prove to be a pivotal instrument to control the soaring index of morbidities and mortalities associated with malnourishment. A strong focus on parental education and awareness among masses is required for its promulgation and controlling the infant health burden linked to this preventable condition.
Collapse
Affiliation(s)
- Muhammad Osama
- General Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Anosh Aslam Khan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | | | - Osama Mohiuddin
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Ammar Hassan
- Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, PAK
| | | | - Neelofar Sami
- Community Medicine, Aga Khan University Hospital, Karachi, PAK
| |
Collapse
|
30
|
Nutritional Deprivation Index is negatively associated with socio-economic factors in Paraguayan households. J Nutr Sci 2020; 9:e19. [PMID: 32577224 PMCID: PMC7288614 DOI: 10.1017/jns.2020.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The present study aimed to examine the nutritional deprivation of Paraguayan households (measured as households' access to diverse diets) and investigate the association between nutritional deprivation and socio-economic characteristics in a large sample. An extension of Alkire–Foster methodology, a technique widely employed in multidimensional poverty measurement, was used to calculate both the incidence and intensity of nutritional deprivation. The resulting Nutritional Deprivation Index allows us to consider minimum food group requirements that vary by food groups as well as by individual characteristics such as age, sex and activity level. Applying the methodology to a nationally representative sample of households from the 2011–2012 Income and Expenditures Household Survey, the study found that about two in every three Paraguayan households (67 %) were inadequately nourished in at least four (of the total of six) food groups. Although no significant differences were found between rural and urban households, the incidence of multi-dimensionally deprived households generally decreased as income increased. Logistic regression results showed that nutritional deprivation decreased as household income and mother's education increased and increased with household size. Our study concludes that the majority of Paraguayan households is significantly nutritionally deprived across most food groups and suggests that strategies are needed to improve their access to diverse diets, especially among its lower- and middle-income segments.
Collapse
|
31
|
Gelli A, Donovan J, Margolies A, Aberman N, Santacroce M, Chirwa E, Henson S, Hawkes C. Value chains to improve diets: Diagnostics to support intervention design in Malawi. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2020. [DOI: 10.1016/j.gfs.2019.09.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
32
|
Quezada-Sánchez AD, Shamah-Levy T, Mundo-Rosas V. Socioeconomic characteristics of mothers and their relationship with dietary diversity and food group consumption of their children. Nutr Diet 2020; 77:467-476. [PMID: 32368858 DOI: 10.1111/1747-0080.12616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/10/2020] [Accepted: 03/29/2020] [Indexed: 01/05/2023]
Abstract
AIM The aim of this study was to analyse the relationship between socioeconomic characteristics of mothers and dietary diversity (DD) as well as food group (FG) consumption of their children in Mexico. METHODS A sample of 1041 children aged 1 to 4 years from the 2012 Mexican National Health and Nutrition Survey was analysed. DD included nine FG: dairy, meat, egg, fish, fruits, vegetables, legumes, tubers and cereals. For DD as well as for each FG, relative means were estimated from Poisson regressions with covariates of mothers' socioeconomic characteristics such as attained educational level, occupation, Indigenous language spoken, household socioeconomic status and child's characteristics. Standard errors were adjusted to account for data dependencies within primary sampling units. RESULTS Children whose mothers had college education were less likely to have low DD (-57%, P < .01) and more likely to consume meat (+27%, P < .05), fruits (+17%, P < .01) and vegetables (+43%, P < .01) compared to children whose mothers had elementary education or none. Children of mothers who speak an Indigenous language had considerably higher (58%, P < .001) probability of low DD than non-Indigenous speaking mothers. CONCLUSIONS Specific mother characteristics may either limit or facilitate access to nutrient diverse diets. These characteristics should be taken into account for designing public policies geared towards improving diet and nutritional status during the first years of life.
Collapse
Affiliation(s)
- Amado D Quezada-Sánchez
- Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Mexico
| | - Teresa Shamah-Levy
- Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Mexico
| | - Verónica Mundo-Rosas
- Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Mexico
| |
Collapse
|
33
|
Khanam M, Ara G, Rahman AS, Islam Z, Farhad S, Khan SS, Sanin KI, Rahman MM, Majoor H, Ahmed T. Factors Affecting Food Security in Women Enrolled in a Program for Vulnerable Group Development. Curr Dev Nutr 2020; 4:nzaa037. [PMID: 32296741 PMCID: PMC7144907 DOI: 10.1093/cdn/nzaa037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/03/2020] [Accepted: 03/09/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Food security is defined as physical and economic access to sufficient food to meet the dietary requirements for a productive and healthy life. Evidence from the literature suggests that >800 million people worldwide are food insecure. Vulnerable Group Development (VGD) is the largest social safety net of the Government of Bangladesh targeting ultra-poor women to end hunger, achieve food security, improve nutrition, and promote sustainable agriculture. OBJECTIVES The objective of this study is to explore the factors associated with food security among VGD women in Bangladesh. METHODS A total of 870 women (435/group) participated in the baseline survey and another 800 women (400/group) participated in the endline survey. Participants in the intervention group received monthly rations of 30 kg fortified rice (FFR) and the control group received 30 kg of non-FFR for 12 mo. Multiple logistic regression analysis was used to establish both crude and confounder-adjusted relations between the primary outcome and response variables. Written consent was proved by study participants. This study (PR-14091) was approved by the Research Review Committee and Ethical Review Committee. RESULTS Severe food insecurity in the endline survey decreased from ∼50% to 6.3% in both groups. The hunger scale also improved between the baseline and endline survey. More than 97% of respondents at endline reported no hunger compared with 80% at baseline; only 3% of women in both groups reported moderate hunger at endline. Multivariable regression model showed that ownership of a house and land for agriculture, wealth index (richest quintile), and absence of fever were significantly associated with food security (P < 0.05). CONCLUSIONS Our analysis shows that the VGD rice distribution program significantly improves the food security status of vulnerable women; however, ownership of a house and land for agriculture were the most significant factors associated with household food security in VGD program areas of Bangladesh.
Collapse
Affiliation(s)
- Mansura Khanam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Gulshan Ara
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ahmed Shafiqur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Zhahirul Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shahriar Farhad
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sihan Sadat Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kazi Istiaque Sanin
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Mahbobor Rahman
- World Food Programme, IDB Bhaban, IDB Bhaban 14th, 16th and 17th Floor E/8-A, Rokeya Sharani Agargaon, Sher-e-Bangla Nagar, Dhaka-1207, Bangladesh
| | - Herma Majoor
- World Food Programme, IDB Bhaban, IDB Bhaban 14th, 16th and 17th Floor E/8-A, Rokeya Sharani Agargaon, Sher-e-Bangla Nagar, Dhaka-1207, Bangladesh
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| |
Collapse
|
34
|
Li Z, Kim R, Vollmer S, Subramanian SV. Factors Associated With Child Stunting, Wasting, and Underweight in 35 Low- and Middle-Income Countries. JAMA Netw Open 2020; 3:e203386. [PMID: 32320037 PMCID: PMC7177203 DOI: 10.1001/jamanetworkopen.2020.3386] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
IMPORTANCE Evidence on the relative importance of various factors associated with child anthropometric failures (ie, stunting, underweight, and wasting) and their heterogeneity across countries can inform global and national health agendas. OBJECTIVE To assess the relative significance of factors associated with child anthropometric failures in 35 low- and middle-income countries (LMICs). DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study of 299 353 children who were born singleton and aged 12 to 59 months with nonpregnant mothers and valid anthropometric measures assessed the strengths of associations of 26 factors with child stunting, underweight, and wasting, using Demographic and Health Surveys (2007-2018) from 35 LMICs. Data analysis was conducted from July 2019 to February 2020. EXPOSURES A total of 9 direct factors (ie, dietary diversity score; breastfeeding initiation; vitamin A supplements; use of iodized salt; infectious disease in past 2 weeks; oral rehydration therapy for children with diarrhea; care seeking for suspected pneumonia; full vaccination; and indoor pollution) and 17 indirect factors (household wealth; maternal and paternal education; maternal and paternal height and body mass index; maternal autonomy for health care, movement, and money; water source; sanitation facility; stool disposal; antenatal care; skilled birth attendant at delivery; family planning needs; and maternal marriage age) were assessed. MAIN OUTCOMES AND MEASURES Three anthropometric failure outcomes were constructed based on the 2006 World Health Organization child growth standards: stunting (height-for-age z score less than -2 standard deviations [SDs]), underweight (weight-for-age z score less than -2 SDs), and wasting (weight-for-height z score less than -2 SDs). RESULTS Among the 299 353 children aged 12 to 59 months included in the analysis, 38.8% (95% CI, 38.6%-38.9%) had stunting, 27.5% (95% CI, 27.3%-27.6%) had underweight, and 12.9% (95% CI, 12.8%-13.0%) had wasting. In the pooled sample, short maternal height was the strongest factor associated with child stunting (odds ratio [OR], 4.7; 95% CI, 4.5-5.0; P < .001), followed by lack of maternal education (OR, 1.9; 95% CI, 1.8-2.0; P < .001), poorest household wealth (OR, 1.7; 95% CI,1.6-1.8; P < .001), and low maternal body mass index (OR, 1.6; 95% CI, 1.6-1.7; P < .001). Short paternal height was also significantly associated with higher odds of stunting (OR, 1.9; 95% CI, 1.7-2.2; P < .001). Consistent results were found for underweight (eg, short maternal height: OR, 3.5; 95% CI, 3.3-3.7; P < .001; lack of maternal education: OR, 1.8; 95% CI, 1.7-2.0; P < .001) and wasting (eg, low maternal body mass index: OR, 2.3; 95% CI, 2.1-2,4; P < .001; poorest household wealth: OR, 1.2; 95% CI, 1.1-1.3; P < .001). Parental nutritional status and household socioeconomic conditions ranked the strongest (1st to 4th) for most countries, with a few exceptions (eg, lack of maternal education ranked 18th-20th in 8 countries for child wasting). Other factors were not associated with anthropometric failures in pooled analysis and had large country-level heterogeneity; for example, unsafe water was not associated with child underweight in the pooled analysis (OR, 0.97; 95% CI, 0.95-1.00; P < .001), and it ranked from 4th to 20th across countries. CONCLUSIONS AND RELEVANCE In this study, socioeconomic conditions and parental nutritional status were the strongest factors associated with child anthropometric failures. Poverty reduction, women's education, and nutrition programs for households could be important strategies for reducing child undernutrition; however, country-specific contexts should be considered in national policy discussions.
Collapse
Affiliation(s)
- Zhihui Li
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Rockli Kim
- Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul, South Korea
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, South Korea
- Harvard Center for Population and Development Studies, Cambridge, Massachusetts
| | - Sebastian Vollmer
- Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Germany
| | - S. V. Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Harvard Center for Population and Development Studies, Cambridge, Massachusetts
| |
Collapse
|
35
|
Tasie MM, Gebreyes BG. Characterization of Nutritional, Antinutritional, and Mineral Contents of Thirty-Five Sorghum Varieties Grown in Ethiopia. INTERNATIONAL JOURNAL OF FOOD SCIENCE 2020; 2020:8243617. [PMID: 32258096 PMCID: PMC7086442 DOI: 10.1155/2020/8243617] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/08/2020] [Indexed: 11/18/2022]
Abstract
An experiment was carried out to characterize the proximate compositions and antinutritional and mineral contents of sorghum varieties released for production by the Ethiopian sorghum improvement programme. Sorghum is an extensively researched crop in Ethiopia. However, comprehensive information on nutritional, antinutritional, and mineral content has not been generated. In the present study, thirty-five sorghum varieties released by the national sorghum improvement programme were used and evaluated for their proximate compositions, tannin, and mineral nutrient. AOAC methods of analysis were used for proximate compositions and mineral content together, i.e., whereas for tannin, vanillin-HCL assay methods of analysis were used. Differences between sorghum varieties were significant (P ≤ 0.05) for all measured parameters. Proximate composition values such as moisture, ash, crude fat, crude fiber, crude protein, and CHO varied from 9.66 to 12.94, 1.12 to 2.29, 2.48 to 4.60, 2.17 to 8.59, 8.20 to 16.48, and 67.56 to 76.42, respectively. The highest mineral content of P (367.965), Na (6.151), Mg (207.526), K (314.011), Ca (67.159), Fe (14.018), and Zn (6.484) as measured by mg/100 g was found from the varieties Macia, Abshir, Chiro, Birmash, Dagem, and Assossa-1 (Fe and Zn), respectively. Maximum tannin values of 3337.200 and 2474.7 mg/100 g were obtained from Lalo and Dano, respectively. The varieties such as Miskir, Abshir, ESH-1, Meko-1, Red Swazi, and Karimtams have higher nutritional and mineral and lower antinutritional values among the tested varieties. The abovementioned varieties should be considered for food product development due to their nutritional qualities.
Collapse
Affiliation(s)
- Masresha Minuye Tasie
- Food Science and Nutrition, Ethiopian Institute of Agricultural Research, P.O. Box 2003, Addis Ababa, Ethiopia
| | - Belay Gezahegn Gebreyes
- Food Science and Nutrition, Ethiopian Institute of Agricultural Research, P.O. Box 2003, Addis Ababa, Ethiopia
| |
Collapse
|
36
|
Venter C, Greenhawt M, Meyer RW, Agostoni C, Reese I, Toit G, Feeney M, Maslin K, Nwaru BI, Roduit C, Untersmayr E, Vlieg‐Boerstra B, Pali‐Schöll I, Roberts GC, Smith P, Akdis CA, Agache I, Ben‐Adallah M, Bischoff S, Frei R, Garn H, Grimshaw K, Hoffmann‐Sommergruber K, Lunjani N, Muraro A, Poulsen LK, Renz H, Sokolowska M, Stanton C, O'Mahony L. EAACI position paper on diet diversity in pregnancy, infancy and childhood: Novel concepts and implications for studies in allergy and asthma. Allergy 2020; 75:497-523. [PMID: 31520486 DOI: 10.1111/all.14051] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/27/2019] [Accepted: 09/09/2019] [Indexed: 02/06/2023]
Abstract
To fully understand the role of diet diversity on allergy outcomes and to set standards for conducting research in this field, the European Academy of Allergy and Clinical Immunology Task Force on Diet and Immunomodulation has systematically explored the association between diet diversity and allergy outcomes. In addition, a detailed narrative review of information on diet quality and diet patterns as they pertain to allergic outcomes is presented. Overall, we recommend that infants of any risk category for allergic disease should have a diverse diet, given no evidence of harm and some potential association of benefit in the prevention of particular allergic outcomes. In order to harmonize methods for future data collection and reporting, the task force members propose relevant definitions and important factors for consideration, when measuring diet diversity in the context of allergy. Consensus was achieved on practice points through the Delphi method. It is hoped that the definitions and considerations described herein will also enable better comparison of future studies and improve mechanistic studies and pathway analysis to understand how diet diversity modulates allergic outcomes.
Collapse
Affiliation(s)
- Carina Venter
- Section of Allergy and Immunology Children's Hospital Colorado University of Colorado Denver School of Medicine Aurora CO USA
| | - Matthew Greenhawt
- Section of Allergy and Immunology Children's Hospital Colorado University of Colorado Denver School of Medicine Aurora CO USA
| | | | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda ‐ Ospedale Maggiore Policlinico Milano Italy
- Dipartimento di Scienze Cliniche e di Comunita Universita' degli Studi Milano Italy
| | - Imke Reese
- Dietary Counseling and Nutrition Therapy Centre Munich Germany
| | - George Toit
- Department of Paediatric Allergy Division of Asthma, Allergy and Lung Biology King's College London London UK
- Guy's & St Thomas' Hospital London UK
| | - Mary Feeney
- Department of Paediatric Allergy Division of Asthma, Allergy and Lung Biology King's College London London UK
- Guy's & St Thomas' Hospital London UK
| | | | - Bright I. Nwaru
- Institute of Medicine Krefting Research Centre University of Gothenburg Gothenburg Sweden
| | - Caroline Roduit
- University Children's Hospital Zurich Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
| | - Eva Untersmayr
- Institute for Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | | | - Isabella Pali‐Schöll
- Department of Nutrition and Dietetics Hanze University of Applied Sciences Groningen The Netherlands
- Comparative Medicine Messerli Research Institute of the University of Veterinary Medicine Vienna Medical University Vienna Vienna Austria
| | - Graham C. Roberts
- The David Hide Asthma and Allergy Research Centre St Mary’s Hospital Newport UK
- NIHR Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
- Faculty of Medicine Clinical and Experimental Sciences Human Development in Health Academic Units University of Southampton Southampton UK
| | - Peter Smith
- School of Medicine Griffith University Southport QLD Australia
| | - Cezmi A. Akdis
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | | | - Miriam Ben‐Adallah
- Section of Allergy and Immunology Children's Hospital Colorado University of Colorado Denver School of Medicine Aurora CO USA
| | - Stephan Bischoff
- Institute of Nutritional Medicine University of Hohenheim Stuttgart Germany
| | - Remo Frei
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Holger Garn
- Philipps University of Marburg - Medical Faculty Institute of Laboratory Medicine and Pathobiochemistry Universities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL) Marburg Germany
| | - Kate Grimshaw
- Faculty of Medicine Experimental Sciences & Human Development in Health Academic Units University of Southampton Southampton UK
- Department of Dietetics Salford Royal Foundation Trust Salford UK
| | - Karin Hoffmann‐Sommergruber
- Institute for Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Nonhlanhla Lunjani
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- University of Cape Town Cape Town South Africa
| | - Antonella Muraro
- Centro di Specializzazione Regionale per lo Studio e la Cura delle Allergie e delle Intolleranze Alimentari presso l'Azienda Ospedaliera Università di Padova Padova Italy
| | - Lars K. Poulsen
- Department of Skin and Allergy Diseases Allergy Clinic Copenhagen University Hospital at Gentofte Copenhagen Denmark
| | - Harald Renz
- Institute of Laboratory Medicine Universities of Giessen and Marburg Lung Center (UGMLC) German Center for Lung Research (DZL) Philipps Universität Marburg Marburg Germany
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | | | - Liam O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Department of Medicine and Microbiology APC Microbiome Ireland National University of Ireland Cork Ireland
| |
Collapse
|
37
|
Ameliorating Food and Nutrition Security in Farm Households: Does Informatization Matter? SUSTAINABILITY 2020. [DOI: 10.3390/su12020522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Improving food and nutrition security in Sub-Saharan Africa’s farm households has become a prominent priority subject for researchers and policymakers alike. Interestingly, it is realized through enhancement in dietary diversity and quality. To this end, better access to food and information is considered a prerequisite. Given that mobile phone coverage offers new prospects for increasing rural households’ access to information, can informatization (mobile phone used as a concrete example) possibly influence dietary diversity and quality? Cross-sectional data collected from farm households in Zambia is used to address this topic by applying the ordinary least square and endogenous switching regression (ESR). Household dietary diversity score was constructed based on a 7-days recall approach to measure consumption patterns. Our robust regression result indicates that mobile phone use positively and significantly influences dietary diversity and quality. Particularly, gender-disaggregated regression reveals that male-headed households have stronger positive associations than their counterparts. We also find that in comparison to non-adopters, adopters consume three more foods weekly. This is attributable to the income gains and increased frequency in information access on account of mobile phone adoption. Conversely, average consumption would increase by two more foods weekly if mobile phones were adopted in non-adopting households. Therefore, our study puts forwards substantial empirical evidence to warrant policy formulation directed at promoting informatization among farm households. Eventually, this could possibly recuperate dynamism in agricultural food production as food and nutrition security in farm households ameliorates.
Collapse
|
38
|
Sandoval-Moreno LM, Fandiño-Losada A, Pacichana-Quinayaz SG, Gutiérrez-Martínez MI. Letter to the Editors on the paper by Ferdos & Rahman. CAD SAUDE PUBLICA 2020; 36:e00189719. [DOI: 10.1590/0102-311x00189719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 12/11/2019] [Indexed: 11/21/2022] Open
|
39
|
Custodio E, Kayikatire F, Fortin S, Thomas AC, Kameli Y, Nkunzimana T, Ndiaye B, Martin-Prevel Y. Minimum dietary diversity among women of reproductive age in urban Burkina Faso. MATERNAL AND CHILD NUTRITION 2019; 16:e12897. [PMID: 31856424 PMCID: PMC7083435 DOI: 10.1111/mcn.12897] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 11/27/2022]
Abstract
Micronutrient malnutrition is a challenge for women of reproductive age, who are particularly vulnerable due to greater micronutrient needs. The minimum dietary diversity for women (MDD‐W) indicator is a micronutrient adequacy's proxy for those women, but little is known about its relation to other dimensions. We assessed MDD‐W and its association with other socioeconomic, food security and purchasing practices in urban Burkina Faso. We conducted multi‐stage cluster sampling in two main cities of Burkina Faso, stratified by type of district, and interviewed 12 754 women in the 2009‐2011 period. We obtained food consumption data through unquantified 24 hour recalls and computed MDD‐W as consuming at least five out of ten predefined food groups. We constructed multivariable regression models with sociodemographic and food security covariates. MDD‐W in urban Burkina Faso was 31%, higher in Ouagadougou (33%) than in Bobo‐Dioulasso (29%), and lower in unstructured districts. The most frequently consumed food groups were ‘all starchy', ‘vitamin A rich dark green leafy vegetables' and ‘other vegetables'. Household's expenses were associated with higher likelihood of MDD‐W, while the association with household food security indicators varied by year and type of district. Purchasing foods in markets and choosing the place of purchase based on large choice rather than proximity showed a positive association with the MDD‐W. Only one in three women in urban Burkina Faso reached the minimum dietary diversity, and although socioeconomic and food security variables had the greatest effect on MDD‐W, purchasing practices, like going to the market, also showed a positive effect.
Collapse
Affiliation(s)
| | | | - Sonia Fortin
- NUTRIPASS, Univ Montpellier, Institut de Recherche pour le Développement, Montpellier SupAgro, Montpellier, France
| | | | - Yves Kameli
- NUTRIPASS, Univ Montpellier, Institut de Recherche pour le Développement, Montpellier SupAgro, Montpellier, France
| | | | | | - Yves Martin-Prevel
- NUTRIPASS, Univ Montpellier, Institut de Recherche pour le Développement, Montpellier SupAgro, Montpellier, France
| |
Collapse
|
40
|
Vizcarra M, Palomino AM, Iglesias L, Valencia A, Gálvez Espinoza P, Schwingel A. Weight Matters-Factors Influencing Eating Behaviors of Vulnerable Women. Nutrients 2019; 11:nu11081809. [PMID: 31390758 PMCID: PMC6723940 DOI: 10.3390/nu11081809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 11/16/2022] Open
Abstract
Women from low socioeconomic backgrounds are more affected by obesity than men. The influence of weight as a determinant of women's eating behaviors has seldom been studied, especially in Latin America. In this study, we analyzed the food choices of vulnerable women according to their weight status. We conducted photo-elicitation interviews with 31 women from low-income neighborhoods in Santiago, Chile. Weight and height were measured and participants were divided into normal weight (n = 9), overweight (n = 15), and obese groups (n = 7) according to World Health Organization (WHO) body mass index (BMI) categories (p < 0.001). Quantitative and qualitative approaches were used for the analysis. Women in overweight and obese groups described more about their families, temporality, financial issues, and food perception. When weight groups were analyzed separately, more factors explaining eating behaviors were found (mental and physical health, body dissatisfaction, gender role, and obstacles for eating healthy) in the obese group. Results suggest that women with obesity or overweight based their diets on more internal and external factors than did normal weight women. This study contributes to our understanding of why changing behaviors can be difficult in women with obesity. Health care providers should consider these factors in the implementation of programs to address the need for a healthy diet for overweight and obese women.
Collapse
Affiliation(s)
- Marcela Vizcarra
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Ana María Palomino
- Department of Nutrition, College of Medicine, Universidad de Chile, Santiago 8380453, Chile
- Department of Primary Care and Family Health, College of Medicine, Universidad de Chile, Santiago 8900085, Chile
| | - Lorena Iglesias
- Department of Nutrition, College of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | - Alejandra Valencia
- Department of Nutrition, College of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | | | - Andiara Schwingel
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| |
Collapse
|
41
|
Menyanu E, Russell J, Charlton K. Dietary Sources of Salt in Low- and Middle-Income Countries: A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2082. [PMID: 31212868 PMCID: PMC6617282 DOI: 10.3390/ijerph16122082] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 05/25/2019] [Accepted: 06/06/2019] [Indexed: 12/22/2022]
Abstract
Rapid urbanization in low- and middle-income countries (LMICs) is transforming dietary patterns from reliance on traditional staples to increased consumption of energy-dense foods high in saturated fats, trans fats, sugars, and salt. A systematic literature review was conducted to determine major food sources of salt in LMICs that could be targeted in strategies to lower population salt intake. Articles were sourced using Medline, Web of Science, Scopus, and grey literature. Inclusion criteria were: reported dietary intake of Na/salt using dietary assessment methods and food composition tables and/or laboratory analysis of salt content of specific foods in populations in countries defined as low or middle income (LMIC) according to World Bank criteria. Of the 3207 records retrieved, 15 studies conducted in 12 LMICs from diverse geographical regions met the eligibility criteria. The major sources of dietary salt were breads, meat and meat products, bakery products, instant noodles, salted preserved foods, milk and dairy products, and condiments. Identification of foods that contribute to salt intake in LMICs allows for development of multi-faceted approaches to salt reduction that include consumer education, accompanied by product reformulation.
Collapse
Affiliation(s)
- Elias Menyanu
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
| | - Joanna Russell
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
| | - Karen Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia.
| |
Collapse
|
42
|
Nutrient-Dense Crops for Rural and Peri-Urban Smallholders in Kenya—A Regional Social Accounting Approach. SUSTAINABILITY 2019. [DOI: 10.3390/su11113017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Kenya ranks among the countries with the highest micronutrient deficiency worldwide. Due to their high micronutrient content, African indigenous vegetables (AIVs) can be a solution to this problem, and urban areas in Kenya have seen a rise in demand for these crops in the previous decade. To fill the gap between supply and demand, programmes to promote AIV production have been implemented in rural and peri-urban areas. However, the effects of increased AIV production on income and food security in the regional economies are not clear. Thus, in this analysis, we first evaluate differences between the livelihoods of household groups with different levels of food security in rural and peri-urban Kenya using a two-step cluster analysis. Then, we generate a regional social accounting matrix (SAM) and calculate the direct and indirect income effects of AIVs and other crops grown in the area using a multiplier analysis. For the analysis, a total of 706 small-scale vegetable producers in four counties in Kenya were interviewed in 2015. Households in rural areas were more food insecure, especially with respect to the utilization and stability dimension of food security. Multiplier analysis showed increased indirect income effects of AIVs in the regional economy compared to those of many cash crops. We suggest further promoting the production of AIVs in rural and peri-urban Kenya.
Collapse
|
43
|
Kunto YS, Bras H. Ethnic Group Differences in Dietary Diversity of School-Aged Children in Indonesia: The Roles of Gender and Household SES. Food Nutr Bull 2019; 40:182-201. [DOI: 10.1177/0379572119842993] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background: Despite the importance of dietary diversity for nutritional status, studies on issues surrounding ethnicity and dietary diversity in developing countries are limited. Objective: We analyzed cross-ethnic differences in dietary diversity and examined the roles of gender and household socioeconomic status (SES) in 3 Indonesian ethnic groups with different kinship systems: Javanese (bilateral), Batak (patrilineal), and Minangkabau (matrilineal). Methods: Data were from the Indonesian Family Life Survey 2000-2015 that consisted of 6478 school-aged children (7-12 years of age) born to 3878 mothers. The children’s dietary diversity was measured using a Berry-Index. We used cluster-robust multivariate linear regression models. Results: Gendered dietary diversity occurred for ethnic groups with unilineal kinship but was less evident for ethnic with bilateral kinship. Batak and Minangkabau girls, rather than boys, had higher dietary diversity because boys from these 2 ethnic groups consumed low-status foods (eg, tubers and vegetables) less often. Household SES influenced ethnic-related dietary diversity differently, perhaps because of food culture. Batak children from lower SES households consumed fruits and dairy products less often, most likely to enable them to consume the pricier but culturally preferable animal-source foods. This lowered their dietary diversity. Conclusion: The overall results indicate gendered and household SES-related effects of ethnicity on dietary diversity. Nutrition interventions targeting boys should be on policy-makers’ agendas. Boys should be advised to consume healthy low-status foods more often to improve their dietary diversity. The Batak case shows that children from lower SES backgrounds should depend less on the pricier foods to enable them varying their diet better.
Collapse
Affiliation(s)
- Yohanes Sondang Kunto
- Sociology of Consumption and Households Group, Wageningen University & Research, Wageningen, the Netherlands
- Faculty of Economics, Petra Christian University, Surabaya, Indonesia
| | - Hilde Bras
- Rural and Environmental History Group, Wageningen University & Research, Wageningen, the Netherlands
| |
Collapse
|
44
|
Christian AK, Marquis GS, Colecraft EK, Lartey A, Soueida R. Household food insecurity but not dietary diversity is associated with children's mean micronutrient density adequacy in rural communities across Ghana. Nutrition 2019; 65:97-102. [PMID: 31079019 DOI: 10.1016/j.nut.2019.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/13/2019] [Accepted: 03/20/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to examine predictors of household food insecurity, dietary diversity, and children's mean micronutrient density adequacy and the relationship among these dietary measures. METHOD Baseline analysis of a quasi-experimental 16-mo intervention study conducted in 12 rural communities in the three main agroecological zones in Ghana. The study included 608 caregivers with their 2- to 5-y-old children. Nutrient density adequacy was estimated for a subsample of 120 children. RESULTS Food insecurity was more severe among farming households than their non-farming counterparts (P = 0.032). Dietary diversity score was significantly higher among non-farming households than farming households (P < 0.001). Food insecurity was negatively correlated with both household dietary diversity (r = -0.385; P < 0.001) and child mean micronutrient adequacy (r = -0.305; P < 0.001). There was no significant correlation between dietary diversity and children's mean micronutrient density adequacy. Belonging to a household that is severely food insecure and household size were significant predictors of children's mean micronutrient density adequacy (ß = -0.124, P = 0.006; ß = 0.011, P = 0.006, respectively). CONCLUSION Household food insecurity continues to be a good indicator of lower nutrient intake in children.
Collapse
Affiliation(s)
- Aaron Kobina Christian
- Regional Institute for Population Studies (RIPS), University of Ghana, Legon-Accra, Accra, Ghana.
| | - Grace S Marquis
- School of Dietetics and Human, Nutrition McGill University, Ste Anne de Bellevue, QC Canada
| | - Esi K Colecraft
- Department of Nutrition and Food Science, University of Ghana, Legon-Accra, Accra, Ghana
| | - Anna Lartey
- Nutrition Division, Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Rula Soueida
- Nursing Research Centre of the Jewish General Hospital, affiliated with McGill University, Ste Anne de Bellevue, QC Canada
| |
Collapse
|
45
|
Dietary Diversity among Preschoolers: A Cross-Sectional Study in Poor, Rural, and Ethnic Minority Areas of Central South China. Nutrients 2019; 11:nu11030558. [PMID: 30845662 PMCID: PMC6471221 DOI: 10.3390/nu11030558] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 02/26/2019] [Accepted: 03/01/2019] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to document the dietary diversity status of preschool children in poor, rural, and ethnic minority areas of Central South China and examine its associated factors both at home and in preschools. A cross-sectional study including 1328 preschool children aged three or five years from two nationally designated poverty counties in Hunan Province was conducted. A dietary diversity score (DDS) was constructed to measure the dietary patterns based on the 24 h recall method. The mean DDS among the sample children was 5.77 (95% confidence interval: 5.70⁻5.83, range 1 to 9) with a standard deviation of 1.22. Both household characteristics (including the education level of the child's primary caregiver and the nutritional knowledge of the caregiver) and preschool factors (including the nutritional knowledge of the child's preschool principal and teachers, nutritional training to children, and the preschool kitchen manager) were positively associated with children's DDS. The dietary diversity status of children in poor, rural, and ethnic minority areas of Central South China is much lower than that of their peers in other areas. Nutritional education should be provided to caregivers, preschool staff, and children to narrow the gap.
Collapse
|
46
|
Seymour G, Masuda YJ, Williams J, Schneider K. Household and child nutrition outcomes among the time and income poor in rural Bangladesh. GLOBAL FOOD SECURITY 2019. [DOI: 10.1016/j.gfs.2019.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
47
|
Barros L, Lopes C, Oliveira A. Child and family characteristics are associated with a dietary variety index in 4-year-old children from the Generation XXI cohort. Nutr Res 2019; 63:76-85. [DOI: 10.1016/j.nutres.2018.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/18/2018] [Accepted: 12/03/2018] [Indexed: 11/16/2022]
|
48
|
Adubra L, Savy M, Fortin S, Kameli Y, Kodjo NE, Fainke K, Mahamadou T, Le Port A, Martin-Prevel Y. The Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) Indicator Is Related to Household Food Insecurity and Farm Production Diversity: Evidence from Rural Mali. Curr Dev Nutr 2019; 3:nzz002. [PMID: 30899899 PMCID: PMC6423422 DOI: 10.1093/cdn/nzz002] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/05/2018] [Accepted: 01/02/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The popularity of nutrition-sensitive interventions calls for high-quality monitoring and evaluation tools. In this context, the Minimum Dietary Diversity for Women of Reproductive Age (MDD-W), validated as a proxy of micronutrient adequacy, does fill a gap. However, because it is a newly endorsed indicator, information on its linkages with other dimensions of food and nutrition security is still scarce. OBJECTIVE The objective of this study was to investigate whether the MDD-W is related to household food insecurity and farm production diversity. METHODS A cross-sectional survey on a representative sample of 5046 women of reproductive age was conducted in the region of Kayes, Mali, in 2013. Dietary diversity was assessed through qualitative 24-h recall, and MDD-W was computed. MDD-W equaled 1 if the women consumed at least 5 different food groups and 0 otherwise. Food insecurity was measured using the Household Food Insecurity Access Scale and the Household Hunger Scale (HHS), and a farm production diversity score (FPDS) was calculated based on a count of food crops/livestock groups produced. Logistic regressions were used to assess the relation between MDD-W and the indicators of household food security. RESULTS Only 27% of women reached the MDD-W. These women consumed animal source foods and/or vitamin A-rich vegetables and fruits more frequently than did other women. Women from extremely food insecure households (moderate to severe hunger according to the HHS) were less likely to reach the MDD-W (OR: 0.70; 95% CI: 0.50, 0.97). One more group in the FPDS increased the odds of attaining the MDD-W (OR: 1.12; 95% CI: 1.06, 1.18). CONCLUSION In the rural region of Kayes, Mali, women's dietary diversity, as measured by the MDD-W, was associated with household-level food security indicators. This study was registered at ISRCTN.org as ISRCTN08435964.
Collapse
Affiliation(s)
- Laura Adubra
- NUTRIPASS, University of Montpellier, French National Research Institute for Sustainable Development (IRD), Montpellier SupAgro, Montpellier, France
- Sorbonne University, Pierre and Marie Curie University Paris 06, Paris, France
| | - Mathilde Savy
- NUTRIPASS, University of Montpellier, French National Research Institute for Sustainable Development (IRD), Montpellier SupAgro, Montpellier, France
| | - Sonia Fortin
- NUTRIPASS, University of Montpellier, French National Research Institute for Sustainable Development (IRD), Montpellier SupAgro, Montpellier, France
| | - Yves Kameli
- NUTRIPASS, University of Montpellier, French National Research Institute for Sustainable Development (IRD), Montpellier SupAgro, Montpellier, France
| | | | | | | | - Agnes Le Port
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Dakar, Senegal
| | - Yves Martin-Prevel
- NUTRIPASS, University of Montpellier, French National Research Institute for Sustainable Development (IRD), Montpellier SupAgro, Montpellier, France
| |
Collapse
|
49
|
How well do different dietary and nutrition assessment tools match? Insights from rural Kenya. Public Health Nutr 2018; 22:391-403. [PMID: 30376906 DOI: 10.1017/s1368980018002756] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Various indicators and assessment tools exist to measure diets and nutrition. Most studies eventually rely on one approach. Relatively little is known about how closely results match when different tools are used in the same context. The present study compares and correlates different indicators for the same households and individuals to better understand which indicators can be used as proxies for others. DESIGN A survey of households and individuals was carried out in Kenya in 2015. Seven-day food consumption and 24 h dietary recalls were administered at household and individual level, respectively. Individual height and weight measures were taken. Different indicators of food access (energy consumption, household dietary diversity scores), dietary quality (individual dietary diversity scores, micronutrient intakes) and nutrition (anthropometric indicators) were calculated and correlated to evaluate associations. SETTING Rural farm households in western Kenya.ParticipantsData collected from 809 households and 1556 individuals living in these households (782 female adults, 479 male adults, 295 children aged 6-59 months). RESULTS All measures of food access and dietary quality were positively correlated at individual level. Household-level and individual-level dietary indicators were also positively correlated. Correlations between dietary indicators and anthropometric measures were small and mostly statistically insignificant. CONCLUSIONS Dietary indicators from 7d food consumption recalls at the household level can be used as proxies of individual dietary quality of children and male and female adults. Individual dietary diversity scores are good proxies of micronutrient intakes. However, neither household-level nor individual-level dietary indicators are good proxies of individual nutritional status in this setting.
Collapse
|
50
|
Intra-household double burden of malnutrition in a North African nutrition transition context: magnitude and associated factors of child anaemia with mother excess adiposity. Public Health Nutr 2018; 22:44-54. [DOI: 10.1017/s1368980018002495] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AbstractObjectiveIn the Middle East and North Africa region, the nutrition transition has resulted in drastic increases in excess adiposity, particularly among women, while some types of undernutrition remain prevalent, especially among pre-school children. We assessed the magnitude, nature and associated factors of the within-household co-occurrence of anaemia in children and excess adiposity in mothers.DesignCross-sectional survey using stratified two-stage random cluster sampling to survey households with women aged 20–49 years. BMI≥25·0 kg/m2 defined overweight and BMI≥30·0 kg/m2 obesity, while anaemia for children was defined as Hb<110 g/l. The associations between child anaemia and mother excess adiposity, and sociodemographic and lifestyle factors were estimated by multinomial regression.SettingGreater Tunis area, Tunisia, in 2009–2010.SubjectsChildren aged 6–59 months living with their 20–49-year-old mothers (437 child–mother pairs).ResultsThe most prevalent double burden of malnutrition in child–mother pairs by far was the anaemic child and overweight mother (24·4 %; 95 % CI 20·1, 29·3 %). A significant proportion of pairs were anaemic child and obese mother (14·4 %; 95 % CI 11·0, 18·5 %). The co-occurrence of anaemia in child and excess adiposity in mother was neither synergetic nor antagonistic (P=0·59 and 0·40 for anaemia–overweight and anaemia–obesity, respectively). This double burden was more frequent among child–mother pairs with younger children, with mothers of higher parity and higher energy intakes.ConclusionsThe high prevalence of anaemic child and overweight or obese mother requires special attention e.g. through interventions which simultaneously target both types of malnutrition within the same household.
Collapse
|