Significance of wild vegetables in micronutrient intakes of women in Vietnam: an analysis of food variety

Food Insecurity and its Association with Dietary Diversity: A Cross-Sectional Study in Rural Households in Jammu

Background

Food insecurity is a matter of public health concern as it is associated with adverse health outcomes particularly among vulnerable population. Accessibility and availability of nutritious and culturally appropriate food is paramount to achieve zero hunger. To assess the prevalence of household food insecurity, to estimate the household dietary diversity and its association with household food insecurity.

Material and Methods

Using multistage sampling 381 rural households were surveyed. Household Food Insecurity Access Scale and House hold Dietary Diversity Scale were used as study instruments. Chi square test was used to compare the two groups and P < 0.05 was considered to be statistically significant.

Results

Prevalence of household insecurity was 33.3% (127) among the surveyed households and 8.1% (31) had severe food insecurity. The mean HFIS score was 6.85 ± 4.82. The household Dietary diversity score was 8.14 ± 1.54 for food secure and 6.51 ± 1.38 for severely food insecure households. There was a statistically significant difference in intake of milk and milk products, fruits, eggs and meat/poultry among food secure and insecure households (P < 0.001 respectively).

Conclusion

Food insecurity was high in rural households and was associated with lower dietary intake of foods from protein group, necessitating a need to reinforce the food security programmes in rural India with focus to enhance protein rich diet.

An ethnobotanical study of wild edible plants used by the Tibetan in the Rongjia River Valley, Tibet, China

BACKGROUND

Wild edible plants (WEPs) play a crucial role in communities with limited communication with the outside world, where unstable factors, such as poor food supply and insufficient access to timely nutritional supplementation, are common, as in the Himalayan region. To document the traditional knowledge of WEPs and explore their significance for communities with minimal global economic exchange, an ethnobotanical study was conducted in the town of Rongjia, which lies in a narrow valley near Mount Everest, Tibet, China.

METHODS

This ethnobotanical study was conducted in three villages in the Rongjia River Valley between August 2021 and June 2023. Semi-structured interviews and participatory observations were used to collect information on WEPs. The fieldwork was performed with the assistance of local guides. Voucher specimens were collected from each documented plant species for taxonomic identification. We used the use report (UR) and relative frequency of citations (RFC) to evaluate the comprehensive utilization value of WEPs.

RESULTS

We interviewed 161 informants who provided us with 2499 use reports. We collected 50 WEPs belonging to 28 families and 42 genera used by the Tibetan people in the Rongjia River Valley. WEPs are used in vegetables, fruits, seasonings, healthcare foods, substitute grains, and beverages. Wild vegetables were the most commonly used, followed by wild fruits. Leaves were the most commonly consumed part of the plant. The three most important WEPs ordered by RFC values were Rosa sericea var. glandulosa Osmaston (RFC = 0.76), Zanthoxylum bungeanum Maxim. (RFC = 0.75), and Urtica hyperborea Jacquem. ex Wedd. (RFC = 0.71). Other than that, we also document some of WEPs used in the past. Arisaema erubescens Schott, Pinellia ternata (Thunb.) Makino, and Satyrium nepalense var. ciliatum (Lindl.) Hook. f. used to serve as important substitute grains, are no longer in use, however, they remain vivid in the memories of older people.

CONCLUSIONS

WEPs included wild vegetables, fruits, seasonings, healthcare food, and substitute grains for Tibetan people in the Rongjia River Valley. Some WEPs have become important cultural symbols for older people, which can help in understanding the relationship between plants and local people in the past. In addition, WEPs can increase the resilience of local people living in remote areas when facing sudden destabilizing events in future. This is the significance of WEPs for communities with minimal global economic exchange. Therefore, we suggest that future studies focus more on WEPs in communities with limited communication with the world to improve their resilience.

Can common dietary assessment methods be better designed to capture the nutritional contribution of neglected, forest, and wild foods to diets?

Food systems are the primary cause of biodiversity loss globally. Biodiversity and specifically, the role that wild, forest and neglected and underutilised species (NUS) foods might play in diet quality is gaining increased attention. The narrow focus on producing affordable staples for dietary energy has contributed to largely homogenous and unhealthy diets. To date, evidence to quantify the nutritional contribution of these biodiverse foods is limited. A scoping review was conducted to document the methods used to quantify the contribution of wild, forest and NUS foods. We found 37 relevant articles from 22 different countries, mainly from Africa (45%), the Americas (19%), and Asia (10%). There were 114 different classifications used for the foods, 73% of these were specifically related to wild or forest foods. Most dietary assessments were completed using a single day qualitative or quantitative 24 h open recall (n = 23), or a food frequency questionnaire (n = 12). There were 18 different diet related indicators used, mainly nutrient adequacy (n = 9) and dietary diversity scores (n = 9). Often, no specific nutritionally validated diet metric was used. There were 16 studies that presented results (semi) quantitatively to measure the contribution of wild, forest or NUS foods to dietary intakes. Of these, 38% were aggregated together with broader classifications of 'traditional' or 'local' foods, without definitions provided meaning it was not possible to determine if or to what extend wild, forest of NUS foods were included (or not). In almost all studies there was insufficient detail on the magnitude of the associations between wild, forest or NUS foods and dietary energy or nutrient intakes or the (qualitative) diet recall methodologies that were used inhibited the quantification of the contribution of these foods to diets. A set of six recommendations are put forward to strengthen the evidence on the contribution of wild, NUS, and forest foods to human diets.

A systematic review and meta-analysis of the association of dietary diversity with undernutrition in school-aged children

BACKGROUND

Malnutrition in childhood has lasting consequences; its effects not only last a lifetime but are also passed down from generation to generation such as short stature, school-aged children are the most vulnerable section of the population and require special attention, including nutrition.

METHOD

We searched Medline through PubMed, Scopus, and Web of Science to identify all observational studies published before Jun 2022. Observational studies with a pediatric population aged 5-18 years that evaluated risk estimate with 95% confidence intervals the relationship between dietary diversity and undernutrition (wasting, stunting, and thinness) were included. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were followed.

RESULTS

This is a first systematic review and meta-analysis with a total of 20 studies were eligible (n = 18 388). Fourteen data evaluated stunting resulting in a pooled effect size estimated odds ratio of 1.43 (95% CI: 1.08-1.89; p = 0.013). Ten data evaluated Thinness resulting in a pooled effect size estimated odds ratio of 1.10 (95% CI: 0.81-1.49; P = 0.542). Two studies were revealed wasting with a odds ratio of 2.18 (95% CI: 1.41-3.36; p-value < 0.001).

CONCLUSION

According to the conclusions of this meta-analysis of cross-sectional studies, inadequate dietary diversity increases the risk of undernutrition in growth linear but not in thinness in school-aged children. The findings of this analysis suggest that initiatives that support improvements to the diversity of children's diets to reduce the risk of undernutrition may be warranted in LMICs.

Health-related quality of life and its association with socioeconomic status and diet diversity in Chinese older adults

Objectives

The study aimed at examining the combined association of socioeconomic status (SES) and diet diversity (DD) with health-related quality of life (HRQoL) and exploring whether DD played a mediating role in the relationship between varied SES and HRQoL among Chinese older persons.

Method

A multi-stage random sampling method was conducted in Shanxi Province of China, with 3,250 older adults participating in this cross-sectional survey. SES was divided into groups by quartiles and DD by means, and these variable groups were combined in pairs to generate a total of eight combinations. The PROCESS macro developed by Hayes was employed for the simple mediation analysis.

Results

Compared with the reference group (those with both high SES and high DD), older adults who were classified to have lower SES or DD had elevated odds of having worse HRQoL: low SES/ low DD (OR = 1.65, 95% CI 1.41-2.92); low SES/ high DD (OR = 1.45, 95% CI 1.17-1.80); middle low SES/ low DD (OR = 1.43, 95% CI 1.24-1.65); middle low SES/ high DD (OR = 1.23, 95% CI 1.03-1.47); upper high SES/ low DD (OR = 1.41, 95% CI 1.21-1.65); and high SES/ low DD (OR = 1.30, 95%CI 1.10-1.53). The mediation analysis revealed that DD mediated the relationship between SES and HRQoL (B=0.011, 95% CI 0.008-0.013), with its indirect effects accounting for 39.29% of the total effects.

Conclusions

These findings highlighted the role of DD as a mediator of the relationship between SES and HRQoL. As DD could be protective, modifiable, and easy for older adults to understand and implement, village clinics and community health stations should work collaboratively to design proper DD intervention measures for better HRQoL.

Effects of dietary diversification during pregnancy on birth outcomes in east Gojjam, northwest Ethiopia: A prospective cohort study

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.

An ethnobotany survey of wild plants used by the Tibetan people of the Yadong River Valley, Tibet, China

INTRODUCTION

Plant resources gathered from the wild are important sources of livelihood needs, especially for low-income populations living in remote areas, who rely on these plants for food, fuelwood, medicine and building materials. Yadong County is a valley at the border between the China, India and Bhutan in southern Tibet. Yadong is rich in biodiversity and culture, but ethnobotanical knowledge has not been systematically studied. This study aimed to document the ethnobotanical knowledge of Tibetans in Yadong County.

METHODS

Ethnobotanical data were documented through free listings, key informant interviews, and semi-structured interviews during fieldwork. The culture importance index (CI) and informant consensus factor index (FIC) were used as the quantitative indices.

RESULTS

In total, 163 informants (46 women and 117 men). A total of 3,031 use reports and 121 plant species belonging to 52 families and 91 genera were included. These use reports were then classified into 20 categories belonging to 9 major categories. The utilisation category that containing the most plant species was food, followed by economic, medicine, animal feed, social uses, other uses, environmental uses, materials and fuels. Among the economic plants, 32 medicinal plants are traditionally used in the local region. Plants with high CI included Fritillaria cirrhosa, Neopicrorhiza scrophulariiflora, Betula utilis, Rheum nobile, and Urtica hyperborean.

CONCLUSION

This research demonstrates the diversity of the types and functions of Yadong Tibetan traditional plant knowledge. Knowledge of edible and medicinal plants in this area is prominent, reflecting the ability to cope with the lack of fruits and vegetables and basic family medical care. There were exchanges between the traditional plant culture in the study area and its surroundings. With socioeconomic development, the commercial value of medicinal plants has increased, and locals are also seeking ways to adoptsustainable development to cope with the excessive consumption of plant resources.

Prevalence and determinants of dietary practices among pregnant women in eastern Ethiopia

Introduction

Appropriate dietary practices in pregnancy are critical to meet the increased metabolic and physiological demands; however, information about dietary practices among pregnant women, particularly rural residents, is limited. The study aimed to assess the level of appropriate dietary practices and associated determinants among pregnant women in Haramaya District, eastern Ethiopia, 2021.

Methods

A community-based cross-sectional study was conducted among 448 pregnant women in Haramaya District, Eastern Ethiopia. Data was collected through face-to-face interviews by trained research assistants, using a validated frequency questionnaire. The pregnant women were labeled as “appropriate dietary practice” when they consumed at least four meals daily, had a good food variety score, high dietary diversity score, and high consumption of animal source foods during the reference period. Otherwise, they were defined as “inappropriate.” A Poisson regression model with robust variance estimation was used to investigate the association of the independent variables with the dietary practice. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p-value < 0.05.

Results

The appropriate dietary practice among the study participants was 15.2% (95% CI = 12–18%). Of the respondents, 29.46, 37.5, and 24.7% had a high dietary diversity, high food variety score, and high consumption of animal source foods. The appropriate dietary practice was more prevalent among merchant women (APR = 2.07; 95% CI 1.07–4.02) and those whose husbands have at least a high school educational level (APR = 1.96; 95% CI 1.06–3.46). However, the prevalence of appropriate dietary practice was significantly lower among those who chewed khat (APR = 0.58; 95% CI 0.37–0.90) and among respondents who reported restriction of the intake of some foods (APR = 0.36; 95% CI 0.20–0.65).

Conclusion

We found sup-optimal appropriate dietary practice among pregnant women in this predominantly rural setting. Additionally, the lower appropriate dietary practice was observed among women who reported chewing khat and experienced restriction of dietary consumption during pregnancy. Therefore, nutrition policy programs and interventions aimed at encouraging maternal nutritional guidance and counseling are recommended.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40795-021-00494-4.

Dietary Intake Quality Is Affected by Knowledge and Dietary Intake Frequency among Pregnant Women in Muntinlupa, Philippines: A Cross-Sectional Study

Improving the nutrition of pregnant women is essential in reducing maternal and child mortality, which is one of the global nutritional goals of 2025. This study evaluated the factors related to the quality of dietary intake among pregnant women in Muntinlupa, Philippines. We conducted a cross-sectional study of 280 pregnant women at a hospital in Muntinlupa from March 2019 to August 2019 using questionnaires. After the primary aggregation, multivariate logistic regression analysis was used to identify factors associated with the quality of dietary intake in pregnant women. Approximately half of the women (46.4%, n = 130) had a low dietary diversity during pregnancy. Less than 30% of the respondents consumed beans, soybean products, and nuts. In the logistic regression analysis, poor maternal knowledge of nutritional sources to prevent anemia (odds ratio (OR) 4.25, 95% confidence interval (CI) 1.47-12.32, p = 0.01) and less frequent meal consumption (OR 2.15, 95% CI 1.08-4.29, p = 0.03) were significantly associated with poor dietary diversity. Our findings are crucial because they suggest that increasing the knowledge of pregnant women about good nutrition and ensuring that dietary intake is frequent and adequate through antenatal care can improve the nutrition of pregnant women.

Evaluating a novel dietary diversity questionnaire to assess dietary diversity and adequacy of New Zealand women

OBJECTIVES

We sought to develop and evaluate the relative validity of a dietary diversity questionnaire (DDQ) that reflects food-group diversity, food variety, and micronutrient adequacy among New Zealand women.

METHODS

A cross-sectional study included New Zealand women (Auckland based; ages 16-45 y, n = 101), completing a 7-d DDQ and 4-d weighed food record (reference method). The relative validity of the DDQ was evaluated by correlating nutritious and discretionary dietary diversity scores (DDSs; number of food groups) and food-variety scores (number of foods), calculated from both methods. The dietary mean adequacy ratio (MAR; micronutrient intakes relative to estimated average requirements) was calculated from the weighed food record and correlated to dietary diversity and food-variety scores from the DDQ to assess construct validity. Cross-tabulation was used to explore dietary diversity measures versus adequacy ratios. Significance was set at P < 0.05.

RESULTS

The median (interquartile range) DDSs (maximum 25) from the DDQ-23 (21-23)-and the weighed food record-18 (17-19)-were significantly correlated (r_s = 0.33, P < 0.001), as were the food-variety scores (maximum 237)-respectively, 75 (61-87) and 45 (37-52) (r_s = 0.22, P < 0.03). A mean (± SD) MAR of 0.94 ± 0.04 suggested a near-adequate diet, but one-third of foods consumed were from discretionary sources. Nutritious DDS was significantly correlated with MAR for micronutrients (r_s = 0.20, P ≤ 0.05). An inverse trend was observed between discretionary DDS and MAR.

CONCLUSIONS

The DDQ is a quick, low-burden tool for describing nutritious and discretionary dietary diversity reflecting micronutrient adequacy in high-income settings. It requires further validation across different time frames, population groups, and settings.

Impact of modernization on urinary concentrations of arsenic, cadmium, lead, and selenium in rural residents of Northern Laos

OBJECTIVES

The impacts of modernization on toxic heavy metal exposure and essential trace element intake in indigenous populations of subsistence societies are unknown. We assessed urinary trace element concentrations in rural residents of Northern Laos and examined associations with levels of modernization.

METHODS

A cross-sectional study was conducted comprising 380 residents of three villages in Northern Laos with different levels of modernization. We surveyed general characteristics and measured the weight and height of 341 participants. Arsenic, cadmium, lead, and selenium concentrations were measured in spot urine samples by inductively coupled plasma mass spectrometry. We examined associations between urinary trace element concentrations and variables related to modernization (village, roofing material, possessions index [total number of possessions], and body mass index [BMI]) using multilevel analyses with household as a random effect, after adjusting for sex, age, and smoking status.

RESULTS

Urinary concentrations of arsenic and cadmium were high, while those of lead and selenium were low in comparison to previous reports of populations in non-contaminated regions or without excess/deficiency. We observed associations between urinary trace element concentrations and village-level modernization: lead and selenium concentrations were higher in more modernized villages and cadmium concentration was highest in the least modernized village. Urinary arsenic concentration was not predicted by the modernization level of a village, although we observed significant differences among villages. In addition, urinary selenium concentration was higher in participants inhabiting more modernized houses.

CONCLUSION

Modernization of villages may impact toxic heavy metal exposure and selenium intake in rural residents of Northern Laos.

Collection calendar: the diversity and local knowledge of wild edible plants used by Chenthang Sherpa people to treat seasonal food shortages in Tibet, China

BACKGROUND

Wild edible plants (WEPs) are non-cultivated and non-domesticated plants used for food. WEPs provided food, nutrition, herbs and other plant products for people in underdeveloped areas, such as the Everest region, to maintain their daily lives. Chenthang Town is the only Sherpa ethnic township in Tibet, China. The core purpose of this research is to investigate, collect and record the WEPs and related local knowledge and functions within the Sherpa community. The ultimate goal is to answer the question of why Sherpa people choose these particular plants.

MATERIALS AND METHODS

The field study was carried out in the six Sherpa communities of Chenthang Township from September 2019 to August 2020. The WEPs and related local knowledge were collected through semistructured interviews and direct observations. The field work was performed with the assistance of local guides. During the field survey, we collected plant specimens based on the principle of one plant with one vernacular name. In this study, we utilised a use report (UR) and cultural importance index (CI) to evaluate the comprehensive utilization value of WEPs in the daily diet of Sherpa people.

RESULTS

We interviewed 78 people individually who provided us with 1199 use reports. In total, we collected 84 WEPs belonging to 65 genera in 41 families. These species were identified as 78 distinct ethno-species by local people, and the vernacular name of each ethno-species was recorded. Then, these use reports were classified into six use categories. All these plants were native wild plants. In these plants, Arisaema utile, Sorbus cuspidata and Elaeagnus umbellata have been introduced into home gardens by local people. Following the description of the Sherpa people, we articulated a collection calendar for WEPs. The Sherpa collect WEPs throughout nearly the entire year, January and February being the exceptions.

CONCLUSION

The collection calendar of wild edible plants reflects the wisdom of the Sherpa in terms of survival. The Sherpa cleverly survive the food shortage periods by harnessing the phenology of different species. In general, WEPs can provide the Sherpa with seasonal carbohydrates, nutrition, healthcare supplements and other products and services necessary for survival, which is likely why the Sherpa choose these plants.

Toward Dietary Diversity Among Adult People Living With HIV in Public Hospitals in Southwest Ethiopia Using Theory of Planned Behavior. A Mixed Methods Study

Dietary diversity is a crucial element of an inclusive care for people living with HIV (PLWHIV), particularly in resource-limited countries where undernutrition, poor intention, and poor attitude toward diversified diets are the common challenges. The aim of this study was to assess the Intention toward dietary diversity behavior among adult PLWHIV in Jimma zone public hospitals, South West Ethiopia. A hospital-based survey was carried out in 5 public institutions among sampled 403 adult PLWHIV. Data were entered into EpiData, and exported to SPSS version 20 for analysis. Relationships among variables were assessed using correlation coefficients. The multivariable linear regression model was fitted to assess predictors of behavioral inclination toward dietary diversity at P-value ≤ .05. The quantitative data was supplemented by qualitative data, which was collected through key informant interviews and analyzed thematically. The significant predictors of intention to use dietary diversity were attitude (β = .196, P < .01) and subjective norm (β = .390, P < .01) of adult PLWHIV. The constructs of theory of planned behavior (TPB) independently explained the variance in inclination toward dietary diversity by 25.7%. All the intermediate, proximal, and distal components of TPB explained the final model with 32.2% of variance in the intention to use dietary diversity. The qualitative findings indicated that delivery of HIV care requires a drive for livelihood development and economic improvement, creating a sense of responsibility for sustainable HIV care by creating behavioral change at the individual level. Conclusion: Dietary inadequacy was strongly correlated with being in the sociodemographic groups that are at heightened risk of adverse clinical outcomes. It is worthwhile to investigate behavioral intention as a potential determinant of the clinical outcomes rather than choose symptomatic treatment of malnutrition. Conclusion: Dietary inadequacy was strongly correlated with being in the sociodemographic groups that are at heightened risk of adverse clinical outcomes. It is worthwhile to investigate behavioral intention as a potential determinant of the clinical outcomes rather than choose symptomatic treatment of malnutrition.

Dietary adequacy and nutritional status of Meitei community of Manipur, Northeast India

Meitei is the main ethnic community that belongs to the north-eastern state of Manipur in India. This community is bestowed with rich biodiverse resources with indigenous foods still form an integral part of their diet. However, limited data on the food and nutrient consumption as well as nutritional status of this community are available. This study was carried out on the children, adolescents and women of reproductive age (WRA) of this community from 12 villages, to determine their food consumption pattern and nutritional status. Basic anthropometry and 24-h dietary intake assessment was conducted. The prevalence of underweight was 27%, stunting was 45% and wasting was 12% in children below 5 years. Stunting was observed among 34% of children 5-17 years of age. About 7% of WRA were undernourished, while 28% were overweight or obese. About 55% of 1-7 year-old children had mean probability adequacy of 12 micronutrients <0.5, and the adequacy of individual micronutrients namely vitamin A, E and calcium were low. Dietary determinants such as low dietary diversity score, dietary species richness and the lowest tertiles of different food groups' intake (except for sugars, fish and sea foods and spices and condiments) predicted micronutrient inadequacy. In addition to a high prevalence of undernutrition in children and adolescents and overnutrition in WRA, the effect of various dietary determinants on micronutrient adequacy in the study group of the Meitei community are reported.

Aspects of Dietary Diversity Changes across Adulthood in Racially Diverse Adults

Knowledge of various aspects of dietary diversity (DD)—an essential healthful dietary component—across adulthood is limited. This study examined three DD aspects over time in racially diverse adults. Participants were from the National Institute on Aging, Healthy Aging in Neighborhoods of Diversity across the Life Span study. DD measures were calculated at baseline (N = 2177), and first and second examination follow-ups (N = 2140 and N = 2066, respectively) using two 24-h recalls. The count was based on the consumption of ≥50% of an equivalent from 21 food groups. Evenness was derived using the Berry-Index adjusted by the food’s health value; dissimilarity, by Mahalanobis Distance. Mixed-effects linear regression models were conducted to test changes in DD across adulthood, adjusting for sex, race, poverty status and education as fixed effects, and adjusting for smoking, age and energy as time-dependent variables. Only dissimilarity showed significant interactions of time × race (p = 0.0005), and time × poverty status (p = 0.0325), indicating a slower rate of increase over time in dissimilarity scores among Whites compared with African–Americans and those with income >125% poverty versus <125% poverty. A significant interaction between time×energy (p < 0.0001) was noted for both evenness and dissimilarity scores. To our knowledge, this is the first study to document the differential change in dissimilarity scores by race and income over time.

Nutritional Deprivation Index is negatively associated with socio-economic factors in Paraguayan households

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.

Cassava consumption and the occurrence of cyanide in cassava in Vietnam, Indonesia and Philippines

OBJECTIVE

To make a tentative assessment of the consumption of cassava in three countries in South-east Asia and the cyanogenic potential (CNp) of the crop as a possible food safety issue.

DESIGN

We used data from the Ministry of Health in Vietnam and Statistics Authorities in Indonesia and Philippines (mean household consumption per province) to assess cassava consumption. Conversions of units were needed to facilitate the comparison of cassava consumption between countries. The most up-to-date data available regarding both cassava consumption and the CNp of cassava grown in the respective countries were assessed.

SETTINGS

Vietnam, Indonesia and Philippines.

PARTICIPANTS

Respondents from provinces in Vietnam (nineteen), Indonesia (thirty-three) and Philippines (eighty-one) were asked to complete a recall questionnaire detailing either the previous 24-h' or the 7-d' cassava consumption.

RESULTS

Among the three countries, available data indicated that the highest median cassava-consumption figures percapita were from Indonesia and the Philippines (9·01 and 7·28 g/capita per d, respectively), with Vietnam having the least (1·14 g/capita per d). Published information regarding the CNp of cassava in the three countries was limited.

CONCLUSIONS

While the findings of the present study are somewhat limited by a lack of available information regarding both the extent of cassava consumption and the CNp of cassava consumed in the three countries, it appears likely that cyanogen intake arising from cassava consumption among the three countries exceeds the FAO/WHO Provisional Maximum Tolerable Daily Intake, although any risk to public health appears limited to a minority of provinces in each country.

EAACI position paper on diet diversity in pregnancy, infancy and childhood: Novel concepts and implications for studies in allergy and asthma

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.

Association of food security and other socio-economic factors with dietary diversity and nutritional statuses of children aged 6-59 months in rural Bangladesh

Introduction

Dietary diversity score (DDS) is a proxy indicator for measuring nutrient adequacy. In this study, we aimed to identify the nutritional statuses and current patterns of DDS among children between 6–59 months old and their associations with different individual and household level factors in rural Bangladesh.

Methods

The Nobokoli programme of World Vision Bangladesh was implemented in Mymensingh, Sherpur, Rangpur, Dinajpur, Thakurgaon, Panchagar, and Nilphamari districts of Bangladesh between 2014 and 2017. A cross-sectional community household survey was administered between July and October 2014 to collect baseline data to evaluate the Nobokoli programme. A total of 6,468 children between 6–59 months old were included in the final analysis. Anthropometric data was collected following WHO guidelines on using wooden height and digital weight scales. We collected food intake information for the past 24 hours of the survey. The WHO’s child growth standard medians were used to identify the nutritional indices of stunting, wasting, and underweight. Food items consumed were categorized into nine food groups and the DDS was constructed by counting the consumption of food items across these groups during the preceding 24 hour period. The association of DDS and nutritional status (stunting, wasting and underweight) with sociodemographic factors and household food security status were examined using multivariable models; linear regression and logistics regression respectively.

Results

The prevalence of stunting, wasting and underweight among children aged 6-59months were 36.8%, 18.2% and 37.7% respectively. Our findings revealed that almost all children ate any form of starch followed by consumption of milk or milk products (76%) and fleshy meat /fish (61%) respectively. The mean DDS among children was 3.93(sd 1.47). Forty percent of the children obtained a DDS score less than 4. Multivariable analysis suggested that children whose mothers had higher educational attainment and are skilled workers had higher DDS (15% and 48% respectively) compared to their counterparts. The DDS showed strong positive association with household wealth status. Children from food secure households had 26% higher DDS compared to children from food insecure households. Similarly, increasing maternal education and household wealth were found to be protective against childhood stunting and undernutrition.

Discussion

Our findings reiterate the need for improving household socioeconomic factors and household food security status for improving dietary diversity practices and nutritional status of children. Evidence-based solutions are needed to be implemented and expanded at scale to ensure appropriate dietary practices and improve nutritional status of the children in local context.

Local traditional foods contribute to diversity and species richness of rural women's diet in Ecuador

OBJECTIVE

To evaluate the dietary diversity and the nutrient contribution of traditional foods (locally cultivated and wild) by conducting a food intake study in rural Ecuador.

DESIGN

Repeated 24 h recalls over a 14 d interval and frequency of consumption served to simulate the usual diet by the Multiple Source Method. Data on missing visits (n 11) were imputed using multivariate imputation by chained equations. The intakes of three macro- and six micronutrients were reported. Nutrient Adequacy Ratios, Mean Adequacy Ratio (MAR), Dietary Species Richness (DSR) and Minimum Dietary Diversity for Women were used as measures of dietary quality. A linear quantile mixed model was used to investigate the association between DSR, local species, MAR, age, education and occupation.

SETTING

Guasaganda, Cotopaxi (Ecuador).

PARTICIPANTS

Rural, indigenous adult women, non-pregnant and not breast-feeding.

RESULTS

The studied diet had MAR of 0·78. Consumption of traditional foods contributed 38·6 % of total energy intake. Daily requirements for protein, carbohydrates, Fe and vitamin C were reached. An extra level of consumption of local species was associated with an increase in median MAR for macronutrients of 0·033 (P < 0·001). On the other hand, an extra level of consumption of local species was associated with an increase in median MAR for micronutrients of 0·052 (P < 0·001).

CONCLUSIONS

We found statistical evidence that traditional foods contribute to adequate intakes of macro- and micronutrients and dietary diversification in the studied population. Future public health interventions should promote the cultivation and consumption of traditional foods to increase the quality of the local diet.

Dietary diversity and associated factors among HIV positive adults attending antiretroviral therapy clinics at Hiwot Fana and Dilchora Hospitals, eastern Ethiopia

Background

Nutritional care is considered a crucial component of comprehensive care for people living with HIV/AIDS (PLWHA), particularly in resource-limited settings where malnutrition and food insecurity are endemic problems, and low quality monotonous diets are the norm. The findings of this study provide baseline information on dietary diversity and related factors for health care providers so that they will be able to improve nutritional care and support activity. Therefore, the aim of this study was to assess dietary diversity and associated factors among HIV positive adults (18-65 years old) attending antiretroviral therapy (ART) clinics at Hiwot Fana and Dilchora Hospitals, eastern Ethiopia.

Patients and methods

An institution-based cross-sectional study was conducted from November 2015 to February 2016 at the ART clinics of Hiwot Fana and Dilchora Hospitals. Using a systematic random sampling technique, a total of 303 patients were selected from all adults attending the ART clinics. The data were collected with a 95% CI used to show association between dietary diversity and independent factors.

Results

A total of 303 adult HIV positive individuals on ART participated in the study and 62.4% were females. The largest numbers of participants (49.5%) were 30-40 years of age. Eighty-seven (28.7%) participants had low dietary diversity (≤4 food groups). Duration of anti-retroviral treatment was the factor significantly associated with dietary diversity: respondents with a duration of antiretroviral treatment of more than 2 years were almost two times more likely to have high dietary diversity compared with those with less than a year of antiretroviral treatment (adjusted odds ratio =0.490; 95% CI: 0.091, 0.978).

Conclusion

Low dietary diversity was found to be a nutritional problem among HIV positive adults. Duration of antiretroviral treatment was the predictor of low dietary diversity. Therefore, appropriate dietary management of side effects of ART is important.

Higher agrobiodiversity is associated with improved dietary diversity, but not child anthropometric status, of Mayan Achí people of Guatemala

OBJECTIVE

Child undernutrition remains one of the greatest challenges for public health nutrition in rural areas in developing countries. Interventions aiming to increase and conserve agrobiodiversity seem to be promising alternatives to improve child nutrition. However, the existing literature on these interventions is not conclusive about their effectiveness in combating child undernutrition. We tested the hypothesis that 'higher agrobiodiversity is associated with greater dietary diversity and better anthropometric status' in rural Guatemala.Design/Setting/SubjectsIn the summer of 2016, we conducted a cross-sectional study with a sample of 154 children (6-60 months). We conducted dietary recalls and structured interviews, measured children's weight and height, and visited food production systems (Milpas, home gardens, coffee plantations). Crop species richness, nutritional functional diversity, dietary diversity scores and anthropometric status were calculated.

RESULTS

Higher food self-sufficiency, nutritional functional diversity and dietary diversity scores were positively correlated with higher crop and animal species richness. Contrarily, remoteness to the local market was negatively correlated with dietary diversity scores. However, higher dietary diversity scores were not correlated with better child anthropometric status. Better child anthropometric status was positively correlated with improved sanitary conditions and maternal education; and negatively correlated with large household size and frequent child morbidity.

CONCLUSIONS

Agricultural diversification could diversify diets, increase nutrient availability and improve child anthropometry. However, these interventions need to be accompanied by sanitation improvements, family planning, nutritional education and women's empowerment to strengthen their positive effect on diet and nutrition.

DIETARY DIVERSITY AND ITS RELATIONSHIP WITH NUTRITIONAL STATUS AMONG ADOLESCENTS AND ADULTS IN RURAL INDIA

Dietary diversity is associated with household or individual food availability and intake of nutrients from different food groups and is an important component of nutritional outcome. This study examined the Nutrient Adequacy Ratio (NAR) and the Mean Adequacy Ratio (MAR) of three dietary diversity indices and their relationship with the nutritional status of adolescents and adults in rural regions of two states in India, Wardha district in Maharashtra and Koraput district in Odisha, in 2014. Individual dietary diversity was calculated using 24-hour diet recall (FS24hr) data and household dietary diversity was measured with food frequency data using Berry's index (DDI) and food scores (FSFFQ). The nutritional status of individuals was assessed using anthropometric indices. The diets in both locations were cereal dominated. It was observed that 51% of adolescent boys and 27% of adolescent girls had 'thinness' and stunting. The prevalence of undernutrition was higher among adult women (48%) than adult men (36%). The mean diversity indices were FS24hr of 8, DDI of 89-90 and FSFFQ of 64-66 in the two locations. The FS24hr was found to be positively correlated with the NAR of all nutrients while DDI and FSFFQ were correlated with seven and six nutrients, respectively. The DDI and FS24hr showed an association with MAR if the two locations were combined together. Sensitivity and specificity analysis showed that FS24hr gave more true positives than false positives and the area under the Receiver Operating Characteristic curve was 0.68, implying that this measure truly differentiates individuals having low dietary diversity with low MAR from those with low dietary diversity and a high MAR. All three measures of dietary diversity showed a linear association with the nutritional outcomes of adults, while in the adolescent group only DDI showed a relationship. It is concluded that 24-hour diet recall is a good measure for studying the relationship between dietary diversity and nutritional status in adults.

Seasonality affects dietary diversity of school-age children in northern Ghana

BACKGROUND AND OBJECTIVES

Dietary diversity score (DDS) is relatively easy to measure and is shown to be a very useful indicator of the probability of adequate micronutrient intake. Dietary diversity, however, is usually assessed during a single period and little is known about the effect of seasonality on it. This study investigates whether dietary diversity is influenced by seasonality.

METHODS

Two cross-sectional surveys were conducted in two different seasons-dry season (October 2010) and rainy season (May 2011) among the same school-age children (SAC) in two rural schools in northern Ghana. The study population consisted of 228 school-age children. A qualitative 24-hour dietary recall was conducted in both seasons. Based on 13 food groups, a score of 1 was given if a child consumed a food item belonging to a particular food group, else 0. Individual scores were aggregated into DDS for each child. Differences in mean DDS between seasons were compared using linear mixed model analysis.

RESULTS

The dietary pattern of the SAC was commonly plant foods with poor consumption of animal source foods. The mean DDS was significantly higher (P < 0.001) in the rainy season (6.95 ± 0.55) compared to the dry season (6.44 ± 0.55) after adjusting for potential confounders such as age, sex, occupation (household head and mother) and education of household head. The difference in mean DDS between dry and rainy seasons was mainly due to the difference in the consumption of Vitamin A-rich fruits and vegetables between the seasons. While vitamin A-rich fruits (64.0% vs. 0.9%; P < 0.0001) and vitamin A rich dark green leafy vegetables (52.6% vs. 23.3%, P < .0001) were consumed more during the rainy season than the dry season, more children consumed vitamin A-rich deep yellow, orange and red vegetables during the dry season than during the rainy season (73.7% vs. 36.4%, P <0.001).

CONCLUSION

Seasonality has an effect on DDS and may affect the quality of dietary intake of SAC; in such a context, it would be useful to measure DDS in different seasons. Since DDS is a proxy indicator of micronutrient intake, the difference in DDS may reflect in seasonal differences in dietary adequacy and further studies are needed to establish this.

STATE-LEVEL DIETARY DIVERSITY AS A CONTEXTUAL DETERMINANT OF NUTRITIONAL STATUS OF CHILDREN IN INDIA: A MULTILEVEL APPROACH

This study aimed to identify the determinants of nutritional status of children in India with a special focus on dietary diversity at the state level. Household-level consumption data from three rounds of the Consumer Expenditure Survey of the National Sample Survey Organization (1993-2012) were used. Information on the nutritional status of children was taken from the National Family Health Survey (2005-06). Dietary diversity indices were constructed at the state level to examine diversity in quantity of food consumed and food expenditure. Multilevel regression analysis was applied to examine the association of state-level dietary diversity and other socioeconomic factors with the nutritional status of children. It was observed that significant variation in childhood stunting, wasting and underweight could be explained by community- and state-level factors. The results indicate that dietary diversity has increased in India over time, and that dietary diversity at the state level is significantly associated with the nutritional status of children. Moreover, percentage of households with a regular salaried income in a state, percentage of educated mothers and mothers receiving antenatal care in a community are important factors for improving the nutritional status of children. Diversity in complementary child feeding is another significant determinant of nutritional status of children. The study thus concludes that increasing dietary diversity at the state level is an effective measure to reduce childhood malnutrition in India.

Promoting Healthy Diets and Tackling Obesity and Diet-Related Chronic Diseases: What are the Agricultural Policy Levers?

Background

Diet-related chronic diseases are now a serious global public health problem. Public health groups are calling for the agricultural sector to play a greater role in tackling the threat.

Objective

To identify potential points of policy intervention in the agricultural sector that could be leveraged to promote healthy diets and tackle obesity and diet-related chronic diseases.

Methods

A review of the literature on the dietary implications of agriculture, a conceptual analysis of the issues, and the identification of relevant examples.

Results

There are two main potential points of intervention in the agricultural sector that could be leveraged to promote healthy diets: agricultural policies and agricultural production practices. Agricultural policies and practices affect diet through their influence on food availability, price, and nutrient quality, which in turn affects food choices available to consumers. Agricultural policies amenable to intervention include input, production, and trade policies; agricultural production practices amenable to intervention include crop breeding, crop fertilization practices, livestock-feeding practices, and crop systems diversity.

Conclusions

It is well-known that agricultural policies and production practices influence what farmers choose to grow. Agricultural policies and production practices could also play a role in influencing what consumers choose to eat. To identify how agricultural policies and practices can usefully contribute toward promoting healthy diets and tackling obesity and diet-related chronic diseases, health policymakers need to examine whether current agricultural policies and production practices are contributing to—or detracting from—efforts to attain dietary goals; where and how could agricultural intervention help achieve dietary goals; and whether there are trade-offs between these interventions and other important concerns, such as undernutrition and the livelihoods of agricultural producers. Given the potential of agriculture to contribute to large-scale, population-level dietary improvements, these questions warrant closer attention from health policymakers.

Five challenges to reconcile agricultural land use and forest ecosystem services in Southeast Asia

Southeast Asia possesses the highest rates of tropical deforestation globally and exceptional levels of species richness and endemism. Many countries in the region are also recognized for their food insecurity and poverty, making the reconciliation of agricultural production and forest conservation a particular priority. This reconciliation requires recognition of the trade-offs between competing land-use values and the subsequent incorporation of this information into policy making. To date, such reconciliation has been relatively unsuccessful across much of Southeast Asia. We propose an ecosystem services (ES) value-internalization framework that identifies the key challenges to such reconciliation. These challenges include lack of accessible ES valuation techniques; limited knowledge of the links between forests, food security, and human well-being; weak demand and political will for the integration of ES in economic activities and environmental regulation; a disconnect between decision makers and ES valuation; and lack of transparent discussion platforms where stakeholders can work toward consensus on negotiated land-use management decisions. Key research priorities to overcome these challenges are developing easy-to-use ES valuation techniques; quantifying links between forests and well-being that go beyond economic values; understanding factors that prevent the incorporation of ES into markets, regulations, and environmental certification schemes; understanding how to integrate ES valuation into policy making processes, and determining how to reduce corruption and power plays in land-use planning processes.

Impact of agricultural interventions on the nutritional status in South Asia: A review

Nearly half of the malnourished population of the world lives in South Asia, and agriculture is the main source of livelihood of the people in this region. Many review exercises have analysed the available evidences to understand the ways in which agriculture can be leveraged to enhance nutritional status; however, very few of them have employed a systematic approach ensuring internal and external validity. The present paper seeks to fill this gap for strengthening the policy recommendations. It demonstrates an association between agricultural interventions and nutritional outcomes; and it shows that the production of targeted nutrition-rich crops, homestead gardens, and diversification of the agricultural production system towards fruits and vegetables and aquaculture can potentially improve nutrient intake and nutritional outcomes. The empowerment of women and nutrition knowledge play a crucial role in establishing linkage between agriculture and nutritional outcomes.

Contribution of forest foods to dietary intake and their association with household food insecurity: a cross-sectional study in women from rural Cameroon

OBJECTIVE

To determine the contribution of forest foods to dietary intake and estimate their association with household food insecurity.

DESIGN

Cross-sectional survey conducted among 279 households. Using a 7 d recall questionnaire, information on household food consumption was collected from women and used to determine the household dietary diversity score, food variety score and forest food consumption score (FFCS). Household Food Insecurity Access Scale (HFIAS) score was determined and Spearman rank correlation was used to establish the relationship between consumption of forest foods and HFIAS score. Women's dietary intake was estimated from two 24 h recalls. The contribution of forest foods to women's nutrient intakes was calculated and women's nutrient intakes were compared with estimated average nutrient requirements.

SETTING

Rural forest-dependent households in twelve villages in eastern and southern Cameroon.

SUBJECTS

Household heads and their non-pregnant, non-lactating spouses.

RESULTS

Forty-seven unique forest foods were identified; of these, seventeen were consumed by 98 % of respondents over the course of one week and by 17 % of women during the two 24 h recall periods. Although forest foods contributed approximately half of women's total daily energy intake, considerably greater contributions were made to vitamin A (93 %), Na (100 %), Fe (85 %), Zn (88 %) and Ca (89 %) intakes. Despite a highly biodiverse pool of foods, most households (83 %) suffered from high food insecurity based on the HFIAS. A significant inverse correlation was observed between the HFIAS score and the FFCS (r 2=-0·169, P=0·0006), demonstrating that forest foods play an important role in ensuring food security in these forest-dependent communities.

CONCLUSIONS

Forest foods are widely consumed by forest-dependent communities. Given their rich nutrient content, they have potential to contribute to food and nutrition security.

Wild food plants and fungi used in the mycophilous Tibetan community of Zhagana (Tewo County, Gansu, China)

BACKGROUND

The aim of the study was to investigate knowledge and use of wild food plants and fungi in a highland valley in the Gannan Tibetan Autonomous Region on the north-eastern edges of the Tibetan Plateau.

METHODS

Field research was carried out in four neighbouring villages in a mountain valley of the Diebu (Tewo) county, surrounded by spruce forests. The study consisted of 30 interviews with single informants, or group interviews (altogether 63 informants). Apart from collecting voucher specimens, we also identified fungi using DNA barcoding.

RESULTS

We recorded the use of 54 species of vascular plants. We also recorded the use of 22 mushroom taxa, which made up the largest category of wild foods. Fruits formed the largest category of food plants, with 21 species, larger than the wild greens category, which consisted of 20 species eaten after boiling or frying and 7 as raw snacks. We also recorded the alimentary use of 10 species of edible flowers and 3 species with underground edible organs. On average, 20.8 edible taxa were listed per interview (median - 21). The most listed category of wild foods was green vegetables (mean - 7.5 species, median - 8 species), but fruits and mushrooms were listed nearly as frequently (mean - 6.3, median - 6 and mean - 5.8, - median 6 respectively). Other category lists were very short, e.g., flowers (mean - 1.3, median - 1) and underground edible parts (mean - 0.7, median - 1). Wild vegetables are usually boiled and/or fried and served as side-dishes, or their green parts are eaten as snacks during mountain treks (e.g., peeled rhubarb shoots). Wild fruits are mainly collected by children and eaten raw, they are not stored for further use. The most widely used wild staple foods are Potetilla anserina roots, an important ceremonial food served on such occasions as New Year or at funerals. They are boiled and served with sugar and butter. The most important famine plants remembered by people are the aerial bulbils of Persicaria vivipara. Flowers are used as children's snacks - their nectar is sucked.

CONCLUSIONS

The number of wild taxa eaten in the studied valley is similar to that of other Tibetan areas. The structure of wild food plant taxa is also very typical for Tibetan speaking areas (e.g., the use of rhubarb shoots, Potentilla anserina, Persicaria vivipara). The studied community show a high level of mycophilia.

Associations of dietary diversity scores and micronutrient status in adolescent Mozambican girls

PURPOSE

In low-income settings, dietary diversity scores (DDSs) often predict the micronutrient adequacy of diets, but little is known about whether they predict levels of biochemical indicators of micronutrient status.

METHODS

In 2010, we studied two samples of non-pregnant 14- to 19-year-old girls in central Mozambique, the first in January-February ('hunger season'; n = 227) and the second in May-June (harvest season; n = 223). In this paper, we examined whether a low Women's Dietary Diversity Score (WDDS) predicts a low concentration of haemoglobin, serum ferritin, zinc, and folate, and plasma retinol in adolescent Mozambican girls. We constructed three scores: WDDS based on 24-h recalls, WDDS15g based on 24-h recall and employing a 15 g limit, and 7dWDDS based on 7-day food frequency questionnaires. Logistic regression models, stratified by season, were used to estimate the odds of having a low concentration of a status indicator (≤25th percentile of the season-specific distribution or cut-off from the literature) in those with a low score compared to those with a higher score.

RESULTS

In January-February, after adjusting for confounders, a low (≤3) WDDS and a low (≤5) 7dWDDS were each associated with higher odds of having low serum zinc compared to having a higher score, regardless of which of the two types of cut-offs for serum zinc was used. These associations were not present in May-June.

CONCLUSIONS

Our data from Mozambique suggest that dietary diversity is associated with serum zinc, but this association seems to be limited to the hunger season.

Factors influencing consumption of nutrient rich forest foods in rural Cameroon

Studies show that a number of forest foods consumed in Cameroon are highly nutritious and rich in health boosting bioactive compounds. This study assessed the knowledge and perceptions towards the nutritional and health promoting properties of forest foods among forest dependent communities. The relationship between knowledge, perceptions and socio-demographic attributes on consumption of forest foods was also determined. A total of 279 females in charge of decision making with respect to food preparation were randomly selected from 12 villages in southern and eastern Cameroon and interviewed using researcher administered questionnaires. Multivariate logistic regression analysis was used to identify the factors affecting consumption of forest foods. Baillonella toxisperma (98%) and Irvingia gabonesis (81%) were the most known nutrient rich forest foods by the respondents. About 31% of the respondents were aware of the nutritional value and health benefits of forest foods. About 10%-61% of the respondents expressed positive attitudes to questions related with health benefits of specific forest foods. Consumption of forest foods was found to be higher among polygamous families and also positively related to length of stay in the forest area and age of respondent with consumption of forest foods. Education had an inverse relationship with use of forest foods. Knowledge and positive attitude towards the nutritional value of forest foods were also found to positively influence consumption of forest foods. Since knowledge was found to influence attitude and consumption, there is need to invest in awareness campaigns to strengthen the current knowledge levels among the study population. This should positively influence the attitudes and perceptions towards increased consumption of forest foods.

Nutrition among men and household food security in an internally displaced persons camp in Kenya

OBJECTIVE

To determine the nutritional status of men and the food security status of their households in an internally displaced persons (IDP) camp in Kenya.

DESIGN

A descriptive, cross-sectional study using a questionnaire and biometric measurements was completed in June 2013.

SETTING

IDP camp, Rongai, Kenya.

SUBJECTS

A total of 267 men aged ≥18 years residing within the camp were recruited via respondent-driven sampling. Statistical associations between categorical variables were analysed using Pearson's χ 2 tests, while independent t tests were used for continuous variables.

RESULTS

Among the men surveyed, we found a mean BMI of 20·3 (sd 2·5) kg/m2, with 23·9% of participants in the underweight category (BMI<18·5 kg/m2). The mean Individual Dietary Diversity Score was 6 out of a maximum score of 9. The mean Household Food Insecurity Access Scale score was 11·6 (sd 6·8), with 180 participants (71·7%) residing in households categorised as severely food insecure. Low monthly household income (<2000 Kenyan Shillings, or $US 25) was associated with a higher food insecurity score (P<0·001), greater likelihood of residing in a severely food-insecure household (P<0·001), low dietary diversity score (P<0·05) and being underweight (P<0·01).

CONCLUSIONS

While the nutritional status of men in the IDP camp is comparable to non-displaced men in Kenya, household food insecurity is relatively high. Efforts to improve food security for the future are essential to minimise the impact of severe food insecurity on mental health, disease profiles and family well-being reported in other IDP settings.

Effects of agricultural biodiversity and seasonal rain on dietary adequacy and household food security in rural areas of Kenya

BACKGROUND

Kenya has a high prevalence of underweight and stunting in children. It is believed that both agricultural biodiversity and seasonal rainfall influences household food security and dietary intake. In the present study we aimed to study the effects of agricultural biodiversity and seasonal rains on dietary adequacy and household food security of preschool Kenyan children, and to identify significant relationships between these variables.

METHODS

Two cross-sectional studies were undertaken in resource-poor households in rural Kenya approximately 6 months apart. Interviews were done with mothers/caregivers to collect data from randomly selected households (N = 525). A repeated 24-hour recall was used to calculate dietary intake in each phase while household food security was measured using the Household Food Insecurity Access Scale (HFIAS). A nutrient adequacy ratio (NAR) was calculated for each nutrient as the percent of the nutrient meeting the recommended nutrient intake (RNI) for that nutrient. A mean adequacy ratio (MAR) was calculated as the mean of the NARs. Agricultural biodiversity was calculated for each household by counting the number of different crops and animals eaten either from domestic sources or from the wild.

RESULTS

Dietary intake was low with the majority of households not meeting the RNIs for many nutrients. However intake of energy (p < 0.001), protein (p < 0.01), iron (p < 0.01), zinc (p < 0.05), calcium (p < 0.05), and folate (p < 0.01) improved significantly from the dry to the rainy season. Household food security also increased significantly (p < 0.001) from the dry (13.1 SD 6.91) to the rainy season (10.9 SD 7.42). Agricultural biodiversity was low with a total of 26 items; 23 domesticated and 3 from the natural habitat. Agricultural biodiversity was positively and significantly related to all NARs (Spearman, p < 0.05) and MAR (Spearman, p < 0.001) indicating a significant positive relationship between agricultural biodiversity of the household with dietary adequacy of the child's diet.

CONCLUSION

Important significant relationships were found in this study: between agricultural biodiversity and dietary adequacy; between agricultural biodiversity and household food security and between dietary adequacy and household food security. Furthermore, the effect of seasonality on household food security and nutrient intake was illustrated.

Adequately diversified dietary intake and iron and folic acid supplementation during pregnancy is associated with reduced occurrence of symptoms suggestive of pre-eclampsia or eclampsia in Indian women

Background/Objective

Pre-eclampsia or Eclampsia (PE or E) accounts for 25% of cases of maternal mortality worldwide. There is some evidence of a link to dietary factors, but few studies have explored this association in developing countries, where the majority of the burden falls. We examined the association between adequately diversified dietary intake, iron and folic acid supplementation during pregnancy and symptoms suggestive of PE or E in Indian women.

Methods

Cross-sectional data from India’s third National Family Health Survey (NFHS-3, 2005-06) was used for this study. Self-reported symptoms suggestive of PE or E during pregnancy were obtained from 39,657 women aged 15-49 years who had had a live birth in the five years preceding the survey. Multivariable logistic regression analysis was used to estimate the association between adequately diversified dietary intake, iron and folic acid supplementation during pregnancy and symptoms suggestive of PE or E after adjusting for maternal, health and lifestyle factors, and socio-demographic characteristics of the mother.

Results

In their most recent pregnancy, 1.2% (n=456) of the study sample experienced symptoms suggestive of PE or E. Mothers who consumed an adequately diversified diet were 34% less likely (OR: 0.66; 95% CI: 0.51-0.87) to report PE or E symptoms than mothers with inadequately diversified dietary intake. The likelihood of reporting PE or E symptoms was also 36% lower (OR: 0.64; 95% CI: 0.47-0.88) among those mothers who consumed iron and folic acid supplementation for at least 90 days during their last pregnancy. As a sensitivity analysis, we stratified our models sequentially by education, wealth, antenatal care visits, birth interval, and parity. Our results remained largely unchanged: both adequately diversified dietary intake and iron and folic acid supplementation during pregnancy were associated with a reduced occurrence of PE or E symptoms.

Conclusion

Having a adequately diversified dietary intake and iron and folic acid supplementation in pregnancy was associated with a reduced occurrence of symptoms suggestive of PE or E in Indian women.

Analysis of six elements (Ca, Mg, Fe, Zn, Cu, and Mn) in several wild vegetables and evaluation of their intakes based on Korea National Health and Nutrition Examination Survey 2010-2011

Wild vegetables, those edible among naturally grown vegetables, have been reported to contain many bioactive substances, dietary fibers, vitamins, and minerals. The purpose of this study is to examine the six elements of the wild vegetables frequently consumed by Koreans and assess the element intakes through them. Contents of six kinds of elements (Ca, Mg, Fe, Zn, Cu, and Mn) in 11 wild vegetables were analyzed by inductively coupled plasma optical emission spectroscopy. Using these analysis data, the 6-element intakes from the wild vegetables were evaluated in healthy Korean adults aged 19-64 years from the Korea National Health and Nutrition Examination Survey (2010-2011). Sedum and shepherd's purse contained over 100 mg of Ca in 100 g of their edible portion. The Mg content per 100 g of the 11 wild vegetables ranged from 12.1 mg to 43.4 mg. The wild vegetable with the highest mineral content per 100 g was sedum for Ca, spinach for Mg, shepherd's purse for Fe, spinach for Zn, bracken for Cu, and fragrant edible wild aster for Mn. The element intakes from the 11 wild vegetables compared with dietary reference intakes in the healthy Koreans were 1.0 % for Ca, 2.1 % for Mg, 5.3 % for Fe, 1.4 % for Zn, 0.3 % for Cu, and 1.8 % for Mn. Considering the low intake ratio (1.2 %) of the wild vegetable to total food intake, wild vegetables may contribute to some element intakes. Our results show the nutritional value of the wild vegetables in the aspect of mineral nutrition; however, further research is needed to evaluate the bioavailability of various elements in wild vegetables.

Wild foods from farm and forest in the East Usambara Mountains, Tanzania

This study explored the role of wild foods in the diets of children and mothers in the East Usambara Mountains (N = 274 dyads). We identified 92 wild food species. Although dietary diversity (most measures) was not different between seasons, wild foods accounted for a greater percentage of items consumed in the wet (food insecure) season. Many wild foods were obtained on farm; wild foods obtained from the forest accounted for less than 3% of food items consumed. Wild foods were used by virtually all informants but contributed only 2% of total energy in the diet. However, they contributed large percentages of vitamin A (RAE) (31%), vitamin C (20%), and iron (19.19%). Agricultural factors (e.g., hours spent in farm) were associated with greater wild food use. These findings suggest participation in agriculture may be important for the maintenance of wild food use, and that wild foods can play an important role in the nutritional resilience of local people.

Wild leafy vegetable use and knowledge across multiple sites in Morocco: a case study for transmission of local knowledge?

BACKGROUND

There are few publications on the use and diversity of wild leafy vegetables (WLVs) in Morocco. In order to address this gap, we conducted ethnobotanical field work in Taounate, Azilal and El House regions.

METHODS

Ethnobotanical collections, free listing, qualitative interviews and a 7 day food frequency questionnaire.

RESULTS

More than 30 species in 23 genera of WLV were identified. Of these 4 had not previously recorded as WLVs used in Morocco in the literature. WLVs were used by 84% of households surveyed in Taounate (N = 61, in March 2005), and were used up to 4 times a week. Qualitative data revealed both positive and negative perceptions of WLVs and detailed knowledge about preparation among women. The greatest diversity of WLV knowledge and use was in the Rif Mountains (Taounate). There was significant variation in nomenclature and salience of WLVs, not only between regions, but also between villages in the same region. Within the same region (or even village) different local names were used for a given species or genus, and different species were identified by the same local name (including species from different botanical families). Data showed greater overlap in knowledge among villages using the same market.

CONCLUSION

We believe the results suggest that markets are important sites for WLV knowledge transmission.

Wild food plants and wild edible fungi in two valleys of the Qinling Mountains (Shaanxi, central China)

BACKGROUND

The aim of the study was to investigate knowledge and use of wild food plants in two mountain valleys separated by Mount Taibai--the highest peak of northern China and one of its biodiversity hotspots, each adjacent to species-rich temperate forest vegetation.

METHODS

Seventy two free lists were collected among the inhabitants of two mountain valleys (36 in each). All the studied households are within walking distance of primary forest vegetation, however the valleys differed in access to urban centers: Houzhenzi is very isolated, and the Dali valley has easier access to the cities of central Shaanxi.

RESULTS

Altogether, 185 wild food plant species and 17 fungi folk taxa were mentioned. The mean number of freelisted wild foods was very high in Houzhenzi (mean 25) and slightly lower in Dali (mean 18). An average respondent listed many species of wild vegetables, a few wild fruits and very few fungi. Age and male gender had a positive but very low effect on the number of taxa listed.Twelve taxa of wild vegetables (Allium spp., Amaranthus spp., Caryopteris divaricata, Helwingia japonica, Matteucia struthiopteris, Pteridium aquilinum, Toona sinensis, Cardamine macrophylla, Celastrus orbiculatus, Chenopodium album, Pimpinella sp., Staphylea bumalda &S. holocarpa), two species of edible fruits (Akebia trifoliata, Schisandra sphenanthera) and none of the mushrooms were freelisted by at least half of the respondents in one or two of the valleys.

CONCLUSION

The high number of wild vegetables listed is due to the high cultural position of this type of food in China compared to other parts of the world, as well as the high biodiversity of the village surroundings. A very high proportion of woodland species (42%, double the number of the ruderal species used) among the listed taxa is contrary to the general stereotype that wild vegetables in Asia are mainly ruderal species. The very low interest in wild mushroom collecting is noteworthy and is difficult to explain. It may arise from the easy access to the cultivated Auricularia and Lentinula mushrooms and very steep terrain, making foraging for fungi difficult.

Food insecurity, food based coping strategies and suboptimal dietary practices of adolescents in Jimma zone Southwest Ethiopia

Despite the high prevalence of adolescent food insecurity in Ethiopia, there is no study which documented its association with suboptimal dietary practices. The objective of this study is to determine the association between adolescent food insecurity and dietary practices. We used data on 2084 adolescents in the age group of 13-17 years involved in the first round survey of the five year longitudinal family study in Southwest Ethiopia. Adolescents were selected using residence stratified random sampling methods. Food insecurity was measured using scales validated in developing countries. Dietary practices were measured using dietary diversity score, food variety score and frequency of consuming animal source food. Multivariable regression models were used to compare dietary behaviors by food security status after controlling for socio-demographic and economic covariates. Food insecure adolescents had low dietary diversity score (P<0.001), low mean food variety score (P<0.001) and low frequency of consuming animal source foods (P<0.001). After adjusting for other variables in a multivariable logistic regression model, adolescent food insecurity (P<0.001) and rural residence (P<0.001) were negatively associated with the likelihood of having a diversified diet (P<0.001) and frequency of consuming animal source foods, while a high household income tertile was positively associated. Similarly, multivariable linear regression model showed that adolescent food insecurity was negatively associated with food variety score, while residence in semi-urban areas (P<0.001), in urban areas (P<0.001) and high household income tertile (P = 0.013) were positively associated. Girls were less likely to have diversified diet (P = 0.001) compared with boys. Our findings suggest that food insecurity has negative consequence on optimal dietary intake of adolescents. Food security interventions should look into ways of targeting adolescents to mitigate these dietary consequences and provide alternative strategies to improve dietary quality of adolescents in Southwest Ethiopia.

Use of dietary diversity score as a proxy indicator of nutrient adequacy of rural elderly people in Sri Lanka

Background

Macro and micro nutrient deficiencies are public health concerns in most developing countries including Sri Lanka, partly due to monotonous, cereal-based diet that lacks diversity. The objective of the study was to assess validity of food variety score (FVS), dietary diversity score (DDS) and dietary serving score (DSS) as indicators of nutrient adequacy of rural elderly people in Sri Lanka.

Findings

A sample of 200 apparently healthy elderly people >60y of age were studied. A single 24 h recall was performed to compute dietary diversity indicators. Pearson’s correlation was used to assess the utility of FVS, DDS and DSS as indicators of nutrient adequacy. Sensitivity (Se) and specificity (Spe) analysis were done to determine the most appropriate cut-off points for using FVS and DDS to categorize elderly people with adequate nutrient intake. The average (standard deviation) of the food variety score, dietary diversity score and dietary serving score was 8.4 (2), 4.4 (0.9) and 11.4 (2.5), respectively. Mean adequacy ratio (MAR) of 12 nutrients was 0.39 (39%). Pearson’s correlation coefficients between MAR and FVS was 0.45 (P < 0.01), for DDS it was 0.48 ( P < 0.01) and for DSS it was 0.58 ( P < 0.01). When maximizing sensitivity and specificity, the best cut-off point for achieving 50% of MAR was about 9 and 4.5 for FVS and DDS, respectively.

Conclusion

In conclusion, FVS, DDS and DSS were useful proxy indicators of nutrient adequacy of rural elderly people in Sri Lanka. Indeed, the performance of the indicators is improved when considering the quantities of food consumed.