Consumer Nutrition Knowledge and Dietary Behavior in Urban Ethiopia: A Comprehensive Study

Outcomes of a homestead food production program on nutritional knowledge, dietary diversity, food security and empowerment of rural women in Tehran province, Iran

BACKGROUND

Food and nutrition insecurity is a major health issue in developing countries. Homestead food production (HFP) programs are strategies for improving food and nutrition security of a country. Iran implemented a HFP program entitled "Nutrition Improvement of Rural and Nomadic Women" in its villages for a five-year period from 2017. The current study assessed the outcomes of this mentioned program and its determinants among rural women in Tehran province.

METHODS

The population of this cross-sectional study comprised a group covered by the program (n = 143) and a non-covered group (n = 160). The participants were selected randomly from 32 villages of five counties in Tehran province. Data was collected using five questionnaires: (1) General information, (2) Women's empowerment, (3) Nutritional knowledge, (4) Dietary diversity, and (5) Household Food Insecurity Access Scale (HFIAS). Data was analyzed using the IBM SPSS version 21 and the IBM Amos SPSS version 22 software.

RESULTS

The results of the study showed no significant improvement in the expected indicators, such as frequency of home gardening, nutritional knowledge, dietary diversity, women's empowerment, and household food insecurity status among women covered by the program (p > 0.05). The structural equation modelling (SEM) results indicated that women's empowerment from the dimension of decision-making power (r = 0.151) and nutritional knowledge (r = 0.135) were the significant positive predictors of dietary diversity (p < 0.05), while household food insecurity predicted it negatively (r=-0.138) (p < 0.05).

CONCLUSION

Because the current evaluated program has not been able to improve the expected indicators, modification of the program implementation may be needed, such as: addressing the probable barriers and challenges and strengthening the facilities in the covered villages. The current study presents a model of the dietary diversity predictors for consideration in redesigning or enhancing the program.

Does livestock ownership predict animal-source food consumption frequency among children aged 6-24 months and their mothers in the rural Dale district, southern Ethiopia?

Background

Animal-source foods are food items that come from animals. Animal-source foods provide a variety of micronutrients that plant-source foods cannot provide to the same extent and without extra precaution. Milk, eggs, poultry, flesh meat and fish are animal-source foods mainly used in Ethiopia. Low animal-source food consumption among children and mothers is a great concern in many low-income settings. This study aimed to describe animal-source food consumption frequencies among children aged 6-24 months and their mothers in rural southern Ethiopia where livestock farming is very common. We also analysed the association between livestock ownership and animal-source food consumption among children and mothers.

Methods

A community-based cross-sectional study was conducted among 851 randomly selected households with child-mother pairs from August to November 2018. The study was conducted in the rural Dale District, southern Ethiopia. Structured and pre-tested questionnaires were used to collect data on mother and child information, livestock ownership, and animal-source foods consumption frequencies. Ordinal logistic regression analysis was used to describe associations between animal-source foods consumption and livestock ownership.

Result

Nearly, three-quarters (74.1%) of the households owned cows, and a quarter (25%) had goats or sheep. Dairy, egg and meat consumption among children during the past month was 91.8%, 83.0% and 26.2%, respectively. Likewise, the consumption of dairy, eggs and meat among mothers was 96.0%, 49.5% and 34.0%, respectively. The percentage of children who had not consumed any animal-source foods during the month prior to our survey was 6.6%, and the figure was 2.2% for the mothers. Dairy consumption was 1.8 times higher among children (aOR = 1.8, 95% CI [1.3-2.5]) and 3.0 times higher among mothers (aOR = 3.0, 95% CI [2.2-4.2]) in households that kept cows than in households without cows. The egg consumption frequency was positively associated with hen and goat/sheep ownership for both children and mothers. Meat consumption frequency among children was negatively associated with cow ownership (aOR = 0.66, 95% CI [0.45-0.95]); however, cow ownership was not associated with meat consumption among mothers.

Conclusion

Dairy products were common animal-source foods consumed by young children and mothers in the study area. However, meat consumption was low among children and mothers. Strategies like promoting the keeping of goats/sheep and hens to improve complementary feeding and mothers' nutrition are warranted in the study area.

Nutritional composition and consumer acceptance of tomato paste fortified with palm weevil larvae (Rhynchophorus phoenicis Fabricius) in the Ashanti region, Ghana

Edible insects, such as palm weevil larvae, have been promoted as an alternative source of nutrients in developing countries for their nutritional benefits, cost-effective rearing, and yearly availability. Unfortunately, consumer acceptance remains a barrier to their utilization. A supplemental palm weevil larvae and tomato paste were developed as part of efforts to understand whether incorporating edible insects into staple foods could help overcome this barrier. Palm weevil larvae flour and tomato paste were mixed in three formulations that had 8, 15, and 30% of palm weevil larvae flour. Samples were subjected to proximate and mineral content analyses and sensory evaluation. Among the blends, tomato paste containing 30% palm weevil larvae had the highest protein, fat, and total solids content as compared to unfortified tomato paste. Iron and zinc levels also increased with increasing levels of palm weevil larvae flour. Carbohydrate and crude fiber concentrations of the samples, however, decreased with increasing fortification levels. The overall acceptance and willingness to purchase fortified tomato paste as determined by sensory evaluation was high for all samples and increased with increasing knowledge about palm weevil larvae's nutritional benefits. Overall acceptance and willingness to purchase fortified tomato paste were significantly dependent on the samples' color and consumers' overall liking of the products. Tomato paste fortified with palm weevil larvae can provide a complementary source of iron for Ghanaians.

Food safety knowledge, attitude, and practice among male and female food handlers: Evidence from fruit and vegetable producers in Ethiopia

Studies on the level of knowledge, attitude and handling practice towards food safety would help to determine the associated factors of knowledge, attitude and practice towards food safety; however, these studies did not explicitly address food safety concerns related to fruit and vegetables in Ethiopia. Men and women could have different levels of knowledge, attitude, and handling practice; however, these gendered effects were not addressed in previous studies. Using data collected in 2021 from 311 farm households in Ethiopia, this study aimed to analyze the level of knowledge, attitude, and handling practice of fruit and vegetable and associated factors among male and female food handlers. Data was analyzed using descriptive statistics, spearman's correlation, and econometric models (logit, multinomial logit and ordered probit). Education has a positive significant effect on knowledge, attitude and handling practices of fruit and vegetable handlers. However, the effect was higher in the females. No correlation could be obtained between knowledge and practices for the total respondents. However, knowledge had a positive but weak significant association with practices in the female group. We found a significant positive correlation between knowledge and attitude. These findings indicated that food safety knowledge of fruit and vegetable handlers will influence their attitude and a positive attitude would influence the practice in safe handling of fruit and vegetables. It therefore may require more targeted campaigns (i.e. from awareness creation to behavior change) to increase the ability of the community members to adopt best practices while reducing the barriers associated with consuming unhealthy diets.

Food environment around schools and adolescent consumption of unhealthy foods in Addis Ababa, Ethiopia

Adolescent diets may be influenced by the retail food environment around schools. However, international research to examine associations between the proximity of retail food outlets to schools and diet provides equivocal support for an association. This study aims to understand the school food environment and drivers for adolescents' consumption of unhealthy foods in Addis Ababa, Ethiopia. Mixed-methods research was conducted, 1200 adolescents (10-14 years) from randomly selected government schools were surveyed, along with vendors within 5-min' walk of the schools and focus group discussions (FGDs) with adolescent groups. Mixed-effect logistic regression investigated the relationship between the number of vendors around the schools and the consumption of selected unhealthy foods. Thematic analysis was used to summarize findings from the FGDs. Consumption of sweets and sugar-sweetened beverages (S-SSB) and deep-fried foods (DFF) at least once a week was reported by 78.6% and 54.3% of the adolescents, respectively. Although all schools were surrounded by food vendors selling DFF and S-SSB, consumption was not associated with the number of vendors available around the school. However, adolescents' awareness and perception of healthy food, and their concerns about the safety of foods in the market, influenced their dietary choices and behaviours. Lack of financial resources to purchase food as desired also played a role in their selection of food and eating habits. Reported unhealthy food consumption is high among adolescents in Addis Ababa. Thus, further research is warranted to come up with school-based interventions that promote access and healthy food choices among adolescents.

The role of nutrition knowledge in dietary adjustments during COVID-19 pandemic

Knowledge/awareness significantly influences people's dietary choices, lifestyle, and inadvertently their health outcomes; hence it is imperative that people have correct information with regards to food and health. This study was undertaken to establish the role of nutrition knowledge on dietary choices and habits of people in Calabar, especially after the hard COVID-19 lockdown, and to ascertain if there was any positive or negative effect on the lifestyle of the people. It consisted of a cross-sectional survey in Calabar, Cross River State - Nigeria. An online questionnaire was prepared after sample size determination and its content validated. The questionnaire was designed to obtain data on the socio-economic status, participants' lifestyle, and changes in dietary intake/health before and during the COVID-19 lockdown, while the questionnaire link was in circulation for 6 weeks (April/May 2021). Descriptive statistics was used to define the proportion of responses for each question and Pearson's correlation was used to check for association between variables. Most participants were undergraduates depending on parents/sponsors. Financial decline appeared to have contributed to a post lockdown decrease in food consumption. Many (82.6%) respondents recorded high nutrition knowledge scores (NKS) and 83.1% of the respondents had high health scores. The results show that NKS influenced the kind of foods the respondents consumed frequently and there was a positive correlation between NKS consumption of fruits/vegetables. NKS had effect on their access to healthy foods and it varied significantly with respondent's total health score. No association existed between NKS and the reason for skipping meal - 'lack of time to prepare meals'. Nutrition knowledge and proper awareness, contributed significantly in dietary choices (regardless of limited resources), thus ensuring adequate nutrition and reduced health problems (most respondents recorded high health scores) during a pandemic. This study affirms the effectiveness of adequate nutrition education and awareness in ensuring healthy dietary choices, promoting optimal health, and reducing risks of diseases.

Determinants of Honey and Other Bee Products Use for Culinary, Cosmetic, and Medical Purposes

Bee products have been used for centuries for culinary, medicinal, and cosmetic purposes, and their properties are still a subject of research, which provide new arguments in favour of their use. The research aimed to determine the current state of use of bee products by Polish consumers and determine the ways and conditions of their use, with particular reference to the level of nutritional knowledge and health status. The survey was conducted using the CAWI (Computer-Assisted Web Interview) method on 487 respondents. It was found that honey is used mainly for culinary purposes and, to a lesser extent, for medicinal and cosmetic purposes. Other bee products are much less commonly used than honey-mainly beeswax and royal jelly for cosmetic purposes and propolis and bee pollen for medicinal purposes. Segments distinguished by the frequency of use of honey for particular purposes were differentiated by gender, age, income level, use of other bee products, and motivation to use them. Their differences were also found in terms of the level of nutritional knowledge and self-assessed health status-the highest ratings in both categories were indicated by representatives of the Honey users' segment, which consisted of people who use honey most frequently for cooking, cosmetic and medicinal purposes. Regression analysis additionally showed that higher levels of nutritional knowledge and better health status were associated with the use of honey to treat gastrointestinal ailments and with the use of propolis for medicinal purposes.

Impact of healthy food and diet information on household food security: A randomized control trial in Kampala, Uganda

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.

Dietary patterns and their association with cardiovascular risk factors in Ethiopia: A community-based cross-sectional study

Purpose

To identify the dietary patterns and their association with cardiovascular risk factors among adult people in urban and rural areas of Wolaita, southern Ethiopia.

Methods

A total of 2,483 participants aged 25-64 years were selected using a three-stage random sampling. Data for this study were collected using structured questionnaires, the previous 24-h dietary intake assessment, anthropometric, blood pressure, and biochemical measurements. We used factor analysis to identify dietary patterns. Factors associated with dietary patterns were analyzed using multiple linear regression models. The adjusted regression coefficients with their 95% CI were used to ascertain the association.

Result

We identified three major dietary patterns that explained 51% of the variance in food consumption. The western dietary pattern was characterized by the consumption of meat/organ meat, biscuits/sweets, chicken stew, pasta-macaroni recipes, butter, white wheat bread, egg recipe, and Ethiopian dish shiro-wet, and was positively associated with urban residence, obesity, hypertension, blood glucose, and total cholesterol levels. Adherence to the consumption of tubers, whole-grain maize products, coffee leaves-and-herbs beverage, legumes, and sweet potatoes featured the traditional dietary pattern. The traditional dietary pattern showed a positive relationship with rural residence, physical activity, and obesity, and it had a negative relationship with hypertension. The healthy dietary pattern was characterized by the intake of green leafy vegetables, green pepper, and whole-grain maize products, and negatively related to obesity, and hypertension, while positively related to urban residence.

Conclusion

The coexistence of western, traditional, and healthy dietary patterns in the present study indicates the transition to a new dietary pattern in the study area. All dietary patterns were associated with one or more cardiovascular risk factors, but the western dietary pattern was associated with most of these, while the traditional diet showed fewer such associations. Therefore, it might be useful to promote healthy and traditional dietary patterns along with physical activity. Interventions related to the current findings, if initiated early in life, may benefit the public in preventing cardiovascular risk factors such as obesity, hypertension, and type 2-diabetes.

Determinants of undernutrition among young children in Ethiopia

Ethiopia is one of the countries in sub-Saharan Africa with the highest burden of childhood undernutrition. Despite the high burden of this scourge, little is known about the magnitude and contributing determinants to anthropometric failure among children aged 0-23 months, a period regarded as the best window of opportunity for interventions against undernutrition. This study examined factors associated with undernutrition (stunting, wasting, and underweight) among Ethiopian children aged 0-23 months. This study used a total weighted sample of 2146 children aged 0-23 months from the 2019 Ethiopian Mini Demographic and Health Survey. The data were cleaned and weighted using STATA version 14.0. Height-for-age (HFA), weight-for-height (WFH), and weight-for-age (WFA) z-scores <  - 2 SD were calculated and classified as stunted, wasting, and underweight, respectively. Multilevel mixed-effects logistic regression models adjusted for cluster and survey weights were used. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were estimated. Statistical significance was declared at p < 0.05. The overall weighted prevalence of stunting, wasting, and underweight respectively were 27.21% [95% CI (25.32-29.18)], 7.80% [95% CI (6.71-9.03)], and 16.44% [95% CI (14.90-18.09)] among children aged 0-23 months in Ethiopia. Female children were less likely to be associated with stunting [AOR: 0.68, 95% CI (0.54-0.86)], wasting [AOR: 0.70, 95% CI (0.51, 0.98)], and underweight [AOR: 0.64, 95% CI (0.49, 0.83)] than their male counterparts. Conversely, older children aged 12-17 months [AOR: 2.22, 95% CI (1.52, 3.23)] and 18-23 months [AOR: 4.16, 95% CI (2.75, 6.27)] were significantly at an increased odds of becoming stunted. Similarly, the likelihood of being underweight was higher in older age groups: 6-11 months [AOR: 1.74, 95% CI (1.15, 2.63)], 12-17 months [AOR: 2.13, 95% CI (1.40, 3.24)], and 18-23 months [AOR: 4.08, 95% CI (2.58, 6.44)] compared with the children younger than 6 months. Lower wealth quintile was one of the other significant determinants of stunting and underweight. The study's findings indicated that the most consistent significant risk factors for undernutrition among children aged 0-23 months are: male sex, older age groups and lower wealth quintile. These findings emphasize the importance of strengthening nutrition-specific and sensitive interventions that address the immediate and underlying drivers of childhood undernutrition in early life, as well as targeting low-income households with male children, in order for Ethiopia to meet the Sustainable Development Goals (SDGs) 1,2 and 3 by 2030.

Correlation between dietary information sources and knowledge of adequate diets in Eastern China

Knowledge of adequate diets can improve an individual's health status. Although previous studies have identified the main resources from which Chinese people acquire dietary knowledge, it is still unclear whether information sources regarding diets (ISRDs) can increase individuals' knowledge of adequate diets (KAD) and which ISRDs are most effective in conveying KAD to the Chinese population. In this study, we interviewed 4,710 residents in Eastern China regarding their ISRDs and KAD. Descriptive statistics, ANOVA, and multivariate linear regression were used to analyze the effectiveness of different ISRDs in transmitting KAD to Chinese individuals and to determine the relationship between ISRDs and KAD. Results showed that the KAD scores of the respondents were low overall in Eastern China. Providing dietary information through expert lectures, books, newspapers, magazines, and social media could significantly improve the average KAD score of Chinese individuals. Respondents with a greater number of ISRDs were more likely to have higher KAD scores. These findings suggest that the number of ISRDs should be increased. In particular, emphasis should be placed on the role of expert lectures, books, newspapers, magazines, and social media.

Food Choice Determinants and Perceptions of a Healthy Diet among Italian Consumers

Healthy food choices are crucial for a healthy lifestyle. However, food choices are complex and affected by various factors. Understanding the determinant factors affecting food choices could aid policy-makers in designing better strategies to promote healthy food choices in the general public. This study aims to evaluate the food choice motivations and to segment consumer groups, according to their food choice motivations, in a sample of 531 Italian consumers (collected by convenience sampling), through offline and online survey platforms. K-means cluster analysis was applied to identify consumer groups using six food choice motivation categories (health, emotional, economic and availability, social and cultural, environmental and political, and marketing and commercial). The results suggest that the strongest determinants for the food choices of Italian consumers are Environmental factors and Health. Two consumer profiles were identified through the segmentation analysis: Emotional eating and Health-driven consumers. The respondents were found to have a good awareness of what comprises a healthy diet. There is a potential market for healthy and sustainable food products, especially products with minimal or environmentally friendly packages. Food labels and information strategies could be promoted as tools to assist consumers to make healthy food choices.