Food Crop Diversity, Women's Income-Earning Activities, and Distance to Markets in Relation to Maternal Dietary Quality in Tanzania

Dietary diversity and its determinants among women of reproductive age residing in the urban area of Nouakchott, Mauritania

BACKGROUND

The intake of nutrient-rich foods from diverse diets ensures adequate nutrition for women. This study aims to determine dietary diversity among women of reproductive age (WRA) using the MDD-W indicator and how it relates to their socio-economic characteristics in the city of Nouakchott, Mauritania.

METHODS

A community-based cross-sectional study was conducted on 240 women of reproductive age, aged 15-49 years. Food consumption data were obtained through unquantified 24 h recall which is designed to identify all foods consumed by the women during this period. We computed MDD-W as the consumption of at least five out of ten predefined food groups according to the guideline of the Food and Agriculture Organization (FAO) of the United Nations. In order to determine which factors had a statistically significant influence on dietary diversity among women, we used a value of P < 0.05.

RESULTS

The mean of dietary diversity was 5.48 and 71.7% of WRA had an acceptable minimum dietary diversity. During the study period, 96.25% and 80% of women consumed vitamin A and iron-rich foods respectively. The consumption rate of starchy foods, vitamin A-rich fruits and vegetables, meat, fish and chicken, milk and dairy products, dark green leafy vegetables and finally other vegetables was higher; 99.6%, 75.3%, 80%, 62.5%, 60.4% and 83.3% respectively. On the other hand, the consumption of legumes, eggs and other fruits was low; at 21.7%, 14.2% and 13.8% respectively.

CONCLUSIONS

The study showed that more than half of the studied population had an acceptable minimum dietary diversity. The diet was mainly based on the consumption of starchy foods, meat and other vegetables than those rich in vitamin A.

Does online food shopping boost dietary diversity? Application of an endogenous switching model with a count outcome variable

Increasingly, rural households in developing countries are shopping for food online, and the COVID-19 pandemic has accelerated this trend. In parallel, dietary guidelines worldwide recommend eating a balanced and healthy diet. With this in mind, this study explores whether online food shopping boosts dietary diversity-defined as the number of distinct food groups consumed-among rural households in China. Because people choose to shop for food online, it is important to account for the self-selection bias inherent in online food shopping. Accordingly, we estimate the treatment effects of online food shopping on dietary diversity using the endogenous switching model with a count outcome variable. The results indicate that online food shopping increases dietary diversity by 7.34%. We also find that education, asset ownership, and knowing the government's dietary guidelines are the main factors driving rural households' decisions to shop for food online.

Dietary quality and risk of heart failure in men

BACKGROUND

Due to the increasing disease burden, strategies to predict and prevent heart failure (HF) are urgently needed.

OBJECTIVE

We aimed to investigate whether the Alternative Healthy Eating Index (AHEI) and the clinically abbreviated Prime Diet Quality Score (PDQS) are associated with the risk of overall HF, HF with preserved ejection fraction (HFpEF), and HF with reduced ejection fraction (HFrEF).

METHODS

Our study included 44,525 men from the Health Professionals Follow-up Study (HPFS) who were free from cardiovascular disease and cancer at baseline. The AHEI and PDQS were computed based on dietary data repeatedly measured using semiquantitative FFQs. HF, HFpEF, and HFrEF were adjudicated based on review of medical records through 2008. Associations of diet quality with incident HF were estimated with multivariate-adjusted Cox proportional hazards models.

RESULTS

During 929,911 person-years of follow-up, 803 HF cases were documented, including 184 with HFpEF and 181 with HFrEF among those with ejection fraction (EF) data. Adjusting for potential confounders, we did not observe a significant association between the AHEI and overall HF (HR per SD: 0.96; 95% CI: 0.89, 1.04; P-trend = 0.57) or between the PDQS and overall HF (HR per SD: 0.98; 95% CI: 0.91, 1.06; P-trend = 0.82). Both dietary indices were not significantly associated with HFpEF. However, a higher AHEI was associated with lower risk of HFrEF upon comparison of the extreme quintiles (HR per SD: 0.81; 95% CI: 0.69, 0.96; P-trend = 0.02). Every SD increment in the PDQS was associated with 20% lower risk of HFrEF (HR per SD: 0.80; 95% CI: 0.68, 0.95; P-quadratic = 0.03).

CONCLUSIONS

A healthy overall diet was associated with lower risk of HFrEF, and associations were similar with the AHEI and PDQS. We did not observe a significant association between dietary indices and either overall HF or HFpEF.

Impact of COVID-19 on Nutrition, Food Security, and Dietary Diversity and Quality in Burkina Faso, Ethiopia and Nigeria

Coronavirus disease 2019 (COVID-19) can have far-reaching consequences for developing countries through the combined effects of infection and mortality, and the mitigation measures that can impact food systems and diets. Using a mobile platform, this cross-sectional study evaluated the effect of COVID-19 on food prices and dietary quality for 1797 households in Nouna and Ouagadougou in Burkina Faso, Addis Ababa and Kersa in Ethiopia, and Lagos and Ibadan in Nigeria. We assessed the consumption of 20 food groups during the previous 7 days. The dietary diversity scores (DDS) and Prime Diet Quality Scores (PDQS) were used to assess dietary diversity and quality. We used generalized estimating equation (GEE) linear models to evaluate associations between price changes for staples, pulses, vegetables, fruits, and animal source foods (ASFs) with the DDS and PDQS PDQS. Most participants reported increasing prices of staples, pulses, fruits, vegetables and ASF, and ≥ 40% reported the decreased consumption of staples, legumes, and other vegetables and fruits. The DDS (except in Kersa and Ouagadougou) and PDQS were lower during the COVID-19 pandemic. Higher pulse prices were associated with lower DDS (estimate, -0.35; 95% confidence interval [CI], -0.74 to 0.03; P = 0.07) in the combined analysis and in Burkina Faso (estimate, -0.47; 95% CI, -0.82 to -0.11). Higher vegetable prices were positively associated with the DDS (estimate, 0.22; 95% CI, 0.08 to 0.37). Lower crop production (estimate, -0.54; 95% CI, -0.80 to -0.27) was associated with lower DDS. The price increases and worsening dietary diversity and quality call for social protection and other strategies to increase the availability and affordability of nutrient-rich foods during the COVID-19 pandemic and public health emergencies.

Food Systems as Drivers of Optimal Nutrition and Health: Complexities and Opportunities for Research and Implementation

The Sustainable Development Goals (SDGs) are intricately linked to food systems. Addressing challenges in food systems is key to meeting the SDGs in Africa and South Asia, where undernutrition and micronutrient deficiencies persist, alongside increased nutrition transition, overweight and obesity, and related chronic diseases. Suboptimal diets are a key risk factor for mortality and 3 billion people cannot afford a healthy diet; in addition, food systems are not prioritizing environmental sustainability. Optimizing food systems and increasing agricultural productivity beyond calories, to nutrient-rich vegetables and fruits, legumes, and livestock, and sustainable fishing, are required. Strengthening of research around food systems-on pathways, value chains, and development and validation of metrics of diet quality-is required. The development of new technology in crop management and pest control and addressing natural resource degradation is key. Engaging with the public and private sectors, outreach to donors and policymakers, and strengthening cross-disciplinary collaborations are imperative to improving food systems.