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Richterman A, Sinha P, Ivers LC, Gross R, Rantleru T, Tamuhla N, Bisson GP. Food Insecurity and Undernutrition Are Associated With Distinct Immunologic Profiles in People With Tuberculosis and Advanced HIV Starting Antiretroviral Therapy. J Acquir Immune Defic Syndr 2024; 95:494-504. [PMID: 38346410 PMCID: PMC10947883 DOI: 10.1097/qai.0000000000003386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/20/2023] [Indexed: 03/17/2024]
Abstract
BACKGROUND Food insecurity and undernutrition are related but distinct concepts contributing to poor HIV and tuberculosis outcomes. Pathways linking them with immunologic profile, which may relate to clinical outcomes, remain understudied. METHODS We analyzed data from a cohort study of 165 antiretroviral therapy (ART)-naïve adults with advanced HIV and newly diagnosed tuberculosis in Botswana from 2009 to 2013. Twenty-nine plasma biomarkers were measured pre-ART and 4 weeks post-ART initiation. We used principal components analysis (PCA) and multivariable linear regression models to assess relationships between immunological profiles and food insecurity (based on the Household Food Insecurity Access Scale), undernutrition (body mass index <18.5 kg/m 2 ), and clinical outcomes. RESULTS PCA identified 5 principal components with eigenvalues >1. After adjustment, food insecurity was associated with PC3 pre-ART (0.19 per increased category of severity, 95% CI: 0.02 to 0.36) and post-ART (0.24, 95% CI: 0.07 to 0.41). PC3 was driven by higher levels of IFN-α, IFN-γ, interleukin (IL)-12p40, vascular endothelial growth factor, IL-1α, and IL-8 and decreased concentrations of IL-3. Undernutrition was associated with PC5 post-ART (0.49, 95% CI: 0.16 to 0.82). PC5 was driven by higher levels of IL-8, MIP-1α, IL-6, and IL-10 and decreased concentrations in IP-10 and IFN-α. Post-ART PC3 (4.3 percentage point increased risk per increased score of 1, 95% CI: 0.3 to 8.9) and post-ART PC5 (4.8, 95% CI: 0.6 to 8.9) were associated with death in adjusted models. DISCUSSION We identified 2 distinct immunologic profiles associated with food insecurity, undernutrition, and clinical outcomes in patients with advanced HIV and tuberculosis. Different pathophysiologic processes may link food insecurity and undernutrition with poor outcomes in this vulnerable patient population. Future studies should assess the impact of improving food access and intake on immune function and clinical outcomes.
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Affiliation(s)
- Aaron Richterman
- Department of Medicine (Infectious Diseases), University of Pennsylvania, Philadelphia, PA
| | - Pranay Sinha
- Department of Medicine (Infectious Diseases), Boston University Chobanian and Avedisian School of Medicine, Boston, MA
| | - Louise C Ivers
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
- Center for Global Health, Massachusetts General Hospital, Boston, MA
| | - Robert Gross
- Department of Medicine (Infectious Diseases), University of Pennsylvania, Philadelphia, PA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; and
| | | | - Neo Tamuhla
- Botswana-UPenn Partnership, Gaborone, Botswana
| | - Gregory P Bisson
- Department of Medicine (Infectious Diseases), University of Pennsylvania, Philadelphia, PA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; and
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Sheikh S, Barolia R, Habib A, Azam I, Qureshi R, Iqbal R. "If the food is finished after my brother eats then we (girls) sleep hungry." Food insecurity and dietary diversity among slum-dwelling adolescent girls and boys in Pakistan: A mixed methods study. Appetite 2024; 195:107212. [PMID: 38242362 DOI: 10.1016/j.appet.2024.107212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 01/21/2024]
Abstract
To explore gender differences in food insecurity (FI) and minimum dietary diversity (MDD) among adolescent girls and boys in a slum community in Karachi, we employed an explanatory sequential mixed methods study that included a survey of 391 girls and boys of 10-19 years of age and followed by semi-structured interviews of eight purposely selected food insecure adolescents. Survey data was analyzed by Cox proportional algorithm and adjusted prevalence ratios (APR) with 95% confidence intervals (CI) were estimated for associated factors of FI and thematic analysis was undertaken for qualitative work. Meta inferences for mixed methods study were drawn by joint display analysis of survey results juxtaposed to qualitative findings. Overall, FI among adolescents was prevalent (46.5%) which was not different between boys (52.7%) and girls (47.3%) (APR 0.8, (95% CI 0.6, 1.2); p-value-0.4). MDD (5/10 food groups consumed) was achieved by only 23.0% and it was also not different between boys (25.1%) and girls (20.9%) (p-value-0.3). The survey found no significant difference in FI and MDD between boys and girls however, qualitative findings provided insight into the cultural practices at mealtimes that prefer boys. Qualitative results contrasted the survey results and revealed the increased vulnerability of girls towards FI and low MDD compared to boys due to gender norms.
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Affiliation(s)
- Sana Sheikh
- Department of Obstetrics and Gyanecology, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Rubina Barolia
- School of Nursing and Midwifery, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Atif Habib
- Department of Peadiatrics and Child Health, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Rahat Qureshi
- Department of Obstetrics and Gyanecology, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, Pakistan.
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Gebremichael MA, Lema TB. Effect of behavior change communication through the health development army on birth weight of newborns in Ambo district, Ethiopia: a cluster randomized controlled community trial. BMC Womens Health 2024; 24:200. [PMID: 38532388 PMCID: PMC10964566 DOI: 10.1186/s12905-024-03009-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Poor behavior change communication on maternal nutrition and health throughout pregnancy is thought to be to blame for Ethiopia's high rate of low birthweight babies, and this has implications for neonatal morbidity and mortality. The effect of behavior change communication on birth weight in the study district was not examined. This study was to determine whether improving neonatal birthweight using nutrition and health behavior change communication (NHBCC) interventions was successful. METHODS A cluster randomized controlled trial was conducted in the Ambo district of Ethiopia from May 5, 2018-January 30, 2019. At the beginning of the study, 385 women in the 24 intervention groups and 385 women in the 24 control groups were recruited. In the intervention group, health development armies delivered the NHBCC core message every two weeks for four months by grouping pregnant women in specific clusters. Pregnant women in the control group received the routine treatment offered by the healthcare system during their ANC visits. Within 24 h of birth, the birthweights of 302 and 292 neonates in the intervention and control groups, respectively, were measured at the end point of the study. A binary generalized linear model analysis was employed. RESULT The control group had a larger absolute risk of neonates with low birthweight (0.188 vs. 0.079, p < 0.001) than the intervention group. Pregnant women in the intervention group had an absolute risk difference of 10.9% for low birthweight. Pregnant women who received the intervention were 62% less likely to have low-risk birthweight compared to pregnant women who were in the control group (ARR = 0.381, 95% CI: 0.271-0.737). CONCLUSION Nutrition and health behavior change Communication by health development armies improves birthweight. The findings demonstrated that to improve birthweight, NHBCC must be administered to pregnant women in groups via health development armies in their communities. TRIAL REGISTRATION NUMBER PACTR201805003366358.
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Affiliation(s)
- Mitsiwat Abebe Gebremichael
- Department of Public Health, College of Health Sciences and Referral Hospital, Ambo University, Ambo, Ethiopia.
- Ambo University, P. O. Box 19, Ambo, Ethiopia.
| | - Tefera Belachew Lema
- Department of Nutrition and Dietetics, Faculty of Public health, Jimma University, Jimma, Ethiopia
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Kohanmoo A, Hashemzadeh M, Teymouri M, Zare M, Akhlaghi M. Food insecurity is associated with low diet quality and unhealthy cooking and eating habits in Iranian women. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:42. [PMID: 38486251 PMCID: PMC10941397 DOI: 10.1186/s41043-024-00533-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/02/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Food insecurity affects diet and nutrition intakes. We explored the relationship between food insecurity and dietary intakes in a group of Iranian women. METHODS The cross-sectional study was performed on 190 healthy females aged 20-55 years attending primary healthcare centers in Shiraz. Food insecurity was evaluated by Household Food Insecurity Access Scale, which is a validated tool for assessing food insecurity in developing countries. Diet was assessed using a food frequency questionnaire. The association of dietary patterns and food insecurity was assessed by linear regression. RESULTS Assessment of dietary intakes revealed that consumption of red meat, poultry, fish, dairy, fruits, non-starchy vegetables, and nuts decreased whereas that of grains, processed meats, potato, and sugary foods increased with increasing food insecurity. Among nutrients, carbohydrates, fiber, vitamin A, vitamin C, folic acid, potassium, calcium, and magnesium decreased while fat and sodium increased as food insecurity increased. Three major dietary patterns were detected. Healthy dietary patterns showed inverse associations with food insecurity in the crude (β = -0.422 and - 0.435, P < 0.001) and adjusted (adjusted for age, marital status, and educational level) (β = -0.475 and - 0.341, P < 0.001) models of regression analysis but unhealthy pattern did not show an association with food insecurity. Compared to food secure participants, a higher percentage of food insecure individuals indicated unhealthy eating habits, such as skipping breakfast, lower snack ingestion, more fast and fried food consumption, and using unhealthy cooking methods. CONCLUSION Overall, this study showed that food insecurity was associated with less healthy diet and unhealthy cooking and eating habits.
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Affiliation(s)
- Ali Kohanmoo
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maral Hashemzadeh
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Teymouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Morteza Zare
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Mulat E, Tamiru D, Abate KH. Impact of indoor Air Pollution on the Linear growth of children in Jimma, Ethiopia. BMC Public Health 2024; 24:488. [PMID: 38365615 PMCID: PMC10870508 DOI: 10.1186/s12889-024-17975-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/03/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Stunting in children is the term for reduced linear growth and development, which is frequently brought on by a persistently inadequate diet, recurrent infections and chronic diseases or poor health conditions. Apart from the classic covariates of stunting, which include diet and illness, the relative contribution of household air pollution to chronic nutrition conditions is least studied. Hence, this study is conducted to investigate the impact of household air pollution on the linear growth of under-five children in Jimma town, Ethiopia. METHODS A prospective cohort study was employed to collect data from 280 under-five children who lived in households using solid fuel (exposed group, n = 140) and clean fuel (unexposed group, n = 140). Height-for-age Z scores were compared in both groups over a 12-month follow-up period. The difference in differences estimators were used for comparison of changes in the height-for-age Z scores from baseline to end line in exposed and non-exposed groups. The independent effect of the use of solid fuels on height-for-age Z scores was analyzed through a multivariable linear regression model. Statistical Significances were declared at P < 0.05 and 95% CI level. RESULTS In an unadjusted model (Model 1), compared with the clean fuel type, the mean difference in the height-for-age Z score of children in households using solid fuel was lower by 0.54 (-0.54, 95% CI -0.97, -0.12, P = 0.011). The beta coefficient remained negative after adjusting for age and sex (Model 2 -0.543, 95% CI -1.373, -0.563) and sociodemographic variables (Model 3: -0.543, 95% CI -1.362, -0.575). In the final model (Model 4), which adjusted for wealth quantile, dietary practice, water, sanitation and hygiene status and household food insecurity access scale, the beta coefficient held the same and significant (beta: -0.543, 95% CI -1.357, -0.579, P < 0.001). Higher HAZ scores were observed among female child (β: = 0.48, 95%CI: 0.28, 0.69), Child with father attended higher education (β: = 0.304 95%CI: 0.304, 95% CI 0.19, 0.41) as compared to male gender and those who did not attend a formal education, respectively. In contrast, child living in households with poor hygiene practices had lower HAZ score (β: -0.226, 95% CI: -0.449, -0.003), P < 0.001. CONCLUSIONS Exposure to indoor air pollution was inversely related to linear growth. Furthermore, sex, educational status and hygiene were found relevant predictors of linear growth. In such a setting, there is a need to step up efforts to design and implement public education campaigns regarding the health risks associated with exposure to household air pollution. Promoting improvements to kitchen ventilation and the use of improved cooking stoves, which will help to mitigate the detrimental effects of indoor air pollution on child growth impairment and its long-term effects.
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Affiliation(s)
- Elias Mulat
- Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Food and Nutrition Research Institute, Jimma University, Jimma, Ethiopia
| | - Kalkidan Hassen Abate
- Department of Nutrition and Dietetics, Food and Nutrition Research Institute, Jimma University, Jimma, Ethiopia
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Kera AM, Zewdie Zenebe A, Melkamu Kitila K, Befkadu Tola Z, Bekana T. Factors associated with inadequate dietary diversity among adolescent girls in Hurumu Woreda High School, Oromia Region, Southwest Ethiopia. Front Nutr 2024; 11:1234224. [PMID: 38406186 PMCID: PMC10884121 DOI: 10.3389/fnut.2024.1234224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
Background Inadequate diet among adolescent girls leads to anatomical and physiological disturbances which will contribute to the vicious intergenerational cycle of malnutrition. However, only a few studies are available in Ethiopia on dietary diversity among adolescent girls who are attending school. Objective The objective of this study is to assess factors associated with inadequate dietary diversity among high school adolescent girls in Hurumu Woreda, Southwest Ethiopia, 2022. Methods An institution-based cross-sectional study was conducted among 374 high school adolescent girls from 3 May 2022 to 12 June 2022 and selected by using simple random sampling techniques. Data were collected through face-to-face interviews using structured questionnaires. Epi-data version 4.6.0 was used to enter the data, which were then exported to SPSS version 26 for analysis. Simple binary and multivariable logistic regressions were performed to identify factors associated with inadequate dietary diversity. Results In this study, the magnitude of inadequate dietary diversity among adolescent girls was 62.6% [95% CI: 57.5-66.5]. Living with more than five family members (AOR = 1.8, 95% CI: 1.16-3.44), consumption of sweet foods/beverages (AOR = 2.2, 95% CI: 1.07-3.41), poor nutritional knowledge (AOR = 2.5, 95% CI: 1.48-3.89), and poor household wealth tercile (AOR = 2.8, 95% CI: 1.44-5.12) were significantly associated with inadequate dietary diversity. Conclusion Living with more than five family members, poor household wealth status, consumption of sweet foods/beverages, family size, and poor nutritional knowledge were factors significantly associated with inadequate dietary diversity. Hence, nutrition education, the use of family planning methods, and securing income-generating activities should be implemented.
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Affiliation(s)
- Abeza Mitiku Kera
- Department of Public Health, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Asrat Zewdie Zenebe
- Department of Public Health, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Keno Melkamu Kitila
- Department of Public Health, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Zewudu Befkadu Tola
- Department of Biomedical Science, College of Health Science, Mattu University, Mattu, Ethiopia
| | - Teshome Bekana
- Department of Medical Laboratory Science, College of Health Science, Mattu University, Mattu, Ethiopia
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Tesfaye A, Gerbaba M, Tamiru D, Belachew T. Inadequate dietary diversity practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia: a community-based cross-sectional study. Sci Rep 2024; 14:2871. [PMID: 38311634 PMCID: PMC10838914 DOI: 10.1038/s41598-024-53467-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 01/31/2024] [Indexed: 02/06/2024] Open
Abstract
The aftermath of dietary modifications made during pregnancy has the most substantial effects on nutritional status and birth results, despite the important influence of nutritional reserves. Numerous studies have been conducted on dietary practices and their determinants among pregnant women; however, there is a gap in evidence among pregnant adolescents. Therefore, this study sought to close this gap by examining dietary practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia. This community-based cross-sectional study was conducted among 459 pregnant adolescents between February and March 2023. Cluster sampling was used for selecting pregnant adolescents. Structured questionnaires were used for data collection. The data were entered into the Kobo toolbox and exported to SPSS version 25 software for analysis. Dietary diversity was assessed using the 24-h dietary recall method. Binary and multivariable logistic regression analyses were used to identify independent predictors of dietary practices. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to identify the factors associated with the outcome variables. A p value ≤ 0.05 indicated statistical significance. The prevalence of inadequate dietary practices among the pregnant adolescents was 78.4% (95% CI 74.3%, 82.8%), and a level of nutritional knowledge [AOR = 2.4, 95% CI (1.82-4.74]; an unfavorable attitude toward dietary diversity [AOR = 4.3, 95% CI 2.9-5.83]; a food insecurity status [AOR = 8.7, 95% CI 2.37-10.24]; and a low perceived severity of poor dietary practices [AOR = 4.7, 95% CI 3.26-5.47]. These factors were significantly associated with inadequate dietary practices among pregnant adolescents. The most frequently consumed foods were starchy foods (81.3%) and pulses (79%), and the least consumed foods were meat (2.8%) and fruits (3.48%). The magnitude of inadequate dietary practices was high, and it was significantly associated with educational, behavioral, and economic status. Nutritional interventions focused on communicating nutritional behavioral changes and strengthening sustainable income-generating strategies are recommended to improve the dietary practices of pregnant adolescents.
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Affiliation(s)
- Adane Tesfaye
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
| | - Mulusew Gerbaba
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Gutema BT, Levecke B, Sorrie MB, Megersa ND, Zewdie TH, Yesera GE, De Henauw S, Abubakar A, Abbeddou S. Effectiveness of intermittent iron and high-dose vitamin A supplementation on cognitive development of school children in southern Ethiopia: a randomized placebo-controlled trial. Am J Clin Nutr 2024; 119:470-484. [PMID: 37952928 DOI: 10.1016/j.ajcnut.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Iron is an essential mineral whose deficiency results in cognitive alteration, impaired emotional behaviors, and altered myelination and neurotransmission. In animal models, it has been shown that vitamin A (VA) could affect cognition. OBJECTIVES The study aimed to evaluate the effectiveness of intermittent iron and VA supplementation on cognitive development of schoolchildren, and to assess the interaction between these supplementations. METHODS Considering a 2 × 2 factorial design, 504 children were randomly assigned to 1 of the 4 arms: placebo VA and placebo iron supplement; high-dose vitamin VA and placebo iron supplement; iron supplement and placebo VA; and iron and high-dose vitamin VA supplements. Cognitive development was assessed using Raven's Coloured Progressive Matrices, digit span, Tower of London, and visual search tasks. RESULTS The mean [± standard deviation (SD)] age of the enrolled children was 9.6 (±1.6) y. One-fifth of the children had iron deficiency or anemia, whereas 2.9%, 3.9%, and 12.1% of children had low iron stores, iron deficiency anemia, and VA deficiency, respectively. Intermittent iron supplementation did not result in any significant improvement of children's cognitive development and had a negative effect on the performance index of the visual search task compared with placebo (-0.17 SD, 95% confidence interval: -0.32, -0.02). Effects were evident among children with stunting, thinness, or children coming from understimulating home environments. High-dose VA supplementation resulted in a significant improvement of digit span z-score with a mean difference of 0.30 SD (95% confidence interval: 0.14, 0.46) compared with placebo VA. VA had a more beneficial impact for girls, children infected with helminths, and those from food secure households. CONCLUSION In a population where the prevalence of iron deficiency is low, intermittent iron supplementation did not have any or negative effect on the child's cognitive development outcomes. Conversely, VA supplementation improved the child's working memory. TRIAL REGISTRATION NUMBER The study is registered at clinicaltrials.gov as NCT04137354 (https://clinicaltrials.gov/study/NCT04137354).
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Affiliation(s)
- Befikadu Tariku Gutema
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Bruno Levecke
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Muluken Bekele Sorrie
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nega Degefa Megersa
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tadiwos Hailu Zewdie
- School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gesila Endashaw Yesera
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Amina Abubakar
- Kenya Medical Research Institute (KMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Beressa G, Whiting SJ, Belachew T. Effect of nutrition education integrating the health belief model and theory of planned behavior on dietary diversity of pregnant women in Southeast Ethiopia: a cluster randomized controlled trial. Nutr J 2024; 23:3. [PMID: 38166908 PMCID: PMC10763129 DOI: 10.1186/s12937-023-00907-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Maternal anemia, miscarriage, low birth weight (LBW), preterm birth (PTB), intrauterine growth restriction (IUGR), prenatal and infant mortality, morbidity, and the risk of chronic disease later in life are all increased by a lack of dietary diversity during pregnancy. However, evidence for the effect of nutrition education on the dietary diversity score (DDS) among pregnant women was sparse in Ethiopia, particularly in the study areas. This study aimed to assess the effect of nutrition education on dietary diversity among pregnant women in urban settings in Southeast Ethiopia. METHODS A community-based two-arm parallel cluster randomized controlled trial was conducted among 447 randomly selected pregnant women attending antenatal care (224 intervention group and 223 control group) at health facilities from February to December 2021. A multistage cluster sampling technique, followed by systematic sampling, was used to select the pregnant women. Pregnant women who participated in the interventions were given nutrition education starting at 16 weeks of gestation and continuing for 6 months. We used a pre-tested, interviewer-administered, structured questionnaire to collect the data. A 24-hour qualitative dietary recall was used to calculate the dietary diversity score (DDS). A multivariable generalized estimating equation (GEE) model was conducted to evaluate the intervention effect. RESULTS After the intervention, the proportion of adequate dietary diversity was 14.15% higher in the intervention arm compared to the control group (45.09% versus 30.94%, P = 0.002). The overall difference in adequate dietary diversity between the two groups was 8.5%. After adjusting for background characteristics, the multivariable GEE binary logistic model revealed that having received intervention [(AOR = 1.89, 95% CI: 1.27, 2.79)], being literate [(AOR = 3.41, 95% CI: 1.13, 10.23)], and having high wealth [(AOR = 1.60, 95% CI: 1.09, 2.35)] significantly improved adequate dietary diversity. CONCLUSION The findings indicated that having received the intervention, being literate, and having a high level of wealth significantly improved maternal dietary diversity. Efforts should be made to increase nutrition education using the health belief model (HBM) and the theory of planned behavior (TPB). Moreover, there is a need to improve literacy and economic empowerment through income-generating activities to enhance adequate dietary diversification during pregnancy. TRIAL REGISTRATION Clinicaltrials.gov (PACTR202201731802989, Retrospectively registered on 24 January 2022).
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Affiliation(s)
- Girma Beressa
- Department of Public Health, School of Health Sciences, Madda Walabu University, Goba, Ethiopia.
- Nutrition and Dietetics Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
| | - Susan J Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Tefera Belachew
- Nutrition and Dietetics Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Mekonnen FA, Biks GA, Azale T, Mengistu NW. Evaluation of effectiveness of school-based nutrition education in improving the consumption of pulses-based food among female adolescents in Northwest Ethiopia: a cluster randomized controlled trial. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:109. [PMID: 37849015 PMCID: PMC10580639 DOI: 10.1186/s41043-023-00446-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 09/22/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Protein undernutrition is a prevalent health problem in Ethiopia severely affecting the reproductive outcome of women. This is mainly because of inadequate consumption of protein due to the high cost of animal-origin food and the lack of knowledge about the benefits and the methods of preparation of pulses-based foods. Therefore, this trial was conducted to evaluate the effectiveness of nutrition education in improving the consumption of pulses-based foods among female adolescents. METHODS A two-arm pragmatic cluster randomized controlled trial was conducted among female adolescents in Northwest Ethiopia. Clusters were schools assigned into intervention and control groups by cluster randomization. The trial participants were female adolescents. The intervention was pulses-based nutrition education, and the comparator was the usual dietary practice of adolescent girls. The education was delivered over four weeks on a 45-60 min session per week basis. The primary outcome of the intervention was pulses-based food consumption, and the secondary outcomes were knowledge and attitude about pulses food. Data on the outcome and the confounding variables were collected at baseline and end-line of the intervention. The analysis was based on intention-to-treat analysis, and a log-binomial logistic regression model was fitted to the data to calculate relative risk with the corresponding p value adjusted for baseline characteristics. The intervention was considered effective when the p value was < 0.05. RESULTS A total of 269 intervention and 278 control participants from the four clusters completed the trial making response rates of 92.1% and 95.2%, respectively. The pulses-based nutrition education enabled participants in the intervention group to maintain their pulses-based food consumption state, while participants in the control group significantly reduced their consumption by about threefold [ARR; 95% CI 2.99 (1.87, 4.79)] from harvesting to non-harvesting season. The consumption of pulses-based food was higher by 16% among the intervention participants as compared to the control participants [ARD; 95% CI 0.16 (0.10, 0.21)]. CONCLUSION Pulses-based nutrition education is effective in improving the consumption of pulses-based food among female adolescents. Therefore, policies and strategies are required to integrate this intervention in the school nutrition program. TRIAL REGISTRATION The trial was registered in the Pan African Clinical Trials Registry (PACTR202111813445259) on 02 November 2021.
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Affiliation(s)
- Fantahun Ayenew Mekonnen
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie Biks
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Netsanet Worku Mengistu
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kushi EN, Belachew T, Tamiru D. The impacts of okra consumption on the nutritional status of pregnant women, west Ethiopia. Food Sci Nutr 2023; 11:5554-5564. [PMID: 37701227 PMCID: PMC10494605 DOI: 10.1002/fsn3.3512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 09/14/2023] Open
Abstract
Food-insecurity and poor-quality diets remain a challenge for pregnant women. Consumption of okra has a great impact on improving the nutritional status of pregnant women. Okra plays a critical role in the prevention of malnutrition among pregnant women living in resource-limited settings. The evidence is scarce on the impacts of okra on mid-upper arm circumference (MUAC) measurement of pregnant women. A community-based cross-sectional study was employed among randomly selected 224 pregnant women from June 1 to July 30, 2020. An interviewer-administered questionnaire was used. The MUAC was measured by using an adult MUAC measuring tape. Data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis by linear regression. The statistical significance of variables was declared at a p-value of .05, and unstandardized beta (β) coefficients along with a 95% confidence interval were computed. The proportion of pregnant women with low MUAC (≤22 cm) was 42.4%. In the multivariable linear regression model, hemoglobin concentration (β = 0.346, [95% CI: 0.153, 0.539], p = .001), food insecurity (β = -0.887, (95% CI: -1.441, -0.334), p = .002), daily consumption of okra (β = 1.269, [95% CI: 0.583, 1.956], p ≤ .001), and women working in NGO (β = 0.443, [95% CI: 0.256, 0.630], p ≤ .001) were significant variables. The prevalence of malnutrition among pregnant women (MUAC ≤ 22 cm) was 42.4%. Therefore, behavioral change communication interventions to promote okra consumption on regular basis were recommended.
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Affiliation(s)
| | - Tefera Belachew
- Departments of Nutrition and DieteticsJimma UniversityJimmaEthiopia
| | - Dessalegn Tamiru
- Departments of Nutrition and DieteticsJimma UniversityJimmaEthiopia
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12
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Kushi EN, Belachew T, Tamiru D. Antenatal care follow-up was significantly associated with a higher probability of high dietary diversity score among pregnant women in okra-producing areas of western Ethiopia: proportional odds model. Food Nutr Res 2023; 67:9608. [PMID: 37533449 PMCID: PMC10392863 DOI: 10.29219/fnr.v67.9608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 08/04/2023] Open
Abstract
Background Dietary diversity is important for pregnant women since it has been associated with nutrient adequacy. It is very crucial to ensure optimal fetal health and development. There is no evidence at the community level on the magnitude of dietary diversity and its predictors among pregnant women in okra-producing areas of western Ethiopia. Objective This study aimed to assess the level of dietary diversity and its associated factors among pregnant women. Design A community-based cross-sectional study was employed among randomly selected 224 pregnant women in western Ethiopia. An interviewer-administered questionnaire was used to collect the data. The qualitative open 24-h recall was used to assess the level of dietary diversity. Ordinal logistic regression analyses were used by SPSS version 25. An adjusted proportional odds ratio along with a 95% confidence interval [CI] was computed to measure the strengths of the association at a P ≤ 0.05. Result This study revealed that more than one-fourth, 64 (28.6%), of the respondents were found to have high dietary diversity scores. Antenatal Care [ANC] visits (Adjusted Odds Ratio [AOR] = 2.10, [95% CI: 1.13, 3.90], P = 0.01), changing food intake (AOR = 2.97, [95% CI: 1.16, 3.67], P = 0.002), and being food secure household (AOR = 2.63, [95% CI: 1.38, 5.00], P = 0.003) were significantly associated with a higher probability of having high dietary diversity score. However, lack of formal education (AOR = 0.34, [95% CI: 0.61, 0.89]) was inversely associated with the probability of having high dietary diversity. Conclusion More than half of pregnant women in western Ethiopia were found to have low dietary diversity. Therefore, ANC follow-up, dietary modification, and promotion of frequent use of wild edible plants (okra) to maintain household food security were very crucial.
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Affiliation(s)
- Efrem Negash Kushi
- Department of Public Health, College of Health and Medical Science, Mettu University, Mettu, Ethiopia
| | - Tefera Belachew
- Departments of Nutrition and Dietetics, Public Health Institute, Jimma University, Jimma, Ethiopia
| | - Dessalegn Tamiru
- Departments of Nutrition and Dietetics, Public Health Institute, Jimma University, Jimma, Ethiopia
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13
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Fite MB, Tura AK, Yadeta TA, Oljira L, Wilfong T, Mamme NY, Asefa G, Gurmu DB, Habtu W, Waka FC, Demiss NT, Woldeyohannes M, Tessema M, Alemayehu D, Hassen TA, Motuma A, Roba KT. Co-occurrence of iron, folate, and vitamin A deficiency among pregnant women in eastern Ethiopia: a community-based study. BMC Nutr 2023; 9:72. [PMID: 37353841 DOI: 10.1186/s40795-023-00724-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 06/09/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND It is well known that the magnitude of undernutrition in Ethiopia is unacceptably high. The burden of co-occurrence of iron, folate, and vitamin A deficiency, on the other hand, has received less attention. Thus, in this study, we looked at the prevalence of iron, folate, and vitamin A deficiency in pregnant women in eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among 397 pregnant women in Haramaya district, eastern Ethiopia. An interview-assisted questionnaire and blood serum were collected from pregnant women using standard techniques and shipped to an EPHI for micronutrient analysis. Factors associated with the co-occurrence of iron, folate, and vitamin A deficiency were identified using binary and multiple logistic regressions. RESULTS According to this study, 81.6% of the participants were deficient in at least one micronutrient, and 53.53.2% were deficient in two or more. Women who did not receive iron-folic acid supplementation (AOR = 2.44; 95% CI = 1.52-3.92), did not attend Antenatal care (ANC) follow up (AOR = 2.88; 95% CI = 1.81-4.61), and reported low consumption of diversified diet (AOR = 2.18 (95% CI = 1.35-3.51) had a higher risk of co-occurrence of iron, folate, and vitamin A deficiency. CONCLUSION This study found that more than half of pregnant women were in multiple micronutrients, indicating a major public health issue. In addition to the IFA supplementation programs that are already in place, there is a need for multiple micronutrient supplementation.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tara Wilfong
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Newas Yusuf Mamme
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gemechu Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Demiraw Bikila Gurmu
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wossene Habtu
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Feyissa Challa Waka
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Nahom Tefera Demiss
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Meseret Woldeyohannes
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Masresha Tessema
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dawit Alemayehu
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tahir Ahmed Hassen
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Aboma Motuma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
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14
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Wiafe MA, Ayensu J, Yeboah GB. Predictors of food variety and food consumption scores of adolescents living in a rural district in Ghana. PLoS One 2023; 18:e0286477. [PMID: 37256891 DOI: 10.1371/journal.pone.0286477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/16/2023] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION There is a dearth of information about the food variety and consumption scores of adolescents in Ghana. This study assessed predictors of food variety and consumption scores of adolescents living in a rural district in Ghana. METHOD In this cross-sectional study, a multi-stage sampling method was used to select one hundred and thirty-seven (137) adolescents from the Asante-Akim South Municipality of Ghana. A structured questionnaire was used to collect data on sociodemographic, food practices and dietary intakes of study participants. Descriptive, chi-square, T-test, partial correlation and binary logistic regression were used for the data analysis. RESULTS The mean food variety score was 25.8±6.4 (range 7-42) and food consumption score was 35±5.1 (range 18.6-49.9). Food variety score was significantly (p<0.05) associated with guardian income status. A significant and positive partial correlation existed between food variety score and calcium intake (r = 0.236, p<0.05). About 49% and 51% of adolescents were food insecure and food secure, respectively. Food consumption score had significant association (p<0.05) with gender (X2 = 6.1), residence (X2 = 7.0), frequency of meal (X2 = 6.8) and food variety score (X2 = 5.4). Adolescent male (AOR = 2.3, 95% CI (1.2-4.6), p = 0.017), peri-urban residency (AOR = 2.1, 95%CI (1.0-4.4), p = 0.036), having three or more meals per day (AOR = 4.2, 95% CI (1.3-13.6), p = 0.018), and a high food variety score (AOR = 2.1, 95%CI (1.0-4.2), p = 0.041) significantly predicted food consumption scores. CONCLUSION Moderate income status was associated with food variety score in our study participants. Linear relationship existed between food variety and calcium intake. Adolescent males, peri-urban residency, frequency of meals and high food variety score were the predictors of food consumption score. Nutrition-specific and nutrition sensitive programmes aimed at promoting adolescent health should involve guardians.
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Affiliation(s)
| | - Jessica Ayensu
- Department of Clinical Nutrition and Dietetics, University of Cape Coast, Cape Coast, Ghana
| | - Georgina Benewaa Yeboah
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
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15
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Mamme NY, Roba HS, Fite MB, Asefa G, Abrahim J, Yuya M, Wilfong T, Gurmu DB, Waka FC, Tessema M, Habtu W, Woldeyohannes M, Raru TB, Kure MA, Alemayehu D, Motuma A, Roba KT. Serum folate deficiency and associated factors among pregnant women in Haramaya District, Eastern Ethiopia: a community-based study. BMJ Open 2023; 13:e068076. [PMID: 37156586 PMCID: PMC10174039 DOI: 10.1136/bmjopen-2022-068076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
OBJECTIVES We aimed to estimate the prevalence of folate deficiency and contributing factors among pregnant women. DESIGN A community-based, cross-sectional study. SETTING Haramaya District, Eastern Ethiopia. PARTICIPANTS Four hundred and forty-six pregnant women participated in the study. PRIMARY OUTCOME MEASURE The prevalence of folate deficiency and risk factors. RESULTS Overall, the prevalence of folate deficiency was 49.3% (95% CI 44.6% to 54.1%). Pregnant women with iron deficiency anaemia were 2.94 times more likely to develop folate deficiency (adjusted OR (AOR)=2.9, 95% CI 1.9 to 4.7). Respondents with good knowledge of folate-rich foods (AOR=0.3, 95% CI 0.1 to 0.7) and those who took iron and folic acid supplementation (AOR=0.6, 95% CI 0.4 to 0.9) during their pregnancy were less likely to develop folate deficiency. CONCLUSIONS In this study, a considerable proportion of pregnant women had folate deficiency during their pregnancy. Therefore, it is critical that nutritional treatment, education and counselling be strengthened to facilitate iron and folic acid supplementation during pregnancy.
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Affiliation(s)
- Newas Yusuf Mamme
- School of Public Health, Haramaya University College of Health and Medical sciences, Harar, Ethiopia
| | - Hirbo Shore Roba
- School of Public Health, Haramaya University College of Health and Medical sciences, Harar, Ethiopia
| | - Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Gemechu Asefa
- School of Public Health, Haramaya University College of Health and Medical sciences, Harar, Ethiopia
| | - Jemal Abrahim
- School of Public Health, Haramaya University College of Health and Medical sciences, Harar, Ethiopia
| | - Mohammed Yuya
- School of Public Health, Haramaya University College of Health and Medical sciences, Harar, Ethiopia
| | - Tara Wilfong
- School of Public Health, Haramaya University College of Health and Medical sciences, Harar, Ethiopia
| | - Demiraw Bikila Gurmu
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Feyissa Challa Waka
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Masresha Tessema
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wossene Habtu
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Meseret Woldeyohannes
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Temam Beshir Raru
- School of Public Health, Haramaya University College of Health and Medical sciences, Harar, Ethiopia
| | - Mohammed Abdurke Kure
- School of Nursing and Midwifery, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Dawit Alemayehu
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Aboma Motuma
- School of Nursing and Midwifery, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
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Demilew YM, Nigussie AA, Almaw H, Sewasew B. Diet quality of preparatory school students in Awi Zone, Ethiopia: a cross-sectional study. BMJ Open 2023; 13:e067852. [PMID: 37085317 PMCID: PMC10124249 DOI: 10.1136/bmjopen-2022-067852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVE The study aimed to assess diet quality and associated factors among preparatory school students in Awi Zone, Ethiopia. DESIGN A school-based cross-sectional study design was used in this study. SETTING The study was carried out in Awi Zone, Amhara Region, Ethiopia. PARTICIPANTS A total of 834 preparatory school students participated in the study. OUTCOME MEASURES Diet quality was the outcome variable, and it was computed using the dietary diversity score, food variety score and consumption of animal-source foods. Students with high dietary diversity scores, appropriate animal-source food consumption and adequate food variety scores were labelled as having good-quality diets. Data were collected using a pretested structured self-administered questionnaire. Bivariate and multivariable logistic regressions were employed to analyse the data. Variables with p≤0.2 in the bivariate logistic regression analysis were included in the multivariable logistic regression model. Multivariable logistic regression analysis was done to determine the strength of the association. Statistical significance was determined at p value less than 0.05. RESULTS Only 24.7% (95% CI: 21.7%, 27.7%) of preparatory school students had good-quality diets. Being female (adjusted OR (AOR)=2.88, 95% CI: 2.0, 4.1), residing in an urban setting (AOR=1.90, 95% CI: 1.1, 3.2), having an educated mother (AOR=1.78, 95% CI: 1.1, 2.7), having pocket money (AOR=1.83, 95% CI: 1.2, 2.6) and nutrition information (AOR=1.90, 95% CI: 1.2, 3.1), and family monthly income >8000 Ethiopian birrs (AOR=3.90, 95% CI: 2.2, 7.1) were factors significantly associated with having good-quality diet. CONCLUSION The majority of the preparatory school students had poor-quality diets. These findings highlight the necessity of nutrition education that considers the sociodemographic characteristics of the students and their families. Implementing income-generating interventions for low-income households was also recommended by the findings.
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Affiliation(s)
| | | | - Hunegnaw Almaw
- Department of Nutrition and Dietetics, Bahir Dar University, Bahir Dar, Ethiopia
| | - Belete Sewasew
- Department of Pediatrics, Bahir Dar University, Bahir Dar, Ethiopia
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Wiafe MA, Apprey C, Annan RA. Nutrition Education Improves Knowledge of Iron and Iron-Rich Food Intake Practices among Young Adolescents: A Nonrandomized Controlled Trial. INTERNATIONAL JOURNAL OF FOOD SCIENCE 2023; 2023:1804763. [PMID: 37020950 PMCID: PMC10070029 DOI: 10.1155/2023/1804763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/16/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023]
Abstract
Introduction. Nutrition education targeting adolescents’ health has the potential to enhance their well-being into adulthood. This study assessed the impact of nutrition education on the knowledge of iron and iron-rich food intake practices of adolescents living in rural communities in Ghana. Method. An intervention study was conducted among 137 adolescents; 69 were assigned to the intervention group and 68 to the control group. Participants and guardians in the intervention group were involved in the nutrition education programme for six months. Participants in both groups completed sociodemographic, knowledge of iron, and iron-rich food intake practice questionnaires at pre- and postintervention. Data were analyzed by chi-square and
-tests. Results. At postintervention, the mean knowledge score (
) in the intervention group and control group was
and
, respectively. Interventions (76%) and controls (46%) had good knowledge status. The mean knowledge score of participants with good knowledge status in the intervention group was
(
), and the control group was
(
). Forty-two percent of participants in the interventions and 26% in the controls had good food intake status. Participants with good food intake status had mean food intake scores of
(
) and
(
) for the intervention and control groups, respectively. Both groups increased and had the same mean food intake score (
,
), however, relatively higher in the intervention group. Conclusion. Nutrition education improved the knowledge of iron and iron-rich food intake practices of participants in the intervention group compared to the control group. Nutrition education should be a critical component in the management and prevention of micronutrient deficiency in adolescents.
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Berhanu G, Dessalegn B, Ali H, Animut K. Determinants of nutritional status among primary school students in Dilla Town; Application of an ordinal logistic regression model. Heliyon 2023; 9:e13928. [PMID: 36895335 PMCID: PMC9988510 DOI: 10.1016/j.heliyon.2023.e13928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
Background One of the most frequent reasons for children's poor physical and mental development is malnutrition, becoming a more significant issue in most developing nations, including Ethiopia. Prior research used multiple anthropometric measurements separately to pinpoint undernutrition concerns in children. However, the impact of each explanatory variable on a single response category was not considered in these investigations. This study used a single composite index of anthropometric parameters to identify the factors affecting elementary school students' nutritional condition. Methods In Dilla, Ethiopia, 494 primary school students took part in a cross-sectional institutional survey during the 2021 academic year. Principal component analysis was used to create a single composite measure of nutritional status using z-scores for the anthropometric indices of height-for-age and body mass index-for-age. The relative effectiveness of a partial proportional odds model was compared with several other ordinal regression models to identify the important variables for children's nutritional status. Results 27.94% of primary school students were undernourished (7.29% severely and 20.65% moderately). According to the fitted partial proportional odds model, the mother's education level (secondary or higher) was positively correlated with the nutritional status of primary school students, given that in this case the students ate three or more times per day and had a high dietary diversity score (OR = 5.94; CI: 2.2-16.0). Nevertheless, there was a negative correlation between larger family size (OR = 0.56; CI: 0.32-0.97), unprotected groundwater (OR = 0.76; CI: 0.6-0.96), and severely food insecure households (OR = 0.3; CI: 0.14-0.68). Conclusion In Dilla, Ethiopia, undernutrition among primary school students is a serious issue. It is essential to implement nutrition education and school feeding programs, improve drinking water sources, and boost the community's economy to alleviate the problems.
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Affiliation(s)
- Getasew Berhanu
- Department of Statistics, College of Natural and Computational Science, Dilla University, Dilla, Ethiopia
- Corresponding author.
| | - Behailu Dessalegn
- Department of Statistics, College of Natural and Computational Science, Dilla University, Dilla, Ethiopia
| | - Helen Ali
- Department of Public Health Nutrition, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Kassahun Animut
- Department of Statistics, College of Natural and Computational Science, Dilla University, Dilla, Ethiopia
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Yazew T, Daba A, Hordofa L, Garedew G, Negash A, Merga G, Bakala T. Covid-19 related factors to food security and dietary diversity among urban households in western Oromia, Ethiopia. Heliyon 2023; 9:e14476. [PMID: 36942244 PMCID: PMC10008806 DOI: 10.1016/j.heliyon.2023.e14476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
Background This study aims to assess factors associated with food security and dietary diversity among poor urban households of western Oromia, Ethiopia, after the outbreak of the Covid-19 pandemic. Method A cross-sectional, community-based study was conducted in May to June 2021 with 361 poor urban households in the Horo Guduru Wollega zone, western Oromia, Ethiopia. A pre-tested structured questionnaire was used to collect primary data. Twenty-four hour reminder points were used to assess household dietary diversity, and household food security was assessed using the Household Food Insecurity Access Scale tool. Data were evaluated using the statistical software SPSS version 25.0. Results This study showed a prevalence of food insecurity in households of 59.6%. The mean and standard deviation of household dietary diversity values were 4.19 ± 1.844. Family size (AOR = 8.5; 95% CI:3.295-21.92), monthly income (AOR = 3.52; 95% CI; 1.771-6.986), dietary diversity (AOR = 8.5; 95% CI; 3.92-18.59), knowledge (AOR = 3.0, 95% CI = 1.08-)8.347), attitude (AOR = 8.35, 95% CI:3.112-22.39) and practices against Covid-19 (AOR = 2.12; 95% CI:1.299-11.4) were factors significantly associated with food insecurity. Variables like educational status (AOR = 3.46; 95% CI:1.44-8.312), increased family size after the Covid-19 pandemic (AOR = 2.26; 95% CI:1.02-5.04), food security (AOR = 6.7; 95% CI:4.01-19.01), knowledge (AOR = 3.96; 95% CI:1.57-10.0), attitude (AOR = 3.9; 95% CI:1.75-8.82) and practices toward coronavirus (AOR = 2.23; 95% CI:2.18-23.95) were predictors significantly associated with dietary diversity. Conclusion This study concluded that family size, monthly income, and dietary diversity were factors contributed to household food security. On the other hand, variables such as educational status, family size, and food security were highly relevant factors for dietary diversity after the outbreak of the Covid-19 pandemic. Knowledge, attitudes, and practices were also variables related to both household food security and dietary diversity. Therefore, immediate interventions such as nutrition-specific interventions can be suggested to address food insecurity and problems of inadequate food intake in poor urban households. In addition, governmental and non-governmental organizations should raise awareness and policies to support those at higher risk by developing affordable, sustainable and targeted social protection systems that ensure food security and adequate dietary intake at the household level.
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Key Words
- AOR, Adjusted Odd Ratio
- Associated factors
- CI, Confidence Level
- COR, Crude Odd Ratio
- Covid-19
- Dietary diversity
- EU, European Union
- Ethiopia
- Food security
- HFIAS, Household Food Insecurity Access Scale
- NPC, National Planning Commission
- SPSS, Statistical Package for Social Sciences
- UN, United Nations
- USD, United states Dollar
- USDA, United States Department of Agriculture
- Urban
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Affiliation(s)
- Tamiru Yazew
- Department of Public Health, College of Health Sciences, Salale University, Fitche, 245, Ethiopia
- Corresponding author.
| | - Agama Daba
- Department of Food and Nutritional Sciences, Faculty of Agriculture, Wollega University, Nekemte, 395, Ethiopia
| | - Lelisa Hordofa
- Department of Natural Resource Management, Faculty of Resource Management and Economics, Wollega University, Nekemte, 395, Ethiopia
| | - Girma Garedew
- Department of Public Health, College of Health Sciences, Salale University, Fitche, 245, Ethiopia
| | - Abdi Negash
- Department of Medical Laboratory Sciences, College of Health Sciences, Salale University, Fitche, 245, Ethiopia
| | - Gizachew Merga
- Department of Horticulture, College of Agriculture and Natural Resources, Salale University, Fitche, 245, Ethiopia
| | - Tasama Bakala
- Department of Food and Nutritional Sciences, Faculty of Agriculture, Wollega University, Nekemte, 395, Ethiopia
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Mohammed B, Belachew T, Kedir S, Abate KH. Effect of school feeding program on body mass index of primary school adolescents in Addis Ababa, Ethiopia: A prospective cohort study. Front Nutr 2023; 9:1026436. [PMID: 36698481 PMCID: PMC9868593 DOI: 10.3389/fnut.2022.1026436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Background Governments and developmental organizations are encouraged to devote adequate resources to the establishment of free school meals to low-income children in developing countries. In Ethiopia, the school feeding program (SFP) is implemented in a few regions including the capital, Addis Ababa. However, the nutritional benefit of the program was not monitored and reported thus far. In this study, we evaluated the effect of the SFP on the body mass index (BMI) of primary school adolescents in Addis Ababa, Central Ethiopia. Method A prospective cohort study was employed to collect data from 644 SFP-beneficiary adolescents (n = 322) and non-SFP (n = 322). Nutritional outcomes were measured following 6 months of follow-up. WHO Anthroplus were used to convert anthropometric data into body-mass-index-for-age Z scores. The independent effect of school feeding is analyzed through a multivariable linear regression model. Result In linear regression, unadjusted model (Model 1), compared with the non-school-fed adolescents, the mean difference in difference of BAZ-score of school-fed adolescent was higher by 0.36 (β 0.36, 95% CI 0.17, 0.55). The beta coefficient remained positive after adjusted for age and sex (Model 2: β 0.35, 95% CI 0.16, 0.54) and sociodemographic variable (Model 3: β 0.35, 95% CI 0.16, 0.54). In the final model, adjusted for model four, lifestyle and health status there was a significant difference in favor of school-fed adolescents on BAZ-score indices (Model 4: β 0.4, 95% CI 0.18-0.62). On the contrary, for a unit increase in family size, the BAZ score will decrease by 0.06 (β 0.06, 95% CI -0.12--0.01). Similarly, adolescents with a middle tertile wealth index decreased their BAZ score by 0.30 (β 0.30, 95% CI -0.55--0.05) as compared to the higher tertile wealth index. Conclusion School feeding was positively associated with a change in BAZ score whereas family size and middle tertile wealth index were negatively associated. This implies that school feeding can serve as an optimal strategy for addressing the nutrition needs of adolescents.
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Affiliation(s)
- Bekri Mohammed
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Nutrition and Dietetics, Food and Nutrition Research Institute, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Food and Nutrition Research Institute, Jimma University, Jimma, Ethiopia
| | - Shemsu Kedir
- Department of Public Health, College of Medicine and Health Science, Werabe University, Werabe, Ethiopia
| | - Kalkidan Hassen Abate
- Department of Nutrition and Dietetics, Food and Nutrition Research Institute, Jimma University, Jimma, Ethiopia
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Factors associated with undernutrition among pregnant women in Haramaya district, Eastern Ethiopia: A community-based study. PLoS One 2023; 18:e0282641. [PMID: 36893154 PMCID: PMC9997975 DOI: 10.1371/journal.pone.0282641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 02/20/2023] [Indexed: 03/10/2023] Open
Abstract
INTRODUCTION Although undernutrition in pregnancy has continued to get global attention as pregnancy is considered a critical period in the life cycle owed to increase the metabolic and physiological demands, evidence is scarce on undernutrition and associated factors among pregnant women in eastern Ethiopia. Therefore, this study assessed the undernutrition and associated factors among pregnant women in Haramaya district, Eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. Data were collected through face-to-face interviews, anthropometric measurement, and hemoglobin analysis by trained research assistants. An adjusted Prevalence ratio (aPR), and a 95% confidence interval (CI), were used to report associations. Poisson regression analysis model with a robust variance estimate identified variables associated with undernutrition. Data were double entered using Epi-data 3.1 and cleaned, coded, checked for missing and outliers, and analyzed using Stata 14 (College Station, Texas 77845 USA. Finally, the p-value <0.05 was the cut-off point for the significant association. RESULTS A total of 448 pregnant women with a mean age of 25.68 (± 5.16) were included in the study. The prevalence of undernutrition among pregnant women was 47.9% (95% CI: 43%-53%). From the analysis, the undernutrition was more likely higher among respondents who had five or more family members (APR = 1.19; 95% CI = 1.02-1.40), lower dietary diversity (APR = 1.58; 95% CI = 1.13-2.21) and those who were anemic (APR = 4.27; 95% CI = 3.17-5.76). CONCLUSION Nearly half of the pregnant women in study area were undernourished. High prevalence was found among women who had large family sizes, low dietary diversity and anemia during pregnancy. Improving dietary diversity, strengthening family planning services and giving special attention to pregnant women, supplementation of iron and folic acid, and early detection and treatment of anemia is essential to improve the high burden of undernutrition and the adverse effect on pregnant women and the fetus.
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Engidaye G, Aynalem M, Adane T, Gelaw Y, Yalew A, Enawgaw B. Undernutrition and its associated factors among children aged 6 to 59 months in Menz Gera Midir district, Northeast Ethiopia: A community-based cross-sectional study. PLoS One 2022; 17:e0278756. [PMID: 36473009 PMCID: PMC9725165 DOI: 10.1371/journal.pone.0278756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Undernutrition can lead to impaired physical growth, restricted intellectual skills, low school performance, reduced working capacity, and rooted disability in adult life. Thus, this study was designed to assess the prevalence and associated factors of undernutrition among children aged 6 to 59 months. METHODS A community-based cross-sectional study was conducted among 432 children aged 6 to 59 months in the Menz Gera Midir District. A multi-stage sampling technique was applied to recruit the study participants. Socio-demographic and socio-economic variables were collected by using structured questionnaires. Anthropometric measurements of the children were measured according to the World Health Organization's recommendation. A data collection sheet was used to collect information on the types of foods and number of meals consumed by the child. A bivariable and multivariable logistic regression was performed to identify factors associated with undernutrition. RESULT In this study, about 11.3% (95% CI: 8.3-14.3%), 50.2% (95% CI: 45.5-55.0%), and 28% (95% CI: 23.8-32.3%) were wasted, stunted, and underweight, respectively. Children aged 12-23 months (AOR: 1.97; 95% CI: 1.01-3.87), 36-47 months (AOR: 2.05; 95% CI: 1.00-4.19), and being anemic (AOR: 2.92; 95% CI: 1.73-4.92) were found to be an independent predictor of stunting. Moreover, being anemic was found to be significantly associated with wasting (AOR: 6.84; 95% CI: 3.16-14.82). CONCLUSION According to the findings of this study, undernutrition was a serious public health issue among 6-59 month old children in the Menz Gera Midir District. Children's age and anemia status were significantly associated with stunting and wasting. Therefore, community-based nutrition programs are vital to reduce childhood undernutrition.
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Affiliation(s)
- Getabalew Engidaye
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Melak Aynalem
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Tiruneh Adane
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yemataw Gelaw
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Aregawi Yalew
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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McKune SL, Mechlowitz K, Miller LC. Dietary animal source food across the lifespan in LMIC. GLOBAL FOOD SECURITY 2022. [DOI: 10.1016/j.gfs.2022.100656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ayal BG, Demilew YM, Derseh HA, Kidie AA. Micronutrient intake and associated factors among school adolescent girls in Meshenti Town, Bahir Dar City Administration, Northwest Ethiopia, 2020. PLoS One 2022; 17:e0277263. [PMID: 36445906 PMCID: PMC9707767 DOI: 10.1371/journal.pone.0277263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 10/25/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Adolescent girls have a greater nutrient demand and their poor dietary intake is associated with micronutrient deficiencies and poor maternal outcomes. Having information on micronutrient intake inadequacy in adolescent girls is critical for promoting healthy behavior and breaking the cycle of intergenerational malnutrition. Thus, this study assessed overall micronutrient intake inadequacy and associated factors among school adolescent girls in Meshenti town of Bahir Dar City Administration, North West Ethiopia. METHODS A school-based cross-sectional study was conducted among 401 adolescent girls from February 7 to 23, 2020. A Simple random sampling technique was used to select study participants. A multiple-pass 24-hour dietary recall with portion size estimation method and recommended dietary allowance cut-off point were used to assess micronutrient intake inadequacy. Overall micronutrient intake inadequacy was measured using the mean adequacy ratio. Nutrient databases were developed by ESHA FOOD PROCESSOR version 8.1 software. Data were entered into Epi-data version 3.1 and exported to SPSS version 23 for analysis. Multivariable logistic regression was performed to identify determinants of overall micronutrient intake inadequacy and an adjusted odds ratio at a p-value of less than 0.05 was used to see the strength of statistical association. RESULTS The prevalence of overall micronutrient intake inadequacy was 44.4% (95% CI: 39.7%-49.6%). Early adolescent age (AOR: 2.75, 95% CI: 1.71-4.42), food-insecure household (1.74, 95%CI: 1.087-2.784), low dietary diversity score (AOR = 2.83, 95% CI: 1.35-5.92), and high peer pressure on eating and body concern (AOR = 1.853, 95% CI: 1.201-2.857) were significantly associated factors with overall micronutrient intake inadequacy. CONCLUSION Findings of this study revealed that micronutrient intake inadequacy among adolescent girls was a high public health problem in the study area. Therefore, attention should be given to adolescent girls of the study area, especially the ones in the early adolescent age. Interventions should also focus on nutrition-sensitive activities to address food insecurity, a less diversified diet, and the negative impact of peer influence.
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Affiliation(s)
- Birtukan Gizachew Ayal
- School of public health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
- * E-mail:
| | - Yeshalem Mulugeta Demilew
- Department of Nutrition and Dietetics, School of public health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Hunegnaw Almaw Derseh
- Department of Nutrition and Dietetics, School of public health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Atitegeb Abera Kidie
- School of public health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
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Fite MB, Bikila D, Habtu W, Tura AK, Yadeta TA, Oljira L, Roba KT. Beyond hemoglobin: uncovering iron deficiency and iron deficiency anemia using serum ferritin concentration among pregnant women in eastern Ethiopia: a community-based study. BMC Nutr 2022; 8:82. [PMID: 35978383 PMCID: PMC9382738 DOI: 10.1186/s40795-022-00579-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the high burden of anemia among pregnant women in low-resource settings like Ethiopia is well documented, evidence is scarce on the underlying causes using biochemical tests. Therefore, this study assessed the iron status and factors associated with iron deficiency (ID) using serum ferritin concentration among pregnant women in Haramaya district, eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. The serum ferritin (SF) concentration was measured in the National Biochemical Laboratory of Ethiopia on a fully automated Cobas e411 (German, Japan Cobas 4000 analyzer series) immunoassay analyzer using the electro-chemiluminescence (ECL) method and standard procedures. A log-binomial regression analysis identified variables associated with iron deficiency, and defined as serum ferritin concentration < 15 μg/L (per the World Health Organization recommendation in developing countries). An adjusted risk ratio (aRR), and a 95% confidence interval (CI), were used to report associations. Finally, the p-value < 0.05 was the cut-off point for the significant association. RESULTS A total of 446 pregnant women with a mean age of 24.78 (+ 5.20) were included in the study. A total of 236 (52.91%; 95% CI: 48.16-57.63) had iron deficiency. The overall prevalence of anemia and iron deficiency anemia (IDA) was 45.96% (95% CI: 41.32-50.71) and 28.03% (95% CI: 21.27-32.44), respectively. The risk of iron deficiency was more likely among women with low dietary diversity (aRR = 1.36; 95% CI = 1.07-1.72) and those who skipped meals (aRR = 1.29; 95% CI = 1.05-1.57), but less among women who had antenatal care (aRR = 0.73 (95% CI = 0.61-0.88). CONCLUSION More than half of the pregnant women in eastern Ethiopia had iron deficiency. Improving dietary diversity, meal frequency, and prenatal follow-up is essential to improve the high burden of ID and the adverse effect on pregnant women and the fetus. Moreover, a prospective study comparing maternal and perinatal outcomes among these spectra-iron depletion, ID, and IDA-is crucial for understanding their impact on maternal and perinatal mortality and morbidity.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Demiraw Bikila
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wossene Habtu
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Prevalence, predictors of low birth weight and its association with maternal iron status using serum ferritin concentration in rural Eastern Ethiopia: a prospective cohort study. BMC Nutr 2022; 8:70. [PMID: 35883202 PMCID: PMC9327330 DOI: 10.1186/s40795-022-00561-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Low birth weight (LBW) is one of the major predictors of perinatal survival, infant morbidity, and mortality, as well as the risk of developmental disabilities and illnesses in future lives. The effect of the nutritional status of pregnant women on birth outcomes is becoming a common research agenda, but evidence on the level of low birth weight (LBW) and its association with prenatal iron status in Ethiopia, particularly among rural residents, is limited. Thus, this study aimed to assess the prevalence, predictors of LBW, and its association with maternal iron status using serum ferritin concentration in Haramaya district, eastern Ethiopia, 2021. Methods A community-based prospective cohort study design was conducted. Of a total of 427 eligible pregnant women followed until birth, 412 (96.48%) were included in the final analysis. Iron status was determined using serum ferritin (SF) concentration from venous blood collected aseptically from the ante-cubital veins analyzed on a fully automated Cobas e411 (German, Japan Cobas 4000 analyzer series) immunoassay analyzer. Iron deficiency(ID) and iron deficiency anemia (IDA) were classified as having SF less than 15 μg/L and SF less than 15 μg/L and Hb level of < 11.0 g/dl during the first or third trimester or < 10.5 g/dl during the second trimester as well, respectively. Birthweight was measured within 72 h of birth and < 2500 g was considered LBW. Birthweight was measured within 72 h of birth and < 2500 g was considered as LBW. A Poisson regression model with robust variance estimation was used to investigate the factors associated with LBW and the association between maternal iron status and LBW. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p-value < 0.05. Results About 20.2% (95% CI: 16%-24%) of neonates were born with LBW. The prevalence of LBW was 5.04 (95% CI = 2.78–9.14) times higher among women who were iron deficient during pregnancy compared to those who were normal. The neonates of women who were iron deficient during pregnancy had lower birth weight (aPR=5.04; 95% CI = 2.78–9.14) than the neonates of women who were normal. Prevalence of LBW was higher among mothers who were undernourished (MUAC < 23cm) (aPR = 1.92; 95% CI= 1.33–2.27), stunted (height <145cm) (aPR=1.54; 95% CI=1.04–2.27) and among female neonates (aPR=3.70; 95% CI= 2.28–6.00). However, women who were supplemented with iron and folic acid (IFAS) during pregnancy had a 45% decreased chance of delivering low birth weight (aPR= 0.55; 95% CI=0.36–0.84). Conclusion We found that LBW is of public health significance in this predominantly rural setting. ID during pregnancy is found to have a negative effect on birth weight. IFA supplementation, the maternal under-nutrition, height, and sex of neonates were identified as predictors of low weight at birth. To improve maternal nutritional status, health interventions must address targeted strategies promoting desirable food behavior and nutritional practices. These include; promoting the consumption of diversified and rich iron food to improve the maternal nutritional status. A continued effort is needed in enhancing universal access and compliance with IFA supplementation to improve maternal health. Intervention strategies that are complementary and comprehensive across the vulnerable periods for women during pregnancy and their neonates that are based on a life-cycle approach are suggested.
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Tsegaye D, Tamiru D, Belachew T. Theory-based nutrition education intervention through male involvement improves the dietary diversity practice and nutritional status of pregnant women in rural Illu Aba Bor Zone, Southwest Ethiopia: A quasi-experimental study. MATERNAL & CHILD NUTRITION 2022; 18:e13350. [PMID: 35315583 PMCID: PMC9218320 DOI: 10.1111/mcn.13350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/02/2022] [Accepted: 02/24/2022] [Indexed: 06/14/2023]
Abstract
Maternal undernutrition is a major public health problem that disproportionately affects women in low-income countries. Despite attempts to address maternal nutritional needs, Ethiopia still has a high rate of undernutrition. Hence, this study aimed to evaluate the effect of theory-based nutrition education through male engagement on dietary practice and the nutritional status of pregnant women. A pretest-posttest quasi-experimental study was conducted among 403 pregnant women selected from 22 kebeles of Illu Aba Bor zone, Southwest Ethiopia from July to December 2019. A pre-tested, structured interviewer-administered questionnaire was used for data collection. A qualitative 24-h dietary recall was used to assess dietary diversity, and the Mid-Upper Arm Circumference was used to assess nutritional status. The intervention effect was evaluated using difference-in-difference, generalized estimating equation, and linear mixed-effects models. The mean dietary diversity score differed significantly between the couple group, women-alone and the control group (p < 0.001). According to the multivariable generalized estimating equations model, couples were 3.9 times; adjusted odds ratio (AOR) = 3.91, 95% CI: (2.57, 6.88) and women alone were 2.8 times; AOR = 2.86, 95% CI: (2.17, 3.88) more likely to consume a diverse diet than the control group. The nutritional status of the women in the couple group improved significantly by the end of the intervention (p < 0.001). This study showed that involving males in nutrition education intervention was effective in improving the dietary diversity practice and nutritional status of pregnant women. The findings imply the need for targeting couples in designing nutrition education interventions.
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Affiliation(s)
- Dereje Tsegaye
- Department of Nutrition and Dietetics, Institute of HealthJimma UniversityJimmaEthiopia
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Institute of HealthJimma UniversityJimmaEthiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Institute of HealthJimma UniversityJimmaEthiopia
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Kedir S, Hassen K, Melaku Y, Jemal M. Determinants of overweight and/or obesity among school adolescents in Butajira Town, Southern Ethiopia. A case-control study. PLoS One 2022; 17:e0270628. [PMID: 35763506 PMCID: PMC9239474 DOI: 10.1371/journal.pone.0270628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 06/15/2022] [Indexed: 11/29/2022] Open
Abstract
Background The global rise of adolescent overweight and obesity is posing a new challenge to the public health sector by determining the forthcoming generation for the most awful and upsetting quality of social life by inducing bantering, social isolation, and stigmatization among children that contribute to the mental wellbeing of the growing adolescents. Risk factors for overweight and/or obesity might not be the same across different regions due to differences in socioeconomic characteristics, culture, ethnicity, and geographical location. Moreover, in this study area, no report has been documented so far on the determinant factors of overweight and/or obesity among school adolescents. Hence, this study aimed at identifying context-specific determinants of overweight and/or obesity among adolescents in the study area. Methods and materials School-based unmatched case-control study design was employed from March 1–30, 2019, in Butajira town, Southern Ethiopia. Data were collected regarding sociodemographic, dietary practice, physical activity, nutritional knowledge-related factors, and anthropometric measurements. Multivariable logistic regression models were fitted to identify independent predictors of overweight/obesity. Results We enrolled 297 adolescents: 99 cases, 198 controls. Multivariable binary logistic regression analysis revealed that those in high socioeconomic status [AOR = 5.8, 95% CI (2.66, 12.5)], consumed soft drinks 3 and above times per week [AOR = 3.7, 95% CI (1.8, 7.3)], physically inactive [AOR = 4.4 95% CI (1.68, 11.6)], spent free time by watching television/movies for 3 and above hours per day [AOR = 8.6, 95% CI (4.3, 17)] and with poor nutritional knowledge [AOR = 3.4, 95%CI (1.7, 6.9)] were significantly associated with overweight and/obesity. Conclusion High socioeconomic status, consumption of soft drinks, physical inactivity, sedentary behavior, and poor nutritional knowledge were significantly associated with overweight/obesity. Therefore, strengthening parent and school-based health education in healthy nutrition behaviors and promotion tactics such as enhancing physical activity, limiting watching television, and soft drinks will be helpful to minimize overweight and obesity among adolescents.
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Affiliation(s)
- Shemsu Kedir
- Departement of Public Health, College of Medicine and Health Science, Werabe University, Werabe, Ethiopia
- * E-mail:
| | - Kalkidan Hassen
- Department of Nutrition and Dietetics, College of Health Science, Jimma University, Jimma, Ethiopia
| | - Yabsra Melaku
- Department of Nutrition and Dietetics, College of Health Science, Jimma University, Jimma, Ethiopia
| | - Musa Jemal
- Departement of Public Health, College of Medicine and Health Science, Werabe University, Werabe, Ethiopia
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Consumption of animal source food and associated factors among pregnant women in eastern Ethiopia: A community-based study. PLoS One 2022; 17:e0270250. [PMID: 35714168 PMCID: PMC9205500 DOI: 10.1371/journal.pone.0270250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/07/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Animal source foods contain quality nutrients, immunity, and behavioral outcome and are important for growth, and development. However, evidence on the level of animal source food consumption frequency and associated factors among pregnant women in Ethiopia, particularly rural residents are limited. Therefore, this study aimed to assess the consumption frequency of animal source food and to identify associated factors among pregnant women in the Haramaya district. Methods A community-based cross-sectional study was conducted among 448 pregnant women. Data were collected through face-to-face interviews by trained research assistants, using a validated frequency questionnaire. Consumption of animal food sources was assessed by counting the frequency of each food from animal sources that pregnant women ate over a seven-day reference period. The highest tertile for animal source food consumption was considered as the high frequency of animal source food consumption; whereas the two lower tertiles were taken as the low frequency of animal source food consumption. A binary logistic regression model was used to investigate the association of the independent variables with the animal source food consumption. An adjusted odds ratio with a 95% confidence interval was reported to show an association using a p-value <0.05. Results The high frequency of animal source food consumption among the study participants was 24.78% (95% CI = 21%-29%). High animal source food consumption was more likely higher among respondents who were literate (AOR = 1.80; 95% CI = 1.048–3.095), and those who owned milk cows (ARO = 1.70; 95% CI = 1.003–2.863). However, respondent who reported chewing khat (AOR = 0.51; 95% CI = 0.313–0.805) (AOR = 0.56; 95% CI = 0.349–0.903), were less likely experienced animal source food consumption. Conclusion We found low animal source food consumption among pregnant women in this predominantly rural setting. Women’s educational level and milk cow ownership were positively associated with animal source food consumption. Additionally, a lower frequency of animal source food consumption was observed among women who reported chewing khat. Therefore, nutrition policy programs and interventions aimed at encouraging maternal nutritional guidance and counseling are recommended.
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Dietary practice among cohort pregnant women who gave birth to neonates with and without neural tube defect: a comparative cross-sectional study. J Nutr Sci 2022; 11:e24. [PMID: 35399554 PMCID: PMC8943563 DOI: 10.1017/jns.2022.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 01/19/2023] Open
Abstract
Despite the high burden of neural tube defects (NTD) in eastern Ethiopia, there is no evidence that it is related to maternal dietary practice. The aim of the present study was to compare dietary practice between women who gave birth to newborns with and without NTDs. A comparative cross-sectional study was performed on a total of 276 (138 in each group) mothers who delivered neonates with or without NTD. Study participants were selected from three hospitals found in the eastern part of Ethiopia. The dietary practice was determined using the indicators including meal frequency, dietary diversity score (DDS), food variety score (FVS) and consumption of animal source food (ASF) generated from the dietary data collected using validated and pre-tested Food Frequency Questionnaire (FFQ). A multivariable logistic regression model was fitted to isolate independent predictors of dietary practices. The prevalence of good dietary practice was 29 % (95 % CI 23·6 %, 34·3 %). There was a significant difference in dietary practices (P = 0·034), in FVS (P = 0·01), in DDS (P = 0·045) between the two groups. In multivariable logistic regression, independent predictors of having good dietary practice were: not being the mother of a newborn with NTDs [adjusted odds ratio (AOR) 2·1, 95 % CI 1·07, 4·1], being from a rural residence area (AOR 0·29, 95 % CI 0·1, 0·7) and being illiterate (AOR 0·16, 95 % CI 0·03, 0·8). The present study found that dietary practice is associated with the development of NTDs. Nutrition education, food fortification and supplementation are needed to address this issue, and further research is needed to explore the mechanism.
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Fite MB, Tura AK, Yadeta TA, Oljira L, Roba KT. Factors associated with food consumption score among pregnant women in Eastern Ethiopia: a community-based study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2022; 41:6. [PMID: 35232495 PMCID: PMC8889778 DOI: 10.1186/s41043-022-00286-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 02/10/2022] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Although assessing the nutritional status of pregnant women is becoming a common research agenda, evidence on food consumption scores, particularly among rural residents, is limited. This study aimed to assess the level of food consumption score and associated factors 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 were collected through face-to-face interviews by trained research assistants, using a validated food frequency questionnaire. Food consumption score, a proxy measure for food security, was assessed through a seven-day dietary recall of consumption of food items. Each food item was given a score of 0-7 depending on the number of days it was consumed then grouped into food groups and summed up each food group. The pregnant women were labeled as "acceptable food consumption score" when they had a food composite score of > 42 during the reference period. Otherwise, they were defined as "unacceptable." A Poisson regression model with robust variance estimation was used to investigate the association of the independent variables with the food consumption score. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p value < 0.05. RESULTS The acceptable food consumption score among the study participants was 54.46% (95% CI 49-59%). The level of acceptable food consumption score was higher among respondents who were in the richest class (APR = 1.31; 95% CI 1.04-1.66), those who had ANC follow-up (APR = 1.78; 95% CI 1.40-2.27), those who had a favorable attitude toward dietary practice (APR = 1.30; 95% CI 1.12-1.52), and those who consumed high animal source foods (APR = 1.28; 95% CI 1.01-1.51). However, acceptable food consumption score was lower among women who were not owned agricultural land (APR = 0.84; 95% CI 0.72-0.99). CONCLUSION We found a low acceptable food consumption score among pregnant women in this predominantly rural setting. Nutritional counseling in pregnancy should address the importance of food diversity and consumption of animal source foods to improve nutrition in pregnancy. Our findings highlight the imperative requirement for policies and programs to support farmers who had no farmland to improve their overall food security and maximize their food consumption score. Assessing perinatal outcomes associated with food consumption score is essential for unraveling the spectrum of nutrition in pregnancy and beyond.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Israel E, Hassen K, Markos M, Wolde K, Hawulte B. Central Obesity and Associated Factors Among Urban Adults in Dire Dawa Administrative City, Eastern Ethiopia. Diabetes Metab Syndr Obes 2022; 15:601-614. [PMID: 35241919 PMCID: PMC8887614 DOI: 10.2147/dmso.s348098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/16/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Central obesity (CO) is a medical problem in which extra fat is accumulated in the abdomen and stomach extent that it may harm health. Furthermore, previous studies in Ethiopia predominantly relied on body mass index used to measure obesity and do not show distribution of fat. However, there is a paucity of information on the measurement of central obesity using waist circumference and associated factors in Ethiopia particularly in the study area. Hence, the purpose of this study is to assess the prevalence of central obesity and associated factors among urban adults in Dire Dawa, administrative city, Eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among 633 adults in selected kebeles of administrative city from October 15 to November 15, 2020. A multistage and systematic sampling procedure was used to select study participants. Central obesity is defined as a condition with waist circumference ≥83.7 cm for men and ≥78 cm for women with or without general obesity (GO). Odds ratio along with 95% confidence interval was estimated to identify factors associated with central obesity using multiple logistic regression analysis. RESULTS The overall prevalence of central obesity was 76.1%; at 95% CI (73%, 80%). Associated factors of central obesity were age 45 years and above [AOR = 3.75, 95% CI (1.86, 7.55)], being female [AOR = 2.52, 95% CI: (1.62, 3.94)], alcohol consumption [AOR = 2.61, 95% CI: (1.69, 4.05], physical inactivity [AOR = 2.05, 95% CI: (1.23, 3.42)], and two hour and more time spent on watching television [AOR = 3.30, 95% CI: (1.59, 6.82)]. CONCLUSION The study shows central obesity was high in the study area. Age 45 years and above, being females, married, physically inactive, alcohol consumption, and spending a long time watching television was associated with central obesity. Having regular physical activity, limiting alcohol drinking, and limiting time spent watching television were recommended to prevent central obesity and associated risk among adults.
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Affiliation(s)
- Ephrem Israel
- Dire Dawa Regional Health Bureau, Dire Dawa City Administration, Dire Dawa, Ethiopia
| | - Kalkidan Hassen
- Department of Population and Family Health, Institute of Health Science, Jimma University, Jimma, Ethiopia
| | - Melese Markos
- Department of Public Health, College of Health and Medical Science, Wachemo University Durame Campus, Durame, Ethiopia
| | - Kiber Wolde
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Bahailu Hawulte
- School of Public Health, College of Medicine and Health Science, Haramaya University, Harar, Ethiopia
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Fite MB, Tura AK, Yadeta TA, Oljira L, Roba KT. Prevalence and determinants of dietary practices among pregnant women in eastern Ethiopia. BMC Nutr 2022; 8:3. [PMID: 35012664 PMCID: PMC8751267 DOI: 10.1186/s40795-021-00494-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Hernández-Ruiz Á, Díaz-Jereda LA, Madrigal C, Soto-Méndez MJ, Kuijsten A, Gil Á. Methodological Aspects of Diet Quality Indicators in Childhood: A Mapping Review. Adv Nutr 2021; 12:2435-2494. [PMID: 34192740 PMCID: PMC8634546 DOI: 10.1093/advances/nmab053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/12/2021] [Accepted: 04/02/2021] [Indexed: 01/16/2023] Open
Abstract
Diet quality indicators (DQIns) are tools that aim to assess an individual's overall diet quality. Previous reviews focused mainly on health-related outcomes but did not provide detailed information about components, assessment variables, or important methodological issues for the development and application of DQIns in the pediatric age. The current mapping review aims to provide comprehensive guidance regarding DQIns developed through a priori methodology in children aged ≤14 y that have been applied worldwide. A mapping review was conducted, whereby 1665 original articles describing the development, modifications, and updates of DQIns, published up to June 26, 2020, in English and Spanish, were retrieved. A total of 139 articles were identified and classified into 13 subgroups. There were 10 overall DQIns: Healthy Eating Indexes (n = 25), Dietary Diversity Scores (n = 20), Diet Quality Indexes (n = 16), Food Variety Scores (n = 11), Healthy and Unhealthy Scores (n = 11), Feeding and Eating Indexes (n = 10), Diet Quality Scores (n = 5), Nutritional Adequacy and Micronutrients Indexes (n = 5), Dietary Guidelines Indexes (n = 5), and Other Healthy Diet Indexes (n = 13). Three additional subgroups of dietary and lifestyle indicators found were Mediterranean Diet Indexes (n = 10), Diet-Lifestyle Indexes (n = 5), and Breakfast Quality Indexes (n = 3). This compilation of DQIns will help researchers select the most appropriate tool for future epidemiological studies by considering a careful selection of information about the assessment components, scoring methods, and key methodological issues. The main limitations of this review are that, due to its nature, a risk-of-bias assessment was not performed and the article screening was completed in 2 databases (PubMed/MEDLINE and Scopus). More research is needed to identify health-related outcomes associated with DQIns in the pediatric population, using clearer and more standardized methodological criteria.
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Affiliation(s)
| | | | - Casandra Madrigal
- Iberoamerican Nutrition Foundation (FINUT), Granada, Spain
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, Granada, Spain
| | | | - Anneleen Kuijsten
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Granada, Spain
- Department of Biochemistry and Molecular Biology II, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Granada, Spain
- Biosanitary Research Institute ibs.GRANADA, Granada University Hospital Complex, Granada, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain
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Angeles-Agdeppa I, Toledo MB, Zamora JAT. Moderate and Severe Level of Food Insecurity Is Associated with High Calorie-Dense Food Consumption of Filipino Households. J Nutr Metab 2021; 2021:5513409. [PMID: 34777860 PMCID: PMC8580648 DOI: 10.1155/2021/5513409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 10/03/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
Food insecurity is often deeply rooted in poverty. Hence, accessibility and the quality of foods consumed may affect the dietary pattern. The study aims to assess the relationship between food insecurity and dietary consumption. This investigation analyzed the data from the 2015 Updating of Nutritional Nutrition Survey. The Household Food Insecurity Access Scale (HFIAS) was used to determine household food security status and the prevalence of food insecurity. Food weighing, food inventory, and food recall were the methods used to collect food consumption data of sampled households. The study revealed poor nutrient quality and a greater likelihood of inadequacy of nutrients among moderate and severe food insecure households. Mild, moderate, and severe levels of food insecurity were found to affect 12%, 32%, and 22% of the population, respectively. The test showed that both moderate and severe food insecure families have significantly lower mean consumption of meat, milk, and fats and oils in contrast to food secure households. In comparison with food secure households, moderate and severe food insecure households consume higher amounts of cereals and cereal products, rice, and vegetables. Moderate and severe food insecure households have higher consumption of total carbohydrates but have significantly lower average intake of vitamin A, riboflavin, niacin, and total fat related to food stable households. Moreover, the results of the multiple logistic regression revealed that food insecure households have a higher likelihood to be deficient in energy, protein, calcium, vitamin A, thiamin, riboflavin, niacin, and vitamin C intakes, but except for iron (p value <0.05). Indeed, household food insecurity was associated with the higher consumption of calorie-dense food among Filipino households. This explains a lower nutrient quality and a higher likelihood of inadequacy of nutrients among moderate and severe food insecure households.
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Affiliation(s)
- Imelda Angeles-Agdeppa
- Department of Science and Technology, Food and Nutrition Research Institute, Bicutan, Taguig City, Philippines
| | - Marvin B. Toledo
- Department of Science and Technology, Food and Nutrition Research Institute, Bicutan, Taguig City, Philippines
| | - Jezreel Ann T. Zamora
- Department of Science and Technology, Food and Nutrition Research Institute, Bicutan, Taguig City, Philippines
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Bayesian Analysis of Dietary Diversity among Lactating Mothers in Finote Selam District, Northwest Ethiopia: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9604394. [PMID: 34497855 PMCID: PMC8421177 DOI: 10.1155/2021/9604394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/15/2021] [Indexed: 11/18/2022]
Abstract
Background Dietary diversity is an essential element of diet quality. Lactation is one of the most complex and nutritionally demanding phases of the human life cycle, and the breastfed infant is dependent on mother nutrition. The objective of this study was to assess the prevalence of dietary diversity and its predictors among lactating mothers. Methods A cross-sectional study design was employed in January 2020 among 416 lactating women using systematic sampling techniques. Data was collected using a structured interviewer-administered questionnaire. Bayesian estimation was used on logistic regression to identify the significant predictors of dietary diversity. Convergence of algorithm was assessed by using time series plot, density plot, and autocorrelation plot. Result The prevalence of adequate dietary diversity was 23.1%, and the significant predictors of dietary diversity were marital status of mother, education of spouse, occupation of mother and spouse, family size, gravidity, ANC follow up, nutritional education, wealth index, and food security status. Conclusion From the result, unmarried, having more family size, multigravidity, poor wealth indexed, and food in secured women were less likely to have adequate dietary diversity, whereas employed women, having ANC follow up and nutrition education, were strongly associated with adequate dietary diversity. Family planning should be given to minimize the impact of large family size of dietary diversity. Any concerned body should give attention to minimize food insecurity of lactating women. Attention should be given for ANC follow-up and nutritional education of mothers by health professional and policy maker.
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Alamneh YM, Akalu TY, Shiferaw AA, Atnaf A. Magnitude of anemia and associated factors among children aged 6-59 months at Debre Markos referral hospital, Northwest Ethiopia: a hospital-based cross-sectional study. Ital J Pediatr 2021; 47:172. [PMID: 34389033 PMCID: PMC8362241 DOI: 10.1186/s13052-021-01123-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background Anemia, the most common micro-nutrient deficiency disorder, is the world’s second leading cause of morbidity and morbidity, affecting 24.8% of the population, of which 47.4% are under-five children. The prevalence of anemia ranges from 44 to 56% in Ethiopia. Although its magnitude has shown decreases across regions; it continues to be a significant public health problem, particularly in developing countries including Ethiopia. Despite this evidence, the magnitude and associated factors of anemia was not systematically explored and there is a limited information or limited evidences in the study area. Hence, the aim of this study was to assess the magnitude and associated factors of anemia among children aged 6–59 months attending at Debre Markos Referral Hospital, Northwest Ethiopia. Methods A hospital-based cross-sectional study was conducted at Debre Markos referral hospital Northwest Ethiopia from September 30 to December 30, 2019. Data on socio-demographic and socio-economic factors, health and nutritional features of children and their mothers were obtained using pre-tested structured questionnaires in a face-to-face interview with child care providers. Blood samples and stool examination for intestinal parasites were performed. Hemoglobin level was analyzed using the HemoCue device (HemoCueHb 301). The collected data were coded, cleared and entered into Epi-Data version 3.1, and analyzed using Stata version 14 software. To identify candidates and predictor variables, bivariate and multivariate logistic regressions were applied respectively. The significance level was determined at a confidence interval of 95% at p-value < 0.05. Results Of the total of 341 participants planned to be participated, about 310 mother-child pairs participated in the study, giving a response rate of 91%; and data were collected from children as well as their parents or guardians. In this study, the magnitude of anemia was 11.9% (95% CI, 8.5, 16.2%). Poor dietary diversity (AOR = 2.3; 95% CI: 1.12, 5.14), food-insecure households (AOR = 3.24; 95% CI: 1.85, 4.52), complementary feeding initiation time (AOR = 3.20; 95% CI:1.23, 6.61), intestinal parasites infection (AOR = 3.20; 95% CI:1.23, 6.61) and family income (AOR = 2.87; 95% CI:1.57, 5.0) were found to be factors significantly associated with anemia. Conclusion Overall, anemia is considered a public health problem among children aged 6–59 months attending at Debre Markos referral hospital, based on the cut-off point of the World Health Organization. Poor dietary diversity, complementary feeding initiation time, household food insecurity, intestinal parasite infection and family income were significantly associated with childhood anemia. Thus, it needs for proven interventions in public health such as food diversification, anti-helmintic drug provision and household food security. In addition, educating women about nutrition and diet diversification, as well as involving them in alternative sources of income-generating activity, can be vital in the study area.
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Affiliation(s)
- Yoseph Merkeb Alamneh
- Department of Biomedical Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
| | - Tadesse Yirga Akalu
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos Ethiopia, P.O. Box 269, Debre Markos, Ethiopia
| | - Abtie Abebaw Shiferaw
- Department of Medical Laboratory Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Aytenew Atnaf
- Department of Medical Laboratory Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
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Chaudhuri S, Roy M, McDonald LM, Emendack Y. Coping Behaviours and the concept of Time Poverty: a review of perceived social and health outcomes of food insecurity on women and children. Food Secur 2021. [DOI: 10.1007/s12571-021-01171-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Susilo E, Purwanti P, Fattah M, Qurrata VA, Narmaditya BS. Adaptive coping strategies towards seasonal change impacts: Indonesian small-scale fisherman household. Heliyon 2021; 7:e06919. [PMID: 33997422 PMCID: PMC8105632 DOI: 10.1016/j.heliyon.2021.e06919] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 02/25/2021] [Accepted: 04/22/2021] [Indexed: 11/27/2022] Open
Abstract
Small-scale fishers are always expected to adapt to fishing activities that cannot be conducted all year round due to weather and fishing season. This condition, especially when it is not the fish season, makes fishers face a problem. Notwithstanding, fishermen households need to develop an adequate adaptation strategy to solve the problem of fulfilling their needs, known as coping strategies. This study aims to analyze fishermen households' coping strategies in facing the fishing season and non-fish season by using fishermen's family resources and two types of internal and external family coping strategies. The data were gathered from approximately 150 small-scale fishing households using simple random sampling. The results indicate the fishers do fishing activities in three batch: peak season (68%), mild season (20%), and off-season (12%). The use of resources for fishermen households' coping strategy is carried out by diversifying the sources of household income. Some economic activities include cultivating forest land belonging to the forest department, marine tour guides, livestock, and his wife. This study also confirm that all households use internal family coping strategies with humor indicator as the highest percentage. Accordingly, the households also adopt the external family coping strategy to deal with the existing situation. This strategy follows the local community's characteristics and culture who are friendly and open and based on religion. The household coping strategy strengthening model is generated through the synergy of formal institutional roles in society and government institutions as policymakers.
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Affiliation(s)
- Edi Susilo
- Socio-Economy Fisheries and Marine, Faculty of Fisheries and Marine Science, Brawijaya University, Indonesia
- Corresponding author.
| | - Pudji Purwanti
- Socio-Economy Fisheries and Marine, Faculty of Fisheries and Marine Science, Brawijaya University, Indonesia
| | - Mochammad Fattah
- Socio-Economy Fisheries and Marine, Faculty of Fisheries and Marine Science, Brawijaya University, Indonesia
| | - Vika Annisa Qurrata
- Economic Development Department, Faculty of Economics, Universitas Negeri Malang, Indonesia
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Endalifer ML, Andargie G, Mohammed B, Endalifer BL. Factors associated with dietary diversity among adolescents in Woldia, Northeast Ethiopia. BMC Nutr 2021; 7:27. [PMID: 33926578 PMCID: PMC8082914 DOI: 10.1186/s40795-021-00430-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Consuming diversified food during the adolescent period is essential to build a healthy and active mind for their later life. Food prices increased in the local market due to fewer production of crops. Thus, exploring the dietary diversity of adolescents in this area is crucial to estimate diet quality. So the aim of the study was to identify determinant factors of dietary diversity. Methods An institution-based cross-sectional study was conducted among adolescent students in Woldia town. A total of four hundred eleven students were included in the study. A simple random sampling technique was used to select the participants. The outcome variable was dietary diversity; it was calculated by summing of the number of food group consumed by individuals in the given reference period. Bivariable and multivariable logistic analysis was done. The odds ratio with a 95% confidence interval was computed to measure an association. A variable with a P-value less than 0.05 is considered a significant factor. Results The proportion of inadequate dietary diversity was 49.1% (95% CI 44.5–53.8). Being female (AOR =5.53, 95% CI 3.447–8.859), secondary and above mothers’ education level (AOR=0. 27, 95%CI 0.153–0.477), living in a family size five and above (AOR= 2.09, 95CI% 1.31–3.34), and poor knowledge about nutrition (AOR=4.56, 95% CI 2.727–7.639) were significantly associated with inadequate dietary diversity. Conclusions and recommendations Inadequate dietary diversity was associated with sex, knowledge of nutrition, maternal education level, and family size. It is better to design a nutrition intervention program that focus on nutrition education to scale up diversified food consumption among adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-021-00430-6.
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Affiliation(s)
- Melese Linger Endalifer
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia.
| | - Gashaw Andargie
- Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bekri Mohammed
- Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bedilu Linger Endalifer
- Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Berlie AB. The Invisible Crisis of Urban Food Security in Amhara Regional State, Ethiopia. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2020.1838983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Arega Bazezew Berlie
- Department of Geography Environmental Studies, Bahir Dar University, Bahir Dar, Ethiopia
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Demilew YM, Alene GD, Belachew T. Effects of guided counseling during pregnancy on birth weight of newborns in West Gojjam Zone, Ethiopia: a cluster-randomized controlled trial. BMC Pediatr 2020; 20:466. [PMID: 33023521 PMCID: PMC7542400 DOI: 10.1186/s12887-020-02363-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 09/28/2020] [Indexed: 11/23/2022] Open
Abstract
Background The high proportion of birth weight in Ethiopia is hypothesized to be due to inadequate maternal diet which is associated with poor nutrition education during pregnancy. There was no study that evaluated the effect of nutrition education on birth weight in the study area. This study aimed to assess the effects (overall, direct and indirect effects) of guided counseling on the birth weight of neonates. Methods A two-arm parallel cluster randomized controlled community trial was conducted from May 1, 2018, to April 30, 2019, in West Gojjam Zone, Northwest Ethiopia. At the baseline, 346 pregnant women in the 11 intervention clusters and 348 pregnant women in the 11 control clusters were recruited. However, birth weight was measured from 258 and 272 newborns in the intervention and control groups, respectively. In the intervention group, counseling was given monthly for four consecutive months in the participant’s homes. Besides, leaflets with key counseling messages were distributed to each woman in the intervention arm. Pregnant women who attended routine nutrition education given by the health system were recruited as control. Dietary practice, nutritional status, and birth weight were the primary, secondary and tertiary outcomes of this intervention. Data were collected using a structured data collection tool. Birth weight was measured within 48 h after birth. Independent sample t-test, linear mixed-effects model, and path analysis were fitted to assess effects of the intervention. Results The intra-cluster correlation coefficient was 0.095. The average birth weight of newborns in the intervention group was 0.257 kg higher compared with their counterparts in the control arm (β = 0.257, P < 0.001). The direct effect of this intervention on birth weight was 0.17 (β = 0.17, P<0.001 ) whereas the indirect effect of this intervention was 0.08 (β = 0.08, P<0.001 ). Conclusion Counseling using the health belief model and the theory of planned behavior has a positive effect on improving birth weight. The findings suggest the need for enhancing nutrition education of pregnant women through the application of theories to improve birth weight. Trial registration Clinical Trials.gov NCT03627156, “Retrospectively registered Jun, 13, 2018”.
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Affiliation(s)
- Yeshalem Mulugeta Demilew
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia.
| | - Getu Degu Alene
- Department of Biostatics and Epidemiology, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University
- , P.O. Box 378, Jimma, Ethiopia
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Murendo C, Aziz T, Tirivanhu D, Mapfungautsi R, Stack J, Mutambara S, Langworthy M, Mafuratidze C. Dietary Diversity and Food Coping Strategies in Zimbabwe: Do Resilience and Food Insecurity Status Matter? Ecol Food Nutr 2020; 60:116-136. [PMID: 32856483 DOI: 10.1080/03670244.2020.1808784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study assessed how dietary diversity and food coping strategies differ by resilience and food insecurity status. Proportionate sampling technique was used to interview 3440 households in 18 districts of Zimbabwe. Results show that resilient and food secure households had good diet diversification and were less likely to adopt food coping strategies when compared to less resilient and food insecure ones. Adaptive and absorptive resilience capacities and income reduced the use of food coping strategies. Interventions that improve household resilience capacities and income should be promoted to reduce the use of food coping strategies.
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Affiliation(s)
- Conrad Murendo
- Socio-Economics, International Crops Research Institute for the Semi-Arid Tropics , Bulawayo, Zimbabwe
| | - Towfique Aziz
- Research, Tango International , Tucson, Arizona, USA
| | - Doreen Tirivanhu
- Institute of Environmental Studies, University of Zimbabwe , Harare, Zimbabwe
| | | | - Jayne Stack
- Resilience Knowledge Hub, Mercy Corps , Portland, Zimbabwe
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Exploring Rural Adolescents' Dietary Diversity and Its Socioeconomic Correlates: A Cross-Sectional Study from Matlab, Bangladesh. Nutrients 2020; 12:nu12082230. [PMID: 32722644 PMCID: PMC7468778 DOI: 10.3390/nu12082230] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/17/2020] [Accepted: 07/23/2020] [Indexed: 12/01/2022] Open
Abstract
The majority of 36 million Bangladeshi adolescents live in rural areas. Improved understanding of their dietary patterns is of great public health importance. This study aimed to explore dietary diversity (DD) with its socioeconomic and gender stratification in a rural adolescent cohort and to isolate factors associated with inadequate DD. Household survey provided data for constructing dietary diversity scores (DDS) and assessing relevant socio-demographic variables. Final analysis included 2463 adolescents. Means and proportions were compared, and a binary logistic regression model was fitted. Inadequate DD was observed among 42.3% (40.3–44.2). Consumption of nutrient-rich foods varied significantly across gender and SES categories. Belonging to the poorest households (adjusted odds ratio (aOR) 1.59; 95% CI: 1.27, 2.00) and food insecure households (aOR 1.34; 95% CI: 1.13, 1.59), adolescents’ attainment of secondary education (aOR 1.38; 95% CI: 1.11, 1.71), and having mothers with secondary education or above (aOR 0.76; 95% CI: 0.60, 0.96) were associated with inadequate DD. Compared with girls from food secure households, girls from food insecure ones had higher odds of inadequate DD (aORgirl 1.42; 95% CI: 1.12, 1.81). Improving rural adolescents’ DD would require targeted interventions as well as broader poverty alleviation.
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Tsegaye D, Tamiru D, Belachew T. Factors Associated with Dietary Practice and Nutritional Status of Pregnant Women in Rural Communities of Illu Aba Bor Zone, Southwest Ethiopia . NUTRITION AND DIETARY SUPPLEMENTS 2020. [DOI: 10.2147/nds.s257610] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Demilew YM, Alene GD, Belachew T. Dietary practices and associated factors among pregnant women in West Gojjam Zone, Northwest Ethiopia. BMC Pregnancy Childbirth 2020; 20:18. [PMID: 31906981 PMCID: PMC6945405 DOI: 10.1186/s12884-019-2702-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 12/24/2019] [Indexed: 12/22/2022] Open
Abstract
Background The optimal dietary practice is a critical requisite for maternal nutrition. However, the majority of Ethiopian pregnant women have inadequate nutrient intakes. These may be due to their poor dietary habits. Identifying factors affecting the dietary practices of pregnant women is crucial to design appropriate interventions. In this country, the dietary practices of pregnant women and determinants are not well studied. Therefore, the purpose of this study was to assess the dietary practices and associated factors among pregnant women in West Gojjam Zone, Northwest Ethiopia. Methods A community-based cross-sectional study was carried out among 712 pregnant women from May to August 2018. Quantitative data complemented with a qualitative method. Pregnant women were selected using a cluster sampling technique. Structured questionnaires were utilized for data collection. Data were entered into Epi-Info version 7.2.2 and exported to SPSS version 23 software for analysis. Data were described using frequencies and mean. A logistic regression analysis was done. Three focus group discussions and 17 key-informant interviews were conducted for the qualitative data. Focus group discussion participants were mothers, husbands, and health professionals. Typical case and homogeneous sampling techniques were used for the key-informant interviews and focus group discussions, respectively. Thematic analysis was used for the qualitative data. Results Only 19.9% of respondents had appropriate dietary practices. On the multivariable logistic regression analyses, being food secure [AOR = 2.25, 95% CI: (1.1, 4.5)], having high edible crop production [AOR = 2.00, 95% CI: (1.2, 3.2)] and a favorable attitude [AOR = 1.69, 95% CI: (1.1, 2.6)] were significantly associated with the appropriate dietary practices of pregnant women. In the qualitative study, lack of knowledge on maternal diet, cultural prohibition, and knowledge gap of the professionals were barriers that interfere with dietary practices during pregnancy. Conclusion Pregnant women in the study area are found to have suboptimal dietary practices. Therefore, health professionals should give regular nutrition counseling using cards and role models for promoting diversified food production and consumption.
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Affiliation(s)
- Yeshalem Mulugeta Demilew
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia.
| | - Getu Degu Alene
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, P.O. Box 378, Jimma, Ethiopia
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Naja F, Itani L, Kharroubi S, Diab El Harake M, Hwalla N, Jomaa L. Food insecurity is associated with lower adherence to the Mediterranean dietary pattern among Lebanese adolescents: a cross-sectional national study. Eur J Nutr 2020; 59:3281-3292. [PMID: 31900578 DOI: 10.1007/s00394-019-02166-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To derive dietary patterns (DPs) of Lebanese adolescents (10-18 years) and evaluate associations between identified DPs and household food insecurity (HFI). METHODS Data on adolescents (n = 693) were drawn from a national survey conducted in 2015 on a representative sample of Lebanese households with children. In addition to a sociodemographic questionnaire, data collection included the validated Arabic-version of the Household Food Insecurity Access Scale, used to evaluate HFI. Dietary intake was assessed using a 187-item validated food frequency questionnaire. Associations between HFI scores and DPs were examined using multiple linear regressions. RESULTS HFI was observed in 55.2% of the study sample. Two DPs were derived among adolescents: Western and Lebanese-Mediterranean (LM). The Western DP was characterized by higher consumption of sweetened beverages, fast foods, sweets, and refined grains, whereas the LM DP was characterized by higher intakes of fruits, vegetables, dairy products, and whole grains. Scores of the Western DP were negatively associated with fiber, calcium, iron, and vitamins A and D, while the LM DP scores were positively correlated with fiber, proteins, iron, calcium, and vitamins A and D (p < 0.01). LM DP scores were also negatively correlated with total fat, saturated and polyunsaturated fats, p < 0.05. After adjustment for sociodemographics, multiple linear regression showed that higher HFI scores were associated with lower adherence to LM DP among adolescents (β = - 0.026, 95% CI - 0.046, - 0.006). CONCLUSIONS HFI was associated with lower adherence to the Mediterranean pattern among Lebanese adolescents. Preventive strategies are needed to promote better diet quality among food-insecure youth.
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Affiliation(s)
- Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, PO Box 11-5020, Riad El Solh, Beirut, 1107-2809, Lebanon
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
| | - Marwa Diab El Harake
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon
| | - Lamis Jomaa
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, PO Box 11-0236, Riad El Solh, Beirut, 1107-2020, Lebanon.
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Engidaye G, Melku M, Yalew A, Getaneh Z, Asrie F, Enawgaw B. Under nutrition, maternal anemia and household food insecurity are risk factors of anemia among preschool aged children in Menz Gera Midir district, Eastern Amhara, Ethiopia: a community based cross-sectional study. BMC Public Health 2019; 19:968. [PMID: 31324244 PMCID: PMC6642588 DOI: 10.1186/s12889-019-7293-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Ethiopian, the prevalence of anemia among preschool aged children widely varied across regions. Since anemia adversely affects the cognitive and physical development of the children, it is important to determine its burden for implementing appropriate measurements. Therefore, this study was aimed at determining the anemia prevalence and associated factors among preschool aged children. METHOD A community based cross-sectional study was conducted on a total of 432 preschool children in Menz Gera Midir district from January to May, 2017. A multi stage sampling procedure was applied to select the target groups. Hemocue analyzer for Haemoglobin determination; anthropometric measurements for assessment nutritional status, structured questionnaires for socio-demographic and economic variables were used for data collection. The morphological appearance of red blood cell was assessed microscopically to determine type of anemia. Descriptive statistics were employed to summarize the data and binary logistic regression was used for inferential statistics. A p value less than 0.05 was considered as statistically significant. RESULT The overall prevalence of anemia was 123 (28.5%); of which 38 (30.9%) and 85 (69.1%) were moderate and mild, respectively. Morphologically about 50.4, 37.4 and 12.2% were microcytic hypochromic, normocytic normochromic and macrocytic anemias, respectively. Child age 6-11 months (COR: 5.67, 95% CI: 2.2, 14.86), child age 12-23 months (COR: 5.8, 95% CI: 2.3, 14.7), wasting (COR: 3.5, 95% CI: 1.2, 9.8), stunting (COR: 3.8, 95% CI: 1.92, 7.77), underweight (COR: 2.12, 95% CI: 1.07, 4.38), MUAC measurement below 13 cm (COR: 5.6, 95% CI: 2.83, 11.15), household headed by female (COR: 3.24, 95% CI: 1.1, 9.63), maternal anemia (COR: 4, 95% CI: 2.2, 7.23) and household food insecurity (COR: 2.12, 95% CI: 1.09, 4.12) were significantly associated with anemia. CONCLUSION The prevalence of anemia among the children was found to be high and associated with child age group, child nutritional status, house hold headed by female, maternal anemia and household food insecurity. Further studies on nutritional anemia, community based nutritional education, iron supplementation to children at risk should be promoted.
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Affiliation(s)
- Getabalew Engidaye
- Amhara Regional State Debre Berhan Health Science College, Debre Berhan, Ethiopia.,Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aregawi Yalew
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fikir Asrie
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Getaneh Z, Melku M, Geta M, Melak T, Hunegnaw MT. Prevalence and determinants of stunting and wasting among public primary school children in Gondar town, northwest, Ethiopia. BMC Pediatr 2019; 19:207. [PMID: 31238889 PMCID: PMC6591879 DOI: 10.1186/s12887-019-1572-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 06/04/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Undernutrition among school age children has an impact on their health, cognition, and educational achievement. Therefore, this study aimed to assess the prevalence and associated factors of stunting and wasting among school age children in Gondar town, northwest, Ethiopia. METHODS An institution-based cross-sectional study was done among school children aged 6-14 years. Data on socio-demographic, nutritional and dietary status of children were collected using structured questionnaire. Anthropometric measurements were carried out to determine the status of stunting and wasting. Data were entered into Epi-Info version 3.5.3 and transferred to SPSS version 20 for further analysis. Bivariable and multivariable logistic regression models were fitted to identify associated factors of stunting and wasting. Both crude odds and adjusted odds ratios with 95% CI were used to measure the strength of associations. In the multivariable analysis, variables with < 0.05 p-values were considered statistically significant. RESULTS A total of 523 school age children were with the median age of 12 (10-13 inter quartile range) years participated in the study. The overall prevalence of stunting and wasting among primary school children was 241(46.1%; 95% CI: 42.3, 50.3) and 47 (9%; 95% CI: 6.7, 11.7), respectively. Child age (AOR = 1.9, 95% CI: 1.29, 2.80), public tab/yard water source (AOR = 2.22; 95%CI: 1.46, 3.39), DDS < 4 (AOR = 1.89 95%CI: 1.08, 3.30), tea drinking habit (AOR = 0.46, 95%CI: 0.27, 0.80) and anemia (AOR = 1.72 95%CI: 1.05, 2.83) were significant predictors of stunting. Moreover, child age (AOR = 3.91; 95% CI: 1.62, 9.44), maternal/care-givers' age ≤ 34 (AOR = 0.34; 95%CI: 0.16, 0.71), maternal education (AOR = 2.55; 95%CI: 1.15, 5.65), family poverty (AOR = 3.23; 95% CI: 1.30, 7.93) and alcohol consumption (AOR = 2.93; 95%CI: 1.16, 7.42) were found significantly associated with wasting. CONCLUSION Stunting and wasting were then major problems among school age children. Child age, water source for dinking, DDS < 4 and anemia resulted in stunting. On the other hand, child age, maternal education and age, family poverty and alcohol drinking were risk factors for wasting. Therefore, launching community based nutritional education programs, implementing school feeding and strengthening economic level of the communities are essential to reduce the problems.
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Affiliation(s)
- Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mekuanint Geta
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tadele Melak
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Melkamu Tamir Hunegnaw
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Macuácua ME, Taconeli CA, Osório MM. Dietary patterns and associated socio-economic factors in rural Mozambican adolescents. Malawi Med J 2019; 31:25-30. [PMID: 31143393 PMCID: PMC6526348 DOI: 10.4314/mmj.v31i1.5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Assessing food consumption in adolescents is essential for the determination of an appropriate nutritional status. This study intended to assess dietary patterns and its associated factors in rural Mozambican adolescents. Methods This was a cross-sectional study of 323 adolescents. A food frequency questionnaire was used and food was grouped into nine groups. An exploratory factorial analysis identified the food patterns. A principal component analysis provided food consumption scores in each factor, split into three groups. An adjustment of multinomial regression models was made. Results Two diet patterns were identified: pattern 1 (fats, beans, meats and eggs, cereals and sugars) and pattern 2 (vegetables, roots and tubers, fruits, chestnuts and walnuts). The proportional model for pattern 1 indicated highest consumption for adolescents with per capita family income equal to or greater than 78.13 meticais (Mozambique's currency) and for adolescents whose parents had a formal job. For pattern 2, consumption was lower for adolescents whose guardians had high school education or more. The consumption in the first three quartiles was lower for individuals with an income between 1 and 78.12 meticais. Conclusions For Mozambican adolescents, higher income, education and parents' jobs were predictive variables for consumption of fats, beans, meats and eggs, cereals, and sugars, while higher education and higher income implies lower consumption of vegetables, roots and tubers, fruits, chestnuts, and walnuts.
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Affiliation(s)
- Milagre E Macuácua
- Federal University of Pernambuco, Graduate Program in Nutrition. Recife, Brazil
| | - Cesar A Taconeli
- Federal University of Paraná, Graduate Program in Statistic. Curitiba, Brazil
| | - Mônica M Osório
- Federal University of Pernambuco, Graduate Program in Nutrition. Recife, Brazil
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