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Abdelmenan S, Berhane HY, Turner C, Worku A, Selling K, Ekström EC, Berhane Y. Perception of affordable diet is associated with pre-school children's diet diversity in Addis Ababa, Ethiopia: the EAT Addis survey. BMC Nutr 2024; 10:47. [PMID: 38449007 PMCID: PMC10916157 DOI: 10.1186/s40795-024-00859-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/22/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Despite improvements in food access and nutrition security over the last few decades, malnutrition remains a major public health problem. One of the significant contributors to these problems is affordability of nutritious food. This study aimed to examine the association between perceived food affordability and pre-school children's diet diversity in Addis Ababa, Ethiopia. METHODS Cross-sectional data from 2017 to 18 were used for the analysis. A 24-hour dietary recall assessment was done to assess children's dietary diversity (DD). We used a modified operational definition of affordability indicator called perceived affordability of dietary diversity (afford-DD) to evaluate the impact of the food environment in terms of affordability at the household level. A sample (n 4,898) of children aged 6-59 months representative of households in Addis Ababa was randomly selected using a multistage sampling procedure including all districts in the city. Mixed-effects linear regression models were used to assess the association between children's DD and afford-DD. RESULTS The survey revealed that the mean (standard deviation [SD]) of children's DD was 3.9 [± 1.4] while the mean [SD] of afford-DD was 4.6 [± 2.1]. Overall, 59.8% of children met the minimum dietary diversity (≥ 4 food groups). White roots and tubers were the most commonly consumed food groups regardless of their affordability. Considerable variations were observed between households that reported the food item affordable and not affordable in consumption of Vitamin A rich vegetables and fruits, meat and fish, egg, and dairy. The children's DD was positively associated with afford-DD after adjusting for maternal education, household wealth status and other relevant confounding. Higher maternal education modified the association between affordability and children's diet diversity. CONCLUSIONS This study suggests higher perceived food affordability was associated with better diet diversity in children. A higher level of maternal education had the potential to mitigate affordability challenges in meeting the children's dietary diversity needs. Our study emphasizes the need for inclusive food programs and nutrition interventions addressing social differences, intensifying efforts to make nutrient-rich diets affordable for the less privileged, and highlights the potential benefits of targeting maternal education in addressing child dietary diversity.
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Affiliation(s)
- Semira Abdelmenan
- Global Health and Migration Unit, Department of Women's and Children Health, Uppsala University, 751 85, Uppsala, Sweden.
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Hanna Y Berhane
- Global Health and Migration Unit, Department of Women's and Children Health, Uppsala University, 751 85, Uppsala, Sweden
- Department of Nutrition and Behavioral sciences, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Christopher Turner
- Department of Population Health, Faculty of Epidemiology and Population Health, School of Hygiene and Tropical Medicine, London, UK
| | - Alemayehu Worku
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Katarina Selling
- Global Health and Migration Unit, Department of Women's and Children Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Eva-Charlotte Ekström
- Global Health and Migration Unit, Department of Women's and Children Health, Uppsala University, 751 85, Uppsala, Sweden
| | - Yemane Berhane
- Global Health and Migration Unit, Department of Women's and Children Health, Uppsala University, 751 85, Uppsala, Sweden
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Bekele TH, Covic N, Alemayehu D, Trijsburg LE, Brouwer ID, Feskens EJM, de Vries JHM. The feasibility of implementing food-based dietary guidelines and food graphics in Ethiopia. Food Secur 2023; 15:805-822. [PMID: 36691456 PMCID: PMC9850324 DOI: 10.1007/s12571-022-01335-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 11/15/2022] [Indexed: 01/20/2023]
Abstract
This study aimed to test the acceptability, cultural appropriateness, consumers' understanding, and practicality of the Ethiopian food-based dietary guideline's messages, tips, and food graphics. A qualitative study design was applied with focus group discussions and key informant interviews. Four different participant groups were included: 40 consumers, 15 high-level nutrition experts, 30 frontline community health extension workers (HEWs), and 15 agriculture extension workers (AEWs) to incorporate different stakeholder perspectives. Data collection was conducted using 7 focus group discussions (FGDs) and 30 key informant interviews (KIIs). Collected data were coded and analyzed using QSR International NVivo V.11 software. Most of the study participants were highly interested in implementing the dietary guidelines once these guidelines are officially released. Based on the participants' views, most of the messages align with the current nutrition education materials implemented in the country except the messages about physical activity and alcohol intake. However, participants suggested defining technical terms such as ultra-processing, whole grain, safe and balanced diet in simpler terms for a better understanding. Practicality, affordability, availability, and access to the market were the major barriers reported for adherence to the guidelines. To be more inclusive of cultural and religious beliefs, findings show that the guideline should address fasting and traditional cooking methods. In conclusion, the dietary guidelines were well received by most stakeholders. They are thought to be feasible once feedback on wording, affordability, availability, and access is considered in the messages, tips, and graphic designs.
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Affiliation(s)
- Tesfaye Hailu Bekele
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Namukolo Covic
- International Food Policy Research Institute, Addis Ababa, Ethiopia
| | | | - Laura E. Trijsburg
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Inge D. Brouwer
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Jeanne H. M. de Vries
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
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Perceived neighbourhood food access is associated with consumption of animal-flesh food, fruits and vegetables among mothers and young children in peri-urban Cambodia. Public Health Nutr 2022; 25:717-728. [PMID: 34593072 PMCID: PMC9991642 DOI: 10.1017/s1368980021004122] [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: 11/07/2022]
Abstract
OBJECTIVE To examine whether mothers' perceived neighbourhood food access is associated with their own and their young children's consumption of animal-flesh food, fruits and vegetables in peri-urban areas of Cambodia. DESIGN A cross-sectional survey measured food consumption frequency and perceived neighbourhood food access, the latter including six dimensions of food availability, affordability, convenience, quality, safety and desirability. Multivariate logistic regression was used to assess the association between perceived food access and food consumption. SETTING Peri-urban districts of Phnom Penh and Siem Reap, Cambodia. PARTICIPANTS 198 mothers of children between 6 and 24 months old. RESULTS Over 25 % of the mothers and 40 % of the children had low consumption (< once a day) of either animal-flesh food or fruits and vegetables. Compared with perceived high food access, perceived low food access was associated with an adjusted 5·6-fold and 4·3-fold greater odds of low animal-flesh food consumption among mothers (95 % CI 2·54, 12·46) and children (95 % CI 2·20, 8·60), respectively. Similarly, relative to perceived high food access, perceived low food access was associated with 7·6-times and 5·1-times higher adjusted odds of low fruits and vegetables consumption among mothers (95 % CI 3·22, 18·02) and children (95 % CI 2·69, 9·83), respectively. CONCLUSIONS Mothers' perceived neighbourhood food access was an important predictor of their own and their young children's nutrient-rich food consumption in peri-urban Cambodia. Future work is needed to confirm our findings in other urban settings and examine the role of neighbourhood food environment in the consumption of both nutrient-rich and nutrient-poor food.
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Gutiérrez Román AIF, Laynes Zela PF, Acuña Payano RK, Nolasco Cárdenas OP, Santa-Cruz Carpio CM, Leiva Eriksson NR. Production of Sustainable Proteins Through the Conversion of Insects to Proteins Using Beauveria bassiana Cultures. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2021.760274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Various strategies are being suggested to solve the challenges in the food system, such as changing the source of nutrients, including the use of non-traditional food sources such as insects. Although insects are promoted as a cheap and sustainable source of protein, consumers are reluctant to eat them. The mycoproteins produced by fungi, on the other hand, are very well received and appreciated by consumers. Thus, in this work we have studied the use of the entomopathogenic fungi Beauveria bassiana (Ascomycota: Hypocreales) for the production of protein using insects as feed. B. bassiana was cultivated in culture medium containing entire insects from the species Eurysacca and Hypothenemus or single carbon sources such as glucose or laminarin from Laminaria digitata. The results showed that B. bassiana can produce up to 16-fold more biomass and 8-fold more protein when grown in insect-based medium than when grown in glucose. The results also indicated that the production of proteins continuously increased when B. bassiana was grown in medium containing insects, reaching its maximum at 9 days (up to 3 mg/mL). On the other hand, when cultivated in glucose-supplemented medium, the production of proteins was constantly low (~0.5 mg/mL). In conclusion, B. bassiana was a large biomass producer and exuded a large amount of protein when grown in medium containing insect powder, making it an ideal intermediate link between insects and protein. Furthermore, the proteins produced by fungi such as B. bassiana can be used in the food, health, and cosmetic industries.
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Kebede A, Jirström M, Worku A, Alemu K, Berhane HY, Turner C, Ekström EC, Berhane Y. Residential Food Environment, Household Wealth and Maternal Education Association to Preschoolers' Consumption of Plant-Based Vitamin A-Rich Foods: The EAT Addis Survey in Addis Ababa. Nutrients 2022; 14:296. [PMID: 35057477 PMCID: PMC8778225 DOI: 10.3390/nu14020296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 11/29/2022] Open
Abstract
Vitamin A deficiency is common among preschoolers in low-income settings and a serious public health concern due to its association to increased morbidity and mortality. The limited consumption of vitamin A-rich food is contributing to the problem. Many factors may influence children's diet, including residential food environment, household wealth, and maternal education. However, very few studies in low-income settings have examined the relationship of these factors to children's diet together. This study aimed to assess the importance of residential food availability of three plant-based groups of vitamin A-rich foods, household wealth, and maternal education for preschoolers' consumption of plant-based vitamin A-rich foods in Addis Ababa. A multistage sampling procedure was used to enroll 5467 households with under-five children and 233 residential food environments with 2568 vendors. Data were analyzed using a multilevel binary logistic regression model. Overall, 36% (95% CI: 34.26, 36.95) of the study children reportedly consumed at least one plant-based vitamin A-rich food group in the 24-h dietary recall period. The odds of consuming any plant-based vitamin A-rich food were significantly higher among children whose mothers had a higher education level (AOR: 2.55; 95% CI: 2.01, 3.25), those living in the highest wealth quintile households (AOR: 2.37; 95% CI: 1.92, 2.93), and in residentials where vitamin A-rich fruits were available (AOR: 1.20; 95% CI: 1.02, 1.41). Further research in residential food environment is necessary to understand the purchasing habits, affordability, and desirability of plant-based vitamin A-rich foods to widen strategic options to improve its consumption among preschoolers in low-income and low-education communities.
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Affiliation(s)
- Adane Kebede
- Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Magnus Jirström
- Department of Human Geography, Lund University, 223 62 Lund, Sweden;
| | - Alemayehu Worku
- School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa 1176, Ethiopia;
| | - Kassahun Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia;
| | - Hanna Y. Berhane
- Department of Nutrition and Behavioral Sciences, Addis Continental Institute of Public Health, Addis Ababa 26751/1000, Ethiopia;
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
| | - Christopher Turner
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK;
| | - Eva-Charlotte Ekström
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
| | - Yemane Berhane
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa 26751/1000, Ethiopia
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