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Mahal S, Kucha C, Kwofie EM, Ngadi M. A systematic review of dietary data collection methodologies for diet diversity indicators. Front Nutr 2024; 11:1195799. [PMID: 38577154 PMCID: PMC10992480 DOI: 10.3389/fnut.2024.1195799] [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: 03/28/2023] [Accepted: 02/16/2024] [Indexed: 04/06/2024] Open
Abstract
The purpose of the current study was to critically assess the gaps in the existing methodologies of dietary data collection for diet diversity indicators. The study proposed the importance of smartphone application to overcome the drawbacks. The review paper identified and assessed the conventional methodologies used in diet diversity indicators including Minimum Dietary Diversity for Women (MDD-W), Minimum Dietary Diversity of Infant and Young Child Feeding Practices (IYCF-MDD), and Household Dietary Diversity Score (HDDS). The 80 research studies from 38 countries were critically assessed on the basis of their research aim, study design, target audience, dietary data collection methodology, sample size, dietary data type, dietary data collection frequency, and location point of dietary data collection. Results indicated that most studies employed interviewer-administered 24-h recall assessing the dietary diversity. The review paper concluded that smartphone application had potential to overcome the identified limitations of conventional methodologies including recall bias, social-desirability bias, interviewer training, and cost-time constraints.
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Affiliation(s)
- Subeg Mahal
- Department of Bioresource Engineering, McGill University, Ste-Anne-de-Bellevue, QC, Canada
| | - Christopher Kucha
- Department of Food Science and Technology, University of Georgia, Athens, GA, United States
| | - Ebenezer M. Kwofie
- Department of Bioresource Engineering, McGill University, Ste-Anne-de-Bellevue, QC, Canada
| | - Michael Ngadi
- Department of Bioresource Engineering, McGill University, Ste-Anne-de-Bellevue, QC, Canada
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Jing H, Teng Y, Chacha S, Wang Z, Shi G, Mi B, Zhang B, Cai J, Liu Y, Li Q, Shen Y, Yang J, Kang Y, Li S, Liu D, Wang D, Yan H, Dang S. Is Increasing Diet Diversity of Animal-Source Foods Related to Better Health-Related Quality of Life among Chinese Men and Women? Nutrients 2023; 15:4183. [PMID: 37836467 PMCID: PMC10574670 DOI: 10.3390/nu15194183] [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] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Diet plays a crucial role in regulating individuals' lifestyles and is closely related to health. The intake of animal-sourced foods (ASF) provides the human body with high-quality protein and various micronutrients. This study aimed to investigate whether the diversity of animal foods has a positive impact on the health-related quality of life (HRQoL) among residents. The data came from the Shaanxi baseline survey of the Northwest Chinese Regional Ethnic Cohort Study, which recruited more than 100 thousand participants aged 35 to 74 from five provinces between June 2018 and May 2019. A total of 39,997 participants in Shaanxi (mean age: 50 years; 64% women) were finally included in this current study. The animal source food diet diversity score (ASFDDS) was established based on the frequency of consuming pork, mutton, beef, poultry, seafood, eggs, pure milk, and yogurt. The physical component score (PCS) and mental component score (MCS), ranging from 0 to 100 on the 12-Item Short Form Survey (SF-12), were used to assess participants' HRQoL. Better PCS/MCS was defined as scores higher than the 90th percentile. The results showed that men had a higher intake of ASF and ASFDDS than women. After adjusting for potential confounders, compared with those who never or rarely consumed animal foods, the likelihood of having better PCS and MCS increased by 16% (OR = 1.16, 95%CI: 1.01-1.34) and 24% (OR = 1.24, 95%CI: 1.03-1.448), respectively, in men with an ASFDDS ≥ 2. In women, a 34% increase (OR = l.34, 95%CI: 116-l.54) likelihood for better PCS was observed for an ASFDDS ≥ 2, but no association was observed for MCS. Increasing each specific animal source's food intake was associated with better PCS after adjusting for all covariates. However, for MCS, positive associations were only observed in seafood consumption among men and eggs among women. Restricted cubic splines showed a substantial dose-response association between intake frequency of animal-source foods and PCS, both in men and women. The study suggests that a diverse intake of animal-sourced foods can potentially improve the HRQoL of Chinese adults.
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Affiliation(s)
- Hui Jing
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Yuxin Teng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Samuel Chacha
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Ziping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Guoshuai Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Binyan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Jiaxin Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Yezhou Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Qiang Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Yuan Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Jiaomei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Yijun Kang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Shanshan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Danmeng Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L7 8XZ, UK;
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
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Alam MJ, Begum IA, Mastura T, Kishore A, Woodhill J, Chatterjee K, Jackson T. Agricultural diversification and intra-household dietary diversity: Panel data analysis of farm households in Bangladesh. PLoS One 2023; 18:e0287321. [PMID: 37352323 PMCID: PMC10289449 DOI: 10.1371/journal.pone.0287321] [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: 12/11/2022] [Accepted: 06/04/2023] [Indexed: 06/25/2023] Open
Abstract
This paper investigates the associations between agricultural diversification and dietary diversity among men, women and children of farm households in Bangladesh. Using three waves of nationally representative Bangladesh Integrated Household Survey (BIHS- 2011-12, 2015 and 2018) data and a panel data model, the study found that agricultural production diversification can emphasize the dietary diversification across the life cycle of farm household members. The balanced panel data reveals that agricultural production diversification has a statistically significant and positive impact on dietary diversity of individual members (men, women and children) of farm households. Moreover, other important factors that impact on agricultural diversification and improve dietary diversity like women's education and employment, commercialization of farm households, access to non-farm income sources, and access to information facilities also have a strong association in improving dietary status, food and nutritional security as well. Although there is currently limited diversity in the diets of adult men, women and children of rural farm households, the situation can be improved over time with proper and consistent support. The findings suggest policy interventions should target not only agricultural diversification but also improve women's education and on and off farm employment opportunities and facilitate better access to information for rural households. These recommendations can support improved dietary diversity for all household members under different settings.
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Affiliation(s)
- Mohammad Jahangir Alam
- Department of Agribusiness and Marketing, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Ismat Ara Begum
- Department of Agricultural Economics, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Tamanna Mastura
- Department of Agribusiness and Marketing, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Avinash Kishore
- International Food Policy Research Institute, New Delhi, India
| | - Jim Woodhill
- Environmental Change Institute, University of Oxford, Oxford, United Kingdom
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Nyhus Dhillon C, Vossenaar M, Weiligmann B, Sanwal N, Djimeu EW, Kneepkens M, Mushahary B, Stone G, Neufeld LM. A Nutrition Behavior Change Program Moderately Improves Minimum Diet Diversity and Handwashing Behaviors Among Tea Workers in Assam and Tamil Nadu, India. Food Nutr Bull 2022; 43:159-170. [PMID: 35172626 PMCID: PMC9118494 DOI: 10.1177/03795721211070706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Many workers in global supply chains remain nutritionally vulnerable despite the income they earn. The Seeds of Prosperity (SOP) program was implemented in Tamil Nadu and Assam, India, for tea supply chain workers (estate workers, small holder farmers, and farm workers). The aim was to enhance demand for diverse and nutritious foods and improve practices related to handwashing. The program used a behavior change communication approach wherein participants received weekly 1-hour group sessions with messaging on dietary diversity for 5 weeks and handwashing for 4 weeks. An impact evaluation was conducted to estimate changes in reported dietary and hygiene knowledge and behaviors among women. The study used a longitudinal quasi-experimental design in a subsample of program participants at baseline and post-intervention among both intervention and comparison. There was a small but significant increase in mean dietary diversity (DD) for all 4 worker groups (ranging from DD score changes of 0.3 to 0.7; P < .05) and in the proportion of women meeting the minimum dietary diversity in 2 of the 4 groups. Similarly, a significant increase in the mean number of handwashing moments was observed in 2 of the worker groups. An increase in home garden use was observed in 1 of the 4 worker groups. While the SOP program resulted in improvements in dietary diversity, most tea farming women still do not achieve minimum dietary diversity. Nutritious food access may be an important constraint to further improvement.
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Affiliation(s)
| | | | - Bärbel Weiligmann
- Global Alliance for Improved Nutrition (GAIN), Utrecht, The Netherlands
| | - Neha Sanwal
- Catalysts Management Services Pvt Ltd, Ashwathnagar, Bengaluru, Karnataka, India
| | - Eric W. Djimeu
- Global Alliance for Improved Nutrition (GAIN), Washington, DC, USA
| | - Mirjam Kneepkens
- Global Alliance for Improved Nutrition (GAIN), Washington, DC, USA
| | - Biju Mushahary
- Global Alliance for Improved Nutrition (GAIN), New Delhi, India
| | - Genevieve Stone
- Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland
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Correa Guzmán N, Calvo Betancur VD, Sepúlveda Herrera DM, Cárdenas Sánchez DL, Manjarrés Correa LM. Validation of an instrument to assess food diversity in women of childbearing age in Medellín, Colombia. Public Health Nutr 2022; 25:1-11. [PMID: 35393003 PMCID: PMC9991835 DOI: 10.1017/s1368980022000854] [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: 09/17/2021] [Revised: 03/11/2022] [Accepted: 04/04/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To validate a Food Diversity Questionnaire (CDA, for its name in Spanish) that identifies the prevalence of the risk of deficiency in the intake of eleven micronutrients. DESIGN The CDA paper form, an online application for data entry and handling, was designed and compared with the 24-h recall (24HR) as a reference method. All data were processed in Personal Computer Software for Intake Distribution Estimation (PC-SIDE) v1 software. A descriptive analysis and comparisons between prevalence, concordance and reproducibility analyses were performed. SETTING Medellín, Colombia. PARTICIPANTS Women of childbearing age between 19 and 50 years (n 186) who worked for the Buen Comienzo programme in 2019. RESULTS When comparing the adjusted 24HR technique and the CDA, there was no significant difference in population-level data at risk of deficiency in any micronutrient intake. However, based on individual-level data of the best linear unbiased predictor, the concordance analyses were weak, and although agreements were high according to the diagnostic performance tests, a good ability to detect deficiency was only observed in a few nutrients: vitamin A 100·0 %, Ca 98·7 %, Fe 92·8 %, folates 91·6 %, and pyridoxine 81·8 %. CONCLUSIONS The CDA validated in this study is useful and faster at evaluating population-level data at risk of deficiency in the intake of Ca, Fe, Zn, thiamine, riboflavin, niacin, pyridoxine, folates, vitamin B12, vitamin C and vitamin A. Based on individual-level data, a good ability to detect deficiencies was observed in the intake of vitamin A, Ca, Fe, folates and pyridoxine.
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Affiliation(s)
- Nathalia Correa Guzmán
- School of Nutrition and Dietetics, University of Antioquia (Universidad de Antioquia), Medellín051054, Colombia
- Research Group on Food and Human Nutrition, Medellín, Colombia
| | | | | | - Diana Liseth Cárdenas Sánchez
- School of Nutrition and Dietetics, University of Antioquia (Universidad de Antioquia), Medellín051054, Colombia
- Research Group on Food and Human Nutrition, Medellín, Colombia
| | - Luz Mariela Manjarrés Correa
- School of Nutrition and Dietetics, University of Antioquia (Universidad de Antioquia), Medellín051054, Colombia
- Research Group on Food and Human Nutrition, Medellín, Colombia
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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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Katenga-Kaunda LZ, Kamudoni PR, Holmboe-Ottesen G, Fjeld HE, Mdala I, Shi Z, Iversen PO. Enhancing nutrition knowledge and dietary diversity among rural pregnant women in Malawi: a randomized controlled trial. BMC Pregnancy Childbirth 2021; 21:644. [PMID: 34551744 PMCID: PMC8456581 DOI: 10.1186/s12884-021-04117-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/10/2021] [Indexed: 12/02/2022] Open
Abstract
Background In many sub-Saharan African countries, such as Malawi, antenatal care (ANC) services do not deliver sufficient nutrition awareness to improve adequate dietary intake in pregnancy. We therefore compared the effects of supplementary nutrition education and dietary counselling with routine ANC service on nutrition knowledge and dietary intakes among Malawian pregnant women. Methods We used data from a two-armed cluster randomised controlled trial (RCT) of which the intervention group received supplementary nutrition education, dietary counselling and routine ANC services whereas the controls received only routine ANC services. The RCT was conducted in 10 control and 10 intervention villages in Mangochi, Southern Malawi and included pregnant women between their 9th and 16th gestational weeks. We examined the changes in nutrition knowledge and dietary diversity from enrolment (baseline) to study end-point of the RCT (two weeks before expected delivery). We used three linear multilevel regression models with random effects at village level (cluster) to examine the associations between indicators of nutrition knowledge and diet consumption adjusted for selected explanatory variables. Results Among 257 pregnant women enrolled to the RCT, 195 (76%) were available for the current study. The supplementary nutrition education and counselling led to significant improvements in nutrition knowledge, dietary diversity and nutrition behaviour in the intervention group compared with controls. Most women from both study groups had a moderate consumption of diversified foods at study end-point. A significant positive association between nutrition knowledge and consumption of a diversified diet was only observed in the intervention group. Conclusions Nutrition knowledge and dietary diversity improved in both study groups, but higher in the intervention group. Increased nutrition knowledge was associated with improved dietary diversity only in the intervention women, who also improved their nutrition perceptions and behaviour. Antenatal nutrition education needs strengthening to improve dietary intakes in pregnancy in this low resource-setting. Trial registration Clinical trials.gov ID: NCT03136393 (registered on 02/05/2017).
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Affiliation(s)
- Lillian Ziyenda Katenga-Kaunda
- Malawi Government, Health and Social Services, Mzuzu City Council, Mzuzu, Malawi.,Department of Nutrition, University of Oslo, Oslo, Norway
| | | | - Gerd Holmboe-Ottesen
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
| | - Heidi E Fjeld
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
| | - Zumin Shi
- QU Health, Qatar University, Doha, Qatar
| | - Per Ole Iversen
- Department of Nutrition, University of Oslo, Oslo, Norway. .,Department of Haematology, Oslo University Hospital, Oslo, Norway. .,Division of Human Nutrition, Stellenbosch University, Tygerberg, South Africa.
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Jungert A, McNulty H, Hoey L, Ward M, Strain JJ, Hughes CF, McAnena L, Neuhäuser-Berthold M, Pentieva K. Riboflavin Is an Important Determinant of Vitamin B-6 Status in Healthy Adults. J Nutr 2020; 150:2699-2706. [PMID: 32805038 DOI: 10.1093/jn/nxaa225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/26/2020] [Accepted: 07/08/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Riboflavin is required to generate the active form of vitamin B-6 (pyridoxal 5'-phosphate; PLP) in tissues, but the relevance of this metabolic interaction for nutritional status of vitamin B-6 is unclear because riboflavin biomarkers are rarely measured in human studies. OBJECTIVES The purpose of this study was to identify the determinants of biomarkers of vitamin B-6 and riboflavin status and to examine the relationship between these nutrients in healthy adults. METHODS Multiple linear regression was performed on observational data in 407 healthy adults aged 18-92 y who did not use B-vitamin supplements. Vitamin B-6 status was assessed by plasma PLP concentrations and erythrocyte glutathione reductase activation coefficient (EGRac) was used as a functional indicator of riboflavin status. RESULTS Dietary intakes of vitamin B-6 and riboflavin were below the average requirements in 10% and 29% of participants, respectively. Suboptimal status of vitamin B-6 (PLP ≤30.0 nmol/L) was more prevalent in adults aged ≥60 y than in younger participants (i.e., 14% compared with 5%), whereas a high proportion (i.e., overall 37%) of both age groups had deficient riboflavin status (EGRac ≥1.40). In multiple regression analysis, EGRac (P = 0.019) was a significant determinant of plasma PLP, along with dietary vitamin B-6 intake (P = 0.003), age (P < 0.001), BMI (kg/m2) (P = 0.031), and methylenetetrahydrofolate reductase gene (MTHFR) genotype (P < 0.001). Significant determinants of EGRac were dietary riboflavin intake (P < 0.001), age (P < 0.001) and MTHFR genotype (P = 0.020). Plasma PLP showed a stepwise decrease across riboflavin status categories from optimal (EGRac ≤1.26) to low (EGRac 1.27-1.39) to deficient status (P = 0.001), independent of dietary vitamin B-6 intake. CONCLUSIONS The findings are consistent with the known metabolic dependency of vitamin B-6 on riboflavin status and indicate that riboflavin may be the limiting nutrient, particularly in older people, for maintaining adequate vitamin B-6 status.
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Affiliation(s)
- Alexandra Jungert
- Interdisciplinary Research Center for Biosystems, Land Use and Nutrition (IFZ), Biometry and Population Genetics, Justus Liebig University, Giessen, Germany
| | - Helene McNulty
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | - Leane Hoey
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | - Mary Ward
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | - J J Strain
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | - Catherine F Hughes
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | - Liadhan McAnena
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
| | | | - Kristina Pentieva
- Nutrition Innovation Centre for food and Health (NICHE), Ulster University, Coleraine, United Kingdom
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Weingarten SE, Dearden KA, Crookston BT, Penny ME, Behrman JR, Humphries DL. Are Household Expenditures on Food Groups Associated with Children's Future Heights in Ethiopia, India, Peru, and Vietnam? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4739. [PMID: 32630270 PMCID: PMC7370180 DOI: 10.3390/ijerph17134739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/16/2020] [Accepted: 06/24/2020] [Indexed: 11/16/2022]
Abstract
Household expenditure surveys, routinely conducted in low-and middle-income countries (LMICs), usually include questions pertaining to recent household expenditures on key food groups. When child anthropometrics are also available, such expenditure data can provide insights into household food purchasing patterns that are associated with subsequent child growth measures. We used data from 6993 children, born around 2001, from Ethiopia, India, Peru, and Vietnam, from the Young Lives younger cohort. We compared associations between two weeks of household food expenditures (in PPP-Purchasing Power Parity adjusted dollars) on food groups and child height-for-age-Z score (HAZ) at subsequent time points to assess longitudinal associations. Total food expenditures, rural/urban residence, maternal and paternal schooling, and child sex were included in our adjusted models because they may affect the relations between household food group expenditures and future child HAZ. In Ethiopia, India, and Peru every extra PPP$ spent on fats was associated with 0.02-0.07 higher future HAZ. In Vietnam every extra PPP$ spent on starches, was significantly associated with a 0.01 lower future HAZ. Across countries, different patterns of food expenditure and procurement may be differentially critical for predicting child HAZ. Our results demonstrate how expenditures on specific food groups can be associated with children's linear growth. This study provides additional evidence of the utility of longitudinal household food expenditure data in understanding child nutritional status.
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Affiliation(s)
- Sarah E. Weingarten
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA;
| | | | | | - Mary E. Penny
- Instituto de Investigación Nutricional, La Molina 15024, Peru;
| | - Jere R. Behrman
- Departments of Economics and Sociology, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Debbie L. Humphries
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510, USA;
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Dietary intake and processes of behaviour change in a nutrition education intervention for pregnant women in rural Malawi: a cluster-randomised controlled trial. Public Health Nutr 2020; 23:2345-2354. [PMID: 32419688 PMCID: PMC7426887 DOI: 10.1017/s1368980020000294] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective: To examine if increased intake of locally available nutrient-dense foods among pregnant women improved the quality of their dietary intake and if use of the Theory of Planned Behaviour could explain changes in their dietary behaviour. Design: We used data from a randomised controlled trial where the intervention group received nutrition education and dietary counselling. We promoted the use of recipes that utilised powders to enhance dietary diversity. We examined how the intervention achieved changes in dietary intakes and used mixed effects logistic regression models with random effects at village level to explore changes over time of the outcomes, adjusted for selected explanatory variables. Setting: The study was conducted in twenty villages in rural Malawi. Participants: Data from 257 pregnant women who were enrolled during late first trimester and followed until birth. Results: The intervention achieved improvements in the Dietary Diversity Score (DDS) and the Six Food Group Pyramid (SFG) score, especially in intakes of micronutrient-rich foods. A third of the women in the intervention group attained optimal DDS, whereas about 50 % attained optimal SFG. The theorised behaviour mediators (i.e. nutrition attitudes, nutrition behaviour control and subjective norm) that had improved were also significantly associated with high DDS. Conclusions: Improved dietary intakes were achieved through promoting the use of locally available nutrient-dense foods. Attainment of high DDS was a consequence of the women’s belief in the effectiveness of the proposed nutrition recommendations. We identified critical personal and environmental constraints related to dietary intakes during pregnancy in a low-resource setting.
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Bationo F, Humblot C, Songré-Ouattara LT, Hama-Ba F, Le Merrer M, Chapron M, Kariluoto S, Hemery YM. Total folate in West African cereal-based fermented foods: Bioaccessibility and influence of processing. J Food Compost Anal 2020. [DOI: 10.1016/j.jfca.2019.103309] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Bellows AL, Canavan CR, Blakstad MM, Mosha D, Noor RA, Webb P, Kinabo J, Masanja H, Fawzi WW. The Relationship Between Dietary Diversity Among Women of Reproductive Age and Agricultural Diversity in Rural Tanzania. Food Nutr Bull 2019; 41:50-60. [PMID: 31840547 DOI: 10.1177/0379572119892405] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Agriculture can influence diets through consumption of home-produced foods or increased purchasing power derived from sale of agricultural commodities. OBJECTIVE This article explores cross-sectional relationships between agricultural diversification and dietary diversity (a proxy for micronutrient adequacy) among women of reproductive age in rural Tanzania. METHODS Dietary diversity was measured using the women's minimum dietary diversity score indicator. Data were analyzed from the baseline survey of a cluster randomized control trial in Rufiji, Tanzania. One woman of reproductive age was randomly surveyed from each eligible household, totaling 1006 individuals. Generalized linear mixed-effects models were used to estimate the relationship between agricultural indicators and dietary diversity. RESULTS Median dietary diversity score for women was 3.00 (interquartile range: 2-3). Approximately 73% of households grew at least 1 crop in the previous year. Women's dietary diversity score was positively associated with cropping diversity (P for trend = .04), ownership of livestock (adjusted coefficient: 0.30; 95% confidence interval [CI]: 0.08-0.44; P = .005), cash crop production (adjusted coefficient: 0.22; 95% CI: 0.03-0.41; P = .02), and production of pulses (adjusted coefficient: 0.50; 95% CI: 0.27-0.74; P < .0001) and other vegetables (adjusted coefficient: 0.64; 95% CI: 0.11-1.17; P = .02). CONCLUSIONS Average dietary diversity is well below the recommended 5 food groups per day, a widely used indicator of micronutrient adequacy. Since the majority of households participate in agriculture, the efforts to promote agricultural diversification and/or specialization and sale of agricultural goods may positively influence dietary diversity and associated health and nutrition outcomes.
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Affiliation(s)
- Alexandra L Bellows
- Department of Global Health and Population, Harvard TH. Chan School of Public Health, Boston, MA, USA
| | - Chelsey R Canavan
- Department of Global Health and Population, Harvard TH. Chan School of Public Health, Boston, MA, USA
| | - Mia M Blakstad
- Department of Global Health and Population, Harvard TH. Chan School of Public Health, Boston, MA, USA
| | | | - Ramadhani A Noor
- Department of Global Health and Population, Harvard TH. Chan School of Public Health, Boston, MA, USA
| | - Patrick Webb
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Joyce Kinabo
- Department of Food Science and Technology, Sokoine University of Agriculture, Morogoro, Tanzania
| | | | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard TH. Chan School of Public Health, Boston, MA, USA
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Bationo F, Songré-Ouattara LT, Hama-Ba F, Baye K, Hemery YM, Parkouda C, Lingani-Sawadogo H, Diawara B, Humblot C. Folate Status of Women and Children in Africa – Current Situation and Improvement Strategies. FOOD REVIEWS INTERNATIONAL 2019. [DOI: 10.1080/87559129.2019.1608558] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Fabrice Bationo
- Département Technologie Alimentaire, Institut de Recherche en Sciences Appliquées et Technologies/Centre National de la Recherche Scientifique et Technique, Ouagadougou, Burkina Faso
- Food and nutrition research in the global south/Institut de Recherche pour le Développement, University of Montpellier/Montpellier SupAgro, Montpellier, France
| | - Laurencia Toulsoumdé Songré-Ouattara
- Département Technologie Alimentaire, Institut de Recherche en Sciences Appliquées et Technologies/Centre National de la Recherche Scientifique et Technique, Ouagadougou, Burkina Faso
| | - Fatoumata Hama-Ba
- Département Technologie Alimentaire, Institut de Recherche en Sciences Appliquées et Technologies/Centre National de la Recherche Scientifique et Technique, Ouagadougou, Burkina Faso
| | - Kaleab Baye
- Center for Food Sciences and Nutrition, College of Natural Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Youna M. Hemery
- Food and nutrition research in the global south/Institut de Recherche pour le Développement, University of Montpellier/Montpellier SupAgro, Montpellier, France
| | - Charles Parkouda
- Département Technologie Alimentaire, Institut de Recherche en Sciences Appliquées et Technologies/Centre National de la Recherche Scientifique et Technique, Ouagadougou, Burkina Faso
| | - Hagrétou Lingani-Sawadogo
- Département Technologie Alimentaire, Institut de Recherche en Sciences Appliquées et Technologies/Centre National de la Recherche Scientifique et Technique, Ouagadougou, Burkina Faso
| | - Bréhima Diawara
- Département Technologie Alimentaire, Institut de Recherche en Sciences Appliquées et Technologies/Centre National de la Recherche Scientifique et Technique, Ouagadougou, Burkina Faso
| | - Christèle Humblot
- Food and nutrition research in the global south/Institut de Recherche pour le Développement, University of Montpellier/Montpellier SupAgro, Montpellier, France
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Comparing intake estimations based on food composition data with chemical analysis in Malian women. Public Health Nutr 2017; 20:1351-1361. [PMID: 28173883 DOI: 10.1017/s1368980017000015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Food composition databases are essential for estimating nutrient intakes in food consumption surveys. The present study aimed to evaluate the Mali food composition database (TACAM) for assessing intakes of energy and selected nutrients at population level. DESIGN Weighed food records and duplicate portions of all foods consumed during one day were collected. Intakes of energy, protein, fat, available carbohydrates, dietary fibre, Ca, Fe, Zn and vitamin A were assessed by: (i) estimating the nutrient intake from weighed food records based on an adjusted TACAM (a-TACAM); and (ii) chemical analysis of the duplicate portions. Agreement between the two methods was determined using the Wilcoxon signed-rank test and Bland-Altman plots. SETTING Bamako, Mali. SUBJECTS Apparently healthy non-pregnant, non-lactating women (n 36) aged 15-36 years. RESULTS Correlation coefficients between estimated and analysed values ranged from 0·38 to 0·61. At population level, mean estimated and analysed nutrient intakes differed significantly for carbohydrates (203·0 v. 243·5 g/d), Fe (9·9 v. 22·8 mg/d) and vitamin A (356 v. 246 µg retinol activity equivalents). At individual level, all estimated and analysed nutrient intakes differed significantly; the differences tended to increase with higher intakes. CONCLUSIONS The a-TACAM is sufficiently acceptable for measuring average intakes of macronutrients, Ca and Zn at population level in low-intake populations, but not for carbohydrate, vitamin A and Fe intakes, and nutrient densities.
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The role of seasonality on the diet and household food security of pregnant women living in rural Bangladesh: a cross-sectional study. Public Health Nutr 2016; 20:121-129. [PMID: 27573667 DOI: 10.1017/s136898001600183x] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the association of seasonality with dietary diversity, household food security and nutritional status of pregnant women in a rural district of northern Bangladesh. DESIGN A cross-sectional study was conducted from February 2013 to February 2015. Data were collected on demographics, household food security (using the Household Food Insecurity Access Scale), dietary diversity (using the women's dietary diversity questionnaire) and mid-upper arm circumference. Descriptive statistics were used to explore demographics, dietary diversity, household food security and nutritional status, and inferential statistics were applied to explore the role of seasonality on diversity, household food security and nutritional status. SETTING Twelve villages of Pirganj sub-district, Rangpur District, northern Bangladesh. SUBJECTS Pregnant women (n 288). RESULTS Seasonality was found to be associated with dietary diversity (P=0·026) and household food security (P=0·039). Dietary diversity was significantly lower in summer (P=0·029) and spring (P=0·038). Food security deteriorated significantly in spring (P=0·006) and late autumn (P=0·009). CONCLUSION Seasons play a role in women's household food security status and dietary diversity, with food security deteriorating during the lean seasons and dietary diversity deteriorating during the second 'lesser' lean season and the season immediately after. Interventions that aim to improve the diet of pregnant women from low-income, subsistence-farming communities need to recognise the role of seasonality on diet and food security and to incorporate initiatives to prevent seasonal declines.
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Nair MK, Augustine LF, Konapur A. Food-Based Interventions to Modify Diet Quality and Diversity to Address Multiple Micronutrient Deficiency. Front Public Health 2016; 3:277. [PMID: 26779472 PMCID: PMC4700276 DOI: 10.3389/fpubh.2015.00277] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 12/07/2015] [Indexed: 11/23/2022] Open
Abstract
Global data indicate a high prevalence of hidden hunger among population. Deficiencies of certain micronutrients such as folic acid, iodine, iron, and vitamin A have long lasting effects on growth and development and therefore have been a National priority from many decades. The strategy implemented so far limits to the use of supplemental sources or fortified foods in alleviating the burden of deficiencies. These approaches however undermine the food-based strategies involving dietary diversification as the long-term sustainable strategy. There is lack of understanding on the level of evidence needed to implement such strategies and the level of monitoring required for impact evaluation. Dietary diversity concerns how to ensure access for each individual to a quality and safe diet with adequate macro- and micronutrients. The key to success in using dietary diversity as a strategy to tackle hidden hunger is in integrating it with the principles of bioavailability, translated to efficient food synergies with due emphasis on food accessibility, affordability, and outdoor physical activity/life style modifications. Promoting enabling environment and sustainable agriculture is crucial for practicing dietary diversification with behavior change communication as an integral segment. It can be concluded that food-based strategies require careful understanding of the factors associated with it and moderate it to form an effective strategy for controlling multiple micronutrient deficiencies.
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Affiliation(s)
- Madhavan K. Nair
- Micronutrient Research, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - Little Flower Augustine
- Micronutrient Research, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - Archana Konapur
- Micronutrient Research, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
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Desalegn A, Mossie A, Gedefaw L. Nutritional iron deficiency anemia: magnitude and its predictors among school age children, southwest Ethiopia: a community based cross-sectional study. PLoS One 2014; 9:e114059. [PMID: 25438147 PMCID: PMC4250059 DOI: 10.1371/journal.pone.0114059] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 11/03/2014] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Iron deficiency anemia (IDA) is a global public health problem among school age children, which retards psychomotor development and impairs cognitive performance. There is limited data on prevalence and risk factors for IDA. OBJECTIVE The aim of this study was to determine the prevalence, severity, and predictors of nutritional IDA in school age children in Southwest Ethiopia. METHODOLOGY A community based cross-sectional study was conducted in Jimma Town, Southwest Ethiopia from April to July 2013. A total of 616 school children aged 6 to 12 years were included in the study using multistage sampling technique. A structured questionnaire was used to collect sociodemographic data. Five milliliter venous blood was collected from each child for hematological examinations. Anemia was defined as a hemoglobin level lower than 11.5 g/dl and 12 g/dl for age group of 5-11 years and 12-15 years, respectively. Iron deficiency anemia was defined when serum iron and ferritin levels are below 10 µmol/l and 15 µg/dl, respectively. Moreover, fresh stool specimen was collected for diagnosis of intestinal parasitic infection. Stained thick and thin blood films were examined for detection of Plasmodium infection and study of red blood cell morphology. Dietary patterns of the study subjects were assessed using food frequency questionnaire and anthropometric measurements were done. Data were analyzed using SPSS V-20.0 for windows. RESULT Overall, prevalence of anemia was 43.7%, and that of IDA was 37.4%. Not-consuming protein source foods [AOR = 2.30, 95%CI(1.04,5.14)], not-consuming dairy products [AOR = 1.83, 95%CI(1.14,5.14)], not-consuming discretionary calories [AOR = 2.77, 95%CI(1.42,5.40)], low family income [AOR = 6.14, 95%CI(2.90,12.9)] and intestinal parasitic infections [AOR = 1.45, 95%CI(1.23, 5. 27)] were predictors of IDA. CONCLUSION Iron deficiency anemia is a moderate public health problem in the study site. Dietary deficiencies and intestinal parasitic infections were predictors of IDA. Therefore, emphasis should be given to the strategies for the prevention of risk factors for IDA.
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Affiliation(s)
- Amare Desalegn
- Department of Biomedical Sciences, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Andualem Mossie
- Department of Biomedical Sciences, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Lealem Gedefaw
- Department of Medical Laboratory Science and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
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Belachew T, Lindstrom D, Gebremariam A, Hogan D, Lachat C, Huybregts L, Kolsteren P. Food insecurity, food based coping strategies and suboptimal dietary practices of adolescents in Jimma zone Southwest Ethiopia. PLoS One 2013; 8:e57643. [PMID: 23554864 PMCID: PMC3595236 DOI: 10.1371/journal.pone.0057643] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 01/28/2013] [Indexed: 01/10/2023] Open
Abstract
Despite the high prevalence of adolescent food insecurity in Ethiopia, there is no study which documented its association with suboptimal dietary practices. The objective of this study is to determine the association between adolescent food insecurity and dietary practices. We used data on 2084 adolescents in the age group of 13-17 years involved in the first round survey of the five year longitudinal family study in Southwest Ethiopia. Adolescents were selected using residence stratified random sampling methods. Food insecurity was measured using scales validated in developing countries. Dietary practices were measured using dietary diversity score, food variety score and frequency of consuming animal source food. Multivariable regression models were used to compare dietary behaviors by food security status after controlling for socio-demographic and economic covariates. Food insecure adolescents had low dietary diversity score (P<0.001), low mean food variety score (P<0.001) and low frequency of consuming animal source foods (P<0.001). After adjusting for other variables in a multivariable logistic regression model, adolescent food insecurity (P<0.001) and rural residence (P<0.001) were negatively associated with the likelihood of having a diversified diet (P<0.001) and frequency of consuming animal source foods, while a high household income tertile was positively associated. Similarly, multivariable linear regression model showed that adolescent food insecurity was negatively associated with food variety score, while residence in semi-urban areas (P<0.001), in urban areas (P<0.001) and high household income tertile (P = 0.013) were positively associated. Girls were less likely to have diversified diet (P = 0.001) compared with boys. Our findings suggest that food insecurity has negative consequence on optimal dietary intake of adolescents. Food security interventions should look into ways of targeting adolescents to mitigate these dietary consequences and provide alternative strategies to improve dietary quality of adolescents in Southwest Ethiopia.
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Affiliation(s)
- Tefera Belachew
- Department of Population and Family Health, Jimma University, Jimma, Ethiopia.
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Sossa C, Delisle H, Agueh V, Sodjinou R, Ntandou G, Makoutodé M. Lifestyle and dietary factors associated with the evolution of cardiometabolic risk over four years in West-African adults: the Benin study. J Obes 2013; 2013:298024. [PMID: 23555051 PMCID: PMC3608277 DOI: 10.1155/2013/298024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Accepted: 02/06/2013] [Indexed: 11/18/2022] Open
Abstract
AIM To assess in adults from Benin changes in cardiometabolic risk (CMR) using both the Framingham risk score (FRS) and metabolic syndrome (MetS) and to examine the effects of diet, and lifestyles, controlling for location and socioeconomic status. METHODS Apparently healthy subjects (n = 541) aged 25-60 years and randomly selected in the largest city, a small town, and rural areas were included in the four-year longitudinal study. Along with CMR factors, socioeconomic, diet and lifestyle data were collected in individual interviews. A food score based on consumption frequency of four "sentinel" food groups (meat and poultry, dairy, eggs, and vegetables) was developed. Lifestyle included physical activity, alcohol and tobacco use. Education and income (proxy) were the socioeconomic variables. RESULTS Among the subjects with four-year follow-up data (n = 416), 13.5% were at risk at baseline, showing MetS or FRS ≥ 10%. The incidence of MetS and FRS ≥ 10% during follow-up was 8.2% and 5%, respectively. CMR deteriorated in 21% of subjects. Diet and lifestyle mediated location and income effects on CMR evolution. Low food scores and inactivity increased the likelihood of CMR deterioration. CONCLUSION Combining MetS and FRS might be appropriate for surveillance purposes in order to better capture CMR and inform preventive measures.
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Affiliation(s)
- Charles Sossa
- TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, University of Montreal, CP 6128, Succursale Centre-Ville, Montréal, QC, Canada H3C 3J7.
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Verger EO, Mariotti F, Holmes BA, Paineau D, Huneau JF. Evaluation of a diet quality index based on the probability of adequate nutrient intake (PANDiet) using national French and US dietary surveys. PLoS One 2012; 7:e42155. [PMID: 22870293 PMCID: PMC3411671 DOI: 10.1371/journal.pone.0042155] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 07/02/2012] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Existing diet quality indices often show theoretical and methodological limitations, especially with regard to validation. OBJECTIVE To develop a diet quality index based on the probability of adequate nutrient intake (PANDiet) and evaluate its validity using data from French and US populations. MATERIAL AND METHODS The PANDiet is composed of adequacy probabilities for 24 nutrients grouped into two sub-scores. The relationship between the PANDiet score and energy intake were investigated. We evaluated the construct validity of the index by comparing scores for population sub-groups with 'a priori' differences in diet quality, according to smoking status, energy density, food intakes, plasma folate and carotenoid concentrations. French and US implementations of the PANDiet were developed and evaluated using national nutritional recommendations and dietary surveys. RESULTS The PANDiet was not correlated with energy for the French implementation (r = -0.02, P>0.05) and correlated at a low level for the US implementation (r = -0.11, P<0.0001). In both implementations, a higher PANDiet score (i.e. a better diet quality) was associated with not smoking, having a lower-energy-dense diet, consuming higher amounts of fruits, vegetables, fish, milk and other dairy products and lower amounts of cheese, pizza, eggs, meat and processed meat, and having higher plasma folate and carotenoid concentrations after controlling for appropriate factors (all P<0.05, carotenoid data for US not available). CONCLUSIONS The PANDiet provides a single score that measures the adequacy of nutrient intake and reflects diet quality. This index is adaptable for use in different countries and relevant at the individual and population levels.
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Affiliation(s)
- Eric O Verger
- AgroParisTech, CRNH-IdF, UMR914 Nutrition Physiology and Ingestive Behavior, Paris, France.
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Termote C, Bwama Meyi M, Dhed'a Djailo B, Huybregts L, Lachat C, Kolsteren P, Van Damme P. A biodiverse rich environment does not contribute to a better diet: a case study from DR Congo. PLoS One 2012; 7:e30533. [PMID: 22291981 PMCID: PMC3265488 DOI: 10.1371/journal.pone.0030533] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 12/23/2011] [Indexed: 11/22/2022] Open
Abstract
The potential of biodiversity to increase and sustain nutrition security is increasingly recognized by the international research community. To date however, dietary assessment studies that have assessed how biodiversity actually contributes to human diets are virtually absent. This study measured the contribution of wild edible plants (WEP) to the dietary quality in the high biodiverse context of DR Congo. The habitual dietary intake was estimated from 2 multiple-pass 24 h dietary recalls for 363 urban and 129 rural women. All WEP were collected during previous ethnobotanical investigations and identified and deposited in the National Botanical Garden of Belgium (BR). Results showed that in a high biodiverse region with precarious food security, WEP are insufficiently consumed to increase nutrition security or dietary adequacy. The highest contribution came from Dacryodes edulis in the village sample contributing 4.8% of total energy intake. Considering the nutrient composition of the many WEP available in the region and known by the indigenous populations, the potential to increase nutrition security is vast. Additional research regarding the dietary contribution of agricultural biodiversity and the nutrient composition of WEP would allow to integrate them into appropriate dietary guidelines for the region and pave the way to domesticate the most interesting WEP.
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Affiliation(s)
- Céline Termote
- Laboratory of Tropical and Subtropical Agronomy and Ethnobotany, Faculty of Bioscience Engineering, Ghent University, Gent, Belgium.
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Ruel MT, Deitchler M, Arimond M. Developing simple measures of women's diet quality in developing countries: overview. J Nutr 2010; 140:2048S-50S. [PMID: 20881078 DOI: 10.3945/jn.110.123695] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Marie T Ruel
- Division of Poverty, Health and Nutrition, International Food Policy Research Institute, Washington, DC 20006, USA.
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