Nutrition knowledge, dietary patterns and anthropometric indices of older persons in four peri-urban communities in Ga West municipality, Ghana

Nutritional status is associated with cognition and grip strength among older adults: A 10-y longitudinal study in Ghana and South Africa

OBJECTIVES

The current study examined the association between nutritional status and changes in cognition and grip strength among older Ghanaian and South African adults over time using three waves of data from the WHO Study on global AGEing and adult health (SAGE).

METHODS

In total, 6113 and 3623 records of adults aged 60+ y were assessed from Ghanaian and South African datasets, respectively. These were extracted from three waves of the SAGE, conducted between 2007 and 2019. The six-item Mini Nutritional Assessment-Short Form questionnaire, five cognitive performance tests, and dynamometer were used to measure nutritional status, cognition, and handgrip strength, respectively. Data were analyzed by one-way analysis of variance and linear mixed models.

RESULTS

After adjusting for all significant covariates, participants at risk of malnutrition (Ghana 3.05 [Standard error (SE) = 0.56], P < 0.0001; South Africa 3.79 [SE = 1.58], P = 0.016) and those with adequate nutritional status (Ghana 6.36 [SE = 0.59], P < 0.0001; South Africa 8.30 [SE = 1.56], P < 0.0001) had significantly higher cognitive scores compared with malnourished participants. In both Ghana and South Africa, handgrip strength was significantly different between the categories of nutritional status in all three study waves (analysis of variance Ghana W1: P < 0.0001, W2: P = 0.0007, W3: P = 0.0043; South Africa P < 0.0001 for all). Significantly higher handgrip strength was measured in participants either classified at risk of malnutrition (Ghana; 2.69 [SE = 0.47], P < 0.0001; South Africa; 4.18 [SE = 2.02], P = 0.038) or those with adequate nutritional status (Ghana; 4.27 [SE = 0.51], P < 0.0001; South Africa; 9.76 [SE = 1.97], P < 0.0001) compared with participants classified as malnourished in both countries. After adjustment for covariates, these differences remained significant in Ghana, but only for those with adequate nutritional status in South Africa.

CONCLUSIONS

This study confirmed a positive longitudinal association between nutritional status and both cognitive function and hand grip strength for older adults in Ghana and South Africa. These findings highlight the importance of nutritional intervention to promote access to adequate, nutritious diets as people in low- and middle-income countries age.

Tools for screening maternal mental health conditions in primary care settings in sub-Saharan Africa: systematic review

Introduction

In sub-Saharan Africa, pregnant and postpartum women with mental health problems are often missed in healthcare systems. To address this, a practical and simple screening tool for maternal mental health should be available to primary healthcare workers. An important step toward having such a tool is to assess the existing tools and their effectiveness in primary care settings.

Methods

We systematically searched PubMed, LILAC, CINAHL, Google Scholar, African Index Medicus, HINARI, and African Journals Online from inception to 31 January 2023, without language restriction. Reference lists of retrieved articles were reviewed and experts in the field were contacted for studies not captured by our searches. All retrieved records were collated in Endnote, de-duplicated, and exported to Rayyan for screening. Study selection and data extraction were done by at least two reviewers using a pre-tested flow chart and data extraction form. Disagreements between reviewers were resolved through discussion. We contacted primary authors for missing or insufficient information and conducted a content analysis of the psychometric properties of the tools.

Results

In total, 1,181 studies were retrieved by our searches, of which 119 studies were included in this review. A total of 74 out of 119 studies (62%) were screened for depression during pregnancy and or the postpartum period. The Edinburg Postpartum Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9) were the most commonly used tools. In total, 12 studies reported specificity and sensitivity for tools for measuring depression (EPDS, PHQ-9, and Whooley) and psychological distress [Self Report Questionnaire (SRQ) and Kessler Psychological Distress Scale (KPDS)]. The average sensitivity and specificity of the EPDS reported were 75.5 and 76.5%, respectively, at a cut-off of ≥13. The EPDS appears to be the most acceptable, adaptable, user-friendly, and effective in screening for maternal mental health conditions during pregnancy and postpartum. However, the methodological approach varied for a particular tool, and documentation on the attributes was scanty.

Conclusion

The EPDS was the most commonly used tool and considered as most acceptable, adaptable, user-friendly, and effective. Information on the performance and psychometric properties of the vast majority of screening tools was limited.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022323558, identifier CRD42022323558 (PROSPERO).

Dietary practice and associated factors among elderly people in Northwest Ethiopia, 2022: Community based mixed design

BACKGROUND

The planet's population is aging at an incredible speed. Poor dietary practices are a major problem among the elderly. However, literature is scarce on dietary practices among elders in the study area. Therefore, the results of this study may give information to decision-makers.

OBJECTIVE

This study aimed to assess dietary practices and associated factors among elderly people in Northwest Ethiopia, in 2022.

METHODS

A community-based mixed study design was employed among elderly people from May 20 to July 2, 2022. Systematic random sampling and purposive sampling techniques were used for selecting study participants in quantitative and qualitative studies, respectively. Data were collected using an interviewer-administered structured questionnaire for the quantitative part and an interview guide for the qualitative part. Binary logistic regression analysis was used. A P-value less than or equal to 0.05 was used to declare statistically significant variables. A crude odds ratio and an adjusted odds ratio with a 95% confidence interval were used to measure the strength of the association. Thematic analysis was used for qualitative data analysis.

RESULTS

A total of 422 participants were recruited for the study. Twenty-six in-depth interviews were done. The prevalence of adequate dietary practice was only 54.5% [95% CI: (49.8, 59.2)]. It was significantly associated with being aged between 65 to 74 years (AOR: 8.32; 95 CI: 3.9, 18.1), being aged between 75 to 84 years (AOR: 2.90; 95% CI: 1.1, 7.9), eating sometimes alone (AOR: 1.86; 95% CI: 1.03, 3.4), eating always with family members (AOR: 4.96; 95% CI: 2.6, 9.4), and food security (AOR: 3.13; 95% CI: 1.8, 5.4). Thematic analysis revealed three themes that interfere with the dietary practices of elders. A majority of in-depth interviewees mentioned that there were taboos and cultural beliefs which favor inadequate dietary practices of the elderly; the study participants reported that individual, economic, societal, and physiological factors are barriers affecting the dietary practices of the elderly, and all respondents have no experiences regarding elderly dietary practices.

CONCLUSION

The prevalence of adequate dietary practice was low. It was significantly associated with age, with whom feeding, and household food security status. Taboos and cultural beliefs, barriers, and experiences hampered the dietary practices of elders. Therefore, improving the dietary practices of elders focusing on advanced age, loneliness, food security, taboos, cultural beliefs, barriers, and experiences regarding dietary practices should be done.

Dietary practice and nutritional status of low-income earners in a rural adult population in Delta State, Nigeria: a cross-sectional study

Introduction

due to the inability of low-income populations to access nutritious foods or basic education, these groups usually consume unhealthy diets, which frequently lead to nutrition issues like obesity, malnutrition, and other health morbidities. The purpose of the study was to evaluate the nutritional knowledge, dietary practices, nutritional status, and factors influencing the dietary habits of low-income persons living in a rural constituency in Southern Nigeria.

Methods

a cross-sectional study was carried out on 419 consenting low-income adults (18 years and older) using a simple random technique, in order to collect data on their socio-demographic traits, nutritional knowledge, dietary practices, and nutritional status. Statistical Package for Social Sciences (SPSS) version 22.0 was used to analyze the data generated.

Results

the respondents´ the average age was 40.9 ± 15.68 years while 224 (53.5%) of those surveyed were females. The proportion of responders with a secondary education was highest 279 (66.6%). The most common occupation among respondents was farming 151 (36.1%) and petty trading 135 (32.2%). Overall, 314 (74.9%) of low-income adults had poor dietary habits, and 245 (60.6%) had poor nutrition knowledge. Occupation and gender were significantly associated with nutritional status P<0.05. The majority of respondents 56.2% (235) were overweight or obese, and multivariate logistic regression analysis shows that respondents with concern about gaining weight were more likely to be overweight or obese (OR=1.065, 95% CI=0.832-1.363).

Conclusion

the findings from the study indicate that inadequate nutritional knowledge and poor dietary habits, reflected in respondents' body weight are likely to increase the risk of non-communicable diseases, necessitating the need for nutritional education among rural populations.

Understanding Healthy Eating Habits of Elderly People in a Geriatric Center in Kirkuk City: A Cross-Sectional Study

Background A person's nutritional knowledge has a great influence on their eating habits and nutritional status. Identifying knowledge gaps can lead to educational efforts to reduce the probability of malnutrition and encourage healthy aging. This study aimed to assess older people's knowledge of healthy eating and identify associated factors in the Geriatric Center in Kirkuk City. Methods This was a cross-sectional study conducted from November 5, 2023, to February 25, 2024, at the Geriatric Center in Kirkuk City on 25 older adults who were targeted at the only specialist center in Kirkuk City. All center residents were included (≥60 years old and without severe cognitive impairment). A non-probability, purposive sample was employed in the study. Data were collected using an interview-structured questionnaire. The structured questionnaire consisted of two parts. The first part focused on socio-demographic variables such as age, gender, marital status, education level, and type of work before admission to the center, as well as smoking status, walking, and medical history. The second part related to assessing older people's knowledge of healthy eating using 17 items. Data entry and analysis were performed using SPSS (v 26; IBM Corp., Armonk, NY, US). Data are reported as frequency and percentage and the chi-square test/Fisher exact test was used for categorical variables. The significance level for statistical analysis was set at p<0.05. Results Of the 25 participants included in the study, 20 (80%) were men and 5 (20%) were women. Approximately two-thirds of the 17 (68%) were between 60 and 69 years old, with a mean age of 69.44 ± 5.71 years. Of the 25 older people surveyed, 16 (64%) had low knowledge of healthy eating while 9 (36%) had high knowledge. Knowledge level was significantly associated with age (p = 0.001), gender (p = 0.040), education level (p = 0.006), and smoking status (p = 0.037). Conclusions In the geriatric center in Kirkuk City, the level of knowledge of healthy eating was low. The knowledge level of people tends to be related to factors like age, gender, education level, and smoking status. This, in turn, requires implementing educational programs by healthcare providers at the center to promote knowledge and understanding of healthy diets and practices.

Family Income Level, Income Structure, and Dietary Imbalance of Elderly Households in Rural China

In rural areas, the aging of households is becoming increasingly severe, and the issue of dietary imbalance among the elderly is becoming increasingly prominent. Using data from the China Health and Nutrition Survey (CHNS), the negative binomial regression method was used to investigate the impact of household income level on dietary imbalance among rural elderly people, and to explore the heterogeneity of household income structure and its role in the relationship between the two. Research has found that an increase in total household income significantly improves the dietary quality of rural elderly people, and the income structure variable enhances its negative pulling effect on dietary imbalance. For elderly people with moderate dietary imbalance, the effect of increased family income is most significant. In different income groups, the impact of total household income on dietary imbalance in the high-income group is greater than that in the low-income group, and there is also a significant difference in the role played by the proportion of net income from agricultural operations. Therefore, it is necessary to increase the non working income of the elderly, strengthen social responsibility for elderly care, and alleviate the problem of dietary imbalance among rural elderly people.

Dietary patterns among adults in three low-income urban communities in Accra, Ghana

OBJECTIVE

Dietary patterns describe the dietary behaviour and habits of individuals. Unhealthy dietary patterns provide individuals with limited nutrients while increasing the risk of nutrition-related diseases. Unhealthy dietary patterns are high in urban areas, especially among low-income urban residents. This study examined dietary patterns in three low-income urban communities in Accra, Ghana, between 2011 and 2013.

METHODS

This study used Wave 2 and 3 data from the Urban Health and Poverty Survey (EDULINK 2011 and 2013). The sample size was 960 in 2011 and 782 in 2013. Dietary pattern was examined using factor analysis and the NOVA food classification system. Summary statistics were computed for sociodemographic characteristics and diet frequency and pattern. Differences in dietary behaviours between 2011 and 2013 were also estimated. Three logistic regression models were computed to determine the predictors of dietary patterns.

RESULTS

The frequency of consumption of animal-source foods (ASF) and fruits was higher in 2013 compared with 2011. The intake of processed culinary ingredients (NOVA Group 2), processed foods (NOVA Group 3) and ultra-processed foods (NOVA Group 4) was higher in 2013 versus 2011. In 2013, 29% consumed ultra-processed foods compared to 21% in 2011. Three dietary patterns (rice-based, snack-based, and staple and stew/soup) were identified. About two out of every five participants consumed the food items in the rice (43%) and staple and sauce patterns (40%). The proportion of participants who consumed the food items in the snack pattern was 35% in 2011 but 41% in 2013. Respondents aged 25-34 and those with higher education often consumed the snack-based and rice-based dietary patterns. In 2013, participants in Ussher Town had a higher probability of consuming food items in the snack pattern than those living in Agbogbloshie.

CONCLUSIONS

This study found that between 2011 and 2013, more participants consumed ASFs, fruits, and processed foods. A complex interplay of personal and socio-cultural factors influenced dietary intake. The findings of this study mirror global changes in diet and food systems, with important implications for the primary and secondary prevention of NCDs. Health promotion programs at the community level are needed to address the increasing levels of processed food consumption.

Magnitude of undernutrition and its association with dietary diversity among older persons in Ethiopia: a systematic review and meta-analysis, 2023

Undernutrition in elders remains under-detected, under-treated, and under-resourced and leads to further weight loss, increased infections, and delay in recovery from illness as well as increased hospital admissions and length of stay. The reports of the findings were fragmented and inconsistent in Ethiopia. Therefore, the main objective of this meta-analysis was to estimate the pooled prevalence of undernutrition and its association with dietary diversity among older persons in Ethiopia. Online databases (Medline, PubMed, Scopus, and Science Direct), Google, Google Scholar, and other grey literature were used to search articles until the date of publication. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. The random effect model was used to estimate the pooled prevalence; whereas subgroup analysis and meta-regression were performed to identify the probable source of heterogeneity using Stata version 14.0 software. Out of 522 studies accessed, 14 met our criteria and were included in the study. A total of 7218 older people (aged above 60 years old) were included in the study. The pooled proportion of undernutrition among older persons in Ethiopia was 20⋅6 % (95 % CI 17⋅3, 23⋅8). Elders who consumed low dietary diversity scores were strongly associated with undernutrition among older persons. Therefore, promoting appropriate intervention strategies for elders to improve dietary diversity practices and nutritional status is crucial.

Nutritional status and associated factors among the elderly in Guinea: a first national cross-sectional study

Aging of the Guinean population is a public health concern for the coming years, and the nutritional status of older people is virtually unknown. We also know that this population is growing and that undernutrition and obesity can affect the health of older adults. This study aimed to assess the nutritional status of older people in the general population of Guinea and its associated factors. A representative cross-sectional survey was conducted using sociodemographic, clinical, and anthropometric data (weight and height). Oral status was assessed by using the University of Nebraska Oral Status Scale. Visual acuity was assessed using the Monoyer scale. The standardized prevalence ratio (SPR) of the nutritional status was calculated for each region. The sample included 1698 subjects with a mean BMI of 22.6 ± 4.3 kg/m2. A total of 50.3% had impaired oral status and 20.3% had moderately to severely impaired visual acuity. The prevalence of undernutrition was 14.4% and of obesity 5.7%. Differences in the prevalence of nutritional status were found between regions, with an SPR > 1 for undernutrition in the Labé region (SPR 1.9, 95% CI = 1.5-2.5) and for obesity in the Conakry and Kindia regions (SPR of 2.90, 95% CI = 2.0-4.05 and 2.32, 95% CI = 1.5-3.3, respectively). In Guinea, The prevalence of nutritional disorders was approximately 20%. Screening and management of the health and nutritional status of older adults should be a national priority, and management should be adapted to each region of the country.

Double burden of malnutrition and its associated factors among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a multinomial regression model analysis

Background

The double burden of malnutrition (DBM), contained both undernutrition and overnutrition, is a growing public health concern that presents a significant challenge to the food and nutrition policies of developing nations such as Ethiopia. However, the prevalence and contributing factors of DBM among adolescents in the study area have not been adequately investigated by Ethiopian researchers. Therefore, this study aims to determine the prevalence of DBM and contributing factors among secondary school students in Debre Berhan City, Ethiopia.

Methods

A school-based cross-sectional study was conducted among 742 adolescents aged 10-19 years from October 13, 2022, to November 14, 2022, using a multi-stage sampling method. Data were collected using the online Kobo toolbox tool. A multinomial logistic regression model was used to analyze the data. The data were cleaned and analyzed in R software 4.2.2. Adolescents who had body mass index for age Z score (BAZ) < -2 SD, > +1 SD, and > +2 from the median value were considered thin, overweight, and obese, respectively.

Results

The overall prevalence of DBM was 21.5% (14.8% thinness and 6.7% overweight/obesity). In the multivariable multinomial logistic regression analysis models factors such as age [AOR = 0.79, 95% CL: (0.67, 0.93)], sex [AOR = 3.86, 95% CL: (2.35, 6.32)], school type [AOR 5.03, 95% CL: (2.30, 10.99)], minimum dietary diversity score [AOR = 2.29, 95% CL: (1.27, 4.14)], frequency of meals [AOR = 2.09, 95% CL: (1.13, 3.89)], home gardening practice [AOR = 2.31, 95% CL: (1.44, 3.67)], history of illness [AOR = 0.57, 95% CL: (0.36, 0.93)], and knowledge of nutrition [AOR = 4.96, 95% CL: (1.61, 15.33)] were the significant predictors of either thinness or overweight/obesity (DBM).

Conclusion

More than one-fifth of adolescents were affected by DBM in the study area. This prevalence is higher compared with the national and regional prevalence that found to be a public health concern. Thus, interventions like double-duty interventions should consider the age, sex, school type, minimum dietary diversity score, frequency of meals, home gardening practice, history of illness, and nutritional knowledge of adolescents.

Clinical Trial Registration

clinicaltrial.gov, identifier NCT05574842.

Nutritional status and its associated factors among elderly people in Ilu Aba Bor Zone, Southwest Ethiopia: a community-based cross-sectional study

OBJECTIVES

This study aimed to assess the nutritional status and its associated factors among elderly people.

DESIGN

A community-based cross-sectional study.

SETTING

The study was conducted in urban and semiurban areas.

PARTICIPANTS

The study included 620 elderly community dwellers in Southwest Ethiopia from 3 October 2021 to 10 November 2021. Those who were seriously ill, could not get around or were on special diets were excluded from the study.

OUTCOME MEASURE

The Mini Nutritional Assessment was used to evaluate nutritional status and the STEPwise approach was used to collect data on backgrounds and lifestyle. SPSS V.22.0 was used for data analysis. Logistic regression was computed. The level of significance was set at 0.05.

RESULTS

Elderly people who were malnourished or at risk of malnutrition were found to make up 48.1% (44.1%) and 17.4% (14.5%) of the population, respectively. Those aged 80 years and older had a chance of being at risk of malnutrition (adjusted OR (AOR)=22.555; 95% CI: 7.963 to 63.881), while the odds of being malnourished were 11.5 times higher (AOR=11.755; 95% CI: 4.825 to 28.638). Informal education was a significant predictor of being at risk of malnutrition (AOR=6.102; 95% CI: 2.684 to 13.871). Urban dwellers were 8.9 times more likely to be malnourished. Inadequate financial resources make people 3.7 times more likely to be malnourished. A lower wealth index was a significant predictor of being at risk of malnutrition (AOR=4.156; 95% CI: 1.361 to 12.692). Single elderly people had a 3.4-fold higher risk of malnutrition. Elderly people with chronic pain, who were smokers and alcoholics, and who had depression were all at risk of nutritional problems.

CONCLUSION

The risk of malnutrition and malnourishment was high. Age, urbanisation, finances, education, economics, being a woman, smoking and alcohol are associated factors. Interventional studies are warranted to minimise malnutrition challenges in the study population.

Dietary Habits and Nutritional Challenges of the Elderly in Ghana

The elderly population is increasing worldwide. Dietary habits play a crucial role in prolonging life and preventing diseases. This cross-sectional study sought to investigate the dietary habits of the elderly in the Kwahu South District of the Eastern Region of Ghana and further ascertain the factors that constitute nutritional challenges among this group. A mixed method approach was used for the study. A questionnaire and focus group discussion guide were used to solicit data from study participants. A total of 97 participants made up of 59 males and 38 females participated in the study. Data on food habits reveal that staple food consumption especially those grown within the study area is common. Rice (34.1%), game meat (47.1%), banana (63.9%), and garden eggs (27.8%) were the commonly consumed foods by frequency. Mood (41.2%) and stress (24.8%) were identified as the most predominant determinants of food habits. Poly medication, toothache and loss, immobility, and financial and technological challenges were amongst the nutritional challenges mentioned by the elderly in this study. Results from the focus group discussion revealed high nutrition knowledge among the elderly through factors such as financial constraints that were mentioned as a barrier to the translation of this knowledge into practice. Strengthening of existing interventional programmes such as the Livelihood Empowerment Against Poverty and social interventions is needed to improve the dietary habits and nutritional intakes of the elderly.

Malnutrition among the aged population in Africa: A systematic review, meta-analysis, and meta-regression of studies over the past 20 years

BACKGROUND

Nowadays, malnutrition among the advanced age (60 years and older) population is becoming a public health problem worldwide, especially in low-income countries including Africa. Hence, the prevalence in Africa is still not known. So, this review aimed to assess the pooled prevalence of under-nutrition among the advanced age population in Africa.

METHODS

A study search was carried out using databases (such as African Journals Online, Web of Science, Global Index Medicus, Embess, and PubMed) and gray literature following PRISMA guidelines from April 20, 2022, to May 30, 2022, with no restriction on date of publication. We used a standardized extraction format to compile eligible studies as per the inclusion criteria. Then, systematic review and meta-analysis were employed using a random effect model to obtain the pooled prevalence of malnutrition among aged population living in Africa. The counter-funnel plot and at the 5% significance level, Egger's test and Begg's test were used to check for publication bias. Furthermore, a meta-regression analysis was carried out to identify the relationship between the outcome of interest and different predictors.

RESULTS

A total of 731 studies were identified and 28 met the inclusion criteria, which were conducted in 17 African countries. The pooled prevalence of under-nutrition in Africa was 17% (95%CI; 13.5-20.6). The prevalence of malnutrition among the elderly varied significantly across countries, ranging from 1.8% (95% CI; 0.96-2.63) in South Africa to 39.47% (95% CI; 31.70-47.24) in Kenya. According to meta-regression analysis, the likelihood of a malnutrition problem would be reduced by a factor of 9.84 (β = -9.84, 95 percent CI; _-14.97, -4.70, P = 0.00) in upper-middle income countries. In addition, based on the publication year, malnutrition has decreased by a factor of 0.75 (β = -0.75, 95%CI:-1.49, -0.01, P = 0.04) from 1998 to 2021.

CONCLUSION

There is a high prevalence of malnutrition among the aged population. So, this underserved population should be targeted for intervention programs and/or integrated into maternal and child nutrition programs.

Prevalence of malnutrition among old people in Africa: systematic review and meta-analysis

OBJECTIVE

To summarise available evidence and estimate the pooled prevalence of malnutrition among old people in Africa.

DESIGN

Systematic review and meta-analysis.

SETTING

Any healthcare or community research reporting the prevalence or incidence of malnutrition in Africa from January 2000 to October 2021.

PARTICIPANTS

Old people, aged above 60 years.

OUTCOME MEASURES

Malnutrition, either undernutrition or overnutrition.

RESULTS

A total of 1442 studies were retrieved based on the search strategy, where only 36 studies (n=15 266 participants) reported from 11 African countries were included for meta-analysis. The reported prevalence of malnutrition ranges from 2.2% to 77.3% across the continent. Overall, the pooled prevalence rates of undernutrition and overnutrition were 18% (95% CI: 15% to 22%; I²=98.1; p<0.001) and 33% (95% CI: 22% to 44%; p<0. 001), respectively.

CONCLUSION

The prevalence of malnutrition in old African people is high and differs by setting, assessment tool and country of residence. Hence, due attention to geriatric nutrition is mandatory, and the need for a valid, reliable and simple screening tool should be thought of.

Prevalence of malnutrition among old age people in Africa

Background: Improved health care and rising life expectancy are creating a growing pool of old age people all over the world, including Africa. Malnutrition in the old age people is associated with both short- and long-term negative health outcomes. However, the reported burdens of malnutrition are fragmented and inconsistent, where more compiled evidence is warranted to aid decision-makers. Hence, this paper is aimed to estimate the pooled prevalence of malnutrition among old age people in Africa. Methods: A systematic search for research reporting the prevalence of malnutrition among old age people (aged above 60 years) was conducted from HINARI/PubMed and Google Scholar databases using combination keywords. Published articles in English language starting from January 2000 to October 2021 were screened. We presented the results based on the standard for reporting systematic review and meta-analysis of observational studies. A random-effect meta-analysis was done to estimate the prevalence of malnutrition along with the 95% confidence intervals. The publication bias was assessed using the funnel plot. Results: A total of 1,442 studies were retrieved based on the search strategy, where only 36 studies (n = 15,266 participants) reported from 11 African countries were included for meta-analysis. The reported prevalence of malnutrition ranges from 2.2 to 77.3% across Africa. Overall, the pooled prevalence of malnutrition was 18% (95% CI: 15-22; I2 = 98.1; p < 0.001). The prevalence is higher in the Central Africa (3.8%; 95% CI: 3.2-4.4), in the community (3.1%; 95% CI: 2.7-3.7), and among advanced age (3.5%; 95% CI: 2.3-5.4). Conclusion: The prevalence of malnutrition in African old age people is high and differs by setting, assessment tool, and country of residence. Hence, due attention to geriatric nutrition is mandatory, and the need for a valid, reliable, and simple screening tool should be thought of.

Nutritional status and dietary pattern of the elderly in Thulamela Municipality of Vhembe District

BACKGROUND

Dietary patterns provide comprehensive information about the food consumption habits within a population and how an individual's dietary pattern may change with age.

AIM

To evaluate the nutritional status and dietary patterns of the elderly in Thulamela municipality of Vhembe district, Limpopo province.

SETTING

Study was conducted in Thulamela municipality of Vhembe district, Limpopo province.

METHODS

This study included 300 elderly people recruited from Thulamela municipality of Vhembe district, Limpopo province. The municipality was randomly selected, and convenience sampling was used to choose elderly people. Body weight and height were measured using standard techniques. Body mass index (BMI) was determined and classified using BMI categories. Data on dietary patterns and dietary intake were collected using a food frequency questionnaire.

RESULTS

A total of 300 elderly people from villages participated in the study. About 38.6% of elderly people had a primary education, while 28.1% had a secondary education. The prevalence of underweight, overweight and obesity was 2.0%, 34.0% and 17.0%, respectively. Less than half of the elderly people did not meet the reference intake of energy (p = 0.023). More than half of the elderly people did not meet the reference intake of protein, iron, zinc, potassium, calcium and vitamins B1, B12 and C. It was found that 13.7% of the elderly skipped breakfast every day. About 19.6% of the elderly ate supper sometimes, while 13.7% did not eat supper.

CONCLUSION

The findings of the study revealed that most of the participants ate three main meals a day, with a minority skipping either breakfast or dinner or eating in between meals. The prevalence of underweight was low and that of overweight and obesity was high.Contribution: Poor food choices and physiological changes may reduce the inclusion of food rich in minerals and vitamins in the elderly's diets and prompt the prevalence of malnutrition.

Nutritional status and associated factors of older persons in sub-Saharan Africa: a scoping review

BACKGROUND

The older person population is rapidly increasing globally, including sub-Saharan Africa (SSA). Concurrently, malnutrition is also increasing among older persons in SSA, with a dearth of empirical evidence on nutritional status and associated factors among the older persons in the region to inform effective interventions to promote healthy ageing.

AIM/OBJECTIVE

This review assessed the nutritional status and associated factors among older persons in SSA.

METHOD

PubMed, Google Scholar, and Cochrane Library electronic databases were searched for published articles from 2010 to 2021 using keywords and Boolean logic. Also, we carried out a free web-based search to retrieve other relevant evidence that assesses the older persons' nutritional status. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart was used to appraise the research articles that responded to the study's research questions.

FINDINGS

Twenty studies met the inclusion criteria, from which data were extracted as findings. The malnutrition prevalence was between 6 to 54% among older persons in SSA. We found that the prevalence of malnutrition vary and could be as high as 28.4% in a low socio-economic status area. Of these studies, twelve (12) provided data on undernutrition with prevalence ranging from 2.9 to 41%;10 provided data on overweight (8.1-54.1%) and 5 on obesity (2.7-44.7%). Seventeen of the studies evaluated factors associated with malnutrition; 4 studies revealed the association between socioeconomic status and malnutrition, 7 studies reported a significant association between dietary habits and malnutrition. Four studies showed an association between educational status and malnutrition. Disease conditions associated with malnutrition were reported in four of the studies.

CONCLUSION

This review shows that malnutrition is a problem among older persons in SSA coupled with many risk factors which should be given critical attention. We recommend nutrition education for older persons as well as the development of nutrition interventions for this vulnerable group.

Assessment of dietary habits, nutritional status and common health complications of older people living in rural areas of Bangladesh

Background

Old age is one of the vulnerable and prone stages in terms of health status. So this study aimed to assess the nutritional status and common health complications of older people.

Methods

Simplified Nutritional Appetite Questionnaire (SNAQ), Anthropometric measurements, Diet History Method, and Mini Nutritional Assessment (MNA) tools were used to measure the nutritional status. Data were analyzed by using Statistical Package for Social Science (SPSS) version 16.

Results

Out of the total 320 elderly participants the mean ± SD value for the age of male and female was 67.25 ± 6.5 and 67.32 ± 7.7 years respectively. According to BMI classification, it was noticed that with advancing age the percentage of underweight was also increased such as for 60–75 years old age group the underweight percentage was 30.0% where for 76 to 85 and >85 years old age group the underweight percentage was 45.0% and 60.0% respectively. According to the MNA score, 97 elderly respondents were malnourished and a total of 172 respondents had SNAQ scores below 14. This study found a statistically significant (P < 0.05) correlations among various health complications with nutritional status according to MNA score. In addition 56.6% (OR = 1.24, 95% CI = .799–1.939), 63.8% (OR = 1.18, 95% CI = .745–1.857) and 64.7% (OR = 1.14, 95% CI = .720–1.804) respondents had diabetes mellitus, hypertension and cardiovascular disease respectively. The risk of musculoskeletal pain (OR = 1.073, 95% CI = .684–1.681), bedsore (OR = 1.884, 95% CI = .903–3.934) and decreased sense of thirst (OR = 1.278, 95% CI = .821–1.991) were higher among females than males. A little number of the elderly used to take milk, meat, and fish daily.

Conclusion

During this cross-sectional study, significant correlations among nutritional changes with health complications were determined. To prevent malnutrition among the elderly a proper health policy as well as periodical nutritional screening should be conducted.

Nutrition-related knowledge, practice, and weight status of patients with chronic diseases attending a district hospital in Nigeria

Background:

Aim:

Methods:

Results:

Conclusion:

Gestational Diabetes Mellitus per Different Diagnostic Criteria, Risk Factors, Obstetric Outcomes and Postpartum Glycemia: A Prospective Study in Ghana

The surge in gestational diabetes mellitus (GDM) globally requires a health system tailored approach towards prevention, detection and management. We estimated the prevalence of GDM using diverse recommended tests and diagnostic thresholds, and also assessed the risk factors and obstetric outcomes, including postpartum glycemia. Using a prospective cohort design, 446 singleton pregnant women without pre-existing diabetes did GDM tests in five hospitals in Ghana from 20-34 weeks using fasting plasma glucose (FPG), one-hour and 2-h oral glucose tolerance test (OGTT). Birth outcomes of 403 were assessed. GDM was diagnosed using six international diagnostic criteria. At 12 weeks postpartum, impaired fasting glucose (6.1-6.9 mmol/L) and diabetes (FPG ≥7.0 mmol/L) were measured for 100 women. Per FPG and 2-h OGTT cut-offs, GDM prevalence ranged between 8.3-23.8% and 4.4-14.3%, respectively. Risk factors included overweight (OR = 2.13, 95% CI: 1.13-4.03), previous miscarriage (OR = 4.01, 95% CI: 1.09-14.76) and high caloric intake (OR = 2.91, 95% CI: 1.05-8.07). Perineal tear (RR = 2.91, 95% CI: 1.08-5.57) and birth asphyxia (RR = 3.24, 95% CI: 1.01-10.45) were the associated perinatal outcomes. At 12 weeks postpartum, 15% had impaired fasting glucose, and 5% had diabetes. Tackling modifiable risk factors is crucial for prevention. Glycemic monitoring needs to be integral in postpartum and well-child reviews.

Reference intervals for selected haematological and biochemical parameters among apparently healthy adults in different eco-geographical zones in Ghana

Background

Due to the influence of gender, race/genetics, age, lifestyle habits and geography on the references intervals (RIs), the Clinical and Laboratory Standards Institute (CLSI) recommends the determination of population-specific RIs. Ghana continues to depend on pre-established RIs from other countries which poses the risk of misdiagnoses and wrong treatment. This study presents the haemato-biochemical RIs from four eco-geographical zones in Ghana.

Methods

In this population-based cross-sectional study, a total of 1227 randomly selected healthy voluntary blood donors from the four eco-geographic zones (Coastal Savannah, Rain Forest, Savannah and Transitional) were enrolled and screened. Based on the CLSI Guidance Document C28A2992, the data of eligible participants were used to non-parametrically determine the RIs for the haemato-biochemical parameters at the 2.5^th and 97.5^th percentiles. Comparison of analytes by gender was done by Wilcoxon rank sum test and eco-geographic differences were assessed using the Kruskal-Wallis with the Dunn post hoc multiple comparison tests.

Results

There were statistically significant differences in most of the haematological parameters (RBC, Hb, HCT, MCV, PLT, WBC; p-values <0.0001 and MCH; p-value = 0.007), and biochemical analytes (Urea, Cr, Trig, HDL-C, AST, ALT, ALP, GGT, BID, BIT, Prot-T and Albumin; p-values <0.0001) based on gender. Significant inter eco-geographic (intra-population) variations and substantial differences between the established RI and the RIs accompanying the analyzers used were also observed.

Conclusion

This study reports significant inter-sex and inter-geographical differences in haemato-biochemical RIs in Ghana as well as differences in RIs with both the RIs accompanying the analyzers and those of other countries. Determining RIs representative of populations and including them in the report systems of laboratories to ensure effective and efficient healthcare service delivery is thus recommended.

Trends and Associated Factors of Dietary Knowledge among Chinese Older Residents: Results from the China Health and Nutrition Survey 2004-2015

Promoting a healthy diet of the elderly is an important task in the current "Healthy China Action". This study aimed to describe the changing trends of the dietary knowledge elderly Chinese during 2004-2015 and to examine the associated factors of dietary knowledge. Elderly people aged ≥60 years were included as study subjects from the China Health and Nutrition Survey 2004-2015. A total of 15,607 samples were involved in the analysis. The correct rate of dietary knowledge items followed upward trends over time, except for two items regarding physical activity intensity (Question 11, Cochran-Armitage χ² = 20.05, p < 0.001) and healthy weight (Question 12, Cochran-Armitage χ² = 43.93, p < 0.001). Four of the twelve dietary knowledge items consistently followed the lowest correct rate between 2006 and 2015, regarding physical activity intensity (Question 11, 24.5%-25.8%), staple food consumption (Question 5, 36.6%-41.5%), animal product consumption (Question 6, 45.8%-59.5%), and fatty meat and animal fat consumption (Question 7, 63.6%-64.9%). Participants who had a lower educational level or lived in rural areas or western regions, did not know about the Chinese Food Pagoda (CFP) or Dietary Guidelines for Chinese Residents (DGCR), and did not proactively look for nutrition knowledge were less likely to have adequate dietary knowledge literacy. Targeted interventions should be developed to promote dietary knowledge level of the elderly.

Factors influencing dietary behaviours in urban food environments in Africa: a systematic mapping review

Objective:

To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research.

Design:

We systematically reviewed published/grey literature (protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical and macro.

Setting:

Urban food environments in Africa.

Participants:

Studies involving adolescents and adults (11–70 years, male/female).

Results:

Thirty-nine studies were included (six adolescent, fifteen adolescent/adult combined and eighteen adult). Quantitative methods were most common (twenty-eight quantitative, nine qualitative and two mixed methods). Studies were from fifteen African countries. Seventy-seven factors influencing dietary behaviours were identified, with two-thirds at the individual level (45/77). Factors in the social (11/77), physical (12/77) and macro (9/77) environments were investigated less. Individual-level factors that specifically emerged for adolescents included self-esteem, body satisfaction, dieting, spoken language, school attendance, gender, body composition, pubertal development, BMI and fat mass. Studies involving adolescents investigated social environment-level factors more, for example, sharing food with friends. The physical food environment was more commonly explored in adults, for example, convenience/availability of food. Macro-level factors associated with dietary behaviours were food/drink advertising, religion and food prices. Factors associated with dietary behaviour were broadly similar for men and women.

Conclusions:

The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa. More studies are needed for adolescents and men, and studies widening the geographical scope to encompass all African countries.

Maternal Dietary Intakes, Red Blood Cell Indices and Risk for Anemia in the First, Second and Third Trimesters of Pregnancy and at Predelivery

As anemia remains a major public health problem in Ghana, we examined the effect of dietary intakes, and antenatal care (ANC) practices on red cell indices and anemia prevalence during the pregnancy continuum for 415 women. Dietary history was taken using the Food and Agriculture Organization minimum dietary diversity indicator for women (MDD-W). Intake of ≥5 food groups was a proxy for micronutrient adequacy. Odds for anemia and meeting the MDD-W were estimated using ordinal and binary logistic regressions respectively. Intakes of 41.4% were micronutrient inadequate. At any time point in pregnancy, 54.4% were anemic (mild = 31.1%; moderate = 23.1%; severe = 0.2%) with 10%-point variation across the first (57.3%), second (56.4%) and third (53.3%) trimesters and pre-delivery (47.7%); 27.8% were anemic throughout pregnancy while 17.1% were never anemic. Morphologically, microcytic (79.4%) and hypochromic (29.3%) anemia were most prevalent, indicating nutritional deficiencies. Planning the pregnancy was a significant determinant for meeting the MDD-W. Overall, adolescence, poor diet, suboptimum ANC and underweight were associated with moderate and severe anemia. In specific time-points, dietary counselling, malaria, iron-folic acid supplementation, sickle cell disease and preeclampsia were observed. Decline of anemia during pregnancy suggests the positive impact of ANC services and supports strengthening education on dietary diversification during ANC.

Determination of Haematological Reference Ranges in Healthy Adults in Three Regions in Ghana

Laboratory results interpretation for diagnostic accuracy and clinical decision-making in this period of evidence-based medicine requires cut-off values or reference ranges that are reflective of the geographical area where the individual resides. Several studies have shown significant differences between and within populations, emphasizing the need for population-specific reference ranges. This cross-sectional experimental study sought to establish the haematological reference values in apparently healthy individuals in three regions in Ghana. Study sites included Nkenkaasu, Winneba, and Nadowli in the Ashanti, Central, and Upper West regions of Ghana, respectively. A total of 488 healthy participants were recruited using the Clinical and Laboratory Standards Institute (United States National Consensus Committee on Laboratory Standards, NCCLS) Guidance Document C28A2. Medians for haematological parameters were calculated and reference values determined at 2.5th and 97.5th percentiles and compared with Caucasian values adopted by our laboratory as reference ranges and values from other African and Western countries. RBC count, haemoglobin, and haematocrit (HCT) were significantly higher in males compared to females. There were significant intraregional and interregional as well as international variations of haematological reference ranges in the populations studied. We conclude that, for each geographical area, there is a need to establish geography-specific reference ranges if accurate diagnosis and concise clinical decisions are to be made.