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Ambikapathi R, Irema I, Lyatuu I, Caswell B, Mosha D, Nyamsangia S, Galvin L, Mangara A, Boncyk M, Froese SL, Verissimo CK, Itatiro J, Kariathi V, Kazonda P, Wandella M, Fawzi W, Killewo J, Mwanyika-Sando M, PrayGod G, Leyna G, Patil C, Gunaratna NS. Gender and Age Differences in Meal Structures, Food Away from Home, Chrono-Nutrition, and Nutrition Intakes among Adults and Children in Tanzania Using a Newly Developed Tablet-Based 24-Hour Recall Tool. Curr Dev Nutr 2022; 6:nzac015. [PMID: 35317413 PMCID: PMC8929990 DOI: 10.1093/cdn/nzac015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/18/2022] [Accepted: 01/26/2022] [Indexed: 12/04/2022] Open
Abstract
Background In many regions of the world, little is known about meal structures, meal patterns, and nutrient intake because the collection of quantitative dietary intake is expensive and labor-intensive. Objectives We describe the development and field feasibility of a tablet-based Tanzania 24-h recall tool (TZ-24hr-DR) and dietary intakes collected from adults and children in rural and urban settings. Methods Using the Tanzanian food-composition table, the TZ-24hr-DR tool was developed on an Android platform using the Open Data Kit. The module provides food lists, meal lists, ingredient lists, quantity and amount consumed, breastfeeding frequency, and a recipe feature. Similar to the USDA Automated Multiple Pass Method, this TZ-24hr-DR contains review features such as time in-between meals, a summary of meals, and portion sizes. Results Dietary intake using TZ-24hr-DR was collected among 1) 845 children 0-18 mo of age enrolled in the Engaging Fathers for Effective Child Nutrition and Development in Tanzania (EFFECTS) trial (ClinicalTrials.gov identifier: NCT03759821) in Mara, Tanzania, and 2) 312 adult families from the Diet, Environment, and Choices of positive living (DECIDE) observational study in peri-urban Dar es Salaam. Interviewers were trained on paper-based methods with food models and tablet-based collection. Conversion to nutrient intake was readily linked and accessible, enabling rapid review and analysis. Overall, 2158 and 8197 dietary meal records were collected from the DECIDE study and EFFECTS trial, respectively. Among adults, 63% of men and 92% of women reported eating at home, and there were differences in protein, fat, and zinc. Food consumed outside the home typically occurs for the first 2 meals. Children's intake of nutrients increased with age; however, median micronutrient intakes for calcium, iron, zinc, and vitamin A remained below recommended nutrient intakes. Conclusions The TZ-24hr-DR is a field- and user-friendly tool that can collect large samples of dietary intakes. Further validation is needed. The tool is available freely for research purposes and can be further adapted to other contexts in East Africa.
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Affiliation(s)
- Ramya Ambikapathi
- Departments of Public Health and Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Imani Irema
- Africa Academy of Public Health, Dar es Salaam, Tanzania
| | - Isaac Lyatuu
- Africa Academy of Public Health, Dar es Salaam, Tanzania
| | - Bess Caswell
- Western Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Davis, CA, USA
| | - Dominic Mosha
- Africa Academy of Public Health, Dar es Salaam, Tanzania
| | | | - Lauren Galvin
- Global Communities, Dar es Salaam, Tanzania and Silver Spring, MD, USA
| | - Ally Mangara
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Morgan Boncyk
- Departments of Public Health and Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Savannah L Froese
- Departments of Public Health and Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Cristiana K Verissimo
- Departments of Public Health and Nutrition Science, Purdue University, West Lafayette, IN, USA
| | | | | | - Patrick Kazonda
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Wafaie Fawzi
- Department of Global Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Japhet Killewo
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - George PrayGod
- National Institute for Medical Research, Mwanza, Tanzania
| | - Germana Leyna
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Tanzania Food and Nutrition Center, Dar es Salaam, Tanzania
| | - Crystal Patil
- Department of Women, Children and Family Health Science, University of Illinois Chicago, Chicago, IL, USA
| | - Nilupa S Gunaratna
- Departments of Public Health and Nutrition Science, Purdue University, West Lafayette, IN, USA
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