World Nutrition

Introduction to the final issue of World Nutrition for 2024

Ted Greiner — Tue, 31 Dec 2024 00:00:00 -0700

Impact evaluations can do harm unintentionally – or intentionally

Ted Greiner — Tue, 31 Dec 2024 00:00:00 -0700

Maternal risk factors and vitamin A deficiency among pregnant mothers in Mbeya region, Tanzania: A cross-sectional study

Tue, 31 Dec 2024 00:00:00 -0700

Background
Vitamin A deficiency (VAD) among pregnant women is a public health concern and is widespread in developing countries.
Objective
The present study aimed to assess the prevalence of VAD and associated factors among pregnant women in the Mbeya region of Tanzania.
Methods
A cross-sectional study was conducted among 420 pregnant women in seven district councils in the Mbeya region of Tanzania. Serum retinol concentration was determined by high-performance liquid chromatography (HPLC). Assessment of anthropometric, food consumption and other socio-economic characteristics were performed and clinical information obtained on participants. A multivariate regression analysis was conducted to determine the independent predictors of VAD.
Results
46.1% suffered from any form of VAD and 9.8% from severe VAD. Those pregnant women who belonged to the lowest socioeconomic status, who were anaemic, and who consumed low dietary diversity scores were more likely to have any VAD (ARR = 2.84; 95% CI: 1.58, 5.12), (ARR = 1.73; CI: 1.03, 2.92) and (ARR=1.59; 95%CI: 1.01, 2.51), respectively. Any VAD was more likely among those who resided in Kyela district (largely rural) compared with Mbeya city (ARR = 0.32; 95%CI: 0.11, 0.92). Their marital status, occupation, and education levels were not statistically associated with VAD. Younger women were more likely to have severe VAD (ARR=0.29; 95%CI: 0.10, 0.84).
Conclusions
VAD among pregnant women in the Mbeya region of Tanzania is a mild public health concern according to the WHO’s categorization. Additionally, VAD was significantly associated with low socio-economic status, anaemia, and low maternal dietary diversity scores.

Maternal socio-demographic characteristics as correlates to nutritional status of under-five children: Multivariate regression model approach

Tue, 31 Dec 2024 00:00:00 -0700

All ages require nutritious food to grow, but children, especially those under the age of five, have a greater need for it -- for growth and development of essential organs and tissues. It is evident that under-five malnutrition is prevalent in sub-Sahara Africa and Nigeria in particular. Determining the correlates of nutritional status will play a vital role in combating malnutrition. Common indicators that are used to estimate nutritional status have discrepancies in their correlations with determinants of nutritional status, hence there is a need to adopt a model that could employ multiple indicators simultaneously. This study adopted a descriptive design among 227 <5 children whose mother was attending immunization at Onueke, Ebonyi State. Maternal socio-demographic characteristics as well as their anthropometrics were obtained z scores of the weight-for-age, BMI-for-age and height-for-age and MUAC served as indicators of nutritional status. Stunting, thinness, underweight and risk of malnutrition (based on low MUAC) were respectively 43.6%, 45.6%, 45.3% and 49.3%. Based on a multivariate regression model, the only maternal characteristic, correlating with low height for age was being in a polygamous marriage. Low weight for age was associated with younger mothers (age 15-24), those who were farmers, and those with less than high incomes. Low BMI for age was associated with not having a secondary school education and being a farmer or trader. Risk of low MUAC was not associated with any of these maternal characteristics. When all measures of nutritional status were combined, low nutritional status was linked to all measured maternal characteristics except marital status (single, married, divorced). Thus, to bridge discrepancies that may exist when different nutritional status indicators are used, it is recommended that a multivariate regression model which uses multiple indicators simultaneously be adopted to determined significant maternal characteristics that correlated with nutritional status.

Diet quality of in-school adolescents in Abeokuta, Nigeria based on the diet quality index–international: A cross-sectional study

Tue, 31 Dec 2024 00:00:00 -0700

Background
Adolescence is a critical period for growth and a second window of opportunity for catch-up growth after the first growth spurt that occurs during the first 1000 days of life. During adolescence, activities to build healthy nutrition may confer significant long-term benefits.
Objective
This cross-sectional study assessed dietary intake, nutrient adequacy, and diet quality of 303 public secondary school students in Abeokuta, Ogun State.
Methods
Respondents’ anthropometry was measured and WHO Anthroplus was used to calculate the height-for-age and body mass index for-age z-scores. Dietary intake was assessed using a 24-hour diet recall questionnaire, and the Diet Quality Index-International (DQI-I) questionnaire was used to determine diet quality.
Results
Excessive intake of carbohydrates was observed among all respondents while inadequate intakes of calcium, vitamin C, and fibre were observed among 80.8%, 100%, 95.4%, and 66.2% of the respondents, respectively. The total mean score for diet quality was 58.7±6.73 out of 100. Compared to the total score of the DQI-I domains, the highest mean performance was in the moderation category (79.5%), followed by variety (72.8%), and adequacy (45.8%), with the lowest performance in the overall balance category (19.7%).
Conclusions
In conclusion, these adolescents had lower than the cut-off score for a good diet quality. Inadequacies in vegetables and fruit groups below the recommended levels contributed to low mean scores and likely to some of the deficient nutrient intakes. Interventions including regulating the food sold by vendors and nutrition education to encourage better consumption of fruits and vegetables are recommended in schools.

Assessment of breastfeeding practice of mothers and the Nutritional status of infants (0–12 months) in Ife North Local Government Area, Osun State, Nigeria

Olanike Olubunmi BALOGUN, PhD, Olajumoke P Olaniran, Precious I Ogunniyi — Tue, 31 Dec 2024 00:00:00 -0700

Background
According to UNICEF, annually 5.4 million Nigerian children are not exclusively breastfed, worsening the nation's chronic malnutrition issue.
Objective
This study evaluated the breastfeeding knowledge and practices of mothers and the anthropometric status of breastfed infants in Ife North Local Government Area, Osun State, Nigeria.
Methods
In a community-based cross-sectional study, a multi-staged sampling technique was used to recruit 380 women with infants 0–12 months-old from four wards in Ife North LGA. Data on socio-demographic traits of mothers and children, mothers' knowledge and behaviors about breastfeeding, and factors influencing breastfeeding practices were gathered using a semi-structured self-administered questionnaire. The mothers' and infants' anthropometric indices (weight, height, and mid-upper arm circumference (MUAC)) were measured. WHO Anthro was used to analyze and categorize the children’s nutritional status. The chosen significance threshold was p = 0.05.
Results
63.9% of sample mothers were knowledgeable about breastfeeding practices. All the infants had been breastfed and 41.8% of those < 6 months were exclusively breastfeeding on the day before the survey. 67.4% stated that they had started breastfeeding within an hour of delivery. Delays were stated to be due to no breastmilk production (29.5%), insufficient lactation (24.7%), illness (18.7%), and cracked nipples (17.9%). 38.7% of the infants were underweight, 22.9% were stunted, and 7.4% were wasted. MUAC identified 15.3% and 19.5% of children with severe acute and moderate acute malnutrition respectively. Among mothers, 37.6% were overweight and 56.8% had normal BMI.
Conclusions
There is significant malnutrition despite high levels of breastfeeding awareness and behavior. This study's high rates of malnutrition highlight the urgent need for nutrition

Diet quality of women of reproductive age in Sagamu local government area, Ogun state, Nigeria

Tue, 31 Dec 2024 00:00:00 -0700

Background
Diet quality refers to a diversified, balanced and healthy diet which is reflected in variety and diversity, adequacy, moderation and overall balance. Women’s diet quality during reproductive years influences their long-term health.
Objective
This cross-sectional study assessed the socio-demographic and socio-economic status, anthropometric status, dietary intake and diet quality of 270 women of reproductive age.
Methods
A probability sample was taken from households in the Sagamu Local Government Area, Ogun State, Nigeria. A semi-structured interviewer-administered questionnaire was used to obtain information on socioeconomic and socio-demographic characteristics of the respondents. Weight, height, waist and hip circumferences of the respondents were measured, body mass index calculated and compared with standards. Dietary intake was assessed using a multi-pass 24-hour dietary recall questionnaire. The Diet Quality Index International (DQI-I) questionnaire was used to assess diet quality on a scale of 100. The data obtained were analyzed using SPSS, version 23. Chi-square and correlation were employed to determine the association and relationship between variables. The level of significance chosen was at p<0.05.
Results
51.1% had a normal body mass index though there was high prevalence of overweight (29.6%) and obesity (14.4%). 57.4% were centrally obese and 46.7% had high waist-to-hip ratio, indicating high disease risk. The main staples consumed were cereals, roots and tubers and legumes. Carbohydrate and protein were in excess while potassium, calcium, folate, vitamin C and fiber were inadequate. Consumption of fat, saturated fat, cholesterol, sodium, protein, and iron were at recommended levels. The total DQI-I score was 62.9/100. The diet variety score, 12.5, indicating good diet variety. The diet adequacy score was 17.6, indicating low diet adequacy. The diet moderation score was 25.64, indicating good moderation. The dietary balance score was 7.1, indicating good overall balance.
Conclusions
We conclude that most of the respondents had good dietary variety, good dietary moderation and good overall balance; however, there was low diet adequacy, with a distinct pattern of low consumption of fruits and vegetables. It is recommended that the DQI-I tool be widely used in Nigeria as a means of assessing and comparing diet quality at state level.

Nutritional challenges and determinants in children with sickle cell disease in Chhattisgarh, India

Dr ASHISH SINHA, Pradeep Kumar Patra, Prem Sagar Panda — Tue, 31 Dec 2024 00:00:00 -0700

Background
Sickle cell disease (SCD) is one of the commonest single gene disorders recognized as a public health priority. Slow growth is common in children with SCD due to the vicious cycle of malnutrition and infection among them. Increasing knowledge that nutritional problems are fundamental to the severity of the disease has produced interest in promoting dietary supplementation for treating these patients.
Objective
The objective of the present study was to assess nutritional status and associated factors in SCD patients registered at the Sickle Cell Institute Chhattisgarh, Raipur, CG, India.
Methods
We reviewed clinical data from documents/secondary records among a cohort of 671 children with SCD 0-18 years oldat the Sickle Cell Institute.
Results
Out of all 671 children included in the study, 380 (56.6%) were male. Underweight, stunting and wasting proportions were 58%, 37.7% and 38.9% respectively. 16% children had chronic malnutrition (low height for age). 62% of the malnourished children were ≥ 11 years old and38% were ≤ 10 . 64% of the children who needed hospitalization were also in the older age group. Chronic malnutrition was significantly higher among children with an O Rh+ blood group (39.8%). 26.7% had sought care in hospital before diagnosis either for blood transfusion or for a vaso-occlusive crisis.
Conclusions
A significant proportion of chronic malnutrition was seen among the study population mixed with underweight, stunting and wasting. Older children with an O+Ve blood group had increased risk of hospital admission. Children should get priority for nutritional intervention as adjunct treatment with standard care practice to increase survival chances.

Overweight and obesity in women in Burkina Faso: Socio-cultural and behavioural factors

Bernard Dembele — Tue, 31 Dec 2024 00:00:00 -0700

Overweight, obesity, and associated non-communicable diseases are global public health issues. Initially confined to developed nations, they are now spreading to least developed countries as a result of the globalisation of dietary attitudes and practices, which have greatly increased the consumption of ultra-processed and other obesogenic products. In developing countries, women are more likely to be overweight or obese than men. Burkina Faso is not an exception in this pattern. It is the reason why this analysis was initiated to highlight the socio-cultural and behavioural factors underlying this phenomenon among women. It aims at emphasizing the prominent characteristics of overweight/obese women to help formulate accurate actions and interventions. To this end, the data used come from the Burkina Faso 2021 Demographic and Health Survey, which covered a nationally representative sub-sample of 8,852 women aged 15-49 years, on whom anthropometric measurements (height and weight) were collected. The analyses revealed that overweight and obesity affect at least one in five women, and are linked predominantly to the possession of rapid means of transportation, practice of sedentary activities, having a high living standard, consumption of dietary diversity, having a high level of education, older age, frequent consumption of sweetened beverages, connected to internet, urban residence, membership in certain ethnicities and multi-parity. This highlights the multidimensional nature of overweight and obesity and the need for multi-faceted actions to control the current upward trend. Priority should be given to balanced diets low in ultra-processed foods, daily physical exercise, and their influencing parameters.

A cross-sectional study on minimum dietary diversity and anthropometric status of women of reproductive age (15–49 years) in Ikwuano Local Government Area, Abia State Nigeria

Ijioma Okorie, Anita C Ekeh, Chinemerem H Ugo — Tue, 31 Dec 2024 00:00:00 -0700

Introduction and Objective: To prevent nutrient deficiencies and chronic diseases, women of reproductive age (WRA) (15–49 years), need to eat a diversified and adequate diet for the provision of micronutrients and phytochemicals. The purpose of the study was to conduct a seven-day assessment of the minimum dietary diversity (MDD) and anthropometric status of WRA in Ikwuano Local Government Area.

Methodology: A community-based cross-sectional study design was used among 208 consenting WRA from 8 communities in 2 clans of the LGA. A semi-structured 7-day recall questionnaire that measured MDD for women (MDD-W) was used. A score of 5 (out of 10) food groups was considered to be an adequate MDD. The WRA’s body mass index (BMI) and waist-hip ratio (WHR) were evaluated, and BMI was calculated and compared with standards. The data were analyzed using descriptive statistics (frequency and percentage), the paired sample t-test, and Spearman Correlation, while the level of significance was set at p < 0.05.

Result: About 51.0% of sample women achieved MDD, 29.8% were underweight, 14.4% were overweight and 7.2% were obese. There was a significant difference (p < 0.05) in the mean value between day 1 (4.45) and day 7 (4.75) in the MDD of these women. BMI was higher among those who were unemployed, and MDD scores were significantly higher when the WHR was higher.

Conclusions: Most of the respondents achieved MDD, which also contributed to higher WHR. Unemployment was strongly linked to higher BMI status among these respondents.

Household food security status of rural mothers and nutritional status of their children under five years old in Ibadan, Nigeria

Ope Zacchaeus Adeyanju, Grace T Fadupin — Tue, 31 Dec 2024 00:00:00 -0700

Background
The issue of food security in the rural regions of sub-Saharan Africa is of paramount importance, as it has a profound impact on malnutrition rates among children.
Objective
The objective of this study was to assess the household food security status of rural women food producers and the nutritional status of their under-five year old children in Ibadan, Nigeria.
Methods
For this analytical cross-sectional study among 217 mother-child pairs in the rural communities of Ibadan, interviewer-administered questionnaires were administered to obtained information on household, socio-demographic characteristics of mothers and the characteristics of their under-five children. Household food security was assessed using a USDA 18-point scale and categorized as food secure (≤ 2), food insecure without hunger (>2-7), food insecure with moderate hunger (8-12), and food insecure with severe hunger (>12). Child anthropometry was measured and expressed as stunting (height-for-age), wasting (weight-for-height), and underweight (weight-for-age) using Essential Nutrition Action software. Data were analysed using descriptive statistics, Fisher’s Exact Test, and Spearman correlation coefficient correlation at p≤ 0.05.
Results
Ages of mothers and under-five children were 32.3±6.2 years and 35.3±14.1 months respectively. Household size was 6.3±1.7 and 62.2% had no formal education. The household food security mean score was 8.2±3.4; 88.5% were food insecure, 25.3% without hunger, 56.2% with moderate hunger and 7.0% with severe hunger. The totals of moderate or severe underweight, stunting and wasting in children were 30.4%, 40.5%, and 7.8% respectively. Food insecurity was significantly associated with children underweight (p=0.010). Mother’s education (p=0.000), father’s education (P=0.012), and household size (P=0.008) demonstrated significant associations with household food insecurity.
Conclusions
Food insecurity was prevalent in the study population. Provision of infrastructure that can stimulate a good business environment such as electricity, water, good roads, and accessible markets should be made available by all tiers of governments to enhance diversification of means of livelihood to alleviate poverty among the rural households.

Sun-dried tomato powder reduces blood sugar levels and improves the lipid profile among people with type-2 diabetes: A randomized controlled trial

Dr Altaf Ahmed, Prashanth Shetty, Geetha B Shetty — Tue, 31 Dec 2024 00:00:00 -0700

Background
Diabetes mellitus is a complex metabolic disorder characterized by hyperglycaemia, leading to significant health complications and increased healthcare costs. The prevalence of type 2 diabetes mellitus (T2DM) is projected to rise dramatically by 2040, especially in India, where factors such as genetic predisposition, obesity, and lifestyle contribute to its high incidence. Treatment methods usually involve pharmacological interventions that carry side effects, prompting interest in non-pharmacological strategies.
Objective
This study investigates the effects of supplementation with sun-dried tomato powder, rich in antioxidants like lycopene, on glycaemic and lipid profiles in individuals with T2DM.
Methods
This is an open-label, single-centre, two-arm parallel group, prospective randomized controlled trial. A total of 100 T2DM patients were recruited from Army Welfare Housing Organization Society, Belagavi, Karnataka in the southern part of India and randomly assigned to receive for 60 days either sun-dried tomato powder (25g daily) or a control treatment of tepid water with ghee. The primary outcomes included fasting blood sugar (FBS), postprandial blood sugar (PPBS), and HbA1c levels, while the secondary outcomes focused on lipid profile. A group of 10 subjects was formed and divided into 10 cohorts. One cohort provided blood samples daily for 10 consecutive days for laboratory analysis.
Results
There was a significant reduction in FBS and PPBS, along with improvements in lipid profile, including HDL and VLDL, observed exclusively in the experimental group (EG) (p<0.001). Notably, the experimental group showed a significant difference in FBS and PPBS compared to the control group (p<0.001). However, HbA1c did not exhibit any significant changes (p=0.347).
Conclusions
Our findings indicate that sun-dried tomato powder effectively reduces blood sugar levels and improves lipid profiles in patients with type 2 diabetes mellitus (T2DM), offering a promising non-pharmacological intervention.