Abstract
BackgroundNutritional iron deficiency is one of the leading factors for disease, disability and death. A quasi-experimental randomized community study in South-West Nigeria explored whether a branded behaviour change programme increased the use of green leafy vegetables (greens) and iron-fortified bouillon cubes in stews for improved iron intake.MethodsA coinflip assigned the intervention to Ile-Ife (Intervention town). Osogbo (Control town) received no information. At baseline 602 mother-daughter pairs (daughters aged 12–18) were enrolled (Intervention: 300; Control: 302). A Food Frequency Questionnaire assessed the addition of cubes and greens to stews, the primary outcome. Secondary outcomes were the addition of cubes and greens to soups and changes in behavioural determinants measured using the Theory of Planned Behaviour. Structural Equation Modelling (SEM) evaluated the impact of the intervention on behavioural determinants and behaviour.ResultsThe data of 527 pairs was used (Intervention: 240; Control: 287). The increase in greens added to stews was larger in the Intervention town compared to the Control town (MIntervention = 0.3 [SE = 0.03]; MControl = 0.0 [SE = 0.04], p < 0.001, r = 0.36). Change in iron-fortified cubes added to stews did not differ between towns (p = 0.07). The increase in cubes added to soups was larger in the Intervention town compared to the Control Town (MIntervention = 0.9 [SE = 0.2] vs MControl = 0.4 [SE = 0.1], p < .0001, r = 0.20). Unexpectedly, change in greens added to soups was larger in the Control town compared to the Intervention town (MIntervention = − 0.1 [SE = 0.1]; MControl = 0.5 [SE = 0.1], p = 0.003, r = 0.15). The intervention positively influenced awareness of anaemia and the determinants of behaviour in the Intervention town, with hardly any change in the Control town. Baseline SEMs could not be established, so no mediation analyses were done. Post-intervention SEMs highlighted the role of habit in cooking stews.ConclusionsThe behaviour change programme increased the amount of green leafy vegetables added to stews and iron-fortified cubes added to soups. Future research should assess the long-term impact and the efficacy of the programme as it is scaled up and rolled out.
Highlights
Nutritional iron deficiency is one of the leading factors for disease, disability and death
Mean age of the mothers was similar across both towns (MControl = 41.3, SE = 0.43; MIntervention = 41.9, SE = 0.53, ChiSq (1) = 0.01, p = 0.91)
Daughters in the Intervention town were half a year younger compared to the daughters in the Control town, MControl = 14.7, SE = 0.10; MIntervention = 15.2, SE =0.11, ChiSq (1) = 15.52, p < .0001)
Summary
Nutritional iron deficiency is one of the leading factors for disease, disability and death. Anaemia is considered the most prevalent of nutritional deficiencies, estimated to affect 1.62 billion people globally and especially non-pregnant women (496 million) [1]. The first and preferred approach is to modify the diet to improve the nutritional value and iron bio-availability, for example by providing dietary advice to include iron-rich foods and improve cooking skills. This can be challenging as changing behaviours is not easy and there may be practical limitations such as the availability of iron-rich foods. The third approach – micronutrient fortification of regularly consumed processed foods – is a practical and cost-effective long-term solution [5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International Journal of Behavioral Nutrition and Physical Activity
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
