Consumption Of Iron-rich Foods Research Articles

Iron-rich food consumption and predictors among children aged 6-59 months old in Ethiopia: A multilevel complex sample analysis of the Ethiopian mini-demographic and health survey 2019 data.

Children with inadequate iron consumption had slower growth, weaker immunity, and poor cognitive development. Although the public health importance of iron-rich consumption in Ethiopia is known, evidence for iron-rich food consumption and predictors among children aged 6-59 months old in Ethiopia is sparse. This study aimed to assess iron-rich food consumption and predictors among children aged 6-59 months old in Ethiopia. This study used Ethiopia mini demographic and health survey 2019 (EMDHS-2019) data with a total weighted sample size of 5,112 among children aged 6-59 months old. A multilevel mixed effect logistic regression analysis was used to identify predictors of good iron-rich food consumption. The proportion of good consumption of iron-rich foods among children aged 6-59 months was 27.99% (24.22, 32.10%). The findings revealed that children born to mothers who completed primary education [AOR = 1.88, 95% CI: 1.11, 3.19], a higher education [AOR = 4.45, 95% CI: 1.28, 15.48], being born to the poorer family [AOR = 1.89, 95% CI: 1.04, 3.43], richer [AOR = 2.12, 95% CI: 1.03, 4.36], and richest [AOR = 3.57, 95% CI: 1.29, 9.93] were positively associated with good iron-rich food consumption among children aged 6-59 months old. Nevertheless, being 24-59 month-old children [AOR = 0.58, 95% CI: 0.44, 0.72], residents of the Afar [AOR = 0.23, 95% CI: 0.08, 0.67], Amhara region [AOR = 0.30, 95% CI: 0.14, 0.65], and Somali region [AOR = 0.01, 95% CI: 0.01, 0.07] were negatively associated with good iron-rich food consumption among children aged 6-59 months old. The finding revealed that there was low consumption of iron-rich foods among children aged 6-59 months in Ethiopia compared to reports from East African countries. Improving women's literacy and economic empowerment would improve iron-rich food consumption among children aged 6-59 months old. This study's findings would have implications for policymakers in Ethiopia to enhance iron-rich food consumption.

The effect of motivation type on intake and nutritional status of vitamin B12, omega-3 fatty acids, iron and nutrition knowledge in individuals following a vegan diet

The fundamental principle of veganism is to avoid all possible animal exploitation and therefore, animal ethics has always been a primary motivator. Nowadays, the environment and health are also common motivators. Omission of all animal products leads to dietary exclusion of vitamin B12, limited intake of omega-3 fatty acids, specifically EPA and DHA, and intake of low bioavailable iron sources1. Obtaining the knowledge to appropriately plan and replace nutrients through food or supplementation is key to avoiding deficiencies and subsequent consequences. This study aimed to determine the effect of motivation for being vegan on intake of key nutrients and nutritional knowledge. This cross-sectional, observational study recruited participants, who had followed a vegan diet for minimum 2 years. Demographics and nutrition knowledge were obtained from questionnaires. Motivation type was determined using the validated vegetarian eating motives inventory (VEMI) – participants scored the importance of animal ethic, environment and health. Intakes of vitamin B12 and iron, were collected using a 4-day food diary and assessed against Estimated Average Requirement (EAR). Blood samples were taken to determine status of vitamin B12, haemoglobin, serum ferritin, and omega-3 index. Omega-3 index score ≤4 indicates increased risk of coronary heart disease. Animal ethics was the greatest motivator to become vegan, with 83.5% of participants scoring it as very important, compared to 71.7% of people stating the environment, and 53.3% stating health. No association was found between all motivation types and intake of vitamin B12 and iron, nor omega-3 index. Mean vitamin B12 intake (supplements excluded) of 2.11ug/day ± 3.43 exceeded the EAR of 2.0ug/day for both men and women, however intakes ranged between 0.00 and 37.63ug/day. Mean intake of iron (18.77mg/day) exceeded the EAR for both men and women. Overall mean omega-3 index was 3.16%. Both men (162.24g/L) and women (151.44g/L) had adequate mean Hb serum concentrations. Mean serum ferritin was within normal range for both men (64.86ug/L ± 43.48) and women (32.55ug/L ± 26.04). Overall mean serum vitamin B12 was within normal range (316.54pmol/L ± 146.18), however a large range was observed from 72.00pmol/L to 1,015pmol/L. Males and females had similar knowledge, with only one question regarding fibre content in cornflakes found to be significantly different (P = 0.012). Knowledge was varied e.g., 100% of participants could identify that pasta was a carbohydrate source, yet could not identify which fats are most important to reduce. Mean vitamin B12 intake exceeding EAR and normal status despite limited vegan sources, indicates high consumption of high bioavailable fortified foods, and supplementation. Iron status shows large consumption of iron rich foods to overcome bioavailability issues, reflected by adequate iron intake, after increasing EAR by 80% to meet recommendations. The mean omega-3 index shows a low cardioprotective omega-3 fatty acid intake.

Factors associated with dietary iron intakes among pregnant women in Ifako-Ijaiye, Lagos, Nigeria

Iron deficiency anaemia (IDA) in pregnancy is a significant public health problem worldwide, but little is known about factors associated with dietary iron intake among pregnant women especially from low- and middle-income countries(3). This study assessed factors associated with dietary iron intake among pregnant women attending primary health centres in Ifako-Ijaiye Lagos, Nigeria. Sociodemographic information and dietary intakes were elicited from 432 apparently healthy singleton pregnant women using a pre-tested questionnaire and 24 hour- dietary recall, respectively. Dietary iron intakes was estimated from foods and drinks reported using the West African Food Composition Table and adjusted for energy intakes using the residual method(1). Chi-square test and one-way ANOVA was used to compare categorical and continuous variables respectively by tertiles of energy-adjusted dietary iron intakes at a two-sided P<0.05(2).Mean age and dietary iron intake was 28.5 ± 4.6years and 20.3 ± 3.3mg/day, respectively for all respondents. Energy-adjusted iron intakes by tertiles of energy-adjusted dietary intakes were; 16.6 ± 1.4mg/day for the first tertile, 19.7± 1.0mg/day for the second tertile and 23.7 ± 2.0mg/day for the third tertile. Age, gestational age, parity, education, marital status, and income differed insignificantly by tertiles of energy-adjusted dietary iron intakes. Current evidence suggests a statistically insignificant association between sociodemographic factors and dietary iron intakes in this sample, but further studies are vital for designing culturally relevant interventions to promote the consumption of iron-rich foods among women in this population.

Determinants Influencing the Consumption of Iron-Rich Foods among Senegalese Young Children: A Path Analysis

Background: Anaemia is a public health concern among Senegalese children aged 6-59 months old. One of the potential causes of this situation is the low consumption of iron-rich foods (IRF). Understanding factors that influence the provision of IRF among young children could help prevent and control anemia. Using the extended version of the theory of planned behavior (eTPB), this nationwide study examines psychosocial and environmental determinants of the consumption of IRF in children aged 6-23 months.
 Methods and Materials: To this end, an existing questionnaire used for the same purpose was reviewed and re-validated. Using data collected among 418 children's caregivers on each construct of the eTPB, pathways by which individual and environmental constructs may influence the daily IRF consumption were identified. Data on IRF consumption were collected using a food frequency questionnaire.
 Results: Overall, 42% of children consumed IRF, while 95% of caregivers intended to provide them with IRF daily. There was no association between the intention and the actual behavior. The daily IRF consumption was instead predicted by the child's age and environmental factors. In turn, the subjective norm and the perceived behavioral control predicted the intention.
 Conclusion: By using a valid and reliable tool to collect data on individual and environmental factors affecting the consumption of IRF among Senegalese young children on a national scale, our research highlights potential barriers to their provision. These barriers should be considered in the design and implementation of effective interventions to improve their nutrition.

Determinants of iron-rich food deficiency among children under 5 years in sub-Saharan Africa: a comprehensive analysis of Demographic and Health Surveys

BackgroundIron deficiency is a major public health problem that affects the physical and cognitive development of children under 5 years of age (under-5 children) in sub-Saharan Africa (SSA). However, the...

Spatial variations and determinants of iron containing foods consumption among 6–23 months old children in Ethiopia: spatial, and multilevel analysis

Consuming foods high in iron benefits metabolic processes as well as the development of the neonatal and fetal brain. Despite the significance of eating foods high in iron for public health, Ethiopian practices are still limited when compared to the World Health Organization's (WHO) assessment of its consumption of such foods. This study used the Ethiopia Demographic and Health Survey (EDHS) to evaluate the consumption of iron-rich foods, regional clustering, and related characteristics among children aged 6–23 months. The information was taken from the typical EDHS 2019 dataset, which included a weighted sample of 1572 young children aged 6–23 months old in total. Utilizing Kuldorff's SaTScan version 9.6 software, spatial scan statistics were produced. Software from ArcGIS 10.8 was used to display the regional distribution of inadequate consumption of foods high in iron. Utilizing multilevel or mixed effects logistic regression analysis, the associated determinants for a healthy diet rich in foods containing iron were found. In the final model, a P-value of < 0.05 was announced as a statistical significance variable. Overall, in Ethiopia, children aged 6–23 months consumed iron-rich foods at a rate of 27.14% (95% CI 24.99–29.39). Poor intake of foods heavy in iron is concentrated in Ethiopia's regional states of Afar, a sizable portion of Amhara, Oromia, Tigray, Somali, Gambela, and SNNPS. Primary and secondary education (AOR = 1.73, CI 95%: 1.23, 2.41), and (AOR = 1.97,CI 95%: 1.25, 3.10), having ≥ 2 under five children, and current status of breastfeeding (AOR = 0.62 (CI 95%: 0.45, 0.84), and (AOR = 0.32, CI 95%: 0.23, 0.44), giving birth at health facilities (AOR = 1.51, CI 95%: 1.06, 2.13),being from Afar and Somali regions (AOR = 0.39, 95%: 0.17, 0.93), and (AOR = 0.26, CI 95%: 0.10, 0.69) have shown statistically significant association with the outcome variable respectively. In Ethiopia, providing high-iron meals and supplements to under-2-year-old children represents minimal, but persistent, public health expenses. Based on the identified determinants, the Ethiopian federal ministry of health and other stakeholders should pay special attention to the locations designated as hot spots for maternal and child health service enhancement to promote the consumption of iron-rich meals among children aged 6–23 months.

Socio-economic and spatial inequalities in animal sources of iron-rich foods consumption among children 6-23 months old in Ethiopia: A decomposition analysis.

Iron deficiency anaemia is the most common type of anaemia in young children which can lead to long-term health consequences such as reduced immunity, impaired cognitive development, and school performance. As children experience rapid growth, they require a greater supply of iron from iron-rich foods to support their development. In addition to the low consumption of iron-rich foods in low- and lower-middle-income countries, there are also regional and socio-economic disparities. This study aimed to assess contributing factors of wealth-related inequality and geographic variations in animal sources of iron-rich food consumption among children aged 6-23 months in Ethiopia. We used data from the Ethiopian Mini Demographic and Health Surveys (EMDHS) 2019, a national survey conducted using stratified sampling techniques. A total of 1,461 children of age 6-23 months were included in the study. Iron-rich animal sources of food consumption were regarded when parents/caregivers reported that a child took at least one of the four food items identified as iron-rich food: 1) eggs, 2) meat (beef, lamb, goat, or chicken), 3) fresh or dried fish or shellfish, and 4) organs meat such as heart or liver. Concentration indices and curves were used to assess wealth-related inequalities. A Wagstaff decomposition analysis was applied to identify the contributing factors for wealth-related inequality of iron-rich animal source foods consumption. We estimated the elasticity of wealth-related inequality for a percentage change in socioeconomic variables. A spatial analysis was then used to map the significant cluster areas of iron-rich animal source food consumption among children in Ethiopia. The proportion of children who were given iron-rich animal-source foods in Ethiopia is 24.2% (95% CI: 22.1%, 26.5%), with figures ranging from 0.3% in Dire Dawa to 37.8% in the Oromia region. Children in poor households disproportionately consume less iron-rich animal-source foods than those in wealthy households, leading to a pro-rich wealth concentration index (C) = 0.25 (95% CI: 0.12, 0.37). The decomposition model explained approximately 70% of the estimated socio-economic inequality. About 21% of the wealth-related inequalities in iron-rich animal source food consumption in children can be explained by having primary or above education status of women. Mother's antenatal care (ANC) visits (14.6%), living in the large central and metropolitan regions (12%), household wealth index (10%), and being in the older age group (12-23 months) (2.4%) also contribute to the wealth-related inequalities. Regions such as Afar, Eastern parts of Amhara, and Somali were geographic clusters with low iron-rich animal source food consumption. There is a low level of iron-rich animal source food consumption among children, and it is disproportionately concentrated in the rich households (pro-rich distribution) in Ethiopia. Maternal educational status, having ANC visits, children being in the older age group (12-23 months), and living in large central and metropolitan regions were significant contributors to these wealth-related inequalities in iron-rich animal source foods consumption. Certain parts of Ethiopia such as, Afar, Eastern parts of Amhara, and Somali should be considered priority areas for nutritional interventions to increase children's iron-rich animal source foods consumption.

Knowledge regarding iron and consumption of iron-rich foods among urban residents in Accra, Ghana: A pilot study

Knowledge regarding iron and consumption of iron-rich foods among urban residents in Accra, Ghana: A pilot study

Does Mobile Phone Tele-Reminder Increased Iron Status and Diet Quality of Pregnant Women Availing Antenatal Care Services at Phebe and Charles B. Dunbar Hospitals Bong County, Liberia A Cluster Randomized Control Trial

Anemia in pregnancy is a serious public health problem in Liberia. This study aimed to assess the effect of mobile phone tele-reminder on the iron status and diet quality of pregnant women in Liberia. A two-arm, double-blinded cluster randomized control trial was conducted in this study, with ANC screening rooms as a unit of randomization. At the Phebe and Charles B. Dunbar hospitals in Bong County, Liberia, 150 pregnant women who had never previously attended an ANC were recruited for the study (75 intervention women and 75 control women). Iron status measured as hemoglobin (g/dl) and diet quality were primary outcomes of this study. Secondary outcome measures were adherence to daily iron and folic acid supplementation and prevalence of anemia among pregnant women with malaria infection. The analysis was an intent-to-treat. The effect of the intervention on the primary study outcome (iron status) was examined using an independent sample t-test (for group-level analysis). Effects of treatment on diet quality was measured using the Fisher’s Exact Test. A binary logistic regression with a 95% Confidence Interval (CI) was used to analyze the effect of treatment on secondary outcomes. Pregnant women assigned to the intervention group had a significantly greater mean hemoglobin level after the two interventions, t (2.4) = 447, p&lt;0.05; d = 0.23). In the intervention group, there were significant odds in the consumption of 2-3 fish/meat/poultry products compared to the control group (93% versus 83%, adjusted odds ratio, 2.93; 95% CI, 0.99-8.70). A trend towards adherence to the IFA supplementation and an increase in consumption of iron-rich foods was observed. In Liberia, mobile phone tele-reminders appeared to be effective in improving iron status, diet quality, and IFA supplementation adherence when integrated into an existing antenatal care protocol.

Are Complementary Feeding Practices Aligned with Current Recommendations? A Narrative Review.

The complementary feeding introduction period (introduction of solid foods alongside breastmilk or formula) is defining in children's health; however, it appears that many parents do not follow complementary feeding guidelines. Our aim was to describe current parental feeding practices during complementary feeding in relation to current recommendations and explore determinants of adherence to guidelines. We included any relevant studies published within the last decade in French or English and summarized findings by recommendation category. The timing of complementary food introduction varied widely across and within continents (earlier in North America and often delayed in Asia). The introduction of allergenic foods tended to be delayed globally. Although some parents now begin complementary feeding with solid foods (i.e., baby-led weaning), delayed introduction of lumpy textures was still prevalent in the United States and in Europe. The consumption of iron-rich foods was predominantly low in Africa. Added sugars were globally introduced early, especially in America. Evidence for the prevalence of responsive feeding practices among parents is unclear due to the small number of studies. Determinants of complementary feeding practices included parental characteristics, such as age, education, socio-economic status, and race/ethnicity. Interventions aiming to increase adherence to complementary feeding guidelines must account for parental characteristics.

Evaluation of Temperate Maize Inbred Lines for Iron (Fe) Concentration using Atomic Absorption Spectrophotometry

Maize (Zea mays L.) is one of the important cereal crops, ranking third after wheat and rice. It holds the title of the "Queen" of cereals due to its wide cultivation and nutritional value it provides. Especially iron is crucial for the proper functioning of haemoglobin and blood formation. Unfortunately, insufficient consumption of iron-rich foods is the primary cause of iron deficiency in the underdeveloped countries. A research study was conducted at the Department of Plant Breeding and Genetics, University of Agriculture, Faisalabad, aiming to investigate the diversity of 20 indigenous maize (Zea mays L.) inbred lines. Seeds were sown in a Randomized Complete Block Design (RCBD) with three replications. The study was conducted under open field conditions, focusing on genetic variations related to quality and yield traits. The results were analysed using analysis of variance (ANOVA) to determine variability among the inbred lines. Various parameters were recorded at maturity and after harvesting i.e., plant height, ear traits, and grain iron content. The evaluation of grain iron content revealed significant variation among the inbred lines tested. The inbred line with the highest iron content was 6162, recording 40.083 µg/g. Additionally, the analysis of other morphological and yield traits showed significant variations among the inbred lines. Three lines showed promising iron content: 6162 (40.083 µg/g), CRT-3 (36.417 µg/g), and 6199 (35.25 µg/g). Based on these research findings, there is a clear need to develop a breeding plan to enhance iron content in local maize germplasm

Individual and community-level factors associated with iron-rich food consumption among children aged 6-23 months in Rwanda: A multilevel analysis of Rwanda Demographic and Health Survey.

Iron-rich food consumption has an invaluable effect for neonatal and fetal brain development as well as metabolic activities. Despite the public health importance of the consumption of iron-rich foods, there was no study, that assessed iron-rich food consumption in Rwanda. Therefore this study aimed to assess iron-rich food consumption and associated factors among children aged 6-23 months using Rwanda Demographic and Health Survey (RDHS). Secondary data analysis was done using RDHS-2019/20. Total weighted samples of 2455 children aged 6-23 months were included. Data coding, cleaning, and analysis were performed using Stata 16. Multilevel binary logistic regression were performed to identify factors associated with iron-rich food consumption. Adjusted Odds Ratio (AOR) with a 95% CI, and p-value <0.05 were used to declare statistical significance. The prevalence of good iron-rich food consumption was 23.56%(95% CI: 21.92,25.28). Northern province of Rwanda (AOR = 0.26,95%CI: 0.15,0.46), mothers secondary education and above (AOR: 2.37, 95% CI: 1.41, 4.01), married mothers (AOR:1.31, 95% CI: 1.01,1.71), rich wealth status (AOR = 2.06, 95% CI: 1.48, 2.86), having post-natal visit (AOR = 1.45, 95% CI: 1.10,1.91), mothers media exposure (AOR: 1.75, 95% CI: 1.22, 2.52) and drugs given for intestinal parasite (AOR = 1.37, 95% CI: 1.04, 1.80) were associated with iron-rich food consumption. This study shows that overall iron-rich foods consumption was low in Rwanda. The residing in the North province, mother's secondary and higher educational status, married marital status, rich and middle wealth status, having media exposure, drugs given for intestinal parasites, and having child's post-natal checkup were variables significantly associated with iron-rich food consumption. The region-based intervention will improve the consumption of iron-rich food. In addition, health policies and programs should target educating mothers/caregivers, encouraging parents to live together, improving their wealth status, working on mass media access by the women, and encouraging mothers post-natal checkups to improve iron-rich food consumption.

A Comparative Study of Anemia in Adult Women of Telangana Population

Background: Anemia is still a major health problem in females of both rural and urban areas of the developingcountries like India. The objective of the present study was to find out the hematological parameters and bloodindices among adult females in rural and urban areas of Patancheru (Mandal), Telangana and correlate to type ofanemia, degree of anemia, and percentage of anemia in both rural as well as urban areas in adult females.Methods: A cross-sectional study was conducted among adult female subjects of age group 18-35 years comprisedof n=100 subjects selected from rural area and n=100 subjects from urban areas of Patancheru (Mandal),Telangana.The hematological parameters, Hb gm%, MCV (fl), RBC count/mm3,MCH(pg), PCV(%),MCHC(gm/dl) wereinvestigated by Hematology Analyzer-automated blood counter.Results: among the total sample of n=200 adult female subjects of age group 18-45 years, the overall prevalence ofanemia was observed 58%, recording 60% in rural area females and 56% in adult female subjects of urban area. Theoverall microcytic anemia was observed maximum (40%), recording 70% in rural area subjects and 67% in urbanarea subjects. The overall macrocytic and normocytic anemias were recorded 9% each. The macrocytic anemia wasrecorded 13.5% in rural area and 17.8% in urban area. The normocytic anemia’s was recorded 16.6% in rural areaand 14.2% in urban area adult females. Both parameters of urban and Rural females were compared and there washighly Significant P Value (P&lt;0.001).Conclusion: The present study indicated that prevalence of anaemia is slightly higher among rural adult femalesubjects of age group 18-35 years compared to urban area female subjects. The current study results suggests, needof due emphasis on iron and folic acid supplementation and education on consumption of iron rich foods, so as tobring down the prevalence of anemia among the adult females

Maternal Knowledge of Anemia and Adherence to its Prevention Strategies: A Health Facility-Based Cross-Sectional Study Design.

Anemia is a largely preventable and curable medical disease if detected intime. This study aimed to assess maternal knowledge of anemia and its prevention strategies in the public health facilities of Pawi district, Northwest, Ethiopia. A health facility-based cross-sectional study was conducted from February 1/2020 to March 2/2020, among 410 antenatal care attendees in the public health facilities of the Pawi district. The data was collected by systematic random sampling technique and analyzed using SPSS 25.0 version. Logistic regression analyses were done to estimate the crude and adjusted odds ratio with a CI of 95% and a P-value of less than .05 considered statistically significant. Less than half, 184 (44.9%) [95% CI = 40.0-49.8] and almost half, 216 (52.7%) [95% CI = 47.8-57.5] of the pregnant women had good knowledge of anemia and good adherence to its prevention strategies respectively. Women who are found in the age group of 15 to 19, 20 to 24, and 25 to 29 years, rural residency, secondary, and above educational level, vaginal bleeding, third trimester of pregnancy, and medium and high minimum dietary diversification score were significantly associated with knowledge of anemia. On the other hand: women who are found in the age group of 15 to 19 years, secondary above educational level, primigravida women, having ≤2 and 3 to 4 family sizes, second and third trimester of pregnancy, high minimum dietary diversification score, and good knowledge of anemia were significantly associated with adherence to anemia prevention strategies. Maternal knowledge of anemia and adherence to its prevention strategies were low. Nutritional counseling on the consumption of iron-rich foods and awareness creation on the effects of anemia in pregnant women must be strengthened to increase the knowledge of anemia and adherence to its prevention strategies.

Determinants of stunting in children aged between 6-23 months in Musanze region, Rwanda.

Under-nutrition causes approximately half of all deaths in young children every year globally which is exacerbated by the multiple malnutrition burden. Infant and young child feeding practices pose immediate effects on the nutrition status of under 2 years aged children and greatly influence the survival of a child. This study aimed at determining the implication of the infant and young child feeding practices in evaluating stunting in young children among other stunting risk factors. Analytical cross-section study was carried out in Musanze, a district of Rwanda and involved 241 mothers having children aged between 6 and 23 months. Data was collected using a validated semi-structured questionnaire with observations and check list guides. Chi-square test and logistic regressions were used to determine the associations and risk factors of various variables. The results show that minimum meal frequency (MMF) was attained at 83% rate, minimum dietary diversity (MDD) at 57%, minimum acceptable diet (MAD) at 53% with consumption of iron rich foods at 29%. Stunting prevalence was 28%. The MAD had a significant (p = 0.021) association with height-for-age Z-score of a child and was found to be the stunting's predictor. The child's sex, consumption of animal sourced foods, child underweight status and income type were revealed as other stunting risk factors. A holistic approach that promotes infant and young child feeding practices and complementary feeding in particular can contribute to the alleviation of the stunting burden in Rwanda. Further, other associated factors that influence child nutrition status should be taken into consideration by the policy decision makers and development partners when developing food and nutrition sensitive programs and interventions.

Effectiveness of an integrated agriculture, nutrition-specific, and nutrition-sensitive program on child growth in Western Kenya: a cluster-randomized controlled trial

ABSTRACTBackgroundStunting rates remain unacceptably high in many regions, including sub-Saharan Africa. Agricultural programs have led to increased yields and household incomes but showed limited success in improving nutritional status.ObjectivesWe assessed whether linear growth could be improved through a potentially scalable, integrated program adding nutrition-specific and nutrition-sensitive components to an existing agricultural program.MethodsIn this cluster-randomized controlled trial in rural Western Kenya, we randomized children aged 6–35 months from farming families to an agricultural intervention without (control group) or with a bundle of interventions (intervention group), including distribution of micronutrient powders (MNP), poultry to increase egg consumption, seeds of greens and onions, and soap and chlorine solution, as well as provision of monthly behavior change trainings. The primary outcome was the change in height-for-age z-score (HAZ) over 2 years of follow-up. We assessed safety through active morbidity and passive adverse event monitoring. We conducted an intention-to-treat analysis, followed by per-protocol and prespecified subgroup analyses.ResultsFrom March to April 2018, we enrolled 1927 children from 126 clusters (control, 942 children in 63 clusters; intervention, 985 children in 63 clusters). Data on HAZ were available for 1672 (86.6%) children after 2 years. Adherence was >80% for use of MNP, chlorine, and greens and receipt of soap, and ∼40% for egg and red onion consumption. The intention-to-treat analysis indicated a greater change in HAZ over 2 years in the intervention group (adjusted effect size, 0.11; 95% CI: 0.02–0.19). We found a slightly stronger effect in the per-protocol analysis (adjusted effect size, 0.15; 95% CI: 0.06–0.24). Dietary diversity and consumption of iron-rich foods were improved in the intervention group, and reported instances of fever, lower respiratory tract infections, and diarrheal episodes were lower in the intervention group.ConclusionsThis study found a modest improvement in linear growth, indicating the need for multiple, integrated interventions to achieve benefits. The trial was registered with clinicaltrials.gov as NCT03448484.

Consumption of Iron Rich Food, Supplement Intake and Prevalence of Anaemia Among Pregnant Women Attending Antenatal Clinical in Selected Hospitals in Enugu State

ObjectivesIncrease prevalence of anaemia in pregnancy in spite consumption of iron rich foods and micronutrient supplementation is worrisome. Hence, this study investigated the consumption of iron rich food, supplement intake and prevalence of anaemia among pregnant women attending antenatal clinic in selected hospitals in Enugu State.MethodsThe study employed a cross-sectional study design with multistage random selection of 449 pregnant women (PW) attending antenatal clinic in health facilities in Enugu State, Nigeria. Data were collected using a structured questionnaire and biochemical test for Haemoglobim level using a standard procedure. Data was analyzed using SPSS 23. Statistical analysis was done using Chi-square and Pearson correlation to establish the relationship between variables. A p-value < 0.05 was considered as the level of significance.ResultsThe result shows that about 42.1% of the pregnant women were between the age group 26–35years and 30.4% earned < N20,000 ($50) monthly. Less than half of the PW consumed vegetable, fruits, beef and fish ≥ 4 times weekly. Less than half took folic acid, B-complex vitamins and ferrous sulphate twice daily, 36.9% had Anaemia (27.8% mild; 5.3% moderate; and 3.8% severe anaemia) and 76.8% had malaria. There was significant relationships between iron rich consumption, supplement intake especially iron supplement and prevalence of anaemia among pregnant women attending antenatal clinic in this study (P < 0.05).ConclusionsThe study revealed poor consumption of iron rich food and poor compliance to supplements intake among pregnant women which accounted for the high prevalence of anaemia in the study population.Funding SourcesThe research is self funded.

An exploration of cultural influencing factors on dietary diversity in Malagasy children aged 6\u201359\u2009months

BackgroundMore than 1.7 million children in Madagascar are stunted, with low dietary diversity being a determinant. Although diverse crops are produced in the Vakinankaratra region, it registers the highest stunting prevalence rate nationally. While children’s diets may be influenced by region-specific cultural factors, little is known about this link so far. The aim of this study was to determine the influence of cultural habits on dietary diversity in children between 6 to 59 months in the Vakinankaratra region.MethodsA mixed method design with a qualitative lead approach was used, including three transect walks, six focus group discussions and 51 semi-structured interviews with caregivers. The interviews contained a quantitative part to assess the four feeding indicators: ‘minimum meal frequency’, ‘minimum dietary diversity’, ‘minimum acceptable diet’ and the consumption of iron-rich foods. Participants were selected by convenience sampling. Data was collected in November 2019 in three communities displaying maximal possible variation.ResultsSubsistence farming with diverse crops and livestock was found to be a common practice. Minimum meal frequency was achieved by 78% of the sixty included children. In total, 45% attained minimum dietary diversity and 40% consumed a minimum acceptable diet. Across the three communities, the range of children attaining a minimum acceptable diet was 25–60%. Older, no longer breastfed children were prone to not achieving a minimum acceptable diet. Although caregivers had a basic idea of important foods for child development, these were often not available to or affordable for them. An effect of cultural events on diet, especially diversity, was found. Whilst for annual events this effect was short-term, the region-specific ceremony of reburying the dead (Famadihana) was found to have a long-term influence on the diet of certain families.ConclusionsThe dietary diversity of children under five in the Vakinankaratra region is influenced by cultural factors like agricultural practices, caregivers’ knowledge of child nutrition, food taboos and a region-specific cultural event. Cultural determinants, especially important traditions that result in significant expenditures, may thus influence the quality of children’s diet and should therefore be considered in future nutrition programmes and research on child malnutrition and stunting.

Dietary iron intakes and odds of iron deficiency anaemia among pregnant women in Ifako-Ijaiye, Lagos, Nigeria: a cross-sectional study.

Introductioniron deficiency anaemia (IDA) in pregnancy is a prominent risk factor for maternal mortality and poor pregnancy outcomes in low- and middle-income countries, but studies on the significance of dietary iron intake (DII) in IDA in this population are limited. This study assessed the association of DII with odds of IDA among pregnant women attending primary health centres in Ifako-Ijaiye, Lagos, Nigeria.Methodssociodemographic information and dietary intakes were assessed among 432 singleton pregnant women (without pre-existing medical complications) using a pre-tested questionnaire and 24 hr-dietary recall, respectively. Dietary iron intake (DII) was derived from the 24 hr-dietary recall using the West African food composition table. Haemoglobin (Hb) levels in blood samples were measured using the haemoglobin-cyanide technique, and IDA was defined using the World Health Organization criteria. Multivariable-adjusted odds ratios (OR) of IDA and 95% confidence intervals (CI) by energy-adjusted tertiles of DII were estimated using logistic regression with a two-sided P<0.05.Resultsmean age of respondents was 28.5 ± 4.6 years, and the average gestational age was 31.3 ± 4.1 weeks. Mean DII was 20.3 ± 3.3 mg/day, and Hb concentration was 97.9 ± 12.9 g/L. Furthermore, 83.8% had IDA and multivariable-adjusted OR and 95% CI for odds of IDA across tertiles of energy-adjusted DII were 1.00, 0.32 (0.05, 1.77), 0.07 (0.01, 0.36) P for trend < 0.0001 adjusting for age, primigravidae status and monthly income.Conclusionhigher DII was inversely associated with the odds of IDA among pregnant women. Behavioural change communication promoting the consumption of iron-rich foods might be a viable dietary strategy to alleviate the high burden of IDA among women in this population.

Predictors of Low Birth Weight among Newborns Delivered At a Referral Hospital in Hadiya Zone, Southern Ethiopia

Background & aim: In developing countries, such as Ethiopia, neonatal morbidity and mortality, which is usually associated with low birth weight, are still high. Therefore, the aim of this study was to determine the extent and predictors of low birth weight among newborns delivered at a referral hospital in Hadiya Zone, Southern Ethiopia.Methods: A hospital-based cross-sectional study was conducted from 1st to 28th April, 2019. A structured questionnaire and chart review were used to collect data. A systematic sampling technique was used to recruit 363 study participants. The relationship of independent variables with the dependent variable was determined using bivariate and multivariable logistic regression analyses. The odds ratios were calculated with their 95% confidence intervals, and statistical significance was accepted at a p -value of < 0.05. SPSS software (version 23) was used to enter and analyze the data.Results: The prevalence of low birth weight was found to be 12.7%. The predictors of low birth weight comprised of not receiving antenatal care visit (AOR =7.6; 95 % CI: 1.23-6.24), preterm delivery (AOR=4.99, 95% CI: 2.22-11.18), anemia (AOR =4.99; 95% CI: 2.22-11.18) and smoking of cigarette (AOR=5.85; 95% CI: 1.18-28.92).Conclusion: This study revealed that a significant proportion of newborns are delivered with low birth weight. Consumption of iron-rich foods and abstinence from smoking should be encouraged to help prevent low birth weight. Additionally, increasing the uptake of antenatal care visits and prompt diagnosis and treatment of obstetric complications such as preterm delivery are important.