Dietary Diversity Score Research Articles

Factors associated with stunting in under-five children with environmental enteropathy in slum areas of Jimma town, Ethiopia.

Stunting is a major public health issue with a significant influence on the health and development of children in low-income countries, where it affects up to 32% of children. Nutritional intake is impacted by alterations in intestinal permeability and underlying chronic inflammation, which hinder children's normal linear growth. Environmental enteropathy is a poorly understood condition with chronic intestinal inflammation. The purpose of this study was to identify the magnitude of stunting, change in growth, and factors associated with stunting and change in height for the age Z-score of children with an elevated lactulose-to-mannitol ratio. An observational follow-up study was conducted to follow children with an elevated lactulose-to-mannitol ratio for changes in their linear growth. A lactulose-mannitol test was performed to identify children with elevated lactulose-to-mannitol ratios, indicative of environmental enteropathy. After a 1-year follow-up, anthropometry was repeated to assess their linear growth. A multivariable logistic regression analysis was performed to identify the independent predictors for stunting in children with elevated lactulose-to-mannitol ratios. All tests were two-sided, and a p-value of <0.05 was considered significant. The prevalence of stunting in children with an elevated L:M at baseline and end line was found to be 72.4% (95% CI: 60.3, 84.5) and 78.4% (95% CI: 66.7, 90.2), respectively. In a multivariate analysis, a low dietary diversity score (<4 food groups), presence of flies and insects in the toilet area, poor handwashing practices during a critical time, and MUAC z < -2 were significantly associated with stunting. Flies and insects in the toilet area and unsafe disposal of feces were significantly associated with changes in HAZ in children with elevated lactulose-to-mannitol ratios, an indicator of environmental enteropathy. Most of the children with an elevated lactulose-to-mannitol ratio in the study population were stunted, and no significant change in their linear growth was observed after 1-year follow-up. Therefore, further investigation and urgent intervention are needed to prevent environmental enteropathy and stunting among under-five children in this community who are exposed to very poor sanitary conditions and other risk factors for malnutrition.

Integrating nutrition in the Sasakawa Africa Association extension services: Knowledge, attitude and practices among smallholder farmers

This survey aimed to establish nutrition-related knowledge, attitudes and practices, and to observe how gender influences household food-related decision-making processes in the Sasakawa Africa Association (SAA) intervention areas in the Oromia and Southern Nation Nationalities and People regions of Ethiopia. The findings would inform implementation of communication for nutrition social and behaviour change among small-holder farmers as part of the SAA corporate strategy on nutrition-sensitive agriculture. The study population was smallholder farmers supported by SAA from which 311 respondents were selected through multistage sampling. Data were collected via a mixed methods approach consisting of a household survey, focus group discussions (FGDs) and key informant interviews (KIIs). Quantitative data were analysed using descriptive statistics while qualitative data was analysed using a narrative and content approach. The study focused on knowledge, attitudes and practices related to production and consumption of micronutrient-rich foods. Majority (59.5%) of the respondents were male. Men were the main decision makers on staple or commercial food crop production and proportion of produced crops to be consumed at home or sold in the market. Women mainly made decisions regarding production and consumption of fruits and vegetables, intra-household food distribution, preservation and storage. There was a lack of knowledge on iron and vitamin A fortified or biofortified sources of food. Nearly three quarters (72%) of women did not meet the minimum dietary diversity for women, a proxy indicator of adequacy of micronutrient intake and diet quality. The mean dietary diversity score was 3.8 with animal source foods being the least consumed. Not having sufficient money to buy food, unavailability of different food groups and poor intra-household food distribution were among the key reasons for lack of diverse diets. Majority of the respondents were aware of the importance of production and consumption of micronutrient-rich foods. However, there was a gap in practice and awareness about biofortified and fortified foods. While most of the respondents had produced fruits and vegetables in home gardens in the three months prior to this survey, more than half (54%) of the respondents thought it was not likely that they would produce fruits and vegetables for home consumption. More targeted nutrition campaigns are required to increase the ability of small-holder farmers to adopt best practices while reducing the barriers associated with access and consumption. Promotion of fruit and vegetable production in home gardens could be considered as option for improving household dietary quality as well as empowering women to make more decisions. Key words: Sasakawa Africa Association, Small-holder farmers, Nutrition, Knowledge, Practices

Dietary Inflammatory Index and Dietary Diversity Score Associated with Sarcopenia and Its Components: Findings from a Nationwide Cross-Sectional Study.

Little is known about the independent and joint effects of the energy-adjusted dietary inflammatory index (E-DII) and dietary diversity score (DDS) on sarcopenia and its components (low muscle mass, low muscle strength, and low physical performance). A total of 155,669 UK Biobank participants with ≥1 (maximum 5) 24 h dietary assessments were included in this cross-sectional analysis. We used logistic regression models to investigate the associations of E-DII and DDS with sarcopenia and its three components. We further examined the joint effects of E-DII and DDS on sarcopenia and its components using additive and multiplicative interaction analyses. We observed that lower E-DII and higher DDS were associated with lower odds of sarcopenia and its components. There were significant joint associations of E-DII and DDS with sarcopenia and low physical performance (p-interaction < 0.05) on the multiplicative interactive scale. Our study suggests that lower dietary inflammatory potential and higher dietary diversity might be important protective factors against sarcopenia and its components. More cases of sarcopenia and low physical performance might be preventable by adherence to a more anti-inflammatory diet combined with a higher dietary diversity.

A systematic review of diet, nutrition, and medication use among centenarians and near centenarians worldwide

Centenarians represent a phenomenon of successful aging, yet little is known about their lifestyle and health practices, including diet/nutrition, medication use, and health conditions. A protocol for this systematic review was registered previously(1). We systematically searched Medline, CINAHL, Scopus, and grey literature from 2000 to 2022, limited to quantitative studies published in English among adults aged 95 years or above. Two reviewers independently screened 3,392 records and identified and extracted data from 34 eligible studies. Additionally, they independently assessed the study quality using the Modified Newcastle-Ottawa Scale (mNOS)(2). Any disagreement was discussed and resolved with a third reviewer. In analysis, pooled prevalence was provided for categorical variables on demographics, lifestyles, medications, and diseases using % (95%CI); mean or median was provided for continuous variables. Due to study heterogeneity, we conducted a narrative synthesis for the associations between the exposures and outcomes. Over 70% of the included studies met 6/8 criteria based on the mNOS; nearly half did not mention or control for confounders in statistical analyses. The age ranged from 95-118y (32 studies: 100y+; 2 studies: mean age 97-98 y); the majority were females (75%; 95%CI: 71%,78%). Most centenarians did not smoke or drink [current smokers: 7% (5%, 9%); former smokers:16% (12%, 19%); daily drinkers: 27% (20%, 34%); former drinkers:21% (13%, 30%)]. Most centenarians were physically inactive (23%; 20%, 26%). Over 50% had normal weight (52%; 42%, 61%), 33% (14%, 52%) underweight, and 14% (8%, 20%) overweight. Regarding nutrition, the narrative synthesis suggests that centenarians had normal levels of albumin (3.8g/dL), total triglycerides (111mg/dL), total (188mg/dL), and HDL cholesterol (54mg/dL) but high levels of LDL cholesterol (109mg/dL). Regarding medications, nearly 50% took antihypertensive medications (49%; 14%, 84%) or other cardiovascular drugs (48%; 24%, 71%); they took a median of 5 (range: 2-7) drugs. Common conditions included impairment of basic activities of daily living (ADL) (54%; 33%, 74%), hypertension (43%; 21%, 65%), and diabetes (22%; 9%, 52%). In regression analyses among centenarians, high dietary diversity, lower salt preference, and weight status were significant factors for more independence in basic ADL, lower mortality, and greater longevity. For example, a high dietary diversity score was associated with a low mortality risk [0.93 (0.92, 0.94) per unit increase]; those who preferred salty food versus those who did not had a 3.6-fold risk of impaired ADL [adj.OR: 3.59 (1.14, 11.25)]. Being overweight vs. normal weight reduced the risk of ADL impairment [adj.OR: 0.84 (0.78, 0.91] while underweight increased this risk [adj.OR:1.34 (1.28, 1.41)]. Also, overweight [adj.OR: 0.92 (0.90, 0.94)] or abdominal obesity [adj.OR: 0.72 (0.52, 0.996)] reduced the likelihood of longevity per kg increase. This systematic review suggests a healthy lifestyle, good nutrition, and normal body weight may contribute to extreme longevity. Interpreting these summary findings should be cautious due to potential recall bias and heterogeneity of the included studies.

Assessing the effect of women’s empowerment on their dietary intake: a cross-sectional study

Background: Women empowerment is an important strategy to reduce maternal and child undernutrition, which continues to be a major health burden in low- and middle-income countries. The present study aimed to assess the effect of women empowerment on their dietary intake in the two selected blocks of Sultanpuri urban slums, West Delhi. Methods: The baseline was conducted using a cross-sectional research method with girls and women (15-35 years). The research was conducted through a predesigned, pretested, semi-structured questionnaire to capture the information on socio-demographic profiles along with knowledge on social skills, self-esteem, and decision-making. The data were collected on the consumption of food groups in the last 24 hours from 2402 girls and women. We employed unadjusted and adjusted step-wise regression models to assess the effect of domains of women empowerment on dietary intake. Results: The median (interquartile range) age of the women was 27 (22-31) years. We found a 0.17-point increase in the dietary diversity score per one-unit increase in the self-esteem score of the women. Similarly, there was a 0.06-unit increase in the dietary diversity score per one-unit increase in the social skills score of the women. The association remained statistically significant even after adjustments for co-variates like age, education status, and socio-economic status. Conclusions: The present study recommends that focusing on women's empowerment dimensions, particularly social skills, self-esteem, and decision-making power, can be an effective strategy for improving dietary intake among women.

A Comprehensive Analysis of Sports Nutrition Knowledge and Diet Diversity Among South Indian Athletes

Purpose. Athletes can benefit greatly from having knowledge about sports nutrition. However, there are limited studies on athletes' nutritional knowledge and dietary habits in South India. This study aims to assess the athletes' sports nutrition knowledge, analyse their dietary practices and attitudes, and the dietary diversity score. Material &amp; Methods. A descriptive cross sectional study was conducted in selected areas of Chengalpattu district in Tamil Nadu. Eighty-five athletes aged 10-18 training in different sports academies were interviewed individually using a validated questionnaire to analyse their sports nutrition knowledge, attitude and dietary practices. Results. The results showed that only 4.7% of the athletes had adequate nutritional knowledge of over 60%. The mean overall knowledge score was 40.2%, with athletes being most knowledgeable about protein and its sources (mean score of 67.9%), but less aware of carbohydrate and fat sources and recommendations (mean score of 15.08% and 14.01%, respectively). The mean score for attitude and dietary practices were 64.4 and 59.5 respectively. A strong and positive correlation was found between the level of nutritional knowledge and attitude (p=0.0001). Additionally, we found that the occupation of parents and the monthly income of the family were significantly associated with the athletes' nutritional knowledge. Majority of athletes (74.1%) of the athletes had an adequate dietary diversity score (DDS) of ≥ 5, and 25.9% of the athletes had a DDS of ≤ 4. Conclusions. Nutritional educational interventions at the grass root level can potentially improve athletes' knowledge, dietary practices and sports performance in the future. It is crucial to identify and address knowledge gaps, and use technology to monitor and motivate athletes towards consistency in implementing their knowledge.

Assessing the interaction effects of mitochondrial DNA polymorphisms and lifestyle on heel bone mineral density.

Bone mineral density (BMD) is a major predictor of osteoporotic fractures, and previous studies have reported the effects of mitochondrial dysfunction and lifestyle on BMD, respectively. However, their interaction effects on BMD are still unclear. Therefore, we aimed to investigate the possible interaction of mitochondrial DNA (mtDNA) and common lifestyles contributing to osteoporosis. Our analysis included 119,120 white participants (Nfemale=65,949 and Nmale=53,171) from the UK Biobank with heel BMD phenotype data. A generalized linear regression model of PLINK was performed to assess the interaction effects of mtDNA and five life environmental factors on heel BMD, including smoking, drinking, physical activity, dietary diversity score, and vitamin D. In addition, we also performed linear regression analysis for total body BMD. Finally, we assessed the potential causal relationships between mtDNA copy number (mtDNA-CN) and life environmental factors using Mendelian randomization (MR) analysis. Our study identified four mtDNA loci showing suggestive evidence of heel BMD, such as m.16356T>C (MT-DLOOP; P =1.50×10-3) in total samples. Multiple candidate mtDNA×lifetsyle interactions were also detected for heel BMD, such as MT-ND2×physical activity (P = 2.88×10-3) in total samples and MT-ND1×smoking (P = 8.54×10-4) in males. Notably, MT-CYB was a common candidate mtDNA loci for heel BMD to interact with five life environmental factors. Multivariable MR analysis indicated a causal effect of physical activity on heel BMD when mtDNA-CN was considered (P =1.13×10-3). Our study suggests the candidate interaction between mitochondria and lifestyles on heel BMD, providing novel clues for exploring the pathogenesis of osteoporosis.

Socio-demographics, dietary diversity score, and nutritional status of children aged 2–5 years: A cross-sectional study of Indonesian coastal areas

BackgroundClimate change has negatively impacted both food security and food diversity, including malnutrition (stunting, wasting, and underweight), especially among children in coastal areas. The dietary diversity score (DDS) is a good indicator used to assess the quality of food for children. This study aimed to investigate the association between socio-demographic characteristics, DDS, and nutritional status in children aged 2–5 years in the coastal area of Demak, Indonesia. MethodsA cross-sectional study was conducted on 130 households with children aged 2–5 years living in the coastal area of Demak from April to July 2022. The socio-demographic characteristics were determined by interviewing the mother or child caregiver, followed by anthropometric measurements of the children. The DSS was calculated based on the 24-h food recall method. Descriptive statistics, independent samples t-test, and Chi-square were used for statistical analysis. ResultsThe mean age of the subjects was 3.11 ± 0.93 years (girl 46.9% and boy 53.1%). Maternal education was significantly associated with children's DDS (P = 0.016). There was a significant association between the history of acute respiratory infection (ARI) and nutritional status based on HAZ (P = 0.023), and there was also a significant association between exclusive breastfeeding history and family type with nutritional status based on WHZ (P < 0.05). ConclusionThe study indicated a significant association between socio-demographic factors (mother's education, ARI history, exclusive breastfeeding history, and family type) with DDS and children's nutritional status in Demak.

Association between dietary diversity and complications during pregnancy in a South-West District of Bangladesh

Introduction: Poor dietary diversity is one of the key factors that increases the rate of complications during pregnancy. Pregnancy complications significantly increase the risk of maternal mortality. The aim of this study was to explore the associated factors between dietary diversity and complications during pregnancy. Method: A cross-sectional study was conducted among 450 randomly selected pregnant women. Individual dietary diversity score (IDDS) was used to assess dietary diversity based on Food Frequency Questionnaire (FFQ). IDDS was derived from 24-hour recalls from nine food groups. Results: Most of the pregnant women (48.9%) included in this study were in their second trimester; 19.3% and 31.8% were in first trimester and third trimester, respectively. About 83.8% of respondents included in this study experienced pregnancy complications. According to IDDS, most participants (77.1%) consumed a medium-diversified diet. Only 4.4% and 18.4% of pregnant women had low and highly diversified dietary intakes, respectively. Mean IDDS was 5.62±0.93, which indicated medium diversity of dietary intake. Dietary diversity had a statistically significant correlation with age (p=0.003), monthly income (p=0.003), education level (p=0.001), and respondent’s employment (p=0.004). The study exposed that pregnancy complications had a negative correlation with food diversity (r=-0.223), marriage age (r=-0.066), and education level (r=-0.163). Conclusion: The study concluded that pregnancy complications can be alleviated by improving dietary diversity practices during pregnancy.

Pathways and policy options for food and nutrition gaps in arid agricultural farming systems in the Tigray Region, north Ethiopia

Food and nutrition security is a major global challenge especially indeveloping countries.Agriculture is main means of livelihoods and hunger is drastically increasing from time to time especially due to effects of climate change, conflict and other manmade and natural calamities in these countries. Similarly, the Tigray Region is one of the Ethiopia's most food and nutrition insecure regions with agriculture serving as the main source of income and employment. This study was therefore conducted to fill the gap in understanding the socioeconomic situation, bio-physical environment, institutional setting and policy landscape by analysing the existing circumstances in Tigray Region. This research employed quantitative data sets collected from 300 randomely selected Productive Saftey Net Program (PSNP) beneficiarieries and Non-PSNP households using probability proportional to size. The Household Dietary Diversity Score (HDDS) used as a proxy measure to nutrition security as our data is 24 h recall and food gap months as proxy to food security. Besides, Principal Component Analysis (PCA) method is used to construct household asset index. The results of the study revealed that there are clear and significant differences of the PSNP and Non-PSNP households, and gender in land holding (p<0.01%), asset ownership(p<0.01%), food gap months(p<0.01%), dietary diversity(p<0.01%), exposure to hazards and risks, copping strategies, yield, access to agricultural extension services, access to improved varieties (varietal diversification). The male headed households, and Non-PSNP households are better off than the female headed and PSNP households' counterparts. Thus, provision of practical training, conducting farmer's participatory research, field days, promoting and creating access to farmers' preferred high yielding improved varieties and management practices available in the research and extension consortium, support in research and development that develops and disseminate appropriate technologies to help farmers to lower their food gap months is highly important. In addition, sustainable intensification, off-farm employment alternatives, and engaging in agribusiness activities that create resilient livelihood options to those resource poor farm households, strengthening the formal and informal seed system would help to reduce food gap months, improve HDDS, build resilience of the food and nutrition insecure households. Therefore, customized extension services and packages are important for addressing the food and nutrition security gaps by setting goal, outcome and output indicators for future interventions in the research and development arena in filling food gap months, dietary diversity and household asset building through collaboration among relevant stakeholders in the food system.

Food safety and dietary diversity in African urban cities: evidence from Ghana

BackgroundFood safety is integral to food security and is increasingly becoming a significant concern in the urban areas of Africa, which are rapidly growing in population. In the case of Ghana, many urban households depend on traditional open-air markets for most of their food needs. However, these urban food markets also depend on domestic food supply chains, which are prone to risks, including poor hygiene and sanitation and weather seasonality. Food safety compliance has associated costs which increase the unit cost of food products. Thus, higher food price is a risk factor to food availability and accessibility—fundamental pillars of food security.MethodWe use food microbial data and food retail data from food market surveys in major cities in Ghana to assess the safety of selected fresh food commodities and how retailers handle the food products they sell. Additionally, based on a two-wave balanced panel household data, we used fixed effects Poisson and Correlated Random Effects (CRE) Probit models to estimate the effect of weather seasonality on the incidence of diarrhoea and urban household dietary diversity score (HDDS). A final sample of 609 households and 565 market respondents participated in the study.ResultsOur findings show that selected food samples tested positive for Staphylococcus aureus and E.coli and had aflatoxin B1 levels above 5.0 ppb. Additionally, the household incidence of diarrhoea/vomiting, a proxy for food safety status, is higher in the dry season. In the dry season, the household incidence of diarrhoea/vomiting increases on average by a probability of 38% points compared to the rainy season. Regarding HDDS, the average HDDS is 7.3; however, we did not find the effect of seasonality on HDDS to be significant.ConclusionsAlthough urban food availability and household dietary diversity are not challenges for many urban households, food safety is a challenge in the major food markets in Ghanaian cities and is associated with weather seasonality. Foods available in traditional open-air markets are not always safe for consumption, undermining households’ food security. Weak enforcement of food safety regulations contributes to the food safety challenges in Ghanaian urban food markets.

The association between diet quality index-international and dietary diversity score with preeclampsia: a case–control study

BackgroundPreeclampsia is a significant complication that occurs during the second half of pregnancy. Recent studies have indicated that dietary factors play a crucial role in the development of preeclampsia. The Diet Quality Index-International (DQI-I) and Dietary Diversity Score (DDS) are appropriate indices for assessing the quality of foods, meals, and diets. This study aimed to investigate the relationship between DQI-I, DDS, and preeclampsia.MethodsThis study utilized a case-control design. A total of 90 newly diagnosed preeclampsia cases and 90 healthy controls were included from a referral hospital in Tabriz, Iran. DQI-I and DDS were calculated based on information obtained from a reliable Food Frequency Questionnaire consisting of 168 food items, which assessed participants’ usual diet. Logistic regression analysis adjusted for age, body mass index, education, family history of preeclampsia, and total energy intake was used to estimate odds ratios (ORs).ResultsThe mean age and pre-pregnancy body mass index of the participants were: 27.14 ± 4.40 years and 26.09 ± 3.33 kg/m2, respectively. After adjusting for various confounders, we found significant inverse association between the risk of developing preeclampsia and both DQI-I and DDS. The highest quartile of DQI-I had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.02, 95% CI [0.005, 0.08]) (P < 0.001). Similarly, the highest quartile of DDS had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.09, 95% CI [0.03, 0.31]) (P = 0.001).ConclusionsOur findings suggest that maintaining a high-quality and diverse diet is associated with a lower risk of preeclampsia. Further studies are needed to confirm these associations and explore potential causal relationships.

The Mediating Role of Psychological Balance on the Effects of Dietary Behavior on Cognitive Impairment in Chinese Elderly.

Cognitive impairment, a significant problem in older adults, may be associated with diet. This study aims to examine the association between the dietary diversity score (DDS), dietary pattern (DP), and cognitive impairment in elderly Chinese. This research further explored the role of psychological balance (PB) as a mediator in the relationship between diet and cognitive impairment. A total of 14,318 older adults from the Chinese Longitudinal Healthy Longevity Study (CLHLS) in 2018 were included. Latent class analysis (LCA) was used to identify patterns in seven food varieties. Binary logistic regression models were used to determine factors associated with the DDS, DP, and cognitive impairment. The multiple mediation effect model was evaluated using model 6 in the PROCESS version 3.5 program. Among the participants, 4294 (29.99%) developed cognitive impairment. Compared to people in food variety group two or lower, people with a high dietary diversity score (DDS) had lower odds of cognitive impairment. Compared to DP1, DP2 (OR = 1.24, 95%CI = 1.09 to 1.40) was associated with a higher risk of cognitive impairment, and DP4 (OR = 0.79, 95%CI = 0.69 to 0.89) was associated with a lower risk of cognitive impairment. PB mediated the relationship between DDS, DP, and cognitive impairment, with a mediating effect of 27.24% and 41.00%. A DP that is rich in fruits, vegetables, red meat, fish, eggs, beans, nuts, and milk was related to a lower risk of cognitive impairment. PB has an indirect impact on cognitive impairment. Our findings underscore the importance of promoting a diverse diet, which may contribute to a lower risk of cognitive impairment in older adults. The PB of the elderly should also be taken into consideration.

A systematic review of dietary data collection methodologies for diet diversity indicators.

The purpose of the current study was to critically assess the gaps in the existing methodologies of dietary data collection for diet diversity indicators. The study proposed the importance of smartphone application to overcome the drawbacks. The review paper identified and assessed the conventional methodologies used in diet diversity indicators including Minimum Dietary Diversity for Women (MDD-W), Minimum Dietary Diversity of Infant and Young Child Feeding Practices (IYCF-MDD), and Household Dietary Diversity Score (HDDS). The 80 research studies from 38 countries were critically assessed on the basis of their research aim, study design, target audience, dietary data collection methodology, sample size, dietary data type, dietary data collection frequency, and location point of dietary data collection. Results indicated that most studies employed interviewer-administered 24-h recall assessing the dietary diversity. The review paper concluded that smartphone application had potential to overcome the identified limitations of conventional methodologies including recall bias, social-desirability bias, interviewer training, and cost-time constraints.

Dietary diversity linked to anthropometric measurements of women of reproductive age in Ekiti State, Nigeria

PurposeThis purpose of this study was to assess dietary diversity among women of reproductive age (WRA) and the associations between consumption of a diversified diet and overweight/obesity statuses in Ekiti State, Nigeria.Design/methodology/approachCross-sectional study of 207 WRA from six local government areas in Ekiti State, Nigeria, was done. A validated interviewer-administered questionnaire was used to collect data on sociodemographic characteristics, dietary intake and anthropometry. Dietary intake was assessed with 24-h dietary recall to calculate the Minimum Dietary Diversity Score for Women (MDD-W). Data were analyzed using descriptive statistics, Spearman rank correlation and Chi square test at α0.05.FindingsMajority of the participants (65.2%) were aged between 19 and 34 years, 58.5% were married and 49.8% had high school as their highest level of education. Mean MDD-W and body mass index (BMI) were 3.8 ± 0.9 and 25.46 ± 6.4 kg/m2, respectively. All participants (100%) consumed foods from the “grains, white roots and tubers” group and majority also from the “meat and poultry” group (79.7%) but ranked low in the consumption of foods from other food groups. Many were overweight (34.8%), obese (14.0%) and a few (1.9%) had morbid obesity. MDD-W was significantly associated with marital status (X2 = 7.7, P = 0.022) and BMI (X2 = 11.4, P = 0.023) and had a weak positive correlation with BMI (r = 0.189, P = 0.007).Research limitations/implicationsStudy shows that both undernutrition and overweight/obesity coexist in the population, indicating a case of double burden of malnutrition (DBM) at a population level. However, further studies may be needed to investigate the extent of DBM at individual levels. Although there was a positive correlation between MDD-W and BMI, it cannot be used to predict causality. Study further reveals that the micronutrient intake of the WRA population in Ekiti is inadequate. Considering the importance of the 10 food groups highlighted in MDD_W to nutrition and health, the promotion of the consumption of foods from these food groups with more attention to the micronutrient-rich ones needs to be heightened.Originality/valueDiet of participants was not diverse enough, indicating micronutrient inadequacy. Promotion of the consumption of a diverse diet, particularly from the food groups rich in micronutrient, needs to be heightened, while food groups high in calorie should be minimally consumed to forestall DBM.

The impact of large-scale land acquisitions on child food insecurity in Africa

Food insecurity is a major concern in most African countries. Large-scale land acquisitions (LSLAs) frequently have a negative impact on local communities. In this paper, I examine the impact of LSLAs on the nutritional status of neighboring children. To this end, I use a difference-in-differences methodology applied to LSLAs in a large number of African countries at different times since the early 2000s. I analyze data from Demographic and Health Surveys combined with data from the Land Matrix Initiative, supplemented by my own research, ultimately covering 18,276 children living in the vicinity of 45 LSLAs. I show that LSLAs have had a significant negative impact on child nutrition in Africa over the past two decades. Specifically, the dietary diversity scores of children living close to LSLAs were reduced by 20 per cent after acquisition. The results are robust to various statistical tests. I find no changes in work status or household assets. While the impact of LSLAs may be positive for agricultural practices, it is negative for child food security. The analysis highlights the importance of supporting local communities following foreign agricultural investment.

Association of food consumption patterns and nutritional status of children under 5 years from rural households in Northern regions, Namibia

BackgroundMany developing countries, Namibia included, have a high prevalence of malnutrition among children, especially in rural subsistence farming areas where inadequate food supply is common. Poor diets in children under 5 years may result in negative health impacts. This study determined the association of food consumption patterns and nutritional status of children under 5 years from rural households in Oshana and Oshikoto regions in Namibia.MethodEmploying a cross-sectional descriptive design, 377 children under 5 years participated in this study using purposive sampling. Validated dietary diversity and food frequency questionnaires were used to obtain information on demographic characteristics, commonly consumed food per week, and meal frequencies for the recruited children. Anthropometric measurements were obtained to assess nutritional status of children using Emergency Nutrition Assessment (ENA) software. Descriptive and inferential statistics were computed using the IBM® SPSS® Statistics (Statistical Package for Social Sciences) version 27.ResultsStaple foods, mostly grains, roots and tubers, along with flesh foods, legumes and nuts were commonly consumed. Vitamin A-rich fruits and vegetables were solely consumed in Oshana region (10.7%) and not in Oshikoto. Oshana exhibited a lower dietary diversity score (4±1 SD) compared to Oshikoto (5±1 SD). The prevalence of adequate feeding practices varied, with Oshana having 38.8% meeting minimum milk feeding frequency (MMFF), 55.6% minimum dietary diversity (MDD), 69.8% minimum meal frequency (MMF), and 27% minimum acceptable diet (MAD). In Oshikoto, these figures were lower at 2%, 7%, 32%, and 0.5%, respectively. Stunting, underweight, wasting, and overweight were also documented, with slight differences between the two regions. The study did not find association between nutritional status and MMFF, MDD and MAD. However, significant associations were found between specific food types, amount of food, breastfeeding length, MMF and malnutrition indicators in both regions (p<0.05).ConclusionMost study participants consumed locally available staple foods. Stunting, underweight, and wasting were prevalent among children in the two regions which were significantly associated to the amount of food consumed, MMF and/ some food types. Improving food environments and eliminating access barriers to diversified diets can mitigate high prevalence of malnutrition among rural children.

Nutrition-Related Knowledge, Attitudes, Practices, and Anemia Status of Lactating Mothers in Bukavu, Democratic Republic of the Congo-A Cross-Sectional Analysis.

Maternal nutrition is impacted by personal and environmental factors including dietary intake, knowledge, food availability, and affordability. This cross-sectional analysis aimed to evaluate nutrition-related knowledge, attitudes, practices, and associations with hemoglobin concentration among lactating mothers in the Bukavu region, Democratic Republic of the Congo. In 444 lactating mothers, nutrition-related knowledge and practice were assessed by questionnaires and translated into knowledge and practice scores ranging from 0 to 1, attitudes and drivers of food choice were assessed, the Dietary Diversity Score (DDS) was assessed with 24 h dietary recalls in a potential range from 0 to 10, and hemoglobin (Hb) was measured in mothers and their infants. Anemia prevalence was 28.2% among mothers and 74.3% among infants aged 3-8 months. Nutritional knowledge and practice were limited (the median total knowledge score was 0.39, median DDS was 3.0). While there were slight positive correlations between knowledge and maternal Hb, DDS did not significantly correlate with either knowledge or Hb. Although half of the mothers stated a perception about their own susceptibility to anemia or vitamin A deficiency (56.4%, 47.4%), less than half of those could justify their estimation (40.9%, 44.2%). Taste (68.1%), appearance (42.5%), availability (29.0%), and health effects (25.6%) were important drivers of food choice. In conclusion, interventions on the different influencing factors including nutrition education strategies are needed.

Evaluation of hybrid closed-loop insulin delivery system in type 1 diabetes in real-world clinical practice: One-year observational study.

In 2016, the Food and Drug Administration approved the first hybrid closed-loop (HCL) insulin delivery system for adults with type 1 diabetes (T1D). There is limited information on the impact of using HCL systems on patient-reported outcomes (PROs) in patients with T1D in real-world clinical practice. In this independent study, we evaluated glycemic parameters and PROs over one year of continuous use of Medtronic's 670G HCL in real-world clinical practice. To assess the effects of hybrid closed loop system on glycemic control and quality of life in adults with T1D. We evaluated 71 patients with T1D (mean age: 45.5 ± 12.1 years; 59% females; body weight: 83.8 ± 18.7 kg, body mass index: 28.7 ± 5.6 kg/m2, A1C: 7.6% ± 0.8%) who were treated with HCL at Joslin Clinic from 2017 to 2019. We measured A1C and percent of glucose time-in-range (%TIR) at baseline and 12 months. We measured percent time in auto mode (%TiAM) for the last two weeks preceding the final visit and assessed PROs through several validated quality-of-life surveys related to general health and diabetes management. At 12 mo, A1C decreased by 0.3% ± 0.1% (P = 0.001) and %TIR increased by 8.1% ± 2.5% (P = 0.002). The average %TiAM was only 64.3% ± 32.8% and was not associated with A1C, %TIR or PROs. PROs, provided at baseline and at the end of the study, showed that the physical functioning submodule of 36Item Short-Form Health Survey increased significantly by 22.9% (P < 0.001). Hypoglycemia fear survey/worry scale decreased significantly by 24.9% (P < 0.000); Problem Areas In Diabetes reduced significantly by -17.2% (P = 0.002). The emotional burden submodules of dietary diversity score reduced significantly by -44.7% (P = 0.001). Furthermore, analysis of Clarke questionnaire showed no increase in awareness of hypoglycemic episodes. WHO-5 showed no improvements in subject's wellbeing among participants after starting the 670G HCL system. Finally, analysis of Pittsburgh Sleep Quality Index showed no difference in sleep quality, sleep latency, or duration of sleep from baseline to 12 mo. The use of HCL in real-world clinical practice for one year was associated with significant improvements in A1C, %TIR, physical functioning, hypoglycemia fear, emotional distress, and emotional burden related to diabetes management. However, these changes were not associated with time in auto mode.

Enhancing dietary diversity and food security through the adoption of climate-smart agricultural practices in Nigeria: a micro level evidence

AbstractThe paranoid belief that climate change will gradually reduce the ability of the world to meet the demand for food serves as the rationale for Nigerian smallholder farmers’ advocacy of climate-smart agriculture (CSA) techniques. The study investigates the effects of CSA practice on the food security status of rural farming households in Nigeria. A multi-stage sampling technique was employed in selecting 480 rural farming households across three selected states from Southwest, Nigeria. Data were analyzed using descriptive and inferential statistics. Obtained results showed that 59.79% of the respondents were food insecure while severe and depth of food insecure among the farming households were 0.0711 and 0.1913 respectively. The result of the household dietary diversity score revealed the diverse consumption-ability of the respondents and the contributions of CSA practice in their farming system. This implies that households engaged in climate-smart farming are more likely to achieve higher levels of food consumption score, dietary diversity, and food security. The probit regression revealed that the food security status among rural farming households was significantly influenced by household heads’ gender, farm size, and contact with extension agents as well as adopted CSA practices such as crop diversification, agroforestry, and use of Fadama land for agricultural activities. This research concludes that CSA lowered the probability of food insecurity among rural farming households in Nigeria. Accordingly, the study suggests that the government and the key players should encourage the use of CSA practices in order to ensure agricultural sustainability and food security in agrarian communities by reducing the impact of climate change.