Good Dietary Diversity Research Articles

State of Food and Nutritional Security of Urban Households in Grand Lome: Approach by Measuring Household Indicators

In West Africa, the number of people facing food crises increases each year in both rural and urban areas, due to interdependent factors. The city of Grand Lome in Togo faces an increasingly large population that must ensure access to food, which it hardly produces anymore, because of the establishment of housing and infrastructure. In addition, the increase in the price of food products in this city further weakens the purchasing power of city dwellers in the context of poverty. The objective of this article is to determine the state of food and nutritional security of households in Grand Lome. The methodology adopted is based on documentary research and field surveys. A total of 310 households were interviewed on questions allowing the construction of indicators of food and nutritional security. The results show that despite the availability of food in urban markets, the food situation of households in Grand Lome is not very good. Nearly 49% of households do not have good dietary diversity, and 48% have adopted stress and crisis strategies to access food. Similarly, in Grand Lome, the prevalence of global acute malnutrition is 2.6% of children under 59 months.

Association of dietary diversity and weight change with cognitive impairment among Chinese elderly: A prospective national cohort study

BackgroundDietary diversity is reported to be beneficial for cognitive function, while the effect may be offset by weight change status. We aimed to examine the association of dietary diversity and weight change with cognitive impairment among older adults. MethodsWe used three waves from 2008 to 2014 of the Chinese Longitudinal Survey of Health and Longevity, which included 16,954 participants for the subsequent screening and analysis. Dietary diversity information was collected from the food frequency questionnaire. Cognitive function was assessed using the Mini Mental State Examination. The relation of dietary diversity and weight change with cognitive impairment was investigated using Cox proportional hazards models and cubic spline regression. ResultsCompared with those reported poor dietary diversity at baseline, participants with good dietary diversity had a 16 % (hazard ratio [HR] = 0.84, 95 % confidence interval [CI]: 0.71–0.99) lower risk of cognitive impairment. The HR and 95 % CI of participants with consistently good dietary diversity from 2008 to 2011 was 0.71 (0.57–0.89) for cognitive impairment compared to those with consistently poor dietary diversity. Compared with the weight stable group, the HRs and 95 % CI for cognitive impairment were 1.34 (1.10–1.64) in weight loss group, and 1.08 (0.88–1.33) in weight gain group. Restricted cubic splines showed the risk of cognitive impairment decreased with higher dietary diversity score or less weight change, though no significant interaction between dietary diversity and weight change was found. LimitationGiven the observational nature of this study, there might be a reverse causation for the observed association. ConclusionEstablishing and maintaining good dietary diversity were associated with a lower risk of cognitive impairment regardless of weight change status, whereas weight loss was associated with increased cognitive impairment risk independently among older Chinese adults.

Association of dietary quality during pregnancy with fetal immune function in Guangzhou

To investigate the situation of women's dietary quality during pregnancy and explore the correlations between maternal dietary index and fetal immune function. From September 2010 to February 2011, pregnant women who had routine physical examination in Yuexiu District and Baiyun District Maternal and Child Health Hospital of Guangzhou were recruited as study objects to use 3-day 24-hour dietary review to investigate diet during pregnancy, and general demographic information of pregnant women was collected through questionnaire, and the neonatal umbilical cord blood was collected during delivery. Laboratory detection of immunological indicators included IgG, IgA, IgM, IFN-γ and IL-6. The quality of diet during pregnancy was evaluated by diet quality index for pregnancy(DQI-P), dietary balance index for pregnancy(DBI-P) and alternate Medierranean diet score(aMED). Spearman correlation analysis and multiple linear regression analysis were used to explore the correlations between dietary quality during pregnancy and fetal immune function. The mean score of total DQI-P score of the study subjects was 55.8±10.0, and the mean score of overall food diversity and protein food source diversity was as high as 12.0±2.4 and 4.8±0.7. The mean score of nutrient energy ratio and fatty acid energy ratio was only 0.3±1.0 and 0.4±1.0, indicating that the population had good dietary diversity during pregnancy, but the dietary adequacy, suitability and balance were poor. The total score of DBI-P score was-19.2±9.4. The positive end score was 4.6±2.9, only 7.2% of the subjects had a high degree of dietary intake during pregnancy. The negative end score was 23.9±7.9, indicating the status of moderate dietary intake. Dietary quality was 28.5±7.1. Only 0.6% of the study population had a balanced dietary situation, and more than 67.9% of pregnant women had high intake imbalance. The mean total score of aMED score was 4.9±1.3, and the proportion of the food intake of beans and nuts was less than the median population was 62.5% and 79.1%, respectively, indicating that the food intake of beans and nuts was insufficient in this population. After adjusting for confounding factors such as maternal age, parity, parity, prepregnancy BMI, weight gain during pregnancy, and mode of delivery, multiple linear regression analysis showed DQI-P during pregnancy and negatively with IL-6(β=0.143, β=-0.155, P<0.05). DBI-P was negatively associated with IL-6(β=-0.177, P<0.01) and aMED and IFN-γ(β=-0.161, P<0.01). The dietary quality of women in late pregnancy in Guangzhou is low, the dietary structure is unbalanced. Higher dietary quality during pregnancy can promote the development of fetal immune system and improve fetal immune function.

Effect of nutrition education on dietary diversity and academic achievement among adolescent school girls in North Shoa Zone, Oromia, Ethiopia

ObjectivesGlobally, adolescent students, particularly girls, are severely affected by malnutrition, in part because of their specific biological needs, and that they have not been considered a health and nutrition priority. Hence, this study was designed to evaluate the effect of a health belief model–based nutrition education on the dietary diversity and grades of adolescent school girls in the north Shewa zone, Oromia, Ethiopia. MethodsA quasi-experimental study was done in the north Shewa zone, Oromia, Ethiopia. Adolescent school girls ages 10 to 19 y old were selected from the zone districts from February 1 to May 30, 2023. The main outcome variables included grades and dietary diversity, which were collected on the baseline and end line from the intervention and control groups. ResultsThis study revealed that there were statistically significant differences in good nutritional knowledge, 88.1% versus 69.2% (χ2 = 16.835, P < 0.001), good dietary diversity; 77.4% versus 45.9% (χ2 = 33.247, P < 0.001) and grades above average, 90.6% versus 65.4% (χ2 = 29, P < 0.001) among school adolescent girls between the intervention and control groups, respectively. Regarding positive attitude, 84.3% versus 85.5% (χ2 = 0.098, P = 0.876), there was no statistically significant difference between the intervention and control groups. ConclusionsIn this study, the dietary diversity scores and grades of adolescent school girls in the intervention group were higher than those in the control group. Therefore, health belief model-based strategies should be recommended as effective communication channels to improve adolescent school girls' dietary diversity and academic performance.

Examining Patterns and Trends of Household Food Consumption of in the City of Ati (Chad)

Households in Ati face high food consumption costs which determine different states of food and nutritional security. This study was carried out with the aim of analyzing household food consumption in order to contribute to better knowledge of the food and nutritional situation and to inform stakeholders working in the field of food security so that they can better guide their intervention strategies. A prospective, cross-sectional descriptive research survey was adopted for the study and was conducted from 15 April to 14 June 2022 in the city of Ati. The study involved 135 households selected in the neighborhoods of the city of Ati. Data were collected using a questionnaire survey form and then processed using Excel 2016. The food consumption score was used to reflect dietary diversity, frequency of consumption as well as household nutritional intake relative to products and food groups consumed individually. Results showed that more than a third of households (38.52%) consumed at least 3 meals per day and more than half of the households surveyed (54.07%) had 2 meals per day. The group of cereals and tubers is the most consumed by the majority of households. The results show that 30.60% of households surveyed had a poor ACS, 63.60% had a borderline ACS and 5.80% had an acceptable ACS. It emerges that 76.6% of households have low AMDS, 17.9% have average diversity and only 5.50% have good dietary diversity.

Effect of nutrition education on improving dietary diversity of children aged 6–23 months in Horo district, Oromia region, Ethiopia

BackgroundUnmet minimum dietary diversity (MDD) feeding practices in poor nations place children at high risk of undernutrition and its related effects, which are far-reaching and difficult to correct later in life. ObjectiveThis study aimed to assess the effect of maternal nutrition education and another determinant on the dietary diversity of children aged 6–23 months. MethodsA community-based cluster randomized trial study design was conducted from July 2019 to January 2020 in the Horo district. Twenty-three kebeles were assigned to two clusters. From two clusters, two kebeles were selected by simple random sampling. Two kebeles were assigned as intervention (150) and control (150) groups by the lottery method, at the end of the line as intervention (139) and control (137) groups. Simple random sampling techniques were used to select the study subjects. The nutrition education intervention, which lasted three months and consisted of eight sessions, was given to the intervention group, which was made up of mothers and other caregivers of children aged 6–23 months.Data entry into Epi-data and analysis were done using IBM SPSS version 26 computer software. At a 95% confidence level, values with P ≤ 0.05 were considered statistically significant. B-ivariable and multivariable conditional fixed-effect logistic regression analyses were done to identify the determinants of the dietary diversity score. Variables with a p-value of less than 0.05 were considered statistically significant. The crude odds ratio (COR) and adjusted odds ratio (AOR) were used to describe the strength and direction of the association. ResultThe result was that the proportion of children with a good dietary diversity score was 52 (34.7%) and 40 (26.7%) in the control group and intervention groups at baseline, respectively. Household food security [AOR = 4.06, 95% CI: (2.45, 6.73] and being in the intervention group [AOR = 1.90, 95% CI: (1.10, 3.29] were both positive predictors of the dietary diversity score, while maternal age (35–45 years) was a negative predictor. ConclusionAt baseline, a high proportion of children aged 6–23 months did not receive the World Health Organization's minimum dietary diversity recommendation for both groups. The consumption of animal sources and vitamin-A-rich fruits and vegetables was poor among both groups. At the end of the day, after nutrition education, the dietary diversity score improved in the intervention groups but not in the control groups. New strategies and programs should be made at all levels to improve childhood nutritional status. This includes providing nutrition education for mothers aged between 35 and 45 years old.

Dietary diversity practice and associated factors among adolescents in Ethiopia, systematic review and meta-analysis.

Adolescence (10-19 years) is a critical life period for growth and health. An increase in dietary diversity in the food is related to improved nutrient adequacy of the diet. However, studies conducted on dietary diversity practice among adolescents showed non-conclusive and inconsistent findings on the magnitude of the problem. Likewise, there was no meta-analysis conducted in the study area. Hence, this systematic review and meta-analysis were conducted to estimate the pooled prevalence of good dietary diversity practice and its associated factors among adolescents in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. All articles were systematically searched by Google Scholar, PubMed, Hinari, Cochrane Library, Global Health and CINAHL. Meta-analysis was conducted by using STATA 14 software. Forest plots were used to present the pooled prevalence of good dietary diversity practices. A random effect model was used to compute the pooled prevalence; while subgroup analysis was performed to identify the possible source of heterogeneity. Publication bias was assessed by the begg's and egger's test. Moreover, the associated factor of dietary diversity practices was observed. This review involved 7 studies, and 3,950 participants. The pooled prevalence of good dietary diversity practice among adolescents in Ethiopia was 39.24% (95% CI: 30.82, 47.66). Mothers with formal education [AOR = 1.98, (95% CI: 1.65, 2.36)], fathers with formal education [AOR = 2.30, (95% CI: 1.81, 2.93)], Medium wealth index [AOR = 2.75, (95% CI: 1.96, 3.86)] and urban residence [AOR = 2.88, (95% CI: 1.59, 5.22)] were positively associated with good dietary diversity practice. The pooled prevalence of good dietary diversity practices among adolescents is low. Being urban residents, the medium wealth quintile, mothers' educational status and fathers' educational status were independent factors of good dietary diversity practice among adolescents. Therefore, focused nutritional interventions should be given to rural residents and adolescents from low economic status.

Undernutrition and associated factors among adult prisoners in Fiche town, central Ethiopia: a facility-based cross-sectional study.

Undernutrition is a major public health problem worldwide, particularly in developing countries like Ethiopia. However, nutritional problems are frequently overlooked in low-income countries, especially among vulnerable populations such as imprisoned people. The scientific data on the rate of undernutrition among imprisoned people in Ethiopia is limited. Hence, this study aimed to assess the magnitude and associated factors of undernutrition among adult prisoners in Fiche town, central Ethiopia. A facility-based cross-sectional study was conducted from August 15 to September 15, 2020. A systematic random sampling technique was used to select participants. All prisoners whose age was 18 years and above who have been in prison for at least 6 months were included. Data were collected using interviewer-administered pretested semi-structured questionnaires and standard anthropometric measurements. A cut-off point of body mass index <18.5 kg/m2 was used to measure undernutrition. Data were coded, entered into Epi-data version 3.1, and analyzed using Statistical Package for Social Sciences version 20.0. A binary logistic regression analysis was conducted to identify factors associated with undernutrition. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was calculated to measure the strength of the association and a p-value of less than 0.05 was considered statistically significant. The overall magnitude of undernutrition among adult prisoners was 20% (95% CI: 16.5-23.6). Duration of imprisonment, incarcerated for 25 to 59 months (AOR = 3.07; 95% CI: 1.33, 7.04) and for greater than 59 months (AOR = 4.56; 95% CI: 2.0, 10.45), mild and moderate depression (AOR = 1.9; 95% CI: 1.05, 3.45), and moderately severe and severe depression (AOR = 2.78; 95% CI: 1.17, 6.60) were significantly associated with increased odds of undernutrition. However, being female (AOR = 0.51; 95% CI: 0.26, 0.98), having financial support (AOR = 0.36; 95% CI: 0.15, 0.87), engaging in income-generating work within the prison (AOR = 0.27; 95% CI: 0.15, 0.47), having medium dietary diversity (AOR = 0.35; 95% CI: 0.15, 0.80), and having good dietary diversity (AOR = 0.23; 95% CI: 0.08, 0.61) significantly decreased the odds of undernutrition. The magnitude of undernutrition among adult prisoners was high, with one in five prisoners in Fiche town prison having undernutrition. Sex, financial support, duration of imprisonment, income-generating work in the prison, dietary diversity, and depression were predictors of undernutrition. Hence, access to healthy food and diversified diets should be ensured for prisoners, and implementing early screening and treatment of depression, as well as encouraging prisoners to engage in income-generating work within the prison is recommended to reduce the burden of undernutrition.

Is good dietary diversity a predictor of academic success?

Interest in identifying factors influencing educational success is growing. Many studies have examined factors that may affect academic performance. It is often observed that a group of students sharing the same external variables (school environment) yet have different results, which states that individual variables have more impact on the determination of academic performance. Therefore, the present study aims to substantiate this controversy by investigating the association between dietary habits and academic performance in a population of adolescents attending school in Eastern Morocco Methods: Cross-sectional study based on a self-administered questionnaire. Items included sociodemographic variables, eating and sleeping habits, physical activity practice and the last semester grade point average of mathematics (GPAm) and first foreign language (GPAf) subjects Results: Dietary diversity score (DDS) is a significant predictor of academic performance. Weight status and sleep duration was found to be strongly associated with academic achievement. Absenteeism and smoking are negatively associated with school achievement Conclusions: Findings indicate associations between dietary diversity and academic performance of students in eastern Morocco which support creation of effective nutrition education policies to eradicate the double burden of malnutrition on the one side leanness and on the other side fighting against obesity by promoting good diet in terms of quality and quantity and encouraging physical exercise. It is also essential to review the lifestyle of adolescents by raising awareness against the scourge of smoking near schools. The results of these actions are likely to be healthier schools and improved behavioral development and academic performance of children. (www.actabiomedica.it).

Assessment of the diets and food security of households hosting and not hosting internally displaced persons in the Kora, Burkina Faso

Introduction. Terrorism is escalating in the Sahel region of Africa, forcing massive population displacement and worsening food insecurity. Aim. The objective of the present study was to assess the level of food insecurity within households hosting internally displaced persons (IDP), known as host households, compared to households not hosting internally displaced persons, known as non-host households in the Kora area in Burkina Faso. Methods. A cross-sectional study was conducted in June 2020 at the Kora area and included 70 host households and 73 non-host households. Results. Most of the households had smallholding and were living from subsistence farming. Host households had better quality diets in terms of diet diversification compared to non-host households. In addition, the non-host household were the most vulnerable in terms of food insecurity. Factors associated with household food insecurity were household status (i.e. host or non-host household) and the occupation (i.e. function) of the head of the households. Conclusion. Food assistance received by IDPs improved the quality of food for their host families but did not protect them from food insecurity with all its consequences. Recommendation. The Burkinabe state, in collaboration with the concerned stakeholders should promote good dietary diversity practices, improve food availability and access and monitor host households and provide them with substantial food aid without forget the non-host households which are also exposed.

Dietary Diversity, Micronutrient Adequacy and Bone Status during Pregnancy: A Study in Urban China from 2019 to 2020.

Diet quality during reproduction is crucial to maternal and infant health. However, the association between dietary diversity and bone health of pregnant women remains unclear. We aimed to evaluate the dietary quality of Chinese urban gravidas using the dietary diversity score (DDS), and to explore the relationship of the DDS with micronutrient adequacy and bone health. In this cross-sectional study, we analyzed data from 775 pregnant women aged 18 years or older in urban China. Dietary diversity was assessed using the Minimum Dietary Diversity for Women (MDD-W) indicator. A 24-h dietary recall was used to collect diet data and to calculate the MDD-W and the nutrient intake. Bone health was measured using quantitative ultrasound and assessed by the speed of sound (SOS). Pearson's correlation coefficients between the DDS and the nutrient adequacy ratio (NAR) were calculated. A multivariable linear regression model was used to estimate the effect size of the DDS on the SOS. The mean DDS was 6.61 ± 1.53 points and 91.0% of participants reported the consumption of five or more food groups. Women in the diverse diet subgroup (DDS ≥ 7 points) were more likely to consume all kinds of food except starchy staples and had higher NARs. Pearson's correlation coefficients between the DDS and the NAR ranged from 0.161 to 0.484. For participants in the second trimester, those with a diverse diet had a higher SOS. A multivariable linear regression analysis showed that the DDS was positively and significantly associated with the SOS (β = 17.18, 95% CI = 5.97-28.39, p = 0.003), but this was not the case for women in the first and third trimesters. Urban Chinese women had good dietary diversity during pregnancy. A higher dietary diversity was associated with a higher NAR. From the point of view of bone, a diverse diet was positively correlated with better bone status, suggesting the importance of improving diet diversity for pregnant women, especially from mid-pregnancy.

The Effect of Gestational Weight Gain on Low Birth Weight, Case-Control Study in Northeast Amhara Regional State, Ethiopia, 2019

Background: Intrauterine growth and development are one of the most vulnerable periods in the human life cycle that contribute to appropriate fetal development. Therefore, this study aimed to assess the effect of gestational weight on low birth weight (LBW).&#x0D; Methods: A case-control study was conducted from June 30, 2018, to January 1, 2019, in seven governmental hospitals in the northeast Amhara region on 451 participants(150 cases and 301 controls).&#x0D; Results: Inadequate gestational weight gain increases the risk of LBW by four times (AOR: 4.2, 95% CI: 2.4, 6.4). Anemic mothers were 3 times (AOR: 3.2, 95%CI: 2.5, 5.1) more likely to give birth to LBW newborns than non-anemic women. Mothers with a height of less than 150 cm were 2 times more likely to deliver low birth weight babies than their counterparts (AOR:2.1, 95% CI: 1.5,4.4). The odds of LBW delivery were 3.5 times (AOR: 3.5, 95% CI: 2.3, 5.3) higher for mothers with poor dietary diversity than for mothers with good dietary diversity.&#x0D; Conclusion: Inadequate gestational weight gain during pregnancy was found to be a risk factor for LBW. Additionally, anemia, short stature, and poor dietary diversity were also risk factors for LBW. Therefore, selectively targeted interventions such as improving maternal nutrition, anemia prevention, and proper maternal weight monitoring during pregnancy are needed.

Prevalence and predictors of anemia among pregnant women in Ethiopia: Systematic review and meta-analysis.

BackgroundIn Ethiopia limited information is available regarding the prevalence and predictors of anemia in pregnancy. This systematic review and meta-analysis estimated the pooled prevalence of anemia among pregnant women in Ethiopia and also identified its predictors.Materials and methodsThe published primary studies were searched in the following electronic databases; PubMed/Medline, Google scholars, AJOL, and EMBASE. All primary studies published from 01/01/2010 to 30/05/2020 and written in English language were included without restriction on study setting and design. Critical appraisal of all available articles was done and extracted data was analyzed using STATA software version 14. The pooled prevalence of anemia was presented using a forest plot. The I2 statistical test for heterogeneity, and the Egger’s and Begg’s tests for publication bias were used. The relative risk was used to assess the association of predictor variables with anemia.ResultAfter screening 274 articles, sixty studies were included in the analysis. The pooled prevalence of anemia among pregnant women was 26.4(95% CI: 23.1, 29.6). Sub-group analysis showed higher pooled prevalence from community-based studies than institutional-based studies. Factors that were protective against maternal anemia included urban residence, formal education and smaller family size. Short birth interval and not having antenatal care (ANC) are associated with a higher risk of maternal anemia. Women with low dietary diversity [RR: 2.61(95% CI, 1.85, 3.68)], mid-upper arm circumference (MUAC) less than 23 cm [RR: 2.35(95% CI, 1.53, 3.68)] and those not taking iron-folic acid [RR: 1.53(95% CI: 1.30, 1.81)] also had a higher risk of anemia.ConclusionAlmost one in four pregnant women in Ethiopia had anemia. Being literate, living in urban areas with small family size and adequate birth spacing, as well as good dietary diversity are associated with a lower risk of anemia in pregnancy.Registration number(ID: CRD42020211054).

Socio-anthropometric features and lifestyle in ketosis-prone diabetes vs controls

: In West Africa, the various types of diabetes according to WHO or the American Diabetes Association (ADA) are endemic; however, a particular type referred to as atypical ketosis-prone diabetes mellitus requires specific attention. We implemented a case-control study including 101 cases versus 89 controls. Controls are people living in apparent good health and patients are diabetics newly diagnosed and attended hospitals for the first time. We included socio-demographic and anthropometric informations, some questions about dietary habits of participants. We tested fasting plasma glucose and HbAC according to manufacturer’s instructions. : Dietary diversification was lower in patients with less of 10% having a good dietary diversity. Correlation tests showed a significant statistical link in relation with waist circumference and body mass index in accordance with glycaemia in patients newly diagnosed diabetics. Wenoted adecreasing of mean value of glycaemia in overweight or obese patients, otherwise, the fat gaining was marked as glycaemia lowering. This trend has been related in correlation with HbA1C in patients without significant statistical correlation. We also notified a significant link between amount of diet usually ingested by controls and the variation of HbA1C. : It clearly appears that lifestyle has certainly an impact in the occurrence of metabolic diseases in overall and on diabetes in particular. There is a close link between these diseases with genetic or family predisposition. It seems urgent to act upstream to prevent such diseases living as a burden for our deprived population.

Food consumption patterns, socio-demographic status and nutritional risks of women in low and middle income communities in Kwandengezi, Kwazulu-Natal, South Africa

Food consumption patterns have changed dramatically in recent times. Traditional diets are replaced by “westernised diets” causing nutritional risks like malnutrition. Unemployment and lack of nutrition education have an impact on communities, in terms of the foods being purchased and consumed. This research seeks to establish a true reflection of the nutritional status, food intake patterns of the communities participating in the study and influencing factors. This is to estimate if the low income community, the north section is in a more disadvantaged situation when compared to the middle income community, the south section. The objective was to determine the socio-demographic status, food consumption patterns and nutritional risk of a low-income and middle-income community that reside in KwaNdengezi Township in KwaZulu-Natal, South Africa.The research being undertaken consists of descriptive and theoretical studies. Upon consention, participants data were collected by means of an interview setting. A set of questionnaires included, Socio-demographic, Food Frequency and 24-Hour Recall questions. The anthropometric measurements were taken in order to determine the body mass index status. Both sections of the township were affected by unemployment. The education status of the participants showed concern as both sections had fewer graduates. The mean Food Variety Scores (FVS) (±SD) for all items consumed from various food groups during seven days, indicated a medium where both sections had a good dietary diversity score ranging from 7-9 food groups, which summarize the food group diversity as being in the majority in the north section. The results of energy distribution of macronutrients from the average of the 24-hr recall when compared to the WHO dietary factor goals showed that the participants’ diet was well balanced, in relation to macronutrient intake for both sections but was lacking in micronutrient intake. Overweight and obesity tests showed disturbing results with majority of women caregivers in both sections found to be obese, showing risks of obesity related illnesses (NCDs). More nutrition knowledge should be geared towards educating the most vulnerable and poverty stricken communities. The micronutrient intake must be promoted at lower and middle income communities.. The government should devise and implement projects that empower women so that they are not co- dependent. Key words: Food, Consumption, Low and Middle- income, Education, Nutritional risks, KwaNdengezi, South Africa

Dietary diversity concordance among mother-to-child pairs and its associated factors in Gedeo zone, Southern Ethiopia

PurposeAchieving optimal nutrition among mothers and children is still a challenge in many developing country settings, including Ethiopia. Study on dietary diversity concordance of mother-to-child dyads is limited. Hence, this study aims to assess dietary diversity concordance among mother-to-child pairs and its associated factors in Gedeo zone, Southern Ethiopia.Design/methodology/approachA community-based cross-sectional study was carried out in Gedeo zone, South Ethiopia, from January 1 to February 15, 2019. A multistage sampling technique was used to select study participants. Data was collected by using a pretested and structured questionnaire. Data entry and analysis were done by Epi data version 3.1 and SPSS version 23.0 software, respectively. Bivariate and multivariate logistic regression models were used. Variables with p < 0.25 at bivariate analysis were chosen for multivariate analysis. Variables with a p-value of <0.05 were considered statistically significant.FindingsA total of 665 mother and child dyads participated, with a response rate of 98.6%. High concordance of dietary diversity among mother-to-child pairs was 9%. Age of the mother (adjusted odds ratio [AOR] = 0.21; 95% confidence interval [95% CI]: 0.05–0.84), age of the child between 6 and 11 months (AOR = 5.2; 95% CI: 2.3–11.6), being female (AOR = 1.8; 95% CI: 1.0–3.4), previous history of infection (AOR = 4.4; 95% CI: 1.8–11.5), source of food from the market (AOR = 0.34; 95% CI: 0.12–0.81) and rich wealth index (AOR = 5.7; 95% CI: 2.5–12.9) were the significant factors of high concordance of dietary diversity.Originality/valueThe prevalence of high-concordant dietary diversity among mother and children dyads was very low. Therefore, ensuring multisectoral nutrition interventions that focus on both mothers and children should be considered to improve the good dietary diversity practice.

Combined impact of lifestyle-related factors on total mortality among the elder Chinese: a prospective cohort study

BackgroundThe combined impact of healthy lifestyle factors on total mortality among elder Chinese is unclear. This study aimed to investigate the overall impact of lifestyle factors on total mortality in a senior Chinese population, and determine whether these associations were consistent in the presence of different characteristics, including physical comorbidities.MethodsThe Chinese Longitudinal Healthy Longevity Survey (CLHLS) is a large population-based prospective cohort study in 22 of 31 provinces from mainland China. We included 15,163 adults aged ≥65 years recruited from 1998- to 2002 and followed-up until 2014. A healthy lifestyle score was calculated considering five lifestyle factors (exercise, smoking, dietary diversity, body mass index and drinking). The scores ranged from zero to five points and were classified into the following three categories: unhealthy (0-1 point), intermediate (2-3 points) and healthy (4-5 points). Cox proportional hazards regression analyses were used to assess the associations between the combined healthy lifestyle score and total mortality, adjusting for demographic characteristics and physical comorbidities, as appropriate. Stratification analyses and interaction analyses were further performed.ResultsAmong the 15,163 participants, the mean age (SD) was 86.2 (11.6) years. During an average follow-up period of 12.5 (SD = 3.9) years, 9655 deaths occurred. The adjusted hazard ratios (HRs) of total mortality decreased as the number of healthy lifestyle factors increased. Compared to the unhealthy lifestyle group, the healthy lifestyle group had a HR and 95% CI of 0.78 and 0.72-0.83. The population attributable risk of total death among those without a healthy lifestyle was 25.2%. A healthier lifestyle pattern was associated with a lower total mortality risk among individuals with different severities of physical comorbidities, although the associations were stronger among those with fatal physical comorbidities (p-interaction < .001).ConclusionsIn this large-scale study, a healthier lifestyle measured by regular exercise participation, never smoking, never drinking, good dietary diversity and normal weight, was inversely associated with total mortality, regardless of physical comorbidity status. These findings support the necessity of multiple lifestyle modifications to prevent premature death in both general elderly populations and those with physical comorbidities.

Dietary diversity practice and its influencing factors among pregnant women in Afar region of Ethiopia: mixed method study

BackgroundPregnancy can aggravate nutritional deficiencies, especially micronutrient deficiencies, which can have major health impact for the fetus and mother. Women in low-income countries are frequently malnourished when they become pregnant. Identifying the magnitude of dietary diversity and its influencing factors among pregnant women in the pastoral region of Afar, where no study has been conducted, is critical for establishing an intervention program in the region.MethodA mixed study comprising 241 pregnant women and six focus group discussions was conducted from October 1 to November 10, 2018. Participants in the quantitative study were selected by a systematic sampling method, whereas those in the focus group discussions were selected by a purposive sampling method. The data were collected using pretested questionnaires administered via face-to-face interviews. Logistic regression determines the association between the dietary diversity practice and its influencing factors. The results were presented by the odds ratio with a 95% confidence interval. A P-value of < 0.05 is used to declare a statistically significant. A thematic framework was used to analyze the qualitative data.ResultsSeventy-three percent of pregnant women had poor dietary diversity. Dietary diversity was higher in younger pregnant women who were under the age of 20 years (AOR = 5.8; at 95% CI: 1.6–13.5) and aged between 21 and 25 years (AOR = 3.9; at 95% CI: 1.1–12.2) than those pregnant women over the age of 30 years. Those participants with a high average family income (above 4500 birr) had good dietary diversity compared to those with an average family income of less than 1500 birr (AOR = 0.1: 95% CI; 0.02–0.7) and 1500–3000 birr (AOR = 0.05: 95% CI; 0.01–0.2). Pregnant women who had one antenatal care visit had less dietary diversity practice than those who had four or more antenatal care visits (AOR = 0.18: 95% CI; 0.04–0.8). Protein-rich foods (meat and eggs), cereal-based semi-solid foods (porridge and soup), milk, bananas and cabbage, were the most commonly tabooed foods during pregnancy. Protein-rich foods were thought to increase the size of the fetus. Semi-solid foods (porridge and soup), bananas, and cabbage, on the other hand, were thought to stick to the fetus's body.ConclusionMost of the study participants had poor dietary diversity. Older women have lower dietary diversity practices than younger women. Pregnant women with a low family income and only one prenatal care visit were less likely to practice dietary diversity than pregnant women with a high family income and those with four or more antenatal care visits. Pregnant women practiced food taboos due to misconceptions that were producing large babies and attached to the babies’ bodies. A public health campaign emphasizing the necessity of antenatal care follow-ups should be launched. Community nutrition education should be provided to reduce the traditional beliefs about certain foods, especially for older women.

Predictors of malnutrition among pregnant women in Ethiopia: A systematic review and meta-analysis

Reproductive aged women are especially vulnerable to protein energy deficiency and under nutrition. Malnutrition is the underlying cause of significant maternal morbidity and mortality. In addition, malnutrition among women is a major risk factor for adverse birth outcomes. Its extent and consequences is highly prevalent in developing countries. This major burden can be reduced through effective nutritional interventions. So, up to date meager evidences were warranted. Therefore, this systematic review and meta-analysis was aimed to estimate the overall pooled prevalence of malnutrition and its predictors among pregnant women in Ethiopia. Articles were systematically searched using PubMed, EMBASE, Google Scholar, World Health Organization's (WHO) Hinari portal data bases and institutional repositories. Newcastle‒Ottawa quality assessment scale adapted for observational studies was applied. We used Stata version 14 for data analysis. Heterogeneity and publication bias were checked using I 2 statistic, funnel plot asymmetry and Egger's test. Random effect model was applied to estimate the pooled prevalence of malnutrition and its predictors. Odds Ratio (OR) with 95% Confidence Interval (CI) was also considered to identify factors. Generally, 24 eligible articles were included for final analysis. The average pooled prevalence of malnutrition among pregnant women in Ethiopia was 29.07% (95% CI: 24.84, 33.30). Maternal illiteracy (OR = 1.60, 95% CI: 1.01, 2.53), low income (<1000 Ethiopian Birr) (OR = 3.07, 95% CI: 1.36, 6.92), unplanned pregnancy (OR = 1.33, 95% CI: 1.01, 1.37), number of meal < three/day (OR = 4.63, 95% CI: 3.00, 7.15), poor dietary diversity (OR = 2.89, 95% CI: 1.28, 6.53), absence of antenatal care (OR = 2.53, 95% CI: 1.18, 5.42) and iron supplementation (OR = 0.63, 95% CI: 0.45, 0.88) were predictors of the pooled prevalence of malnutrition among pregnant women in Ethiopia. significant number of pregnant women in Ethiopia were suffered from malnutrition. Maternal illiteracy education level, low income, unplanned pregnancy, low number of meal, poor dietary diversity, absence of antenatal care and iron supplementation were significant predictors of malnutrition. This meta-analysis suggests that global methods to improve girls’ education, access to health care, and economic opportunities to reduce poverty will be needed to reduce burden of malnutrition. • In Ethiopia, nearly one-third of pregnant women had malnutrition. • Global methods to improve girls’ education, access to health care, and economic opportunities to reduce poverty will be needed to reduce burden of malnutrition. • Family planning utilization and encouraging good dietary diversity were also recommended.

The association between sleep duration and risk of mortality in Chinese older adults: a national cohort study.

Cohort studies about the sleep duration on the risk of death among Chinese older adults are still lacking. The aim of this study was to examine whether extremely long or short sleep duration was associated with mortality in Chinese adults aged 65 years or older. We included participants aged 65 years or older in 2011 at baseline in 23 provinces from the Chinese Longitudinal Healthy Longevity Survey who were followed up in 2014/2018 in China. Sleep duration was categorized as short sleep duration (< 7 hours) and long sleep duration (> 8 hours). We used the Cox proportional hazards model and restricted cubic spline analysis to explore the association between sleep duration and mortality. Among 9578 participants, short sleep duration was associated with an 11% higher risk of death (adjusted hazard ratio [aHR]: 1.11; 95% confidence interval [CI]: 1.02-1.20) and long sleep duration was associated with a 24% higher risk of death (aHR: 1.24; 95% CI: 1.15-1.34), after adjustment for all covariates. There was a U-shaped association between sleep duration and all-cause mortality (nonlinear, P < .0001). Stratified analyses showed that the risk was higher among older people who smoked and with a higher level of education both for short and long sleepers than for those who never smoked and were illiterate (P value for interaction < .05). There was a U-shaped association between sleep duration and all-cause mortality in Chinese older adults, especially in more educated individuals and smokers. Du M, Liu M, Liu J. The association between sleep duration and the risk of mortality in the Chinese older adults: a national cohort study. J Clin Sleep Med. 2021;17(9):1821-1829.