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Iyassu A, Laillou A, Tilahun K, Workneh F, Mogues S, Chitekwe S, Baye K. The influence of adolescents' nutrition knowledge and school food environment on adolescents' dietary behaviors in urban Ethiopia: A qualitative study. MATERNAL & CHILD NUTRITION 2024; 20 Suppl 5:e13527. [PMID: 37150888 PMCID: PMC11258761 DOI: 10.1111/mcn.13527] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 05/09/2023]
Abstract
Adolescence is a critical period of physical, cognitive, and social development that needs to be supported with healthy diets. Dietary behaviours of adolescents can be shaped by their nutrition-literacy and their interaction with parents and peers as well as their school food environment. Therefore, the present study aimed to assess factors that influence dietary behaviours of adolescents in urban Ethiopia. Sex-disaggregated, focused group discussions (n = 70) were conducted in 36 private and government schools (n = 12/city) among adolescents (n = 432) 15-19 years of age in Addis Ababa, Bahir Dar, and Dire Dawa. Photovoice was applied in a subgroup of participants (n = 216) to gain further insights into adolescents' perception of their school food environment. Key informant interviews were conducted among school principals (n = 36). Adolescents had a relatively good nutrition knowledge and recognised the importance of diverse diets, but misperceptions also existed. They identified fruit and vegetables as healthy foods, but their consumption was deterred by food safety concerns. The adolescents identified foods high in salt, fat, and sugar, including processed/packaged foods as unhealthy, but still consumed them frequently due to their taste, affordability, availability and accessibility in and around schools. Both undernutrition and overweight/obesity were linked to social exclusion and bullying in school. Effective behavioural change communication is required to address common misperceptions. School nutrition programs should integrate water, sanitation and hygiene programs to ensure food safety. Regulations promoting healthy eating while discouraging unhealthy dietary behaviours are vital. Interventions to make nutrient-dense and healthy foods available, accessible, and affordable are urgently needed to improve the nutrition and health outcome of adolescents.
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Affiliation(s)
- Abreham Iyassu
- Research Center for Inclusive Development in Africa (RIDA)Addis AbabaEthiopia
| | | | - Kassahun Tilahun
- Department of Psychology, College of Social ScienceDebre Berhan UniversityDebre BerhanEthiopia
| | | | | | | | - Kaleab Baye
- Research Center for Inclusive Development in Africa (RIDA)Addis AbabaEthiopia
- Center for Food Science and NutritionAddis Ababa UniversityAddis AbabaEthiopia
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Posey I, Nsiah-Asamoah C, Fergusson Russell N, Darkwa Entwi E, Okronipa H. Experiences of Food Insecurity Among Pregnant Adolescents and Adolescent Mothers in Ghana: A Photovoice Method. Int J Public Health 2024; 69:1607043. [PMID: 38808213 PMCID: PMC11130365 DOI: 10.3389/ijph.2024.1607043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 04/30/2024] [Indexed: 05/30/2024] Open
Abstract
Objectives: Food insecurity (FI) remains a major public health problem globally. However, there is limited information about adolescents' experiences. The current study explored FI experiences of pregnant adolescents and adolescent mothers in Cape Coast, Ghana using a Photovoice method. Methods: This study recruited 34 pregnant adolescents and adolescent mothers from communities in Cape Coast, Ghana. Each participated in a training session then was provided prompts to take photos that portrayed food access barriers, facilitators and coping strategies. In a debrief session, each participant selected two pictures they took and explained the image, followed by a group discussion of the selected photos. Debrief sessions were audio recorded and transcribed verbatim to develop themes using a theory-driven approach. Results: Most participants reported several or many experiences with FI (64.7%) in the previous month. Participants discussed money, unwanted pregnancy, and unstable work as barriers to obtaining food and working, selling goods, and family support as facilitators to obtaining food. Coping strategies mentioned include providing services to others, borrowing food and goods, meal stretching, pawning personal items and trading. Conclusion: The FI experience of this population is complex; interventions, including trade training or school retention, should be multifaceted.
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Affiliation(s)
- Isabelle Posey
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, United States
| | | | | | - Esther Darkwa Entwi
- Department of Clinical Nutrition and Dietetics, University of Cape Coast, Cape Coast, Ghana
| | - Harriet Okronipa
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, United States
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Erol I, Mutuş B, Ayaz ND, Stowell JD, Sırıken B. Food Safety Awareness, Changes in Food Purchasing Behaviour and Attitudes towards Food Waste during COVID-19 in Türkiye. Foods 2023; 12:4396. [PMID: 38137200 PMCID: PMC10742672 DOI: 10.3390/foods12244396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: The COVID-19 pandemic brought the key issues of food security, food safety, and food waste into sharp focus. Türkiye is in the enviable position of being among the top ten agricultural economies worldwide, with a wide diversity of food production. This survey was undertaken in order to gain insights into consumer behaviour and attitudes in Türkiye with respect to these issues. The objective was to highlight strengths and weaknesses, identify areas for improvement, and present strategies for the future. (2) Methods: This survey was carried out between April and May 2022 in 12 provinces throughout Türkiye. Face-to-face interviews were performed with 2400 participants representing a cross-section of ages, educational attainment, and socio-economic categories. The findings were evaluated statistically. (3) Results: The results provide an insight into attitudes and behaviours, both pre-COVID-19 and during the pandemic. In several ways, the pandemic enhanced knowledge and improved behaviour, leading to improvements in diet and reductions in food waste. However, worrying concerns about food safety persist. Specific attention has been given to understanding patterns of bread consumption, particularly in consideration of waste. (4) Conclusions: It is hoped that the results of this survey will increase dialogue between the components of the food sector, encourage education initiatives, and contribute to improving food safety and security and reducing food waste in Türkiye and beyond.
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Affiliation(s)
- Irfan Erol
- Faculty of Health Sciences, Lokman Hekim University, 06510 Çankaya, Türkiye
- Faculty of Health Sciences, Atılım University, 06830 İncek, Türkiye
| | - Begüm Mutuş
- Sabri Ülker Food Research Foundation, Üsküdar, 34692 Istanbul, Türkiye; (B.M.); (J.D.S.)
| | - Naim Deniz Ayaz
- Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Kırıkkale University, 71450 Yahsihan, Türkiye;
| | - Julian D. Stowell
- Sabri Ülker Food Research Foundation, Üsküdar, 34692 Istanbul, Türkiye; (B.M.); (J.D.S.)
| | - Belgin Sırıken
- Department of Aquatic Animal Diseases, Faculty of Veterinary Medicine, Ondokuz Mayıs University, 55139 Atakum, Türkiye;
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Gichohi-Wainaina WN, Kee-Tui SH, Zoethout M, Talsma EF, Edel I, Hauser M. Determinants of dietary diversity and drivers of food choice among low-income consumers in urban Kenya, Malawi and Zimbabwe. J Hum Nutr Diet 2023; 36:2180-2200. [PMID: 37798958 DOI: 10.1111/jhn.13244] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/07/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Rapid urbanisation affects lifestyle and eating habits, predominantly causing a dietary shift that adds challenges to meet dietary recommendations within a complex food system. This research investigated dietary diversity and food choice drivers among low-income consumers in three urban settlements (Nairobi, Kenya; Bulawayo, Zimbabwe and Lilongwe, Malawi, representing rapid, moderate and slow urban growth patterns, respectively) as a first step towards improving diets across cultures and geographies. METHODS Mixed methods data collection was employed for this study. Qualitative methods such as rapid foodscape appraisal workshops and food stories in selected low-income settlements in Nairobi, Bulawayo and Lilongwe were utilised to collect information on the food environments (food balances, infrastructure, safety, policies and institutions). Quantitative data such as socio-demographic characteristics and dietary diversity were collected via structured questionnaires using Cognitive Edge's SenseMaker® (n = 890, 450 and 440 for Nairobi, Bulawayo and Lilongwe, respectively). The dietary intake of respondents was assessed using a 24-h recall, which was then converted to the food group diversity score (FGDS). RESULTS Different levels of compounded stress affected dietary diversity and quality, including high food prices, concerns about sanitation and hygiene and the role of food standards regulation bodies. The mean FGDS across all locations was lower than the recommended cut-off of 5 (4.5, 2.8 and 2.6 across Nairobi, Zimbabwe and Lilongwe, respectively). Additionally, in Nairobi, there were gender differences in diet diversity, with men having a higher dietary diversity score than women (4.6% vs. 4.3%; p = 0.004). The majority of respondents in Lilongwe (65%) reported price as the most important driver of food choice, compared to 38% in Nairobi and 42% in Bulawayo. DISCUSSION/CONCLUSIONS Our observation of poor-quality diets provides further evidence of the need for food policies that are cognisant of the nutrition and health of the growing population of the urban poor. Such policies would focus on lowering the costs of nutritious foods as well as ensuring food safety within the complex food system observed in the urban low-income environment.
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Affiliation(s)
- Wanjiku N Gichohi-Wainaina
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Lilongwe, Malawi
- Food, Policy and Nutrition Laboratory, Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Sabine Homann Kee-Tui
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Bulawayo, Zimbabwe
- Alliance Bioversity International and CIAT, Lilongwe, Malawi
| | - Manon Zoethout
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Elise F Talsma
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Immaculate Edel
- International Crops Research Institute for the Semi Arid Tropics (ICRISAT), Nairobi, Kenya
| | - Michael Hauser
- International Crops Research Institute for the Semi Arid Tropics (ICRISAT), Nairobi, Kenya
- University of Natural Resources and Life Sciences, Vienna, Austria
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Sadaf A, Balal RM, Jaffar MT, Javed SA, Javaid MM. Influence of brassinosteroid and silicon on growth, antioxidant enzymes, and metal uptake of leafy vegetables under wastewater irrigation. INTERNATIONAL JOURNAL OF PHYTOREMEDIATION 2023; 26:936-946. [PMID: 38630443 DOI: 10.1080/15226514.2023.2285015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Vegetable cultivation under sewage irrigation is a common practice mostly in developing countries due to a lack of freshwater. Long-term usage provokes heavy metals accumulation in soil and ultimately hinders the growth and physiology of crop plants and deteriorates the quality of food. A study was performed to investigate the role of brassinosteroid (BRs) and silicon (Si) on lettuce, spinach, and cabbage under lead (Pb) and cadmium (Cd) contaminated sewage water. The experiment comprises three treatments (control, BRs, and Si) applied under a completely randomized design (CRD) in a growth chamber. BRs and Si application resulted in the highest increase of growth, physiology, and antioxidant enzyme activities when applied under canal water followed by distilled water and sewage water. However, BRs and Si increased the above-determined attributes under the sewage water by reducing the Pb and Cd uptake as compared to the control. It's concluded that sewerage water adversely affected the growth and development of vegetables by increasing Pb and Cd, and foliar spray of Si and BRs could have great potential to mitigate the adverse effects of heavy metals and improve the growth. The long-term alleviating effect of BRs and Si will be evaluated in the field conditions at different ecological zones.
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Affiliation(s)
- Anam Sadaf
- Department of Horticulture, College of Agriculture, University of Sargodha, Sargodha, Pakistan
| | - Rashad Mukhtar Balal
- Department of Horticulture, College of Agriculture, University of Sargodha, Sargodha, Pakistan
| | | | - Syed Ayyaz Javed
- Department of Soil and Environmental Sciences, College of Agriculture, University of Sargodha, Sargodha, Pakistan
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Kushitor SB, Alangea DO, Aryeetey R, de-Graft Aikins A. Dietary patterns among adults in three low-income urban communities in Accra, Ghana. PLoS One 2023; 18:e0293726. [PMID: 37943866 PMCID: PMC10635542 DOI: 10.1371/journal.pone.0293726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE Dietary patterns describe the dietary behaviour and habits of individuals. Unhealthy dietary patterns provide individuals with limited nutrients while increasing the risk of nutrition-related diseases. Unhealthy dietary patterns are high in urban areas, especially among low-income urban residents. This study examined dietary patterns in three low-income urban communities in Accra, Ghana, between 2011 and 2013. METHODS This study used Wave 2 and 3 data from the Urban Health and Poverty Survey (EDULINK 2011 and 2013). The sample size was 960 in 2011 and 782 in 2013. Dietary pattern was examined using factor analysis and the NOVA food classification system. Summary statistics were computed for sociodemographic characteristics and diet frequency and pattern. Differences in dietary behaviours between 2011 and 2013 were also estimated. Three logistic regression models were computed to determine the predictors of dietary patterns. RESULTS The frequency of consumption of animal-source foods (ASF) and fruits was higher in 2013 compared with 2011. The intake of processed culinary ingredients (NOVA Group 2), processed foods (NOVA Group 3) and ultra-processed foods (NOVA Group 4) was higher in 2013 versus 2011. In 2013, 29% consumed ultra-processed foods compared to 21% in 2011. Three dietary patterns (rice-based, snack-based, and staple and stew/soup) were identified. About two out of every five participants consumed the food items in the rice (43%) and staple and sauce patterns (40%). The proportion of participants who consumed the food items in the snack pattern was 35% in 2011 but 41% in 2013. Respondents aged 25-34 and those with higher education often consumed the snack-based and rice-based dietary patterns. In 2013, participants in Ussher Town had a higher probability of consuming food items in the snack pattern than those living in Agbogbloshie. CONCLUSIONS This study found that between 2011 and 2013, more participants consumed ASFs, fruits, and processed foods. A complex interplay of personal and socio-cultural factors influenced dietary intake. The findings of this study mirror global changes in diet and food systems, with important implications for the primary and secondary prevention of NCDs. Health promotion programs at the community level are needed to address the increasing levels of processed food consumption.
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Affiliation(s)
- Sandra Boatemaa Kushitor
- Department of Community Health, Ensign Global College, Kpong, Ghana
- Department of Food Science and Centre for Complex Systems in Transition, Stellenbosch University, Stellenbosch, South Africa
| | - Deda Ogum Alangea
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Richmond Aryeetey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Ama de-Graft Aikins
- Institute of Advanced Studies, University College London, London, United Kingdom
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Laar A, Amoah JM, Massawudu LM, Pereko KKA, Yeboah-Nkrumah A, Amevinya GS, Nanema S, Odame EA, Agyekum PA, Mpereh M, Sandaare S. Making food-related health taxes palatable in sub-Saharan Africa: lessons from Ghana. BMJ Glob Health 2023; 8:e012154. [PMID: 37813441 PMCID: PMC10565179 DOI: 10.1136/bmjgh-2023-012154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/05/2023] [Indexed: 10/13/2023] Open
Abstract
Amidst high burden of infectious diseases, undernutrition and micronutrient deficiencies, non-communicable diseases (NCDs) are predicted to become the leading cause of death in Ghana by 2030. NCDs are driven, to a large extent, by unhealthy food environments. Concerned, the Ghana Ministry of Health (MOH) has since 2012 sought to garner the support of all to address this challenge. We aimed to support the MOH to address the challenge through public health policy measures, but would soon be reminded that longstanding challenges to policy development such as data poverty, and policy inertia needed to be addressed. To do this, the we generated the needed evidence, curated the evidence, and availed the evidence to Ghanaian policymakers, researchers and civil society actors. Thus, we addressed the problem of data poverty using context-relevant research, and policy inertia through advocacy and scholar activism. In this paper, we share how a public interest coalition used context-relevant research, evidence-informed advocacy and scholar activism to valorise and increase demand for healthy food policy (including food-related health taxes) in Ghana.
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Affiliation(s)
- Amos Laar
- Department of Population, Family & Reproductive Health, University of Ghana School of Public Health, Accra, Greater Accra, Ghana
| | | | | | | | - Annabel Yeboah-Nkrumah
- Department of Population, Family & Reproductive Health, University of Ghana School of Public Health, Accra, Greater Accra, Ghana
| | - Gideon S Amevinya
- Department of Population, Family & Reproductive Health, University of Ghana School of Public Health, Accra, Greater Accra, Ghana
| | - Silver Nanema
- Department of Population, Family & Reproductive Health, University of Ghana School of Public Health, Accra, Greater Accra, Ghana
| | - Emmanuel Ankrah Odame
- Ghana Ministry of Health, Accra, Greater Accra, Ghana
- Korle-Bu Teaching Hospital, Accra, Ghana
| | | | - Mary Mpereh
- National Development Planning Commission, Accra, Greater Accra, Ghana
| | - Sebastian Sandaare
- Parliament of Ghana, Accra, Accra, Ghana
- Coalition of Actors for Public Health Advocacy, Accra, Ghana
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The diverse and complementary components of urban food systems in the global South: Characterization and policy implications. GLOBAL FOOD SECURITY 2023. [DOI: 10.1016/j.gfs.2022.100663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Onyango EO, Crush JS, Owuor S. Food Insecurity and Dietary Deprivation: Migrant Households in Nairobi, Kenya. Nutrients 2023; 15:1215. [PMID: 36904214 PMCID: PMC10005626 DOI: 10.3390/nu15051215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
The current study focuses on food consumption and dietary diversity among internal migrant households in Kenya using data from a city-wide household survey of Nairobi conducted in 2018. The paper examined whether migrant households are more likely to experience inferior diets, low dietary diversity, and increased dietary deprivation than their local counterparts. Second, it assesses whether some migrant households experience greater dietary deprivation than others. Third, it analyses whether rural-urban links play a role in boosting dietary diversity among migrant households. Length of stay in the city, the strength of rural-urban links, and food transfers do not show a significant relationship with greater dietary diversity. Better predictors of whether a household is able to escape dietary deprivation include education, employment, and household income. Food price increases also decrease dietary diversity as migrant households adjust their purchasing and consumption patterns. The analysis shows that food security and dietary diversity have a strong relationship with one another: food insecure households also experience the lowest levels of dietary diversity, and food secure households the highest.
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Affiliation(s)
| | - Jonathan S. Crush
- Balsillie School of International Affairs, Laurier University, Waterloo, ON N2L 6C2, Canada
- University of the Western Cape, Cape Town 7535, South Africa
| | - Samuel Owuor
- Department of Geography, Population and Environmental Studies, University of Nairobi, Nairobi P.O. Box 30197-00100, Kenya
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Isanovic S, Constantinides SV, Frongillo EA, Bhandari S, Samin S, Kenney E, Wertheim-Heck S, Nordhagen S, Holdsworth M, Dominguez-Salas P, Ambikapathi R, Laar A, Patil CL, Kulkarni B, Bukachi SA, Ngutu M, Blake CE. How Perspectives on Food Safety of Vendors and Consumers Translate into Food-Choice Behaviors in 6 African and Asian Countries. Curr Dev Nutr 2023; 7:100015. [PMID: 37181131 PMCID: PMC10100931 DOI: 10.1016/j.cdnut.2022.100015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/30/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background Consumption of unsafe foods increases morbidity and mortality and is currently an issue, particularly in low- and middle-income countries. Policy actions to ensure food safety are dominated by mitigation of biological and chemical hazards through supply-side risk management, lessening the degree to which consumer perspectives of food safety are considered. Objectives This study aimed to provide an in-depth understanding, from vendor and consumer perspectives, of how food-safety concerns of consumers translate into their subsequent food-choice behaviors in 6 diverse low- and middle-income countries. Methods Six Drivers of Food Choice projects (2016-2022) provided transcripts from 17 focus group discussions and 343 interviews conducted in Ghana, Guinea, India, Kenya, Tanzania, and Vietnam. Qualitative thematic analysis was used to identify emerging themes important to food safety. Results The analysis suggests that consumers constructed meaning about food safety through personal lived experience and social influences. Community and family members contributed knowledge about food safety. Concerns about food safety were influenced by reputations of and relationships with food vendors. Consumers' mistrust of food vendors was amplified by purposeful adulteration or unsafe selling practices and new methods used to produce food. Moreover, consumers were reassured of food safety by positive relationships with vendors; meals cooked at home; implementation of policies and following regulations; vendor adherence to environmental sanitation and food-hygiene practices; cleanliness of vendors' appearance; and vendors' or producers' agency to use risk mitigation strategies in production, processing, and distribution of food. Conclusions Consumers integrated their meanings, knowledge, and concerns about food safety to achieve assurance about the safety of their foods when making food-choice decisions. The success of food-safety policies hinges on consideration of consumers' food-safety concerns in their design and implementation, alongside actions to reduce risk in food supply.
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Affiliation(s)
- Sejla Isanovic
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shilpa V. Constantinides
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Edward A. Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shiva Bhandari
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sharraf Samin
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Emma Kenney
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sigrid Wertheim-Heck
- Environmental Policy Group, Department of Social Sciences, Wageningen University, Wageningen, the Netherlands
| | | | - Michelle Holdsworth
- Montpellier Interdisciplinary Center on Sustainable Agri-food Systems, University of Montpellier, French Agricultural Research Centre for International Development, International Center for Advanced Mediterranean Agronomic Studies, Mediterranean Agronomic Institute of Montpellier, French National Institute for Agricultural Research, Institut Agro, French National Research Institute for Sustainable Development, Montpellier, France
| | - Paula Dominguez-Salas
- Natural Resources Institute, University of Greenwich, London, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Ramya Ambikapathi
- Department of Public Health, Purdue University, West Lafayette, IN, USA
- Department of Global Development, Cornell University, Ithaca, NY, USA
| | - Amos Laar
- University of Ghana, Department of Population, Family and Reproductive Health, School of Public Health, Accra, Ghana
| | - Crystal L. Patil
- Department of Human Development Nursing Science, University of Illinois–Chicago, Chicago, IL, USA
| | - Bharati Kulkarni
- Division of Reproductive Biology, Maternal and Child Health and Nutrition, Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - Salome A. Bukachi
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Mariah Ngutu
- Institute of Anthropology, Gender and African Studies, University of Nairobi, Nairobi, Kenya
| | - Christine E. Blake
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Garcia S, Ordoñez S, López-Molina VM, Lacruz-Pleguezuelos B, Carrillo de Santa Pau E, Marcos-Zambrano LJ. Citizen science helps to raise awareness about gut microbiome health in people at risk of developing non-communicable diseases. Gut Microbes 2023; 15:2241207. [PMID: 37530428 PMCID: PMC10399471 DOI: 10.1080/19490976.2023.2241207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/20/2023] [Indexed: 08/03/2023] Open
Abstract
Citizens lack knowledge about the impact of gut microbiota on health and how lifestyle and dietary choices can influence it, leading to Non-Communicable Diseases (NCDs) and affecting overall well-being. Participatory action research (PAR) is a promising approach to enhance communication and encourage individuals to adopt healthier behaviors and improve their health. In this study, we explored the feasibility of integrating the photovoice method with citizen science approaches to assess the impact of social and environmental factors on gut microbiota health. In this context, citizen science approaches entailed the involvement of participants in the collection of samples for subsequent analysis, specifically gut microbiome assessment via 16S rRNA gene sequencing. We recruited 70 volunteers and organized six photovoice groups based on age and educational background. Participants selected 64 photographs that represented the influence of daily habits on gut microbiota health and created four photovoice themes. Analysis of the gut microbiome using 16S rRNA gene sequencing identified 474 taxa, and in-depth microbial analysis revealed three clusters of people based on gut microbiome diversity and body mass index (BMI). Our findings indicate that participants enhanced their knowledge of gut microbiome health through PAR activities, and we found a correlation between lower microbial diversity, higher BMI, and better achievement of learning outcomes. Using PAR as a methodology is an effective way to increase citizens' awareness and engagement in self-care, maintain healthy gut microbiota, and prevent NCD development. These interventions are particularly beneficial for individuals at higher risk of developing NCDs.
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Affiliation(s)
- Silvia Garcia
- Computational Biology Group, Precision Nutrition and Cancer Research Program, IMDEA Food Institute, Madrid, Spain
| | - Sheyla Ordoñez
- Computational Biology Group, Precision Nutrition and Cancer Research Program, IMDEA Food Institute, Madrid, Spain
| | - Victor Manuel López-Molina
- Computational Biology Group, Precision Nutrition and Cancer Research Program, IMDEA Food Institute, Madrid, Spain
| | - Blanca Lacruz-Pleguezuelos
- Computational Biology Group, Precision Nutrition and Cancer Research Program, IMDEA Food Institute, Madrid, Spain
| | | | - Laura Judith Marcos-Zambrano
- Computational Biology Group, Precision Nutrition and Cancer Research Program, IMDEA Food Institute, Madrid, Spain
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Wanjohi MN, Pradeilles R, Asiki G, Holdsworth M, Kimani-Murage EW, Muthuri SK, Irache A, Laar A, Zotor F, Tandoh A, Klomegah S, Graham F, Osei-Kwasi HA, Green MA, Coleman N, Mensah K, Akparibo R, Aryeteey R, Rousham EK, Bricas N, Bohr M, Griffiths P. Community perceptions on the factors in the social food environment that influence dietary behaviour in cities of Kenya and Ghana: a Photovoice study. Public Health Nutr 2022; 26:1-13. [PMID: 36305344 PMCID: PMC9989710 DOI: 10.1017/s1368980022002270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/08/2022] [Accepted: 10/04/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To explore communities' perspectives on the factors in the social food environment that influence dietary behaviours in African cities. DESIGN A qualitative study using participatory photography (Photovoice). Participants took and discussed photographs representing factors in the social food environment that influence their dietary behaviours. Follow-up in-depth interviews allowed participants to tell the 'stories' of their photographs. Thematic analysis was conducted, using data-driven and theory-driven (based on the socio-ecological model) approaches. SETTING Three low-income areas of Nairobi (n 48) in Kenya and Accra (n 62) and Ho (n 32) in Ghana. PARTICIPANTS Adolescents and adults, male and female aged ≥13 years. RESULTS The 'people' who were most commonly reported as influencers of dietary behaviours within the social food environment included family members, friends, health workers and food vendors. They mainly influenced food purchase, preparation and consumption, through (1) considerations for family members' food preferences, (2) considerations for family members' health and nutrition needs, (3) social support by family and friends, (4) provision of nutritional advice and modelling food behaviour by parents and health professionals, (5) food vendors' services and social qualities. CONCLUSIONS The family presents an opportunity for promoting healthy dietary behaviours among family members. Peer groups could be harnessed to promote healthy dietary behaviours among adolescents and youth. Empowering food vendors to provide healthier and safer food options could enhance healthier food sourcing, purchasing and consumption in African low-income urban communities.
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Affiliation(s)
- Milkah N Wanjohi
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, P.O Box 01787-00100, Nairobi, Kenya
| | - Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, Loughborough, UK
| | - Gershim Asiki
- Health and Systems for Health Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-food systems), (Université Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institute Agro, IRD), Montpellier, France
| | - Elizabeth W Kimani-Murage
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, P.O Box 01787-00100, Nairobi, Kenya
| | - Stella K Muthuri
- Population Dynamics and Reproductive Health Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Ana Irache
- Warwick Center for Applied Health Research and Delivery, Warwick Medical School, University of Warwick, Coventry, UK
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Francis Zotor
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Akua Tandoh
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Senam Klomegah
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Fiona Graham
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Mark A Green
- Department of Geography & Planning, University of Liverpool, Liverpool, UK
| | - Nathaniel Coleman
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, Korle Bu, Accra, Ghana
| | - Kobby Mensah
- Department of Marketing and Entrepreneurship, University of Ghana Business School, Legon, Accra, Ghana
| | - Robert Akparibo
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Richmond Aryeteey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Emily K Rousham
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, Loughborough, UK
| | - Nicolas Bricas
- French Agricultural Research Centre for International Development (CIRAD), Montpellier Cedex 5, France
| | - Marco Bohr
- School of Art and Design, Nottingham Trent University, Nottingham, UK
| | - Paula Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, Loughborough, UK
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Zhang Z, Luo Y, Zhang Z, Robinson D, Wang X. Unraveling the Role of Objective Food Environment in Chinese Elderly's Diet-Related Diseases Epidemic: Considering Both Healthy Food Accessibility and Diversity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13924. [PMID: 36360812 PMCID: PMC9658263 DOI: 10.3390/ijerph192113924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/22/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
The essential role of the objective food environment in achieving healthy aging has been widely recognized worldwide. However, the existing empirical evidence is mostly based on Western cases, and how the objective food environment associates with health outcomes among Chinese elderly remains poorly understood. By merging nationally representative micro survey data with Baidu-based spatial data on the location of food outlets, this study develops accessibility and diversity indicators to explore the relationship between food environment and diet-related diseases among Chinese elderly and investigates how healthy lifestyles moderate this relationship. The results show that improvement in healthy food accessibility and diversity decreases both the probability and the number of diet-related diseases that the elderly suffer. Having more healthy lifestyle factors is associated with a lower risk of suffering from diet-related diseases and strengthens the negative effect of healthy food environment on suffered diet-related diseases. Heterogeneity effect analysis suggests that the relationship between objective food environment and diet-related diseases differs by city scale and income level. The findings of this study shed light on designing tailor-made policies for non-Western countries to promote healthy aging.
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Affiliation(s)
- Zhaohua Zhang
- School of Economics, Tianjin University of Commerce, Tianjin 300134, China
| | - Yuxi Luo
- School of Economics and Management, Guangxi Normal University, Guilin 541004, China
| | - Zhao Zhang
- College of Information and Electrical Engineering, China Agricultural University, Beijing 100083, China
| | - Derrick Robinson
- Aquaculture Economist, National Oceanic & Atmospheric Administration, San Diego, CA 92037, USA
| | - Xin Wang
- School of Economics, Tianjin University of Commerce, Tianjin 300134, China
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Liguori J, Pradeilles R, Laar A, Zotor F, Tandoh A, Klomegah S, Osei‐Kwasi HA, Le Port A, Bricas N, Aryeetey R, Akparibo R, Griffiths P, Holdsworth M. Individual-level drivers of dietary behaviour in adolescents and women through the reproductive life course in urban Ghana: A Photovoice study. MATERNAL & CHILD NUTRITION 2022; 18:e13412. [PMID: 35938776 PMCID: PMC9480960 DOI: 10.1111/mcn.13412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
Evidence on the individual-level drivers of dietary behaviours in deprived urban contexts in Africa is limited. Understanding how to best inform the development and delivery of interventions to promote healthy dietary behaviours is needed. As noncommunicable diseases account for over 40% of deaths in Ghana, the country has reached an advanced stage of nutrition transition. The aim of this study was to identify individual-level factors (biological, demographic, cognitive, practices) influencing dietary behaviours among adolescent girls and women at different stages of the reproductive life course in urban Ghana with the goal of building evidence to improve targeted interventions. Qualitative Photovoice interviews (n = 64) were conducted in two urban neighbourhoods in Accra and Ho with adolescent girls (13-14 years) and women of reproductive age (15-49 years). Data analysis was both theory- and data-driven to allow for emerging themes. Thirty-seven factors, across four domains within the individual-level, were identified as having an influence on dietary behaviours: biological (n = 5), demographic (n = 8), cognitions (n = 13) and practices (n = 11). Several factors emerged as facilitators or barriers to healthy eating, with income/wealth (demographic); nutrition knowledge/preferences/risk perception (cognitions); and cooking skills/eating at home/time constraints (practices) emerging most frequently. Pregnancy/lactating status (biological) influenced dietary behaviours mainly through medical advice, awareness and willingness to eat foods to support foetal/infant growth and development. Many of these factors were intertwined with the wider food environment, especially concerns about the cost of food and food safety, suggesting that interventions need to account for individual-level as well as wider environmental drivers of dietary behaviours.
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Affiliation(s)
- Julia Liguori
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri‐Food Systems)CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro Montpellier, IRDMontpellierFrance
| | - Rebecca Pradeilles
- Centre for Global Health and Human Development, School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Amos Laar
- Department of Population, Family & Reproductive Health, School of Public HealthUniversity of GhanaAccraGhana
| | - Francis Zotor
- Department of Family and Community Health, School of Public HealthUniversity of Health and Allied SciencesHoGhana
| | - Akua Tandoh
- Department of Population, Family & Reproductive Health, School of Public HealthUniversity of GhanaAccraGhana
| | - Senam Klomegah
- Department of Family and Community Health, School of Public HealthUniversity of Health and Allied SciencesHoGhana
| | | | - Agnès Le Port
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri‐Food Systems)CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro Montpellier, IRDMontpellierFrance
| | - Nicolas Bricas
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri‐Food Systems)CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro Montpellier, IRDMontpellierFrance
| | - Richmond Aryeetey
- Department of Population, Family & Reproductive Health, School of Public HealthUniversity of GhanaAccraGhana
| | - Robert Akparibo
- School of Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - Paula Griffiths
- Centre for Global Health and Human Development, School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri‐Food Systems)CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro Montpellier, IRDMontpellierFrance
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Mensah DO, Oyebode O. "We think about the quantity more": factors influencing emerging adults' food outlet choice in a university food environment, a qualitative enquiry. Nutr J 2022; 21:49. [PMID: 35906594 PMCID: PMC9338622 DOI: 10.1186/s12937-022-00801-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent decades, the food environment has seen rapid transformation globally, altering food availability and access along with how people interact with the food environment and make food-related choice. OBJECTIVES & METHOD This explorative study aimed to identify the factors that shape the decision-making process for food outlet choices among emerging adults in a Ghanaian University food environment. The study uses focus group discussions in combination with novel dyadic interviews with best friend pairs. Verbatim transcripts were analysed thematically using NVivo 12. RESULTS Drawing on socio-ecological model (SEM) of behaviour, the study used testimony from 46 participants aged 18-25, 47% female, including individuals from major ethnicities and religions in Ghana, and identified three interwoven levels of influence shaping emerging adults' choices of food outlet. The main factors influencing food outlet choice were identified as food prices, spatial accessibility, budget, and food quantity/satiety with additional factors including hygiene, variety of foods, food quality and taste preferences as well as societal factors such as ambience and peer influence. CONCLUSION Multi-component approaches that combine structural level interventions in food retailing along with individual level components may be effective at changing emerging adult consumption behaviour in SSA, although this needs to be studied.
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Affiliation(s)
- Daniel Opoku Mensah
- Warwick Center for Global Health, Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK.
| | - Oyinlola Oyebode
- Warwick Center for Global Health, Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
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Food Environments and Their Influence on Food Choices: A Case Study in Informal Settlements in Nairobi, Kenya. Nutrients 2022; 14:nu14132571. [PMID: 35807752 PMCID: PMC9268418 DOI: 10.3390/nu14132571] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022] Open
Abstract
The food environments that people have access to shape their food choices. The purpose of this study was to use mixed methods to characterize the external food environment in informal settlements in Nairobi, Kenya and to examine the individual factors that influence the way in which women interact with those environments to make food choices. We used a combination of food environment assessments (vendor mapping, collection of food prices, food quality assessments) and five focus group discussions with women (n = 26) in four villages within two informal settlements in Nairobi (Mukuru and Kibera) to better understand the drivers of food choice. We found a large number (n = 1163) of vendors selling a variety of food within the settlements. The highest number of vendors were selling fruits and/or vegetables; however, there was limited diversity of fruits available. Animal-source foods were considered relatively expensive as compared to plant-based foods, including prepared fried snacks. We found that the way women interacted with their food environments was influenced by individual factors such as income, time, convenience, and preferences. Our findings suggest that interventions targeting both the external food environment as well as individual factors such as income will be necessary to support healthy diets among low-income populations living in informal settlements in Kenya.
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How do food safety concerns affect consumer behaviors and diets in low- and middle-income countries? A systematic review. GLOBAL FOOD SECURITY 2022. [DOI: 10.1016/j.gfs.2021.100606] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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