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Di Maso M, Bravi F, Polesel J, Dal Maso L, Patel L, La Vecchia C, Ferraroni M. A novel approach to assess diet diversity: a development of the Nutritional Functional Diversity indicator. Front Nutr 2023; 10:1170831. [PMID: 37927502 PMCID: PMC10620300 DOI: 10.3389/fnut.2023.1170831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Background and aims Diversity is a key element of diet quality. The Food Variety Score (FVS) is used to assess diversity, especially in low- and middle-income countries. It sums up the number of foods consumed ignoring their nutrient content. A more suitable index should combine the number of foods consumed and their nutritional composition. We adapted the Nutritional Functional Diversity indicator (NFD), proposed by ecologists, to measure diversity in the human diet. We compared NFD and FVS evaluating subjects' distributions across quartiles of the two diversity indices. To evaluate which one reflected a higher diet quality, we estimated associations between these two diversity indices and diet quality measures, i.e., the Mediterranean Diet Score (MDS) and the Healthy Eating Index-2015 (HEI-2015). Associations were expressed by odds ratios (OR) and corresponding 95% confidence intervals (CI). Materials and methods We used the data of controls only derived from an integrated series of hospital-based case-control cancer studies conducted in different Italian areas. The NFD identifies groups of foods based on a set of nutrients according to a cluster analysis. Some steps are required: creating a food-nutrient matrix; clustering of the Euclidean food-food distance matrix to identify groups of foods with nutritional (dis)similarities; and calculating the NFD as the ratio between the sum of branch lengths of the dendrogram belonging to the number of foods consumed by individuals (i.e., subject-specific diversity) and the sum of all branch lengths of the dendrogram (i.e., maximal diversity). Results More than one quarter of individuals (28.4%) were differently classified within quartiles of the two diversity indices. For both indices, increasing the diversity level increased the risk for adhering to MDS (OR for NFD = 11.26; 95% CI: 7.88-16.09, and OR for FVS = 6.80; 95% CI: 4.84-9.54) and to HEI-2015 (OR for NDF = 2.86; 95% CI: 2.39-3.42, and OR for FVS = 2.72; 95% CI: 2.27-3.26). Associations were stronger for NFD. Conclusion Our findings showed a greater ability of NFD to assess diet quality quantifying the degree of diversity.
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Affiliation(s)
- Matteo Di Maso
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro”, Università degli Studi di Milano, Milan, Italy
| | - Francesca Bravi
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro”, Università degli Studi di Milano, Milan, Italy
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Luigino Dal Maso
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Linia Patel
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro”, Università degli Studi di Milano, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro”, Università degli Studi di Milano, Milan, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro”, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Xiao Q, Li Y, Li B, Li T, Li F, Li Y, Chen L, Zhao Z, Wang Q, Rong S. Dietary Diversity and Mild Cognitive Impairment in Middle-Aged and Older Chinese People: A Cross-Sectional Study. J Alzheimers Dis Rep 2023; 7:1045-1053. [PMID: 37849631 PMCID: PMC10578335 DOI: 10.3233/adr-230060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/24/2023] [Indexed: 10/19/2023] Open
Abstract
Background The evidence concerning dietary diversity and cognitive function remains insufficient. Objective To investigate the association of dietary diversity score (DDS) with mild cognitive impairment (MCI) and cognitive performance in different domains. Methods Data from The Lifestyle and Healthy Aging of Chinese Square Dancer Study was used in this study. DDS was constructed based on the intake frequencies of 9 food groups assessed by a validated food frequency questionnaire. MCI was diagnosed by Petersen's criteria. A neuropsychological test battery was used to assess the performance on cognitive domains, and test scores were standardized to Z scores. Multiple linear regression models and logistic regression models were used to estimate the β and odds ratios and their 95% CIs, respectively. Results Among 1,982 participants, the mean (SD) age was 63.37 (5.00) years, 1,778 (89.71%) were women, and 279 (14.08%) had MCI. Compared to the DDS quartile (0, 6], the multivariable-adjusted odds ratios (95% CI) were 0.74 (0.48, 1.15) for DDS quartile (6, 7], 0.65 (0.43, 0.97) for DDS quartile (7, 8], and 0.55 (0.37, 0.84) for DDS quartile (8, 9]. Furthermore, higher DDS was positively associated with better performance of cognitive domains, including global cognitive function (β= 0.20, 95% CI: 0.12, 0.30), episodic memory (β= 0.21, 95% CI: 0.07, 0.35), attention (β= 0.15, 95% CI: 0.03, 0.26), language fluency (β= 0.24, 95% CI: 0.10, 0.38), and executive function (β= - 0.24, 95% CI: - 0.38, - 0.10). Conclusions This study indicated that higher DDS was associated with better cognitive function among middle-aged and older Chinese people.
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Affiliation(s)
- Qing Xiao
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yonggang Li
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Benchao Li
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Tingting Li
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Fengping Li
- Department of Nutrition, School of Public Health, Wuhan University, Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuanyuan Li
- Department of Nutrition, School of Public Health, Wuhan University, Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuangju Zhao
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Qing Wang
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Shuang Rong
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
- Department of Nutrition, School of Public Health, Wuhan University, Research Center of Public Health, Renmin Hospital of Wuhan University, Wuhan, China
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Wiafe MA, Ayensu J, Yeboah GB. Predictors of food variety and food consumption scores of adolescents living in a rural district in Ghana. PLoS One 2023; 18:e0286477. [PMID: 37256891 PMCID: PMC10231777 DOI: 10.1371/journal.pone.0286477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/16/2023] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION There is a dearth of information about the food variety and consumption scores of adolescents in Ghana. This study assessed predictors of food variety and consumption scores of adolescents living in a rural district in Ghana. METHOD In this cross-sectional study, a multi-stage sampling method was used to select one hundred and thirty-seven (137) adolescents from the Asante-Akim South Municipality of Ghana. A structured questionnaire was used to collect data on sociodemographic, food practices and dietary intakes of study participants. Descriptive, chi-square, T-test, partial correlation and binary logistic regression were used for the data analysis. RESULTS The mean food variety score was 25.8±6.4 (range 7-42) and food consumption score was 35±5.1 (range 18.6-49.9). Food variety score was significantly (p<0.05) associated with guardian income status. A significant and positive partial correlation existed between food variety score and calcium intake (r = 0.236, p<0.05). About 49% and 51% of adolescents were food insecure and food secure, respectively. Food consumption score had significant association (p<0.05) with gender (X2 = 6.1), residence (X2 = 7.0), frequency of meal (X2 = 6.8) and food variety score (X2 = 5.4). Adolescent male (AOR = 2.3, 95% CI (1.2-4.6), p = 0.017), peri-urban residency (AOR = 2.1, 95%CI (1.0-4.4), p = 0.036), having three or more meals per day (AOR = 4.2, 95% CI (1.3-13.6), p = 0.018), and a high food variety score (AOR = 2.1, 95%CI (1.0-4.2), p = 0.041) significantly predicted food consumption scores. CONCLUSION Moderate income status was associated with food variety score in our study participants. Linear relationship existed between food variety and calcium intake. Adolescent males, peri-urban residency, frequency of meals and high food variety score were the predictors of food consumption score. Nutrition-specific and nutrition sensitive programmes aimed at promoting adolescent health should involve guardians.
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Affiliation(s)
| | - Jessica Ayensu
- Department of Clinical Nutrition and Dietetics, University of Cape Coast, Cape Coast, Ghana
| | - Georgina Benewaa Yeboah
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, Jiangsu, 212013, China
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Althaiban MA, Aljefree NM, Almoraie NM, Shatwan IM. Malnutrition is associated with increased disease risk in older people in the Makkah region of Saudi Arabia: A cross-sectional study. Front Public Health 2023; 11:1149739. [PMID: 37077189 PMCID: PMC10106578 DOI: 10.3389/fpubh.2023.1149739] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023] Open
Abstract
IntroductionThere is little research on the nutritional status of older people in Saudi Arabia. This study investigated the factors associated with the nutritional status of older people in the Makkah region, Saudi Arabia. We hypothesized that older people who are at risk of malnutrition are at higher risk of different diseases.Materials and methodsThis cross-sectional study surveyed 271 people aged ≥60 years from October 2021 to January 2022. We collected data on demographics, body mass index, the Geriatric Depression Scale-Short Form, Geriatric Oral Health Assessment Index, Mini Nutritional Assessment, Eating Attitudes Test, and Household Dietary Diversity score.ResultsAmong the 271 participants, 13.3% were malnourished and 53.9% were at risk of malnutrition. The oral health (P < 0.001), depression (P < 0.001), and eating disorder (P < 0.002) scores were significantly associated with malnutrition. Congestive heart failure, asthma, peripheral vascular disease, Alzheimer's disease, and hypertension were more prevalent among malnourished participants—this supports our original hypothesis. The HDD score showed no significant differences between men and women.ConclusionMalnutrition was associated with overweight or obesity, poor oral health, and depression. Older people in the Makkah region, Saudi Arabia, had a high risk of malnutrition.
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Hou M, Qing P, Min S. Multiple indicators of household dietary diversity in rural China: Effects of income and dietary knowledge. Nutrition 2021; 91-92:111406. [PMID: 34388584 DOI: 10.1016/j.nut.2021.111406] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to examine the association among family income, dietary knowledge, their interaction, and the multiple household dietary diversity indices (HDDIs), including dietary diversity score (DDS), entropy index (EI), Shannon equitability index (SEI), Herfindahl index (HI), and Simpson index (SI). METHODS Based on 24-h dietary recall data collected from 1076 rural households in three provinces of Central China, we calculated HDDIs and compared them according to different levels of income and dietary knowledge. A set of multivariate linear regression were further established and estimated to examine the association among family income, dietary knowledge, and household dietary diversity. RESULTS Although the calculation formulas are different, the distributions of the five diversity indices, namely, DDS, EI, SEI, HI, and SI are similar. Family income and dietary knowledge were significantly and positively correlated with various HDDIs (P < 0.01) in addition to HI. Specifically, with a 1-unit (10 000 yuan [US $1545]) income increase, the DDIs respectively changed by 1.70% (DDS), 1.23% (EI), 0.92% (SEI), -0.62% (HI, reverse), and 0.45% (SI). With a 1-point dietary knowledge score increase, the DDIs changed by 0.91% (DDS), 1.33% (EI), 1.29% (SEI), -1.19% (HI, reverse), and 0.81% (SI). The interaction effect of income and dietary knowledge on HDDIs were significantly and negatively correlated with various HDDIs (P < 0.05) in addition to HI. CONCLUSIONS The present findings indicated that with an increase in income and dietary knowledge, rural residents in China would consume more diversified foods. There was a substitution effect of family income and dietary knowledge on HDDIs; that is, with an increase in family income, the effect of dietary knowledge on HDDIs would decrease. The findings of this study contributed to a better understanding of issues related to the dietary diversity of rural residents in China in the context of rising income and residents' increasing dietary knowledge.
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Affiliation(s)
- Minghui Hou
- College of Economics and Management, Huazhong Agricultural University, China
| | - Ping Qing
- College of Economics and Management, Huazhong Agricultural University, China
| | - Shi Min
- College of Economics and Management, Huazhong Agricultural University, China.
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Food insecurity and depression among low-income adults in the USA: does diet diversity play a role? Findings from the 2013-2014 National Health and Nutrition Examination Survey. Public Health Nutr 2020; 24:1877-1888. [PMID: 33190667 DOI: 10.1017/s1368980020004644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Food insecurity is associated with a greater risk of depression among low-income adults in the USA. Members of food-insecure households have lower diet diversity than their food-secure counterparts. This study examined whether diet diversity moderates the association between food insecurity and depression. DESIGN Multiple logistic regression was conducted to examine independent associations between food insecurity and depression, between diet diversity and depression, and the moderating effect of diet diversity in the food insecurity-depression link. SETTING Cross-sectional data from the National Health and Nutrition Examination Survey (2013-2014). PARTICIPANTS 2636 low-income adults aged 18 years and older. RESULTS There was a positive association between food insecurity and depression among low-income adults. Diet diversity was not associated with depression. Diet diversity had a moderating effect on the association between food insecurity and depression among low-income adults. CONCLUSIONS Food insecurity is independently associated with depression among low-income adults in the USA. However, this association differs across levels of diet diversity. Longitudinal studies are needed to confirm the role diet diversity may play in the pathway between food insecurity and depression.
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Zhang J, Zhao A, Wu W, Yang C, Ren Z, Wang M, Wang P, Zhang Y. Dietary Diversity Is Associated With Memory Status in Chinese Adults: A Prospective Study. Front Aging Neurosci 2020; 12:580760. [PMID: 33117146 PMCID: PMC7494158 DOI: 10.3389/fnagi.2020.580760] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/12/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND AIM Subjective memory complaints are common in elderly people. Nutrition plays an important role in keeping brain health, however, the evidence on dietary diversity and subjective memory status is limited. This study aimed to investigate the effect of dietary diversity score (DDS) on memory status in Chinese adults in a prospective cohort study. METHODS Data of the China Health and Nutrition Survey was used in this study. A total of 4356 participants aged 50 years or older were enrolled in the analysis. DDS was calculated based on the dietary recall data collected in the wave of 2011. Information on self-report memory status (OK, good, or bad) and memory change in the past 12 months (stayed the same, improved, or deteriorated) were obtained from the wave of 2015. A memory score was calculated based on a subset of items of the Telephone Interview for Cognitive Status-modified. Multinomial logistic regression models were used to estimate the associations of DDS with memory status and memory change, and linear regression models were carried out to estimate the association between DDS and memory score. RESULTS In the study population, the percentages of participants who thought their memory was OK, bad, and good were 43.3, 24.3, and 32.4%, respectively. There were 1.4% of participants reported memory improvement in the past 12 months and 47.2% reported memory decline. Average memory score among participants was 12.8 ± 6.1. Compared with participants who thought their memory was OK, a higher DDS was associated with self-reported good memory (Odds Ratio [OR] 1.15, 95%CI 1.07-1.24) and inversely associated with bad memory (OR 0.82, 95%CI 0.75-0.89). In subgroup analysis, however, in participants aged 65 years and above, the association between DDS and self-reported good memory was insignificant (OR 1.09, 95%CI 0.94-1.25). Compared with participants whose memory stayed the same, higher DDS was inversely associated with memory decline (OR 0.85, 95%CI 0.80-0.91). Besides, higher DDS was associated with higher memory score (β 0.74, 95%CI 0.56-0.91). CONCLUSION This study revealed that higher DDS was associated with better memory status and was inversely associated with self-reported memory decline in Chinese adults.
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Affiliation(s)
- Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Wei Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Chenlu Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Zhongxia Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Meichen Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Peiyu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
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Park S, Kim HJ, Kim K. Do Where The Elderly Live Matter? Factors Associated with Diet Quality among Korean Elderly Population Living in Urban Versus Rural Areas. Nutrients 2020; 12:E1314. [PMID: 32380737 PMCID: PMC7284551 DOI: 10.3390/nu12051314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/26/2020] [Accepted: 04/30/2020] [Indexed: 11/17/2022] Open
Abstract
This study aimed to examine whether there is an area difference on diet quality among the Korean elderly population. The effect of personal factors on diet quality is also estimated and compared between rural and urban areas. A cross-sectional data from the 2013-2015 Korea National Health and Nutrition Examination Survey (KNHANES) was used for this study. The participants were older adults aged ≥ 65 years (n = 3207) who participated in the KNHANES. Urban and rural areas classified the region and the Korean Healthy Eating Index (KHEI) assessed the diet quality. Personal factors that were related to diet quality included socio-demographic factors, health behaviors, and health conditions. This study found that the diet quality was different between urban and rural areas in the Korean elderly population, showing a higher mean of KHEI scores in urban areas than rural areas (67.3 for urban seniors, 63.6 for rural seniors, p < 0.001), and the regional difference was still significant, even after adjusting for the personal factors (p < 0.001). Different sets of personal factors were found to be significant that explain the diet quality of participants between areas, such as economic resources, walking exercise, and perceived oral health status in urban areas, and age and food insecurity in rural areas. In conclusions, this study found that there was a regional disparity in diet quality and some personal factors affecting diet quality were dependent on areas, which implied that regional environment with diverse contexts could influence diet quality. These findings emphasize the need to provide targeted intervention programs that take into account both the characteristics of individuals and local food environments in order to improve the overall diet quality in older adults.
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Affiliation(s)
- Sohyun Park
- Department of Food Science and Nutrition, Hallym University, 24252 Chuncheon, Korea;
| | - Hyun Ja Kim
- Department of Food and Nutrition, Gangneung-Wonju National University, 25457 Gangneung, Korea
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, 31116 Cheonan, Korea
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Quansah DY, Boateng D. Maternal dietary diversity and pattern during pregnancy is associated with low infant birth weight in the Cape Coast metropolitan hospital, Ghana: A hospital based cross-sectional study. Heliyon 2020; 6:e03923. [PMID: 32420489 PMCID: PMC7217998 DOI: 10.1016/j.heliyon.2020.e03923] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/23/2019] [Accepted: 04/30/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND This study investigated the associations between mother's dietary diversity score and dietary patterns during pregnancy and the odds of low birth weight at the Cape Coast Metropolitan Hospital in Ghana. METHODS Mothers attending the postnatal clinic from January to August 2016 at the Cape Coast Metropolitan Hospital were included. Dietary information during pregnancy was assessed with a food frequency questionnaire. In reference to the women's dietary diversity score, women were categorized into low, medium or high dietary diversity score groups. The primary outcome was low birth weight and was defined as weight <2500 g at birth. Factor analysis was conducted to identify maternal dietary patterns and a multivariable logistic regression analysis was used to determine the associations between dietary diversity score and dietary patterns with low birth weight. RESULTS The prevalence of low birth weight in infants was 43.8% (95% CI = 39%-49%). After adjusting for covariates, the odds of low birth weight was four times higher in the low dietary diversity score group compared to the high dietary diversity score group (odds ratio [OR] = 4.29, 95% confidence interval [CI], 1.24-6.48). Three dietary patterns namely "Western", "Traditional" and "Healthy", which explained 58.23% of the total variance in food intake were identified. The subjects in the highest quartiles of "healthy" and "traditional" dietary pattern scores had significantly lower odds of low birth weight (healthy: OR = 0.23, 95% CI, 0.19-0.39, P trend <0.0001; traditional: OR = 0.14, 95% CI, 0.06-0.35, P trend <0.0001, respectively) compared to those in the lowest quartiles of dietary pattern score. CONCLUSION Low dietary diversity score during pregnancy was associated with higher odds of infant low birth weight whereas dietary patterns considered as "healthy" and "traditional" during pregnancy were associated with lower odds of infant low birth weight. Findings of this study suggests that higher dietary diversity and "healthy" and "traditional" dietary patterns during pregnancy may be protective of LBW in the study area.
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Affiliation(s)
- Dan Yedu Quansah
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Daniel Boateng
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Eme PE, Kim ND, Douwes J, Burlingame B, Foliaki S, Wham C. Are Households in Kiribati Nutrition Secure? A Case Study of South Tarawa and Butaritari. Food Nutr Bull 2020; 41:131-146. [PMID: 32048881 DOI: 10.1177/0379572119891024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES This study assessed the nutritional status among householders in urban South Tarawa and rural Butaritari in Kiribati. METHODS AND STUDY DESIGN In this cross-sectional study, we assessed energy and nutrient intakes, food variety scores, and dietary diversity scores of men and women from 468 households randomly selected in South Tarawa (n = 161) and Butaritari (n = 307) using a 24-hour dietary recall. Nutrient adequacy ratios and mean adequacy ratios of selected nutrients were also determined from 3-day weighed food records collected among participants living in a further 28 households from South Tarawa (n = 29) and Butaritari (n = 44). RESULTS Based on the 24-hour dietary recall, the average energy intake for men and women was 2536 kcals and 2068 kcals, respectively. Carbohydrate (CHO), fat, and protein intakes for men and women were 332.5 g, 76.5 g, and 130.4 g and 291.7 g, 55.1 g, and 103.5 g, respectively. The mean and standard deviation of household Food Variety Score and Dietary Diversity Score was 3.90 ± 1.25 and 5.44 ± 1.92, respectively. Intakes of vitamin A, calcium, and iron, and zinc were notably deficient in both locations, with the urban participants having lower intakes of vitamin B-1, vitamin B-2, magnesium, and potassium than their rural counterparts. Mean sodium intakes exceeded recommendations for all age groups in South Tarawa except children aged 4 to 6 years. CONCLUSIONS Food consumption patterns of the households in South Tarawa and Butaritari reflected high consumption of nontraditional diets and refined foods, which manifested in inadequate micronutrient intake estimates and low dietary diversity: strong risk factors for noncommunicable diseases such as obesity and diabetes.
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Affiliation(s)
- Paul Eze Eme
- Department of Nutrition and Dietetics, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Nick D Kim
- School of Health Sciences, College of Health, Massey University, Wellington, New Zealand
| | - Jerone Douwes
- Centre of Public Health Research, Massey University, Wellington, New Zealand
| | - Barbara Burlingame
- Department of Nutrition and Dietetics, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Sunia Foliaki
- Centre of Public Health Research, Massey University, Wellington, New Zealand
| | - Carol Wham
- School of Sport, Exercise and Nutrition, College of Health, Massey University, North Shore City, Auckland, New Zealand
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Casale D, Espi G, Norris SA. The predictors of different measures of dietary diversity among one-year-olds in South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2019. [DOI: 10.1080/16070658.2019.1612653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Daniela Casale
- School of Economic and Business Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Gabriel Espi
- School of Economic and Business Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- MRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
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Kasimba S, Covic N, Motswagole B, Laubscher R, Claasen N. Consumption of Traditional and Indigenous Foods and Their Contribution to Nutrient Intake among Children and Women in Botswana. Ecol Food Nutr 2019; 58:281-298. [PMID: 30957545 DOI: 10.1080/03670244.2019.1598980] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In Botswana, traditional diets are gradually being replaced by westernized diets high in energy-dense and nutrient- poor, while micro nutrient deficiencies among the population remain. We determined the consumption of traditional and indigenous foods (TIF) and their contribution to nutrient intake among children and women in Botswana. TIF accounted for relatively high percentages of energy intake in children (41%) and women (36%) respectively. The mean intake of vitamin A in children and vitamin A and zinc in women was high from TIF compared to non-TIF. Research attention to determining the full potential of TIF in contributing to nutrition and health is warranted.
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Affiliation(s)
- Salome Kasimba
- a Centre of Excellence for Nutrition (CEN) , North-West University , Potchefstroom , South Africa
| | - Namukolo Covic
- b Poverty, Health and Nutrition Division , International Food and Policy Research Institute , Addis Ababa , Ethiopia
| | - Boitumelo Motswagole
- c Department of Nutrition and Dietetics , National Food Technology Research Centre (NFTRC) , Botswana
| | - Ria Laubscher
- d Biostatics' Unit , Medical Research , Tygerberg , South Africa
| | - Nicole Claasen
- e Africa Unit for Transdisciplinary Health Research (AUTHeR) , North-West University , Potchefstroom , South Africa
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Napier CE, Oldewage-Theron WH, Grobbelaar HH. Testing of developed Food Based Dietary Guidelines for the elderly in South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2017. [DOI: 10.1080/16070658.2017.1388560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- CE Napier
- Food and Nutrition, Durban University of Technology – Steve Biko Campus , Durban, South Africa
| | - WH Oldewage-Theron
- Department of Nutritional Sciences, Texas Tech University , Lubbock, TX, USA
| | - HH Grobbelaar
- Food and Nutrition, Durban University of Technology – Steve Biko Campus , Durban, South Africa
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Nutritional status and the influence of TV consumption on female body size ideals in populations recently exposed to the media. Sci Rep 2017; 7:8438. [PMID: 28814743 PMCID: PMC5559456 DOI: 10.1038/s41598-017-08653-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/17/2017] [Indexed: 11/23/2022] Open
Abstract
Television consumption influences perceptions of attractive female body size. However, cross-cultural research examining media influence on body ideals is typically confounded by differences in the availability of reliable and diverse foodstuffs. 112 participants were recruited from 3 Nicaraguan villages that differed in television consumption and nutritional status, such that the contribution of both factors could be revealed. Participants completed a female figure preference task, reported their television consumption, and responded to several measures assessing nutritional status. Communities with higher television consumption and/or higher nutritional status preferred thinner female bodies than communities with lower television consumption and/or lower nutritional status. Bayesian mixed models estimated the plausible range of effects for television consumption, nutritional status, and other relevant variables on individual preferences. The model explained all meaningful differences between our low-nutrition villages, and television consumption, after sex, was the most likely of these predictors to contribute to variation in preferences (probability mass >95% when modelling only variables with zero-order associations with preferences, but only 90% when modelling all possible predictors). In contrast, we found no likely link with nutritional status. We thus found evidence that where media access and nutritional status are confounded, media is the more likely predictor of body ideals.
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Kiboi W, Kimiywe J, Chege P. Determinants of dietary diversity among pregnant women in Laikipia County, Kenya: a cross-sectional study. BMC Nutr 2017. [DOI: 10.1186/s40795-017-0126-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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16
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Linking farm diversification to household diet diversification: evidence from a sample of Kenyan ultra-poor farmers. Food Secur 2016. [DOI: 10.1007/s12571-016-0617-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Cheng Y, Rosenberg M, Yu J, Zhang H. Food security for community-living elderly people in Beijing, China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:747-757. [PMID: 26094641 DOI: 10.1111/hsc.12255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 06/04/2023]
Abstract
Food security has been identified as an important issue for elderly people's quality of life and ageing in place. A food security index composed of three indicators (food intake, food quality and food affordability) was developed to measure the food security status of community-living elderly people. Food security was then examined among community-living elderly in the central urban districts of Beijing, China. Data were collected by a questionnaire survey in the summer of 2013 and the response rate was 78.5%. Descriptive statistics and binary logistic regression were applied to analyse food security and the associations between food security and demographic and socioeconomic factors. The results showed that 54.2% of the surveyed elderly experienced food security. Participants with better education (OR = 1.68) and better health (OR = 1.47) were more likely to experience food security. The young-old were less likely to experience food security than the older old (OR = 0.94). Elderly people who lived with their children were less likely to experience food security than those who lived alone (OR = 0.43). The results of impact factors on food security highlight both similarities with studies from more developed countries and the unique challenges faced in a rapidly changing China with its unique social, cultural and political systems. The food security index we developed in this study is a simple and effective measure of food security status, which can be used in surveys for evaluating the food security status of elderly people in the future.
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Affiliation(s)
- Yang Cheng
- School of Geography, Beijing Normal University, Beijing, China.
| | - Mark Rosenberg
- Department of Geography, Queen's University, Kingston, Ontario, Canada
| | - Jie Yu
- Department of Geography, Queen's University, Kingston, Ontario, Canada
| | - Hua Zhang
- School of Geography, Beijing Normal University, Beijing, China
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Tavakoli S, Dorosty-motlagh AR, Hoshiar-Rad A, Eshraghian MR, Sotoudeh G, Azadbakht L, Karimi M, Jalali-Farahani S. Is dietary diversity a proxy measurement of nutrient adequacy in Iranian elderly women? Appetite 2016; 105:468-76. [DOI: 10.1016/j.appet.2016.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 05/24/2016] [Accepted: 06/08/2016] [Indexed: 11/24/2022]
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Basu N, Clarke E, Green A, Calys-Tagoe B, Chan L, Dzodzomenyo M, Fobil J, Long RN, Neitzel RL, Obiri S, Odei E, Ovadje L, Quansah R, Rajaee M, Wilson ML. Integrated assessment of artisanal and small-scale gold mining in Ghana--part 1: human health review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:5143-76. [PMID: 25985314 PMCID: PMC4454960 DOI: 10.3390/ijerph120505143] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 04/27/2015] [Accepted: 05/08/2015] [Indexed: 12/28/2022]
Abstract
This report is one of three synthesis documents produced via an integrated assessment (IA) that aims to increase understanding of artisanal and small-scale gold mining (ASGM) in Ghana. Given the complexities surrounding ASGM, an IA framework was utilized to analyze economic, social, health, and environmental data, and co-develop evidence-based responses with pertinent stakeholders. The current analysis focuses on the health of ASGM miners and community members, and synthesizes extant data from the literature as well as co-authors' recent findings regarding the causes, status, trends, and consequences of ASGM in Ghana. The results provide evidence from across multiple Ghanaian ASGM sites that document relatively high exposures to mercury and other heavy metals, occupational injuries and noise exposure. The work also reviews limited data on psychosocial health, nutrition, cardiovascular and respiratory health, sexual health, and water and sanitation. Taken together, the findings provide a thorough overview of human health issues in Ghanaian ASGM communities. Though more research is needed to further elucidate the relationships between ASGM and health outcomes, the existing research on plausible health consequences of ASGM should guide policies and actions to better address the unique challenges of ASGM in Ghana and potentially elsewhere.
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Affiliation(s)
- Niladri Basu
- Faculty of Agricultural and Environmental Sciences, McGill University, CINE Building Macdonald Campus of McGill University, 21,111 Lakeshore Rd., Ste. Anne de Bellevue, QC H9X 3V9, Canada.
| | | | - Allyson Green
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | | | - Laurie Chan
- Faculty of Science, Department of Biology, University of Ottawa, ON K1N 6N5, Canada.
| | - Mawuli Dzodzomenyo
- Department of Biological, Environmental, and Occupational Health Sciences, School of Public Health, University of Ghana, Legon Boundary, Accra, Ghana.
| | - Julius Fobil
- Department of Biological, Environmental, and Occupational Health Sciences, School of Public Health, University of Ghana, Legon Boundary, Accra, Ghana.
| | - Rachel N Long
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | - Richard L Neitzel
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | - Samuel Obiri
- Council for Scientific and Industrial Research-Water Research Institute, Accra, Ghana.
| | | | - Lauretta Ovadje
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | - Reginald Quansah
- Department of Biological, Environmental, and Occupational Health Sciences, School of Public Health, University of Ghana, Legon Boundary, Accra, Ghana.
- Noguchi Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Boundary, Accra, Ghana.
| | - Mozhgon Rajaee
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | - Mark L Wilson
- Department of Epidemiology, Department of Ecology and Evolutionary Biology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
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Hondras M, Myburgh C, Hartvigsen J, Haldeman S, Johannessen H. How can we assess the burden of muscle, bone and joint conditions in rural Botswana: context and methods for the MuBoJo focused ethnography. Chiropr Man Therap 2015; 23:11. [PMID: 25780559 PMCID: PMC4361207 DOI: 10.1186/s12998-015-0056-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/27/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Musculoskeletal diseases are the most common causes of long-term pain and disability worldwide and a growing international public health concern. However, the everyday burden and impact of musculoskeletal conditions are not well understood, especially among people living in low- and middle-income countries in Africa. Since 2011, World Spine Care, a nongovernmental organisation, has collaborated with the Botswana Ministry of Health to open spine care centres and to conduct research. The broad aim of the Muscle, Bone and Joint (MuBoJo) research project is to examine the sociocultural, organisational and clinical characteristics for the burden of living with and caring for people living with musculoskeletal conditions in rural Botswana. In this paper, we describe the community context, theoretical framework, and research methods to address the project aim with a qualitative study. METHODS/DESIGN This focused ethnography is based on eight months (November 2011, April 2013, October 2013-March 2014) of fieldwork in Botswana. The project was theoretically informed by the concepts of explanatory models of illness, social suffering, and biographical disruption. Data collection included fieldnotes, non-participant and participant observations, and informal and in-depth interviews with villagers and healthcare providers. Villager interviews were typically conducted in Setswana with an interpreter. Audio recordings were transcribed verbatim in the language spoken with Setswana contextually translated into English. Computer software supported qualitative data management. Analysis is ongoing using constant comparison and a template organising style to facilitate pattern-finding and reveal insights for the burden and care of musculoskeletal conditions. DISCUSSION Findings from the MuBoJo Project will document the context of musculoskeletal burden, illness beliefs, self-care behaviours, and healthcare options in a Botswana rural village. These data will inform ongoing efforts to establish spine care clinics for underserved populations in low-middle income countries and sustain these healthcare services through local providers and volunteer health professionals. This study also will generate new knowledge about the burden and impact of muscle, bone and joint disorders for cross-cultural comparisons and patient-centred interventions. CONCLUSIONS Our systematic and transparent methodology to conduct musculoskeletal research in more than one language and in a cross-cultural setting may be useful for investigators and NGO healthcare personnel.
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Affiliation(s)
- Maria Hondras
- />Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, Odense M, Denmark
- />World Spine Care, 801 North Tustin Avenue, Suite 202, Santa Ana, California, USA
| | - Corrie Myburgh
- />Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, Odense M, Denmark
| | - Jan Hartvigsen
- />Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, Odense M, Denmark
- />World Spine Care, 801 North Tustin Avenue, Suite 202, Santa Ana, California, USA
- />Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, Odense M, Denmark
| | - Scott Haldeman
- />World Spine Care, 801 North Tustin Avenue, Suite 202, Santa Ana, California, USA
- />Department of Neurology, University of California, Irvine, California USA
- />Department of Epidemiology, School of Public Health, University of California, Los Angeles, California USA
| | - Helle Johannessen
- />Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000 Odense C, Denmark
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Narmaki E, Siassi F, Fariba Koohdani, Qorbani M, Shiraseb F, Ataie-Jafari A, Sotoudeh G. Dietary diversity as a proxy measure of blood antioxidant status in women. Nutrition 2014; 31:722-6. [PMID: 25837219 DOI: 10.1016/j.nut.2014.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 12/09/2014] [Accepted: 12/09/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Dietary diversity is recognized as a key indicator of dietary quality. However, its association with blood antioxidant levels has not been investigated. The aim of this study was to assess the association of the dietary diversity score (DDS) with blood antioxidant status in women who attend the sports clubs of a municipality in western Tehran, Iran. METHODS A cross-sectional survey was conducted with 397 randomly selected women from the sport clubs of a Tehran municipality. Sociodemographic data were recorded and the women's weight and height were measured. Body mass index (BMI) was calculated by dividing the weight (kg) by height squared (m(2)). A 24-h recall questionnaire was used to estimate food intake. Biochemical indices, including serum total antioxidant capacity (TAC) and erythrocyte activities of glutathione peroxidase (GPx) and superoxide dismutase (SOD), were measured in 90 women selected randomly from all participants. DDS was computed according to the guidelines of the Food and Agriculture Organization. The mean of SOD, TAC and GPx were compared across DDS quartiles after adjustment for age, education level, physical activity, energy intake, and BMI using analysis of covariance test. RESULTS The mean of TAC, SOD, and GPx was linearly increased with increasing the quartile of DDS, after adjustment for age, education level, physical activity, energy intake, and BMI (Ptrend < 0.001). Significant differences were observed for intake of different food groups, except cereals and white roots, between the DDS quartiles. CONCLUSION DDS is associated with blood antioxidant markers. Increasing the dietary diversity might be associated with a reduction in oxidative stress.
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Affiliation(s)
- Elham Narmaki
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereydoun Siassi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Koohdani
- Department of Cellular, Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Department of Community Medicine, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran; Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Asal Ataie-Jafari
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Nutrition, Faculty of Medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Diet quality score is a predictor of type 2 diabetes risk in women: the Australian Longitudinal Study on Women's Health. Br J Nutr 2014; 112:945-51. [PMID: 25201303 DOI: 10.1017/s0007114514001688] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The present study aimed to determine the ability of two diet quality scores to predict the incidence of type 2 diabetes in women. The study population comprised a nationally representative sample of 8370 Australian middle-aged (45-50 years) women participating in the ALSWH (Australian Longitudinal Study on Women's Health), who were free of diabetes and completed FFQ at baseline. The associations between the Australian Recommended Food Score (ARFS) and Dietary Guideline Index (DGI) with type 2 diabetes risk were assessed using multiple logistic regression models, adjusting for sociodemographic characteristics, lifestyle factors and energy intake. During 6 years of follow-up, 311 incident cases of type 2 diabetes were reported. The DGI score was inversely associated with type 2 diabetes risk (OR comparing the highest with the lowest quintile of DGI was 0·51; 95% CI 0·35, 0·76; P for trend = 0·01). There was no statistically significant association between the ARFS and type 2 diabetes risk (OR comparing the highest with the lowest quintile of ARFS was 0·99; 95% CI 0·68, 1·43; P for trend = 0·42). The results of the present prospective study indicate that the DGI score, which assesses compliance with established dietary guidelines, is predictive of type 2 diabetes risk in Australian women. The risk of type 2 diabetes among women in the highest quintile of DGI was approximately 50% lower than that in women in the lowest quintile. The ARFS was not significantly predictive of type 2 diabetes.
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Kimura M, Moriyasu A, Kumagai S, Furuna T, Akita S, Kimura S, Suzuki T. Community-based intervention to improve dietary habits and promote physical activity among older adults: a cluster randomized trial. BMC Geriatr 2013; 13:8. [PMID: 23343312 PMCID: PMC3560222 DOI: 10.1186/1471-2318-13-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 01/12/2013] [Indexed: 11/10/2022] Open
Abstract
Background The fastest growing age group globally is older adults, and preventing the need for long-term nursing care in this group is important for social and financial reasons. A population approach to diet and physical activity through the use of social services can play an important role in prevention. This study examined the effectiveness of a social health program for community-dwelling older adults aimed at introducing and promoting physical activity in the home at each individual’s pace, helping participants maintain good dietary habits by keeping self-check sheets, and determining whether long-standing unhealthy or less-than-ideal physical and dietary habits can be changed. Method This cluster randomized trial conducted at 6 community centers in an urban community involved 92 community-dwelling older adults aged 65–90 years. The intervention group (3 community centers; n = 57) participated in the social health program “Sumida TAKE10!” which is an educational program incorporating the “TAKE10!® for Older Adults” program, once every 2 weeks for 3 months. The control group (3 community centers; n=35) was subsequently provided with the same program as a crossover intervention group. The main outcome measures were changes in food intake frequency, food frequency score (FFS), dietary variety score (DVS), and frequency of walking and exercise. The secondary outcome measures were changes in self-rated health, appetite, and the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence score. Results Compared to baseline, post-intervention food intake frequency for 6 of 10 food groups (meat, fish/shellfish, eggs, potatoes, fruits, and seaweed), FFS, and DVS were significantly increased in the intervention group, and interaction effects of FFS and DVS were seen between the two groups. No significant differences were observed between baseline and post-intervention in the control group. Frequency of walking and exercise remained unchanged in both groups, and no significant difference in improvement rate was seen between the groups. Self-rated health was significantly increased in the intervention group. Appetite and TMIG Index of Competence score were unchanged in both groups. Conclusions The social health program resulted in improved dietary habits, as measured by food intake frequency, FFS, and DVS, and may improve self-rated health among community-dwelling older adults. Trial registration number UMIN000007357
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Affiliation(s)
- Mika Kimura
- Center for Health Promotion, International Life Sciences Institute Japan, Nishikawa Bldg, 3-5-19 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan.
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Zainal Badari SA, Arcot J, Haron SA, Paim L, Sulaiman N, Masud J. Food Variety and Dietary Diversity Scores to Understand the Food-Intake Pattern among Selected Malaysian Households. Ecol Food Nutr 2012; 51:265-99. [DOI: 10.1080/03670244.2012.674445] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lee MS, Huang YC, Su HH, Lee MZ, Wahlqvist ML. A simple food quality index predicts mortality in elderly Taiwanese. J Nutr Health Aging 2011; 15:815-21. [PMID: 22159767 DOI: 10.1007/s12603-011-0081-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To assess the relative predictive ability for mortality of the Overall Dietary Index-Revised (ODI-R) and the Dietary Diversity Score (DDS) among representative Taiwanese aged 65 and older. DESIGN Prospective cohort. SETTING The Elderly Nutrition and Health Survey in Taiwan during 1999-2000. PARTICIPANTS One thousand seven hundred forty three (860 men and 883 women). MEASUREMENTS Dietary quality measures, the ODI-R (0-100) and DDS (0-6) were based on 24-hour dietary recall and a food frequency questionnaire at baseline. Death by National Death Registry up to 2008 was the outcome measure. RESULTS During follow-up, 624 subjects died. The survivors had both significantly higher (P <0.001) ODI-R (66.9 vs. 63.6) and DDS (4.69 vs. 4.30) than the deceased. The two indices were correlated (r=0.46). After adjustment for potential covariates, the hazard ratios (HR) (95% CI) were 0.63 (0.42-0.97), 0.71 (0.49-1.04) and 0.53 (0.37-0.76) for those whose ODI-R scores were 60-65, 65-70, >70, respectively, compared to those whose ODI-R scores were > 50 (P for trend <0.001). For DDS, the multi-variable HRs (95% CI) were 0.74 (0.55-1.00), 0.52 (0.38-0.72) and 0.50 (0.31-0.81) for those whose DDS were 4, 5, 6, respectively, compared to those whose DDS were ≤3 (P for trend<0.001). Total cancer, diabetes mortalities and pneumonia were similarly benefited according to trends. CONCLUSION ODI-R ≥ 60, and DDS ≥ 4 are predictors of all-cause and cause-specific mortalities. Of the two, DDS is the more predictive. Nutrition policy could be informed and clinical practice enhanced by these population relevant food-health relationships.
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Affiliation(s)
- M-S Lee
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.
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Socio-economic status and urbanization are linked to snacks and obesity in adolescents in Botswana. Public Health Nutr 2011; 14:2260-7. [PMID: 21806869 DOI: 10.1017/s1368980011001339] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe patterns of food consumption associated with overweight/obesity (OW/OB) and their links to socio-economic status (SES) and urbanization. DESIGN A nationwide cross-sectional survey. SETTING Secondary schools in cities, towns and villages in Botswana, Africa. SUBJECTS A total of 746 adolescent schoolchildren. RESULTS OW/OB is associated with greater SES, city residence and a snack-food diet pattern. Students belonging to higher SES compared with those from a lower SES background reported significantly (P < 0·01) more daily servings of snack foods (1·55 v. 0·76) and fewer servings of traditional diet foods (0·99 v. 1·68) and also reported that they ate meals outside the home more often (90% v. 72%). Students in cities ate significantly (P < 0·01) more servings of snacks (1·69 v. 1·05 v. 0·51) and fewer servings of traditional foods (0·67 v. 1·52 v. 1·61) compared with those in urban and rural villages. The odds of OW/OB were increased 1·16-fold with a snack-food diet, a result that was diminished when controlled for SES. CONCLUSIONS These data suggest that nutritional transition occurs at different rates across urbanization and SES levels in Botswana. In cities, increasing the availability of fruit while reducing access to or portion sizes of snack items is important. Emphasis on continued intake of traditional foods may also be helpful as rural areas undergo economic and infrastructural development.
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Oldewage-Theron W, Kruger R. Dietary diversity and adequacy of women caregivers in a peri-urban informal settlement in South Africa. Nutrition 2011; 27:420-7. [DOI: 10.1016/j.nut.2010.05.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Revised: 04/23/2010] [Accepted: 05/09/2010] [Indexed: 11/16/2022]
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Oldewage Theron WH, Kruger R. Impact of food aid on food variety and dietary diversity of an elderly community in Sharpeville, South Africa. J Nutr Health Aging 2009; 13:300-8. [PMID: 19300864 DOI: 10.1007/s12603-009-0027-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objective of this paper was to discuss the impact of a two-year food aid intervention programme on dietary diversity and adequacy of an elderly community. This project was undertaken amongst the elderly (n=300), voluntarily attending a day care centre in Sharpeville, South Africa. In a baseline study (2004) in this community the dietary diversity scoring (DDS) method revealed low dietary diversity (3.41) and food variety (4.77) scores (FVS), and a trend that higher scores resulted in a better mean nutrient adequacy ratio. An intervention study, implemented in 2005, aimed to improve the dietary diversity of this elderly community by providing breakfast and lunch five days a week at the care centre. The impact of this food aid was investigated by comparing the DDS, FVS and nutrient adequacy ratios (NAR) before and after the intervention. METHODS The methods included socio-demographic, health, food frequency questionnaire (FFQ), 24 hour-recall (24h-recall), anthropometric and biochemical measurements in 107 elderly people who regularly attended the care centre since 2004. RESULTS At baseline, the majority of respondents (n=82, 55.1%) were classified with low DDS utilizing 0-3 food groups compared to after the intervention, where 98.1% (n=105) was classified with a high dietary diversity utilizing all nine nutritious food groups. The mean individual DDS of 3.41 that improved to 8.5 after the intervention further supported this. The mean adequacy ratio (MAR) showed a statistically significant improvement from baseline (0.77 +/- 0.48) to 1.02 +/- 0.66 after the intervention, indicating improvement of the adequacy of the overall diet to meet the daily requirements for this elderly community. CONCLUSIONS The results of this study represent the first demonstration that food aid proved to be an effective short term nutrition intervention that improved the level of dietary diversity. Other food-based approaches or nutrition education activities should be implemented simultaneously to improve self-sufficiency in such a community for long-term effectiveness in terms of nutrient inadequacy and dietary diversity.
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Affiliation(s)
- W H Oldewage Theron
- Institute of Sustainable Livelihoods, Vaal University of Technology, Private Bag X021, Vanderbijlpark.
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McGarry DK, Shackleton CM. Children navigating rural poverty: Rural children's use of wild resources to counteract food insecurity in the Eastern Cape, South Africa. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/10796120802677594] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
The proportion of the population that is > or = 60 years of age in sub-Saharan Africa (SSA) is increasing rapidly and is likely to constrain healthcare systems in the future. Nevertheless, the elderly are not a health policy priority for African countries. This paper reviews the nutritional and health status of older adults in SSA and their determinants. Literature was abstracted through the Medline, Google Scholar, and Dogpile databases using the following search terms: sub-Saharan Africa, older adults, nutrition, health. Findings showed that up to half (6-48%) of elderly Africans in SSA are underweight and almost a quarter (2.5-21%) are overweight, while 56% of older South Africans are obese. Low-quality diets contribute to poor nutritional status. Poverty, HIV/AIDS, and complex humanitarian emergencies are major determinants of undernutrition. Effective interventions need to consider socioeconomic, health, and demographic factors; social pensions may be the most cost-effective option for improving the health and nutritional status of the elderly in SSA.
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Affiliation(s)
- Ruth W Kimokoti
- Department of Family Medicine, Boston University School of Medicine, Boston, MA 02118, USA.
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Oldewage-Theron WH, Kruger R. Food variety and dietary diversity as indicators of the dietary adequacy and health status of an elderly population in Sharpeville, South Africa. ACTA ACUST UNITED AC 2009; 27:101-33. [PMID: 18928193 DOI: 10.1080/01639360802060140] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This cross-sectional, analytical study was a comprehensive health assessment focusing on dietary quality of 170 randomly selected elderly respondents in Sharpeville, South Africa. The methods included a sociodemographic, health food frequency questionnaire, 24h-recall questionnaires, and anthropometric and biochemical measurements. The low mean +/- standard deviation (SD) dietary diversity score (3.41 +/- 1.34) and food variety score (4.77 +/- 2.2) compared with poverty parameters confirmed household food insecurity in this community. Although three (n = 99, 58.6%) or two (n = 49, 28.9%) daily meals were mostly consumed, these were mainly carbohydrate-based and nutrient-deficient. The cereal group (2.01 +/- 0.81) had the highest mean food variety score +/- SD, followed by dairy (0.62 +/- 0.53) and flesh foods (0.40 +/- 0.53). When a mean adequacy ratio of 70% was used as a cut-off point for nutrient adequacy, it was found that the food variety score must be eight or higher and the dietary variety score must be at least six. These indicators thus have a high ability to identify those respondents with an inadequate diet but lower ability to identify those respondents with a nutritionally adequate diet. The data further showed a trend that with a higher food variety and dietary diversity, a better mean adequacy ratio is reached for this low-income group of elderly subjects. In conclusion, the results showed that food variety and dietary diversity scores give a fairly good assessment of the adequacy of the diet, and scoring dietary diversity is a significant, yet simple tool to identify elderly persons at risk of food and nutrition insecurity.
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Affiliation(s)
- Wilna H Oldewage-Theron
- Institute of Sustainable Livelihoods, Vaal University of Technology, Vanderbijlpark, South Africa.
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Maruapula S, Chapman-Novakofski K. Health and dietary patterns of the elderly in Botswana. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2007; 39:311-319. [PMID: 17996626 DOI: 10.1016/j.jneb.2007.07.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2007] [Revised: 07/06/2007] [Accepted: 07/13/2007] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To describe associations among socioeconomic conditions and dietary patterns of Botswana elderly. DESIGN Secondary analysis from a cross-sectional nationwide survey. PARTICIPANTS Subjects (N = 1086, 60-99 years old) were selected after multistage sampling. MAIN OUTCOME MEASURES Dietary patterns were dependent variables; health and socioeconomic variables were independent variables. ANALYSIS Factor analysis with varimax rotation; least squares regression. RESULTS The most widely consumed food items were tea (91%), sorghum (82%), and maize-meal (63%). Five dietary patterns emerged: beer; meat/fruit; vegetable/bread; seasonal produce; and milk/tea/candy patterns. Elderly women, those attending church, and those living with grandchildren were less associated with the Beer Pattern. The Vegetable and Bread Pattern was more common among grandparents living with children and those living in towns (urban). Widowed elders were less likely to consume meat/fruit (P < .005). Half had a large family size (6 to 10 children), with about 30% supporting 1 to 5 children. CONCLUSIONS AND IMPLICATIONS Dietary patterns suggested both food to be emphasized in nutrition education programs and those who may benefit most. Nutrition education efforts in Botswana should focus on improving food diversity, with particular targeting of widowed elderly and those in rural areas, and on increasing vegetable, fruit, meat, and milk intake.
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Clausen T, Wilson AO, Molebatsi RM, Holmboe-Ottesen G. Diminished mental- and physical function and lack of social support are associated with shorter survival in community dwelling older persons of Botswana. BMC Public Health 2007; 7:144. [PMID: 17615069 PMCID: PMC1925080 DOI: 10.1186/1471-2458-7-144] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2007] [Accepted: 07/05/2007] [Indexed: 11/10/2022] Open
Abstract
Background Mortality rates for older persons in Botswana have been unavailable and little is known of predictors of mortality in old age. This study may serve as a precursor for more detailed assessments. The objective was to assess diminished function and lack of social support as indicators of short term risk of death. Methods A national population based prospective survey was undertaken in Botswana; twelve rural areas and three urban centers were included. 372 community-dwelling persons aged sixty years and over, were included; 265 were followed-up. Sixteen subjects were deceased at follow-up. Subjects were interviewed and clinically assessed at home. Measures of cognitive function, depression and physical function and sociodemographic information were collected. Subjects were followed-up at average 6.8 months after baseline. Results Overall mortality rate was 10.9 per 100 person years. Age-adjusted odds ratios (OR) for death during follow-up were; 4.2 (CI 1.4–12.5) and 3.6 (CI 1.0–12.7) for those with diminished physical- and cognitive function, respectively. Indicators of limited social support; household with only 1 or 2 persons and eating alone, yielded age adjusted ORs of 4.3 (CI 1.5–12.5) and 6.7 (CI 2.2–20), respectively, for death during follow-up. Conclusion Older community dwelling persons with diminished cognitive- or physical function, solitary daily meals and living in a small household have a significantly increased risk of rapid deterioration and death. Health policy should include measures to strengthen informal support and expand formal service provisions to older persons with poor function and limited social networks in order to prevent premature deaths.
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Affiliation(s)
- Thomas Clausen
- University of Oslo, Institute of Psychiatry, Oslo, Norway
| | - Adrian O Wilson
- The African Foundation for Research and Interdisciplinary Training in Ageing (AFRITA), Harare, Zimbabwe
| | | | - Gerd Holmboe-Ottesen
- University of Oslo, Institute of General Practice and Community Medicine, Oslo, Norway
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Shannon J, Shikany JM, Barrett-Connor E, Marshall LM, Bunker CH, Chan JM, Stone KL, Orwoll E. Demographic factors associated with the diet quality of older US men: baseline data from the Osteoporotic Fractures in Men (MrOS) study. Public Health Nutr 2007; 10:810-8. [PMID: 17381915 DOI: 10.1017/s1368980007258604] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Throughout the world, the proportion of the male population aged 65 years and older is increasing. Yet, we have limited information regarding diet quality and predictors of diet quality in this segment of the population. The objectives of the current analyses are to describe the diet quality of a cohort of men >65 years of age, and identify lifestyle factors associated with poor diet quality. METHODS We present a cross-sectional analysis of the diet quality of 5928 men, aged 65-100 years, who are participants in the Osteoporotic Fractures in Men (MrOS) cohort study. Dietary intake was determined using a modified Block 98 food-frequency questionnaire. Diet quality was calculated using the previously validated Diet Quality Index-Revised (DQI-R). Univariate and multivariate modelling was used to estimate the variance in diet quality predicted by a number of sociodemographic factors, including age, race/ethnicity, body mass index (BMI), marital status, education, smoking status, physical activity, self-perceived health and nutritional supplement use. RESULTS Overall, we found that in this geographically diverse group of older men, diet quality was low, with a mean modified DQI-R for the entire study population of 62.5 (standard deviation 13.1) out of an ideal of 100. Further, younger age, very low total calorie intake (< or = 1187 kcal day- 1), higher BMI, residence in a North or Southeast community, being of African-American or Hispanic race, being less educated, not using dietary supplements and smoking were each significant independent predictors of a poorer diet. CONCLUSION These data may prove useful in both understanding the dietary intake of older US men as it relates to published dietary guidelines, and for targeting future dietary intervention programmes.
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Affiliation(s)
- J Shannon
- Oregon Health and Science University, Portland, OR, USA.
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Chul Ahn B, Engelhardt K, Joung H. Diet Variety is Associated With Socio-economic Factors. Ecol Food Nutr 2006. [DOI: 10.1080/03670240600985183] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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