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Herter-Aeberli I, Fischer MM, Egli IM, Zeder C, Zimmermann MB, Hurrell RF. Addition of Whole Wheat Flour During Injera Fermentation Degrades Phytic Acid and Triples Iron Absorption from Fortified Tef in Young Women. J Nutr 2020; 150:2666-2672. [PMID: 32805002 DOI: 10.1093/jn/nxaa211] [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: 04/14/2020] [Revised: 05/18/2020] [Accepted: 06/30/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Iron deficiency is a major public health concern in Ethiopia, where the traditional diet is based on tef injera. Iron absorption from injera is low due to its high phytic acid (PA) content. OBJECTIVES We investigated ways to increase iron absorption from FeSO4-fortified tef injera in normal-weight healthy women (aged 21-29 y). METHODS Study A (n = 22) investigated the influence on fractional iron absorption (FIA) from FeSO4-fortified injera of 1) replacing 10% tef flour with whole wheat flour (a source of wheat phytase), or 2) adding an isolated phytase from Aspergillus niger. Study B (n = 18) investigated the influence on FIA of replacing FeSO4 in tef injera with different amounts of NaFeEDTA. In both studies, the iron fortificants were labeled with stable isotopes and FIA was calculated from erythrocyte incorporation of stable iron isotopes 14 d after administration. RESULTS In study A, the median (IQR) FIA from the 100% tef injera meal was 1.5% (0.7-2.8%). This increased significantly (P < 0.05) to 5.3% (2.4-7.1%) on addition of 10% whole wheat flour, and to 3.6% (1.6-6.2%) on addition of A. niger phytase. PA content of the 3 meals was 0.62, 0.20, and 0.02 g/meal, respectively. In study B, the median (IQR) FIA from the 100% tef injera meal was 3.3% (1.1-4.4%) and did not change significantly (P > 0.05) on replacing 50% or 75% of FeSO4 with NaFeEDTA. CONCLUSIONS FIA from tef injera by young women was very low. NaFeEDTA was ineffective at increasing iron absorption, presumably due to the relatively low EDTA:Fe molar ratios. Phytate degradation, however, greatly increased during tef fermentation on addition of native or isolated phytases. Replacing 10% tef with whole wheat flour during injera fermentation tripled FIA in young women and should be considered as a potential strategy to improve iron status in Ethiopia.
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Affiliation(s)
- Isabelle Herter-Aeberli
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Maren M Fischer
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Ines M Egli
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Christophe Zeder
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Richard F Hurrell
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
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Vila-Real C, Pimenta-Martins A, Gomes AM, Pinto E, Maina NH. How dietary intake has been assessed in African countries? A systematic review. Crit Rev Food Sci Nutr 2017; 58:1002-1022. [PMID: 27996293 DOI: 10.1080/10408398.2016.1236778] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Dietary patterns are often considered as one of the main causes of non-communicable diseases worldwide. It is of utmost importance to study dietary habits in developing countries since this work is scarce. OBJECTIVE To summarize the most recent research conducted in this field in African countries, namely the most used methodologies and tools. METHODS A systematic review was conducted on MEDLINE®/PubMed, aiming to identify scientific publications focused on studies of dietary intake of different African populations, in a ten-year period. Papers not written in English/Portuguese/Spanish, studies developed among African people but not developed in African countries, studies aiming to assess a particular nutrient/specific food/food toxin and studies that assessed dietary intake among children were excluded. FINDINGS Out of 99 included studies, the 24-hour recall and the food-frequency questionnaire were the most used dietary intake assessment tools, used to assess diet at an individual level. It was also observed that often country-unspecific food composition databases are used, and the methodologies employed are poorly validated and standardized. CONCLUSIONS There is an emergent need to improve the existing food databases by updating food data and to develop suitable country-specific databases for those that do not have their own food composition table.
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Affiliation(s)
- Catarina Vila-Real
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal
| | - Ana Pimenta-Martins
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal
| | - Ana Maria Gomes
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal
| | - Elisabete Pinto
- a Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado , Escola Superior de Biotecnologia , Rua Arquiteto Lobão Vital, Porto , Portugal.,b Instituto de Saúde Pública, Universidade do Porto , Porto , Portugal
| | - Ndegwa Henry Maina
- c Division of Food Technology, Department of Food and Environmental Sciences , University of Helsinki , Helsinki , Finland
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Haidar J, Melaku U, Pobocik R. Folate deficiency in women of reproductive age in nine administrative regions of Ethiopia: an emerging public health problem. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2016. [DOI: 10.1080/16070658.2010.11734327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ben Gharbia H, Gartner A, Traissac P, Delpeuch F, Maire B, El Ati J. A frequency questionnaire to estimate free-living physical activity among Tunisian preadolescent and adolescent children. Public Health Nutr 2014; 17:2253-62. [PMID: 24124989 PMCID: PMC10282629 DOI: 10.1017/s1368980013002759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 08/31/2013] [Accepted: 09/04/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To develop a child- and adolescent-appropriate physical activity frequency questionnaire (PAFQ) in Tunisia, North Africa. DESIGN A PAFQ was developed from a physical activity (PA) inventory that comprised major activity components (at home, preparing meals, school time, transport, non-sport leisure, sports, prayer and sleeping time). Then, type and duration of each activity undertaken during the past week were estimated. Total energy expenditure (TEE) estimated by the PAFQ was compared with data derived from two criterion methods: heart-rate monitoring (HRM) and a 24 h PA recall (24h-R), both collected during a 3 d period including one weekday and two weekend days. SETTING Two elementary schools and two high schools of the most developed and urbanized area, Greater Tunis. SUBJECTS One hundred and forty-two volunteer children and adolescents aged 10-19 years. RESULTS The PAFQ strongly was correlated with both HRM (r = 0·70; 95% CI 0·62, 0·76) and 24h-R (r = 0·81; 95% CI 0·77, 0·84). It featured acceptable agreement with both criterion measures, slightly underestimating TEE compared with 24h-R (-2·8%, mean of individual differences -272·7 kJ/d; 95% CI -490·6, -57·4 kJ/d) and moderately overestimating it compared with HRM (+11·3%, mean of individual differences +1106·2 kJ/d; 95% CI 845·8, 1366·6 kJ/d). Reliability ranged from moderate to good (weighted kappa coefficients from 0·47 to 0·78 and intra-class correlation coefficients between 0·79 and 0·86 for energy expenditure by PA categories), indicating strong agreement between the two assessments. CONCLUSIONS This PAFQ could be useful in the description and surveillance of PA patterns or for the evaluation of population-based interventions directed at promoting PA in Tunisian children and adolescents.
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Affiliation(s)
- Houda Ben Gharbia
- Department of Studies and Planning, National Institute of Nutrition and Food Technology (INNTA), 11 rue Jebel Lakhdar, Bab Saadoun, 1007 Tunis, Tunisia
| | - Agnès Gartner
- Institut de Recherche pour le Développement (IRD), UMR 204 NUTRIPASS, IRD-UM2-UM1, Montpellier, France
| | - Pierre Traissac
- Institut de Recherche pour le Développement (IRD), UMR 204 NUTRIPASS, IRD-UM2-UM1, Montpellier, France
| | - Francis Delpeuch
- Institut de Recherche pour le Développement (IRD), UMR 204 NUTRIPASS, IRD-UM2-UM1, Montpellier, France
| | - Bernard Maire
- Institut de Recherche pour le Développement (IRD), UMR 204 NUTRIPASS, IRD-UM2-UM1, Montpellier, France
| | - Jalila El Ati
- Department of Studies and Planning, National Institute of Nutrition and Food Technology (INNTA), 11 rue Jebel Lakhdar, Bab Saadoun, 1007 Tunis, Tunisia
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Amare B, Moges B, Moges F, Fantahun B, Admassu M, Mulu A, Kassu A. Nutritional status and dietary intake of urban residents in Gondar, Northwest Ethiopia. BMC Public Health 2012; 12:752. [PMID: 22958394 PMCID: PMC3490783 DOI: 10.1186/1471-2458-12-752] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 09/04/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is paucity of data on the dietary intake and nutritional status of urban Ethiopians which necessitates comprehensive nutritional assessments. Therefore, the present study was aimed at evaluating the dietary intake and nutritional status of urban residents in Northwest Ethiopia. METHODS This cross-sectional community based nutrition survey was conducted by involving 356 participants (71.3% female and 28.7% male with mean age of 37.3 years). Subjects were selected by random sampling. Socio demographic data was collected by questionnaire. Height, weight, hip circumference and waist circumference were measured following standard procedures. Dietary intake was assessed by a food frequency questionnaire and 24-h dietary recall. The recommended dietary allowance was taken as the cut-off point for the assessment of the adequacy of individual nutrient intake. RESULTS Undernourished, overweight and obese subjects composed 12.9%, 21.3% and 5.9% of the participants, respectively. Men were taller, heavier and had higher waist to hip ratio compared to women (P < 0.05). Fish, fruits and vegetables were consumed less frequently or never at all by a large proportion of the subjects. Oil and butter were eaten daily by most of the participants. Mean energy intakes fell below the estimated energy requirements in women (1929 vs 2031 kcal/day, P = 0.05) while it was significantly higher in men participants (3001 vs 2510 kcal/day, P = 0.007). Protein intake was inadequate (<0.8 g/kg/day) in 11.2% of the participants whereas only 2.8% reported carbohydrate intake below the recommended dietary allowances (130 g/day). Inadequate intakes of calcium, retinol, thiamin, riboflavin, niacin and ascorbic acid were seen in 90.4%, 100%, 73%, 92.4%, 86.2% and 95.5% of the participants. CONCLUSIONS The overall risk of nutritional inadequacy among the study participants was high along with their poor dietary intake. Hence, more stress should be made on planning and implementing nutritional programmes in urban settings aimed at preventing or correcting micronutrient and some macronutrient deficiencies which may be useful in preventing nutrition related diseases in life.
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Affiliation(s)
- Bemnet Amare
- Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Beyene Moges
- Department of Immunology and Molecular Biology, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Feleke Moges
- Department of Microbiology, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Bereket Fantahun
- Department of Pediatrics, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mengesha Admassu
- Department of Environmental Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Andargachew Mulu
- Department of Microbiology, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Afework Kassu
- Department of Microbiology, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Nyuar KB, Khalil AKH, Crawford MA. Dietary intake of Sudanese women: a comparative assessment of nutrient intake of displaced and non-displaced women. Nutr Health 2012; 21:131-144. [PMID: 23275454 DOI: 10.1177/0260106012467244] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To determine the daily intake of essential micro- and macronutrients in Sudanese women, with specific focus on dietary fat and essential fatty acids, and compare the dietary intakes of internally displaced women with those of the non-displaced population. METHODS Dietary intakes of displaced southern (n=44) and non-displaced southern (n=30) and northern (n=39) Sudanese women were obtained by single 24-hour recall method, and daily nutrient intakes were calculated using 'Foodbase' nutritional software. The displaced women were recruited from Mayo and Soba Aradi camps, south of Khartoum city; and non-displaced southern and northern Sudanese women were recruited from antenatal clinics, universities, hospitals and the community in Khartoum city and Omdurman, Sudan. RESULTS Carbohydrates provided over 60% of dietary energy for all the Sudanese women groups. The displaced women had significantly lower intake of energy (1744 ± 344 kcal/d), starch (p<0.001) and carbohydrates (312 ± 11 g/d, p<0.01) than both non-displaced southern (1972 ± 229 kcal/d energy, 358 ± 56 g/d carbohydrates) and northern Sudanese women (1988 ± 226 kcal/d energy, 357 ± 56g/d carbohydrates). Fat intake was also lower in the displaced group (34.1 ± 11.9 g/d) than in the non-displaced counterpart (38.5 ± 10.2 g/d) (p<0.05), but was not significantly different from northern Sudanese women (37.6 ± 10.6, p>0.05). Intakes of iodine (33.60-56.96 µg/d), zinc (7.12-9.92 mg/d), retinol (226.1-349.7 µg/d), riboflavin (0.44-0.70 mg/d) and docosahexaenoic acid (11.70-33.49 mg/d) amongst Sudanese women were very low compared with recommendations. CONCLUSION The Sudanese diet was less diverse and differences in energy and nutrients intakes between groups were due to the amounts of food consumed. This view is supported by a lack of significant differences when intakes were expressed as proportion of whole energy between all groups of women.
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Affiliation(s)
- Kot B Nyuar
- Institute of Brain Chemistry and Human Nutrition, London Metropolitan University, London, UK.
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Jung JY, Han KA, Kwon HR, Ahn HJ, Lee JH, Park KS, Min KW. The usefulness of an accelerometer for monitoring total energy expenditure and its clinical application for predicting body weight changes in type 2 diabetic korean women. KOREAN DIABETES JOURNAL 2010; 34:374-83. [PMID: 21246011 PMCID: PMC3021114 DOI: 10.4093/kdj.2010.34.6.374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the usefulness of an accelerometer in predicting body weight (BW) change during a lifestyle intervention and to find out whether exercise or overall physical activity is associated with change in insulin sensitivity and body composition. METHODS A total of 49 overweight (body mass index [BMI] ≥ 23 kg/m(2)) women with diabetes were enrolled and performed lifestyle intervention while monitoring BW, total energy expenditure (TEE) and physical activity energy expenditure (PAEE) using an accelerometer, and energy intake (EI) using a three-day dietary record at baseline and every 2 weeks for 12 weeks. We assessed body composition using bioimpedance analysis and compared the actual BW change to the predicted BW change, which was calculated from the energy deficit (ED) between EI and TEE (ED = EI-TEE). RESULTS Mean age was 57.2 years, duration of diabetes was 8.0 years, and BMI was 27.8 kg/m(2). There was no significant difference between EI and TEE at baseline. For 12 weeks, the ED was 474.0 kcal·day(-1), which was significantly correlated with BW change (-3.1 kg) (r = 0.725, P < 0.001). However, the actual BW change was 50% lower than the predicted BW change. Both TEE and PAEE correlated with change in K(ITT) (r = 0.334, P = 0.019; r = 0.358, P = 0.012, respectively), BMI (r = -0.395, P = 0.005; r = -0.347, P = 0.015, respectively), and fat mass (r = -0.383, P = 0.007; r = -0.395, P = 0.005, respectively), but only TEE correlated with fat free mass change (r = -0.314, P = 0.030). CONCLUSION The accelerometer appears to be a useful tool for measuring TEE under free-living conditions for both short- and long-term periods.
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Affiliation(s)
- Ji Yeon Jung
- Diabetes Center, Eulji University Hospital, Seoul, Korea
| | - Kyung Ah Han
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Hwi Ryun Kwon
- Diabetes Center, Eulji University Hospital, Seoul, Korea
| | - Hee Jung Ahn
- Diabetes Center, Eulji University Hospital, Seoul, Korea
| | - Jae Hyuk Lee
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Kang Seo Park
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Kyung Wan Min
- Diabetes Center, Eulji University Hospital, Seoul, Korea
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
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Haidar JA, Pobocik RS. Iron deficiency anemia is not a rare problem among women of reproductive ages in Ethiopia: a community based cross sectional study. BMC BLOOD DISORDERS 2009; 9:7. [PMID: 19735547 PMCID: PMC2749016 DOI: 10.1186/1471-2326-9-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Accepted: 09/07/2009] [Indexed: 01/23/2023]
Abstract
BACKGROUND In Ethiopia, the existence of iron deficiency anemia is controversial despite the fact that Ethiopia is one of the least developed in Africa with a high burden of nutrient deficiencies. METHODS The first large nutrition study of a representative sample of women in Ethiopia was conducted from June to July 2005 and a systematically selected sub-sample of 970 of these subjects, 15 to 49 years old, were used in this analysis of nutritional anemia. Hemoglobin was measured from capillary blood using a portable HemoCue photometer. For serum ferritin, venous blood from antecubital veins was measured by an automated Elecsys 1020 using commercial kits. Diets were assessed via simplified food frequency questionnaire. The association of anemia to demographic and health variables was tested by chi-square and a stepwise backward logistic regression model was applied to test the significant associations observed in chi square tests. RESULTS Mean hemoglobin +/- SD was 11.5 +/- 2.1 g/dL with a 29.4% prevalence of anemia. Mean serum ferritin was 58 +/- 41.1 ug/L with a 32.1% prevalence of iron deficiency. The overall prevalence rate of iron deficiency anemia was 18.0%. Prevalence of anemia, iron deficiency, and iron deficiency anemia was highest among those 31-49 years old (p < 0.05). Intake of vegetables less than once a day and meat less than once a week was common and was associated with increased anemia (p = 0.001). Although the prevalence of anemia was slightly higher among women with parasitic infestation the difference was not significant (p = 0.9). Nonetheless, anemia was significantly higher in women with history of illness and the association was retained even when the variable was adjusted for its confounding effect in the logistic regression models (AOR = 0.3; 95%CI = 0.17 to 0.5) signifying that the most probable causes of anemia is nutrition related and to some extent chronic illnesses. CONCLUSION Moderate nutritional anemia in the form of iron deficiency anemia is a problem in Ethiopia and therefore, the need for improved supplementation to vulnerable groups is warranted to achieve the United Nation's Millennium Development Goals. Chronic illnesses are another important cause of anemia.
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Affiliation(s)
- Jemal A Haidar
- School of Public Health, Addis Ababa University, P.O. Box: 27285/1000, Addis Ababa, Ethiopia
- Ethiopian Health and Nutrition Research Institute, P.O. Box 5654, Addis Ababa, Ethiopia
| | - Rebecca S Pobocik
- School of Family and Consumer Sciences, Bowling Green State University and Northwest Ohio Consortium for Public Health, 302 Johnston Hall, Bowling Green, OH, 43403-0059, USA
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In this issue. Public Health Nutr 2008; 11:657. [DOI: 10.1017/s1368980008002863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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