Contribution of forest foods to dietary intake and their association with household food insecurity: a cross-sectional study in women from rural Cameroon

Even low levels of tree cover improve dietary quality in West Africa

Forests are attracting attention as a promising avenue to provide nutritious and "free" food without damaging the environment. Yet, we lack knowledge on the extent to which this holds in areas with sparse tree cover, such as in West Africa. This is largely due to the fact that existing methods are poorly designed to quantify tree cover in drylands. In this study, we estimate how various levels of tree cover across West Africa affect children's (aged 12-59 months) consumption of vitamin A-rich foods. We do so by combining detailed tree cover estimates based on PlanetScope imagery (3 m resolution) with Demographic Health Survey data from >15,000 households. We find that the probability of consuming vitamin A-rich foods increases from 0.45 to 0.53 with an increase in tree cover from the median value of 8.8 to 16.8% (which is the tree cover level at which the predicted probability of consuming vitamin A-rich foods is the highest). Moreover, we observe that the effects of tree cover vary across poverty levels and ecoregions. The poor are more likely than the non-poor to consume vitamin A-rich foods at low levels of tree cover in the lowland forest-savanna ecoregions, whereas the difference between poor and non-poor is less pronounced in the Sahel-Sudan. These results highlight the importance of trees and forests in sustainable food system transformation, even in areas with sparse tree cover.

Understanding the traditional values and use of okra among pregnant women in western Ethiopia: a qualitative study

OBJECTIVES

This study explored the traditional values and use of okra among pregnant women, how okra plants are obtained, prepared and used by pregnant women, and the associated beliefs and meanings attached to it in western Ethiopia.

DESIGN

Qualitative research.

SETTING

Rural areas of western Ethiopia.

PARTICIPANTS

A purposive sampling technique was used to select a total of 86 pregnant women (14 for in-depth interviews and 72 for focus group discussions) in western Ethiopia.

RESULTS

Traditionally okra is used as a source of income and is a common food for guests visiting homes. In line with this, pregnant women in the western part of Ethiopia mainly consumed okra pods. For future consumption and preservation for a long period, they usually transform okra into powder.

CONCLUSIONS

Other parts of the okra plant rather than pods are not known as a food source and are the most neglected food sources in rural districts of western Ethiopia. The study provides evidence that supports nutritional behavioural change communication interventions on promoting the utilisation of different parts of okra and awareness creation on the nutritional values of okra.

Is stunting in children under five associated with the state of vegetation in the Democratic Republic of the Congo? Secondary analysis of Demographic Health Survey data and the satellite-derived leaf area index

Background

The prevalence of stunting in the Democratic Republic of the Congo (DRC) is one of the highest globally. However, only a few studies have attempted to measure the association between stunting and vegetation, which is an important food source. The leaf area index (LAI) is an excellent measure for the vegetation state.

Objective

This paper intended to measure the association between the LAI and stunting among children under five years of age in the DRC. Its aim was to better understand the boundary conditions of stunting and explore potential links to climate and environmental change.

Methods

This paper adopts a secondary data analysis approach. We used data on 5241 children from the DRC Demographic Health Survey (DHS) 2013-2014, which was collected from a nationally representative cross-sectional survey. We used the satellite-derived LAI as a measure for the state of vegetation and created a 10-km buffer to extract each DHS cluster centroid's corresponding mean leaf-area value. We used a generalised mixed-effect logistic regression to measure the association between LAI and stunting, adjusting the model for mother's education, occupation and birth interval, as well as child's age and national wealth quintile. A height-for-age Z-score (HAZ) was calculated and classified according to WHO guidelines.

Results

Children in communities surrounded by high LAI values have lower odds of being stunted (OR [odds ratio] = 0.63; 95% CI [confidence interval] = 0.47-0.86) than those exposed to low LAI values. The association still holds when the exposure is analysed as a continuous variable (OR = 0.84; 95% CI = 0.74-0.95).When stratified in rural and urban areas, a significant association was only observed in rural areas (OR = 0.6; 95% CI = 0.39-0.81), but not in urban areas (OR = 0.9; 95% CI = 0.5-0.5). Furthermore, the study showed that these associations were robust to LAI buffer variations under 25 km.

Conclusions

Good vegetation conditions have a protective effect against stunting in children under five years of age. Further advanced study designs are needed to confirm these findings.

Importance of palm's heart for pregnant women

The consumption of locally nutrient-rich edible plants in rural areas can be used to satisfy the dietary diversity of pregnant women. Date palm is one of the wild edible plants in different parts of the world. Studies on wild edible plants in Ethiopia cover only about 5 % of the country's districts. Furthermore, the nutrient composition of the palm heart of Phoenix reclinata is not yet investigated as it is commonly consumed by indigenous people in western Ethiopia. The utilization of such plants requires strong policy support based on scientific evidence to maintain the nutrition security of pregnant women. Homogeneous samples of 1000 grams (g) of palm hearts were collected randomly. The macronutrient contents were determined using standard methods of the Association of Official Analytical Chemists (AOAC, 2000). The flame Photometric method was used for potassium and sodium determination. The carbohydrate concentration (g/100 g) was 78⋅2. It covers approximately 78⋅5 % of the total daily Recommended Dietary Allowance (RDA). In line with this, the concentrations of minerals such as potassium (K+) and sodium (Na+), per milligram (mg/100 g) of the sample were 1962⋅3 and 7⋅9, respectively. The palm heart of Phoenix reclinata has many nutritional values and is important for pregnant women. Its nutrient composition is comparable with different staple foods of the country and can contribute to household food security in rural communities.

Finding food in the hunger season: A mixed methods approach to understanding wild plant foods in relation to food security and dietary diversity in southeastern Madagascar

In many rural farming societies, wild plant foods (WPFs) continue to play an important role in everyday diets as well as in coping with hunger during food shortages. However, WPF collection and consumption may pose challenges to biodiversity conservation efforts (e.g., in protected areas), and some “famine foods,” foods not typically eaten under normal conditions, may have deleterious health impacts. Using data from a cross-sectional survey of 328 smallholder farmers and fisherfolk living in 15 villages surrounding Manombo Special Reserve on the southeastern coast of Madagascar, we examine the relationship between food security, dietary diversity, and consumption of WPFs, specifically giant aquatic arrowhead or via (Typhonodorum lindleyanum) and Polynesian arrowroot or tavolo (Tacca leontopetaloides), during the region's main lean season. We complement survey findings with focus group interviews to document traditional ecological knowledge and perceptions of these WPFs, including how tavolo and via are rendered edible, as well as human health effects from collecting, preparing, and eating them. Using multilevel logistic regression modeling, we found that consumption of these WPFs were significantly associated with inadequate nutrition among farmers. Wealthier households were less likely to consume these WPFs as a coping strategy during food insecure periods, while larger and more food insecure households were more likely to consume them. These findings reaffirm the importance of access to natural areas and support the design of protected area conservation strategies that honor local foodways and consider WPFs that serve as food safety nets for more vulnerable populations.

Assessment of Biodiversity in Food Consumption Studies: A Systematic Review

The assessment of food biodiversity has gained importance in nutrition due to the positive association between the diversity of foods consumed and the quality of diets. To date, however, we do not know systematically how food consumption studies address food biodiversity. Our objective with this paper was to characterize how food consumption studies address biodiverse foods, both in terms of (i) new methods capable of overcoming the limitations of existing methods, and (ii) indicators capable of measuring the contribution of biodiversity to nutrition. We conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), using four databases: Web of Science, Medline/PubMed (via National Library of Medicine), Scopus, and Google Scholar. We selected papers focused on the consumption of biodiverse foods without time constraints. In addition, we assessed the methodological quality of the studies we selected. We reviewed a total of 22 studies, and summarized the methods and indicators most used. We found that some researchers used biodiversity mapping strategies based on ethnographic approaches before the dietary assessment. Regarding dietary assessment tools, retrospective direct methods were the most used by researchers. We list 23 indicators used by the authors, among them the Dietary Species Richness (DSR), used in 18% of the studies. Studies that used biodiversity mapping strategies based on ethnographic approaches before the dietary assessment portrayed the local availability of biodiverse foods more consistently, i.e., presented lists with local edible species satisfactorily identified. We believe researchers in the future can avoid many of the limitations of current methods by ensuring that teams are interprofessional. We emphasize that most of the indicators we summarized are not sensitive enough to biodiversity since they do not measure edible resources at the species level. In this sense, the DSR is promising, because it fills information gaps, especially in the case of wild or neglected species.

Role of Wild Food Environments for Cultural Identity, Food Security, and Dietary Quality in a Rural American State

Wild foods are primary components of traditional and Indigenous food systems that are valued for food security while being vulnerable to global change. This case study examines practices, experiences, and perceptions associated with wild food environments through a household survey in the rural American state of Montana. Findings highlight that wild food environments contribute to cultural identity, sense of place, food security, and dietary quality of surveyed households while being vulnerable to loss of traditional ecological knowledge as well as climate and land-use change. Of the 182 informants, 80% hunt, 83% fish, and 68% forage wild botanicals. More than half of the informants agreed that wild food procurement is part of their cultural identity (66%). Collectively, informants procure more than 172 wild food species with the most prevalent being deer, waterfowl, elk, trout, bass, a range of berries, mushrooms, and botanicals used medicinally. Participants have a multidimensional value system where wild food procurement is valued for diets, recreation, family time, spirituality, and connection to the environment. The majority of participants agreed that the consumption of wild foods contributes to the nutritional quality (87%) and diversity (82%) of their diets while lowering food costs (59%). At least half of the informants reported observing changes in climate patterns over the past decade including increased temperature (50%) and more extreme and variable weather patterns (38%) that they perceive are impacting wild food environments including shifts in wild game, fish, and edible plant populations. Based on findings, we support that wild food environments and associated bio-cultural resources are a critical place to understand, conserve, and promote for nutrition. We thus advance the concept of “conservation for nutrition”. Community engagement, education, and policy plans are called for to promote wild food environments toward supporting sustainable diets and planetary health.

Deforestation reduces fruit and vegetable consumption in rural Tanzania

Two billion people across the planet suffer from nutrient deficiencies. Dietary diversification is key to solving this problem, yet many food and nutrition security policies, especially in low- and middle-income countries, still focus on increasing agricultural production and access to sufficient calories as the main solution. But calories are not all equal. Here, we show how deforestation in Tanzania caused a reduction in fruit and vegetable consumption (of 14 g per person per day) and thus vitamin A adequacy of diets. Using a combination of regression and weighting analyses to generate quasi-experimental quantitative estimates of the impacts of deforestation on people’s food intake, our study establishes a causal link between deforestation and people’s dietary quality.

Strategies to improve food and nutrition security continue to promote increasing food via agricultural intensification. Little (if any) consideration is given to the role of natural landscapes such as forests in meeting nutrition goals, despite a growing body of literature that shows that having access to these landscapes can improve people’s diets, particularly in rural areas of low- and middle-income countries. In this study, we tested whether deforestation over a 5-y period (2008–2013) affected people’s dietary quality in rural Tanzania using a modeling approach that combined two-way fixed-effects regression analysis with covariate balancing generalized propensity score (CBGPS) weighting which allowed for causal inferences to be made. We found that, over the 5 y, deforestation caused a reduction in household fruit and vegetable consumption and thus vitamin A adequacy of diets. The average household member experienced a reduction in fruit and vegetable consumption of 14 g⋅d⁻¹, which represented a substantial proportion (11%) of average daily intake. Conversely, we found that forest fragmentation over the survey period led to an increase in consumption of these foods and dietary vitamin A adequacy. This study finds a causal link between deforestation and people’s dietary quality, and the results have important implications for policy makers given that forests are largely overlooked in strategies to improve nutrition, but offer potential “win–wins” in terms of meeting nutrition goals as well as conservation and environmental goals.

Okra (Abelmoschus esculentus) in a refugee context in East Africa: Kitchen gardening helps with mineral provision

Kitchen gardening is considered a way to reconnect with agriculture and complement the cereal-based relief food offered to refugees in East Africa. This work aimed at profiling mineral content of okra in four refugee camps and settlements located in Ethiopia and Uganda and its contribution to adequate intake (AIs) or recommended dietary allowances (RDAs) for young children and pregnant and lactating women (PLW). The study also evaluated the applicability of portable X-ray fluorescence (PXRF) as compared with inductively coupled plasma mass spectrometry (ICP-MS) for mineral profiling of okra powder samples. The contents of minerals (mg kg-1) from the ICP-MS readings were in the following ranges: K (14,385-33,294), Ca (2610-14,090), P (3178-13,248), Mg (3896-7986), Cu (3.81-19.3), Fe (75.7-1243), Zn (33-141) and Mn (23.1-261). Regardless of geographic origin, at low-end consumption probability (17 g day-1 for young children and 68 g day-1 for PLW), okra could contribute ˂ 15% (2.7-12.9%) AI for macro-minerals (K and Ca). In addition, the contributions to RDA values for Fe and Zn, elements of known public health interest, ranged from 4.5 to 34.7% for young children. Interestingly, regression lines revealed strong agreement between ICP-MS and PXRF readings for Mn and Zn, with R2 values > 0.91. This information is useful in support of nutrition-sensitive kitchen gardening programs through scaling culturally important crops in refugee settings.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s42452-021-04898-6.

Wild Food Plants and Trends in Their Use: From Knowledge and Perceptions to Drivers of Change in West Sumatra, Indonesia

Wild food plants (WFPs) are often highly nutritious but under-consumed at the same time. This study aimed to document the diversity of WFPs, and assess perceptions, attitudes, and drivers of change in their consumption among Minangkabau and Mandailing women farmers in West Sumatra. We applied a mixed-method approach consisting of interviews with 200 women and focus group discussions with 68 participants. The study documented 106 WFPs (85 species), and Minangkabau were found to steward richer traditional knowledge than Mandailing. Although both communities perceived WFPs positively, consumption has declined over the last generation. The main reasons perceived by respondents were due to the decreased availability of WFPs and changes in lifestyle. The contemporary barriers to consuming WFPs were low availability, time constraints, and a limited knowledge of their nutritional value. The key motivations for their use were that they are free and "unpolluted" natural foods. The main drivers of change were socio-economic factors and changes in agriculture and markets. However, the persistence of a strong culture appears to slow dietary changes. The communities, government and NGOs should work together to optimize the use of this food biodiversity in a sustainable way. This integrated approach could improve nutrition while conserving biological and cultural diversity.

A Review of Indigenous Food Crops in Africa and the Implications for more Sustainable and Healthy Food Systems

Indigenous and traditional foods crops (ITFCs) have multiple uses within society, and most notably have an important role to play in the attempt to diversify the food in order to enhance food and nutrition security. However, research suggests that the benefits and value of indigenous foods within the South African and the African context have not been fully understood and synthesized. Their potential value to the African food system could be enhanced if their benefits were explored more comprehensively. This synthesis presents a literature review relating to underutilized indigenous crop species and foods in Africa. It organizes the findings into four main contributions, nutritional, environmental, economic, and social-cultural, in line with key themes of a sustainable food system framework. It also goes on to unpack the benefits and challenges associated with ITFCs under these themes. A major obstacle is that people are not valuing indigenous foods and the potential benefit that can be derived from using them is thus neglected. Furthermore, knowledge is being lost from one generation to the next, with potentially dire implications for long-term sustainable food security. The results show the need to recognize and enable indigenous foods as a key resource in ensuring healthy food systems in the African continent.

Evaluating the nutritional content of an insect-fortified food for the child complementary diet in Ghana

BACKGROUND

Due to rising food insecurity, natural resource scarcity, population growth, and the cost of and demand for animal proteins, insects as food have emerged as a relevant topic. This study examines the nutrient content of the palm weevil larva (Rhynchophorus phoenicis), a traditionally consumed edible insect called akokono in Ghana, and assesses its potential as an animal-source, complementary food.

METHODS

Akokono in two "unmixed" forms (raw, roasted) and one "mixed" form (akokono-groundnut paste) were evaluated for their macronutrient, micronutrient, amino acid, and fatty acid profiles.

RESULTS

Nutrient analyses revealed that a 32 g (2 tbsp.) serving of akokono-groundnut paste, compared to recommended daily allowances or adequate intakes (infant 7-12 months; child 1-3 years), is a rich source of protein (99%; 84%), minerals [copper (102%; 66%), magnesium (54%; 51%), zinc (37%; 37%)], B-vitamins [niacin (63%; 42%), riboflavin (26%; 20%), folate (40%; 21%)], Vitamin E (a-tocopherol) (440%; 366%), and linoleic acid (165%; 108%). Feed experiments indicated that substituting palm pith, the typical larval diet, for pito mash, a local beer production by-product, increased the carbohydrate, potassium, calcium, sodium, and zinc content of raw akokono. Akokono-groundnut paste meets (within 10%) or exceeds the levels of essential amino acids specified by the Institute of Medicine criteria for animal-source foods, except for lysine.

CONCLUSIONS

Pairing akokono with other local foods (e.g., potatoes, soybeans) can enhance its lysine content and create a more complete dietary amino acid profile. The promotion of akokono as a complementary food could play an important role in nutrition interventions targeting children in Ghana.

Foraging Wild Food in Urban Spaces: The Contribution of Wild Foods to Urban Dietary Diversity in South Africa

Globally, approximately one billion people benefit from contributions of wild foods to their food security and dietary diversity. Wild foods are known to be important in rural communities in terms of food and micronutrient provision, diversifying diets, reducing vulnerability to non-communicable diseases and overall health. However, the potential contribution of wild foods towards food security and dietary diversity in urban food systems has been largely overlooked. This study examined the contribution of wild foods to household dietary diversity in two towns in South Africa, based on a survey of 137 households. Household diets were quite diverse, with half (51%) having consumed ≥ 8 food groups, 39% consumed 6 or 7 food groups, and only 10% recorded ≤ 5 food groups in the previous 48 h. Wild foods were prevalent across the sample, with 62% of the households consuming them to some degree. Wild vegetables and fruits were the most common wild foods, consumed by 96 and 79% of the households, respectively. Although wild foods had limited significance on overall dietary diversity, they exhibited substantial contributions within particular food groups. For example, the consumption of vegetables and oil and fats was most prevalent among households consuming wild foods than those who did not. The findings show that wild foods could contribute towards diversifying urban diets at a micro-level, within particular food groups consumed, such as vegetables and fruits. Hence, wild foods are important in ameliorating the monotonous diets of some households and in turn promoting dietary diversity.

Identification and frequency of consumption of wild edible plants over a year in central Tunisia: a mixed-methods approach

OBJECTIVE

To identify wild plants used as food and assess their frequency of consumption over a year in a region of Tunisia where agriculture is undergoing a major transformation from smallholder farming to an intensive high-input agricultural system.

DESIGN

Qualitative ethnobotanical study followed by a survey of women's frequency of consumption of wild plants conducted using FFQ at quarterly intervals.

SETTING

Sidi Bouzid governorate of central Tunisia.

PARTICIPANTS

Mixed-gender group of key informants (n 14) and focus group participants (n 43). Survey sample of women aged 20-49 years, representative at governorate level (n 584).

RESULTS

Ethnobotanical study: thirty folk species of wild edible plants corresponding to thirty-five taxa were identified by key informants, while twenty folk species (twenty-five taxa) were described by focus groups as commonly eaten. Population-based survey: 98 % of women had consumed a wild plant over the year, with a median frequency of 2 d/month. Wild and semi-domesticated fennel (Foeniculum vulgare Mill. and Anethum graveolens) was the most frequently consumed folk species. Women in the upper tertile of wild plant consumption frequency were more likely to be in their 30s, to live in an urban area, to have non-monetary access to foods from their extended family and to belong to wealthier households.

CONCLUSIONS

In this population, wild edible plants, predominantly leafy vegetables, are appreciated but consumed infrequently. Their favourable perception, however, offers an opportunity for promoting their consumption which could play a role in providing healthy diets and mitigating the obesity epidemic that is affecting the Tunisian population.

Dietary intake, forest foods, and anemia in Southwest Cameroon

BACKGROUND

Forest cover has been associated with higher dietary diversity and better diet quality in Africa. Anemia prevalence among women of reproductive age in sub-Saharan Africa is very high and diet is one known contributor of a high prevalence rate. We investigated whether living in communities with high forest cover was associated with better diet quality and lower anemia prevalence among women of reproductive age in Southwest Cameroon.

METHODOLOGY

We conducted a cross-sectional survey of 247 women of reproductive age from four forest-based villages (n = 126) and four non-forest villages (n = 121). We assessed the Hemoglobin (Hb) levels, anthropometric status, and diet (by 24-hour recall), as well as anemia-related morbidity and socio-demographic characteristics. Differences between groups were assessed with Pearson's chi-square and independent T-tests. We used a number of multivariate regression models to estimate the impacts of forest proximity on adjusted hemoglobin status of women of reproductive age, as well as to identify the most likely pathway through which forest proximity was important.

RESULTS

We found that women living in forest communities had higher adjusted hemoglobin levels (mean hemoglobin concentration 11.10±1.53 g/dl vs.10.68±1.55g/dl; p = 0.03 for women forest and non-forest communities respectively). Moderate to severe anemia prevalence was significantly higher in women living in the non-forest villages compared to women in forest villages (forest 63% vs. 73%; p = 0.04). Compared with women from non-forest villages, women from forest-based villages had consumed significantly more vitamin A rich fruits and vegetables and animal source foods, and more of these came from the forest (as opposed to the farm or purchased sources). We found that the consumption of Gnetum africanum (Eru), a leafy green vegetable that grows in forests of the Congo Basis, was best able to account for the higher levels of adjusted hemoglobin in women in forest communities.

CONCLUSION

This study contributes to the growing evidence that in some circumstances, forests make important contributions to diet quality and nutrition. The results of this study suggest that plant foods from the forest may make important contributions to iron intake and reduce the risk of anemia in women. Efforts to prevent forest loss and maintain ecosystem services are warranted to enhance nutrition and health of forest-based communities.

Impacts of forests on children's diet in rural areas across 27 developing countries

Micronutrient deficiency affects about a third of the world's population. Children in developing countries are particularly vulnerable. Consequences include impaired cognitive and physical development and increased childhood morbidity and mortality. Recent studies suggest that forests help alleviate micronutrient deficiency by increasing dietary diversity. However, evidence is mostly based on weakly designed local case studies of limited relevance to global policies. Furthermore, impacts of forests on diet vary among communities, and understanding this variation can help target actions to enhance impact. We compile data on children's diets in over 43,000 households across 27 developing countries to examine the impacts of forests on dietary diversity. We use empirical designs that are attentive to assumptions necessary for causal interpretations and that adequately account for confounding factors that could mask or mimic the impact. We find that high exposure to forests causes children to have at least 25% greater dietary diversity compared to lack of exposure, a result comparable to the impacts of some nutrition-sensitive agricultural programs. A closer look at a subset of African countries indicates that impacts are generally higher for less developed communities, but highest with certain access to markets, roads, and education. Our results also indicate that forests could help reduce vitamin A and iron deficiencies. Our study establishes the causal relationship between forests and diet and thus strengthens the evidence for integrating forest conservation and management into nutrition interventions. Our results also suggest that providing households some access to capital can increase the impact of forest-related interventions on nutrition.