Mineral content of traditional leafy vegetables from western Kenya

Determination of Essential Minerals in the Indigenous Vegetables Solanum nigrum (Stout Shade) and Gynandropsis gynandra (Spider Plant) from Two Agroecological Zones in Kisii County, Kenya

Vegetables are good sources of essential mineral elements that promote good health and immunity. Information on the nutritional contents of indigenous vegetables is scarce. Therefore, this study sought to ascertain the concentrations of magnesium, manganese, chrome, zinc, copper, and iron in Solanum nigrum and Gynandropsis gynandra indigenous vegetables from two agroecological zones (upper midland and lower highland) of Kisii County, Kenya, using inductively coupled plasma optical emission spectroscopy (ICP‒OES). For Gnandropsis gynandra, the most abundant erythrocytic synthesis element was Fe (1856.67 ± 15.28 mg/kg DW) for plants harvested from Nyanchwa (UM), and the least was Cu (8.90 ± 0.44 mg/kg DW) in plants harvested from Kari (LH). In addition, Mg was the hypoglycemic element with the highest concentration (5975.00 ± 10.00 mg/kg DW), and Cr lowest (3.16 ± 0.45 mg/kg DW) in samples harvested from Matongo (UM). For Solanum nigrum, the most erythrocytic synthesis element was Fe (1280.00 ± 10.00 mg/kg DW for samples collected from Kiamabundu (UM), and the least was Cu (9.08 ± 0.15 mg/kg DW) in the samples from Nyanchwa (UM), whereas Mg in samples from Nyabioto (UM) was the hypoglycemic element with the highest concentration (4920.00 ± 10.00 mg/kg DW) and Cr in samples from Mariba (LH had the lowest concentration) (3.95 ± 1.63 mg/kg DW). The concentrations of elements in the two indigenous vegetables from the UM agroecological zone were slightly greater than those in the LH agroecological zone. Nonetheless, the variations observed were not statistically significant (P < 0.05). Enzymatically bio accessed concentrations of iron, zinc, chromium, magnesium, manganese, and copper were higher than those obtained aquatically. The indigenous vegetable bio avails substantial amounts of iron and copper to enable them be used in the management pernicious anaemia; on the other hand, the substantial bio availed levels of zinc, manganese, magnesium, and chromium enables the vegetable to be used in the management of diabetes.

Leaf elemental composition analysis in spider plant [Gynandropsis gynandra L. (Briq.)] differentiates three nutritional groups

Understanding the genetic variability within a plant species is paramount in implementing a successful breeding program. Spider plant (Gynandropsis gynandra) is an orphan leafy vegetable and an extraordinary source of vitamins, secondary metabolites and minerals, representing an important resource for combatting malnutrition. However, an evaluation of the leaf elemental composition, using a worldwide germplasm collection to inform breeding programs and the species valorization in human nutrition is still lacking. The present study aimed to profile the leaf elemental composition of G. gynandra and depict any potential geographical signature using a collection of 70 advanced lines derived from accessions originating from Asia and Eastern, Southern and West Africa. The collection was grown in a greenhouse using a 9 × 8 alpha lattice design with two replications in 2020 and 2021. Inductively coupled plasma-optical emission spectrometry was used to profile nine minerals contents. A significant difference (p < 0.05) was observed among the lines for all nine minerals. Microelements such as iron, zinc, copper and manganese contents ranged from 12.59-430.72, 16.98-166.58, 19.04-955.71, 5.39-25.10 mg kg-1 dry weight, respectively, while the concentrations of macroelements such as potassium, calcium, phosphorus and magnesium varied in the ranges of 9992.27-49854.23, 8252.80-33681.21, 3633.55-14216.16, 2068.03-12475.60 mg kg-1 dry weight, respectively. Significant and positive correlations were observed between iron and zinc and calcium and magnesium. Zinc, calcium, phosphorus, copper, magnesium, and manganese represented landmark elements in the genotypes. Eastern and Southern African genotypes were clustered together in group 1 with higher phosphorus, copper and zinc contents than Asian and West African lines, which clustered in group 2 and were characterized by higher calcium, magnesium and manganese contents. An additional outstanding group 3 of six genotypes was identified with high iron, zinc, magnesium, manganese and calcium contents and potential candidates for cultivar release. The genotype × year interaction variance was greater than the genotypic variance, which might translate to phenotypic plasticity in the species. Broad-sense heritability ranged from low to high and was element-specific. The present results reveal the leaf minerals diversity in spider plant and represent a baseline for implementing a minerals-based breeding program for human nutrition.

Evaluation of Nutritional Value, Antioxidant Activity, and Phenolic Content of Protium serratum Engl and Artocarpus chama Buch.-Ham, Wild Edible Fruits Available in Tripura, a North-Eastern State of India

Background:

Protium serratum Engl (Indian red pear) and Artocarpus chama Buch.- Ham (wild jackfruit) are typical wild edible fruits that have a wide range of folk medicinal properties.

Objectives:

Our present study deals with the exploration of nutritional value, antioxidant activity, and total phenolic content present in Protium serratum Engl and Artocarpus chama Buch.-Ham fruits.

Methods:

The soxhlet apparatus was used to extract crude samples. The quantitative analysis of the wild edible fruits was broadly done by proximate and ultimate analysis techniques.

Results:

The results showed that the moisture contents in P. serratum and A. chama Buch. are 78.53% and 74.23%, respectively. The obtained ash (8.59%), fiber (3.17%), total sugar (5.495 mg/100g), and fat (0.66%) contents are high in P. serratum. In contrast, A. chama Buch. has a high content of protein (0.52%). Vitamin C content is higher in P. serratum (550 mg/100g) than that in A. chama Buch. (350 mg/100g). The result shows that the Ca and Mg contents are higher in P. serratum compared to A. chama Buch. Indian red pear shows good antioxidant properties and has high total phenolic content as compared to wild jackfruit and some commercial fruits.

Conclusion:

The study establishes that further investigation must be done to determine the development of new products, processing, and preservation techniques so that two underutilized fruits can become a part of our regular dietary habits. By doing so, we can enrich the fruit basket of the country.

In Vitro Antiviral Activity of Potential Medicinal Plant Extracts Against Dengue and Chikungunya Viruses

Dengue and chikungunya are two important mosquito-borne infections which are known to occur extensively in tropical and subtropical areas. Presently, there is no treatment for these viral diseases. In vitro antiviral screening of 25 extracts prepared from the plants of Vitex negundo, Plumeria alba, Ancistrocladus heyneanus, Bacopa monnieri, Anacardium occidentale, Cucurbita maxima, Simarouba glauca, and Embelia ribes using different solvents and four purified compounds (anacardic acid, chloroquinone, glaucarubinone, and methyl gallate) were carried out for their anti-dengue virus (DENV) and anti-chikungunya virus (CHIKV) activities. Maximum nontoxic concentrations of the chloroform, methanol, ethyl acetate, petroleum ether, dichloromethane, and hydroalcoholic extracts of eight plants were used. The antiviral activity was assessed by focus-forming unit assay, quantitative real-time RT-PCR, and immunofluorescence assays. Extracts from Plumeria alba, Ancistrocladus heyneanus, Bacopa monnieri, and Cucurbita maxima showed both anti-DENV and CHIKV activity while extract from Vitex negundo showed only anti-DENV activity. Among the purified compounds, anacardic acid, chloroquinone and methyl gallate showed anti-dengue activity while only methyl gallate had anti-chikungunya activity. The present study had identified the plant extracts with anti-dengue and anti-chikungunya activities, and these extracts can be further characterized for finding effective phytopharmaceutical drugs against dengue and chikungunya.

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.

The potential and outgoing trends in traditional, phytochemical, economical, and ethnopharmacological importance of family Onagraceae: A comprehensive review

ETHNOPHARMACOLOGICAL RELEVANCE

The Onagraceae is a widely distributed family of flowering plants comprises about 17 genera and more than 650 species of herbs, shrubs, and trees. Onagraceae also common as willowherb family or evening primrose family is divided into two subfamilies; Ludwigioideae (mainly genus; Ludwigia) and Onagroideae. Family Onagraceae is characterized by its numerous traditional uses as treatment of hormonal imbalances, urinary system ailments, prostate health maintenance, and antimicrobial effects.

AIM OF THE STUDY

This review aims to introduce a holistic overview on the phytochemical composition, economical importance and ethnopharmacological value of different species of family Onagraceae.

MATERIALS AND METHODS

Literature review was performed using different data bases such as PubMed, Web of Science, Google Scholar and Reaxys searching for articles focused on phytochemical composition, bioactivity and ethnopharmacological history of Onagraceae species.

RESULTS

Different species of Onagraceae were reported to have a great variety of phytochemicals including flavonoids, tannins, phenolic acids, triterpenoids, saponins, and volatile/fixed oils. Onagraceae exhibited several health benefits and pharmacological activities including anti-inflammatory, antiarthritic and analgesic, antioxidant, cytotoxic, antidiabetic, and antimicrobial.

CONCLUSIONS

Family Onagraceae is an extremely important family with diverse phytochemical composition which enriches their pharmacological importance and hence it's commercial and economical value.

The first report of iron-rich population of adapted medicinal spinach (Blitum virgatum L.) compared with cultivated spinach (Spinacia oleracea L.)

Folk medicine such as herbal and natural products have been used for centuries in every culture throughout the world. The Chenopodiaceae family with more than 1500 species is dispersed worldwide. The Iranian wild spinach (Blitum virgatum L.) is an important traditional medicinal plant used for antiviral diseases such as pneumonia and other respiratory track infections. This plant is a mountainous herb and is growing upper than 3000 m. We performed a mass selection plant breeding program on wild populations of this Iranian wild spinach during 2013-2020. Based on experimental and field characteristics this plant was identified as B. virgatum, |abbaricum|, and related characteristics were prepared with reference to the International Union for the Protection of New Varieties of Plants (UPOV). Mass selection program resulted from an adapted population named as medicinal spinach (MSP) population. To compare the mineral content of the mass-selected population with cultivated spinach (Spinacia oleracea L. |Varamin 88|), both plants were planted in pots and fields under similar conditions. In five leaves stage, plant samples were taken from both leaf and crown sections and used for experimental analysis. Atomic absorption spectroscopy was used to determine the mineral content including iron (Fe), zinc (Z), manganese (Mn), and copper (Cu). Our results showed the selected medicinal spinach population (MSP) with about 509 ppm iron was an important iron-rich population with about 3.5-4 times more than the amount of iron in cultivated spinach in the same conditions. Because iron is an important essential element for blood production, respiration process, energy metabolisms, synthesis of collagen, and some neurotransmitters are needed for proper immune function, so the supply of absorbable adequate iron is very important. The reasons such as the prevalence of the COVID-19 pandemic, which affects the amount of exchangeable oxygen in the lungs and historical local evidences of the use of this plant (MSP) for pneumonia, could open new horizons for focusing on studies related to the use of ancestral human experiences in addition to scientifically modern research.

Evaluation of Leaf Mineral, Flavonoid, and Total Phenolic Content in Spider Plant Germplasm

Spider plant (Cleome gynandra L.) is an important leafy vegetable that grows naturally in many parts of the world. The leaves are highly nutritious and are used mainly for human consumption. The mineral content and phenolic compounds of 17 genotypes (local and exotic) of spider plant and four standards (swiss chard, jute mallow, cowpea, and pumpkin) were investigated. Leaf samples were harvested from plants raised at Thohoyandou, South Africa. Exotic genotypes were superior to local genotypes for most of the minerals. Swiss chard possessed significantly high levels of some minerals such as iron and manganese in comparison with exotic spider plant genotypes. The calcium content in the local (‘MP-B-3-CG’) and exotic (‘GPS’) genotypes was >30.0% and >60.0% higher than in swiss chard, respectively. Total phenolics among spider plant genotypes ranged from 9.86 to 12.21 mg GAE/g DW and were superior to pumpkin. In addition, the spider plant genotypes varied significantly in the antioxidant capacity as estimated by the 2,2 diphenyl-1-picrylhydrazyl method and ferric-reducing antioxidant power. The main flavonoid in the leaves of spider plant genotypes was quercetin-3-rutinoside. Crotonoside (glycoside) was detected in all the spider plant genotypes and swiss chard. A positive correlation was observed between total phenolic content and each of the three flavonoids. The PCA biplot associated exotic genotypes (‘ML-SF-29′, ‘PS’, ‘TZ-1’, and ‘GPS’) and local genotypes (‘ML-3-KK’, ‘ML-13-SDM’, and ‘ML-12-TMP’) with high Al, Fe, Zn, N, and TPC. Cluster analysis indicated high “distant groups” between exotic and local genotypes of spider plant. These results indicated that some of the local germplasm of spider plant was largely inferior to the exotic germplasm in terms of their mineral composition but contained considerable quantities of quercetin-3-rutinoside, particularly in the local genotypes ‘MP-B-2-CG’ and ‘MP-B-1-CG’. There is a need for genetic improvement of the local germplasm in some of the minerals particularly to benefit the end-users.

Nutritional, phytochemical and diverse health-promoting qualities of Cleome gynandra

Cleome gynandra (Syn. Gynandropsis gynandra) is fast emerging as one of the most widely consumed leafy vegetables due to its nutrition and health-promoting properties. In addition to its high nutritional content, the plant has a rich pool of diverse antioxidant phytochemicals. The current review provides a critical appraisal on the increasing nutritional significance of Cleome gynandra due to its rich pool of natural bioactive compounds and beneficial health-promoting qualities. The rich nutritional content especially the high levels of macro- and micronutrients is an indication of its potential to mitigate malnutrition and the increasing incidence of diet-related obesity and non-communicable diseases. The presence of health-promoting natural compounds, notably polyphenols, glucosinates and terpernoids has been confirmed in Cleome gynandra using different analytical methods. Cleome gynandra possesses high levels of α-tocopherol, β-tocopherol and γ-tocopherol, ascorbic acid, α-carotene, β-carotene, lutein, violaxanthin, and β-cryptoxanthin. These nutritional compounds could be useful in food applications as supplements, colorants and extending shelf-life of food products. Cleome gynandra extracts have demonstrated promising effects in several biological assays using in vitro and in vivo systems. Clearly, diversified diets that include a regular intake of dark green leafy vegetables including Cleome gynandra, holds great promise in ensuring food and nutrition security.

Traditional consumption of and rearing edible insects in Africa, Asia and Europe

The traditional consumption of edible insects is common in one third of the world's population, mostly in Latin America, Africa and Asia. There are over one thousand identified species of insects eaten in some stage of their life cycle; and they play important roles in ensuring food security. The most common way to collect insects are from the wild, which is seasonal with limited availability and has an increasing demand resulting in a disruption to the ecosystem. There is a growing interest shown in rearing insects for commercial purposes, and an industrial scale production will be required to ensure steady supplies. Industrial production will need to take into account the living environment of insects, the nutritional composition of their feed and the overall efficiency of the production system. We provide a short overview on the consumption of and rearing insects in Africa, Asia and Europe. For Africa, a snapshot is given for Nigeria, Ghana, Central African Republic, Kenya and Uganda, while the following countries are reported for Asia: China, Japan, Lao People's Democratic Republic, Thailand and Vietnam. In addition, a list of insect species with the highest potential for food and feed in the European Union is provided with some reference to The Netherlands and Finland. The review concludes that there is need to better understand the rearing and farming procedures that will yield high quality edible insects in Africa, Asia and Europe.

Traditional African Foods and Their Potential to Contribute to Health and Nutrition

The nutritional state of large segments of the African population remains alarming despite the positive socio-economic development that is taking place. The most significant nutritional problems include undernutrition, iron deficiency and vitamin A deficiency. Malnutrition and deficiencies also exacerbate a number of other diseases and health conditions. Besides undernutrition, the prevalence of overnutrition and obesity on the African continent are rising, as are the associated health conditions such as diabetes and coronary heart diseases. This chapter outlines the unique nutritional and bioactive properties of Traditional African Foods (TAFs) and their potential to contribute to the alleviation of undernutrition, overnutrition and associated health problems. Special emphasis is placed on vegetables, fruits, cereals, edible insects, small fish species, mushrooms, legumes, sesame, tuber and root crops. Some of the identified health benefits of these TAFs include lowering of serum cholesterol, anti-carcinogenic, anti-diabetic and anti-inflammatory, cardiovascular disease prevention and anti-hypertensive properties.

Chemistry and pharmacology of Bidens pilosa: an overview

Bidens pilosa L. is an edible herb and has been traditionally used for a wide range of ailments in many countries. The aim of this review is to present comprehensive information of the chemical constituents, nutraceutical and ethnomedical uses as well as the biological and pharmacological effects and toxicity of this plant based on 218 literary sources reported over 40 years. Major chemical constituents (including 301 compounds) belonging to polyacetylenes, polyacetylene glycosides, flavonoids, flavone glycosides, aurones, chalcones, okanin glycosides, phenolic acids, terpenes, pheophytins, fatty acids and phytosterols have been identified or isolated from the different parts of this plant. Many of them have been considered as the bioactive compounds which are potentially responsible for the pharmacological actions. Various types of preparations, extracts and individual compounds derived from this plant have been found to possess biological and pharmacological activities such as anti-malarial, anti-allergy, anti-hypertensive and smooth muscle relaxant, anti-cancerogenic, anti-diabetic, anti-inflammatory, anti-microbial, antioxidant. The results of data analysis on the chemicals, pharmacological and toxicological characteristics of B. pilosa validate the view of its folk worldwide-medicinal uses. This herb has a great beneficial therapeutic property and is possibly used for complement or alternative to pharmaceutical drugs in some specific cases. However, this herb is known as hyperaccumulator and as-excluder; therefore, harvesting the herb for medicinal uses should be judiciously cautioned.

Analysis of six elements (Ca, Mg, Fe, Zn, Cu, and Mn) in several wild vegetables and evaluation of their intakes based on Korea National Health and Nutrition Examination Survey 2010-2011

Wild vegetables, those edible among naturally grown vegetables, have been reported to contain many bioactive substances, dietary fibers, vitamins, and minerals. The purpose of this study is to examine the six elements of the wild vegetables frequently consumed by Koreans and assess the element intakes through them. Contents of six kinds of elements (Ca, Mg, Fe, Zn, Cu, and Mn) in 11 wild vegetables were analyzed by inductively coupled plasma optical emission spectroscopy. Using these analysis data, the 6-element intakes from the wild vegetables were evaluated in healthy Korean adults aged 19-64 years from the Korea National Health and Nutrition Examination Survey (2010-2011). Sedum and shepherd's purse contained over 100 mg of Ca in 100 g of their edible portion. The Mg content per 100 g of the 11 wild vegetables ranged from 12.1 mg to 43.4 mg. The wild vegetable with the highest mineral content per 100 g was sedum for Ca, spinach for Mg, shepherd's purse for Fe, spinach for Zn, bracken for Cu, and fragrant edible wild aster for Mn. The element intakes from the 11 wild vegetables compared with dietary reference intakes in the healthy Koreans were 1.0 % for Ca, 2.1 % for Mg, 5.3 % for Fe, 1.4 % for Zn, 0.3 % for Cu, and 1.8 % for Mn. Considering the low intake ratio (1.2 %) of the wild vegetable to total food intake, wild vegetables may contribute to some element intakes. Our results show the nutritional value of the wild vegetables in the aspect of mineral nutrition; however, further research is needed to evaluate the bioavailability of various elements in wild vegetables.

Essential and toxic metals in taros (Colocasia esculenta) cultivated in the Canary Islands (Spain): evaluation of content and estimate of daily intake

Taros are a staple in the diet of many people around the world, and they are an excellent source of minerals. Monitoring the levels of metals in food provides basic information that is useful from the perspectives of safety, regulation, and nutrition. Forty-two samples of taros were randomly obtained from supermarkets, vegetable markets, and farmer's plots on the island of Tenerife (Canary Islands, Spain). The edible portion (pulp) was the only part considered for analysis. Flame atomic absorption spectrometry (FAAS) was used to determine the contents of Na, K, Ca, Mg, Cu, Fe, Mn, and Zn. The levels of Cr, Ni, Cd, and Pb were determined using graphite furnace atomic absorption spectrometry (GFAAS). Mean concentrations (mg/kg) were 565.6 Na, 2947 K, 231.4 Ca, 364.5 Mg, 1.224 Cu, 3.818 Fe, 1.408 Mn, 2.242 Zn, 0.044 Cr, 0.021 Ni, 0.003 Cd, and 0.006 Pb. The mean concentrations of Cd and Pb were well below the accepted European Commission limits (0.1 mg/kg weight for both metals, respectively). Daily consumption of taro (10.41 g taro/person/day) contributes to the dietary intake of essential metals and trace elements, mainly Mg (1.265% in adult women and 1.084% in adult men) and Cu (1.182% for adult men and women). The average daily intakes of Cd (0.031 μg/day) and Pb (0.062 μg/day) from taro were below the legislated respective tolerable weekly intakes (TWIs). Thus, the samples analyzed were considered safe to eat based on their metal concentrations and legislated allowable intakes.

Ethno-medicinal knowledge and plants traditionally used to treat anemia in Tanzania: a cross sectional survey

ETHNOPHARMACOLOGICAL RELEVANCE

Indigenous communities have often served as rich repositories of empirical knowledge on medicinal plants used for anemia. Use of these plants need to be validated with respect to their efficacy and safety so as to provide scientific basis of their use. Quantifying presence of medicinal plants used for anemia treatment, validating indigenous knowledge and extent of its use in rural Mkuranga district, Tanzania is the main focus of this paper.

METHODS

A cross sectional study conducted in May and December 2013 at Mkuranga District of Coastal region of Tanzania. Forty key informants including traditional healers, religious leaders, community members and healthcare workers were interviewed using semi structured questionnaire. Eight focus group discussions were also conducted. Both interviews and focus group discussion gathered data on socio-demographics, general knowledge of anemia and plants used to correct anemia. In a brief field visit, all plants mentioned during the interview were collected and later identified. Both NVivo 10 and STATA softwares were employed for statistical analysis.

RESULTS

Out of 40 participants, 31 were traditional healers, majority were male (77.4%). Mean age of the participants was 55.7±15 years. About 45% had no any formal education and majority (80%) were married. Twenty eight plant species are used to treat anemia. Hibiscus sabdariffa was the most mentioned species. The species belongs to 24 families, with Euphorbiaceae (14.3%) having the largest number. Lawsonia inermis, Aloe sp, Uvaria acuminata, Parinari curatellifolia, Ozoroa reticulata, Manihot esculenta, Canthium sp and Afzelia quanzensis were the plant species in which their claimed use for anemia were novel.

CONCLUSIONS

People in rural areas of Mkuranga district possess a rich traditional knowledge of medicinal plants species for anemia treatment. Researches on these plants showed promising anti-anemic activity. Analysis and documentation of this knowledge has not only helped the analysis and recognition of novel information, it also contributed to conserving it for future generations.

Performance outcomes of a pharmacist-managed anticoagulation clinic in the rural, resource-constrained setting of Eldoret, Kenya

BACKGROUND

It is recommended that warfarin therapy should be managed through an anticoagulation monitoring service to minimize the risk of bleeding and subsequent thromboembolic events. There are few studies in Sub-Saharan Africa that describe warfarin management in spite of the high incidence of venous thromboembolism (VTE) and rheumatic heart disease.

OBJECTIVE

To examine the feasibility of the Moi Teaching and Referral Hospital anticoagulation monitoring service and compare its performance with clinics in resource-rich settings.

METHODS

A retrospective chart review compared the percentage time in the therapeutic range (TTR) and rates of bleeding and thromboembolic events to published performance targets using the inference on proportions test. Wilcoxon's rank sum analyses were used to establish predictors of TTR.

RESULTS

For the 178 patients enrolled, the mean TTR was 64.6% whereas the rates of major bleeds and thromboembolic events per year were 1.25% and 5%, respectively. In the primary analysis, no statistically significant differences were found between the results of TTR, major bleeds and thromboembolic events for the clinic and published performance rates. In the secondary analysis, having an artificial heart valve and a duration of follow-up of > 120 days were positively associated with a higher TTR (P < 0.05) whereas venous thromboembolism, history of tuberculosis, HIV and a duration of follow-up of < 120 days were associated with having a lower TTR (P < 0.05).

CONCLUSIONS

The performance of the MTRH anticoagulation clinic is non-inferior to published metrics on the performance of clinics in resource-rich settings.

Dietary patterns, food and macronutrient intakes among adults in three ethnic groups in rural Kenya

Objective

To compare dietary patterns and food and macronutrient intakes among adults in three ethnic groups in rural Kenya.

Design

In the present cross-sectional study, dietary intake was estimated in adult volunteers using two non-consecutive interactive 24 h recalls. Dietary patterns were assessed from the number of meals and snacks per day and from the food items and major food groups registered, and their contribution to energy intake (EI) was calculated. Anthropometric values were measured and sociodemographic data obtained using a questionnaire.

Setting

A cross-sectional study was conducted in the Bondo, Kitui and Transmara districts of rural Kenya. A high prevalence of food insecurity in Kenya underlines the importance of describing the dietary patterns and intakes in different Kenyan ethnic groups.

Subjects

A total of 1163 (61 % women) adult Luo, Kamba and Maasai, with a mean age of 38·6 (range: 18–68) years, volunteered to participate.

Results

Dietary patterns and food groups contributing to EI differed significantly among the ethnic groups. Mean EI ranged from 5·8 to 8·6 MJ/d among women and from 7·2 to 10·5 MJ/d among men, with carbohydrates contributing between 55·7 % and 74·2 % and fat contributing between 14·5 % and 30·2 % of total EI. Mean protein intake ranged from 0·72 to 1·3 g/kg per d, and EI:BMR ratio ranged between 1·1 and 1·6 in both sexes, and was highest among the Luo. Prevalence of underweight (BMI < 18·5 kg/m2) was 13·7 %, 20·5 % and 24·2 % in the Luo, Kamba and Maasai, respectively.

Conclusions

The degree of food insecurity measured as a degree of undernutrition and as dietary patterns differed considerably among the ethnic groups. The Maasai and Kamba in particular were exposed to food insecurity.

Wild leafy vegetables: a study of their subsistence dietetic support to the inhabitants of Nanda Devi Biosphere Reserve, India

Consumption of greens is a major source of vitamins and micro-nutrients for people using only vegetarian diets rich in carbohydrates. In remote rural settlements where vegetable cultivation is not practiced and market supplies are not organized, local inhabitants depend on indigenous vegetables, both cultivated in kitchen gardens and wild, for enriching the diversity of food. Knowledge of such foods is part of traditional knowledge which is largely transmitted through participation of individuals of households. A total of 123 households in six villages of Nanda Devi Biosphere Reserve buffer zone was surveyed using a schedule to assess the knowledge, availability and consumption pattern of wild leafy vegetables. Quantity estimations were done using regular visits with informants from 30 sample households of the six study villages during the collections. Monetization was used to see the value of wild leafy vegetables harvested during a year. The diversity of wild leafy vegetables being use by the local inhabitants is 21 species belonging to 14 genera and 11 families. This is far less than that being reported to be used by the communities from Western Ghats in India and some parts of Africa. Irrespective of social or economic status all households in the study villages had the knowledge and used wild leafy vegetables. The number of households reported to consume these wild leafy vegetables is greater than the number of households reporting to harvest them for all species except for Diplazium esculentum and Phytolacca acinosa. The availability and use period varied for the species are listed by the users. The study indicated that the knowledge is eroding due to changing social values and non participation of younger generation in collection and processing of such wild leafy vegetables.