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Kilandeka V, Mosha T, Kulwa K. Relationship Between School Food Environment and Eating Behaviors of Primary School Children in Dodoma: A Cross-Sectional Study. Ecol Food Nutr 2024; 63:304-322. [PMID: 38776870 DOI: 10.1080/03670244.2024.2357792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
This cross-sectional study assesses the relationship between school food environment and eating behaviors of primary school children in Dodoma among 248 primary school children aged 6-13 years. School characteristics information and socio-demographic characteristics were collected. Multilevel modeling was employed to assess the individual-level variance in eating behaviors. Most of the variances in the investigated eating behaviors were at the personal level. Significant associations (p < .05) were between protein-rich food intake and fats and sugar-rich food with the death of either parent. And association between intake of vitamin and mineral-rich foods and the number of people living in household.
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Affiliation(s)
- Vivian Kilandeka
- Department of Human Nutrition and Consumer Science, College of Agriculture, Morogoro, Tanzania
| | - Theobald Mosha
- Department of Human Nutrition and Consumer Science, College of Agriculture, Morogoro, Tanzania
| | - Kissa Kulwa
- Department of Human Nutrition and Consumer Science, College of Agriculture, Morogoro, Tanzania
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Ayanful-Torgby R, Shabanova V, Essuman AA, Boafo E, Aboagye F, Al-Mahroof Y, Amponsah J, Tetteh JK, Amoah LE, Paintsil E. High prevalence of impaired glucose metabolism among children and adolescents living with HIV in Ghana. HIV Med 2024; 25:577-586. [PMID: 38240173 PMCID: PMC11078607 DOI: 10.1111/hiv.13614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/08/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND Antiretroviral therapy (ART)-associated metabolic abnormalities, including impairment of glucose metabolism, are prevalent in adults living with HIV. However, the prevalence and pathogenesis of impaired glucose metabolism in children and adolescents living with HIV, particularly in sub-Saharan Africa, are not well characterized. We investigated the prevalence of impaired glucose metabolism among children and adolescents living with perinatally infected HIV in Ghana. METHODS In this multicentre, cross-sectional study, we recruited participants from 10 paediatric antiretroviral treatment clinics from January to June 2022 in 10 facilities in Greater Accra and Eastern regions of Ghana. We determined impaired glucose metabolism in the study sample by assessing fasting blood sugar (FBS), insulin resistance as defined by the homeostatic model assessment for insulin resistance (HOMA-IR) index and glycated haemoglobin (HbA1c) levels. The prevalence of impaired glucose metabolism using each criterion was stratified by age and sex. The phenotypic correlates of glucose metabolism markers were also assessed among age, sex, body mass index (BMI) and waist-to-hip ratio (WHR). RESULTS We analysed data from 393 children and adolescents living with HIV aged 6-18 years. A little over half (205/393 or 52.25%) of the children were female. The mean age of the participants was 11.60 years (SD = 3.50), with 122/393 (31.00%) aged 6-9 years, 207/393 (52.67%) aged 10-15 years, and 62/393 (15.78%) aged 16-18 years. The prevalence rates of glucose impairment in the study population were 15.52% [95% confidence interval (CI): 12.26-19.45], 22.39% (95% CI: 18.54-26.78), and 26.21% (95% CI: 22.10-30.78) using HbA1c, HOMA-IR, and FBS criteria, respectively. Impaired glucose metabolism detected by FBS and HOMA-IR was higher in the older age group, whereas the prevalence of abnormal HbA1c levels was highest among the youngest age group. Age and BMI were positively associated with FBS and HOMA-IR (p < 0.001). However, there was negative correlation of WHR with HOMA-IR (p < 0.01) and HbA1c (p = 0.01). CONCLUSION The high prevalence of impaired glucose metabolism observed among the children and adolescents living with HIV in sub-Saharan Africa is of concern as this could contribute to the development of metabolic syndrome in adulthood.
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Affiliation(s)
- Ruth Ayanful-Torgby
- Department of Pediatrics, Yale School of Medicine, New Haven, CT USA
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Veronika Shabanova
- Department of Pediatrics, Yale School of Medicine, New Haven, CT USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT USA
| | - Akosua A. Essuman
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Emmanuel Boafo
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Frank Aboagye
- Biomedical & Public Research Unit, Council for Scientific & Industrial Research-Water Research Institute, Accra, Ghana
| | - Yusuf Al-Mahroof
- Biomedical & Public Research Unit, Council for Scientific & Industrial Research-Water Research Institute, Accra, Ghana
| | - Jones Amponsah
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - John K.A. Tetteh
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Linda E. Amoah
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Elijah Paintsil
- Department of Pediatrics, Yale School of Medicine, New Haven, CT USA
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Kushitor SB, Alangea DO, Aryeetey R, de-Graft Aikins A. Dietary patterns among adults in three low-income urban communities in Accra, Ghana. PLoS One 2023; 18:e0293726. [PMID: 37943866 PMCID: PMC10635542 DOI: 10.1371/journal.pone.0293726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE Dietary patterns describe the dietary behaviour and habits of individuals. Unhealthy dietary patterns provide individuals with limited nutrients while increasing the risk of nutrition-related diseases. Unhealthy dietary patterns are high in urban areas, especially among low-income urban residents. This study examined dietary patterns in three low-income urban communities in Accra, Ghana, between 2011 and 2013. METHODS This study used Wave 2 and 3 data from the Urban Health and Poverty Survey (EDULINK 2011 and 2013). The sample size was 960 in 2011 and 782 in 2013. Dietary pattern was examined using factor analysis and the NOVA food classification system. Summary statistics were computed for sociodemographic characteristics and diet frequency and pattern. Differences in dietary behaviours between 2011 and 2013 were also estimated. Three logistic regression models were computed to determine the predictors of dietary patterns. RESULTS The frequency of consumption of animal-source foods (ASF) and fruits was higher in 2013 compared with 2011. The intake of processed culinary ingredients (NOVA Group 2), processed foods (NOVA Group 3) and ultra-processed foods (NOVA Group 4) was higher in 2013 versus 2011. In 2013, 29% consumed ultra-processed foods compared to 21% in 2011. Three dietary patterns (rice-based, snack-based, and staple and stew/soup) were identified. About two out of every five participants consumed the food items in the rice (43%) and staple and sauce patterns (40%). The proportion of participants who consumed the food items in the snack pattern was 35% in 2011 but 41% in 2013. Respondents aged 25-34 and those with higher education often consumed the snack-based and rice-based dietary patterns. In 2013, participants in Ussher Town had a higher probability of consuming food items in the snack pattern than those living in Agbogbloshie. CONCLUSIONS This study found that between 2011 and 2013, more participants consumed ASFs, fruits, and processed foods. A complex interplay of personal and socio-cultural factors influenced dietary intake. The findings of this study mirror global changes in diet and food systems, with important implications for the primary and secondary prevention of NCDs. Health promotion programs at the community level are needed to address the increasing levels of processed food consumption.
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Affiliation(s)
- Sandra Boatemaa Kushitor
- Department of Community Health, Ensign Global College, Kpong, Ghana
- Department of Food Science and Centre for Complex Systems in Transition, Stellenbosch University, Stellenbosch, South Africa
| | - Deda Ogum Alangea
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Richmond Aryeetey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Ama de-Graft Aikins
- Institute of Advanced Studies, University College London, London, United Kingdom
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Agedew E, Abebe Z, Ayelign A. Dietary patterns in relation with nutritional outcomes and associated factors among adolescents: implications for context-specific dietary intervention for the Agrarian Community, Northwest Ethiopia. Front Nutr 2023; 10:1274406. [PMID: 38024384 PMCID: PMC10651748 DOI: 10.3389/fnut.2023.1274406] [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: 08/08/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Dietary pattern analysis allows us to characterize the dietary intakes of individuals rather than nutrient intake data and strongly predicts disease risks. The relationship between food intake and adolescents' nutritional health is not well understood yet. Therefore, this study aimed to generate evidence for context-specific dietary intervention for adolescents. Objective This study aimed to determine dietary patterns and their relationship with nutritional outcomes and identify the contributing factors among adolescents in the Agrarian Community of Northwest Ethiopia. Methods A cross-sectional survey was conducted among 622 randomly selected adolescents. Dietary data were collected over a 1-week recall period using the Food Frequency Questionnaire (FFQ). After testing the basic assumptions, an exploratory factor analysis was conducted to determine the dietary patterns. Anthropometric data on weight and height were collected to determine the nutritional status using WHO Anthroplus 2010 software. A chi-square test was conducted to evaluate the effect of different dietary patterns on nutritional outcomes. A multivariable binary logistic regression model was used to identify factors affecting the dietary patterns of adolescents. Result Three types of dietary patterns, namely, traditional, mixed, and animal-source foods with traditional alcoholic beverage consumption were identified. These dietary patterns explain 58.64% of the variance in adolescent diet in the study setting. The burden of stunting was 15.12% vs. 11.21, 19.40% vs. 6.94, and 8.36% vs.17.97% among adolescents with lower traditional, mixed, and higher animal sources with alcoholic dietary pattern consumption habits, respectively (value of p <0.05). Adolescents who resided in low-land agroecology (AOR = 2.44; 95% CL: 1.24, 4.81) and had access to animal-source foods (AOR = 1.64; 95% CI: 1.04, 2.60) were associated with lower consumption of traditional dietary patterns. Similarly, adolescents who resided in low-land (AOR = 1.80; 95% CI: 1.18, 2.74) had formal education (AOR = 2.38; 95% CI: 1.35, 4.19) and had poor nutrition knowledge (AOR = 2.83; 95% CL: 1.55, 5.19) were associated with lower consumption of mixed dietary patterns. Moreover, adolescents residing in the high-land (AOR = 2.50; 95% CI: 1.37, 4.56) and being female (AOR =1.87; 95% CI: 1.27, 2.74) were significant factors associated with lower consumption of animal-sourced foods with traditional alcoholic beverage consumption patterns. Conclusion Multidimensional modifiable factors were explored that could be targeted for public health interventions for the identified dietary patterns. Integrated and multifaceted dietary intervention approaches are needed to promote healthy diets and discourage the consumption of unhealthy diets to reduce undernutrition in the study area and similar settings.
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Affiliation(s)
- Eskezyiaw Agedew
- Center for Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Tandoh A, Laar A, Pradeilles R, Le Port A, Osei-Kwasi H, Amevinya GS, Aryeetey RNO, Agyemang C, Holdsworth M. Addressing the marketing and availability of unhealthy food and beverages in and around selected schools in Ghana: a community readiness appraisal. BMJ Open 2023; 13:e075166. [PMID: 37770260 PMCID: PMC10546112 DOI: 10.1136/bmjopen-2023-075166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/21/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVE This study assessed stakeholder readiness to address unhealthy food and beverage marketing and availability in/around Public Basic Schools (for children 4-15 years) in Greater Accra Region, the highly urbanised administrative capital of Ghana. DESIGN The community readiness model was used to conduct in-depth mixed methods interviews with stakeholders. Using predefined anchored rating statements, quantitative readiness scores ranging from 1 to 9 were generated. Thematic qualitative analysis was undertaken to understand barriers and facilitators that could influence the implementation of interventions. SETTING Greater Accra Region, Ghana. PARTICIPANTS 18 key informants from various school/education/citizen sectors, which together represented the 'school community' of Greater Accra Region. RESULTS The mean readiness scores indicated that the 'school community' was at the 'preplanning' stage of readiness (4.44±0.98) to address the marketing and availability of unhealthy food and beverages in and around schools. The mean readiness score for 'leadership' was the highest of all dimensions (5.36±1.60), corresponding to the 'preparation' stage. The lowest scores were found for 'community knowledge of efforts' (3.19±2.45) and 'resources for efforts' (3.64±0.87), both of which were at a 'vague awareness' stage. CONCLUSIONS The 'school community' recognised that the marketing and availability of unhealthy food and beverages was a problem. Additionally, current leadership was actively supportive of continuing/improving efforts that create healthier children's food environments. However, actions that aim to increase the 'school community's' knowledge of existing interventions and securing resources to sustain those interventions are needed before introducing readiness appropriate strategies.
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Affiliation(s)
- Akua Tandoh
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Greater Accra, Ghana
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-food systems), Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro Montpellier, IRD, Montpellier, France
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Greater Accra, Ghana
| | - Rebecca Pradeilles
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-food systems), Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro Montpellier, IRD, Montpellier, France
| | - Agnes Le Port
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-food systems), Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro Montpellier, IRD, Montpellier, France
| | - Hibbah Osei-Kwasi
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Gideon Senyo Amevinya
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Greater Accra, Ghana
| | - Richmond Nii Okai Aryeetey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Greater Accra, Ghana
| | - Charles Agyemang
- Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, Maryland, USA
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-food systems), Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro Montpellier, IRD, Montpellier, France
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Kumma WP, Loha E. Dietary patterns and their association with cardiovascular risk factors in Ethiopia: A community-based cross-sectional study. Front Nutr 2023; 10:1074296. [PMID: 37032774 PMCID: PMC10076605 DOI: 10.3389/fnut.2023.1074296] [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: 10/19/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
Purpose To identify the dietary patterns and their association with cardiovascular risk factors among adult people in urban and rural areas of Wolaita, southern Ethiopia. Methods A total of 2,483 participants aged 25-64 years were selected using a three-stage random sampling. Data for this study were collected using structured questionnaires, the previous 24-h dietary intake assessment, anthropometric, blood pressure, and biochemical measurements. We used factor analysis to identify dietary patterns. Factors associated with dietary patterns were analyzed using multiple linear regression models. The adjusted regression coefficients with their 95% CI were used to ascertain the association. Result We identified three major dietary patterns that explained 51% of the variance in food consumption. The western dietary pattern was characterized by the consumption of meat/organ meat, biscuits/sweets, chicken stew, pasta-macaroni recipes, butter, white wheat bread, egg recipe, and Ethiopian dish shiro-wet, and was positively associated with urban residence, obesity, hypertension, blood glucose, and total cholesterol levels. Adherence to the consumption of tubers, whole-grain maize products, coffee leaves-and-herbs beverage, legumes, and sweet potatoes featured the traditional dietary pattern. The traditional dietary pattern showed a positive relationship with rural residence, physical activity, and obesity, and it had a negative relationship with hypertension. The healthy dietary pattern was characterized by the intake of green leafy vegetables, green pepper, and whole-grain maize products, and negatively related to obesity, and hypertension, while positively related to urban residence. Conclusion The coexistence of western, traditional, and healthy dietary patterns in the present study indicates the transition to a new dietary pattern in the study area. All dietary patterns were associated with one or more cardiovascular risk factors, but the western dietary pattern was associated with most of these, while the traditional diet showed fewer such associations. Therefore, it might be useful to promote healthy and traditional dietary patterns along with physical activity. Interventions related to the current findings, if initiated early in life, may benefit the public in preventing cardiovascular risk factors such as obesity, hypertension, and type 2-diabetes.
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Affiliation(s)
- Wondimagegn Paulos Kumma
- School of Public Health, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- *Correspondence: Wondimagegn Paulos Kumma,
| | - Eskindir Loha
- School of Public Health, Hawassa University, Hawassa, Ethiopia
- Centre for International Health, University of Bergen, Bergen, Norway
- Chr. Michelsen Institute, Bergen, Norway
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Agedew E, Abebe Z, Ayelign A. Exploring barriers to diversified dietary feeding habits among adolescents in the agrarian community, North West Ethiopia. Front Nutr 2022; 9:955391. [PMID: 36570147 PMCID: PMC9768322 DOI: 10.3389/fnut.2022.955391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 10/31/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Adolescence is a critical and neglected age group of the population in any form of nutritional intervention. A comprehensive study that assesses barriers that influence their diversified feeding habit is not well investigated in qualitative approaches. Therefore, this study was conducted to fill this gap by providing evidence on exploring barriers to diversified feeding habits of adolescents in the agrarian community, North West Ethiopia. Objective The aim of the study was to explore barriers to diversified feeding habits of adolescents in the agrarian community, North West Ethiopia. Methods A phenomenological qualitative study design was conducted among adolescents in the age group of 10-19 years, and adults in the age range of 25 to 64 years (representatives of farmers, agricultural, health, and education sectors). We conducted 24 in-depth interviews (12- adolescents, 4-health, 2- agricultural extension, 3-education, and 3-farmer representative) among purposively selected community groups. In-depth interview guides and observation checklist were utilized for data collection. The audio-recorded qualitative data were transcribed word by word into English. Finally, the translated data were exported to ATLAS ti version 7.1 software for thematic analysis based on inductive content analysis. All coded quotations, including memos written throughout the coding process, were then analyzed to identify themes inductively. Results Dietary habit of adolescents in the study area was predominantly plant-based cereals with low protein, vitamins, and mineral contents. Adolescents have limited consumption of fruits, vegetables, and animal source foods. Adolescents with these feeding habits had suboptimal intake of micronutrients and proteins, which are crucial for their rapid growth stage. Individual-level barriers, family-level influence, dietary tradition of community, agricultural practice (poor agroforestry practice of the community, and poor agricultural practice to produce year-round diverse food items), and week multi-sectorial collaboration for nutritional intervention all influenced adolescent dietary habits. Conclusion Multiple layers of barriers influenced the diverse dietary habits of adolescents in the study setting. These multiple and interconnected influences ranged from individual level to multi-sectorial collaboration. Nutritional interventions should be implemented at the individual, family, agricultural, and multi-sectorial levels to improve adolescents' diverse dietary habits.
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Nutritional status of school children in the South Tongu District, Ghana. PLoS One 2022; 17:e0269718. [PMID: 36001627 PMCID: PMC9401153 DOI: 10.1371/journal.pone.0269718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 05/26/2022] [Indexed: 12/02/2022] Open
Abstract
Background Malnutrition is a major public health problem because of the devastating consequences it has on children, their families, and society at large. Our study, therefore, sought to determine the prevalence of undernutrition and overweight/obesity and its associated factors among children aged 6–12 in the South Tongu District, Ghana. Methods A school-based cross-sectional study was conducted among 423 school children aged 6–12 years in the South Tongu District of Ghana. A multistage sampling method was employed to recruit the school children for the study. A semi-structured questionnaire was used to collect data from the respondents. We used a dual-purpose (height and weight) measuring scale to obtain the anthropometric data. The World Health Organization’s AnthroPlus software was used to generate the z-scores for determining the nutritional status. Percentages were used to present the results of the prevalence of undernutrition and overweight/obesity among school children. Bivariate and multivariable binary logistic regression were used to examine the factors associated with undernutrition and overweight/obesity among school children. The results were presented as crude odds ratios (CORs) and adjusted odds ratios (AORs), with their 95% confidence interval (CI). Statistical significance was set at p<0.05. Stata 16.0 was used to perform the analyses. Results The overall prevalence of undernutrition and overweight/obesity were 21.5% (CI = 17.7, 25.7) and 24.8% (CI = 20.8, 29.2), respectively. Specifically, the prevalence of stunting, thinness, underweight, overweight, and obesity were 10.4%, 12.1%, 3.8%, 11.1%, and 13.7%, respectively. School children whose household used water from non-portable sources were more likely to be undernourished [AOR = 2.03, 95% CI = 1.13, 3.63]. The odds of overweight/obesity was higher among school children whose mothers had attained formal education [AOR = 2.10, 95% CI = 1.09, 4.06], those who consumed beverages between meals per day [AOR = 1.87, CI = 1.08, 3.24], and those who had adequate dietary diversity score [AOR = 1.65, 95% CI = 1.02, 2.67]. School children aged 10–12 were less likely to be overweight/obese [AOR = 0.58, 95% CI = 0.35, 0.94] compared to those aged 6–9. Conclusion The study showed a relatively high prevalence of undernutrition and overweight/obesity among school children in the South Tongu District. The identified risk factor(s) for undernutrition was the usage of water from non-potable sources whilst those of overweight/obesity were age (10–12 years), maternal formal education, beverage consumption between meals per day, and adequate dietary diversity. The findings reaffirm that malnutrition is still prevalent among school children. Hence, there is a need for the Ministry of Health, Ghana Education Service, and other Non-Governmental Organizations to pay critical attention to these factors to achieve the Sustainable Development Goal 2, target 2.2. Nutritional behavioural change education should be carried out among parents and school children. School health service activities should be intensified with a special focus on nutritional screening.
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Tay DA, Ocansey RTA. Impact of Urbanization on Health and Well-Being in Ghana. Status of Research, Intervention Strategies and Future Directions: A Rapid Review. Front Public Health 2022; 10:877920. [PMID: 35836994 PMCID: PMC9273841 DOI: 10.3389/fpubh.2022.877920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction Ghana like other African countries is facing multiple health threats due to expansion of urban populations. Globally, the urbanization phenomenon has received considerable attention and modest steps have been undertaken to address it. Ghana is stalling on implementation of policies and interventions targeted at alleviating the menace. Objectives This review examined research evidence, interventions, and policies relating to urbanization and threats to health and well-being of people living in Ghana. The review focused on three areas including urbanization threats to health and well-being, health risks associated with urbanization, and interventions and policies. Materials and Methods The search spanned from year 2000 to February 2022 covering documents related to urbanization, health, and well-being. Databases used for the search include African Journals Online, Annual Reviews (Biomedical, Life & Physical sciences, Social Sciences), BioMedCentral, BioOne, BLDS digital library, Cambridge University Press, ClinicalKey, CINAHL, University of Ghana Digital Collections/UGSpace, JSTOR, Medline and Wiley Online Library. Results Environmental risk factors, urban planning, water-related, behavior-related, and socioeconomic factors were important urbanization threats to health and well-being. Health risks identified include airborne diseases, waterborne diseases, malaria, and non-communicable diseases such as hypertension and lung cancer. Additionally, there is evidence of non-implementation and/or non-enforcement of existing interventions and policies. Conclusion and Recommendation Evidence from this rapid review shows that urbanization impacts on health and well-being of people in Ghana. Urbanization threats that expose populations to health risks could be reduced through commitment to implementation, surveillance and monitoring of policies and interventions. Communities and individuals must be equipped to take control of their health and well-being.
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Adeomi AA, Fatusi A, Klipstein-Grobusch K. Food Security, Dietary Diversity, Dietary Patterns and the Double Burden of Malnutrition among School-Aged Children and Adolescents in Two Nigerian States. Nutrients 2022; 14:789. [PMID: 35215439 PMCID: PMC8875779 DOI: 10.3390/nu14040789] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Little evidence exists on the relationship between diet-related factors and child/adolescent malnutrition in Nigeria. This study aimed to assess the associations between household food insecurity (HFI), dietary diversity (DD), and dietary patterns (DP) with the double burden of malnutrition (DBM) among 6-19-year-olds in two Nigerian States. METHODS This community-based cross-sectional study was carried out among 1200 respondents (6-19 years in age) in the Gombe and Osun States of Nigeria. HFI was assessed using the HFI access scale. DD was assessed using a 24-h dietary recall. DP were determined by principal component analysis using a 30-day food frequency questionnaire. DP scores were categorized into quartiles (Q) for statistical analysis. Diet-related predictors of DBM were assessed using logistic regression. RESULTS HFI was experienced by 568 (47.3%) respondents. The median DD score was 7.0 (maximum of 14). Two DPs were identified, diversified DP (DDP) and traditional DP (TDP). TDP was significantly associated with both thinness (Q4:OR: 2.91; 95% CI: 1.52-5.55; Ptrend: 0.002) and overweight/obesity (Q4:OR: 2.50; 95% CI: 1.43-4.35; Ptrend: 0.007), while DDP was inversely related with thinness (Q4:OR: 0.36; 95% CI: 0.21-0.61; Ptrend: 0.008) as compared to Q1. CONCLUSIONS TDP increased the odds for DBM, while the DDP reduced the odds.
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Affiliation(s)
- Adeleye Abiodun Adeomi
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife 220282, Osun State, Nigeria;
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown 2193, Johannesburg, South Africa;
| | - Adesegun Fatusi
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife 220282, Osun State, Nigeria;
- School of Public Health, University of Medical Sciences, Ondo 220282, Ondo State, Nigeria
| | - Kerstin Klipstein-Grobusch
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown 2193, Johannesburg, South Africa;
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3584 CS Utrecht, The Netherlands
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Nicholaus C, Martin HD, Kassim N, Matemu AO, Kimiywe J. Dietary Practices, Nutrient Adequacy, and Nutrition Status among Adolescents in Boarding High Schools in the Kilimanjaro Region, Tanzania. J Nutr Metab 2020; 2020:3592813. [PMID: 32685204 PMCID: PMC7350084 DOI: 10.1155/2020/3592813] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 03/25/2020] [Accepted: 04/23/2020] [Indexed: 11/18/2022] Open
Abstract
A cross-sectional study was conducted to assess dietary practices, nutrient adequacy, and nutrition status among 164 adolescents aged between 16 and 19 years in boarding secondary schools in the Kilimanjaro region. In-depth interviews and a survey guided by a semistructured and structured questionnaire, including 24-hour recall and food frequency questionnaire techniques, were used to collect information. Nutrition status was assessed using anthropometric measurements and hemoglobin levels. WHO AnthroPlus software and NutriSurvey software were used to analyze anthropometry and dietary data, respectively. Diet in boarding schools was monotonous comprising mainly of cereal-legume meal with low intake of animal sources, fruits, and vegetables. Mean intake of energy, vitamin C, iron, calcium, and zinc was 1392 kcal, 24.8 mg, 9.2 mg, 134.5 mg, and 4.3 mg, respectively, which were below the Recommended Daily Allowance. The average carbohydrate, fat, and protein intake of 471.9 g, 73.7 g, and 80.7 g, respectively, were slightly higher than the Recommended Daily Allowance in both sexes. Male had a significantly higher intake of protein and carbohydrates (P < 0.001). Female had a significantly (P < 0.001) high intake of fat compared to male adolescents. Overall, 23.1% of the adolescents were anaemic, 25% were overweight, and 6.1% were obese. Boarding secondary schools' diet is monotonous and are inadequate in key micronutrients, iron, zinc, calcium, and vitamin C. There is a coexistence of undernutrition and overnutrition among adolescents in boarding schools. Therefore, monitoring adolescents' dietary intake and nutrition status is a key in preventing adolescents' malnutrition in the short term and diet-related diseases in the long term.
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Affiliation(s)
- Calista Nicholaus
- Department of Food Biotechnology and Nutrition Sciences, Nelson Mandela African Institution of Science and Technology, P.O. Box 447, Arusha, Tanzania
| | - Haikael D. Martin
- Department of Food Biotechnology and Nutrition Sciences, Nelson Mandela African Institution of Science and Technology, P.O. Box 447, Arusha, Tanzania
| | - Neema Kassim
- Department of Food Biotechnology and Nutrition Sciences, Nelson Mandela African Institution of Science and Technology, P.O. Box 447, Arusha, Tanzania
| | - Athanasia O. Matemu
- Department of Food Biotechnology and Nutrition Sciences, Nelson Mandela African Institution of Science and Technology, P.O. Box 447, Arusha, Tanzania
| | - Judith Kimiywe
- Department of Food, Nutrition and Dietetics, Kenyatta University, P.O. Box 43844-00100, Nairobi, Kenya
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Cross-country comparison of dietary patterns and overweight and obesity among adult women in urban Sub-Saharan Africa. Public Health Nutr 2020; 24:1393-1403. [PMID: 32390577 DOI: 10.1017/s1368980019005202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To derive dietary patterns (DP) among women of reproductive age (WRA) and older women in urban Sub-Saharan Africa (SSA), and to examine their association with body mass index (BMI), overweight and obesity. DESIGN We used principal component analysis to derive DP. Their association with BMI, overweight and obesity was assessed using linear and multinomial logistic regression models controlling for age, marital status, education and wealth. SETTING Cross-sectional data from prospective studies in Accra, Ghana (2008-2009), Dar es Salaam, Tanzania (2014) and Lilongwe and Kasungu, Malawi (2017-2018) were used. PARTICIPANTS We compared WRA in Ghana (18-54 years, n 1762) and Malawi (19-48 years, n 137), and older women in Ghana (≥55 years, n 514) and Tanzania (≥50 years, n 134). RESULTS Among WRA, protein and healthy DP were identified in both Ghana and Malawi. In Ghana, the protein DP was associated with higher odds of overweight or obesity (adjusted OR 1·82, 95 % CI 1·27, 2·60 for quintile 2). Among older women, three DP were identified in Ghana (cereal, protein and healthy) and two DP in Tanzania (protein and healthy). The protein DP was associated with higher BMI in Ghana (adjusted mean difference 2·83, 95 % CI 0·95, 4·71 for quartile 3). CONCLUSIONS Higher quintiles of the protein DP were associated with higher BMI and odds of overweight or obesity among women in urban Ghana, but not in Malawi or Tanzania. Further research is needed to understand how DP influence overweight and obesity among adult women in urban SSA.
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Abizari AR, Ali Z. Dietary patterns and associated factors of schooling Ghanaian adolescents. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2019; 38:5. [PMID: 30728067 PMCID: PMC6364425 DOI: 10.1186/s41043-019-0162-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/22/2019] [Indexed: 06/03/2023]
Abstract
BACKGROUND Assessment of single nutrients or foods does not normally reflect the diet of population groups. Dietary pattern analyses are useful in understanding the overall diet and its relationship with disease conditions. The objective of the present study was to determine the dietary patterns and associated factors among schooling adolescents in Northern Ghana. METHODS A cross-sectional study involving 366 pupils in 10 junior high schools in the Tamale metropolis was conducted. A Food Frequency Questionnaire (FFQ) which consisted of 60 commonly consumed foods was used to assess pupils' 7-day intake. Foods grouped (14) from FFQ data based on shared nutritional value were used to identify dietary patterns using principal component analysis (PCA). Bivariate and multivariate logistic regression analyses were used to determine the association between identified patterns and sociodemographic, anthropometric status, and household characteristics of pupils. RESULTS Half of the pupils were female (50.3%) and average age was 15.6 ± 2.0 years. PCA identified two dietary patterns which in total explained 49.7% of the variability of the diet of pupils. The patterns were sweet tooth pattern (STP) with high factor loadings for sugar sweetened snacks, energy and soft drinks, sweets, tea and coffee, and milk and milk products, and a traditional pattern (TP) which showed high factor loadings for cereals and grains, local beverages, nuts, seeds and legumes, vegetables, and fish and seafood. Logistic regression showed that pupils who lived with their parents [AOR = 1.95; 95% CI (1.1-3.4); p = 0.019], those who went to school with pocket money [AOR = 4.73; 95% CI (1.5-15.0); p = 0.008], and those who lived in the wealthiest homes [AOR = 3.4; 95% CI (1.6-7.5); p = 0.002)] had higher odds of following the STP. The TP was associated with high dietary diversity (p = 0.035) and household wealth [AOR = 3.518; 95% CI (1.763-7.017); p < 0.001)]. None of the patterns was associated with anthropometric status of pupils. CONCLUSION Adolescents in the present study followed a sweet tooth or a traditional diet pattern which associated more with household- and individual-level factors but not anthropometric status.
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Affiliation(s)
- Abdul-Razak Abizari
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box 1883, Tamale, Ghana
| | - Zakari Ali
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box 1883, Tamale, Ghana
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