Socioeconomic Differences in Dietary Patterns in an East African Country: Evidence from the Republic of Seychelles

Tropical fishery nutrient production depends on biomass-based management

The need to enhance nutrient production from tropical ecosystems to feed the poor could potentially create a new framework for fisheries science and management. Early recommendations have included targeting small fishes and increasing the species richness of fish catches, which could represent a departure from more traditional approaches such as biomass-based management. To test these recommendations, we compared the outcomes of biomass-based management with hypothesized factors influencing nutrient density in nearshore artisanal fish catches in the Western Indian Ocean. We found that enhancing nutrient production depends primarily on achieving biomass-based targets. Catches dominated by low- and mid-trophic level species with smaller body sizes and faster turnover were associated with modest increases in nutrient densities, but the variability in nutrient density was small relative to human nutritional requirements. Therefore, tropical fishery management should focus on restoring biomass to achieve maximum yields and sustainability, particularly for herbivorous fishes.

Traditional Food Consumption in Andean Ecuador and Associated Consumer Characteristics, Shopping and Eating Habits

Traditional foods (TFs) hold increasing global relevance due to their potential to address health and dietary challenges. This study explores TF consumption and patterns in a middle-income country's general population. Using 2017 Ecuadorian highlands survey data, we identified four consumption clusters with distinct TF preferences. Chi-square tests identified variations in independent variables across clusters. Poisson regression models highlighted city, age, education, and food habits as independent predictors of TF-based clusters. Our findings broaden TF importance to nutrition beyond specific populations. Understanding consumption patterns and socioeconomic links supports nuanced public health strategies to tackle contemporary health, social equity, and sustainability issues.

Dietary patterns and diabetes mellitus among people living with and without HIV: a cross-sectional study in Tanzania

Background

Due to the complexity of human diets, it is difficult to relate single foods to health outcomes. We aimed to identify the dietary patterns and associated factors and to assess the association of dietary patterns with prediabetes/diabetes among adults living with and without HIV in Tanzania.

Methods

Diet data were collected by a food frequency questionnaire (FFQ) and dietary patterns were derived by principal component analysis (PCA) and reduced rank regression (RRR). The associations between dietary patterns and associated factors as well as with prediabetes/diabetes were assessed using multinomial logistic regression and presented by marginal plots.

Results

Of 572 recruited, 63% were people living with HIV. The mean (±SD) age was 42.6 (±11.7) years and 60% were females. The PCA identified two major dietary patterns, i.e., vegetable-rich pattern (VRP) and vegetable-poor pattern (VPP) whereas RRR identified one dietary pattern, i.e., carbohydrate-dense pattern (CDP). In comparison to females, males had higher adherence to VPP and CDP, but less to VRP. Higher socioeconomic status was associated with higher adherence to VRP and VPP but low adherence to CDP. Compared to HIV-negative participants, people living with HIV had higher adherence to VRP but less adherence to CDP. Compared to younger people, older people had lower adherence to VPP. High adherence to CDP or VRP was positively associated with prediabetes. Higher adherence to VRP was associated with a borderline decrease in diabetes. No association was observed between VPP with either prediabetes or diabetes.

Conclusion

Our findings suggest that dietary patterns may impact the risk of prediabetes and diabetes differently. Awareness of the health benefits of VRP should be encouraged in the community, especially for men who seem to consume fewer vegetables. Longitudinal studies are needed to explore the contribution of dietary patterns to prediabetes/diabetes development in sub-Saharan Africa.

Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review

In order to achieve the Sustainable Development Goals, considerable dietary shifts, including an increase in the consumption of fruit and vegetables (FV) will be required. However, worldwide consumption of FV is far below international recommendations, including in many low- and middle-income countries (LMICs), particularly in Africa. Understanding what, where, when, and how people choose to eat requires an understanding of how individuals are influenced by factors in their social, physical, and macro-level environments. In order to develop effective interventions to increase fruit and vegetable consumption, the factors influencing consumer behavior need to be better understood. We conducted a rapid review to assess and synthesize data on individual, social, physical, and macro-level factors that enable or constrain fruit and vegetable consumption and purchase among adults living in sub-Saharan Africa. Our conceptual framework is based on a socio-ecological model which has been adapted to settings in LMICs and Africa. We systematically searched four electronic databases including Scopus, Medline (PubMed), PsycInfo, and African Index Medicus, and screened Google Scholar for gray literature. We included a total of 52 studies and narratively summarized the existing evidence for each identified factor across the different levels. We found that most studies assessed demographic factors at the individual level including household or family income, socio-economic status and education. Furthermore we identified a variety of important factors that influence FV consumption, in the social, physical, and macro environment. These include women's empowerment and gender inequalities, the influence of neighborhood and retail food environment such as distance to market and price of FV as well as the importance of natural landscapes including forest areas for FV consumption. This review identified the need to develop and improve indicators both for exposure and outcome variables but also to diversify research approaches.

Clustering Analysis and Machine Learning algorithms in the prediction of dietary patterns: Cross-sectional results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

BACKGROUND

Machine learning investigates how computers can automatically learn. This study aimed to predict dietary patterns and compare algorithm performance in making predictions of dietary patterns.

METHODS

We analyzed the data of public employees (n=12,667) participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The K-means clustering algorithm and six other classifiers (support vector machines, naïve Bayes, K-nearest neighbors, decision tree, random forest, and xgboost) were used to predict the dietary patterns.

RESULTS

K-means clustering identified two dietary patterns. Cluster 1, labeled the Western pattern, was characterized by a higher energy intake and consumption of refined cereals, beans and other legumes, tubers, pasta, processed and red meats, high-fat milk and dairy products, and sugary beverages; Cluster 2, labeled the Prudent pattern, was characterized by higher intakes of fruit, vegetables, whole cereals, white meats, and milk and reduced-fat milk derivatives. The most important predictors were age, sex, per capita income, education level, and physical activity. The accuracy of the models varied from moderate to good (69-72%).

CONCLUSIONS

The algorithms' performance in dietary pattern prediction was similar, and the models presented may provide support in screener tasks and guide health professionals in the analysis of dietary data. This article is protected by copyright. All rights reserved.

Urban physical food environments drive dietary behaviours in Ghana and Kenya: A photovoice study

We identified factors in the physical food environment that influence dietary behaviours among low-income dwellers in three African cities (Nairobi, Accra, Ho). We used Photovoice with 142 males/females (≥13 years). In the neighbourhood environment, poor hygiene, environmental sanitation, food contamination and adulteration were key concerns. Economic access was perceived as a major barrier to accessing nutritionally safe and healthy foods. Home gardening supplemented household nutritional needs, particularly in Nairobi. Policies to enhance food safety in neighbourhood environments are required. Home gardening, food pricing policies and social protection schemes could reduce financial barriers to safe and healthy diets.

Prevalence of Hypertension and Its Associated Risk Factors in a Rural Black Population of Mthatha Town, South Africa

Background: The occurrence of hypertension has been increasing alarmingly in both low and middle-income countries. Despite acknowledging hypertension as the most common life-threatening risk factor for cardiovascular disease (CVD), a dearth of data is available on the prevalence, awareness, and determinants of hypertension in rural parts of South Africa. The principal aim of the current study is to determine the prevalence and associated risk factors of hypertension among a black rural African population from the Mtatha town of Eastern Cape Province. Methods: This was a cross-sectional study, and individuals over 18 years of age were randomly screened using a World Health Organization stepwise questionnaire. Sociodemographic information, anthropometric measurements, fasting blood glucose levels, and three independent blood pressure (BP) readings were measured. Blood pressure measurements were classified according to the American Heart Association guidelines. Univariate and multivariate analyses were performed to determine the significant predictors of hypertension. Results: Of the total participants (n = 556), 71% of individuals had BP scores in the hypertensive range. In univariate analysis, age, westernized diet, education, income, and diabetic status, as well as overweight/obese status were positively associated with the prevalence of hypertension. However, in a multivariate logistic regression analysis only, age, body mass index (BMI), diabetic status, and westernized diet were significantly associated with a higher risk of developing hypertension. Gender, age, and BMI were potential factors having a significant association with the treatment of hypertension. Individuals who did not consider the importance of medicine had higher chances of having their hypertension being untreated. Conclusions: Prevalence of hypertension was high among the black rural African population of Mthatha town. Gender, age, westernized diet, education level, income status, diabetic as well as overweight/obese status were the most significant predictors of hypertension.

Sociodemographic determinants of food consumption pattern: Pró-Saúde Study

AIMS

To identify dietary patterns (DP) and to investigate their association with sociodemographic aspects.

METHODOLOGY

A cross-sectional data analysis of a sub-sample from Phase 4 of the Pró-Saúde Longitudinal Study (2012-2013), constituting a total of 520 participants. DP were obtained by principal component analysis from a food frequency questionnaire. Association between DP and sociodemographic aspects was analyzed by adjusted logistic regression.

RESULTS

Four DP were identified: processed and ultraprocessed products; fresh food; meats and alcoholic beverages; and traditional Brazilian foods. There was a greater adherence chance to "processed and ultraprocessed products" pattern among adults ≥ 55 years and lower chance among men. The probability of adherence to "fresh food" pattern was directly associated to men, subjects with a high educational level and inversely associated to adults aged ≥ 60 years. There was a lower chance of "meats and alcoholic beverages" pattern among men and increased chance of adherence to "traditional Brazilian foods" pattern among whites, subjects with ≥ 60 years and low schooling.

CONCLUSION

Sociodemographic factors were important determinants of DP, especially gender, schooling and age. Presence of a DP composed of processed and ultraprocessed products indicates the need for awareness strategies and supply limitation in this population, since it affects their health.

Factors influencing dietary behaviours in urban food environments in Africa: a systematic mapping review

Objective:

To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research.

Design:

We systematically reviewed published/grey literature (protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical and macro.

Setting:

Urban food environments in Africa.

Participants:

Studies involving adolescents and adults (11–70 years, male/female).

Results:

Thirty-nine studies were included (six adolescent, fifteen adolescent/adult combined and eighteen adult). Quantitative methods were most common (twenty-eight quantitative, nine qualitative and two mixed methods). Studies were from fifteen African countries. Seventy-seven factors influencing dietary behaviours were identified, with two-thirds at the individual level (45/77). Factors in the social (11/77), physical (12/77) and macro (9/77) environments were investigated less. Individual-level factors that specifically emerged for adolescents included self-esteem, body satisfaction, dieting, spoken language, school attendance, gender, body composition, pubertal development, BMI and fat mass. Studies involving adolescents investigated social environment-level factors more, for example, sharing food with friends. The physical food environment was more commonly explored in adults, for example, convenience/availability of food. Macro-level factors associated with dietary behaviours were food/drink advertising, religion and food prices. Factors associated with dietary behaviour were broadly similar for men and women.

Conclusions:

The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa. More studies are needed for adolescents and men, and studies widening the geographical scope to encompass all African countries.

Barriers and Enablers That Influence Overweight/Obesity/Obesogenic Behavior in Adolescents From Lower-Middle Income Countries: A Systematic Review

BACKGROUND

Overweight/obesity during adolescence in lower-middle income countries has become a public health problem with consequences in adulthood. Inadequate dietary habits, poor diet quality, sedentary behavior, and parental obesity have been reported.

OBJECTIVE

To describe management of obesity-like food habits and behavior of adolescents from lower-middle income countries with respect to what keeps them using this diet (barriers) and what helps them avoid it (enablers).

METHODS

Systematic review of the literature related to obesity and food intake of adolescents conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).

RESULTS

We classified 11 eligible studies describing the barriers to and enablers of the management of obesity-like food intake and obesity lifestyle. The dual burdens of malnutrition and increased urbanization have been observed. There is preference for processed food, dietary habits, and obesity-like food intake and sedentary behavior. Barriers to managing body weight gain included mostly consumption of fast-food and snack food, less vegetable and fruit intake, skipping meals, and sedentary behavior. Enablers of managing body weight gain included changes in nutritional habits, perception of the consumption of healthy food, physical activity, and engagement in programs to change lifestyle.

CONCLUSION

The globalization of the fast food industry has provided an obesogenic environmental stimulus for adolescents in lower-middle income countries.

Breastfeeding duration is associated with offspring’s adherence to prudent dietary pattern in adulthood: results from the Nutritionist’s Health Study

Little is known about the long-term effect of breastfeeding on dietary habits. We examined the association between breastfeeding duration and adherence to current dietary patterns of young women. This was a cross-sectional analysis of 587 healthy women aged ≤45 years, undergraduates or nutrition graduates. Maternal characteristics and breastfeeding duration [<6; 6–<12; ≥12 months (reference)] were recalled. Diet was assessed using a food frequency questionnaire and patterns were identified using factor analysis by principal component. Adherence to patterns was categorized in tertiles; the first (T1 = reference) was compared to T2 + T3 (moderate-to-high adherence). Logistic regression was performed considering the minimal sufficient adjustment recommended by the directed acyclic graph. Median age was 22 (interquartile range (IQR) 20; 27) years and body mass index (BMI) 22.2 (IQR 20.4; 25.0) kg/m2. The four dietary patterns identified (Processed, Prudent, Brazilian and Lacto-vegetarian) explained 27% of diet variance. Women breastfed for <6 months showed lower chance of moderate-to-high adherence to the Prudent pattern (odds ratio (OR) = 0.53, p = 0.04). Breastfeeding was not associated with the other patterns. Maternal pre-pregnancy BMI was directly associated with moderate-to-high adherence to the Processed pattern (OR = 2.01, p = 0.03) and inversely to the Prudent pattern (OR = 0.52, p = 0.02). Higher adherence to the Brazilian pattern was associated with proxies of low socioeconomic status and the Lacto-vegetarian pattern with the opposite. Confirmation in prospective studies of the association found in this study between breastfeeding with the Prudent pattern in adult offspring could suggest that early feeding practices influence long-term dietary habits, which could then affect the risk of nutrition-related diseases.

Physiological risk factors for cardiovascular disease in middle-aged (40-60 year) adults and their association with dietary intake, Northern Iran

Background

Considering the importance of healthy diet in the protection of cardiovascular diseases (CVD), this research aimed to assess the physiological risk factors for CVD in middle-aged adults and their association with dietary intake in the north of Iran.

Methods

In this cross-sectional study conducted in the years 2016-2017 among the adults aged 40-60 years living in Amirkola, Babol, the participants´ physical activity, dietary intake, body mass index, fat mass, blood pressure, fasting blood glucose and serum lipid profile were reported. The International Physical Activity Questionnaire was used to assess physical activity and a structured 24-hour food-recall questionnaire was used to assess the participants´ dietary intake. Consumed foods and beverages on two separate days were analyzed and transcribed in 10 food groups (gram).

Results

Two hundred and ninety-one persons (96.7%) had complete participation, 96.2% with at least one CVD risk factor and 75.9% had overweight or obesity; 33% with hypertension; 6.2% had high fasting blood glucose; 64.6% with hypercholesterolemia, 47.8% had hypertriglyceridemia, and 8.9% with low HDL. Mean daily intake values of carbohydrate, protein and fat were all higher than dietary reference intakes for adults. Physical activity less than 1500 MET-minutes per week was significantly associated with having three or more physiological risk factors for CVD [adjusted odds ratio: 2.04 (1.08-3.85)] (P=0.029).

Conclusion

Most of the middle-aged adults in this region had at least one of the physiological risk factors for CVD and daily intakes of carbohydrate and protein were higher than dietary reference intakes (DRIs) for adults.

What Can Dietary Patterns Tell Us about the Nutrition Transition and Environmental Sustainability of Diets in Uganda?

Uganda is undergoing dietary transition, with possible environmental sustainability and health implications, particularly for women. To explore evidence for dietary transitions and identify how environmentally sustainable women's dietary patterns are, principal component analysis was performed on dietary data collected using a 24 h recall during the Uganda Food Consumption Survey (n = 957). Four dietary patterns explained 23.6% of the variance. The "traditional, high-fat, medium environmental impact" pattern was characterized by high intakes of nuts/seeds, fats, oils and spreads, fish and boiled vegetables. High intakes of bread and buns, rice and pasta, tea and sugar characterized the "transitioning, processed, low environmental impact' pattern. The 'plant-based, low environmental impact" pattern was associated with high intakes of legumes, boiled roots/tubers, boiled traditional vegetables, fresh fruit and fried traditional cereals. High intakes of red/organ meats, chicken, and soups characterized the "animal-based high environmental impact" pattern. Urban residence was positively associated with "transitioning, processed, low environmental impact" (β = 1.19; 1.06, 1.32) and "animal-based high environmental impact" (β = 0.45; 0.28, 0.61) patterns; but negatively associated with the "plant-based low environmental impact" pattern (β= -0.49; -0.62, -0.37). A traditional, high-fat dietary pattern with medium environmental impact persists in both contexts. These findings provide some evidence that urban women's diets are transitioning.

Food Purchasing Characteristics and Perceptions of Neighborhood Food Environment of South Africans Living in Low-, Middle- and High-Socioeconomic Neighborhoods

Using intercept surveys, we explored demographic and socioeconomic factors associated with food purchasing characteristics of supermarket shoppers and the perceptions of their neighborhood food environment in urban Cape Town. Shoppers (N = 422) aged ≥18 years, categorized by their residential socioeconomic areas (SEAs), participated in a survey after shopping in supermarkets located in different SEAs. A subpopulation, out-shoppers (persons shopping outside their residential SEA), and in-shoppers (persons residing and shopping in the same residential area) were also explored. Fruits and vegetables (F&V) were more likely to be perceived to be of poor quality and healthy food not too expensive by shoppers from low- (OR = 6.36, 95% CI = 2.69, 15.03, p < 0.0001), middle-SEAs (OR = 3.42, 95% CI = 1.45, 8.04, p < 0.001) compared to the high-SEA shoppers. Low SEA shoppers bought F&V less frequently than high- and middle-SEA shoppers. Purchase of sugar-sweetened beverages (SSBs) and snacks were frequent and similar across SEAs. Food quality was important to out-shoppers who were less likely to walk to shop, more likely to be employed and perceived the quality of F&V in their neighborhood to be poor. Food purchasing characteristics are influenced by SEAs, with lack of mobility and food choice key issues for low-SEA shoppers.

Social Demography of Transitional Dietary Patterns in Thailand: Prospective Evidence from the Thai Cohort Study

In recent decades, a health-risk transition with changes in diet and lifestyle in low and middle-income countries (LMICs) led to an emergence of chronic diseases. These trends in Southeast Asian LMICs are not well studied. Here, we report on transitional dietary patterns and their socio-demographic predictors in Thai adults. Dietary data in 2015 were from a random sub-sample (N = 1075) of 42,785 Thai Cohort Study (TCS) members who completed all three TCS surveys (2005, 2009, 2013). Principle Component Analysis identified dietary patterns and multivariable linear regression assessed associations (Beta estimates (ß) and confidence intervals (CIs)) between socio-demographic factors and dietary intake pattern scores. Four dietary patterns emerged: Healthy Transitional, Fatty Western, Highly Processed, and Traditional. In women, higher income (≥30,001 Baht/month vs. ≤10,000) and managerial work (vs. office assistant) was associated with lower scores for Traditional (ß = −0.67, 95% CI −1.15, −0.19) and Fatty Western diets (ß = −0.60, 95% CI −1.14, −0.05), respectively. University education associated with lower Highly Processed (ß = −0.57, 95% CI −0.98, −0.17) and higher Traditional diet scores (ß = 0.42, 95% CI 0.03, 0.81). In men and women, urban residence associated with higher Fatty Western and lower Traditional diets. Local policy makers should promote healthy diets, particularly in urban residents, in men, and in low-SEP adults.

Prevalence of Hypertension and Associated Risk Factors among Rural Bapedi Women in Sekhukhune Area, Limpopo Province, South Africa

The study investigated the prevalence of hypertension and identified risk factors in the Bapedi women of Sekhukhune area. Fifty (50) women diagnosed with hypertension and receiving treatment from local clinics were recruited. Questionnaires and focus group discussions were used. Most participants were at the average age of 50.50 ± 7.93 years and weight of 81.17 ± 9.96 kg. Blood pressure measurements recorded were systolic blood pressure (SBP) 163 ± 22.41 mmHg and diastolic blood pressure (DBP) 91 ± 5.41 mmHg. An insignificant number of participants had smoking or drinking habits (0% and 2%, respectively). The largest group of women (46%) had primary level of education, 14% completed junior secondary education, 6% completed matric, and 2% had basic education. All women consumed cereal; a large number of women (50%) consumed oils and fats; 44% flesh meats; 30% fruits and vegetables; 26% tubers and roots; 22% organ meats; 10% fish, 10% eggs, and 8% milk. Results showed a high prevalence of hypertension in the Bapedi women in the Sekhukhune area. Changes in diet and lifestyle could significantly improve the health of most women in the area.