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Mezgebe B, Gari T, Belayneh M, Lindtjørn B. Seasonal variations in household food security and consumption affect women's nutritional status in rural South Ethiopia. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003294. [PMID: 39163350 PMCID: PMC11335107 DOI: 10.1371/journal.pgph.0003294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 07/13/2024] [Indexed: 08/22/2024]
Abstract
Food availability varies seasonally in most rural areas of developing nations, especially in areas affected by drought and climate change, with women being one of the most vulnerable groups. This study aimed to assess the effect of seasonal variation in household food security, adequate dietary diversity, food consumption, and wealth on the nutritional status of women of reproductive age in a rural community in South Ethiopia. Further, the study aimed at identifying associated factors with women's nutrition status. An open cohort study was conducted from June 2021 to June 2022, with follow-up visits every three months. Anthropometric measurements were carried out along with interviews. Data were analyzed using STATA version 15. Multilevel, multiple linear regressions were employed. Findings revealed that women's average body mass index (BMI) was 20.4 kg/m2 (95% CI: 20.4-20.5). The highest (20.6 kg/m2, 95% CI: 20.5-20.8) was observed in December, while the lowest (20.2 kg/m2, 95% CI: 20-20.3) occurred in September. During the main postharvest period in December, the household food insecurity score was the lowest (median: 4, Inter quartile range (IQR): 0-9), while the household dietary diversity score (median: 6, IQR: 5-7), and the household food consumption score were the highest (median: 50.5, IQR: 44-70). Factors such as household food security, food consumption, previous season BMI, age, marital status, and membership in safety net programs were identified as determinants of women's BMI. The study showed the vulnerability of women in drought-prone areas to seasonal undernutrition. We recommend collaborative work among stakeholders to ensure sustainable food access and minimize seasonal food shortages' effect on women's nutrition and overall well-being.
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Affiliation(s)
- Bethelhem Mezgebe
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Taye Gari
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Mehretu Belayneh
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Bernt Lindtjørn
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Laurentino JSL, Brito RCDS, de Oliveira-Silva RT, Soares A, Pereira TDC, de Lima EM, dos Santos ABMV, Palmeira PDA. Association between food insecurity and chronic noncommunicable diseases in Brazil: a systematic review. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27:e240041. [PMID: 39140578 PMCID: PMC11323874 DOI: 10.1590/1980-549720240041] [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] [Received: 01/20/2024] [Revised: 04/18/2024] [Accepted: 05/07/2024] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVE To analyze the association of food insecurity (FI) with chronic noncommunicable diseases (NCDs) in the Brazilian context. METHODS The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). The searches were conducted in LILACS and PubMed databases (September/2022). Observational studies carried out in the Brazilian population published since 2003 were included, in which: (1) the association of FI with NCDs was analyzed; and (2) the Brazilian Food Insecurity Scale was used. Studies on pregnant women and those that associated FI with cancer, sexually transmitted infections, and musculoskeletal and respiratory diseases were excluded. The studies were subjected to methodological quality assessment. RESULTS A total of 27 cross-sectional studies were included; nine used secondary data from national surveys, and the others used primary data. An association between FI and overweight and obesity in different age groups was verified in the studies. CONCLUSION The included articles did not produce evidence on other NCDs of interest to health in Brazil such as diabetes and high blood pressure. However, they corroborate the already-known relationship between obesity and FI. Studies on the topic, with a longitudinal design, should be encouraged.
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Affiliation(s)
| | | | | | - Amanda Soares
- Universidade Federal do Rio Grande do Norte, Graduate Program in Public Health – Natal (RN), Brazil
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Abdulai K, Torpey K, Kotoh AM, Laar A. Associated factors of diet quality among people living with HIV/AIDS in Ghana. BMC Nutr 2024; 10:90. [PMID: 38907324 PMCID: PMC11193199 DOI: 10.1186/s40795-024-00898-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 06/19/2024] [Indexed: 06/23/2024] Open
Abstract
INTRODUCTION Nutrition is a very important element of a comprehensive care for people living with HIV/AIDS (PLHIV), especially in resource-constrained settings where malnutrition and food insecurity are common. Dietary diversity is a useful indication of nutritional adequacy (diet quality) in people of all ages. An optimally diverse diet strengthens the body's immune system. OBJECTIVE This study aimed to assess diet quality and its associated factors among PLHIV. METHODS A facility-based cross-sectional study design was employed to select 440 PLHIV from two hospitals in the Eastern Region of Ghana. Dietary intakes were determined using 24-hour recall. A stadiometer and bioimpedance analysis machine were used to obtain anthropometric and body composition data. Diet quality was assessed using FAO's individual dietary diversity score (IDDS) as a proxy. SPSS version 20 was used for analysis. Odds ratios and ordinal logistic regression were used to identify factors associated with diet quality among the PLHIV. P-value was set at 0.05. RESULTS Most of the PLHIV (73%) consumed from 'Starchy staple" food group. Less than 20% of the study sample consumed 'Fruits' and 'Vegetables' (17% and 14% respectively) a day before the survey. The mean IDDS was 4.11 (SD = 1.29). Overall, most of the PLHIV (56%) had medium IDDS which is equivalent to "diet needing improvement', 14% had higher IDDS (good diet), whiles about 31% of the participants actually had poor diet (lower IDDS). Associated factors of diet quality were age (AOR = 0.966: 95%CI: 0.936-0.997: p = 0.031), married (AOR = 4.634: 95%CI: 1.329-16.157: p = 0.0016), separated (AOR = 0.0203: 95%CI: .036-0.994: p = 0.049), and daily meal frequency (AOR = 0.441: 95%CI: .478-1.948: p = 0.020). Overall, the model accounts for about 20% of the variation in diet quality of the participants (pseudo-R square = 0.196). CONCLUSION This study demonstrates that most of the PLHIV did not consume good diet which may have an implication on their immune system, which is already under attack by HIV, and probably emerging infections. Age, marital status, and meal frequency were the variables that predicted diet quality among the study participants.
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Affiliation(s)
- Kasim Abdulai
- Translational Nutrition Research Group, Department of Clinical Nutrition and Dietetics, University of Cape Coast, Cape Coast, Ghana.
| | - Kwasi Torpey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Agnes Millicent Kotoh
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
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Bekele Y, Gallagher C, Batra M, Buultjens M, Eren S, Erbas B. Does oral iron and folate supplementation during pregnancy protect against adverse birth outcomes and reduced neonatal and infant mortality in Africa: A protocol for a systematic review and meta-analysis? Nutr Health 2024:2601060241256200. [PMID: 38778781 DOI: 10.1177/02601060241256200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
BACKGROUND Globally, one-third of pregnant women are at risk of iron deficiency, particularly in the African region. While recent findings show that iron and folate supplementation can lower the risk of adverse birth outcomes and childhood mortality, our understanding of its impact in Africa remains incomplete due to insufficient evidence. This protocol outlines the systematic review steps to investigate the impact of oral iron and folate supplementation during pregnancy on adverse birth outcomes, neonatal mortality and infant mortality in Africa. METHODS AND ANALYSIS MEDLINE, PsycINFO, Embase, Scopus, CINAHL, Web of Science, and Cochrane databases were searched for published articles. Google Scholar and Advanced Google Search were used for gray literature and nonindexed articles. Oral iron and/or folate supplementation during pregnancy is the primary exposure. The review will focus on adverse birth outcomes, neonatal mortality and infant mortality. Both Cochrane Effective Practice and Organization of Care and Newcastle-Ottawa Scale risk of bias assessment tools will be used. Meta-analysis will be conducted if design and data analysis methodologies permit. This systematic review and meta-analysis will provide up-to-date evidence about iron and folate supplementation's role in adverse birth outcomes, neonatal mortality and infant mortality in the African region. ETHICS AND DISSEMINATION This review will provide insights that help policymakers, program planners, researchers, and public health practitioners interested in working in the region. PROSPERO REGISTRATION NUMBER CRD42023452588.
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Affiliation(s)
- Yibeltal Bekele
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
- School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia
| | - Claire Gallagher
- School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Mehak Batra
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Melissa Buultjens
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Senem Eren
- School of Humanities and Social Sciences, Ibn Haldun University, Istanbul, Turkey
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
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Patriota ÉSO, Abrantes LCS, Figueiredo ACMG, Pizato N, Buccini G, Gonçalves VSS. Association between household food insecurity and stunting in children aged 0-59 months: Systematic review and meta-analysis of cohort studies. MATERNAL & CHILD NUTRITION 2024; 20:e13609. [PMID: 38196291 PMCID: PMC10981479 DOI: 10.1111/mcn.13609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/17/2023] [Accepted: 11/28/2023] [Indexed: 01/11/2024]
Abstract
Household food insecurity (HFI) during childhood is associated with poor dietary diversity and malnutrition, placing children's growth at risk. Children with growth disorders, such as stunting, are more likely to have poor cognition and educational performance, lower economic status, and an increased risk of nutrition-related chronic diseases in adulthood. Our study aimed to systematically review and conduct a meta-analysis of cohort studies investigating the association between HFI and stunting in children aged 0-59 months. Peer-reviewed and grey literature were systematically searched in electronic databases with no language or date restrictions. Two reviewers independently assessed the studies for pre-established eligibility criteria. Data were extracted using a standard protocol. Random-effects meta-analysis models were used, and I2 > 40% indicated high heterogeneity across studies. We used the Grading of Recommendations Assessment, Development, and Evaluation system to assess the quality of the evidence. Nine cohort studies comprising 46,300 children were included. Approximately 80% (n = 7) of the studies found a positive association between HFI and stunting. Pooled odds ratio was 1.00 (95% confidence interval [CI]: 0.87-1.14; I2: 76.14%). The pooled hazard ratio between moderate and severe HFI and stunting was 1.02 (95% CI: 0.84-1.22; I2: 85.96%). Due to high heterogeneity, the quality of evidence was very low. Individual studies showed an association between HFI and stunting in children aged 0-59 months; however, this association was not sustained in the pooled analysis, possibly because of high heterogeneity across studies.
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Affiliation(s)
- Érika S. O. Patriota
- Graduate Program in Public Health, Faculty of Health SciencesUniversity of BrasíliaBrasiliaDistrito FederalBrazil
| | - Lívia C. S. Abrantes
- Department of Nutrition and HealthGraduate Program in Nutrition Science, Federal University of Viçosa (UFV)ViçosaBrazil
| | - Ana C. M. G. Figueiredo
- Epidemiology Surveillance, Federal District Health State DepartmentBrasíliaFederal DistrictBrazil
| | - Nathalia Pizato
- Graduate Program in Human Nutrition, Faculty of Health SciencesUniversity of BrasíliaBrasiliaDistrito FederalBrazil
| | - Gabriela Buccini
- Department of Social and Behavioral HealthUniversity of NevadaLas VegasUSA
| | - Vivian S. S. Gonçalves
- Graduate Program in Public Health, Faculty of Health SciencesUniversity of BrasíliaBrasiliaDistrito FederalBrazil
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Chanie ES, Moges N, Baye FD, Mekonnen GB, Fekadie MM, Bazezew LY, Anley DT, Zemene MA, Gebeyehu NA, Adella GA, Kassie GA, Mengstie MA, Seid MA, Abebe EC, Gesese MM, Tegegne KD, Kebede YS, Bantie B, Feleke SF, Dejenie TA, Bayih WA, Kassaw A, Dessie AM, Azanaw MM, Chanie SS. Estimate the burden of malnutrition among children with cerebral palsy in Sub-Saharan Africa: a systematic review with meta-analysis. Sci Rep 2024; 14:6494. [PMID: 38499717 PMCID: PMC10948888 DOI: 10.1038/s41598-024-55730-1] [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] [Received: 05/20/2023] [Accepted: 02/27/2024] [Indexed: 03/20/2024] Open
Abstract
Malnutrition is more prevalent among children with cerebral palsy and a major factor for child morbidity and mortality in children with different co-morbidity, especially in Sub-Saharan Africa: The main aim of this systematic review and meta-analysis was to estimate the burden of malnutrition among children with cerebral palsy in Sub-Saharan Africa. We searched PubMed, Web of Science, Google Scholar, Research Gate, and institutional repositories for papers that reported the proportion of malnutrition among children with cerebral palsy that were published between December 2010 and September 2023. Data were retrieved using the standardized JBI data extraction checklist through Microsoft Excel, and then exported to STATA 17 for further analysis. DerSimonian and Laird's estimator was used to calculate the pooled effect size in the random-effects model. Statistics such as the Cochran Q test and I2 test were employed to measure heterogeneity. Egger's test and the funnel plot were used to look for publication bias. This systematic review and meta-analysis used 16 studies from Sub-Saharan Africa to estimate the proportion of malnutrition among 2,120 children with cerebral palsy. The pooled proportion of malnutrition among children with cerebral palsy in Sub-Saharan Africa by using random-effects model analysis was found to be 59.7% (95% CI; 49.8-69.6). The proportion of malnutrition was also estimated by sample sizes categorized as ≤ 120 and > 120, and the proportion of malnutrition was found to be 54.0 (95% CI: 44.7-63.3) and 64.5 (95% CI: 50.5-78.5). Moreover, the proportion of malnutrition was estimated by accounting for the difference in the year of publication. In this regard, the study classified before ≤ 2017 and > 2017, and the proportion of malnutrition was found to be 53.7 (95% CI: 38.0-69.3) and 62.5 (95% CI: 49.7-75.3) in Sub-Saharan Africa respectively. Malnutrition among children with cerebral in Sub-Saharan Africa was found to be very high. Hence, enhancing and developing strategic guidelines for malnutrition screening, prevention, and nutritional support are crucial among children with cerebral palsy. Furthermore, systematic review, randomized control trials, and qualitative studies are recommended to understand the burden more among children with cerebral palsy in the continent.
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Affiliation(s)
- Ermias Sisay Chanie
- Department of pediatric and child health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Natnael Moges
- Department of neonatal health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Fikadie Dagnew Baye
- Department of pediatric and child health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gebrehiwot Berie Mekonnen
- Department of pediatric and child health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mengistu Melak Fekadie
- Department of pediatric and child health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Lakachew Yismaw Bazezew
- Department of neonatal health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Denekew Tenaw Anley
- Department of public health, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkamu Aderajew Zemene
- Department of public health, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Atnafu Gebeyehu
- Department of midwifery, College of medicine and Health science, Wolaita sodo university, Wolaita, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive Health and Nutrition, School of Public Health, Woliata Sodo University, Woliata, Ethiopia
| | - Gizachew Ambaw Kassie
- Department of Epidemiology and Biostatistics, School of Public Health, Woliata Sodo University, Woliata, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of medicine and health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mohammed Abdu Seid
- Unit of physiology, Department of Biomedical science, college of health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- Department of Medical Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Molalegn Mesele Gesese
- Department of midwifery, College of medicine and Health science, Wolaita sodo university, Wolaita, Ethiopia
| | - Kirubel Dagnaw Tegegne
- Department of comprehensive Nursing, College of Health sciences, Wollo university, Wollo, Ethiopia
| | - Yenealem Solomon Kebede
- Department of medical laboratory science, College of health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Berihun Bantie
- Department of comprehensive Nursing, College of Health sciences, Debre Tabor university, Debre Tabor, Ethiopia
| | - Sefineh Fenta Feleke
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Epidemiology and preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia, and Department of Maternal and neonatal health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amare Kassaw
- Department of pediatric and child health Nursing, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Anteneh Mengist Dessie
- Department of public health, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkalem Mamuye Azanaw
- Department of public health, College of Health sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sewunt Sisay Chanie
- Department of comprehensive Nursing, College of Health sciences, Debre Berhan university, Debre Berhan, Ethiopia
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Kohanmoo A, Hashemzadeh M, Teymouri M, Zare M, Akhlaghi M. Food insecurity is associated with low diet quality and unhealthy cooking and eating habits in Iranian women. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:42. [PMID: 38486251 PMCID: PMC10941397 DOI: 10.1186/s41043-024-00533-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/02/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Food insecurity affects diet and nutrition intakes. We explored the relationship between food insecurity and dietary intakes in a group of Iranian women. METHODS The cross-sectional study was performed on 190 healthy females aged 20-55 years attending primary healthcare centers in Shiraz. Food insecurity was evaluated by Household Food Insecurity Access Scale, which is a validated tool for assessing food insecurity in developing countries. Diet was assessed using a food frequency questionnaire. The association of dietary patterns and food insecurity was assessed by linear regression. RESULTS Assessment of dietary intakes revealed that consumption of red meat, poultry, fish, dairy, fruits, non-starchy vegetables, and nuts decreased whereas that of grains, processed meats, potato, and sugary foods increased with increasing food insecurity. Among nutrients, carbohydrates, fiber, vitamin A, vitamin C, folic acid, potassium, calcium, and magnesium decreased while fat and sodium increased as food insecurity increased. Three major dietary patterns were detected. Healthy dietary patterns showed inverse associations with food insecurity in the crude (β = -0.422 and - 0.435, P < 0.001) and adjusted (adjusted for age, marital status, and educational level) (β = -0.475 and - 0.341, P < 0.001) models of regression analysis but unhealthy pattern did not show an association with food insecurity. Compared to food secure participants, a higher percentage of food insecure individuals indicated unhealthy eating habits, such as skipping breakfast, lower snack ingestion, more fast and fried food consumption, and using unhealthy cooking methods. CONCLUSION Overall, this study showed that food insecurity was associated with less healthy diet and unhealthy cooking and eating habits.
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Affiliation(s)
- Ali Kohanmoo
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maral Hashemzadeh
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Teymouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Morteza Zare
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Azimi MN, Rahman MM. Food insecurity, environment, institutional quality, and health outcomes: evidence from South Asia. Global Health 2024; 20:21. [PMID: 38459556 PMCID: PMC10924333 DOI: 10.1186/s12992-024-01022-2] [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] [Received: 09/06/2023] [Accepted: 02/12/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Food insecurity and environmental degradation pose significant threats to health outcomes in South Asia, necessitating effective policy interventions. Therefore, this study aims to examine the impact of food insecurity and environmental degradation on health outcome indicators amidst global inflationary shocks and institutional quality arrangements. Additionally, it aims to explore the intricate moderating role of institutional quality on the relationship between food insecurity, endogenous variables, and external shocks. METHOD In alignment with the study's objectives, a set of panel data spanning from 2000 to 2021 is compiled for South Asia. The study introduces a novel variable representing inflationary shock, crafted through the integration of inflation datapoints and the application of the generalized autoregressive conditional heteroskedasticity model. Additionally, a distinctive aggregate institutional quality index is formulated, drawing from six key measures of the Worldwide Governance indicators. To scrutinize the effects of food insecurity, environmental degradation, and other explanatory variables, the study employs the two-step system generalized method of moment technique, offering a robust analytical approach to uncover complex relationships and dynamics in the region. RESULTS The results indicate that the prevalence of undernourishment, inequality in per capita calorie intake, and CO2 emissions significantly reduce life expectancy and increase mortality rates. Additionally, it shows that per capita kilocalorie supply, per capita GDP, per capita health expenditures, and urbanization are statistically significant for increasing life expectancy and decreasing mortality rates. The findings reveal that inflationary shocks severely affect food insecurity and environmental factors, exerting further pressure on contemporary life expectancy and mortality rates. In rebuttal, the institutional quality index is found to have significant effects on increasing and decreasing life expectancy and mortality rates, respectively. Furthermore, the institutional quality index is effective in moderating the nexus between food insecurity, environmental degradation, and health outcomes while also neutralizing the negative impact of inflationary shocks on the subject. CONCLUSION The results verify triple health constraints such as food insecurity, environmental factors, and economic vulnerability to global shocks, which impose severe effects on life expectancy and mortality rates. Furthermore, poor institutional quality is identified as a hindrance to health outcomes in South Asia. The findings suggest specific policy implications that are explicitly discussed.
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Affiliation(s)
- Mohammad Naim Azimi
- School of Business, University of Southern Queensland, Toowoomba, Australia.
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Sonderup MW, Kamath PS, Awuku YA, Desalegn H, Gogela N, Katsidzira L, Tzeuton C, Bobat B, Kassianides C, Spearman CW. Managing cirrhosis with limited resources: perspectives from sub-Saharan Africa. Lancet Gastroenterol Hepatol 2024; 9:170-184. [PMID: 38215781 DOI: 10.1016/s2468-1253(23)00279-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/05/2023] [Accepted: 08/14/2023] [Indexed: 01/14/2024]
Abstract
Cirrhosis represents the end stage of chronic liver disease. Sub-Saharan Africa, a resource-constrained region, has a high burden of chronic liver disease, with causes including chronic viral hepatitis, excessive alcohol use, and metabolic dysfunction-associated steatotic liver disease (MASLD), the risk of which is burgeoning. The development of liver cirrhosis predicts for morbidity and mortality, driven by both liver dysfunction and the consequences of portal hypertension. Compensated cirrhosis portends a better prognosis than decompensated cirrhosis, highlighting the need for the early diagnosis of cirrhosis and its causes. With resource challenges, the diagnosis and management of cirrhosis is demanding, but less costly and less invasive interventions with substantial benefits, ranging from simple blood tests to transient elastography, are feasible in such settings. Simple interventions are also available to manage the complex manifestations of decompensation, such as β blockers in variceal bleeding prophylaxis, salt restriction and appropriate diuretic use in ascites, and lactulose and generic rifaximin in hepatic encephalopathy. Ultimately, managing the underlying causative factors of liver disease is key in improving prognosis. Management demands expanded policy interventions to increase screening and treatment for hepatitis B and C and reduce alcohol use and the metabolic factors driving MASLD. Furthermore, the skills needed for more specialised interventions, such as transjugular intrahepatic portosystemic shunt procedures and even liver transplantation, warrant planning, increased capacity, and support for regional centres of excellence. Such centres are already being developed in sub-Saharan Africa, demonstrating what can be achieved with dedicated initiatives and individuals.
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Affiliation(s)
- Mark W Sonderup
- Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
| | | | - Yaw A Awuku
- Department of Medicine, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Hailemichael Desalegn
- Department of Internal Medicine, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Neliswa Gogela
- Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Leolin Katsidzira
- Internal Medicine Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Christian Tzeuton
- Faculty of Medicine and Pharmaceutical Sciences of Douala, University of Douala, Douala, Cameroon
| | - Bilal Bobat
- Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand and Wits Donald Gordon Medical Centre, Johannesburg, South Africa
| | - Chris Kassianides
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - C Wendy Spearman
- Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
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Kota K, Chomienne MH, Yaya S. Examining the disparities: A cross-sectional study of socio-economic factors and food insecurity in Togo. PLoS One 2023; 18:e0294527. [PMID: 38011188 PMCID: PMC10681261 DOI: 10.1371/journal.pone.0294527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 11/01/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Despite many interventions, Togo continues to have one of the highest rates of poverty and food insecurity in the sub-Saharan African region. Currently there is no systematic analysis of the factors associated with household food-insecurity in this country. This study aimed at exploring the factors associated with food insecurity in Togo. METHODS This was a cross-sectional study that used data from five waves (2014 to 2018) of the Gallup World Poll (GWP) for Togo. Sample size included 4754 participants, aged 15 and above. Food insecurity was measured using the Food Insecurity Experience Scale (FIES) questionnaire as per the Food and Agricultural Organization (FAO) guidelines. Our outcome variable was food insecurity, categorized as: 1) food secure (FIES score = 0-3), moderately food insecure (FIES score = 4-6), and severely food insecure (FIES score = 7-8). We did descriptive and multinomial regressions to analyze data using Stata version 16. RESULTS Between 2014 and 2018, the percentage of severe food insecurity fluctuated-42.81% in 2014, 37.79% in 2015, 38.98% in 2016, 45.41% in 2017, and 33.84% in 2018. Whereas that of moderate food insecurity increased from 23.55% to 27.33% except for 2016 and 2017 where the percentage increased to 32.33% and 27.46% respectively. In the logistic regression analysis, we found that respondents with lower than elementary education had a higher relative risk ratio of moderate (RRR = 1.45,95%CI = 1.22-1.72) and severe (RRR = 1.72, 95%CI = 1.46-2.02) food insecurity compared to those with secondary and higher education. Rural respondents had higher RRR of severe food insecurity (RRR = 1.37, 95%CI = 1.16-1.62) compared to those who lived in the urban areas. Compared with those in the richest wealth quintile, respondents in the poorest wealth quintile had 2.21 times higher RRR of moderate (RRR = 2.21, 95%CI = 1.69-2.87) and 3.58 times higher RRR of severe (RRR = 3.58, 95%CI = 2.81-4.55) food insecurity. CONCLUSION About two-thirds of participants experienced some level of food insecurity in 2018. Lower levels of education, rural residency and poorer household wealth index areas were associated with a higher risk of food insecurity. National food security programs should focus on promoting education and improving socioeconomic condition of people especially in rural areas.
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Affiliation(s)
- Komlan Kota
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ontario, Canada
| | - Marie-Hélène Chomienne
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario
- The George Institute for Global Health, Imperial College London, London, United Kingdom
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11
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Tari Selcuk K, Atan RM, Arslan S, Sahin N. Is food insecurity related to sustainable and healthy eating behaviors? ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27694-8. [PMID: 37204579 DOI: 10.1007/s11356-023-27694-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/12/2023] [Indexed: 05/20/2023]
Abstract
In this cross-sectional study, it was aimed to investigate the relationship between sustainable and healthy eating behaviors such as nutritional insecurity and a healthy and balanced diet, interest in regional and organic food products, consumption of seasonal food and avoidance of food waste, preference for locally produced foods, reduction of meat consumption, preference for eggs from free-range chickens, and sustainable fishery products, and consumption of low-fat food products in adults. The study included 410 adults who were reached through social media applications. Data were collected through an online questionnaire including the Descriptive Information Form, the Household Food Insecurity Access Scale (HFIAS), and the Sustainable Healthy Eating Behaviors Scale (SHEBS). The proportion of participants determined as mildly food insecure, moderately food insecure, and severely food insecure was 10.2%, 6.6%, and 7.6%, respectively. Linear regression analysis revealed that in Models 1, 2, and 3, there was a statistically significant negative association between food insecurity and the components of sustainable and healthy eating behaviors such as healthy and balanced diet (β - 0.226, p < 0.001), quality labels (β - 0.230, p < 0.001), seasonal foods, which are of avoidance of food waste (β - 0.261, p < 0.001), animal welfare (β - 0.174, p < 0.001), and fat intake (β - 0.181, p < 0.001). In conclusion, food insecurity negatively affects healthy and balanced diet behaviors, interest in regional and organic food products, seasonal food products consumption and avoidance of food waste, consumption of low-fat food products, and the choice of products such as free-range chicken eggs, and sustainable fisheries.
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Affiliation(s)
- Kevser Tari Selcuk
- Department of Nutrition and Dietetics, Bandirma Onyedi Eylul University, Balikesir, Turkey.
| | - Ramazan Mert Atan
- Department of Nutrition and Dietetics, Bandirma Onyedi Eylul University, Balikesir, Turkey
- Department of Nutrition and Dietetics, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Sedat Arslan
- Department of Nutrition and Dietetics, Bandirma Onyedi Eylul University, Balikesir, Turkey
| | - Nursel Sahin
- Department of Nutrition and Dietetics, Bandirma Onyedi Eylul University, Balikesir, Turkey
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Militao EMA, Uthman OA, Salvador EM, Vinberg S, Macassa G. Food Insecurity and Associated Factors among Households in Maputo City. Nutrients 2023; 15:nu15102372. [PMID: 37242255 DOI: 10.3390/nu15102372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Food insecurity (FI) is a global concern and is one of the main causes of malnutrition in low- and middle-income countries. In Mozambique, the burden of FI and how various factors contribute to FI is not well known. This study aimed to investigate the prevalence of FI and its associated factors in southern Mozambique. Data from 1842 household heads in Maputo City were analyzed in a cross-sectional design. Food insecurity was measured using a modified version of the US Department of Agriculture Household Food Security scale, and its association with socio-demographic factors was assessed through multiple regressions. Altogether, 79% of the households were food insecure; of these, 16.6% had mild FI, 28.1% moderate and 34.4% severe FI. The study revealed that low-income households, those with less educated heads, and those engaged in informal work were significantly more prone to FI. Likewise, dietary diversity and the number of meals were also significant predictors of FI. These findings suggest the need for decent work and job creation, which calls for joint efforts from government, the private sector, and international institutions. Furthermore, these key drivers should be considered in the development of public health policies and programs designed to alleviate household FI and malnutrition in Mozambique.
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Affiliation(s)
- Elias M A Militao
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 801 76 Gävle, Sweden
- Department of Biological Sciences, Faculty of Science, Eduardo Mondlane University, 3453 Julius Nyerere Avenue, Maputo 257, Mozambique
| | - Olalekan A Uthman
- Warwick Centre for Global Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Department of Global Health, Division of Epidemiology and Biostatistics, Faculty of Health Sciences, Stellenbosch University, Francie van Zijl Drive, Cape Town 7505, South Africa
| | - Elsa M Salvador
- Department of Biological Sciences, Faculty of Science, Eduardo Mondlane University, 3453 Julius Nyerere Avenue, Maputo 257, Mozambique
| | - Stig Vinberg
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
| | - Gloria Macassa
- Department of Health Sciences, Faculty of Humanities, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
- Department of Public Health and Sports Science, Faculty of Occupational and Health Sciences, University of Gävle, Kungsbacksvägen 47, 801 76 Gävle, Sweden
- EPI Unit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
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Food Insecurity Is Associated with Dietary Consumption during the COVID-19 Pandemic: Data from the Korea National Health and Nutrition Examination Survey 2019-2020. Nutrients 2023; 15:nu15030772. [PMID: 36771477 PMCID: PMC9919441 DOI: 10.3390/nu15030772] [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: 12/29/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has become a pandemic and has affected people's dietary behaviors, including food insecurity. This study aimed to ascertain whether COVID-19 may alter the prevalence of food insecurity, and if such food security status may be associated with dietary intake among Koreans. The general characteristics, dietary intake and food security status data in the Korea National Health and Nutrition Examination Survey VIII (2019~2020) were analyzed. The prevalence of food insecurity and food group and nutrient consumption by food security status were analyzed before (2019) and after the start of the pandemic (2020). Findings suggested 4.3% of Koreans experienced food insecurity during the first year of the pandemic, yet it did not differ from that in the year before the pandemic. Before COVID-19, there was no significant difference in food group or nutrition consumption by food security status. However, in 2020, the fruit and vitamin C intake of the food-insecure group was significantly lower than that of the food-secure group. Additionally, the food-insecure group's ratio of subjects who did not meet the recommended level of fruits and the vitamin was higher compared to that of the secure group. In conclusion, COVID-19 did not affect food insecurity status, but did have a negative influence on dietary intake for food-insecure Koreans.
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Examining mediators of associations of food insecurity and being bullied with suicide among in-school adolescents in Eswatini: a cross-sectional study. Sci Rep 2023; 13:1668. [PMID: 36717579 PMCID: PMC9886993 DOI: 10.1038/s41598-023-28767-x] [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: 07/17/2022] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
We examined the potential mediating roles of anxiety and loneliness on the association of concurrent food insecurity (FI) and being bullied (BB) with suicidal behavior (SB) in Eswatini, a lower-middle-income country. We used data from the Global School-based Student Health Survey (GSHS; N = 3264), which employed a two-stage cluster sampling: first, 25 schools were selected based on the proportionate probability of enrollment; second, classes were randomly selected. A self-reported 84-item GSHS questionnaire was used to collect data for students aged 13-17 years. FI was measured by requesting students to recall how often they went hungry because of a lack of food at home in the 30 days before the study. Multiple logistic regressions and binary mediation function was applied to examine mediating factors of SB. The prevalence of SB, FI, and BB among adolescents was 27.5%, 7.7%, and 30.2%, respectively. Moreover, the relationship between FI and BB with SB was partly (approximately 24%) mediated by anxiety and loneliness. Our results highlight the mediating roles of anxiety and loneliness in suicidal adolescents who experience FI and BB. In conclusion, interventions for alleviating SB in high-risk adolescents experiencing FI and BB should also be aimed at ameliorating anxiety and loneliness.
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The cost of living crisis: how can we tackle fuel poverty and food insecurity in practice? Br J Gen Pract 2022. [DOI: 10.3399/bjgp22x720761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Coping Strategies for Household Food Insecurity, and Perceived Health in an Urban Community in Southern Mozambique: A Qualitative Study. SUSTAINABILITY 2022. [DOI: 10.3390/su14148710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In low- and middle-income countries, food insecurity (FI) is a living reality for many households, particularly among the most vulnerable groups. The burden of household FI in Mozambique and how FI and coping strategies relate to perceived health are unknown. This study investigated the lived experiences and coping strategies of food-insecure households, along with their perceived health. Altogether, 16 in-depth interviews were performed, audio-recorded, and transcribed verbatim. A qualitative content analysis was carried out and five themes emerged: lived experiences of FI, coping strategies used in situations of FI, food choices, climate change and food security, and FI and perceived health. A wide range of lived experiences and coping strategies were reported, including cooking whatever is available, skipping meals, receiving money or food from friends and relatives, eating unsafe and low-quality foods, taking on additional work, cooking least-preferred foods, and having a monotonous and less-nutritious diet. Furthermore, the participants reported emotional distress, anxiety and depression, substance use, and other negative health outcomes. Some had diagnoses of hypertension, diabetes or HIV/AIDS. The findings suggest the need for employment creation and women’s empowerment, as well as the implementation of appropriate policies and programmes to alleviate household FI.
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