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Dass M, Nyako J, Tortoe C, Fanou-Fogny N, Nago E, Hounhouigan J, Berger J, Wieringa F, Greffeuille V. Comparison of Micronutrient Intervention Strategies in Ghana and Benin to Cover Micronutrient Needs: Simulation of Bene-Fits and Risks in Women of Reproductive Age. Nutrients 2021; 13:nu13072286. [PMID: 34371796 PMCID: PMC8308306 DOI: 10.3390/nu13072286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 11/16/2022] Open
Abstract
Overlapping micronutrient interventions might increase the risk of excessive micronutrient intake, with potentially adverse health effects. To evaluate how strategies currently implemented in Benin and Ghana contribute to micronutrient intake in women of reproductive age (WRA), and to assess the risk for excess intakes, scenarios of basic rural and urban diets were built, and different on-going interventions were added. We estimated micronutrient intakes for all different scenarios. Four types of intervention were included in the scenarios: fortification, biofortification, supplementation and use of locally available nutrient-rich foods. Basic diets contributed poorly to daily micronutrient intake in WRA. Fortification of oil and salt were essential to reach daily requirements for vitamin A and iodine, while fortified flour contributed less. Biofortified products could make an important contribution to the coverage of vitamin A needs, while they were not sufficient to cover the needs of WRA. Iron and folic acid supplementation was a major contributor in the intake of iron and folate, but only in pregnant and lactating women. Risk of excess were found for three micronutrients (vitamin A, folic acid and niacin) in specific contexts, with excess only coming from voluntary fortified food, supplementation and the simultaneous overlap of several interventions. Better regulation and control of fortification and targeting of supplementation could avoid excess intakes.
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Affiliation(s)
- Mamta Dass
- Institut de Recherche pour le Développement (IRD), BP 64501-911, av. d’Agropolis, 34394 Montpellier, France; (M.D.); (J.B.); (F.W.)
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La Réunion, 34394 Montpellier, France
| | - Jolene Nyako
- Nutrition Unit, Food Research Institute, Council for Scientific and Industrial Research (CSIR), Accra P.O. Box M20, Ghana; (J.N.); (C.T.)
| | - Charles Tortoe
- Nutrition Unit, Food Research Institute, Council for Scientific and Industrial Research (CSIR), Accra P.O. Box M20, Ghana; (J.N.); (C.T.)
| | - Nadia Fanou-Fogny
- Faculté des Sciences Agronomiques (FSA), Université d’Abomey-Calavi (UAC), Jéricho 03 BP 2819, Benin; (N.F.-F.); (E.N.); (J.H.)
| | - Eunice Nago
- Faculté des Sciences Agronomiques (FSA), Université d’Abomey-Calavi (UAC), Jéricho 03 BP 2819, Benin; (N.F.-F.); (E.N.); (J.H.)
| | - Joseph Hounhouigan
- Faculté des Sciences Agronomiques (FSA), Université d’Abomey-Calavi (UAC), Jéricho 03 BP 2819, Benin; (N.F.-F.); (E.N.); (J.H.)
| | - Jacques Berger
- Institut de Recherche pour le Développement (IRD), BP 64501-911, av. d’Agropolis, 34394 Montpellier, France; (M.D.); (J.B.); (F.W.)
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La Réunion, 34394 Montpellier, France
| | - Frank Wieringa
- Institut de Recherche pour le Développement (IRD), BP 64501-911, av. d’Agropolis, 34394 Montpellier, France; (M.D.); (J.B.); (F.W.)
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La Réunion, 34394 Montpellier, France
| | - Valerie Greffeuille
- Institut de Recherche pour le Développement (IRD), BP 64501-911, av. d’Agropolis, 34394 Montpellier, France; (M.D.); (J.B.); (F.W.)
- QualiSud, Univ Montpellier, Avignon Université, CIRAD, Institut Agro, IRD, Université de La Réunion, 34394 Montpellier, France
- Correspondence:
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Accrombessi M, Yovo E, Fievet N, Cottrell G, Agbota G, Gartner A, Martin-Prevel Y, Vianou B, Sossou D, Fanou-Fogny N, Djossinou D, Massougbodji A, Cot M, Briand V. Effects of Malaria in the First Trimester of Pregnancy on Poor Maternal and Birth Outcomes in Benin. Clin Infect Dis 2020; 69:1385-1393. [PMID: 30561538 DOI: 10.1093/cid/ciy1073] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 12/12/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In sub-Saharan Africa, malaria in the first half of pregnancy is harmful for both the mother and her fetus. However, malaria in the first trimester of pregnancy, when women are usually not protected against malaria, has been little investigated. For the first time, we assessed the effects of malaria in the first trimester on maternal and birth outcomes using a preconceptional study design. METHODS From June 2014 to March 2017, 1214 women of reproductive age were recruited and followed monthly until 411 became pregnant. The pregnant women were then followed from 5-6 weeks of gestation until delivery. Path analysis was used to assess the direct effect (ie, not mediated by malaria in the second or third trimester) of malaria in the first trimester on maternal anemia and poor birth outcomes. The cumulative effect of infections during pregnancy on the same outcomes was also evaluated. RESULTS The prevalence of malaria infections in the first trimester was 21.8%. Malaria in the first trimester was significantly associated with maternal anemia in the third trimester (adjusted odds ratio 2.25, 95% confidence interval 1.11-4.55). While we did not find evidence of any direct effect of first trimester malaria infections on birth outcomes, their association with infections later in pregnancy tended to increase the risk of low birth weights. CONCLUSIONS Malaria infections in the first trimester were highly prevalent and have deleterious effects on maternal anemia. They highlight the need for additional preventive measures, starting in early pregnancy or even before conception.
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Affiliation(s)
- Manfred Accrombessi
- Joint Research Unit 216, Mothers and Children Facing Tropical Infections (MERIT), French National Research Institute for Sustainable Development, Université Paris 5, Sorbonne Paris Cité, France.,Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Emmanuel Yovo
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Nadine Fievet
- Joint Research Unit 216, Mothers and Children Facing Tropical Infections (MERIT), French National Research Institute for Sustainable Development, Université Paris 5, Sorbonne Paris Cité, France
| | - Gilles Cottrell
- Joint Research Unit 216, Mothers and Children Facing Tropical Infections (MERIT), French National Research Institute for Sustainable Development, Université Paris 5, Sorbonne Paris Cité, France
| | - Gino Agbota
- Joint Research Unit 216, Mothers and Children Facing Tropical Infections (MERIT), French National Research Institute for Sustainable Development, Université Paris 5, Sorbonne Paris Cité, France.,Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Agnès Gartner
- UJoint Research Unit 204, Nutrition and Food of the Populations in the South (NUTRIPASS), French National Research Institute for Sustainable Development, Université de Montpellier, SupAgro, Montpellier, France
| | - Yves Martin-Prevel
- UJoint Research Unit 204, Nutrition and Food of the Populations in the South (NUTRIPASS), French National Research Institute for Sustainable Development, Université de Montpellier, SupAgro, Montpellier, France
| | - Bertin Vianou
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Darius Sossou
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Nadia Fanou-Fogny
- Ecole de Nutrition et des Sciences et Technologies Alimentaires, Faculté des Sciences Agronomiques, Université d'Abomey-Calavi, Benin
| | - Diane Djossinou
- UJoint Research Unit 204, Nutrition and Food of the Populations in the South (NUTRIPASS), French National Research Institute for Sustainable Development, Université de Montpellier, SupAgro, Montpellier, France.,Ecole de Nutrition et des Sciences et Technologies Alimentaires, Faculté des Sciences Agronomiques, Université d'Abomey-Calavi, Benin
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Michel Cot
- Joint Research Unit 216, Mothers and Children Facing Tropical Infections (MERIT), French National Research Institute for Sustainable Development, Université Paris 5, Sorbonne Paris Cité, France
| | - Valérie Briand
- Joint Research Unit 216, Mothers and Children Facing Tropical Infections (MERIT), French National Research Institute for Sustainable Development, Université Paris 5, Sorbonne Paris Cité, France
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Accrombessi M, Yovo E, Cottrell G, Agbota G, Gartner A, Martin-Prevel Y, Fanou-Fogny N, Djossinou D, Zeitlin J, Tuikue-Ndam N, Bodeau-Livinec F, Houzé S, Jackson N, Ayemonna P, Massougbodji A, Cot M, Fievet N, Briand V. Cohort profile: effect of malaria in early pregnancy on fetal growth in Benin (RECIPAL preconceptional cohort). BMJ Open 2018; 8:e019014. [PMID: 29317419 PMCID: PMC5781192 DOI: 10.1136/bmjopen-2017-019014] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE REtard de Croissance Intra-uterin et PALudisme (RECIPAL) is an original preconceptional cohort designed to assess the consequences of malaria during the first trimester of pregnancy, which is a poorly investigated period in Africa and during which malaria may be detrimental to the fetus. PARTICIPANTS For this purpose, a total of 1214 women of reproductive age living in Sô-Ava and Akassato districts (south Benin) were followed up monthly from June 2014 to December 2016 until 411 of them became pregnant. A large range of health determinants was collected both before and during pregnancy from the first weeks of gestation to delivery. Five Doppler ultrasound scans were performed for early dating of the pregnancy and longitudinal fetal growth assessment. FINDINGS TO DATE Pregnant women were identified at a mean of 6.9 weeks of gestation (wg). Preliminary results confirmed the high prevalence of malaria in the first trimester of pregnancy, with more than 25.4% of women presenting at least one microscopic malarial infection during this period. Most infections occurred before six wg. The prevalence of low birth weight, small birth weight for gestational age (according to INTERGROWTH-21st charts) and preterm birth was 9.3%, 18.3% and 12.6%, respectively. FUTURE PLANS REtard de Croissance Intra-uterin et PALudisme (RECIPAL) represents at this time a unique resource that will provide information on multiple infectious (including malaria), biological, nutritional and environmental determinants in relation to health outcomes in women of reproductive age, pregnant women and their newborns. It will contribute to better define future recommendations for the prevention of malaria in early pregnancy and maternal malnutrition in Africa. It confirms that it is possible to constitute a preconceptional pregnancy cohort in Africa and provides valuable information for researchers starting cohorts in the future.
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Affiliation(s)
- Manfred Accrombessi
- UMR216-MERIT, French National Research Institute for Sustainable Development (IRD), Université Paris Descartes, Paris, France
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Cotonou, Benin
| | - Emmanuel Yovo
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Cotonou, Benin
| | - Gilles Cottrell
- UMR216-MERIT, French National Research Institute for Sustainable Development (IRD), Université Paris Descartes, Paris, France
| | - Gino Agbota
- UMR216-MERIT, French National Research Institute for Sustainable Development (IRD), Université Paris Descartes, Paris, France
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Cotonou, Benin
| | - Agnès Gartner
- UMR204-Nutripass, French National Research Institute for Sustainable Development (IRD), Université de Montpellier, Montpellier, France
| | - Yves Martin-Prevel
- UMR204-Nutripass, French National Research Institute for Sustainable Development (IRD), Université de Montpellier, Montpellier, France
| | - Nadia Fanou-Fogny
- Ecole de Nutrition et des Sciences et Technologies Alimentaires (ENSTA), Faculté des Sciences Agronomiques, Université d’Abomey-Calavi, Abomey-Calavi, Benin
| | - Diane Djossinou
- UMR204-Nutripass, French National Research Institute for Sustainable Development (IRD), Université de Montpellier, Montpellier, France
- Ecole de Nutrition et des Sciences et Technologies Alimentaires (ENSTA), Faculté des Sciences Agronomiques, Université d’Abomey-Calavi, Abomey-Calavi, Benin
| | - Jennifer Zeitlin
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre for Epidemiology and Biostatistics (U1153-EPOPé), National Institute for Health and Medical Research (INSERM), Université Paris Descartes, Paris, France
| | - Nicaise Tuikue-Ndam
- UMR216-MERIT, French National Research Institute for Sustainable Development (IRD), Université Paris Descartes, Paris, France
| | - Florence Bodeau-Livinec
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Centre for Epidemiology and Biostatistics (U1153-EPOPé), National Institute for Health and Medical Research (INSERM), Université Paris Descartes, Paris, France
- Département Méthodes Quantitatives en Santé Publique, Ecole des Hautes Etudes en Santé Publique (EHESP), Université de Rennes, Rennes, France
| | - Sandrine Houzé
- UMR216-MERIT, French National Research Institute for Sustainable Development (IRD), Université Paris Descartes, Paris, France
- Laboratoire de Parasitologie, CNR du Paludisme, AP-HP, Hôpital Bichat, Paris, France
| | - Nicola Jackson
- Department of Obstetrics and Gynaecology, Oxford University, Oxford, UK
| | - Paul Ayemonna
- Service de Gynécologie et Obstétrique, Centre Hospitalier Universitaire d’Abomey-Calavi, Abomey-Calavi, Benin
| | - Achille Massougbodji
- Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l’Enfance (CERPAGE), Cotonou, Benin
| | - Michel Cot
- UMR216-MERIT, French National Research Institute for Sustainable Development (IRD), Université Paris Descartes, Paris, France
| | - Nadine Fievet
- UMR216-MERIT, French National Research Institute for Sustainable Development (IRD), Université Paris Descartes, Paris, France
| | - Valérie Briand
- UMR216-MERIT, French National Research Institute for Sustainable Development (IRD), Université Paris Descartes, Paris, France
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Chadare FJ, Madode YE, Fanou-Fogny N, Kindossi JM, Ayosso JO, Honfo SH, Kayodé AP, Linnemann AR, Hounhouigan DJ. Indigenous food ingredients for complementary food formulations to combat infant malnutrition in Benin: a review. J Sci Food Agric 2018; 98:439-455. [PMID: 28731216 DOI: 10.1002/jsfa.8568] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 07/07/2017] [Accepted: 07/10/2017] [Indexed: 06/07/2023]
Abstract
This paper reviews indigenous Beninese food resources as potential ingredients for complementary infant foods with the aim to develop affordable formulations for low-income households in each agro-ecological zone of the country. Potential ingredients were selected on their documented nutritional value. The selected foods encompass 347 food resources, namely 297 plant products from home gardens or collected from natural vegetation and 50 animals, either domesticated or from the wild. The compiled data reveal that the distribution of the available food resources was unbalanced between agro-ecological zones. Only a few animal ingredients are obtainable in northern Benin. Most resources are seasonal, but their availability may be extended. A high variation was observed in energy and nutrient contents. Antinutritional factors were identified in some resources, but processing techniques were reported to reduce their presence in meals. In general, ingredients from local tree foods (Adansonia digitata, Parkia biglobosa) were adequate as sources of nutrients for complementary infant foods. Based on this review, local foods for the development of complementary food formulas for Beninese infants and children may be selected for each agro-ecological zone. The approach used is exemplary for other sub-Saharan African countries in need of complementary infant foods. © 2017 Society of Chemical Industry.
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Affiliation(s)
- Flora J Chadare
- Laboratoire de Sciences des Aliments, Faculté des Sciences Agronomiques, Université d'Abomey-Calavi (LSA/FSA/UAC), Abomey-Calavi, Benin
- Ecole des Sciences et Techniques de Conservation et de Transformation des produits Agricoles, Université Nationale d'Agriculture (ESTCTPA/UNA), Sakété, Bénin
| | - Yann E Madode
- Laboratoire de Sciences des Aliments, Faculté des Sciences Agronomiques, Université d'Abomey-Calavi (LSA/FSA/UAC), Abomey-Calavi, Benin
| | - Nadia Fanou-Fogny
- Laboratoire de Sciences des Aliments, Faculté des Sciences Agronomiques, Université d'Abomey-Calavi (LSA/FSA/UAC), Abomey-Calavi, Benin
| | - Janvier M Kindossi
- Laboratoire de Sciences des Aliments, Faculté des Sciences Agronomiques, Université d'Abomey-Calavi (LSA/FSA/UAC), Abomey-Calavi, Benin
| | - Juvencio Og Ayosso
- Laboratoire de Sciences des Aliments, Faculté des Sciences Agronomiques, Université d'Abomey-Calavi (LSA/FSA/UAC), Abomey-Calavi, Benin
| | - S Hermann Honfo
- Laboratoire de Sciences des Aliments, Faculté des Sciences Agronomiques, Université d'Abomey-Calavi (LSA/FSA/UAC), Abomey-Calavi, Benin
- Laboratoire de Biomathématiques et d'Estimations Forestières, Université d'Abomey-Calavi (Labef/UAC), Abomey-Calavi, Benin
| | - Ap Polycarpe Kayodé
- Laboratoire de Sciences des Aliments, Faculté des Sciences Agronomiques, Université d'Abomey-Calavi (LSA/FSA/UAC), Abomey-Calavi, Benin
| | - Anita R Linnemann
- Food Quality and Design, Wageningen University (FQD/WU), Wageningen, The Netherlands
| | - D Joseph Hounhouigan
- Laboratoire de Sciences des Aliments, Faculté des Sciences Agronomiques, Université d'Abomey-Calavi (LSA/FSA/UAC), Abomey-Calavi, Benin
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Koréissi-Dembélé Y, Fanou-Fogny N, Moretti D, Schuth S, Dossa RAM, Egli I, Zimmermann MB, Brouwer ID. Dephytinisation with intrinsic wheat phytase and iron fortification significantly increase iron absorption from fonio (Digitaria exilis) meals in West African women. PLoS One 2013; 8:e70613. [PMID: 24124445 PMCID: PMC3790800 DOI: 10.1371/journal.pone.0070613] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 06/22/2013] [Indexed: 11/27/2022] Open
Abstract
Low iron and high phytic acid content make fonio based meals a poor source of bioavailable iron. Phytic acid degradation in fonio porridge using whole grain cereals as phytase source and effect on iron bioavailability when added to iron fortified fonio meals were investigated. Grains, nuts and seeds collected in Mali markets were screened for phytic acid and phytase activity. We performed an iron absorption study in Beninese women (n = 16), using non-dephytinised fonio porridge (FFP) and dephytinised fonio porridge (FWFP; 75% fonio-25% wheat), each fortified with 57Fe or 58Fe labeled FeSO4. Iron absorption was quantified by measuring the erythrocyte incorporation of stable iron isotopes. Phytic acid varied from 0.39 (bambara nut) to 4.26 g/100 g DM (pumpkin seed), with oilseeds values higher than grains and nuts. Phytase activity ranged from 0.17±1.61 (fonio) to 2.9±1.3 phytase unit (PU) per g (whole wheat). Phytic acid was almost completely degraded in FWFP after 60 min of incubation (pH≈5.0, 50°C). Phytate∶iron molar ratios decreased from 23.7∶1 in FFP to 2.7∶1 in FWFP. Iron fortification further reduced phytate∶iron molar ratio to 1.9∶1 in FFP and 0.3∶1 in FWFP, respectively. Geometric mean (95% CI) iron absorption significantly increased from 2.6% (0.8–7.8) in FFP to 8.3% (3.8–17.9) in FWFP (P<0.0001). Dephytinisation of fonio porridge with intrinsic wheat phytase increased fractional iron absorption 3.2 times, suggesting it could be a possible strategy to decrease PA in cereal-based porridges.
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Affiliation(s)
- Yara Koréissi-Dembélé
- Department of Food Sciences and Nutrition Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
- Institute of Rural Economy (IER), Regional Agronomical Research Center (CRRA) Sotuba, Food Technology Laboratory (LTA), Bamako, Mali
- * E-mail: (YKD); (NFF)
| | - Nadia Fanou-Fogny
- Department of Food Sciences and Nutrition Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
- Department of Nutrition and Food Sciences, FSA, University of Abomey Calavi, Cotonou, Benin
- * E-mail: (YKD); (NFF)
| | - Diego Moretti
- Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Stephan Schuth
- Steinmann Institute of Geology, Mineralogy, and Petrology, University of Bonn, Bonn, Germany
| | - Romain A. M. Dossa
- Department of Nutrition and Food Sciences, FSA, University of Abomey Calavi, Cotonou, Benin
| | - Ines Egli
- Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Michael B. Zimmermann
- Department of Food Sciences and Nutrition Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
- Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Inge D. Brouwer
- Department of Food Sciences and Nutrition Group, Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
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Koreissi-Dembélé Y, Fanou-Fogny N, Hulshof PJ, Brouwer ID. Fonio (Digitaria exilis) landraces in Mali: Nutrient and phytate content, genetic diversity and effect of processing. J Food Compost Anal 2013. [DOI: 10.1016/j.jfca.2012.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Fanou-Fogny N, van Dam B, Koreissi Y, Dossa RAM, Brouwer ID. Factors predicting consumption of fonio grain (Digitaria exilis) among urban Malian women of reproductive age. J Nutr Educ Behav 2011; 43:219-228. [PMID: 21377935 DOI: 10.1016/j.jneb.2010.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2009] [Revised: 03/16/2010] [Accepted: 03/20/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To identify factors influencing intention to consume an indigenous nutritious grain, fonio (Digitaria exilis), among women in Mali. DESIGN A cross-sectional questionnaire survey based on the Theory of Planned Behavior and the Health Belief Model. SETTING AND PARTICIPANTS One hundred and eight women (31.5 ± 10.5 years), randomly selected by a 3-stage cluster sampling, Bamako, Mali. MAIN OUTCOME MEASURES Model constructs scores, intention to consume fonio, and fonio consumption. ANALYSIS Correlation and multiple regression, Wilcoxon signed rank and Mann-Whitney tests for score comparison. RESULTS Attitudes toward behavior (β = .32, P < .05) was the best predictor of intention to consume fonio, which was significantly correlated with fonio consumption (rho = .78, P < .001). Health value (β = .23, P < .05) was a significant predictor of health behavior identity, which was significantly correlated with attitudes toward behavior (rho = .67, P < 0.001) and perceived barriers (rho = .33, P < .001). The latter formed a significant interaction term between intention and behavior (β = -.72, P < .05). CONCLUSIONS AND IMPLICATIONS Fonio consumption could be increased in Bamako through stimulation of positive attitudes, changing men's beliefs, influencing family and neighbors' opinions, and improving the processing and the skills of women who prepare fonio.
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Affiliation(s)
- Nadia Fanou-Fogny
- Department of Nutrition and Food Sciences, Faculty of Agronomic Sciences, University of Abomey Calavi, Cotonou, Benin.
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Arimond M, Wiesmann D, Becquey E, Carriquiry A, Daniels MC, Deitchler M, Fanou-Fogny N, Joseph ML, Kennedy G, Martin-Prevel Y, Torheim LE. Simple food group diversity indicators predict micronutrient adequacy of women's diets in 5 diverse, resource-poor settings. J Nutr 2010. [PMID: 20881077 DOI: 10.3945/jn.110.123414.2059s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023] Open
Abstract
Women of reproductive age living in resource-poor settings are at high risk of inadequate micronutrient intakes when diets lack diversity and are dominated by staple foods. Yet comparative information on diet quality is scarce and quantitative data on nutrient intakes is expensive and difficult to gather. We assessed the potential of simple indicators of dietary diversity, such as could be generated from large household surveys, to serve as proxy indicators of micronutrient adequacy for population-level assessment. We used 5 existing data sets (from Burkina Faso, Mali, Mozambique, Bangladesh, and the Philippines) with repeat 24-h recalls to construct 8 candidate food group diversity indicators (FGI) and to calculate the mean probability of adequacy (MPA) for 11 micronutrients. FGI varied in food group disaggregation and in minimum consumption required for a food group to count. There were large gaps between intakes and requirements across a range of micronutrients in each site. All 8 FGI were correlated with MPA in all sites; regression analysis confirmed that associations remained when controlling for energy intake. Assessment of dichotomous indicators through receiver-operating characteristic analysis showed moderate predictive strength for the best choice indicators, which varied by site. Simple FGI hold promise as proxy indicators of micronutrient adequacy.
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Affiliation(s)
- Mary Arimond
- Program in International and Community Nutrition, University of California, Davis, CA 95616, USA.
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Kennedy G, Fanou-Fogny N, Seghieri C, Arimond M, Koreissi Y, Dossa R, Kok FJ, Brouwer ID. Food groups associated with a composite measure of probability of adequate intake of 11 micronutrients in the diets of women in urban Mali. J Nutr 2010; 140:2070S-8S. [PMID: 20881080 DOI: 10.3945/jn.110.123612] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The prevalence of micronutrient deficiency is high among women of reproductive age living in urban Mali. Despite this, there are little data on the dietary intake of micronutrients among women of reproductive age in Mali. This research tested the relationship between the quantity of intake of 21 possible food groups and estimated usual micronutrient (folate, vitamin B-12, calcium, riboflavin, niacin, vitamin A, iron, thiamin, vitamin B-6, vitamin C, and zinc) intakes and a composite measure of adequacy of 11 micronutrients [mean probability of adequacy (MPA)] based on the individual probability of adequacy (PA) for the 11 micronutrients. Food group and micronutrient intakes were calculated from 24-h recall data in an urban sample of Malian women. PA was lowest for folate, vitamin B-12, calcium, and riboflavin. The overall MPA for the composite measure of 11 micronutrients was 0.47 ± 0.18. Grams of intake from the nuts/seeds, milk/yogurt, vitamin A-rich dark green leafy vegetables (DGLV), and vitamin C-rich vegetables food groups were correlated (Spearman's rho = 0.20-0.36; P < 0.05) with MPA. Women in the highest consumption groups of nuts/seeds and DGLV had 5- and 6-fold greater odds of an MPA > 0.5, respectively. These findings can be used to further the development of indicators of dietary diversity and to improve micronutrient intakes of women of reproductive age.
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Affiliation(s)
- Gina Kennedy
- Division of Human Nutrition, Wageningen University, 6700 EV Wageningen, The Netherlands.
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Arimond M, Wiesmann D, Becquey E, Carriquiry A, Daniels MC, Deitchler M, Fanou-Fogny N, Joseph ML, Kennedy G, Martin-Prevel Y, Torheim LE. Simple food group diversity indicators predict micronutrient adequacy of women's diets in 5 diverse, resource-poor settings. J Nutr 2010; 140:2059S-69S. [PMID: 20881077 PMCID: PMC2955880 DOI: 10.3945/jn.110.123414] [Citation(s) in RCA: 298] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Women of reproductive age living in resource-poor settings are at high risk of inadequate micronutrient intakes when diets lack diversity and are dominated by staple foods. Yet comparative information on diet quality is scarce and quantitative data on nutrient intakes is expensive and difficult to gather. We assessed the potential of simple indicators of dietary diversity, such as could be generated from large household surveys, to serve as proxy indicators of micronutrient adequacy for population-level assessment. We used 5 existing data sets (from Burkina Faso, Mali, Mozambique, Bangladesh, and the Philippines) with repeat 24-h recalls to construct 8 candidate food group diversity indicators (FGI) and to calculate the mean probability of adequacy (MPA) for 11 micronutrients. FGI varied in food group disaggregation and in minimum consumption required for a food group to count. There were large gaps between intakes and requirements across a range of micronutrients in each site. All 8 FGI were correlated with MPA in all sites; regression analysis confirmed that associations remained when controlling for energy intake. Assessment of dichotomous indicators through receiver-operating characteristic analysis showed moderate predictive strength for the best choice indicators, which varied by site. Simple FGI hold promise as proxy indicators of micronutrient adequacy.
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Affiliation(s)
- Mary Arimond
- Program in International and Community Nutrition, University of California, Davis, CA 95616, USA.
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