RP-Department of Foods, Nutrition & Dietetics

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Constraints and opportunities for implementing nutritionspecific, agricultural and market-based approaches to improve nutrient intake adequacy among infants and young children in two regions of rural Kenya
(2016) Hotz, Christine; Gretel, Pelto; Margaret, Armar-Klemesu; Ferguson, Elaine F.; Chege, Peter; Musinguzi, Enock
Several types of interventions can be used to improve nutrient intake adequacy in infant and young child (IYC) diets, including fortified foods, home fortification, nutrition education and behaviour change communication (BCC) in addition to agricultural and market-based strategies. However, the appropriate selection of interventions depends on the social, cultural, physical and economic context of the population. Derived from two rural Kenyan populations, this analysis combined information from: (1) a quantitative analysis to derive a set of food-based recommendations (FBRs) to fill nutrient intake gaps in IYC diets and identify ‘problem nutrients’ for which intake gaps require solutions beyond currently available foods and dietary patterns, and (2) an ethnographic qualitative analysis to identify contextual factors posing opportunities or constraints to implementing the FBRs, including perceptions of cost, convenience, accessibility and appropriateness of the recommended foods for IYC diets and other social or physical factors that determine accessibility of those foods. Opportunities identified included BCC to increase the acceptability and utilisation of green leafy vegetables (GLV) and small fish and agronomic interventions to increase the productivity of GLVand millet. Value chains for millet, beans, GLV, milk and small fish should be studied for opportunities to increase their accessibility in local markets. Processor-level interventions, such as partially cooked fortified dry porridge mixes or unfortified cereal mixes incorporating millet and beans, may increase the accessibility of foods that provide increased amounts of the problem nutrients. Multisectoral actors and community stakeholders should be engaged to assess the feasibility of implementing these locally appropriate strategies
Determinants of Complementary Feeding and Nutrition Status of Children 6-23 Months in Vihiga County, Kenya
(Bioaccent Group, 2017) Kimiywe, Judith; Chege, Peter
The age 6-23 months is a vulnerable stage of growth mainly due to poor complementary feeding practices. This study aimed to assess the adequacy of complementary foods and explore opportunities of using locally available foods to improve nutrient intake. The research was carried out in four randomly selected districts in Vihiga County, Western Kenya.A cross sectional analytical design was used on a sample of 201 children aged 6-23 months. Actual measurement of the amount of foods consumed was done. Data were analysed using the ENA for SMART, Nutri-survey and SPSS computer software. Most caregivers (78.2%) had low education level of below primary school, were farmers or casual labourer (48.8%) and 77.1% had low levels of income (< 8000 KES). The average household size was 5.71. About 74.6% of infants were breastfed. The average number of meals consumed per day was 4.2. The diet contained more of the starchy foods than the other food groups. Except for protein consumed in adequate amounts by 52%, over 50% did not meet the RDAs for other nutrients including energy. The children consumed a variety of traditional vegetables which were however served as broth. Fruits were not frequently consumed by over 40% of the children. The levels of wasting, stunting and underweight were 3.5%, 15.4% and 7.5%, respectively. The complementary feeding practices did not enable the children to meet the macronutrient and micronutrients requirements. This study recommends use of locally available foods to improve nutrient intake.
Dietary Diversity, nutrient intake and nutritional status among pregnant women in Laikipia County, Kenya
(2016) Kiboi, Willy; Kimiywe, Judith; Chege, Peter
Background/Aim: Pregnancy is a critical period during which adequate nutrition is considered an important factor that affects birth outcome and the health of the mother. Maternal diets during pregnancy have thus been deemed critical since the diet must meet the nutrient requirement for both the child and the mother for satisfactory birth outcome. Research has clearly shown that a diverse diet is strongly associated with nutrient adequacy and better maternal nutritional status. The purpose of this study was to assess dietary diversity, nutrient intake and nutritional status among pregnant women in Laikipia County, Kenya. Methods: This was a cross-sectional analytical study. The study comprised of 254 pregnant women attending antenatal clinic at Nanyuki Teaching and Referral Hospital. Results: The study revealed that the mean Dietary Diversity Score (DDS) was 6.84 ± 1.46 SD The mean intake of energy, carbohydrate, protein, fat, zinc, iron, folate and vitamin C was inadequate while those of Vitamin A and calcium were adequate. In respect to nutritional status, 19.3% were undernourished based on Mid-Upper Arm Circumference (MUAC) while 16.9% were anemic based on haemoglobin levels. The result further showed that dietary diversity was positively correlated with nutrient intake and nutritional status. Conclusion: Dietary diversity is crucial in ensuring adequate nutrient intake and nutritional status among pregnant women
Dietary practices and nutrition status of adult pulmonary tuberculosis patients attending Nyeri County Referral Hospital, Kenya
(Scholars Middle East Publishers, 2017-11) Mwendia, Agnes Wangari; Chege, Peter; Njogu, Eunice
The purpose of this study was to assess the dietary practices and nutrition status of adult pulmonary TB patients attending Nyeri County Referral Hospital, Kenya. The study adopted a cross-sectional analytical design. A sample of 135 participants was calculated using the modified Fisher Formula. The study targeted adult pulmonary TB patients attending TB Clinic. A structured questionnaire and a focus group discussion guide were used to collect data. Data was analyzed using Statistical Package for Social Sciences. About 48.1% of the participants were underweight while 45.9% were normal and 3.7% were overweight. Chi-square tests showed significant relationships between gender (χ2 = 10.917, p=0.012), age (χ2 = 12.261, p=0.046) and income (χ2 15.584, = p=0.036) were significant to nutrition status among the socio-demographic characteristics. Pearson correlation analysis showed a weak relationship (r=0.173, p=0.045) between number of meals per day and nutrition status of TB patients. The study concluded that adult pulmonary TB patients attending Nyeri county referral hospital had poor dietary practices, which led to poor nutrition status. The study recommended that food assistance programs should be strengthened by the government in conjunction with non-governmental organizations to help in mitigating increased vulnerability to food insecurity among TB-affected households. Keywords: Dietary Practices, Extra Pulmonary T.B, Nutrition Status, TB Patient and Pulmonary T.B
Level of micronutrient supplements uptake among people living with HIV/AIDS in Kayole, Nairobi County, Kenya
(Academic Journals, 2017-04) Chege, Peter; Muthamia, Olive Gaceri
Micronutrients reduce morbidity and slow the rate of disease progression and thus, micronutrient supplementation in HIV is recommended. This study established the level of uptake of micronutrient supplements among people living with HIV in Kayole, Nairobi County. A cross-sectional analytical design was adopted on a comprehensive sample of 153 adults living with HIV, enrolled at Comprehensive Care Centre in Kayole Health Centre. Data is described by use of percentages while relationships are assessed using chi-square. Qualitative data from focus group discussions and key informants was transcribed and analyzed to complement the quantitative findings. Results showed that only 13.7% of the respondents were on micronutrients at the time of the study. The micronutrient supplements commonly supplemented were vitamin and mineral mix (50.3%), zinc (34%), vitamin B6 (24.2%), vitamin A (24.2%), folate (12.4%), and iron (15%). The main reason for supplementation was; those on Antiretroviral Therapy (66.7%), due to the presence of opportunistic infections (40.5%), those who had no appetite (28.1%), underweight cases (21.6%) and those on tuberculosis treatment (17.0%). The main reason for low uptake was due to stock outs at treatment centre (24.8%), the high cost of supplements (13.7%) and side effects after intake (5.9%). Adults living with HIV are aware of the importance of micronutrients and had taken micronutrient supplements at one point during the treatment period. However, uptake at the time of the study was low. This was due to lack of guidelines for supplementation, high cost of supplements, stock-outs in health facilities and side effects. This study recommends proper education and sensitization on supplementation. Standard guidelines and policies for micronutrient supplementation should be developed. A pull system should be adapted in the supply of supplements
Longitudinal Changes of Human Milk Nutrient Content in the First 6 Months of Lactation
(Science and Education Publishing, 2020) Kiboi, Willy; Kimiywe, Judith, C; Chege, Peter
Human milk is considered to be the optimal source of nutrition during the first six months of a child’s life. Since the milk is the only source of nutrition for the first six months of an infant’s life, understanding its composition remains a matter of public health concern. Further, few studies have determined the breast milk composition of lactating mothers in African countries. The aim of this research was to assess longitudinal changes of human milk nutrient content in the first 6 months of lactation. A longitudinal descriptive study with repeated measures was adopted by the study. Breast milk nutrient composition was assessed among lactating mothers at the 1st and the 5th month of lactation. The milk energy, lactose, protein, lipids, vitamin A, calcium, magnesium, zinc and iron was assessed at the two time points of lactation (first and fifth month). A total of 104 mature breast human milk samples were collected and analysed for energy and the selected nutrients at the two stages of lactation. Significant differences in the mean nutrient content of proteins (p value = 0.029), vitamin A (p value = 0.004) and iron (p value = 0.015) was observed between the first and the fifth month of lactation. A downward trend in the mean nutrient content for protein was observed while an upward trend was observed for both vitamin A (retinol) and iron between the 1st and 5th month of lactation. Human milk nutrient content varies longitudinally in the first six months of lactation. Studies investigating the causes of the variations are critical in improving the quality of human breast milk and ultimately the growth and development of a child.
Nutritional Status and School Performance among Upper Primary Children in Selected Public Schools in Nairobi County, Kenya
(International Journal of Health Sciences and Research - See more at: http://www.ijhsr.org/#sthash.0mhugdCC.dpuf, 2016) Githinji, Phrashiah; Chege, Peter; Githinji, Scolastica
Background/Aim: School-age is a critical period during which adequate nutrition is considered an important factor that affects learning capabilities. There is an emergence of the dual burden of malnutrition among children in urban setups like Nairobi and yet there is limited information on the effect of these on school performance. Research has shown that nutritional status affects children’s development. The purpose of this study was to investigate the relationship between nutritional status on school performance among children in upper primary in selected public schools in Nairobi County, Kenya. Methods: This was a cross-sectional analytical study. The study comprised of randomly selected 256 children from public schools within Nairobi County. Results: The study confirmed that there is concurrent dual burden of malnutrition among adolescent school children in Nairobi County; (8.6% were overweight while 9% were undernourished). Children with higher Z-scores/ BMI were found to be more likely to be inactive during field games and they preferred sitting in the field during physical activities (P ≤ 0.05). Children within normal weight for their age showed higher chances of performing well in classroom activities such as completion of assignments (P ≤ 0.05). However, the study showed no correlation between nutritional status and attendance. Conclusion: Children’s nutritional status influences their school performance in extra-curriculum activities namely; filed games and school clubs as well as completion of homework assignments.

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