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Browsing by Author "Kimiywe, Judith"

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Acceptability of Germinated Porridges with Micronutrient Powder among Children (6-23 Months) in Kenya: A Parallel Siterandomized Feeding Trial
(African Journal of Agriculture and Food Science, 2025-05) Nyambaka, Hudson; Kimiywe, Judith; Susan, Momanyi-Nyasimi
Introduction: Foods prepared from germinated ingredients have lower antinutrients and thus suitable vehicles for Micronutrient powder (MNP). Unfortunately, home consumption of these food products is declining in Kenya. Methods: Three phase acceptability study: a seven-day phase one using a crossover design, a two-week parallel site-randomized feeding trial, and a focus group discussion with caregivers. Results: Caregivers reported significant differences in color and texture between germinated flour porridge and control porridge, but these differences did not impact overall acceptance. Significantly more non-germinated flour porridges were consumed during the sensory testing. Conversely, germinated flour sorghum porridge (p=0.003), maize (p=0.127), and millet (p=0.073) were consumed over a 2-week feeding phase. Significantly more germinated flour porridges compared to non-germinated flour porridges were consumed in the latter days compared to the initial days ((p<0.001). Caregivers gave positive feedback on the germinated porridges. Conclusion: The three germinated porridges were accepted and could serve as vehicles for MNP in Homa-bay County.
Acceptability of Positive Deviance Mentorship for Diabetes Management among HIV Clients Living with Diabetes in Eastern Uganda a Cross-Sectional Study
(asiapacificpublishers, 2025-01) Okia, David; Kimiywe, Judith; Olupot- Olupot, Peter; Mwanzo, Isaac
Introduction: The high risk of PLHIV on ART to become diabetes clients and to develop metabolic disorders is well investigated. Regular monitoring and health care is an essential requirement. A majority of HIV clients living with diabetes have poor diabetes knowledge and poor treatment outcomes. Positive deviance mentorship may be a better option for improving diabetes knowledge and treatment outcomes among registered HIV clients living with diabetes. Assessing the acceptability of public health interventions is key to understanding their potential for long-term success and feasibility. Limited literature exists about the acceptability of positive deviant mentorship (PDM) for improving knowledge and treatment outcomes among HIV clients living with diabetes.The findings of this study provide additional important insights for improving future positive deviance HIV and diabetes interventions and enhancing health programs and sustainability.Aim: This study, conducted in October 2024, quantitatively evaluated the acceptability of the positive deviant mentorship for improving knowledge and treatment outcomes among diabetes clients living with HIV (mentees) exposed to PDM for three months (July to September) in Eastern Uganda. Study Design: In October 2024, a cross-sectional survey was conducted in Mbale and Soroti Regional Referral Hospitals in Eastern Uganda.Materials and Methods: The sample size was twenty-two registered participants exposed to PDM for three months. Purposive sampling was done to select eligible registered exposed participants. Electronic data collection was done using a structured questionnaire by trained research assistants. The twenty-two participants were asked to rate their agreement with various statements regarding the PDM's perceived satisfaction, effectiveness, and cultural suitability. All the research assistants were trained in data quality management. Ethical approval was obtained from Busitema University REC. Stata version 15 was used for analysis. Descriptive statistics (frequencies and percentages) were employed, to summarise the acceptability scores. Results:All the 22(100%) participants participated in the study. The majority (77.3%) were above the age of 50 years, 54.6% were married, and only 13.6% had tertiary education. More than half of the participants, 54.5%, were employed, and a relatively large proportion, 59.1%, lived within a radius of 5 km from the nearest Health facility. The Muslims were only 31.8% and 45.4% of the participants' source of funds when sick was salary or business. A majority of the participants 95.5% were satisfied (very satisfied/satisfied) with positive deviant mentorship(intervention) and 95.4% would recommend the interventions to other HIV clients with low diabetes knowledge and poor glycemic control. A large proportion of the participants 91% perceived the intervention as feasible and effective in achieving its goals. Almost all the participants 95.5% felt the intervention was culturally appropriate for them.Conclusions:The study revealed that Positive deviant mentorship is highly acceptable among the research participants in Soroti and Mbale Hospitals Eastern Uganda. The positive deviant mentorship-prescribed activities were easy to do and were culturally appropriate. This intervention is recommended for HIV clients living with diabetes who have low diabetes knowledge and poor glycemic control in similar contexts.This study's limitations include selection bias, recall bias, a cross-sectional design, and a small sample size. These were mitigated during the data collection, mentorship and analysis process.
Are Low Intakes and Deficiencies in Iron, Vitamin A, Zinc, and Iodine of Public Health Concern in Ethiopian, Kenyan, Nigerian, and South African Children and Adolescents?
(SAGE Publications, 2017) Harika, Rajwinder; Faber, Mieke; Samuel, Folake; Mulugeta, Afework; Kimiywe, Judith; Eilander, Ans
Objective: To perform a systematic review to evaluate iron, vitamin A, zinc, and iodine status and intakes in children and adolescents (0-19 years) in Ethiopia, Kenya, Nigeria, and South Africa. Method: Both national and subnational data published from the year 2005 to 2015 were searched via MEDLINE, Scopus, and national public health websites. For each micronutrient and country, status data from relevant studies and surveys were combined into an average prevalence and weighted by sample size (WAVG). Inadequate intakes were estimated from mean (SD) intakes. Results: This review included 55 surveys and studies, 17 from Ethiopia, 11 from Kenya, 12 from Nigeria, and 16 from South Africa. The WAVG prevalence of anemia ranged from 25% to 53%, iron deficiency from 12% to 29%, vitamin A deficiency (VAD) from 14% to 42%, zinc deficiency from 32% to 63%, and iodine deficiency from 15% to 86% in children aged 0 to 19 years from 4 countries. Generally, children <5 years had higher prevalence of anemia (32%-63%), VAD (15%-35%), and zinc deficiency (35%-63%) compared to children aged 5 to 19 years. Studies with intake data indicated that inadequate intakes ranged from 51% to 99% for zinc, 13% to 100% for iron, and 1% to 100% for vitamin A. Households failing to consume adequately iodized (>15 ppm) salt ranged from 2% in Kenya to 96% in Ethiopia. Conclusion: With large variation within the 4 African countries, our data indicate that anemia and vitamin A, zinc, and iodine deficiencies are problems of public health significance. Effective public health strategies such as dietary diversification and food fortification are needed to improve micronutrient intake in both younger and older children.
Assessment of nutritional and health interventions on HIV infected children under five years in Mathare North Health Centre, Nairobi
(2012-04-18) Lubeka, Crippina Buyanzi; Judith Kimiywe; Orinda, G. O.; Kimiywe, Judith
About 33.4 million people were living with HIV as of 2008 globally; 2.1 million ofthem were children under 15 years, and about 15.7 million were women. In certain parts of the world, HIV infection has significantly affected child survival. The World Health Report 2005 estimated that HIV infection contributed 3% to the global mortality among children younger than 5 years of age in 2005. According to UNAIDS and WHO 2004, there were more than 1.3 million people infected with HIV and AIDS in Kenya; and more than 100,000 children below the age of 15 years. In the recent years, growth, nutrition and metabolism of HIV infected children have received increased attention, as it has been recognized that HIV infected children generally do not grow as well as their uninfected counterparts. According to the 2005-2010 Kenyan National HIV/AIDS Strategic Plan, the government identified good nutrition as a key component of the national response to the HIV I AIDS epidemic. This study therefore sought to establish the effectiveness of nutritional and health interventions on the health and nutritional status of HIV infected children in Mathare. Respondents to the study included mothers of HIV positive children under five years seeking medical care at Mathare health centre, as well as staff offering services to the caregivers. The objectives of the study were to establish the sociodemographic and socio-economic status among care-givers of HIV infected children, identify nutrition and health interventions in place at Mathare health centre and the proportion of population accessing these interventions, determine the nutrition and health status of the HIV infected children attending clinic at Mathare health centre, assess the relationship between health and nutrition interventions, health status and nutrition status. Data was collected using a structured questionnaire administered on mothers and staff at the facility. These were then entered and analysed by Statistical Package for Social Sciences version 12.q. Descriptive statistics used to summarize the sample population included percentages, frequency distributions and charts. Chi-square was used to determine the relationship between categorical variables namely up-take of health and nutrition interventions versus nutrition status and presence of illnesses. From the study fmdings, marital status, mother's education and income level were the main factors that influenced access to interventions. The interventions at Mathare health centre include: nutritional counselling, micro-nutrient supplementation, food by prescription, immunization, ART and provision of prophylaxis. Twenty two percent of children in the study were stunted, eleven percent wasted while nineteen percent of the children were underweight. The most frequent illnesses and symptoms in the area were diarrhoea (38%), loss of appetite (29%), cold (28%) followed by cough and fever respectively. There was a significant relationship between nutritional counselling and nutrition status of children, there was also a relationship between food by prescription and nutrition status. Up-take of prophylaxis and ART showed a significant relationship with presence of illness but not with nutrition status. There was significant relationship between nutritional counselling and nutrition status. Nutritional counselling is cheap compared to provision of ART and therefore it can be extended that all children may receive as it is cheap yet it has shown to be effective.
Banana and Plantain (Musaspp.) Cultivar Preference, Local Processing Techniques and Consumption Patterns in Eastern Democratic Republic of Congo
(International Journal of Agriculture Sciences, 2012) Kimiywe, Judith; Ekesa, B.N.; Davey, M.; Dhuique-mayer, C.; BERGH, I. V. D.; Karamura, D.; Blomme, G.
This cross-sectional study carried out in North Kivu (NK) and South Kivu (SK) of the Eastern Democratic Republic of Congo aimed to identify the most preferred Musa cultivars, their processing/cooking methods and Musa consumption patterns among rural households. Our results showed that the preferred cooking banana varieties included yellow-pulped AAA-East African Highland bananas [EAHB] ‘Nshikazi’ (SK) and ‘Vulambya’ (NK), which were valued for their cooking qualities, large bunches and suitability for production of banana beer. The preferred plantains were orange-pulped and included ‘Musheba’ (SK) and ‘Musilongo’ (NK) and were preferred for their short maturation period, large bunches and higher market prices. Over 60% of the households examined had consumed EAHB within24hours, whereas <10% had consumed plantains. The most common cooking method was simple boiling of bananas/plantains and main accompaniments include beans and amaranth leaves. Over 69% of surveyed households that had consumed Musa products had con-sumed them boiled. The majority of the households (90%) obtained banana/plantains from their farms, and >55% of households from SK and NK consumed banana products between 2 and 4 times/week. This information will be used to help direct researchers on the Musacultivars that could be further sampled for carotenoid analysis and those found to be rich could be used in the fast-tracking approach to reduce Vitamin A deficiency. Keywords-Banana, plantain, preference, cooking, Democratic Republic of Congo (DRC)
Changes in Nutrient Content for β-Carotene, Iron and Zinc in Solar Dried and Stored Amaranthus cruentus Vegetables
(International Journal of Agriculture Innovations and Research, 2014) Nyambaka, H. N.; Chege, P.; Kuria, E. N.; Kimiywe, Judith
There is increasing need to store the nutrient rich amaranth leaves which are plenty during the wet season for use in dry season, but there is little information on the micronutrient stability on storage of vegetables produced in dry areas meant to bridge the seasonal gap. The stored dry leaves can be utilized during dry season by mixing them with cereal flours for making porridge for children under five who are vulnerable to micronutrient deficiency. The aim was to assess the changes in nutrient content of solar dried amaranth leaves within nine months of storage at ambient condition for the purpose of bridging the seasonal gap. Amaranth leaves were solar dried and ground into powder and stored for nine months. Regular testing of nutrients retention (β-carotene, iron and zinc) was done after every three months. The content of β - carotene was established using UV–VIS Spectrophotoscopy method while for iron and zinc analysis atomic absorption spectophotometry. Results showed that the mean losses of nutrients was 3.7±0.04, 1.4±0.03 and 0.69±0.04 for β-carotene, iron and zinc which translated to a percentage loss of 9.1%, 2.0% and 2.8%, respectively after nine months storage. The study noted no significant change (P>0.05) in the nutritional contents of β-carotene, iron and zinc. The concentration of β-carotene, iron and zinc remained relatively stable as shown by small fluctuations of nutrients. Dried amaranth leaves retain adequate nutrients when stored for nine months and thus can fill the seasonal gap
A comparative study on dietary practices, morbidity patterns and nutrition status of HIV/AIDS infected and non-infected pre-school children in Kibera slum, Kenya
(2012-09-24) Chege, P.; Kuria, E. N.; Kimiywe, Judith
Objectives: The impact of HIV and associated opportunistic infections compounded by inappropriate dietary practices among children leads to under nutrition and micronutrient deficiencies associated with high morbidity and mortality rates. This study determined the dietary practices, morbidity patterns and nutrition status of HIV/AIDS infected and non-infected pre-school children in Kibera slums. Methodology and results: A comparative descriptive design was used to conduct a study in May 2005 among 64 HIV/AIDS infected and 64 non-infected pre-school children in Kibera slum. Data was obtained a researcher administered questionnaire and focus group discussion guides. Results indicated that the average number of meals consumed per day was 3.4. The consumption of cereals, vegetables, fruits and animal products were irregular. Except for fat, intake of macronutrients and micronutrients were inadequate. The main illnesses were malaria, cold, cough and pneumonia which manifested as fever, diarrhea, vomiting and loss of appetite. A total of 44, 33 and 52% of the infected children were stunted, wasted and underweight as compared to 22, 21 and 17%, respectively, for the non-infected group. The education level of the caregiver, amount of kilocalories taken, and number of meals taken per day, household size and morbidity patterns of the children significantly affected the nutrition status. The children’s poor nutrition status was due to poor dietary practices. This was compounded by the effect of the manifestations of various infections like diarrhea, vomiting, fever and loss of appetite which deteriorated the nutrition status. There was no significant difference between the number of meals per day (p = 0.061), amount of kilocalories taken per day (p = 0.093) for the two groups. However, there was a significance difference in the number of sick (p = 0.048), wasted (p = 0.043), stunted (p = 0.035) and underweight (p = 0.028) children for the two groups. The significant difference in morbidity patterns and nutrition status was due to opportunistic infections which increases nutrient needs. The infected children were frequently ill with the manifestations of the infections lasting longer. Conclusions and application of the findings: The study recommends the use of nutrient dense products to provide more nutrients as needed, educating caregivers on nutritional management of HIV patients and initiating income generating activities to improve food security in the study areas.
Comparison between Magnesium Supplement and Ibuprofen as Treatments of Primary Dysmenorrhea and Dietary Intake of School Going Girls in Machakos, Kenya: Randomized Trial
(2014-02-24) Gogi, Julie; Kimiywe, Judith; Okello-Agina, Bonventure Michael
Primary dysmenorrhea refers to painful menstrual cramps accompanied with diarrhea, nausea and vomiting, mood swings and headache. This condition is a leading cause of recurrent class absenteeism with 80.2% of adolescent girls affected in Kenya. The adolescent might not be able to achieve the supplemental dosage (500-1000 mg) for magnesium no matter how much foods rich in magnesium she takes especially during menstruation when she is experiencing nausea and vomiting. Besides, the conventional treatment methods have a failure rate and have often been abused. This study therefore sought to find out nutritional alternatives to treatments of primary dysmenorrhea. The study adopted a randomized trial design with an aim to compare Magnesium supplements and Ibuprofen as treatments on the duration, intensity of menstrual pain, frequency of systemic symptoms, interference on daily activities and the side effects of the two treatments among adolescent girls in Machakos District. Data was cleaned, coded and entered using social statistical package for social sciences. Median, IQR, percentages, chi-square tests, Mann-whitney U, spearman’s correlation and Odds ratio (α = 0.05) were used for analysis. Findings show that at baseline, those who had pain for a shorter time (1/2 day) were 31% and 30% in magnesium and ibuprofen group respectively. After the second treatment more girls had pain for half a day (85%) in magnesium group and (78%) in ibuprofen group than for 2 days or more (7%) in magnesium group and (8%) in ibuprofen group. At baseline 32% and 40% of adolescents had severe pain in magnesium and ibuprofen group respectively, but due to the effect of the treatments, only 6% and 10% presented with severe pains after the second treatment. At baseline, more than half of the girls were able to do their daily activities in magnesium (62%) and ibuprofen group (64%). After the second treatment, almost all (97%) of the adolescents studied were able to do their daily activities in the two treatment groups. There was a positive improvement after the second treatment for the adolescents who had symptoms of primary dysmenorrhea at baseline. Magnesium had no side effects while Ibuprofen had minor side effects on the girls. The adolescent girls who reported not having taken breakfast everyday had a 2.13 increased likelihood to have severe menstrual pain compared to those who did not take breakfast (OR=2.13;95% CI:0.42-31.57;P=0.002). The respondents who took 3-4 cups of coffee and or black tea and or chocolate beverages had a 1.31 increased likelihood to have severe menstrual pain compared to those who rarely or did not take (OR=1.31; 95% CI: 0.49-3.4; P=0.002). Towards the days of their menses, adolescent girls felt the urge to take sweets, chocolate or juggery. In addition, a regression of the urge to take sweet food was very significant at P=0.003. The odds of having a person who is has severe pains to have the urge to eat sweet foods towards their menstruation was 2.56 times higher than the person who did not have severe pain (that is those who either have moderate or no pain). There is no significant difference in Magnesium and Ibuprofen as treatments of primary dysmenorrhea, Magnesium can therefore be used as a nutrition alternative in the management of period pains.
Consumption of Dryland Indigenous Fruits to Improve Livelihoods in Kenya. The Case of Mwingi Distric
(Kenyatta University, 2008) Kung'u, J.B.; Kimiywe, Judith; Simitu, Parnwell Juma; Jamnadass, R.; Kindt, R.
Dry areas of Kenya rely on alternative food products such as indigenous fruits to supplement their diets. Kenya has an estimated 400 indigenous fruit plants, most of which are not fully exploited This is because these species have not been fostered by agricultural and forestry institutions. IFTs show great potential for providing food, vitamins and income to communities e.g Sclerocarya birrea fruit contain 180 mg of vitamin C per 100 g, surpassing exotic lemon, orange and mango Experts have recommended a daily intake of ~ 200 g of fruits for a healthy diet, East Africa consumption is only ~ 40 g. Berche Increased IFT consumption therefore has strong potential to reduce existing micronutrient deficiencies among populations of dryland Kenya, especially in mothers and children Vangueria infausta tree and fruit survey conducted to establish intake levels of indigenous fruits in the drylands of Mwingi District in Kenya Study assessed patterns of consumption and perspectives and practices of use and cultivation of IFTs by smallholder farming communities
Content and Retention of Provitamin A Carotenoids Following Ripening and Local Processing of Four Popular Musa Cultivars from Eastern Democratic Republic of Congo
(Canadian Center of Science and Education, 2013) Kimiywe, Judith; Ekesa, B.N.; Den Bergh, I. V.; Blomme, G.; Dhuique-Mayer, C.; Davey, M.
Changes in the concentrations and retention levels of total and individual provitamin A carotenoids (pVACs) during ripening and local processing of the four most popular Musa cultivars of Eastern Democratic Republic of Congo were established through HPLC analysis. The predominant pVACs were all trans ?- and ?-carotene, together constituting about 90% of total pVACs content in raw and processed Musa fruit pulp. The proportion of ?- and ?-carotene was not significantly different in the tested East African Highland Bananas (AAA-EAHB) (‘Nshikazi’ and ‘Vulambya’); in the plantains (‘Musilongo’ and ‘Musheba’), proportion of ?-carotene was almost twice that of ?-carotene. An increase in total pVACs was observed during ripening, with highest levels at ripening stage 3 in all four cultivars. Total pVACs values were as high as 1081µg/100gfw in ‘Vulambya’ and 1819µg/100gfw in ‘Musilongo’. Boiling of the AAA-EAHB and AAB-Plantains resulted to retention of between 40-90% and >95% respectively. Plantains deep-fried in fully-refined palm oil and crude red palm oil for 2 minutes did not seem to lose any pVACs, the levels of total pVACs observed after frying were 100% of what was observed when the fruit was raw. Retinol Activity Equivalents (RAE), in boiled products varied between 22.3 and 173 RAEµg/100gfw, whereas deep fried products had >190 RAEµg/100g edible portion. These results show that the tested AAA-EAHBs and the plantains could meet at least 14% and 30 % of Vitamin A recommended dietary intakes respectively. The findings can therefore guide consumer consumption patterns to maximize vitamin A intake for improved health in these regions and also direct researchers in the selection of Musa cultivars to be incorporated within existing farming systems in the fight against vitamin A deficiency (VAD).
Contribution of bananas and plantains to the diet and nutrition of Musa-dependent households with preschoolers in Beni and Bukavu territories, eastern Democratic Republic of Congo.
(2013) Kimiywe, Judith; Ekesa, B.N.; Davey, M.; Dhuique-Mayer, C.; Bergh, I.; Blomme, G.
Bananas and plantains serve as important food crops in much of Africa. In the Democratic Republic of Congo (DR Congo), production of bananas is concentrated in the eastern region and ranges between 75,000 and 80,000 t/year. Bananas rank second in importance after cassava in eastern DR Congo and are good sources of carbohydrates, though recent research has confirmed that they also have substantial levels of provitamin A carotenoids. This study was undertaken to establish the contribution of bananas and plantains to the diet and nutrition of Musa-dependent households within eastern DR Congo. The study sites included Beni Territory (North Kivu) and Bukavu Territory (South Kivu). The localities, villages and specific households were established through multistage sampling. Sample size was calculated using Fisher's formula, and mothers/caregivers from 371 households with preschool children were interviewed using a structured questionnaire. Regression analysis with an r2 threshold of 0.045 was carried out to establish the relationship between dietary diversity and banana consumption. Findings showed that the food group consisting of roots, tubers and bananas was the most popular in both Beni and Bukavu territories, with more than 90% of the households having consumed a food item from this group. Although cassava root is the most popular starchy staple, bananas, especially East African Highland bananas (EAHB), had been consumed by more than 60% of the households in the 24 h preceding the survey. In addition, >50% of households indicated that they had consumed these bananas twice to four times a week and that they were mostly simply boiled. Bananas have a significant role in the diets of preschool children and potentially meet their energy needs and needs for nutrients such as potassium and vitamin A. It is therefore important that interventions or research activities geared towards alleviation of hunger and malnutrition should use bananas and plantains as a vehicle for addressing these problems, especially amongMusa-dependent populations.
Demographic characteristics and dietary supplements use by male rugby players in the 2006 season of Kenya cup league
(Kenyatta University, 2009) Mse, E.; Kimiywe, Judith; Njororai, W.W.S.
The purpose of the study was to establish demographic characteristics and dietary supplements use by Kenya Cup Rugby Players. This study investigated the age, level of education, occupation, experience and club affiliation of the players. The study adopted the descriptive survey design. Data were gathered from a sample of 140 respondents obtained through stratified random sampling. The target population included all rugby players who participated in the Kenya Cup Rugby League of the 2006 season. The teams comprised of Kenya Commercial Bank, Harlequins, Nonderscripts, Mwamba, Impala, Mean Machine and United States International University. Questionnaires were used to collect data. Data collected was expressed in terms of frequencies and percentages. The findings revealed that majority (78%) of the players were below the age of 25 years. The largest proportion of the players had attained tertiary/university level of education (65%). A greater number of the players were students (74%). Half of the players had been with their teams for a period of3- 6 years (50%), whereas, a small (12%) proportion of respondents had played for the national team for duration of less than 2 years. The percentages in age declined significantly because the game of rugby is not a professional sport. Most of the players possess high levels of education to enable them have the capacity to assimilate the importance of nutrition for good health. Players tend to play for their teams longer than at the national level since there is high competition at that level which the players may not sustain. The study recommended that youth programmes of the game of rugby should be established to tap talent from the grass root level and it should be made a professional sport. Further research should be conducted on women rugby teams and other variables apart from those in the present study.
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.
Determinants of dietary fibre intake amongst the diabetic patients at Kenyatta National Hospital, Kenya
(2011-11-21) Mbugua, Peris Wangui; Mwanzo, I.; Kimiywe, Judith
Diabetes particuiarly type 2, is reaching epidemic proportions throughout the world as more cultures adopt Western dietary habits. Diet being a major treatment for diabetes, the role played by fibre has become the subject of increased public health attention in recent years. This has come with the realization that high fibre diets are more suitable in the management of diabetes mellitus. While there is no cure for diabetes, it is controllable. If it is not treated correctly, however, it can lead to complications, such as damage to blood vessels, which in turn affect key body organs such as: the eyesight, kidneys, legs and the circulation of blood to the heart leading to stroke and heart attack. Immediate action is needed to stem the tide of diabetes and to introduce an effective treatment strategy to reverse this trend. The study sought to establish determinants of dietary fibre intake among the diabetic patients at Kenyatta national hospital. A descriptive cross sectional study was carried out amongst one hundred and forty diabetic patients seeking treatment at the hospital. Kenyatta national hospital was purposively sampled since it is a public referral hospital that serves patients from all over the country thus expected to have patients form diverse regions and diverse feeding habits. Availability sampling was used to select the sample subjects. Data was collected by use of a structured interview and review of patients records. Quantitative data was analyzed using Social Package for Social sciences (SPSS) software while, qualitative data was described and used to illustrate the main ideas. The findings of the study indicated that 78.6/0 of the patients had a high level of knowledge on what dietary fibre is and 74010 of the patients were aware that it is important for diabetics to eat dietary fibre. Knowledge on what is diabetes and the importance of dietary fibre were highly significant to patients' educational level at (x2=31. 469, df=9,p<0.05) and (x2=19.193, df=9,p<0.05) respectively. Cost also influenced intake of certain foods positively while in others it did so negatively hence, there was a significant relationship between intake of certain food and cost. Unpolished flour intake was positively affected by cost (x2=34.385, df--12, p< 0.05). Apple fruit (x2=89.510, df = 12, p<0.05) and brown rice (xz = 71.575, df =12, p<005) intake were negatively affected by cost as only those spending above Ksh.150 could alTord it on daily basis. Patients' attitude towards dietary fibre was positive as 57.9% believed that it was helpful in management of diabetes while 77.9% believed that it helped in controlling blood sugar. However, cultural influence was attributed to only 100/6 of dietary fibre intake. The study recommends that foods high in dietary fibre should be waived off taxes to make them more affordable to diabetics. There is also need to encourage these patients to consume more vegetables, cereals and fruits as they are rich in dietary fibre.
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 intake of adult women in South Africa and Nigeria with a focus on the use of spreads
(2012-10-05) Steyn, N P; Whadiah, Talip; Nel, J; Waudo, Judith N.; Kimiywe, Judith; Ayah, R; Mbithe, Dorcus
This study examined nutrient intake, dietary habits, and the weight status of adult women in South Africa, Kenya, and Nigeria, with a focus on breakfast intake and the use of spreads on bread. Dietary intake from South African women was based on secondary data analysis of dietary studies which were already undertaken previously (n=992), and those from the National Food Consumption Survey and the South African Demographic and Health Study. A sample of 1008 women was randomly selected from all adult women in Kenya, as a representative sample of four districts. Data from Nigeria came from a national survey undertaken in 2003.a In all three studies, fieldworkers were trained to do personal interviews using specific questionnaires with each participant at their homes, namely a socio-demographic questionnaire, and a 24-hour recall questionnaire. Furthermore, each participant was weighed and waist and hip circumferences were measured. Reliability of the 24-hour recalls in Kenya were checked by means of repeated interviews on a sub-sample of 10% of the participants (n=104). Overall, South African women had an energy intake of 7239 kJ, carbohydrate intake of 244.5 g, protein intake of 61.6 g and a fat intake of 46.6 g while this was 6967 kJ, 231.1 g, 42.4 g and 62.3 g, respectively, in Kenyans. Generally, South African macronutrient and mineral intakes were higher than those of Kenyans were, with the exception of fat, saturated fat and iron intake. Fat intake as a percentage of total energy intake was greater in Kenya (33.1%) compared to that in South Africa (22.9%). Dietary data for South Africa showed that calcium, iron, folate, vitamin B6, and vitamin D were the most deficient in the diet. In Kenya, the most deficient nutrients were also calcium, vitamin B6, niacin, vitamin D, and folate; additionally niacin, thiamine and riboflavin intakes were low. In both countries, distinct significant urban-rural trends were noticed with regard to macronutrient and mineral intakes. Urban women had higher animal protein, fat, saturated fat, added sugar, cholesterol, sodium, selenium, potassium, and zinc intakes, while rural women had higher carbohydrate, plant protein, fibre and magnesium intakes. With regard to the vitamins in both countries, the intakes were generally higher in urban areas. 4 In South Africa the most commonly consumed foods were sugar, tea, maize porridge, brown bread, coffee, white bread, potatoes, hard (brick)b margarine and milk. In Kenya, these were tea, sugar, milk, cooking fat, maize porridge, kale, white bread, and hard margarine. In both countries, more than a third of the women had consumed hard margarine on the previous day. Cooking fat was only used by 6% of the South African women compared with 74% of the Kenyan women. This may have contributed to the higher fat and saturated fat intakes of Kenyan women. Dietary data indicate that in both countries the nutrition transition is underway. This is illustrated by the high prevalence of overweight and obesity and the urban and rural changes in the diet. The finding that more than 30% of energy intake comes from fat in Kenyan women is rather surprising, since traditionally, African diets are not high in fat. Furthermore, the fact that more than 10% of energy comes from saturated fat is not desirable. Both countries illustrate the worst of the developed and the developing world in that their diet is deficient in many micronutrients yet high in fat and saturated fats. However, this is an ideal opportunity to consider improving the fat and nutrient content of the margarines that are produced by Unilever Health Institute, since it can address the issues of over nutrition, under nutrition and micronutrient deficiencies. The most efficient ways to do this would be: 1) to improve the micronutrient content of margarine by adding vitamin B6, niacin, folate, riboflavin and thiamine to high/higher levels of the recommended intakes; 2) to reduce the total fat and saturated fat content of margarines, and to eliminate as much trans fats as possible; 3) to reduce the sodium intake of the margarines to maintain low salt intakes in Kenyan woman and to reduce levels in South African women, and; 4) to increase the omega-3 fat content of the margarines (if feasible). From a social responsibility point of view Unilever Health Institute could ensure that its advertising includes certain essential messages regarding its spreads: 1) the fact that it includes added micronutrients; a low (or zero) trans fat content; 2) has a reduced fat and saturated fat content; 3) has the added benefit of omega-3 fats, and; 4) can be used more liberally in the diets of children under age 5 years, while adults should not increase their levels above 30% of energy intake. These messages should also be used in brochures and other health promotion materials.
Dietary, socio-economic and demographic factors influencing serum zinc levels of pregnant women at Naivasha level 4 hospital Nakuru County, Kenya
(2014-04-28) Mitheko, Agnes Ndutah; Kimiywe, Judith; Njeru, P. N.
Zinc is an essential micronutrient for human health. Its numerous structural and biochemical functions at the cellular and sub cellular level makes it very important during pregnancy. Maternal serum Zn levels at the time of conception and in pregnancy plays a major role in maternal and child health. It is an important determinant of foetal growth and development. Despite availability of data to demonstrate widespread micronutrient deficiency in pregnancy, minimal studies have examined the status of zinc among pregnant women. Hence the present study was undertaken. The objectives of the study were to determine serum zinc levels of pregnant women and to establish dietary, socio-economic and demographic factors influencing serum zinc levels of pregnant women in Naivasha. To achieve this, a cross sectional analytical study design was conducted amongst 172 pregnant women attending antenatal clinic (ANC) at Naivasha level 4 hospital. A systematic random sampling was applied to obtain the sample size. Dietary intake was assessed using 24-hr dietary recall and Food Frequency Questionnaire method. Serum zinc levels were analyzed by atomic absorption spectrophotometer (AAS). Quantitative data obtained was analyzed using SPSS computer software .Means, SEM and ANOVA were used for continuous variables. Regression analysis was applied on categorical factors influencing serum zinc levels and a p value of < 0.05 statistical significant at 95% confidence level was used. The study found a mean serum zinc level of 66 μg/dl (+ 14 SD) ranging between 39 to 123 μg/dl, with a prevalence of 66.9%. About 75.0% of the participants were in low socio-economic class. Dietary zinc intake was not significantly associated with ZD, but women consuming Vitamin C below the recommended dietary allowance had 2.62-fold risk (95% CI: 0.55 – 12.37) of becoming ZD. Parity was significantly associated with ZD (AOR=3.65; 95% CI: 1.27 – 10.49; p=0.016. The study therefore concludes that the high prevalence of zinc deficiency is of public health concern in the area, which could be due to high consumption of cereals, carbohydrates and legumes which are high in zinc inhibitors. This may be addressed through a combination of short, medium and long term strategies which includes adoption of traditional household food processing techniques such as fermentation, sprouting and germination to increase absorbable rate of dietary zinc from plant foods, economic empowerment and livelihood promotion among women.
Effect of soybean (glycine max) Supplementation on nutritional status of school children aged 6-9 years from HIV affected households in Suba District, Kenya
(Biosciences Journals, 2008) Kamau, Joyce; Ohiokpehai, Omo; Mbithe, Dorcus; Kimiywe, Judith; Oteba, Lawrence; Were, Gertrude; King’olla, Brenda
Objective: This study investigated the effect of soybean supplementation on the nutritional status of school children from HIV affected households in western Kenya. Methodology and Results: A research design was used with 54 and 56 randomly selected subjects in the experimental and control groups, respectively. The experimental group received corn-soy blend porridge for three months at school. A structured questionnaire and anthropometry were used to collect data. Malnutrition levels among the experimental group reduced from 10.2, 28.9 and 5.6% for underweight, stunting and wasting, respectively, to 6.2, 16.7 and 3.4%, respectively. The control group registered 11.4, 28.5 and 8.7% underweight, stunting and wasting, respectively at baseline. Underweight and wasting rose to 14.3 and 9.5%, respectively, while stunting dropped to 21.5%, which were insignificant changes. Conclusion and application of findings: The feeding trial using corn-soy blend improved the nutritional status of school children in Suba District. It is likely that significant improvement of the pupils’ nutritional status would be realized with extended feeding periods. Soybean has potential to curb protein energy malnutrition and its utilization should be promoted in HIV and AIDS affected areas to alleviate malnutrition.
Effectiveness of Baby Friendly Community Initiative (BFCI) on complementary feeding in Koibatek, Kenya: a randomized control study
(BioMed Central, 2018) Maingi, Mildred; Kimiywe, Judith; Iron-Segev, Sharon
Background: Appropriate infant and young child nutrition is critical for proper growth and development. In order to promote optimal nutrition at an early age, the World Health Organization (WHO) and UNICEF have developed the Baby Friendly Hospital Initiative (BFHI) to address poor breastfeeding practices in maternity wards. However, impact is limited in less developed countries like Kenya, where more than half of all births are home deliveries. Therefore, Kenya has explored the adoption of Baby Friendly Community Initiative (BFCI) in its rural settings. In contrast to the BFHI, the BFCI supports breastfeeding and optimal infant feeding in community. BFCI has been implemented in Koibatek, in rural Kenya. This study aimed at assessing the effectiveness of BFCI on complementary feeding practices of children aged 6–23 months, by comparing intervention and control groups. Methods: This was a randomized control study design that included 270 mother-infant pairs enrolled in the Baby Friendly Community Initiative (BFCI) project in Koibatek. Evaluation was carried out using structured questionnaires. Results: A statistically significantly higher proportion of children in the intervention group compared to the control group attained minimum dietary diversity (77% vs. 58%; p = 0.001), minimum meal frequency (96% vs. 89%; p = 0.046) and minimum acceptable diet (77% vs. 61%; p = 0.005). The odds of attaining minimum dietary diversity, minimum meal frequency and minimum acceptable diet were statistically significantly higher for the intervention group compared to control group (OR: 4.95; 95%CI 2.44–10.03, p = < 0.001; OR: 14.84; 95%CI 2.75–79.9, p = 0.002; OR: 4.61; 95%CI 2.17–9.78, p = < 0.001 respectively). Conclusion: The BFCI intervention was successful in improving complementary feeding practices. Strengthening and prioritizing BFCI interventions could have a significant impact on child health outcomes in rural Kenya.
Effectiveness of nutrition education in enhancing nutrition quality of complementary foods for children, 6 - 23 months in Mumias and Vihiga sub-counties
(2014-07-23) Kipkorir, Jacqueline Cherotich; Kimiywe, Judith; Kithinji, F.; Itegi, Florence M.
The first two years of a child's life are considered the critical as inadequate nutrition results in sub-optimal growth and development, and increased risk of morbidity. One third of children in Kenya are stunted, reflective of poor nutrition during this critical period. A poor complementary feeding regime is one of the causes, as a study done in Western Kenya has documented. Evidence shows nutrition education is important in the alleviation of regressive child growth and development. The purpose of this study is to determine the effectiveness of nutrition education in enhancing dietary diversity and quality of complementary foods. The target population is children, 6 - 23 months and their caregivers in Vihiga and Mumias sub-counties. These two areas have been selected because of rich agro biodiversity and high stunting rates (34.2%). They are based in different agro ecological zones, namely Humid Lower Midland Zone 1 and Humid Upper Midland Zone 1, respectively. The research design for the study will be a cluster randomized controlled study. Three periodic surveys; baseline, second and end-term will be conducted to determine important characteristics of the population such as socio-demography, anthropometric assessment and dietary assessment. Individual interviews and focus group discussions with both women and men groups will be carried out during the second survey. A sample of 15 villages will be drawn from each area. In each village, 10 mother-child pairs will be randomly selected to make a total of 150 in each sub-county. There will be two study groups: intervention and control. The nutrition education group will undergo four training and two followup sessions over a six month period. The control group will not be exposed to any training. After the baseline survey, the clusters will then be pair matched on the basis of dietary diversity, socioeconomic status and mothers' level of education. The cluster pairs will then be randomly assigned to either the intervention or control groups. Comparisons between the respective groups will be made at the end of study. Data will be analyzed using the latest version of SPSS version 22.0; descriptive statistics will be used to describe the characteristics of the population. Multivariate analysis and exploratory factor analysis will be used to test the difference between the treatment and control groups variables and a significance of will be tested at p<0.05. Dietary intake will be analyzed using NUTRI-SURVEY software and nutrition status using ENA for SMART, 2011. The study is important as it will highlight the relevance of nutrition education in improving complementary feeding practices

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