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Browsing by Author "Kiplamai, Festus Kaino"

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Anthropometric characteristics, dietary patterns and the risk of Glucose Intolerance among rural populations in the Lake Victoria Basin of Kenya
(2011-11-02) Kiplamai, Festus Kaino; Mike, K. Boit; Waudo, Judith N.
Introduction: The primary cause of increase in the prevalence of glucose intolerance in Africa is the lifestyle changes commonly known as the “nutrition transition”. Objective: To determine the effects of dietary intake and anthropometric characteristics on the glucose intolerance of two rural communities of the Lake Victoria Basin in Kenya. Methods: Data from 304 subjects (8/24, M/F with glucose intolerance; 126/146, M/F control subjects) were analyzed in a case control study. Their height, weight, hip circumference (HC), Waist Circumference (WC) Middle Upper Arm Circumference (MUAC), calf circumference (CC) and % Body Fat (BF) were measured. Diet intake was assessed using 24 hour recall and the food frequency questionnaire. Glucose intolerance (IGT + Diabetes) was assessed using the fasting blood glucose level followed by the OGTT test using 75grams of glucose. Results: The BMI (p=0.003), %BF (p=0.002), and HC (p=0.004), differed significantly among glucose intolerant and the controls. Glucose intolerant (GI) subjects were found to have a significantly (p=0.017) lower percentage of protein (12%) intake in their diets than the control (14%). The intake of Poly unsaturated Fatty Acids (PUFA) also differed significantly (p=0.042) with the glucose intolerant group consuming less than the controls. There was significant differences (p=0.015) in the vegetable intake among the two groups with the controls having reported increased intake of the vegetables. Conclusions: Increasing BMI, % BF and HC independent of age and sex are risk factors for glucose intolerance. A high overall protein percent intake in the diet and an elevated PUFA intake have desirable effects in the management of blood sugar metabolism. Increased intake of vegetables was found to have protective effects against glucose intolerance. Recommendations: Individuals are strongly advised to have non-elevated BMI, %BF and HC for purposes of managing the body tolerance to glucose. Increasing the protein percentage, PUFA and vegetable intake in the diet is recommended for all age groups and in both males and females
Association between vitamin D levels and central adiposity in an eastern Africa outpatient clinical population.
(Landes Bioscience, 2013-01) Kiplamai, Festus Kaino; Theuri, G.
Background Eastern Africa is a vast area straddling the Equator at roughly between latitude 18° North and 25° South of the Equator. This region enjoys overhead or near overhead sunshine throughout the year receiving an estimated 200-275 W/M2 of UVB annually. It is a region undergoing rapid socio-economic changes and thus impacting change in work habits and environment from the outdoors to the indoors. There however exists a dearth of vitamin D3 data on people in this region despite the recognition of vitamin D3 deficiency being a global epidemic. The purpose of this study was to examine the status of vitamin D3 and central obesity in this clinical population and their relationship if any. Methods Serum 25(OH)D, Waist circumference (WC) and Waist to Hip ratio (WHR) data on 182 outpatients attending a Therapeutic Lifestyle Changes was retrospectively analyzed by gender, age category and ethnicity. Results Vitamin D deficiency and insufficiency in this clinical population in Eastern Africa, females had lower serum concentration, with the younger population having lower serum concentrations than the elderly. There was also a significant difference in serum levels when data was analyzed by ethnicity. Similarly central obesity was also highly prevalent in this population. The odds of being Vitamin D deficient was 3.3 times (p = 0.022) higher among individuals with elevated waist circumference than those with normal waist circumferences. Among the males, the odds of being Vitamin D deficient and having an elevated waist circumference was 6.8 times (p = 0.011) higher than for males with normal waist circumferences. This was however not observed among the females. Conclusion Living on or close to the equator and having overhead or near overhead sunshine throughout the year in and of itself is not a guarantee of adequate serum 25(OH)D concentrations. It may therefore be prudent for clinicians in this region to risk stratify their patients based on work location, age category and ethnicity.
Cardiorespiratory Fitness and Physical Activity in Luo, Kamba, and Maasai of Rural Kenya.
(Wiley Periodicals, 2012) Boit, Michael K.; Christensen, D.L.; Faurholt-Jepsen, D.; Mwaniki, D.L.; Kilonzo, B.; Tetens, I.; Kiplamai, Festus Kaino; Cheruiyot, S.C.; Friis, H.; Borch-Johnsen, K.; Wareham, N.J.; Brage, S.
BACKGROUND: Although habitual physical activity energy expenditure (PAEE) and cardio-respiratory fitness (CRF) are now well-established determinants of metabolic disease, there is scarcity of such data from Africa. The aim of this study was to describe objectively measured PAEE and CRF in different ethnic populations of rural Kenya. METHODS: A cross-sectional study was done among 1,099 rural Luo, Kamba, and Maasai of Kenya. Participants were 17-68 years old and 60.9% were women. Individual heart rate (HR) response to a submaximal steptest was used to assess CRF (estimated VO(2) max). Habitual PAEE was measured with combined accelerometry and HR monitoring, with individual calibration of HR using information from the step test. RESULTS: Men had higher PAEE than women (∼78 vs. ∼67 kJ day(-1) kg(-1) , respectively). CRF was similar in all three populations (∼38 and ∼43 mlO(2) ·kg(-1) min(-1) in women and men, respectively), while habitual PAEE measures were generally highest in the Maasai and Kamba. About 59% of time was spent sedentary (<1.5 METs), with Maasai women spending significantly less (55%). Both CRF and PAEE were lower in older compared to younger rural Kenyans, a difference which was most pronounced for PAEE in Maasai (-6.0 and -11.9 kJ day(-1) kg(-1) per 10-year age difference in women and men, respectively) and for CRF in Maasai men (-4.4 mlO(2) ·min(-1) kg(-1) per 10 years). Adjustment for hemoglobin did not materially change these associations. CONCLUSION: Physical activity levels among rural Kenyan adults are high, with highest levels observed in the Maasai and Kamba. The Kamba may be most resilient to age-related declines in physical activity.
The dietary patterns and prevalence of type 2 diabetes among different blood types in two rural populations of Kenya
(2012-09-21) Kiplamai, Festus Kaino; Ogata, B.R.; Waudo, Judith N.; Boit, Michael K.
Introduction: Type 2 diabetes is a metabolic disorder that is primarily characterized by insulin resistance, relative insulin deficiency and hyperglycemia. The prevalence of type 2 diabetes was studied in different blood types and the risk diet factors among the different blood types determined. Objective: To determine the prevalence of type 2 diabetes in the different blood types (A, AB, B and O). Method: A total sample size of 302 was randomly selected from two Kenyan populations. Their fasting blood glucose level and two hour post-glucose load blood glucose were determined and recorded under blood types. The participants also made a 24- hour recall of their diet intake from which the protein, milk, PUFA, carbohydrate and meat intake estimates were correlated to fasting glucose level. Results: There were more diabetic cases in blood type B among the Luo community (3.1% of N=32) followed by blood type A among the Kalenjins (2.0% of N=50) and then blood type O in both communities (Luo, 1.3% of N=77 and Kalenjin, 1.6% of N=64). There was a positive correlation between fat intake and diabetes in blood type B (r=0.588, p= 0.000) using the fasting plasma glucose level. There was a significant positive correlation in the amount of fish intake and diabetes in blood type AB (r=0.841, p=0.036). There was a significant positive correlation between meat intake and elevated fasting blood sugar level in blood type B(r=0.424, p= 0.016). Conclusion: Blood types A and O are at a higher risk of being diabetic due to the high cases of impaired glucose metabolism. People with blood type B are at a higher risk of developing diabetes type 2 if they consumed a lot of meat and fat. It is recommended therefore that they should manage their diet intake very closely to avoid foods that predispose them to elevated blood sugar levels.
Effects of Fermentation on the Total Carotenoids, Fat, Free Fatty Acids and Minerals in Soybean and Sweetpotato Flour Blends
(2012-09-21) Kiplamai, Festus Kaino; Tuitoek, P.J.; Ethangatta, L.
Soybeans and sweetpotatoes are high in micronutrients and convertible carotenoids, respectively. Utilization of micronutrients is hampered by anti-nutritional factors intrinsic to nutrient sources. Carotenoids must first be converted to retinol before utilization by the body. This study determined the effects of fermentation on bioavailability of micronutrients and utilization of high carotenoid substrates. Soybean and sweetpotato flours were mixed in the ratio of 1:1 (Composite A) and 1:3 (Composite B) on dry weight basis. Fermentation was done using Lactobacillus plantarum at 37oC for 168 hours with sampling every 24 hours. Aspergillus oryzae fermentation was done at 25oC for six weeks with weekly sampling. Total carotenoids were determined using a spectrophotometer, while retinol, lipid and free fatty acids (FFA) were determined using standard methods. Mineral analysis was done using wet acid digestion and atomic absorption spectroscopy. There was a significant (P<0.001) decrease in total carotenoids in both the L. plantarum and A. oryzae fermentation with a concurrent increase in retinol of 3 μg/g and 4 μg/g, respectively. There was an overall 30% increase in FFA in A. oryzae-fermented samples as compared to 12% in the L. plantarum-fermented samples. There were significant (P<0.001) differences in zinc and calcium contents fermented by the different organisms, but none in iron and magnesium contents. Calcium and zinc extraction was highest after 24 hours of L. plantarum fermentation. The findings suggest that fermentation could be effective in increasing mineral bioavailability, free fatty acid and retinol formation from substrates rich in carotenoids. Therefore, optimal time and microbe fermentation can be used to develop supplementary and complementary foods for people deficient in Vitamin A and minerals.
Elite Kenyan Endurance Runners are Hydrated day-to-day with Ad Libitum Fluid Intake
(Cambridge University Press, 2008-06-01) Easton, C.; Kingsmore, D.; Kiplamai, Festus Kaino; Onywera, V.O.; Westerterp, K.R.; Kayser, B.; Noakes, T.D.; Pitsiladis, Y.P.; Fudge, B.W.
FUDGE, B. W., C. EASTON, D. KINGSMORE, F. K. KIPLAMAI, V. O. ONYWERA, K. R. WESTERTERP, B. KAYSER, T. D. NOAKES, and Y. P. PITSILADIS. Elite Kenyan Endurance Runners are Hydrated Day-To-Day with Ad Libitum Fluid Intake. Med. Sci. Sports Exerc., Vol. 40, No. 6, pp. 1171–1179, 2008. Previous studies of elite Kenyan endurance runners reported that athletes did not consume liquids before or during training and infrequently consumed modest amounts of liquids after training that contributed to low daily fluid intake. Purpose: To assess hydration status of elite Kenyan endurance runners during an important training period. Methods: Hydration status was monitored in fourteen elite Kenyan endurance runners over a 5-d training period 1 wk prior to the Kenyan national trials for the 2005 IAAF Athletics World Championships by measuring body mass, urine osmolality, total body water, and daily fluid intake. Dietary sodium (Na) intake was estimated using a 5-d nutritional diary and biochemical analysis, whilst [Na] was determined in urine and sweat. Intestinal temperature was monitored continuously during training sessions. Results: Daily fluid intake was consistent with previous observations. There was a significant body mass loss during the morning, interval, and afternoon training sessions (P G 0.05). Nevertheless, mean total body water and pretraining body mass were well maintained day-to-day throughout the 5-d recording period (P = 0.194 and P = 0.302, respectively). Furthermore, there was no significant difference between the osmolality of the morning urine sample and the evening sample (P = 0.685). Mean Na intake was not significantly different to Na loss in sweat and urine (P = 0.975). No athlete showed signs or symptoms of heat strain at any time. Conclusions: These results demonstrate that elite Kenyan endurance runners remain well hydrated day-to-day with an ad libitum fluid intake; a pattern and volume of fluid intake that is consistent with previous observations of elite Kenyan endurance runners.
Post-prandial glucose levels and consumption of omega 3 fatty acids and saturated fats among two rural populations in Kenya
(2012-09-21) Wanjihia, V.W.; Kiplamai, Festus Kaino; Waudo, Judith N.; Boit, Michael K.
Background: Amount and quality of dietary fat modifies glucose tolerance. Omega 3 Fatty Acids (n-3F A) are polyunsaturated fats, mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found primarily in fish and they have a positive effect on glucose tolerance. Objective: To compare risk of type 2 diabetes mellitus (T2DM), as demonstrated thourough impaired glucose tolerance (lGT), and n-3FA intake among two rural populations. Design: A descriptive, cross-sectional comparative study. Setting: Bondo District (Luo Community) and Kericho District (Kipsigis Community) of the Lake Victoria basin of Kenya. Subjects: Sample of 150 individuals, aged above 18 years was randomly selected from each of the two communities. Interventions: Impaired glucose tolerance (lGT) was measured according to World Health Organisation diagnostic criteria. The intake of n-3FA was determined using a 24 hour dietary recall and food frequency schedule. Data was analysed using SPSS and Pearson Correlation Coefficient was used to test correlation between n-3FA consumption and IGT. The inter-group comparisons were done using the t-test and analysis of variance. Results: The prevalence of IGT was 11.8% among the Kipsigis and 4.8% among the Luo (P< 0.001). The mean EPA and DHA intake was found to be 0.29g/day and 0.34g/day respectively among the Luo and 0.01 g/day and 0.01 g/day among the Kipsigis (P<0.001). The relationship between 2 hour post-prandial glucose level and consumption of DHA was (r=-0.111, p<0.05), EPA (r=-0.123, p<0.05), polyunsaturated fatty acids (r=- 0.128. p<0.05) and saturated fats (r=-0.002, p=0.973). Conclusion: The levels of IGT were significantly lower (P<0.001) among the Luo, than among the Kipsigis. There was also evidence of significant inverse relationship between IGT and consumption of n-3FA and polyunsaturated fatty acids (PUFA) but no association between saturated fats intake and IGT. The saturated fat ingested did not affect the level of post-prandial glucose. The Luo who consumed higher n-3FA amounts, recorded lower levels of IGT than the Kipsigis who had significantly lower consumption. Recommendations: Effective screening methods should be used at the existing health units to determine risk factors of type 2 diabetes mellitus like IGT among patients. This could help in advising them accordingly on lifestyle changes, especially concerning diet and beneficial fats.
Prevalence of type II diabetes and it's risk factors among the Luo and the Kipsigis of the Lake Victoria basin
(2012-04-19) Kiplamai, Festus Kaino; Judith Waudo; Mike Boit
The prevalence of Type II Diabetes (T2D) in developing countries is increasing at a high rate. The purpose of this study was to assess the modifiable predictors of T2D and variations in predisposing factors among the people living around Lake Victoria region, and in particular to describe variations in dietary factors, physical activity, socio-economic status and prevalence of T2D among two rural communities in the lake Victoria basin. A cross-sectional survey design was used for randomized selection of the subjects from the two rural populations. The total number of subjects recruited was 304 (134 males and 170 females) to fulfill the 95% confidence level required for comparisons. Data were analyzed using ANOVA and T-test, where applicable, for comparison of means between groups and chi square to show associations between variables. There was no significant difference in the mean age of the two populations thus age was not a confounding factor. The overall prevalence of T2D in the rural areas represented by the sample was found to be 2.3% of the population (3.0% and 1.8% among males and females respectively). The overall prevalence ofIGT in the rural areas was at 8.1% (CI: 5.0-11.2) of the total population {3.1% (CI: 0.2-6.0) and 11.3% (CI: 6.3-15.7) among the males and females respectively}. There was significant differences in the BMI between the males and females (p

Browsing by Author "Kiplamai, Festus Kaino"

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