Browsing by Author "Munga, Judith"

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    Chromium supplementation in management of type 2 diabetes among patients attending Thika level 5 hospital, Kenya: a randomized placebo controlled study
    (Kenyatta University, 2015) Munga, Judith
    Diabetes Mellitus is a condition with common elements of hyperglycaemia and glucose intolerance. It is the fourth leading cause of death in high-income countries and evidently epidemic in newly industrialized countries as well as economically developing nations such as Kenya. Type 2 Diabetes is characterized by insulin resistance and relative insulin deficiency. Studies have reported low serum chromium levels in Type 2 diabetics compared to non-diabetic population. Chromium has been reported to potentiate insulin action in muscle cells. Studies show contradictory findings on beneficial effects of chromium on; blood sugar (FBS and HbAlc), blood lipids (LDL, HDL, triglycerides and total cholesterol), adiposity measures (BMI, WC and W/H ratio), fat mass and lean body mass. Consequently similar studies have been recommended to investigate further the benefits of chromium with a view of coming up with conclusive evidence. The purpose of this study therefore was to investigate the contribution of chromium supplementation in the management of fasting blood sugar, HbAlc, LDL, HDL, triglycerides, BMI, W/H ratio and WC in Type 2 Diabetes mellitus patients in Thika level 5 Hospital, Kenya. This was a double blind randomized controlled trial with a sample size of 180 participants on hypoglycaemic drugs. The sample was randomized into two study groups at a ratio of 1:1 (control group and intervention group). Participants in the intervention group received chromium picolinate (500mcg/day) while the control group received placebo for a period of 4 months. Data was collected at baseline, monthly and end of month 4, using semi-structured questionnaires. Information collected included: demographic characteristics, medical history, physical activity and dietary patterns. Additionally, anthropometric measurements (weight, height and waist and hip circumferences) were taken. Blood samples were analysed for chromium levels, HbAlc, serum ferritin and serum lipids (LDL, HDL, total cholesterol and triglycerides). Descriptive statistics such as mean and standard deviation were used to analyze demographic, socioeconomic, blood sugar, blood lipids and anthropometry and nutrient adequacy from 24 hour recall; mode was used to describe the 7 day food frequencies. Principle component analysis was used to determine the wealth index/socioeconomic categories. T-test was used to determine differences in continuous data between the study groups and Chi-square test used to determine associations in categorized variables between the study groups. Wilcoxon test was used to determine differences in food frequencies between the study groups while GPAQ was used to analyze physical activity levels. Multiple regression was used to determine predictors of elevated HbAlc. On the whole, at baseline, the participants had high fasting blood sugar with low serum chromium levels. Chromium supplementation significantly reduced HbAlc (DID: intervention 1.44% versus control -0.79%; p=0.001) and LDL elevation (DID: intervention -0.09 mmol/l versus control -0.91 mmol/l; t-test; p=0.010). Chromium supplementation had no effect on BMI, WC and W/H ratio; no effect on chromium status (t-test; p=0.241), triglycerides (t-test; p=0.648) and HDL (t-test; p=0.648). The predictors for elevated (above 9%) HbAlc were age and fasting blood sugar; the higher the fasting blood sugar and the older the patients, the higher the likelihood of elevated HbAlc. Since chromium supplementation was effective in reducing HbAlc and LDL among Type 2 diabetics in this study; it is recommended that chromium is used in management of blood sugar in Type 2 Diabetes.
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    Determinants of fortified food consumption among children aged 6-23 months in Isiolo County, Kenya
    (International Journal of Community Medicine and Public Health, 2025-05-21) Mkungo, Emily C.; Chege, Peter; Munga, Judith
    Background: Micronutrient deficiencies pose a significant public health challenge among young children in Kenya, particularly in arid regions like Isiolo County. Fortified foods are a cost-effective intervention, yet their consumption remains low. This study examines the role of socio-economic status, availability, and caregiver knowledge in fortified food consumption. Methods: A cross-sectional survey was conducted in Oldonyiro and Ngaremara wards, Isiolo County, from June to August 2022, with 272 caregiver-child pairs. Data were collected using semi-structured questionnaires, focus group discussions, and key informant interviews. Logistic regression analyzed associations between socio-economic status, availability, caregiver knowledge, and fortified food consumption at p<0.05. Results: Non-fortified maize flour (100%) and vegetable oil (96.3%) were consumed daily, while fortified versions were consumed twice weekly by 36% and 47% of children, respectively. Higher socio-economic status (OR=1.729, p=0.0034), better caregiver knowledge (OR=1.227, p=0.0089), and greater availability (OR=1.311, p=0.015) significantly increased fortified food consumption. Only 20.2% of caregivers were knowledgeable about fortification, and fortified foods were less available in rural areas. Conclusions: Socio-economic status, caregiver knowledge, and availability are critical drivers of fortified food consumption. Public health interventions should prioritize awareness campaigns, improve market access, and address economic barriers to enhance uptake
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    An investigation on glycemic index of local foods and use in management of diabetes mellitus : a study in Kisii and Homa- Bay district hospitals
    (2011-11-28) Munga, Judith; Waudo, Judith N.; Nyambaka, H. N.
    Diabetes mellitus is a clinically and genetically heterogeneous disorder characterized by elevated blood glucose levels. Non-Insulin dependent diabetes mellitus (NIDDM) occurs because insulin produced by beta cells of pancreas is either insufficient or not used properly by target tissues. Nutrition services have become quite vital in management of NIDDM. However, the choice of type and amount of food is always not an easy task. Glycemic index (GI) is widely used to select various foodstuffs for use by NIDDM diabetics, though; little has been done regarding Kenyan foods. This study investigated the suitability of locally available foodstuffs in the management of NIDDM by determining their GI. The study was carried out in Homa-Bay and Kisii District Hospitals in Nyanza Province-Kenya, on 116 NIDDM diabetics. A descriptive cross sectional study was used to collect data-on GI, demographic information, medical history, physical activity and meal planning. An interview schedule was used to collect verbal information while blood glucose levels were determined before and 2 hours after consuming a selected local foodstuff. The results were averaged and compared to test food (white bread) to determine their GI. Data collected were coded in Microsoft word and Microsoft excel computer software. Frequencies were done on the SPSS statistical computer software to determine percentages and GI of 10 selected foodstuffs using the formula (x/3.1 x100). The results of the study revealed that NIDDM diabetics have not exhaustively used locally available foods in the management of the disorder due to low education and income levels respectively. The GI of the tested foods point to the potentiality of their usefulness in management of NIDDM. Mixed meals yielded high GI compared to individual foods consumed singly. Application of GI policy in meal planning and management of NIDDM makes locally available foodstuffs appropriate in management of NIDDM. The patients were found not to have exhaustively utilized nutrition as a means of management of NIDDM but majorly relied on drugs. The study recommends use of locally available foods by NIDDM diabetics for both cost effectiveness and conveniences and GI of various foods to be considered in meal planning to enhance continued enjoyment of favorite foodstuffs before the onset of NIDDM. The study generally concludes that locally available foodstuffs are appropriate in the management of NIDDM.