Browsing by Author "Ochola, Sophie"

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    Association between dietary behaviours and weight status of school children: results from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) -Kenya
    (Taylor & Francis, 2020) Wachira, Lucy-Joy; Muthuri, Stella; Ochola, Sophie; Onywera, Vincent; Tremblay, Mark
    Background: Sub-Saharan African countries are undergoing rapid urbanization resulting in vast changes in dietary habits. Dietary practices involving excess energy intake have been associated with overweight/obesity. We assessed the dietary behaviour of children and their relationships with weight status. Methods: Data was collected in Kenya, as part of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). The study recruited 563 children aged 9–11 years from 29 schools in Nairobi. A seven-day food frequency questionnaire was used to assess dietary intake. Dietary behaviours such as consumption of breakfast, school lunch, meals prepared/eaten away from home, emotional eating and snacking while watching television were also assessed. Body mass index (BMI-for-age and sex) was used as the indicator of weight status. Results: Of the sample, 53.5% were girls; 20.8% were classified as overweight/ obese; 72.9% ate meals out of home regularly; 55.2% ate lunch provided by the school; and only 76% had breakfast on all weekdays. Eating more when happy, eating fried foods while watching television, and consumption of vegetables were positively associated with BMI. Majority of overweight children were female (56.6%) and the type of school attended predicted BMI, F(6, 536) = 18.371, p < 0.0001, R2 = 0.171. BMI was negatively associated with consumption of cakes/pastries (χ2 = 14.7, V = 0.165, p = 0.023), potato crisps (χ2 = 21.6, V = 0.197, p = 0.003), and fast foods (χ2 = 13.5, p = 0.036). ANOVA results revealed no significant differences in the consumption of foods with BMI except for vegetables (p = 0.003). Conclusions: Children have healthy diets rich in fruits and vegetables and low in energy-dense foods. Also, less healthy diets were observed in children with lower BMI. There is need for interventions targeting the overweight/obese children, particularly those of higher SES.
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    Average acceleration and intensity gradient of 9–11-year-old rural and urban Kenyan school-going children and associations with cardiorespiratory fitness and BMI: The Kenya-LINX project
    (plos, 2025-08) Kinuthia,Stanley K.; Gareth Stratton; Wachira,Lucy J.; Okoth,Victor O.; Owino,George Evans; Ochola, Sophie; Kiplamai,Festus; Onywera,Vincent; Swindell,Nils
    Abstract Background Physical activity (PA) is crucial for children’s health, cardiorespiratory fitness (CRF) and weight status. However, research on the PA profiles of Kenyan children, especially between rural and urban areas, is limited. Method This study examined the PA profiles of 537 school-aged children (51.6% girls, 9–11-year-olds) from Nairobi City County, Kenya (urban setting), and Kitui County, Kenya (rural setting), using stratified multistage random cluster sampling. Participants wore an accelerometer (Axivity AX3) on their non-dominant wrist for 24 hours a day over seven days. Raw accelerations were extracted and averaged over a 5-s epoch (AvgAcc) to estimate PA volume. Intensity gradient (IG) was calculated as a standardised metric of PA intensity. Participants’ CRF was assessed by the 20-metre multistage fitness test. Anthropometric measurements (mass and stature) were taken to compute BMI z-scores. Results PA metrics varied by sex, weight, and CRF. Boys had higher AvgAcc (p<.001) and IG (p<.001) than girls. Healthy weight participants differed significantly in AvgAcc from overweight (p=.001) and obese (p=.001) groups and in IG from overweight (p=.039) PLOS One | https://doi.org/10.1371/journal.pone.0329173 August 4, 2025 2 / 14 and obese (p=.003). Participants with sufficient CRF and insufficient CRF differed significantly in AvgAcc (p<.001) and IG (p<.001). AvgAcc was negatively associated with BMI z-scores (β=−0.02, p<.001) and positively associated with CRF (β=0.21, p<.001), independent of IG and other covariates. IG showed a significant negative association with BMI z-scores (β=−1.27, p=0.003) and a significant positive association with CRF (β=18.93, p<.001), dependent on AvgAcc. Conclusions This study introduces AvgAcc and IG metrics among Kenyan children. Urban children accumulate less PA volume and exhibit an inferior intensity profile, which is reflected in important health indicators (BMI and CRF). These findings will inform policy as well as targeted interventions to enhance children’s health in diverse contexts.
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    Differences Between Health- and Skill-Related Physical Fitness Profiles of Kenyan Children from Urban and Rural Areas: The Kenya-LINX Project
    (Int. J. Environ. Res. Public Health, 2025-04) Kinuthia, Stanley Kagunda; Stratton, Gareth; Wachira, Lucy Joy; Okoth, Victor; Owino, George Evans; Ochola, Sophie; Amie, Bethan Richards; Kiplamai, Festus; Onywera, Vincent; Swindell, Nils
    Physical fitness is a key indicator of children’s health, yet amidst rising inactivity and obesity, data on Kenyan children are scarce. This study assessed health- and skill-related fitness differences between rural and urban Kenyan children while examining demographic influences. Cardiorespiratory fitness (CRF), BMI, strength, flexibility, speed, agility, and coordination were assessed in 1131 children aged 11.07 ± 0.9 years (52.7% girls) recruited using stratified cluster random sampling. Significant rural–urban disparities were observed. In urban areas, 16.6% were overweight and 2.8% obese, compared to 4% and 0.6% in rural areas (p < 0.001). Conversely, 44.5% of the rural cohort were underweight versus 13.7% urban cohort (p < 0.001). Multivariable regression revealed that rural children demonstrated superior CRF (β = −4.68 laps, p < 0.001) and lower back flexibility (β = −2.77 cm, p < 0.001), while urban children excelled in speed and coordination (β = 3.68 bounces, p < 0.001) and grip strength (β = 2.16 kg, p < 0.001). Boys outperformed girls in explosive leg power (β = −6.75 cm, p < 0.001) and CRF (β = −6.92 laps, p < 0.001). These findings highlight fitness inequities among Kenyan children, emphasising the need for equitable, targeted, and inclusive physical activity opportunities.
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    Effect of Nutrition and Physical Education on Adolescents’ Physical Activity Levels, Nutrition Knowledge, Attitudes and Dietary Practices
    (Fortune Journals, 2020) Wandia, Florence; Ochola, Sophie; Ogada, Irene
    Physical activity, nutrition knowledge, attitude and dietary practices are key factors associated with overweight and obesity. This study aimed to determine the effect of a school-focused nutrition and physical education intervention on the physical activity levels, knowledge, attitudes and dietary practices in relation to body weight among adolescents attending day schools in Kenya. Adolescent students, 15-18 years of age were randomly assigned to either control or intervention group. The intervention group received 8 weeks of nutrition and physical education sessions on healthy eating and physical activity. Data was collected using self-administered questionnaires. The study groups were comparable in baseline characteristics. Metabolic Equivalent for Task (MET) scores were significantly higher in the intervention group (T-test: -3.6998; p=0.002) at 6 months post intervention as compared to the control group, whose MET scores significantly decreased (T-test: 2.816; p=0.005) in the same period.At 8 weeks and 6 months post intervention, mean knowledge scores were higher in the intervention group as compared to the control group (3.798 ± 1.289 and 3.778 ± 1.246) for intervention and control groups respectively. At 6 months post-intervention, the mean knowledge scores were significantly higher in the intervention group compared to the control group (T-test: 2.269; p=0.024). At 6 months post intervention, mean attitude scores were significantly higher in the intervention group compared to the control group (T-test: -6.471; p<0.001). Those in intervention group were more likely to consume less unhealthy foods and more healthy foods at 8 weeks and at 6 months post intervention. This study improved Physical activity levels, Knowledge, Attitudes and Dietary practices of the adolescents.
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    Feeding Practices of Children Aged 0-59 Months Accompanying Incarcerated Mothers in Selected Women’s Prisons in Kenya
    (Bentham Open, 2017) Makau, Mary N.; Ochola, Sophie; Mbithe, Dorcus
    Infant and young child feeding practices have substantial consequences for the growth, development, and survival of children. Children should be exclusively breastfed for the first 6 months of life and thereafter continue to breastfeed for 2 years or longer. Children are vulnerable to malnutrition thus nutrition and health status of the confined children is of interest. The purpose of this study was to establish feeding practices of children 0-59 months incarcerated with their mothers in selected women’s prisons in Kenya. A cross-sectional analytical study was conducted on an exhaustive sample of 202 children and 193 mothers, drawn from a sample of eight out of the 35 women prisons in Kenya. Data collection tools included: a structured researcher-administered questionnaire for mothers and children. Exclusive breastfeeding rate was 69.4%; continued breastfeeding at 1 and 2 years year (88.5%; 52.2%). The mean Dietary Diversity Score (DDS) was 3.52 ± 1.04 foods groups out of 7 groups with 53.3% having attained the minimum DDS and 86.5% of breastfed children having attained the minimum frequency meal consumption. About half of the children (48.6%) attained the minimum acceptable diet. In terms of nutritional status, 21.4% of the children were stunted, 3.8% wasted and 7.5% were underweight. Dietary practices were associated with underweight; not attaining the minimum dietary diversity and minimum acceptable diet was associated with underweight (p = 0.012; p = 0.014); Illness 2 weeks prior to the study was correlated with underweight (p=0.012). Feeding practices significantly influenced nutritional status among children accompanying incarcerated mothers in prisons in Kenya.
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    Gap Analysis: Nutrition Knowledge Assessment and Practical Application Evaluations among College Nutrition Students at a Middle-Level Institution, Kenya
    (International Journal of Health Sciences and Research, 2025-09) Mwaniki, Bridget Nduta; Ochola, Sophie; Kiio, Juliana
    Introduction: Globally, there has been an upsurge of obesity and overweight among college students. In 2022, two and a half billion adults aged 18 years and above (43%) were overweight, among which, 890 million people were obese (16%). Furthermore, a prevalence of 16.5% of overweight was reported among Kenyatta University students in Nairobi, Kenya in 2024. There is scarcity of information on eating habits, physical activity level and the nutrition status of college students in Kenya, particularly those pursuing nutrition programmes. Thus, this study’s purpose was to establish the physical activity and nutrition knowledge levels, eating habits and nutrition status among nutrition and dietetics students in middle-level institutions in Kenya. Materials and Methods: This research employed a mixed methods cross-sectional analytical study design that collected both quantitative and qualitative data. Two hundred and ninetythree (293) third- and second-year nutrition students at Karen, Molo, and Nyandarua Campuses were randomly sampled. Content-validated, semi-structured, self-administered questionnaires were used to collect data on social and physical environmental factors, individual factors, and eating habits. Observation checklist and Focus Group Discussion guides were also used to collect qualitative data. Eating habits was determined using dietary diversity score and meal frequency. Weight, height, waist and hip circumference measurements were collected and the weight status established using Body Mass Index (WHO 2000 cut-off points) and Waist Hip Ratio. Global Physical Activity Questionnaire (GPAQ) (WHO 2022) was used to collect physical activity data. Qualitative data was transcribed and coded for common themes, from which conclusions were drawn. SPSS version 25.0 was used for data analysis. The relationships between study variables were established using a number of tests, including Chi- square test, Man Whitney U test, one-way ANOVA, Bivariate Spearman’s rank order correlation, and Multivariate logistic regression analysis. A p< 0.05 was used as the statistical significance level. Results: Majority of the participants were females (76%). The mean age of the participants was 22.7(±2) years. Majority of the respondents (57.7%) had moderate nutrition knowledge (41–69%). The college students’ meals majorly constituted of ugali, kales, rice beans/green grams, chapati beans/ green grams, and rice, carrot, peas, ugali and cabbage. Majority of the respondents (87%) had diverse diets, where they consumed a daily minimum recommended meal frequency of five meals. However, Sub-optimal eating habits were reported in some respondents, such as consumption of unhealthy snacks, skipping meals, and poor dietary diversity. 20.5% of the respondents were overweight and 7.5% obese. 26.3% and 46.1% of the respondents engaged in vigorous and moderate physical activity respectively. Higher nutrition knowledge was associated with the practice of recommended eating habits (AOR = 0.265, p = 0.006). Conclusion: In conclusion, this study has shown that there was no association between nutrition knowledge and nutrition status of the study participants. There were also inadequate physical activity levels among the nutrition students. Nonetheless, active physical activity promotes an acceptable nutrition status. Hence, there is a need to sensitize nutrition students to ensure that their knowledge is translated to healthy eating habits. This will help in preventing overweight and obesity, and therefore, chronic conditions. The management should also ensure that the college environment supports physical activity and healthy eating.
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    Investigating the Interplay Between Physical- and Social-Environmental Factors, Eating Habits and Nutrition Status among Nutrition Students at a Kenyan Middle-Level Institution - A Cross-Sectional Study
    (International Journal of Health Sciences and Research, 2025-09) Mwaniki, Bridget Nduta; Ochola, Sophie; Kiio, Juliana
    Introduction: Globally, there has been a recent rise in obesity and overweight among college students. In 2022, 43% of adults aged 18 years and above were reported to be overweight. Many physical- environmental and social- environmental factors contribute to nutritional vulnerability among college students, including peer and family influence, media, access and availability of food. There is inadequate research on these physical- and socialenvironmental factors among college nutrition students in Kenya. Therefore, this study aimed at establishing the environmental factors that influence the eating habits and nutrition status of students pursuing the nutrition and dietetics in middle-level institutions in Kenya. Materials and Methods: The research was guided by a mixed methods cross-sectional analytical study design, with an interest in both quantitative and qualitative data. 293 students in third- and second-year, and pursuing nutrition and dietetics at Karen, Molo, and Nyandarua Campuses of Kenya Medical Training College were sampled randomly. The study used questionnaires that were content-validated, semi-structured, and self-administered to collect data on social and physical environmental factors and eating habits. Qualitative data was collected using an observation checklist and Focus Group Discussion guides. Eating habits was determined using dietary diversity score and meal frequency. Waist and hip circumference measurements were collected and the Waist Hip Ratio was established. Qualitative data was transcribed and coded for common themes, from which conclusions were drawn. SPSS version 25.0 was used for data analysis. Descriptive statistics and Chisquare test, Man Whitney U test, one-way ANOVA, Bivariate Spearman’s rank order correlation, and Multivariate logistic regression analysis were also used in establishing the relationships between study variables. A p< 0.05 was used as the statistical significance level. Results: females (76%) constituted the larger portion of the participants, with a mean age 22.7(±2) years. The meals of the students comprised mainly of ugali, kales, rice beans/green grams, chapati beans/ green grams, and rice, carrot, peas, ugali and cabbage. majority of the respondents (87%) consumed diverse diets, with a daily minimum recommended meal frequency of five meals. Sub-optimal eating habits were reported including skipping meals. Over half (58%) of the respondents reported negative and positive peer influence in the choice of the foods consumed. A chi-square test established a positive association between eating habits and the nutrition status of the students (p=0.009). There was a significant association between the occupation of the parents and the respondents’ WHR (p=0.004). Furthermore, there was a significant relationship between the amount of pocket money the students received and nutrition status (AOR = 1.917, p = 0.044). Students who received higher amounts of pocket money were more likely to be obese (high WHR) (AOR = 1.917, p = 0.044). Conclusion: In conclusion, this study has shown that peer and family influence, media, access and availability of food were key factors that influenced the eating habit, and consequently, the nutrition status of the study participants. There is, therefore, need for interventions targeting the physical and social environments for healthier eating habits among college students in middle-level institutions.
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    Optimization of the Period of Steeping and Germination for Amaranth Grain
    (Journal of Agriculture and Food Technology, 2011) Gikonyo, N.K.; Okoth, Judith Kanensi; Ochola, Sophie; Makokha, Anselimo
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    Physical and Nutrition Education Intervention Improves Body Weight Status of Adolescents in Uasin Gishu County, Kenya: A Cluster-Randomized Controlled Trial
    (Current Research in Nutrition and Food Science, 2020) Wandia, Florence; Ochola, Sophie; Ogada Irene
    The study aimed to establish the effect of a school-focused physical and nutrition education intervention on the weight status of adolescent students’ ages 15-18 years in Kenya. This was a Cluster-Randomized Controlled Trial conducted from August 2018 to March 2019, in which 4 schools were randomly placed into two study arms (control and intervention) at a ratio of 1:1. A total of 222 adolescent students were assigned to the 2 study groups (111 per arm) based on their schools’ study group. The Intervention group received physical and nutrition education sessions for a period of 8 weeks, while the control group received no intervention from the research team. The parents and students were both involved in this study which was conducted in parallel at different schools to avoid data contamination or mix of information. Data was collected at baseline, at 8 weeks and at 6 months post intervention. Study arms were similar in all baseline characteristics (demography, socio-economic and anthropometric indices). The intervention group had a significantly lower waist circumference at 8 weeks post intervention compared to the control group (T-test: 3.229; p =0.001), but the mean BMI for age Z scores were not significantly different at the same time period (T-test:-0.357; p=0.720), between the study groups. The intervention group had lower mean waist circumference and lower mean BMI for age Z scores in contrast to the control group, at 6 months post intervention. Significant changes in the mean scores of waist circumference (Difference in Difference (DID) of 1.16; p<0.001) and mean BMI for age z scores (DID of 0.66; p<0.001) were noted when baseline and end line mean scores were compared. This study has demonstrated that school focused physical and nutrition education can be effective in reducing weight status among adolescent students. Interventions that involve creating awareness among the parents for parental support are recommended in future.
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    A Qualitative Exploration of the Determinants of Exclusive Breastfeeding (EBF) Practices in Wajir County, Kenya
    (BioMed Central, 2020) Mohamed, Mahat Jimale; Ochola, Sophie; Owino, Victor O.
    Background: The World Health Organization recommends exclusive breastfeeding for the first six months of life. A qualitative study was conducted to assess the factors that influence the practice of exclusive breastfeeding amongst mothers attending Wajir County Hospital, Kenya. Method: This study was part of a cross-sectional study to compare the exclusive breastfeeding rates amongst primiparous and multiparous mothers with infants under 6 months old attending Wajir County Hospital. Focus group discussions and key informant interviews were conducted to collect information on exclusive breastfeeding and related factors. Four focus group discussions were conducted with mothers who exclusively breastfed and the same number with mothers who did not exclusively breastfeed their babies. Key informant interviews were conducted with nine healthcare providers. The data were transcribed, and a content analysis identified common themes and inferences. Results: The exclusive breastfeeding rate among the mothers in the larger study was 45.5%. There was no disparity between the practice of exclusive breastfeeding between primiparous and multiparous mothers. Despite the high knowledge and positive attitudes towards exclusive breastfeeding of most mothers, the practice of exclusive breastfeeding was unsatisfactory. The major hindrances identified were cultural barriers propagated by mothers-inlaw and traditional birth attendants; the belief that babies cannot live without water; and a few unsupportive health workers. The uptake of exclusive breastfeeding was enhanced by Islamic teaching on breastfeeding, education from a few supportive healthcare providers; support from husbands; and positive deviance among some lactating mothers who practiced exclusive breastfeeding. Conclusions: Deeply rooted cultural factors were the major hindrance to the practice of exclusive breastfeeding. Most of the mothers did not practice exclusive breastfeeding, despite the majority being knowledgeable and having positive attitudes towards the practice. The influence of mother-in-law’s and traditional birth assistants were major barriers. Strengthening the Community Health Strategy through training traditional birth attendants on Infant Young Child Nutrition practices, designing mechanisms linking traditional birth assistants to existing health facilities for support, and capacity building and monitoring is critical in promoting exclusive breastfeeding. Behavior change and communication through multiple channels within the community should be utilized to maximize promotion of exclusive breastfeeding among all stakeholders. Keywords: Exclusive breastfeeding, Primiparous mothers, Multiparous mothers, Determinants, Factors influencing exclusive breastfeeding, Kenya
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    Strengthening Undergraduate Human Nutrition and Dietetics Training in Uganda: The Need to Adopt Competency-Based Education
    (International Knowledge Sharing Platform, 2019) Kikomeko, Peterson Kato; Ochola, Sophie; Ogada, Irene; Kaaya, Archileo N.; Nakitto, Peace
    Competency-based education (CBE) is advocated for, to improve the competence of professionals for health systems performance in the 21st century. Limited evidence of efforts in advancing CBE in the training of Human Nutrition/Human Nutrition and Dietetics (HN/HND) at the undergraduate level exists in Uganda. Failing to develop and validate competencies required of HN/HND professionals to perform in Uganda’s health systems may limit advances towards CBE of HN/HND in the country, lead to the adoption of inappropriate competencies, and cause inefficient investments in HN/HND professional education. The purpose of this review, therefore, is to create awareness for the need to: (1) identify competencies required of HN/HND professionals to competently perform in Uganda’s health systems and (2) develop and validate a competency-based undergraduate HN/HND education model suitable for use in Uganda.