RP-Department of Foods, Nutrition & Dietetics

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Acidification, crushing and thermal treatments can influence the profile and stability of folate poly-γ-glutamates in broccoli (Brassica oleracea L. var. italica)
(Elsevier, 2009-12-01) Munyaka, A. W.; Oey, I.; Verlinde, P.; Loey, A. V.; Hendrickx, M.
The influence of different treatments, i.e., crushing, high temperature short time (90 °C/4 min) (HTST) and low temperature long time (60 °C/40 min) (LTLT) blanching, acidification (pH 4.3), and sequences of these treatments on the folate poly-γ-glutamate profile and stability were investigated. In this study, broccoli was used as a case study. Regarding the folate poly-γ-glutamate profile, endogenous folate poly-γ-glutamates in broccoli florets were found predominantly as hepta- and hexa-γ-glutamates. Crushing raw broccoli, acidification and LTLT blanching enhanced folate deconjugation resulting in monoglutamate, di- and tri-γ-glutamates. Compared to other treatments, HTST blanching preformed prior to crushing resulted in the highest concentration of long chain poly-γ-glutamates. Regarding folate poly-γ-glutamates stability, acidification combined with LTLT blanching decreased folate stability whereas HTST blanching combined with different sequences of blanching and crushing did not affect folate poly-γ-glutamates stability. It was concluded that crushing (prior to heating), acidification and blanching could be strategically applied to increase the folate monoglutamate content of broccoli.
Anemia in the Context of Pregnancy and HIV/AIDS: A Case of Pumwani Maternity Hospital in Nairobi Kenya
(African Scholarly Science Communication Trust, 2009) Waweru, J.; Mugenda, O.; Kuria, E.
Anemia is a major public health problem in Africa affecting over 80% of women in many countries. It is more common during pregnancy due to the increased demand for iron at different stages of pregnancy. In Kenya, one out of every two mothers is affected by some form of anemia. Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among expectant women further increase risk of anemia prevalence and severity. This study was to determine the socio-economic characteristics, dietary pattern of pregnant women and investigate the relationship between iron deficiency anemia (IDA) and HIV/AIDS in pregnancy. A case-control study was conducted in Pumwani Maternity Hospital in Nairobi Kenya. The HIV status was ascertained through HIV-antibody tests using Determine, Uni- Gold and Tie-Breaker reagents. Cases of 57 seropositive and controls of 57 seronegative pregnant women were randomly and co-currently selected. Their hemoglobin (Hb), demographic, socio-economic characteristics were determined. A 24-hour dietary recall and food frequency were used to determine the food consumption pattern. Results showed that both cases and controls were from low socio-economic status and consumed monotonous diets of plant origin particularly Ugali, a paste made from maize flour and kales vegetables locally known as Sukumawiki. Fruits were rarely consumed. The meals were mainly consumed three times in a day with snacks consumed by an insignificant number of women. With exception of pre-eclampsia, other pregnant-related problems including headache, dizziness, loss of appetite, heartburn and vomiting were more predominant among the cases than in the controls. Iron deficiency anemia was more prevalent and severe among the cases (prevalence=68%, mean Hb=9.551g/dl) than the controls (prevalence=26.3 %, mean Hb=11.974g/dl). The relative risk of being anemic was about two times higher for HIV-infected as of the uninfected pregnant women, (Relative risk=2.33). It is concluded that pregnant women from low socio-economic status consume diets with iron of low biological value, have low Hb and are generally anemic. Moreover, HIV-infected pregnant women have lower Hb and are two times more likely to be anemic than the uninfected. The HIV/AIDS infection is therefore associated with low Hb and higher anemia prevalence and severity among pregnant women. There is, therefore, a need for pre-natal nutrition care system that emphasizes improved consumption of essential nutrients including iron of high biological value and implementation of interventions tailored to check anemia prevalence and severity among pregnant women within the context of HIV/AIDS pandemic and low socioeconomic settings.
Anthropometric characteristics and nutritional status of older adults in the Lake Victoria Basin of East Africa: region, sex, and age differences
(MedPharm Publications, 2012) Cheserek, M.J.; Tuitoek, P.J.; Waudo, Judith N.; Msuya, J.M.; Kikafunda, J.K.
Background: Malnutrition, either as undernutrition or overnutrition, leads to detrimental alterations in body composition. The objective of this study was to investigate selected anthropometric measurements, and the nutritional status of older men and women living in the Lake Victoria Basin. This was a cross-sectional study. Setting: The setting was selected rural and urban areas of Kisumu, Jinja, and Mwanza, in Kenya, Uganda and Tanzania, respectively. Subjects: The subjects were older adults (227 men and 310 women) aged ≥ 60 years. Outcome measures: The outcome measures were weight, height, arm span, mid-upper-arm circumference (MUAC) and triceps skin-fold thickness (TSF). Body mass index (BMI) and arm muscle area (AMA) were computed using standard equations. Results: The results show that older adults in the three regions were significantly different (p-value < 0.05) in all anthropometric measurements, except MUAC. The women had significantly higher (p-value < 0.05) BMI, TSF, and MUAC, than the men. Negative slopes indicated a decline in all anthropometric measurements with age. Overall underweight (BMI < 0.05) than older women (24.2%), with overweight (12.5%) and obesity (6.8%) being significantly higher (p-value < 0.05) in older women. Conclusion: The findings suggest energy depletion and loss of muscle mass, with significant differences in the three regions, and in the sex and age groups. A small proportion was overweight and obese. The decline in anthropometric measurements with age indicates poor nutritional status with aging. Thus, nutrition and health interventions should be specific to regions
Application of Stable Isotope Dilution Techniques to Assess Body Fat and Comparison with WHO BMI-For-Age Classification as a Measure of Obesity among Schoolchildren in Nairobi, Kenya
(Cambridge University Press, 2021) Kigaru, Dorcus Mbithe D; Ndung’u, Zipporah W; Macharia-Mutie, Catherine W
Objective: WHO BMI-for-age z score (BAZ) is widely used in epidemiology, yet it does not distinguish body fat-free mass and fat mass which are better indicators of obesity and related risks. The stable isotope dilution techniques (SIDT) are gold standard methods of assessing body composition. Main objective was to assess significant differences in measurement and validity of WHO BMI-for-age classification for defining childhood obesity by comparing with body fatness using SIDT among schoolchildren. Design: A cross-sectional analytical study. A questionnaire, anthropometry and body composition data were used. SPSS was used to analyse data at P < 0·05 at 95 % CI. Setting: Primary schools in Nairobi City County, Kenya Participants: One hundred seventy-nine schoolchildren aged 8–11 years were randomly sampled. Results: Prevalence of adiposity by reference SIDT (24·0 %) was significantly higher than that of obesity by BAZ > 2 SD (2·8 %) (Wilcoxon test, P < 0·05). Concordance coefficient between SIDT and BAZ > 2 SD in diagnosing obesity was poor (κ = 0·167). Only 11·6 % of children with excess body fat were correctly diagnosed as obese by BAZ > 2 SD. The use of BAZ > 1 SD for overweight and obesity showed fair concordance coefficient (κ = 0·409, P < 0·001) with 32·5% of children with excess fat positively identified as overweight and obese. Conclusion: WHO BMI-for-age cut-off points severely underestimate the prevalence of overweight and obesity compared with body composition assessment by stable isotope dilution techniques. Evidence-informed interventions should be based on more accurate estimates of overweight and obesity than that can be provided by BAZ.
Application of thermal inactivation of enzymes during vitamin C analysis to study the influence of acidification, crushing and blanching on vitamin C stability in Broccoli (Brassica oleracea L var. italica)
(Elsevier, 2010-05-15) Munyaka, A. W.; Oey, I.; Loey, A. V.; Hendrickx, M.
The effectiveness of heat inactivation of oxidative enzymes e.g., ascorbic acid oxidase (AAO) to stabilise vitamin C during extraction and analysis was evaluated. The influence of different sequences of performing treatments including acidification (pH 4.3 vs. pH 6.5), crushing, high temperature short time (90 °C/4 min–HTST) and low temperature long time (60 °C/40 min–LTLT)) blanching on vitamin C stability in broccoli florets and stalks was also investigated. Heat inactivation of enzymes prior to matrix disruption resulted in higher vitamin C values mainly in L-ascorbic acid (L-AA) form, while lack of enzyme inactivation resulted in high vitamin C losses resulting from conversion of L-AA to dehydroascorbic acid. Various treatments and their sequence of application influenced vitamin C stability as follows: (i) crushing prior to blanching reduced vitamin C stability and (ii) in the absence of heating, acidification increased vitamin C stability (iii) blanching prior to crushing resulted in higher vitamin C retention, with HTST blanching retaining more vitamin C than LTLT blanching.
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.
Assessing the causal relationship among communication, money management practices, satisfaction with financial status, and satisfaction with quality of life
(Kluwer Academic Publishers-Human Sciences Press, 2011-10-28) Mugenda, Olive M.; Tahira K. Hira; Alyce M. Fanslow
The purpose of the study reported here is to assess the causal relationship among communication, money management practices, satisfaction with financial status, and quality of life. The data used were collected in 1986 through personal interviews. The sample size is 123 interviewees, and the unit of analysis is the household's money manager. Results show that the money managers who are more knowledgeable about financial matters, and those who are highly indebted, communicate more about money matters and report more money management activities. Satisfaction with financial status is caused mainly by economic factors (net worth and savings). The demographic factors that influence satisfaction with quality of life are marital status and household size. Satisfaction with quality of life is also predicted by income and satisfaction with financial status.
Assessment of Nutritional Status among Undergraduate Students at a Nairobi Tertiary Institution Using BMI and Waist Circumference Metrics
(AJND, 2024-06) Ndung’u, Joseph Mburu; Waudo, Judith; Kobia, Joseph
This study investigated the impact of dietary and lifestyle changes on the nutritional status of undergraduate students during their transition to university life and the associated risk for non-communicable diseases. A review of global studies indicated varying prevalence rates of overweight and obesity among university students, influenced by diet, physical activity, and sleep patterns. This research specifically assessed the nutritional status of Kenyatta University students in Nairobi, Kenya, with an emphasis on the limited studies utilizing both BMI and waist circumference for assessment. Employing a cross-sectional, analytical design, the study was conducted at Kenyatta University Main Campus in Nairobi County. This public research university, founded in 1970, was selected for its urban setting and its representation of young adults. The target population comprised undergraduate students pursuing bachelor’s degrees, with inclusion criteria of voluntary participation and at least six months on campus. Multi-stage stratified sampling was used to select 260 participants. Data were collected through a structured questionnaire, pretested on 10% of the sample, with reliability assessed via a test-retest method. Anthropometric measurements were taken by trained research assistants. Data analysis was performed using SPSS version 24, evaluating nutritional status with BMI and waist circumference. Ethical considerations and COVID-19 protocols were rigorously observed. Findings revealed that, based on BMI, 67.5% of respondents had normal weight, while 8.4%, 16.5%, and 7.6% were underweight, overweight, and obese, respectively. The overall prevalence of overweight and obesity (BMI ≥ 25) was 24.1%. Female respondents showed a higher prevalence of obesity (63.2%) and overweight (73.2%) compared to males. In the underweight category, more males were underweight (57.1%) than females. Waist circumference assessment indicated that 21.7% had abdominal obesity, with a higher prevalence among females (87%) compared to males (13%), highlighting a gender-based risk factor for abdominal obesity. The study’s BMI analysis revealed a substantial proportion of respondents within the normal weight range, with significant gender disparities in obesity and overweight prevalence. The waist circumference assessment underscored a notable occurrence of abdominal obesity, particularly among females, indicating gender-specific susceptibility to this health concern.
Assessment of Physical Activity Level and its Effects on Blood Pressure Control among Hypertensive Patients Attending Kiambu Level Five Hospital, Kenya
(International Journal of Health Sciences and Research, 2019) Mbijiwe, Jane; Chege, Peter; Munyaka, Ann
Hypertension is a global public health concern since it contributes to onset of heart related diseases. Control of blood pressure among hypertensive patients is important to reduce cardiovascular disease events. Lifestyle modifications that involve engagement in exercise and physical activity are some of the measures that have been found to be appropriate in maintenance of optimal blood pressure levels among hypertensive patients. There exists paucity of information on physical activity level of hypertensive patients. The objective of this study was therefore to determine the physical activity level of hypertensive patients in Kenya. The study engaged 134 hypertensive adult patients attending Kiambu Level Five Hospital. A structured questionnaire was used to collect data on demographic characteristics and physical activity level. Data analysis was done using statistical package for the social science. The relationship between blood pressure level and physical activity was determined by use of Pearson correlation test. A p-value of <0.05 was used as criterion for statistical significance. The current study found that hypertensive patients had low levels of physical activity (63.0%). Physical activity was found to be negatively correlated to blood pressure meaning that; as physical activity increased blood pressure level decreased (r=-0.211, p=0.012). Subsequently, health professionals should encourage hypertensive patients to engage in physical activity with special attention being drawn on the influence of physical activity to blood pressure level. This could be done by organizing health talks informing the patients of the benefits physical activity would have on their health.
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.
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.
The Availability of Processed Fruit Products and Their Contents of Vitamins A and C in Nairobi, Kenya
(African Scholarly Science Communications Trust, 2009-01) Olielo, T. K. O.; Rombo, G. O.
In Kenya, among children of less than five years, 84% have vitamin A deficiency, 73.4% have iron deficiency, and 51% have zinc deficiency. Among women, 39% have vitamin A deficiency, while among pregnant women, 60% have iron deficiency. Among adult males, 16% have iron deficiency. Improving vitamin A status of children in developing countries reduces child death rates by 20-50%. The WHO recommends per capita consumption of 200 g of fruit on average daily to supply vitamins. Consumption of fruit is low because of lack of awareness on benefits of fruit, poverty and post-harvest losses due to lack of skills for processing and storage. The objectives of this research were to survey household consumption of foods especially processed fruit products in Nairobi, and analyze nutritional quality of processed fruit products. Three estates representing different income groups were selected for the study. Household monthly low, middle, and high incomes were, respectively KES ≤14000, KES 14001 to 56000 and KES >56000; (KES 69 = US$1). A random sample of 130 households per estate was interviewed using 24 hour recall for seven days to assess consumption of processed fruit products. Laboratory analyses were carried out on contents of vitamin A and C. Results showed that all income groups did not consume recommended amounts of fruit products. Those who consumed processed fruit products consisted of 4.5% low income, 33% middle income and 62.5% high income households. Per capita annual consumption by the low income averaged 2.9 L fruit soft drinks, by the middle income was 5.9 L fruit soft drinks and 0.51 kg fruit preserve, and by high income group were 12 L fruit soft drinks and 0.95 kg fruit preserve. Per capita average consumption per annum was 7 L fruit soft drinks and 0.5 kg fruit preserve. Laboratory analysis of processed fruit products showed that they had good content of vitamin C and some vitamin A. However, vitamins are not included in national standards for these products. Quality failure involved one fruit-flavoured drink because it was labelled with fruit pictorial. It is recommended that public education be carried out on use of fruit products for nutrition, poverty reduction and health. Processors should apply quality standards, nutritional labelling and controlled pricing to improve consumption of fruit products. Results of this study shall be useful to processors, consumers, nutritionists, government agencies and UN organizations for promoting production, processing, and consumption of fruit products by Kenyans.
Awareness of Food Hygiene Practices and Practices among Street Food Vendors in Nasarawa State, Nigeria
(International Journal of Health Sciences and Research, 2019) Yusuf, Tabitha; Chege, Peter
Background: Street vended foods are booming businesses in developed and developing countries as most people opt for street foods. This is mainly due to cost and convenience. Food handling practices have been associated with food safety. Where food safety is compromised, food borne illnesses are likely to occur. Objective: This study sought to investigate the level of awareness on hygiene and the respective food handling practices among street food vendors in Nasarawa State, Nigeria. Materials and methods: This study used a cross-sectional descriptive survey with a target population of 410 food vendors in Nasarawa State, Nigeria. Data was collected using questionnaires. Correlation between food vendors‟ level of awareness and hygiene practices was done using chi-square. Results: Results show that majority of vendors (42.1%) were in the middle age group between 26 to 35 years. The female vendors were more than their male counterparts. Majority of vendors were married (53.4%) and were secondary graduates (56.7%). Majority (42.4%) had been in business for1- 5 years. About 70% of the vendors engaged in business to earn income. Only 29.7% persons admitted to having had training on food handling and hygiene. Half of the vendors (50.9%) had license for operation. Conclusion: The study concludes that few vendors are aware of hygienic practices mainly due to lack of training. For they that were aware, few practiced. The level of awareness on hygienic practices correlates with the practices adopted by the vendors. This study recommended that vendors be trained on environmental, food and personal hygiene.
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)
Banana Tissue Culture and Nutrient Enhancement for Food Security and Income Generation among People Living With AIDS in the Lake Victoria Basin
(Ethnobotany and Health, 2013) Wamue-Ngare, G.N.; Mwangi, M.; Ng'ang'a, Z.; Wamono, E.; Muyonga, J.; Manyama, A.
This was a survey in Rachuonyo (Kenya), Bukoba (Tanzania) and Rakai (Uganda) Districts to assess the contribution of bananas to the households for food security and nutrition of PLWHA as well as the potential nutritional benefit of providing nutrient enhanced banana to PLWHA. Data were collected through interviews with 373 PLWHA and key informants (local agricultural support staff and personnel from PLWHA support agencies) and using focus group discussions. A banana-based nutrient enhanced food supplement made by blending banana flour (61%) with soybean flour (39%) and multi-nutrient fortificant premix (0.2% of mixture) was distributed to 15 respondents and their nutrient intake estimated. Majority (71.5%) of survey respondents were females aged 20-50 years; most had no higher than primary level education and were small scale farmers (with gardens <1 acre). Most of the respondents produced and consumed bananas as the study population was generally food insecure. Banana contributed substantially to household food intake for PLWHA in the 3 Districts. Based on the energy and nutrient intake data, PLWHA required supplementary food. The product obtained from banana nutrient enhancement contained 459.7 kcal, 15% protein and substantial levels of vital vitamins and minerals. The product was well accepted and increased energy and nutrient intake by the recipients. At the recorded intake level (average of 66 g per person per day), intake of energy and a few nutrients was still below recommended daily allowances (RDA) as about 204 g of the nutrient enhanced banana flour was required to achieve RDA.
Bioaccessibility of Iron and Zinc in Selected Complementary Foods Fortified with Micronutrient Powders in Kenya
(IFRJ, 2021) Kiio, J.; Nduati, R.; Kuria, E.; Ochola, S.; Okoth, J.
Fortification with Micronutrient Powders (MNPs) is recommended as a strategy for increasing the micronutrient content in complementary foods. However, plant-based diets commonly consumed in developing countries are rich in phytates and tannins, which decrease the micronutrient bioavailability. The present work analysed the relationship between the antinutrient content, and also iron and zinc bioaccessibility, in home-made MNP-fortified complementary feeding porridges refined with white rice, maize, white sorghum, finger millet, pearl millet, Irish potato, and banana samples, which were obtained from the local market and milled into flour. Porridges were prepared using the flour, cooled to 50°C, fortified with MNPs, and subjected to in vitro digestion. Total and bioaccessible zinc and iron were quantified using atomic absorption spectrometry. Tannins and phytates were analysed using Folin-Denis and high-performance liquid chromatography methods, respectively. Porridges were classified as having poor bioavailability if their phytate-zinc and phytate-iron molar ratios were > 15 and > 0.4, respectively. Only pearl millet and soybeans showed tannin levels higher than the recommended values. The lowest phytate level was observed in refined white rice (0.11 ± 0.04 g/100 g), and the highest was in pearl millet (2.83 ± 0.10 g/100 g). Zinc bioaccessibility ranged from 7.31% (finger millet) to 26.05% (corn-soy blend). Only pearl millet porridge was classified as having poor zinc bioavailability. Iron bioaccessibility ranged from 20.73% (refined white rice) to 0.62% (pearl millet). Refined white rice and Irish potato were the only foods with the phytate-iron ratio within the recommended range. Iron bioaccessibility decreased significantly with an increase in both tannin (r = -0.31, p = 0.045) and phytate (r = -0.39, p = 0.01) contents. Zinc bioaccessibility showed a significant positive relationship with tannin levels (r = 0.41, p = 0.008), but an insignificant inverse relationship with phytate levels (r = -0.072, p = 0.700). Iron bioaccessibility was adversely affected by phytate and tannin levels. To improve iron and zinc bioavailability in complementary foods, strategies for lowering the phytate and tannin contents at the household level are recommended.
Bioaccessibility of provitamin A carotenoids in bananas (Musa spp.) and derived dishes in African countries
(2012-09-24) Ekesa, B.N.; Poulaert, M.; Davey, M.; Kimiywe, J.; Inge, V.; Blomme, G.; Dhuique-Mayer, C.
Bananas and plantains (Musa spp.) constitute an important component of the diet in Africa. Substantial levels of provitamin A carotenoids (pVACs) in Musa fruit have been reported, but the bioaccessibility of these pVACs remains unknown. In this study, we used an in vitro digestion model to assess the bioaccessibility (i.e. the transfer into micelles) of pVACs from boiled bananas and derived dishes using the Eastern Democratic Republic of Congo as a study context. In particular, the effect of different food ingredients added to boiled bananas on pVAC’s bioaccessibility was studied. The bioaccessibility of all-trans β-carotene ranged from 10% to 32%, depending on the food recipes, and was modified, particularly when pVACs-rich ingredients (palm oil/amaranth) were added. Efficiency of micellarization of all-trans β-carotene was similar to that of all-trans α-carotene and depended on the cultivar (Musilongo, plantain type, 16%; Vulambya, East African cooking type, 28%), while that of the 13-cis isomer was higher (21–33.5%). Taking into account bioaccessibility, the estimated vitamin A activity was significantly different across the different Musa-based dishes tested. Results are discussed in terms of recommendations to help reduce vitamin A deficiency in Musa-dependent African communities.
Bioequivalence of Micronutrient Powders to Corn-Soy Blend on Serum Zinc Concentration of Children (6–36 Months) With Moderate Acute Malnutrition in Thika Urban Slums, Kenya: A Cluster-Randomized Controlled Trial
(Public Library of Science San Francisco, CA USA, 2022) Kiio, Juliana; Ochola, Sophie; Nduati, Ruth; Kuria, Elizabeth; Mathenge, Scholastica; Okoth, Judith
Zinc deficiency is common among children with Moderate Acute Malnutrition (MAM) and contributes to growth failure, increased morbidity and mortality. Diarrhoea and poor dietary practices are the main causes of zinc deficiency. Corn-soy Blend (CSB), the standard product in management of children with MAM has a limitation of poor micronutrient bioavailability. Micronutrient powders (MNPs) which are added at the point of consumption have a potential in improving micronutrient status however, scientific evidence on efficacy on improving the zinc status is scarce. A cluster-randomized clinical trial was designed to establish bioequivalence of MNPs to CSB on serum zinc status among children (6–36 months) with MAM in Thika informal settlements, Kenya. Sample size was calculated to show bioequivalence within ±20% limit. Twelve villages were randomized to four study groups. Three experimental groups received different formulations of MNPs added to unfortified CSB porridge as; multiple micronutrients containing zinc (CSB-MNP-A n = 84), multiple micronutrients without zinc (CSB-MNP-B n = 88) and zinc only (CSB-MNP-C n = 94). Control group (n = 80) received standard CSB fortified with multiple micronutrients. Standard amount of CSB was consumed in feeding centres for six months. Serum zinc concentration was assessed pre- and post-intervention. Data was analyzed based on treatment assignment regardless of adherence and drop-out status. Mixed effects linear regression was used to model pre-post change in serum zinc concentration, adjusting for clustering effect and baseline differences. Bioequivalence was assessed using two one-sided t-tests. At baseline, 84.4% were zinc deficient (serum zinc <65μg/dL) and zinc intake was sub-optimal (<3 mg/day) for 95.7% of children. Mean change in serum zinc concentration was significantly higher (p = 0.024) in CSB-MNP-A (18.7 ± 2.1) μg/dL compared to control group (11.8 ± 2.6 μg/dL). MNPs are not bioequivalent to CSB within the ±20% bioequivalence limit
Body Composition and Anthropometric Indices Association with Blood Pressure Levels among Hypertensive Patients at a County Hospital in Kenya
(Science and Education Publishing, 2019) Mbae, Dennis; Munga, Judith; Ogada, Irene
Hypertension is one of the leading cardiovascular diseases globally. The documentation on body composition, anthropometric indices and blood pressure level is limited, among Sub-Sahara Africa countries, despite the growing burden of non-communicable diseases. This study determined associations between body composition and anthropometric indices with blood pressure among hypertensive patients attending a referral hospital in Tharaka Nithi County, Kenya. A hospital based cross-sectional study was conducted among 234 adult hypertensive patients attending the hypertension clinic. A researcher administered questionnaire was used to collect data for six months. The body composition, waist circumference, weight and height were measured. A p value of less than 0.05 was considered significant. Most (88.0%) of the participants had increased risk of cardiovascular disease based on waist hip ratio of men: ≥0.90cm; women: ≥0.85cm. Nearly half (42.7%) of the participants had uncontrolled blood pressure (≥140/90 mm Hg). Further, 62.4% of the participants were overweight (BMI: 25.0-29.9), while 25.2% were obese. Blood pressure levels were significantly associated with BMI (X2=26.6; p<0.001), body fat(X2=10.8; p=0.028), waist hip ratio(X2=8.2; p=0.004) and skeletal muscle (X2=16.5; p<0.001). Skeletal muscle, BMI, waist circumference and visceral fat were significantly associated with higher odds of uncontrolled blood pressure. Body composition and anthropometric indices were associated with blood pressure levels among hypertensive patients.
Body Mass Index Vs Deuterium Dilution Method for Establishing Childhood Obesity Prevalence, Ghana, Kenya, Mauritius, Morocco, Namibia, Senegal, Tunisia and United Republic of Tanzania
(World Health Organization, 2018) Diouf, Adama; Adom, Theodosia; Aouidet, Abdel; Hamdouchi, Asmaa El; Joonas, Noorjehan I; Loechl, Cornelia U; Leyna, Germana H; Mbithe, Dorcus; Moleah, Thabisile; Monyeki, Andries; Nashandi, Hilde Liisa; Somda, Serge MA; Reilly, John J
Objective To compare the World Health Organization (WHO) body mass index (BMI)-for-age definition of obesity against measured body fatness in African children. Methods In a prospective multicentre study over 2013 to 2017, we recruited 1516 participants aged 8 to 11 years old from urban areas of eight countries (Ghana, Kenya, Mauritius, Morocco, Namibia, Senegal, Tunisia and United Republic of Tanzania). We measured height and weight and calculated BMI-for-age using WHO standards. We measured body fatness using the deuterium dilution method and defined excessive body fat percentage as > 25% in boys and > 30% in girls. We calculated the sensitivity and specificity of BMI z-score > +2.00 standard deviations (SD) and used receiver operating characteristic analysis and the Youden index to determine the optimal BMI z-score cut-off for classifying excessive fatness. Findings The prevalence of excessive fatness was over three times higher than BMI-for-age-defined obesity: 29.1% (95% CI: 26.8 to 31.4; 441 children) versus 8.8% (95% CI: 7.5 to 10.4; 134 children). The sensitivity of BMI z-score > +2.00 SD was low (29.7%, 95% CI: 25.5 to 34.2) and specificity was high (99.7%, 95% CI: 99.2 to 99.9). The receiver operating characteristic analysis found that a BMI z-score +0.58 SD would optimize sensitivity, and at this cut-off the area under the curve was 0.86, sensitivity 71.9% (95% CI: 67.4 to 76.0) and specificity 91.1% (95% CI: 89.2 to 92.7). Conclusion While BMI remains a practical tool for obesity surveillance, it underestimates excessive fatness and this should be considered when planning future African responses to the childhood obesity pandemic.

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